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255 Cards in this Set
- Front
- Back
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what are moderator variables
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ones that interfere with treatment
-parental psychiatric status -comorbidity -age -supports |
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what are mediator variables
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mediators are the part of the tx that actually WORKED (what mediated change)
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what is the best treatment for ODD
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parent training
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3 pathways of adolescent conduct disorder
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-addiction
-lack of parental involvement -neurological |
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what med has strongest support of its use in ODD and CD
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stimulants
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what is epidemiology
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how common things are (eg rates of behavioral disorders)
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how many children in US meet DSM criteria for behavior disorder
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14-22%
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how many children with behavior disorder get effective care?
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10-20%
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what percentage of school age and preschool children demonstrate psychosocial dysfunction
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school age 13%
preschool 10% |
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there are how many diagnostic possiblities for children and adol?
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42
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how do we decide if behavior is diagnosable?
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-unusual for child's peer group
-impairment |
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what makes up the "4 factor model"
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1-temperament
2-consequences 3-stress 4-parent temperament |
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Barkleys' model consists of what part of the "4 factor model?"
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CONSEQUENCES
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wht are the 3 broad headings under disturbance of conduct?
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-ADHD
-ODD -CD |
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what are developmental precursors of serious antisocial behavior in adolescence?
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annoying oppositional behavior, such as non-compliance and argumentiveness
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In order for ODD to be met the following a main criteria must be present
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Repetitive pattern of defiance in disobedience and and negative or hostile attitude toward authority figure's for at least six months
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But four of the following must be present in order to meet criteria for ODD
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Loss of temper
Arguments with adults Defiance or noncompliance with adult rules and requests Being deliberate source of annoyance Blaming others for one's mistakes Being touchy and annoyed by Others Frequent anger and resentment Spite, vindictiveness |
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In regard to the four behaviors required in ODD, what must these behaviors be in order to be considered pathological
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The behaviors must be common and must lead to impairments in functioning, (academic and social)
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What is the major difference between CD and ODD
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Definitions overlap, but in CD, and the violation of basic rights of others or other age appropriate social rules and norms must be present
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subheadings under CD
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Childhood onset type, adolescent onset type,
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What is necessary for a child to meet adolescent onset Type conduct disorder
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Behavior does not appear before the age of 10
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There is a high Comorbidity of child onset conduct disorder and what
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Adhd
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What is required to meet the diagnosis criteria of childhood onset conduct disorder
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One of the 15 behaviors must appear before the age of 10
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what is the most likely cause a child onset conduct disorder
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Neurological deficiencies
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what are the two bipolar dimensions that are subtypes of disturbance of conduct
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Destructive / Nondestructive
Covert / Overt |
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Give examples of destructive overt and estructive covert behaviors
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Destructive overt-aggression, assault
Destructive covert-property violations, such as stealing, fire |
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But give examples of overt and covert nondestructive behaviors
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Overt nondestructive-anger, stubbornness
Covert nondestructive-* serious, running away, substance abuse, truancy |
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what is the prevalence of conduct disorders in non-clinical populations
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5 to 10%,
of that percentage conduct disorder with serious problems are 2 to 9% |
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List the percentages and disorders that are likely to be Comorbid with ODD
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14%ADHD
14% anxiety 9% depression |
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what disorder usually precedes disturbance of conduct
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ADHD
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What percentage of children diagnosed with antisocial personality disorder at the age of 26 had ADHD
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18%
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What disorder protects against conduct disorder
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Childhood Anxiety disorder
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What is a key precursor to conduct disorder
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Excessive disobedience toward adults
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When are you likely to see comorbid depression and conduct disorder, and why is it concerning?
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Likely to see more of this and girls, concerning because of a risk for increased suicidal ideation and increased substance use in this population
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Conduct disorder is associated with later substance abuse, what does early-onset substance abuse predict
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Criminality
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Aggression is an early sign of what?
