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153 Cards in this Set
- Front
- Back
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What is the most familiar pervasive development disorder?
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Autism
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What is a synonym for pervasive development disorders?
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Autistic spectrum disorders
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What is the prevalence of mental retardation?
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1% of the general population
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What is one of the most common causes of retardation?
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Down Syndrome
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What 3 criteria for mental retardation do the DSM & AAMR agree on?
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- Significant limitations in intellectual functioning (IQ below 70)
- Significant limitations in adaptive functioning (those who function well in life are not considered retarded) - Onset before age 18 |
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What is the standard deviation of an IQ score?
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15 points
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What is the Flynn effect?
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IQ scores in the normal range are increasing across generations
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What can an IQ score predict?
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Potential for school achievement
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What is lower IQ associated with?
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Poverty
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What adaptive behaviors are part of mental retardation definitions?
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- Conceptual skills: self-sufficiency, communication, functional academics, self-direction, health, and safety
- Social skills: understanding how to conduct oneself in social situations - Practical skills: tasks of daily living like self-care, home living, community use, health and safety, work |
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What are the DSM IV classifications of mental retardation?
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Mild: 50-55 to 70, 85% of MR
Moderate: 35-40 to 50-55 Severe: 20-25 to 35-40 Profound: <20-25 |
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Why are mental retardation issues on Axis II?
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In order to call attention to Axis I disorders, and to reflect the lifelong nature of subaverage IQ
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Why might making an accurate diagnosis of mental retardation be a life & death situation?
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The death penalty is unconstitutional for somebody with mental retardation
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Why is the prevalence of mental retardation lower than the prevalence of IQs below 70?
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- IQs cannot be adequately be assessed among very young children, and are omitted from prevalence figures
- Many adults are not considered to have mental retardation because they have adaptive skills |
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What prevalence differences occur in mental retardation?
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- Mental retardation with a known, organic cause has an equal prevalence among all social classes
- Retardation of nonspecific etiology is more common among families living in poverty |
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What are biological causes of Down Syndrome?
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An extra chromosome attached to the 21st pair of chromosomes
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What characteristics of Down Syndrome appear in an affected person's 30s?
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They develop brain pathology similar to Alzheimer's, one third of which also develop dementia. Many die.
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What infectious diseases during fetal development may be related to mental retardation?
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Cytomegalovirus: usually harmless
Toxoplasmosis: ingestion of raw meat or contact with infected cat feces Rubella: can be prevented by vaccinating the mother HIV: only 1/3 develop AIDS, but those who do die quickly Syphilis: treating the mother will cure the fetus Genital herpes: babies can be delivered by C-section if an outbreak is present |
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What chromosomal disorders causing mental retardation exist?
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- Fragile X syndrome: 15% display symptoms of autism
- Klinefelter syndrome: extra X chromosome in boys - XYY syndrome is associated with minor social deviance - Turner syndrome: XO chromosome configuration in girls |
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What genetic disorders causing mental retardation exist?
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- Phenylketonuria (PKU): inability to metabolize phenylalanine
- Tay-Sachs disease: common among Eastern European jews, results in death - Hurler Syndrome (Gargoylism): don't often live past age 10 - Lesch-Nyhan Syndrome: self-mutilation behaviors common |
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What infectious diseases occurring after birth may cause mental retardation?
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Encephalitis: causes permanent damage in 20% of cases
Meningitis: Can cause permanent pressure and damage to the brain |
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What toxins may be related to mental retardation?
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Alcohol, drugs, mercury, lead
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What is reaction range?
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Heredity determines the upper and lower limits of IQ, and experience determines how people fulfill their genetic potential
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What are some psychological factors of mental retardation?
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Severe abuse or wretched environments
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What are some social factors of mental retardation?
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Lack of stimulation and responsiveness required to promote intellectual and social skills
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What is cultural-familial retardation?
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Poverty and psychosocial disadvantage often found among the rural poor
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What modes of prevention exist for mental retardation?
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- Primary prevention: good maternal and child health care, such as vaccinations, pregnancy planning, amniocentesis
- Secondary prevention: Social and educational interventions like Head Start - Tertiary prevention: detection of conditions like PKU, special instruction for self-care skills, and treatment of unusual behaviors - Normalization, including mainstreaming children and adults |
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What are some characteristics of autism?
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profound indifference to social relationships, odd, stereotypical behaviors, impaired communication skills
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What symptoms are typical of pervasive development disorders?
