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229 Cards in this Set

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mood state characterized by strong negative emotion an bodily symptoms of tension in which an individual apprehensively anticipates FUTURE danger or misfortune
IMMEDIATE reaction to danger
the cild experiences excessive and debilitating anxieties
anxiety disorders
autonomic arousal
fight/flight freeze repsonse
physical symptom
expectation of danger
cognitive symptom
behavioral symptom
what kind of symptoms are these
increased heart rate
increased respiration
upset stomach
blurred vision
dry mouth
muscle tension
heart palpitation
physical symptoms
thoughts of being scared or hurt
thoughts or images of monsters or wild animals
self deprecatory or self critical thoughts
thoughts of incompetence or inadequacy
difficulty []
blanking out or forgetfulness
thoughts of appearing foolish
thoughts of bodily injury
images of harm to loved ones
thoughts of going crazy
thoughts of contamination
cognitive symptoms
crying or screaming
nail biting
trembling voice
trembling lip
immobility twitching
thumb sucking
avoiding eye contact
clenched jaw
behavior symptoms
kids with anxiety don't worry more than other kids, they...
worry more intensely
separation anxiety disorder symptoms
constant thoughts and intense fears about the safety of parents and caretakers
refusing to go to school
frequent stomach aches and other physical symptoms
extreme worries about sleeping away from home
being overly clingy
panic or tantrums at time of separation from parents
trouble sleeping or nightmares
separation anxiety symptoms must last at least
4 weeks
separation anxiety disorder prevalence
~10% of all children
equally prevalent in boys and girls
higher prevalence in lower SES families
greater risk if mother has high anxiety
what is the most common of all anxiety disorders
separation anxiety disorder
sep anxiety disorder course
often occurs after major stressor has been experienced
mild to severe
symptoms can fluctuate over time
often refuse to attend school
most recover from though some develop depression later
refusal to attend class or difficulty remaining in school for the entire day
-severe anxiety and somatic symptoms (eg stomach aches)
sep anxiety disorder- school refusal
boys and girls experience sep anxiety disorder- school refusal...
when is sep anxiety disorder- school refusal most common
5-11 years
the child experiences chronic or exaggerated worry and tension almost always anticipating disaster even in the absence of an obvious reason to do so the worring is often accompanied by physical symptoms
GAD prevalence:
____ in boys and girls
onset GAD
avg age range 10-14
symptoms persist over time
(specific phobia)adults have insight into the fact that their fear is unreasonable, kids:
may not experience this insight
5 subtypes of specific phobias
1.animal (insect)
2.natural enviornment (heights, darkness, water, storms)
4.situational (flying, elevators, bridges)
5.other (clowns, loud sounds)
prevalence spe phobia
more common in...
2-4 %
course spec phobia
onset: 7-9 yrs
severity peaks around 10-13 yrs
persistent fear of social or performance requirements that expose them to scutiny and possible embarassment
social phobia
social phobics are _____ of the general pop of children
Why are girls slightly more social phobic?
-more concerned with social competence
-attatch greater importance to interpersonal relationships
social phobia is rare under the age of ___
-develops after puberty
What did Frued have to say about OCD
-anal fixation
-disruption of anal phase
-"rat man" torment of thoughts of rats eating his anas
-sufferes from this illness are able to keep their affliciton a private matter. concealment is made easier fro mthe fac that they are quite well able to fulfill their social duties during a part of the day one they devoted a number of hours to their secret doings..hidden from view"
persistent and intrusive thoughts ideas, impulses or images (kids describe these similar to worries)
repetitive, purposeful, and intentional behaviors or mental acts htat are performed in responses to an obsession
What is the most common obession?
contaimination (germs, dirt, toxins)
What is the most common compulsion?