Given samples of the kinds of aggression |
aggression is early sign of severe conduct disorder
Reactive/proactive Affective /predatory Distinction between these are important because it determines treatment options |
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Give example of reactive aggression
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Defensive, explosive, uncontrollable, in response to perceived threat, fear, anger
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Give example of proactive aggression
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Means for self serving outcome, no emotion
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These biological levels are thought to account for differences in ODD
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adrenal androgen levels elevated in ODD
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list three psychological disorders that follow conduct disorder
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Alcoholism
Drug dependency Antisocial personality disorder |
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Why is it important to use a multi method assessment in disordered conduct children
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Behavior may vary across settings, key areas are to look at:
1 -behavior and interaction all settings 2 -pertinent characteristics (temperament, neurological injury, presence of ADHD, social skills) |
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Family based interventions such as parent training are based on what theory? And whY?
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social learning theory; disturbance of conduct reflects parental difficulty in reinforcement of societal appropriate treatment; parents need to refocus on prosocial behavior
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In the first half of family training program, what is taught
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The principles of behavior management
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What are the six principles of behavior management
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1- consequences: immediacy
and -consequences specificity 2- consequences: predictability 3-consequences: consistency 4-incentive programs before punishment 5-anticipating in planning for misbehavior 6-reciprocity of family interactions (not one person's fault over another, each person shares responsibility) |
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What does PSCT stand for
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Principles of problem solving communication training
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the second half of the family training program uses problem solving communication training to do what
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PSCT is used to teach parents and adolescents problem solving and communication skills for negotiation over conflicts; gradually give increased independence to child; develop realistic expectations
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Within the family structure what is a coalition
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Two people taking sides against a third
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Within the family structure what is triangulation
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Two people put a third in the middle and the third vacillates a siding with one or the other
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how many steps are there in the family training program
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18 steps
The 1st 9 steps are used to help parents regain control, reassert authority (contingency management) and then teach interpersonal skills to develop better conflict resolution In steps 10 to 18 problem solving is taught |
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in parent training a good behavioral plan includes these five steps
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Immediate
Specific Positive Proactive Disciplined |
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what is the primary developmental goal of adolescents, and what are three questions you should ask in regard to things they want to do that you may not agree with?
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INDEPENDENCE is goal
1- is it physcially harmful 2-emotionally harmful 3- unduly tax resources |
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What is the number one correlation of parents behavior with child's defiant behavior
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poor parental monitoring
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What is temperament
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Biologically based personality attributes
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Why don't boot camps work
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The children learn that behaviors from the other kids in the program
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what's the number one complaint from teachers or school about clinicians
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Not enough teachers are asked for assessments, and clinicians don't attend meetings
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Name the Federal laws protecting educational rights of children
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ADDA
IDEA Section 504 |
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name four causes of defiant behavior
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-temperament
-parenting style -stress -consequences |
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Robin And Foster (1981) created this therapy
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PSCT
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Minuchen used...
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structural family therapy
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Robert Brooks suggested this of an intervention for behavioral problems in the school, in regard to speaking with staff
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put the child on display for unique and positive contribution to the school environment
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define TRAAY
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Treatment recommendations for the use of a typical antipsychotic drugs in aggressive youths
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One of the treatment recommendations for the use of antipsychotic drugs in aggressive youth
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1-first treat primary axis one disorder with the best Evidence-Based treatments
2-use behavioral treatments for aggressiveness 3-use monotherapy whenever possible 4-when the above fail, try atypical antipsychotics to treat the aggression |
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According to barkley's theoretical model what is going on in an ADHD brain
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Not so much over activity but disinhibition; power to suppress is less active in the ADHD brain;
Same circuit involved in OCD; Like poor breaks rather than are revved up engine |
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What are the three symptoms in common With the DSM, Achenbach and Cdi
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Sad or depressed mood
Feelings of worthlessness Feelings of guilt |
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What is the most prevalent disorder among children
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Anxiety disorders, about 12%
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what is the compostition of child outpt referrals (% and disorder)
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50% referrls for defiance and aggression
25% hyperactivity |
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the average child in outpt clinic has this many diagnoses
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more than 3.5
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depressed adolescents are ____more likely than controls to be referred to services
and disruptive d/o are ___ times more likely to be referred than controls |
depressed - NO more likely
disruptive d/o 4-5 times more likely |
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how many youth with depression are not diagnosed?
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3/4 s
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of youth identified with depression, how many get treatment?
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70% are NOT treated
(30% get tx) |
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how many kids with ADHD do not receive care?
