Child Psychopathology Final

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Top drugs of choice for adolescents

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alcohol, tobacco, and marijuana

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The developmental stages of adolescents decreases the likelihood that

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that they will exhibit impairmentin occupational and romantic functioning

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alcohol-dependent teens are less likelythan adults to experience

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physiological dependence

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Common adolescent dependence symptoms include: (BSRC)

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blackouts

sexual behavior

reduced activity level

cravings

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In the DSM 5, Substanceuse disorder combines the DSM-IV categories of

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substanceabuse and substance dependence

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In the DSM 5, substance abuse is measured on a continuum from...

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mild to severe

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Criteria for substance abuse in the DSM 5 have been broadened to reflect

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cross-cultural findings

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10 separate classes of drugs ( Holly Is SomeWhat Addicted to Caffeine Since Carol Offered Her Sweet Tea)

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hallucinogens

inhalants

sedatives

alcohol

caffeine

cannabis

opioids

hypnotics

stimulants

tobacco

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All drugs taken in excess have a common direct activation of the

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brain reward system

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Adolescents with a substance use disorder are highly likely to show

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polydrug use

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Adolescents with substance abuse disorders tend to associate with

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deviant peer groups

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In terms of academic achievement, adolescents with substance abuse disorders tend to

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exhibit poorer outcomes and higher rates of academic failure

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adolescent substance use begins with the use of

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gateway drugs

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Association between parental education and SES and drug use appears in

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the middle school years

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SES increases the risk for adolescentsubstance use only when

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poverty is extreme and occurs with childhood behavior problems

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SES may influence specific

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drugs used

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African American high school seniors have lower prevalence rates for

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all drugs

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Substance use is typically initiated in

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adolescence

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Typical time for alcohol use onset is between

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7th and 10th grades

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some substance use during adolescence is

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developmentally and statistically normative

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some data support the idea that early age of onset is a predictor of

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later clinical impairment

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There is a greater likelihood of clinical impairment in substance use disorder when you combine early age of onset with

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family history and high levels of conduct problems

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Peak age of diagnosis with substance use disorder is ages

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18-25

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there is better long term prognosis if recovery occurs during

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young adulthood

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3 pathways for substance use disorder

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1. stress and negative affect

2. Substance use effects

3. deviance-proneness pathway

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specific genes have been identified as markers for

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substance use disorders

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heritability factor may be stronger for what gender?

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males

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according to the deviance-proneness model, the development of substance use or dependence occurs within a broader context of

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the development of conduct problems and antisocial tendencies

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according to the deviance-proneness model, adolescents at risk for abuse of substances are thought to be _____________________ difficult

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temperamentally

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According to the deviance-proneness model, adolescents at risk for substance abuse are prone to cognitive deficits that contribute to

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a lack of self-regulation

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According to the deviance-proneness model, high risk adolescents are thought to have poor

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parents

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According to the deviance-proneness model, a combination of risk factors contribute to failure at school and the mainstream peer group, and results in affiliation with

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deviant peers, who provide opportunities for alcohol and drug use

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The temperament and personality of the individual at risk for substance abuse tend to exhibit these 6 characteristics (PLAIDS)

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poor impulse control

low ego control

aggression

inability to delay gratification

decrease conformity to convention

sensation-seeking behaviors

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Cognitive functioning of individuals at risk for substance abuse tend to be characterized by deficits in these three things

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executive functioning, judgment, and self-regulation

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_____________________ parenting, or parenting that combines high levels of nurturance with consistent discipline, has been associated with lower risk of adolescent substance use.

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Authoritative

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Low levels of ________________________ and ____________________ predict increases in adolescent substance use over time.

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Parental social support and discipline

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Low levels of _________________________________ has been shown to predict onset of substance use and heavy drinking in adolescents

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parental monitoring

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High levels of __________________ are associated with higher levels of adolescent substance use

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family conflict

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Adolescent substance use, higher use over time and later depencence are predicted by ____________________ and aggression.