excessive or ritualized handwashing, showering, bathing, toothbrushing, or grooming
prevalence of ocd in the gen pop
ocd is more common in ____
commorbidities of ocd
substance use disorders
learing disorders
eating disorders
mean onset of ocd is age ___
9-12 years
what are the two peaks of ocd
early adolescence
______ of children with ocd meet the criteria for ocd 2-14 years later
sudden and overwhelming period of intense fear or discomfort that is accompanied by 4 or more physical and cognitive symptoms characteristic of the fight or flight response
panic attack
display recurrent unexpected attacks followed by at least one month of persistent concern about having another attack, constant worry about consequences or a significant change in their behavior related to attacks
panic disorder
worried about having another panic attack
-attacks usually don't last long
-children lack the understanding that physical symptoms might signal something dangerous
-not common for kids
anticipatory anxiety
-Prevalence: 3-5% of panic ______ in adolescents
-Prevalence: panic _____ less common
Comorbities of panic
-50% have no comorb.
-other 50- depression and/or other anxiety disorders
display persistent anxiety following an overwhelming traumatic event that occurs outside the range of usual human experience
name and explain two types of PTSD
type I
-short term
-sudden surprizing
-quick recovery
(eg. car accident, rape)
type II
-chronic, long standing
-intentional *human* design
-long standing probs
-poorer recovery
(eg. physical/sex abuse, war)
PTSD symptoms
1. reexperiencing the event
2. numbing of responsiveness
3.symptoms or increased arousal
4. generalized fears
5. spiritual/psychological consequences
6. blurring of distinction btw friend and enemy
-designed for adults
-for young children alter criteria
-post traumatic play, play reenactment
-not numbing as w adults, but see constricted play
PTSD Prevalence
of those who have experienced @least 1 tram event in their lifetime
_____ of girls
______ of boys
meet criteria for PTSD
3-15% girls
1-6% of boys
_____ is found in 50-60% of people with panic attacks
double jointedness
...this tells us genetic link
highest amt of genetic influence
-obsessive compulsive behaviors
-shyness inhibition
enviornmental influences
-specific fears
-separation anxiety
anxiety disorders: theories and causes: neurobio: HPA axis
too much activity
anxiety disorders...Limbic system especially...
anxiety dis: theories and causes neurobio
-CSPT: cortico striato pallido thalamic circuitry ______
-_____ frontal lobe activity
theories and causes: neurobio: NT
-_______ abnormal regulation-low
-________ overactivation of inhibitory NT, increase fear response
-_______ decreased level
GABA low
norpepinephirne overactive
Tempermant in those w anxiety disorders
the ability to delay one's initial rxns to events or stop behavior once it has begun
-higher motor activity
-react to novelty w restraint
-shy withdrawn fearful
behavioral inhibition
attatchment type in those with anxiety disorders
anxious resistant type
-during strange situation doesn't explore, wary of stranger, caregiver returns- may seek caregiver while crying and fussy
insecure attatchment
______ are helped
rate degree of distress "fear thermometer
graded exposure
prevent them from avoiding stimulus
response prevention
treatment: CBT
-modify thoughts and decrease symptoms
-recognize signs of anxious arousal
-identify cognitive processes associated with anxiety
-strategy for managing anxiety
FEAR teaches
F- feeling frightened?
E- expecting bad things to happen?
A- actions and attitudes
R- results and rewards
What is the best treatment for anxiety disorders?
usually a combo of meds, exposure, response prevention =most effective
what is used to treat (meds) school phobias, panic attacks, ocd, ptsd
1. antidepressants - tricyclics: amitriptyline (elavil), clomipramine (anafranil), imipramine (Tofranil)
2. ssri's= fluoxetine (prozac), sertraline (zoloft), paroxetine (paxil), venlafaxine (effexor), citalopram (celexa)
What (meds) is used to treat antianxiety- severe anxiety?
benzodiazepines= alprazolam (xanax), lorazepam (ativan), diazepam (valium)
What (meds) is used to treat social phobia?