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50%
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advantages to Achenbach
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-kids scales more consistent with parent and teacher ratings
-longer track record of research support -larger clinical sample size -recent evidence of ability to screen juv onset bipolar d/o |
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advantages of BASC-2
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-contains validity measures
-more items cover adaptive functioning -separate scales for the Adhd clusters |
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BASC-2 stands for…
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Behavioral assessment system for children second edition
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The Achenbach measures include.....
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CBCL, YSR, TRF
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advantages of BASC-2
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-contains validity measures
-more items cover adaptive functioning -separate scales for the Adhd clusters |
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How many therapies are available for children
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500
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what is the criteria for "well established" EST?
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2 or more between group designs
tx organzied by manual sample characteristics detailed 2 diff teams demonstrate efficacy |
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what is the criteria for "probably efficacious" ESTs
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all other criteria of "well established" met, except for the 2 research teams element
or 2 experiments demonstrate superiourity to wait list condition |
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HSQ
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home situation questionnaire
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how is Barkley's parent training manual program similar to building a house?
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first lay the foundation, using attention and praise
2nd work on the living space, which is using rewards and punishments then the Roof is the section that deals with school issues and relapse prevention |
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how many sessions in Barkelys' parent training program
how effective? |
8 sessions
64% + successful outcome 117 studies showed overall effect size of .86 |
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what are some moderator variables for parent training (according to Fonagy et al 2002)
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-parent mental illness
-comorbidity -age of child -supports for parents -severity of aggression -degree of parental negatively toward the child |
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how is CBT for children with aggression and violence
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low effect sizes in meta-analytic studies
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discuss outcome data of parent training (for defiant kids)
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-parental attention skills impr
-parenting more effective -defiance is reduced -better attitudes toward children -increased sense of parental confidence -improved marital and sibling functioning |
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CBQ
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conflict behavior questionnaire
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ACP
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anger coping program
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whose work with aggressive adults was the basis for ACP
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Novaco
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the coping power program is the expanded version of what program?
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ACP
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what is the primary goal of MST
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to prevent out of home placements
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# of tx priniciples in MST
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9 core tx priniciples
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typical length of tx in MST
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3-5 months
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how many families helped by MST
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4,800
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MTA
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multimodal treatment study of children with ADHD
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what was ruled out for the MTA study
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-PDD
-IQ deficits -psychosis -tourettes -severe OCD -tx with antipsychotics or hospitalized in past 6 months |
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MTA Behavioral tx condition consists of what?
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Parent training (27 grp, 8 ind sessions)
child focused (8 wk, 5d.wk, 9hr/d grp based recreational setting) school based (10-16 sessions of teacher training and 60 school days of PT aide in class) |
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Curry et al (2006) said this about the MTA study in regard to more educated households
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addition of psychosocial tx to med mgmt significantly enhanced outcome for ADHD sx, in more educated households
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stimulants normalizes ADHD sx in this percentage of kids
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80%
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how many kids respond to the first stimulant tried?
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70-80%
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stimulant use in ADHD reduces the risk of substance abuse by how much?
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HALF the risk
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Jensen and Cooper (2003) think lack of med in ADHD (how many?) suggests that this is the most impt public health problem
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half the kids with ADHD not getting med, which means underdiagnosis is bigger problem than difficulties with overdiagnosis
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children with ADHD have this percentage of comorbid conditions
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75-80 % have comorbid d/o
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ADHD and defiance & aggression should be treated with....
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contingency mgmt
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ADHD and anxiety & depr should be tx with.........
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ind CBT or IPT
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ADHD and LD should be treated with..........
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academic support
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conduct disorder is the psychological gateway into ...
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addiction problems
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extant
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known knowledge base
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STAR
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services for teens at risk (Brent & Poling)
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in a study of adol with depr, what was discovered about untreated parental depression
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untx parental depression and or anxiety impedes the ability for the depr adol to recover fully
therefore, parents of depd and suicidal adol should be assessed at intake |
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altho MDD and DD is rare in preschoolers, may see it...
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associated with extreme abuse or neglect
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prevalence of depression in children? in adol?
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2% children
2-5% in adol |
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cummulative % of depr up to age 18 for boys? girls?