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conduct problems

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The stress and negative affect model hypothesizes that adolescents at high risk for substance use or dependence use alcohol or drugs as a way to decrease negative affect created by

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high levels of environmental stress

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School and neighborhood social norms influence risk for substance use by social norms concerning these 3 things

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DEA

degree of punishments for use

ease of access

acceptability of use

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non suicidal self injury

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direct and deliberate physical harm to oneself in the absence of intent to die

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types of nonsuicidal self-injury/self-mutilation (CHIP)

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CHIP

cutting

hitting or bruising

interfering with healing wounds

pulling out hair

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3 possible etiologies for nonsuicidal self-injury

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DID

decreased serotonin

Increased dopamine

dissociative response

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2 most common types of nonsuicidal self-injury

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cutting and burning

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Nonsuicidal self injury behavior tend to peak in the

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early to mid twenties

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It is hypothesized that nonsuicidal self injury dissipates over time because

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it loses its effectiveness, like other maladaptive coping strategies

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distal vulnerability factors contributing to nonsuicidal self-injury (PHT)

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PHT

poor communication skills

High self criticism

Trauma

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6 risk factors fornonsuicidal self-injury (SHEDS)

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substance abuse

history of psych treatment

eating disorders

depression

suicidal ideation

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Possible gains fromnonsuicidal self-injury

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relief

self nurturing

control

comunication

punishment

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Complications of nonsuicidal self-injury

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shame

scars

isolation

loss of control

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social learning hypothesis concerning nonsuicidal self-injury- most youth learn about nonsuicidal self-injury from

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friends

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2 developmental pathways of anxiety disorder

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cumulative risk pathway

precipitating event pathway

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cumulative risk pathway for anxiety

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anxiety results from a number of predisposing risk factors that place the child at greater risk and exposure to repeated situations that cause anxiety

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precipitating event pathway for anxiety

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anxiety develops as a learned response to an event

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genes play a _______________________ factor in the transmission of anxiety predisposition

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significant

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Inheritability is _________ in panic disorders

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high

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Anxious parents tend to have ______________ children.

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anxious

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In anxiety disorders, there is an overactivation of the _________________, ____________________, and ventral prefrontal cortex

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amygdala, hippocampus

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In anxiety disorders, there is more _____________ within the brain, and there are higher ____________ levels found in anxious children and adolescents.

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assymetry, cortisol

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Tripartite model of emotion

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positive affectivity,

negative affectivity, and

physiological hyperarousal contribute to development of anxiety and depression

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behavioral inhibition is characterized by

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high emotional reactivity, bias to interpret situations as threatening, and poor effortful control

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4 characteristics of Anxious children

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shy, fearful, cautious, introverted

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Overprotection by parents is associated with

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panic disorder

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The cognitive model for anxiety asserts that individuals with anxiety disorders have (MALI)

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-memory bias

-attention and interpretation bia

-lack of effortful control over negative thoughts

-Information processing challenges

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psychosocial factors concerning anxiety

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negative affect is generated by lack of control over stressful events- lack of control then becomes the trigger for negative affect, then stored in memory and integrated into worldview

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Disorders included in the DSM IV-TR Conduct and Oppositional Defiant Disorders

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Conduct disorder

ADHD

ODD

Disruptive Behavior Disorder NOS

Intermittent Explosive Disorder

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Changes in the DSM 5 for Conduct Disorders

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1. ADHD is now classified as a neurodevelopmental disorder instead of a conduct disorder

2. disruptive behavior NOS was removed

3. pyromania, kleptomania, and Other Specified disruptive, impulse-control and conduct dx added

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Diagnostic Criteria for Conduct Dx

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1. persistentpattern of behavior in which the basic rights of others or majorage-appropriate societal norms or rules are violatedas manifested by three or more of the following

a. aggression to people and/or animals

b. destruction of property

c. deceitfulness or theft

d. serious violations of rules

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Callous-lack of empathy specifier

