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50 Cards in this Set
- Front
- Back
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...............ABNORMAL
DMS-IV-TR - when editions published |
- first in 1952
- latest in 2000 |
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...............ABNORMAL
DMS-IV-TR - how it allows for heterogenity of diagnosis |
- includes polythetic criteria set for most dx - which requires client to present only subset of items of larger list
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...............ABNORMAL
DMS-IV-TR - what are the 5 axis? |
I - Clincil dx
II - Personality dx / Mental Retardation III - General Medical Conditions (hearing loss) IV -Psychosocial & Environ Problems (job, finances) V - Global Assess of Fnctg |
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...............ABNORMAL
DMS-IV-TR - what is principale dx |
- when both Axis I and II, then principal one is Axis I UNLES "principal dx" noted by Axis II
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...............ABNORMAL
DMS-IV-TR - What is GAF (Global Assessment of Functioning) |
- rank client's psych, social, occup functiong from 0 to 100
- 2 factors to GAF: Symptom severity and Level of functg - 41-50=serious symptoms (suicide ideation) or serious impair in functg - GAF can be given for functg for current, highest level in last year, or upon discharge |
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...............ABNORMAL
DMS-IV-TR - how do you show dx uncertainty |
1 DX(OR CONDITION) DEFERRED - not enough info to make dx
2 SPECIFIC DX (PROVISIONAL) - tenative but not firm dx 3 [CLASS OF DX] NOT OTHERWISE SPECIFIED - know what class but not spcifc enough for specific dx |
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...............ABNORMAL
CHILD DX - MENTAL RETARDATION - 3 dx criteria |
1 subave intellectual functg (<70)
2 deficit/impair in adaptive functg in 2 areas (not age/cult, comm, self care, social, school, work, safety) 3 onset before 18 |
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...............ABNORMAL
CHILD DX - MENTAL RETARDATION - 4 degrees of severity |
1 MILD - 50-70
2 MODERATE - 35-55 3 SEVERE - 20-40 4 PROFOUND - < than 20-25 |
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...............ABNORMAL
CHILD DX - MENTAL RETARDATION - early signs |
- delays in motor dev
- lack of age-app interest in eviron - no eye contact - no response to voice/mov of others |
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...............ABNORMAL
CHILD DX - MENTAL RETARDATION - etiology - genetic factors |
- 30-40% unknown
- 30% alter embryonic dev - 20% environ/other mental dis) - 10% preg/perinatal prob - 5% heredity - 5% med cond in infancy (lead, malnut) - PKU (rare recessive gene) - detected by blood test - if untreat-irrevis mod-prof MR, impair mot/lang dev, erratic beh - DOWN SYNDROME-extra chrome; features(heart lesions, resp/intes defects, highr risk for Alzheimers) |
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...............ABNORMAL
CHILD DX - MENTAL RETARDATION - differential dx |
- Borderline Intellectual Functioning - IQ 71-80
- MR - if 71-75 AND deficits in adaptive functng |
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...............ABNORMAL
CHILD DX - LEARNING DISORDER - |
= achievement on test in reading, math, written substantially below (2 or more SD bet test and IQ) what is expected for age, school, IQ
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...............ABNORMAL
CHILD DX - LEARNING DISORDER - associated features |
- delay in lang or mot dev
- attention/memory deficits - low self esteem - IQ ave to above age - most freq comorbid dx=ADHD - highr risk for antisocial beh - reading prob more for boys - LD throughout adol and adult |
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...............ABNORMAL
CHILD DX - LEARNING DISORDER - etiology |
- cerebellar-vestibular dysfunctn
- incomplete dominance&hemispheric abnormalities - exposure to toxins (lead) |
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...............ABNORMAL
CHILD DX - COMMUNICATION DX - types |
- Expressive Lang Dx
- Mixed Receptive-Expressive Lang Dx - Phonological Dx - Stuttering |
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...............ABNORMAL
CHILD DX - COMMUNICATION DX - stuttering - features |
- disturbance in normal fluency & time patterning of speech
- age bet 2-7 - stop by 16 - 3x more in boys |
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...............ABNORMAL
CHILD DX - stuttering - tx |
- reduce psych stress in home
- stop reprimanding child - reduce demands - regulate breathing + awareness training + social sup = HABIT REVERSAL |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX -types and features |
Types
- Autistic - Retts - Childhood Disintegrative Dx - Asperger's Dx Features - impair in comm and social and/or - stereotyped beh |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Autistic Dx - features |
- before age 3
1 - (at least 2)-impair in SOCIAL interaction 2 - (at least 1)-impair in COMM-speech, initiate, rep use of words 3 - (at least 1)-RESTRICTED, REPETITIVE, STEREO BEH |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Autistic Dx - features |
- oblivious to others
- no eye contact - 50% mute - speech-echolalia (echo words of others); reverse of pronouns; - narrow interests - fascinated with inanimate obj - strong react to environ change - hand-flapg, rockg, sping - 70% have MR - earliest sign=lack of normal responsiveness to caregivers (no cuddling, smiling, respond to voice) |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Autistic Dx - prognosis and when best outcome |
- prognosis=poor
- 30% have partial indepndce - best outcome --> ability to comm by age 5-6 AND later onset of symptoms |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Autistic Dx - eitology |
- brain - reduced cerebellum & enlarged ventricles
- abnorml levls of norepinephrine, serotinin, dopamine - genes - 50-100x more in siblings, higher in twins |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Autistic Dx - tx |
- enhance daily living, comm, social
- reduce undesirable beh - best = beh tech - shaping; disrimination traing to improv comm |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Rett's dx |