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boys 19%
girls 35% |
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what did Costello, Erkanli and Angold's 2006 study find in regard to whether depression is on the rise in youth?
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prevalence rates did not increase across cohorts
2.8% children 5.7% adol ( 5.9% girls / 4.6 % boys) |
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in clinical samples, how likely to have a comorbid d/o with depression?
of those with comorbidity, how many have more than 1 comordbid d/o? |
40-90% those with depr have a comorbid d/o
those with comorbidity that have more than 1 comorbid d/o is 20-50% |
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how many with depr have comorbid anxiety?
cormorbid conduct problems? |
depr & anx 30-80%
depr & conduct px 10-80 % |
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in kids with depr, what percentage of 1st degree relatives meet criteria for MDD
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30-50%
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what sx of depr are evident in children (vs teens and adults)
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somatic complaints
irritability social withdrawal under age 9, more likely to express behaviorally than to discuss |
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what sx of depr are more evident in teens (and adults) compared to children?
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psychomotor retardation
hypersomnia delusions suicide attempts |
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what is the best predictive family variable of depr in youth
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maternal depression
(parental depr, but mother is highest predictor) |
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since 1950 the suicde rate has grown by.....
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quadrupled
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rate of adol suicide
out of causes of death, suicide accounts for this percent of deaths in ages 10-24 |
8-12%
12 % |
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according to CDC surveys of SERIOUSLY CONSIDERED attempting suicide in HS students, since 1991, the rate of considering suicide has ....
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decreased by half
1991 =29% 2007 14.5 % |
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since 1991, the percentage of hs students who ATTEMPTED suicide has.......
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stayed fairly constant -
1991 7.3% 2007 6.9% |
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ratio of boys to girls with depr is....
at adolescents, this ratio is.... |
children: boys and girls are equal in dx of depr
adol: girls outnumber boys 2:1 |
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one of the 5 criteria that MUST be met in order to dx youth major depression
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must have EITHER:
an increase in depressed or irritable mood OR greatly diminished interest or pleasure |
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for youth to meet criteria for dysthymia, must have sad or irritable mood for how long?
and at least 2 of the following cirteria.... |
dysthymia = sad or irritable mood MOST of the day, more days than not, for at least 1 yr
need 2 of following: poor appetitie/overeating insomnia/hypersomnia low energy / fatigue low self esteem poor concentration /decisiveness feelings of hopelessness |
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what is seligmans's theory of depression
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learned helplessness
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what is Beck's diathesis stress model?
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depression has a genetic predisposition that is brought out by stress
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what might you assess in a child under 10 who is suicidal?
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SI very unusual under age 10, usually this is b/c they are mad and not getting their way
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Gould's (1998) study on suicidal thinking and behavior
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Mecca study
(is this same as the MECA? need to check) |
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King et al's MECA study (2001) of suicide attemptors vs ideators found these variables distinguished the 2 groups
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attempters were more likely:
sexually active smoke cigs use substances numerous stressful events (why? this infers IMPULSIVITY) |
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what is a Functional behavioral analysis?
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An examination of what happened before, during and after an event, both externally and internally
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Approximately what percentage of suicide attempters actually want to die
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Only about 1/3 want to die
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What is the single best predictor of suicidal attempt
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Past behavior
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When completing the lethality assessment, what would we xpect with someone who has vegetative symptoms
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When people are not sleeping or eating their level of impulsivity is decreased, so immediate lethality is decreased
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while females are more likely to make suicide attempts, males are how many more times likely to complete attempts?