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disregards and is unconcerned about the feelings of others

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Risk Factors for Conduct Disorder

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•Genetics

•Psychophysiological/neuroendocrine•Temperamental

•Cognitive/neurocognitive

•Prenatal

•Familial

•Peer

•neighborhood

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Blunted emotional reactivity, blunted cortisol reactivity and decreased oxytocin reactivity are psychophysiological risk factors for CD and are all associated with

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callous, unemotional traits

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emotional/temperamental risk factors for CD

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emotion dysregulation

insensitivity to distress

fearlessness

impulsivity

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cognitive risk factors for CD (GIHBL)

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Low verbal IQ

hostile attribution bias

blame externalization

greater rebellion

impaired moral reasoning

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prenatal risk factors for CD (TAMM)

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TAMM

toxin exposure

postnatal adoption

maternal drug use

malnutrition

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familial risk factors for CD

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low SES

family conflict

maternal depression

parental separation

dysfunctional parenting

low parental warmth

disorganized attachment

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3 Peer risk factors for CD

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deviant peer affiliation

peer rejection

bullying

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2 neighborhood risk factors for conduct disorder

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violence

poor neighborhood quality

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moderating protective factors for CD (PEN)

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Positive disposition

external societal support

nurturing family

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Four DSM 5 Changes for Eating Disorders

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1. Added Binge Eating Disorder

2. Removal of the term refusal

3. Removal of Amenhorrea

4. bulimia- change in frequency of compensatory behavior from twice weekly to once weekly

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__________________and _________________ are low in eating disorders, but may be caused by weight loss.

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cerebrospinal fluid and norepinephrine

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Lower serotonin is associated with

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anorexia

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3 risk factors for eating disorders

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family history

parental alcohol abuse

history of being overweight

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Family temperament risk factors for eating disorders, according to Minuchin

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enmeshment

overprotectiveness

rigidity

conflict avoidance

poor conflict resolution

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family action risk factors for eating disorders

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tension during family meals
frequent parental absence

parental underinvolvement

criticism

parental discord

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Individuals with eating disorders appear to have dysfunction in the _________________ and ________________ systems.

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noradrenergic and seretonergic

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The boundary between anorexia and bulimia is

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unclear

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familial risk factors for child and adolescent depression

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conflict

level of expressed emotion

parenting style

maternal depression

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3 individual risk factors for child and adolescent depression

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difficult temperament

low self esteem

low positive mood

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2 peer risk factors for child and adolescent depression

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peer rejection

aggression

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2 socioeconomic risk factors for child and adolescent depression

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poverty

stressful life events

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New DSM 5 Diagnosis in the depression cluster

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Disruptive Mood Dysregulation Disorder

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DMDD is characterized by

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recurrent outbursts far beyond context that occur 3 or more times per week

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DMDD cannot be diagnosed

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before age 6 or after age 18

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In terms ofchild and adolescent depression, _______ are at greatest risk of suicidal beahviors in adolescence

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boys

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depressed _______ are at highest risk for suicide in middle adolescence

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girls

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In terms ofchild and adolescent depression, there is more weight loss in

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girls

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Adolescents tend to experience _____________, or sleeping more than usual, when depressed.

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hypersomnia

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When depressed, young children report more ____________ symptoms.

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somatic

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More ________________ occurs in children than adolescents when depressed.

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irritability

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Depressed children report less _______________ than adolescents.

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dysphoria

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Children tend to ______________ weight when depressed.

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gain

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5 signs of depression in children (SPILS)

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social withdrawal

physical complaints

irritability or anger

low energy

sensitivity to rejection

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differences between adult depression and adolescent depression

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less anhedonia

more reactivity to situational stressors

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5 major signs of depression in adolescents

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rebellious behavior

somatic complaints

preoccupation with death

frequent tearfulness

guilt