betablockers- propanolol (Ideral)
state of prolonged bouts of sadness
feel little joy and lose interest in nearly all activities
abnormally elevated or expansive mood and feelings of euphoria
exaggerated sense of well being
true mood state. baseline. how you usually are.
depression main features
1. mood
-sadness more exaggerated and persistent
-irritability, guilt, shame
2. behavior
-restlessness, agitation, reduced activated, slowed speech, excessive crying
3.changes in attitude
-feeling of worthlessness and low self esteem
4. thinking
-preoccupied with inner thoughts and tensions
-slowed, reasoning, difficulty []ing
5. physical changes
-disruptions in eating and sleeping
infants raised in a clean but emotionally cold institutional enviornment dispalyed rxns resembling a depressive disorder
anaclitic depression
depression and development
1. infants
2.preschoolers aged kids
1. infants
-anaclitic depression
2. preschoolers
-extremely somber and tearful
-clingy, fear separation
-stomachaches aged kids
-irritability, disruptive behavior, temper tantrums
-weightloss, headaches, sleep disturbances
-suicide threats
the symptom of irritability, disruptive behavior, temper tantrums in school aged children can be confused with...
depression and development
4. preteens
5. teens
4. -self blame, low self esteem, social inhibition
-sleep difficulties
5. teens
-inabilitity to sleep or sleep excessively
-eating disturbances
-angry discussions w parents
-negative body image and self consciousness
-excessive fatigue and energy loss, feeling of loneliness, guilt, worthlessness
-suicidal attempts
symptoms that might indicate depression in
elementary school
-fighting w parents, neegative body image, feeling lonely, guilt, worthlessness
-self blame, low self esteem, social inhbition
elementary school
-tantrums, disruptive behavior, peer probs
-clingy, whiny
-crying, clingy
key features mdd
average episode mdd
8 months
recurrence mdd
-25% risk within 1 yr
-40% risk within 2 yr
-70% risk within 5 yr
lifetime prevalence for any child who has been depressed
20 %
mdd prevalence
school aged
preschoolers 1%
school aged 2%
adolescence 8%
mdd <13 girls __ boys
>13 girls ____ boys
hormonal changes
increased sexual maturity affect social roles
non-normative changes
display depressed mood for most of the day on most days for at least 1 yr
dysthymic disorder
dysthymic disorder=unhappy or irritable most of the time
symptoms ____ but ____than those with mdd
less severe
mdd + dysthymia=
double depression
dysthymic disorder prevalence
during the course of dysthymic dis. ~_____ will have an episode of major depression (double depression)
children 1%
adolescents 5%
dysthymic disorder course
-dd develops ___ yrs earlier than mdd
-___ yrs of age
-duration ___ yrs
(all) depressive disorders associated characteristics: intellectual functioning
-score lower on standardized tests
-lower grades
-poorer []
-psychomotor retardation
-somatic complaints
(all) depressive disorders associated characteristics:
social prob's
social withdrawl
*** this distinguishes depression from other disorders***
(all) depressive disorders associated characteristics:
cognitive disturbances
-feeling of worthlessness
-negative beliefs
-attributions of failure
-depressive ruminative style...focus narrowly on neg events for long periods
-misread situations
-small setbacks= huge catastrophes
(all) depressive disorders associated characteristics:
family prob's
poor relations and conlict w parents and siblings
neg feelings toward parents
depressive disorders theories
-anger turned inward..get mad that lost something turn it toward themselves
-insecure early attachment... avoidant/anxious type... anxious resistant type=fussy
-bad at recieving + reinforcement
-may not be able to experience
-all punishment
-sad..get attention... + reninforcement
depressive disorders cognitive theories
-depressogenic cognitions
-internal stable and global attributions
-neg view of self, world, future
negative perceptual and attributional styles and beliefs
depressogenic cognitions
internal stable global
-something bad happened and they think it's bc of them
-reason i'm to blame won't ever change
-reason s-thing bad happened (my fault) applies to most things they do in most areas