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Early onset (age 3), impaired communication, impaired social interaction, stereotyped behavior/interests/activities, sensory deficits; some exhibit savant performance
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What is dysprosody?
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Disturbances in speech production rate, rhythm, and intonation
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What is the theory of mind?
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Other have a point of reference different from our own, which autistic children fail to appreciate
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What is Asperger's disorder?
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A PDD identical to autism except it involves no significant delay in language
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What is childhood disintegrative disorder?
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Characterized by severe problems in social interaction, communication, and stereotyped behavior. Previously acquired skills are lost.
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What is Rett's disorder?
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5 months of normal development followed by deceleration in head growth, loss of purposeful hand movements, loss of social engagement, poor coordination, delay in language
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What are the diagnostic criteria for autistic disorder?
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j
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What is the frequency of autism?
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60 in 10,000 children
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Why have the number of children affected by autism have exploded in recent years?
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- New environmental agent
- Broadened diagnostic criteria (eg Asperger's) - More children are being diagnosed because of increased awareness and more thorough assessments |
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What might the true prevalence of autism be?
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30 to 60 cases per 10,000 children
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What gender differences in autism exist?
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3-4 times as many boys as girls are affected by autism
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What genetic link has been found in autism?
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Autism is much more common among siblings of a child affected by autism
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What psychological explanations have been proposed to explain autism?
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Maternal hostility, inappropriate parental reinforcement, or parents who are cold and distant; no evidence exists to support these theories
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What biological factors in autism have been proposed?
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- nearly have of autistic children develop seizure disorders by adolescence
- Increases in autism are found in children who have certain know genetic and infectious diseases - Autism is high in prevelence among first-degree relatives, particularly twins - Neurologic abnormalities have been found in children with autism |
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What disorders are comorbid with autism?
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Fragile X syndrome, tuberous sclerosis, PKU, rubella, and encephalitis
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What concordance rates exist for autism?
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MZ twins: 60%
DZ twins: 0% |
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What neurochemicals may be involved in autism?
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- Elevated endorphin levels, making any outside stimulation less rewarding
- Deficits in neuropeptides like vasopressin and oxytocin, which help bonding occur |
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What brain regions may be involved in autism?
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- Subcortical brain structures
- Parts of the limbic system - Parts of the cerebellum - Front lobe |
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What brain development problems may be involved in autism?
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- Brain develops rapidly until age 2 or 3, when it slows so brain volume is smaller than average
- 40% autistics have mutation in brain development gene |
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What is the course and outcome of pervasive developmental disorders?
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Autism is a lifelong disorder, but children who have developed language skills by 5 or 6 have a more positive prognosis, as do children with higher IQs.
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Which developmental periods are important to the course of autism?
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- Early preschool years due to language acquisition
- Early adolescence due to improvement in social and cognitive skills, as well as the possibility of developing a seizure disorder |
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What medications have been used to treat autism?
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- Antipsychotics, antidepressants, amphetamines, psychedelics, megavitamins, Secretin, gluten-free diet.
- None are highly effective, but may reduce certain symptoms of autism |
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What is Applied Behavior Analysis?
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Intensive behavior modification (40 hours/week) using operant conditioning techniques, as they do not view praise as rewarding
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What is the success rate for Applied Behavior Analysis?
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Half of children were able to complete first grade in a normal school; most effective available treatment
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What are externalizing disorders?
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Create problems for a child's external world.
Children fail to control their behavior according to expectations of caretakers. |
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What are internalizing disorders?
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Psychological problems that primarily affect the child's inner world, such as excessive anxiety or sadness
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What symptoms exist for externalizing disorders?
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Rule violations, negativity, anger, aggression, impulsivity, hyperactivity, attention deficits
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What 3 categories of externalizing disorders does the DSM recognize?
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ADHD, oppositional defiant disorder, and conduct disorder
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What is ADHD?
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Characterized by hyperactivity, attention deficit, and impulsivity
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What are the subtypes of ADHD?
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- Inattention
- Hyperactivity and impulsivity |
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What is oppositional defiant disorder (ODD)?
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Pattern of negative, hostile, and defiant behavior
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How do scientists compare ADHD with ODD?
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In the past, some have felt that they reflect the same disorder. Current consensus is that they are separate, but frequently comorbid.
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What disorders are comorbid with externalizing disorders?
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- ADHD is highly comorbid with ODD, and 25% of children with each problem also have a learning disability.
- ADHD is also comorbid with internalizing disorders |
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What is conduct disorder?