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Males are five times more likely to complete suicide attempts
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Which ethnic groups have the highest rates of suicide
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native Americans and non Hispanic whites
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Which adolescents are the greatest risk of adolescent suicide
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homosexual and bisexual youth and
Victims of sexual or physical abuse |
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MSQ
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my standards questionnaire
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Stark, Kendall et al (1996) created this program for children ages 9-13 with depression
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Taking Action Program
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what does the Taking Action Program consist of
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for ages 9-13 with depr
18 sessions with child (2x/wk for first month; 2 x/ month at end) 11 sessions with family (after 4th mtg with child) can be ind or grp format (grp=4-8 kids) therapist and child manuals 60 min avg (can be 50-90 min) |
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the first session of the Taking Action program tries to provide this
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Hope
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In the taking action program, action stands for this
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a - always find something to do better
c - catch the positive t - think about problem to be solved i - inspect the situation o -open yourself to the positive n - never get stuck in the muck |
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Curry et al (2000) created this CBT manual For depressed youth
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TADS
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Weisz et al's (2003) program for ages 8-15 depression
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PASCET program
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this is the problem solving section of the PASCET prgm
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STEPS
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what is TADS
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treatment of adolescent depression study
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Newest et al (2006) studied the effect of omega 3 vs placebo on children's depr rating scale, and found this
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Ss receiving omega3 scored lower in depr rating scale after 16 wk compared to placebo
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which groups were excluded from the TADS study
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active subst use
current/past Bipolar or CD PDD, thought d/o Current drug or therapy tx Hx of non-response to SSRi or CBT hosp for lethality in pst 3 mos |
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leading researcher in youth depression
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nadine kaslow
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acronym PASCET stands for....
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Primary-secondary control enhancement training
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what are the primary control and secondary control skills in the PASCET program (the 2 acronyms)
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primary = ACT
secondary = THINK |
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the presence of youth depr increases the probability of another disorder by ____ %
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20%
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youth depr predicts later depr and an increased long-term risk of ...........(3 things)
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substance use
employment px marital difficulties |
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anti depr are now the ____ most frequently prescribed class of psychotropic drugs in the pediatric populations in the US
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2nd
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PASCET is similar to ___ but adds a few things
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CBT
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DFM
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deployment focused model
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what does STEPS stand for
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S - say what the px is
T - think of solutions E -examine ea one P - pick one& try it out S - See if it worked |
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what does THINK stand for
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T - think positive
H - help from a friend I - identify silver linng N- No replaying of bad thoughts K - keep thinking, don't give up |
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what does ACT stand for
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(AACCT)
A- activities that solve px A- activities I enjoy C - calm C-condident T - talents |
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the PASCET program uses this method of tx development and testing; this method is meant to promote mvmt of clinical trials into service settings
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deployment focused model (DFM)
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what are the steps of a deployment focused model
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1 - protocol / manual
2- efficacy test 3- field cases 4- effectiveness 1 5-effectiveness 2 6- staying power |
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CDRS-R
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children's depr rating scale - revised
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Kratochivil (2006) found that according to clinician ratings, clinical benefit showed up...
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in combined groups first
combined is superior to med or CBT alone (this is also true of overall functioning: combined is best, followed by Rx, then CBT, then placebo |
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what predictors of better improvement in acute phase of depr tx were found in Curry et al's study (2006)
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-better overall fx to start
-depr present for shorter period of time -min. # of melancholic features -one or less comorbid disorders -no comorbid anxiety |
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Kennard et al's study (2009) of TADS 36 wk follow up showed what
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CBT is more effective over time
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Kovaks et al (1996) suggest the avg length of a depr episode is ___ and most recover within _______
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avg episode = 9 months
recovery us. within 1 yr |
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Mufson et al (1993) define depression as _____
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a bilogically based emotional response to the loss of an attachment bonding
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Mufson et al studied this treatment of adol depr
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IPT-A
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who is suitable for IPT-A treatment
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depr adol who are psychologically minded
and who have at least one interpersonal px *limited to mild/limited depr only |
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how many sessions in IPT-A
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12
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Mufson's IPT-A defines 3 stages of disputes
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renegotiation (try to solve)
impasse (stopped communicating) dissolution (end relationship) |
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In the IPT-A area of role transitions, what are deteminants of success?
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adol and family flexibility
adol psychological functionng adol perceived social support |
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SBFT
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systemic-behavioral family therapy
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NST
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non-directive supportive therapy
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what is Beck's negative cognitive triad?
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depr based on inaccurate, negative views of:
-themselves -the world -possibilities for future |
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adol first onset of depr is preceded often by what?
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a negative psychosocial event
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adol are at an increased risk for depr if they encounter any of the following.....