becks neg triad
world= people are no good
self= i'm stupid
future= i'll never graduate
depressive disorders: genetic influences
-genetic contribution is ___ with ____
-risk of depression is ___ greater if parent has had history
-monozygotic twins concordance rate
high with early onset
very high
depressive disorders neurobio influences (structural)
-frontal lobe decreased
-limbic system increased
-hippocampus reduced
-hpa axis disturbed
depressive disorders neurobio influences - neurotransmitters
-decreased seretonin
-decreased dopamine
-decreased norpinephrine
depressive disorders family influences
-more critical &punitive behavior
*conflict and anger
*less warmth
*poorer communication
*marital discord
-depressed moms
*more withdrawn or more intrusive
depressive disorders other influences
*stressful life events
-eg. moving, change schools, serious accident, family illness
*emotional regulation
-may use avoidance or neg behavior to regulate distress
inability to express one's feelings
depressive disorders..treatment...meds
ssri's: fluoxetine (prozac), sertraline(zoloft), paroxetine (paxil), venlafaxine (effexor), citalopram (celexa)
-amitriptyline( elavil), clomipramine (anafranil), imipramine (tofranil)
depressive disorders treatments
not meds
cbt=notice thta they fail to self reinforce...ect
-70% respond
interpersonal therapy
-family therapy
most common psychosocial thearpy
1 or more mixed episodes
1+ major depressive episode
bipolar I disorder
1+ hypomanic
1+ major depressive episode
bipolar II disorder
hypomanic symptoms
depressive symptoms
full criteria not met
cyclothymic disorder
a= always find somethin to do to feel better
c=catch the +
t= think about it as a problem
i=inspect the situation
o= open yourself to the +
n= never get stuck in the negative muck
the criteria are met both for a manic episode and for a major depressive episode (except for duration) nearly every day during at least a 1 wk period
mixed episode
a distinct period of persistently elevated expansive or irritable mood lasting throughout at least 4 days that is clearly different from the usual nondepressed mood
cyclothymic for at least ___ years
bipolar manic symptoms
-sleep (not much)
-pressured speech
-racing thoughts (cant do hw bc thoughts always interupting)
-flight of ideas (illogical jumps)
-psychomotor agitation
bp differential diagnosis
adhd vs. bp
-adhd- show consistent pattern of overactivity or distractibility
-bp= show change from usual behavior to overactivity or distractibility
bp differential diagnosis
bp vs. cd/odd
cd/odd= irritability and disregulation + vindictive, intentional and wo guilt
bp= irritability & dysregulation +impulsivity & sense of omnipotence
bp prevalence
____ of all patients with bp have first episode in adolescence
peak age
15-19 yrs
onset before ____ rare
1st episode usually
BP tends to be _____ and resistant to treatment
in 5 yrs _____ relapsed or never achieved complete remission
bipolar shows reduce volume in the
bp treatment
3. MAOIs

mood stabilizers
_____ increases the risk of a 1st suicide
over ___ of kids who suffer from depression will eventually attempt commiting suicide and 7% will die as a result
___ men commit suicide
____ women attempt sucide
___ abuse substances
# 1 choice for men and women
___ of all youth sucides are result of firearms
#2 choice for women
#2 choice for men
"I wish i were dead"
suicidal thoughts
plan and motivation
suicidal intent
attempt to communicate
suicidal gestures
nonleathal self injury
parasuicidal behavior
2 types of sucide attempts
1.low lethality- slow acting->pills, cut, discovery and saving is possible
2. high lethality- gunshot-> fast acting
completed suicide is the ___ leading cause of death in 15-19 yr olds
completed suicide is the ___ leading cause of death in 10-14 yr olds
suicide risk factors
1. depressed mood
2.substance abuse
3.running away or incarceration
4. family loss or instability
5. expressions of sucidal thoughts or talk of death or afterlife during momemnts of sadness or boredom
6. withdrawal from friends and family
7. difficulties in dealing iwth sexual orientation
8. anhedonic
9. unplanned pregnancy
10. impulsive aggressive behavior or rage
loose pleasure in usual activities
key componet of sucide ideation
why adolescents?