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Similar to ODD, except the rule violations are more serious (illegal and antisocial like assault or robbery), and is more common among adolescents.
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What are index offenses and status offenses?
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Index offenses: crimes against people or property that are illegal at any age
Status offenses: acts that are only illegal because of a youth's status as a minor (truancy, running away from home) |
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What is juvenile delinquency?
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A legal classification decided by a judge
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What is the frequency of externalizing disorders?
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A majority of the 12% of children with mental disorders
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What are six family adversity risk factors for externalizing disorders?
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- Low income
- Overcrowding in the home - Maternal depression - Paternal antisocial behavior - Conflict between parents - Removal of child from the home |
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How are social disadvantage and externalizing disorders related?
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Psychological disorders are found in more than 20% of children living in inner city neighborhoods
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What biological factors are related to externalizing disorders?
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- Temperament
- Neuropsychological abnormalities - Genetics - Gene-environment interactions |
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What social factors are related to externalizing disorders?
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- Parenting styles (authoritative vs authoritarian)
- Conflict & inconsistent discipline - Peers, neighborhoods, television, society |
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What is coercion?
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Occurs when parents positively reinforce children's misbehavior by giving into the child's demands. The child then negatively reinforces the parents by ending the bad behavior as the parents capitulate.
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What psychological factors are related to externalizing disorders?
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- Inability to delay gratification
- Misinterpretation of neutral social cues as negative - Failure to exert self control |
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What medications are used to treat ADHD?
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Psychostimulants, such as Ritalin and Adderall
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What has been found in research on dose-response effects?
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Low dosage of psychostimulants produced gains in learning, but higher dosages interfere with learning although behavior improvements occur.
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What side effects of psychomotor stimulants exist?
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- Minor effects include decreased appetite, increased heart rate, sleeping difficulties.
- More serious side effects include an increase in motor tics for a small percentage of children, slowing of physical growth |
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What is Behavioral Family Therapy (BFT)?
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Teaches parents to be clear and specific in their expectations, to monitor children's actions closely, and to systematically reward positive behavior while ignoring or mildly punishing bad behavior.
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What is Problem Solving Skills Training (PSST)?
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Children are taught to slow down, evaluate a problem, and consider alternative solutions before acting.
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What disorders are BFT and PSST effective and ineffective for?
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Effective for ODD, ineffective for ADHD
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What strategy is central to adolescent Behavioral Family Therapy (BFT) when treating conduct disorders?
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Negotiation; actively involving young people in setting rules.
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What is Multisystemic Therapy (MST), and how can it be used to treat conduct disorders?
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Combines family treatment with coordinated interventions in other important contexts of the child's life such as peer groups, schools, and neighborhoods.
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What is the recidivism rate for MST vs individual therapy?
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Recidivism is significantly lower in MST than individual therapy, but recidivism rates are still high.
- MST: 50% - Individual therapy: 81% |
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What is the course & outcome for externalizing disorders into adulthood?
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- Hyperactivity generally declines in adolescence
- Attention deficits and impulsivity are more likely to continue - Half of children with ODD or CD continue to have problems with antisocial behavior into adulthood |
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What symptoms exist in internalizing disorders?
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Sadness, fears, and somatic complaints, as well other indicators of mood and anxiety disorders, such as feeling nervous or tense
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What depressive symptoms are present at different ages?
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Age 2: Unresponsiveness to caregivers
Age 4: Sad expressions and social withdrawal School-age: Somatic complaints Older school age: Admission of sad feelings or irritability Adolescents: Full blown depression, including suicide risk |
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How is depression similar among, and different between, children and adolescents?
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Similar: Comorbid with externalizing disorders and anxiety
Different: Depression in children is less prevalent, equal among boys and girls, more related to family dysfunction, and less persistent |
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What is separation anxiety disorder?
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Persistent and excessive worry for the safety of an attachment figure, fears of getting lost or kidnapped, nightmares with separation themes, and refusal to be alone, persisting for at least 4 weeks
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What are peer sociometrics?
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Peer sociometrics evaluate children's relationships by obtaining information on who is liked "most" and "least" in a large population.
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What are developmental deviations?
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Significant departures from age-appropriate norms in some area of functioning.
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What are examples of developmental deviations?
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Deviations in reading, writing, or arithmetic are disorders in their own right (dyslexia, dysgraphia, and dyscalulia).
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How are learning disorders defined?
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Difference of one or two standard deviations between aptitude and achievement in a specific area of learning
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What biological factors are involved in internal disorders?