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-familial stress
-parental depr -parent-child conflict -divorce -low cohesion -high levels of expressed emotion |
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what did Brent et al (1997) find when comparing CBT, SBFT and NST in adol ages 13-18
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severity of depr predicted outcome
(the more depr, the poorer the outcome) |
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Brent et al found that this is true of CBT in his adol sample
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altho CBT was better than the others, (60% in CBT had remission) at 2 yr follow up there was NO difference (so the superiority of CBT dissipates over time)
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Mufson was trained by......
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Klerman
(Mufson is adol IPT guy) |
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define passive vs active placebo
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passive placebo = waitlist
active = using a therapy other than one being researched (so it relates to NON-specific effects) |
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Weisz et al's metaanalytic studies found this at 12 weeks
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after 12 wks, there is not a big difference betwn conditions (CBT no better) but it appears that it takes longer for CBT to have it's benefits
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define 'intent-to-treat analysis'
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the study includes people that you planned to treat, but who dropped out
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Jensen et al (2007) said that this type of aggression is associated with psychopathy
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Planned Aggression
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Impulsive aggression is more elevated in these disorders
|
ADHD
bipolar d/o unipolar depr |
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what percentage of children with Axis I d/o show sx of impulsive aggression?
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50-90 %
(Jensen et al 07) |
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according to younstrom et al (2004), diagnosis of Juv onset Bip d/o has increased by this % from 1994 to 2001
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260%
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manic sx predict ___________ across the life span
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legal problems
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what is the chief component of tx for juv onset bipolar
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psychoeducation (of child and parent)
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define:
ultrarapid cycling ultradian cycling |
ultrarapid cycling = 5-364 cycles/yr
ultradian cycling = 365 cycles/yr |
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typical case of juv onset Bipolar has and average of ____ cycles per day
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3.5 (2.0)
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Kowatch uses FIND guidelines for dx manic symptoms, define FIND
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F - frequency
I - intensity N - number D - duration |
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based on Pavuluri's mood spectrum, palmiter noted that we are less likely to see Bip II in childhd onset bip, WHY?
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early onset= greater genetic loading and therefore more severe sx
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cardinal sx for child bipolar d/o
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elated mood
and grandiosity |
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cardinal sx of depr
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depressed mood
and anhedonia |
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TEAM study stands for...
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Treatment of Early Age Mania
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offspring of a bipolar parent has ____ risk of a psychiatric d/o and a __ risk of an affective d/o
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2.5 fold risk
4 fold risk |
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what is the chance your child will have bipolar d/o if family has it
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1st degree relative = 5x risk
one step removed = 2.5 x risk |
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what % of youth dx with major depr go on to develop mania
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20 - 30%
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childhd bipolar d/o has high comorbidity rates with...
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ADHD
ODD |
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MFPGs
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Multifamily psychoeducation groups
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T-F-D
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thinking-feeling-doing
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Biederman et al (2004) say this about sex as a moderator variable in bipolar
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gender DOES NOT moderate expression of Bip (same across sexes)
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according to Mayes et al (2003), LD rates for kids with IQs higher than 80, are highest for which disorder
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bipolar has more LD than ADHD, autism, ODD, anx and depr
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how many dsm conditions cover anxiety sx in children
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12
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GAD is sometimes called this in kids
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overanxious d/o
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there is no anxiety without...
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fear
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Barrios & Hartman define 3 reactions to perceived threat
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subjective (what they think)
motor (what they do about it) psysiological (how they feel about it) |
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becks' concept of anxiety is based on what 2 fundatmental fears
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fear of physical death
fear of social death |
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1/3 cases of child anxiety also meet criteria for this d/o
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a depressive d/o
|
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Tripartite Model (Watson & Clark, 1991) suggests what
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lack of positive affect - uniq to depr
negative affect - both depr, anx physio arousal - uniq to anx physio arousal seems to be related to those with panic sx neg affect strongly related to GAD |
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of those who develop anxiety d/o, temperament of toddlers was usually _____
school age children ____ |
toddlers - irritable shy & fearful
school age - cautious, quiet, introverted |
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children with an anxious parent are ___ times more likely to develop an anx d/o
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7 x
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who created Coping Cat
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Kendall and Hedtke
|
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prevalence of anx in childhood
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8-12 %
|
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what moderates beneficial effects of CBT for children iwth anx d/o
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child's AGE
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age group of Coping Cat
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7-13 yo
|
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coping cat is for use in children with which diagnoses?