-more self aware
-self conscious
-self esteem
-fully grasp concept of hopelessness
sucide protective factors
1.effective care for mental physical and substance abuse disorders
2. easy access to clinical interventions and support
3. family and community support
4. medical and mental health care relationships
5. prob solving skills, conflict resolution, and nonviolent handling of disputes
6. cultural and religious beliefs that discourage
suicide factors leading to an attempt
1. long standing history of prob's from early childhood
2. acceleration of probs in adolescece
3. progressive failure to cope and isolation to cope and islolation from meaningful social relationships
4. dissolution of social relationships
5. justification of suicidal act givng the adolescent permission to make the attempt
most common diagnosis
poor self control, discipline prob's school troubles
...all due to...we treat this with...
low seritionin levels
in sucidal individuals the more comorbidies the ____
more risk
cognitive factors
poor prob solving skills
suicide attempts= predictor of future suicide completion
25% of sucide completers made prior attempts
disinhibition of sucidal behavior
parent psychopathology
substance abuse
family context
1. parent psychopathology
2. poorer parent child relationships
3. lack of support
children who are exposed to suicide are at greater risk for suicide esp. peers
the contagion effect
tips to decrease the contagion effect in the media
1. don't romanticize
2. mention depression or mental illness
3. do no provide suicide method
4. always put where to get help
tips to decrease the contagin effect in schools
1. name a point person
2. counselors should be available immediately after
-speak w friends of deceased student
-go to classes
-identify high risk students
suicide intervention
1. educate parents and peers of risk signs (80% told)
2. crisis intervention
3. cognitive
4. family thearpy
5. dialectical behavioral
dialectical behavioral thearpy targets
emotion reg, stress tolerence, interpersonal prob solving, impulse control
crisis intervention
remove means no harm contract medicate ssri's hospitalize
Galton (darwin's cousin) was famous for
the science which deals with all influences that improve the inborn qualities of a race
-mental retards blamed for prob's of society
collected questionaire data
develped educational psychology
said children 8-12 mature slaves still uncivilized
intelligence perfomance testing and norms
1st to develop intelligence testing
judgement+reasoning= intelligence
Binet and Simon
deviation in development that increases the risk for psycho pathology
**butIS NOT psychopathology**
mental retardation
functioning determined by 2 factors
1. capabilities
-adaptive skills
2. enviornments
majority IQ
____ is extremely important
-build on their strengths
maintain independence
practical skills
being able to talk to a friend
ethical judgements
social intelligence
2 types of a adaptive skills
1. practical skills
2. social intelligence
sensory and motor development are examples of
basic deveopmental skills
expressive language, receptive language, writing and spelling skills are examples of
communication skills
coping entering a new school or job, interpersonal conflict
are examples of
emotional and personal adjustment
bsic interaction skills, group participation, play activities and skills are examples of
social and and interpersonal skills
dressing eating toileting personal hygiene and grooming
self help skills
money handling banking budgeting purchasing
consumer skills
kitchen skills, household cleaning, household management maintance and repair laundering and clothing care
domestic skills
mental retardation enviornments
1. home- are family members supportive?
2. work/school- can work and go to school
3. community- do you stare? ignore? talk?