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Temperamental classification known as "inhibited to the unfamiliar"
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What social factors are involved in internalizing disorders?
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Attachment problems due to neglect (reactive attachment disorder) or insecure attachments
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How are anxious attachments classified?
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- Anxious avoidant: infant is unwary of strange situations and shows little preference for attachment figure
- Anxious resistant attachments: wary of exploration, not soothed by attachment figure, and angry or ambivalent about contact - Disorganized attachments: infant responds inconsistently because of conflicting feelings toward an inconsistent caregiver who offers either reassurance or fear. |
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What problems may correlate with anxious attachment as infants?
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May predict externalizing behavior at age 3
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What research proves children's resilience?
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Research fails to find a relationship between childhood loss and depression during adult life
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What psychological factors may be related to internal disorders?
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Emotion regulation, whereby children learn to identify, evaluate, and control their feelings based on the actions and advice of their parents and others.
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What treatments for internal disorders exist?
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Depression: Perhaps only Prozac in the SSRIs; cognitive-behavior therapy, and interpersonal therapy
Anxiety: CBT and family therapy; Luvox School Refusal: Imipramine and CBT OCD: SSRIs |
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What are 3 life cycle transitions?
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- Transition to adult life (major issues: identity, career, relationships)
- Family transitions (major issues: having children, divorce) - Transition to later life (major issues: retirement, death of loved ones) |
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What are adjustment disorders?
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Clinically significant symptoms in response to stress, but not severe enough to warrant classification as a mental disorder
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What are Erik Erikson's 4 stages of adult development?
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- Identity vs Role confusion
- Intimacy vs self-absorption - Generativity vs stagnation - Integrity vs despair |
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What conflicts characterize each of Erikson's stages?
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- Identity vs Role confusion: Who am I?; identoty crisis
- Intimacy vs self-absorption: centers on conflict between closeness and independence - Generativity vs stagnation: Accomplishments and achievements vs not having a sense of purpose - Integrity vs despair: Looking back with a sense of accomplishment or anger and despair |
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What are Daniel Levinson's 3 major transitions in adult life?
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- Early adult transition: moving away from family & assuming adult roles
- Midlife transition: becoming less driven & more compassionate - Late adult transition: Changing roles & relationships of later life |
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What are social clocks?
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Age-related goals that we set for ourselves
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How did Erikson define moratorium?
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A time of uncertainty about self and goals among goals
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What were Karen Horney's competing social needs of adults?
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- Moving toward people: fulfills needs for love & acceptance
- Moving away from others: establishes independence & efficacy - Moving against others: meets needs for power & dominance |
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What are 4 categories of identity conflict?
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- Identity diffusion: young people who have questioned their childhood identities, but are not searching for adult roles
- Identity foreclosure: young adults who never question themselves or their goals and continue on their predetermined path from childhood - Identity moratorium: in the middle of an identity crisis, searching for adult roles - Identity achievement: questioned their identities, who have successfully decided on their long-term goals |
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What are family characteristics of identity diffusers and identity foreclosures?
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Diffusers: rejecting and distant families
Foreclosers: overprotective families |
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What treatments may be helpful in adult transitions?
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Supportive, nondirective therapy in order to allow the young person to seek autonomy
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What gender differences exist in how people form their identities?
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Women: more likely to form identities based on family relationships, not career
Men: more likely to form identity before entering lasting relationships |
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What is the family life cycle?
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Developmental course of family relationships throughout life
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What problems may be related to ongoing family conflict?
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Ongoing family conflict is linked to depression, especially among women.
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What are interpersonal diagnoses?
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Classifications of troubled close relationships, not just troubled individuals
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What psychological factors are involved in difficult family transitions?
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Communication problems, and family roles
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What are Gottman's 4 communication problems?
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- Criticism: attacking personality rather than actions
- Contempt: insult intended to hurt the other person - Defensiveness: self-justification - Stonewalling: pattern of isolation and withdrawal |
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What social factors are involved in difficult family transitions?
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Poverty, unemployment, crowded living conditions, limited support systems
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What biological factors are involved in difficult family transitions?
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Nature vs nurture debate; individual psychopathology & problems
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What prevention programs for marital distress exist?
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Religious groups and PREP (Premarital Relationship Enhancement Program)
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How is current marital/family distress treated?
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Behavioral family therapy, which focuses on moment-to-moment interactions
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What disorders are most common among older adults?
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With the exception of the cognitive disorders, mood and anxiety disorders are the most common.
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What is behavioral gerontology?