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separation anx d/o (SAD)
GAD social phobia |
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homework for coping cat
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STIC
Show That I can |
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the four step coping program FEAR is part of which progrm? what does FEAR stand for?
|
coping cat
F-feeling frightened E-expecting bad things to happen? A- attitudes and actions that will help R - results and rewards |
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this percentage of children using coping cat no longer met diagnostic criteria
|
64%
|
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treatment terminators of coping cat had these characteristics
|
single parent hshld
ethnic minority less anx sx |
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typical coping cat prgm lasts how long?
|
16-18 sesssions
parents have 2 sessions |
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this comorbid disorder was NOT a rule out for kendalls program (coping cat or CAT)
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comorbid ADHD
|
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at a seven yr f/u, what % if cases from coping cat prgm revealed evidence of long term maintenance of gains
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90%
|
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Barrett and Short proposed this family based CBT prgm for anx children and parents
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FRIENDS
|
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the FRIENDS prgm encourages children to:
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-think of body as their friend (it tells them they're worried)
-be their own friend -make friends -talk to friends |
|
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3 parental factors associated with child's anx sx
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-high parental control
-parental anxiety -parental reinforcement of avoidance coping strategies |
|
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the FRIENDS prgm is founded on 3 specific models
|
-peer learning
-experiential learning -family directed px solving |
|
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format of FRIENDS?
|
for children - ages 7-11
youth - age 12-16 10 sessions 2 boosters 1 hr group format for parents and children / parents seesions preset as 4 - hr and 1/2 sessiosn |
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FAM
|
family anxiety mgmt training
|
|
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what characteristics may lead cliniciam to select a combined parent and child FRIENDS tx over tx for the child alone
|
younger age
and high parental anxiety |
|
|
OCD has the following bimodal distribution
|
age 7 for boys
age 10 for girls |
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this is the only d/o specific to childhood
|
SAD sep anx d/o
about 3/4 show school refusal |
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fears are a part of normal development, so when is it considered an anxiety d/o
|
only d/o when it's persistent and disabling pattern
|
|
|
what is the most common psychological d/o in kids
|
anxiety d/o
|
|
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what percentage of kids meeting criteria for an anxiety d/o are not getting treated?
|
76% not getting tx
|
|
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in younger children, anxiety is more about this
|
anx re harm toward attachment figure
|
|
|
this % of kids with social phobia have another Axis I d/o
|
60%
|
|
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early adol with social phobia are at risk for developing what?
|
substance abuse by mid-to late adol (b/c self-medicate)
|
|
|
the coping cat prgm ends with this
|
kid makes commercial
|
|
|
who is the leading researcher in anxiety d/o in kids
|
Silverman
|
|
|
Coping Koala is now called what?
|
FRIENDS prgm
|
|
|
who created FRIENDS prgm
|
Barrett
(i think, at least he wrote article?) |
|
|
the STEP plan in FRIENDS is an example of this kind of intervention
|
systematic desensitization
|
|
|
suicidal behavior under age 18 is most prevalent in this group
|
bipolar d/o
|
|
|
bipolar d/o can be differentiated from ADHD with these sx that are much more prevalent in bipolar
|
-elated mood
-grandiosity -flight-racing -decreased sleep -hypersexultiy -daredevil acts -rapid cycling of mood -uninhibited people seeking |
|
|
sx that DO NOT differentiate ADHD and bipolar
|
-irritable mood
-accelerated speech -distractibility -increased energy |
|
|
in children with comorbid ADHD and mania, which comes first
|
ADHD begins before mania
|
|
|
in order to dx bipolar, you must have this
|
must have thinking disturbance eg grandiosity
|
|
|
best predictor of relapse in juv onset bip d/o
|
low maternal warmth
|
|
|
first med choice for juv onset bipolar
|
lithium or divalproex
|
|
|
ideal tx for juv onset bipolar
|
medication and psychotherapy at same time
|
|
|
results of study of CBT vs Sertraline vs Combined vs placebo
|
response rates:
CBT 60% sertratline 55% combined 81% placebo 24 |