3 features DSM IV MR
1. IQ score below 70
2. deficits in adaptive behavior
3. early onset (below 18)
What is the largest group of MR?
mild (85%)
severe MR
may learn to talk may be able to do minimal work, simple tasks
profound MR
neurological condition, need constant support
MR levels of support
1. intermittent
3. extensive
4. pervasive
as needed basis
daily in at least some enviorments
constant high intensity several settings restraint
MR boys ___ girls
> slightly
MR socioeconomic status
low associated with very mild
MR emtional and behavioral probs
1. internalizing probs
-increased risk for mood disorders
2. adhd-related symptoms
-IQ diff
3. SIB
MR causes
1. genotype
2. phenotype
3. heritability
factors that contribute to behavioral disturbances in MR
1. neurobiological processes repsonsibel for MR
-side effects of meds
-communications deficits
-inadeq prob solving and coping skills
-family stress
-vulnerability to exploitation and abuse
All MR syndromes have these in common
-tough time with memory
-not good with strategy
-low prob solving skills
-can't play 20 Q
causes risks prenatal
1. genetic disorders
-chromosomal abnormalities
-single gene and other mutations
2. congetnital malformation
-malformation of CNS
causes/risks perinatal
-low birth weigh, premature
-delivery complications (trama, anxoia)
causes/risks postnatal
struct or functional brain defects
toxic substances in blood
Down syndrome cause
trisomy 21
-nondisjuction- 21st pair of mom's chromosomes dont separate during miosis...get three in 21 instead of 2
-Strongly related to maternal age (old ladies having babies increased risk)
phsyical features down syndrome
-small skull, large protruding, tounge, small mouth, almond shaped, eyes sloping, eyebrows, flat nasal bridge
cognitive features down syndrome
-better receptive language than expressive language, can understand, can't express
-hippocampal functioning differs
-can have part of community
-get married
# DS babies has decreased in recent years because of
termination of pregnancy
DS kids can only percieve
global not local features
Fragile X syndrome causes
-pinched chromosome
-inherited from mom
-more males have this
-independent of ethnicity
physical features fragile X
-large forehead, prominent jaw, low protruding ears
cognitive features
-unusual social and communication patterns
-most males show autism like behaviors
-flapping biting repition, 1/3 have comorbid autism
causes prader-willi syndrome
-7 genes on chromosome 15 are missing
physical features prader willi
-short stature
-incomplete sexual development
-low muscle tone
-involuntary urge to eat constantly
cognitive features prader willi
-learning disabilities
-attention difficulties
angelman syndrome causes
7 genes on chromosome 15 are missinge
physical features angelman syndrome
-large jaw open mouthed expression movements, disturbances, ataxia, stumbling walk
cognitive features angelman sydrome
-expressive difficulties, sometimes can't talk, laugh alot, sociable
-attention difficulties
*interited- but enviornment fixes it
-(autosomal recessive) mom recessive, dad recessive
-put on special diet after testing, dont develop
-can't metabolize proteins
-completely normal with the right diet
Lesch Nyhan sydrome causes
-x chromosome
-only obys
-deficency in enzyme HPRT
behavioral disturbances Lesch Nyhan sydrome
-self mutilating behaviors
-irritabilities, uncontrolled agression or compulsive actions
-can't feel pain, need restraint
Lesch Nyhan sydrome movement disturbances
-hypotonia, spastic movements, chorea
unconrollable flailing of arms
Lesch Nyhan sydrome have
moderate to severe MR
range of outcomes associated with all levels of prenatal alcohol exposure
Fetal alcohol spectrum disorder
most extreme form of FASD
Fetal alcohol syndrome
leading cause of mental retardation
fetal alcohol syndrome
-disorder stems from extensive prenatal exposure to alcohol
kids with FAS have prob's in
-intellectual function
-CNS dysfunction
-cranial defects
-behavior prob's
-growth retardation
-physical abnormalities of face
critera that must be fully met for FAS
1. growth deficency
2. FAS facial features
3. CNS damage
4. prenatal alcohol exposure NOT necessary (mom's lie)
3 Facial features for FAS
1. smooth philtrum (smooth between upper lip and nose)
2. thin vermillion (upper lip)
3. small palpebral fissures (short eyes)