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Subdiscipline of health psychology and behavioral medicine, which focuses on studying and treating the behavioral components of health and illness among oldies
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What biological treatment is more effective for older people?
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Electroconvulsive therapy in treating unremitting depression
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What is an expert witness?
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A specialist who the law allows to testify about specific matters of opnion (not just fact) that lie within their area of expertise
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What is the M'Naghten Test?
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Establishes a "right from wrong" principle for determining insanity.
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How do the mental health and legal fields view human behavior differently?
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Criminal law assumes behavior is the product of free will, making people responsible for the choices they make
Mental health professionals assume determinism, where behavior is determined by biological, psychological, and social forces |
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What is insanity?
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Insanity is an exception to criminal responsibility because the insane are assumed not to be acting out of free will
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What is the irresistible impulse test?
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Defendants are insane if they are unable to control their actions due to mental disease
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What is the product test?
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The accused is not criminally responsible if his/her unlawful act was the product of mental disease or defect
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What is competence?
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Competence is a defendant's ability to understand the legal proceedings that are taking place against them & to participate in their own defense
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What sentences are mentally retarded people ineligible for?
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Death penalty
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What sentences do sexual predators get?
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Sexual predator laws keep sexual predators confined indefinitely
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What are libertarian views regarding civil commitment?
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Emphasize the protection of the individual
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What are paternalistic views regarding civil commitment?
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Emphasize the state's duty to protect its citizens
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What 3 grounds are part of most civil commitment laws?
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- Inability to care for self
- Being dangerous to self - Being dangerous to others |
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How do libertarians and paternalists view commitment of children?
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Libertarians: desire an increased recognition of children's rights
Paternalists: Reluctant to interfere with parents' rights or family autonomy |
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What rights do mental patients have following civil commitment?
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- The right to treatment
- The right to treatment in the least restrictive setting - The right to refuse treatment |
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When is it acceptable and unacceptable to force a patient to be medicated?
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Acceptable: To reduce dangerous behavior
Unacceptable: To establish competence to stand trial |
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What distinguishes outpatient commitment from inpatient commitment?
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Require same dangerousness standards, but patient is court-ordered to comply with treatment in the community
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What is the philosophy behind deinstitutionalization?
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Many mentally ill and mentally retarded can be better cared for in their community than in large mental hospitals
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What are Fuller Torrey's 8 problems with deinstituitionalization?
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- Twice as many mentally ill people living on streets than in mental hospitals
- Increasing numbers of mentally ill in prisons - Mentally ill people are regularly released from hospitals with little or no provision for aftercare or follow up - Violent acts perpetrated by untreated mentally ill individuals are increasing in number - Housing and living conditions for the mentally ill are grossly inadequate - Mental health centers were originally funded to provide community care to keep the mentally ill out of state hospitals, yet they have failed - Laws designed to protect the mentally ill protect their right to remain mentally ill - The majority of mentally ill discharged from hospitals have been officially |
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What is physical custody?
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Where children will live at what times
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What is legal custody?
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How parents will make separate or joint about their children's lives
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What are 4 forms of child abuse?
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- Physical abuse
- Sexual abuse - Neglect - Psychological abuse |
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What is the most common form of abuse?
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Neglect
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What are professional responsibilities?
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Obligations for psychiatrists, psychologists, and social workers to meet the ethical standards of their professions and uphold the laws of their states.
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What is negligence?
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Substandard professional service
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What is malpractice?
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Situations in which professional negligence results in harm to clients or patients
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What are 2 common reasons for malpractice claims against mental health professionals?
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Inappropriate use of electroconvulsive therapy and medication
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What are privileged communications?
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Confidential exchanges that legislation explicitly protects from being revealed. Child abuse is not covered.
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What did the Tarasoff case accomplish?
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Therapists must now protect potential victims of violence
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In which case was the execution of mentally retarded individuals outlawed?
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Atkins vs VA (2002)
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In which case was the execution of juveniles outlawed, and why?
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Roper vs Simmons (2005)
Paralysis or long death may occur |
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What are the effects of Head Start?
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- Short term increases in IQ of 5-10 points, as well as achievement
- Less likely to repeat a grade or be placed in special ed classes - More likely to graduate from high school |
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What disorders may be developed by children rejected by their peers as compared with those neglected by their peers?
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Neglected: internalizing
Rejected: externalizing |
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How did the rules regarding use of the insanity defense change after Hinckley's acquittal?
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- Removal of "irresistable impulse" portion of law
- Shift of burden of proof from prosecution to defense |