- normal dev until 5 mos THEN
- head grow slow - loss of hand skills - dev stereotype hand mov - impair in gait or trunk mov - loss of interest in social - impaire lang and psychomotor dev - ONLY IN FEMALES |
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Childhood Disintegrative Dx |
- AFTER at least 2 years of OK, dev REGRESSION in 2 areas of functng (motor, play, social, adaptive beh, lang)
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...............ABNORMAL
CHILD DX - PERVASIVE DEV DX - Asperger's Dx |
- impair in social
- restricted beh/interests/act - NO delay in lang, self help skills, cog or interest in environ - normal IQ (but do better on verbal cog skills tests) - may mis-dx as no dx or stubborness |
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...............ABNORMAL
CHILD DX - ADHD - features |
- before age 7
- at least 6 mos impair in 2 settings and at least 6 symp of INATTENTION OR HYPERACT-IMPULSIVITY |
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...............ABNORMAL
CHILD DX - ADHD - 3 subtypes |
Predominantly Inattentive Type (>6 of this type and < of H-I)
Predominantly Hyperactivy-Impulsive Type Combined Type (6 or more of both Inattention and H-I) |
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...............ABNORMAL
CHILD DX - ADHD - associated features |
- lower IQ but intelligence ave or above ave
- poor academics-reading, LD - social prob - co-dx's - 30-90% also have Conduct Dx - 50% also have LD - others=Oppositional Defiant Dx, Anxiety Dx, Major Depression |
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...............ABNORMAL
CHILD DX - ADHD - prevalence, gender |
prevalence
- 3-7% of school-age children - 1-5% in adults gender - 4-9x more in boys - equal b/g for Predom Inatten Type - equal b/g in adulthood |
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...............ABNORMAL
CHILD DX - ADHD - continuation of this as client ages |
- 60% of child have ADHD as adult
- as client ages: - decrease in gross motor act - hyperactivity --> fidgetg; excessive talk; inner restless; overwhelmed - impulsive --> impatient, irritable; prob with time/$; reckless drive; impulsive sex - as adult - main feature = INATTENTION - adults also have - low self esteem - social prob - lower educ/job achievmnt - highr risk for bipolar dx, depression, anxiety, antisocial, sub abuse - highest risk for sub abuse in adults with ADHD = males, low SES, also have disruptive beh dx |
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...............ABNORMAL
CHILD DX - ADHD - etiology |
- genetic
- brain abnor- (a) lower activity in frontal cortex, basal ganglia (b) smaller caudate nucleus, globus pallidus, prefontal cortex |
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...............ABNORMAL
CHILD DX - ADHD - theories |
1 Behavioral Disinhibition Hypothesis (Barkley)
- sympts come in familiar, highly repetitive / structured, boring sit and when feedback not given (ADHD = inability to regulate beh to fit situational demands) 2 Alternative - ADHD due to inability to regulate attention to nonrelevant stimuli & too much focus on certain stimuli to exclusion of others |
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...............ABNORMAL
CHILD DX - ADHD - tx |
- Ritalin (Methyphenidate)- good for 75% of cases
- combo of med with psychosocial tx (contingency management, time out) - parental involvment - for long term effects |
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...............ABNORMAL
CHILD DX - Conduct Dx - features |
- persistent violate rights of others and age-app social rules
- no concern for well-being of others - blame others (little/no guilt) - hostile attribution bias - at least 3 in last 12 mos of: agg to ppl/animls; destroy property; lie/steal; serious violated rules |
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...............ABNORMAL
CHILD DX - Conduct Dx - 2 subtypes |
Childhood-onset type- < age 10 - higher agg and risk for APD and Sub-related dx
Adolescent-onset type - > age 10 |
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...............ABNORMAL
CHILD DX - Conduct Dx - etiology - MOFFIT |
Life-course-persistent type
- due to neurological impair; difficult temperament; adverse environ Adol-limted type - due to maturity gap bet bio maturatino and lack of opport for adult privileges - beh usually done with peers; inconsistent across settings |
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...............ABNORMAL
CHILD DX - Conduct Dx - tx |
- better to target preadol and involve family
- replace punishment with time out, response cost |
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...............ABNORMAL
CHILD DX - Oppositional Defiant dx |
- recurring negativistic, defiant, hostile beh to authority figures
- loses temper - argues with adults - defies/challenges rules - deliberately annoy ppl - blame others - angry/resentful - spiteful/vindictive |
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...............ABNORMAL
CHILD DX - Pica |
- eating of nonnutritive substances for at least 1 month w/o aversion to food
- onset bet 1-2 years - also in pregnant women |
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...............ABNORMAL
CHILD DX - Tic Dx |
- sudden, rapid, recurrent, stereotype mov or vocalization
- motor - eye blinking, facial grimace, jumping, smelling, echokinesis (copy other's mov) - vocal - grunting, snorting, barking, echolalia, coprolalia (swear), palilalia (repeat own sounds/words) |
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...............ABNORMAL
CHILD DX - Tourette's Dx |
- 1 vocal and multi motor tics
- before age 18 - comorbid dx = OCD, hyperactivity, impulsivity, distractability - tx = haloperidol, pimozide - good for 80% - etiology - related to excessive dopamine |
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...............ABNORMAL
CHILD DX - Enuresis |
- repeated urine
- at least 2x/week for 3 mos after age 5 - no due to medical condition - tx = night alarm (bell&pad or moisture alarm) better than IMIPRAMINE or DESMOPRESSIN in long term |
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...............ABNORMAL
CHILD DX - Separation Anxiety Dx |
- dev inapprop, excessive anxiety when sep from home or attachment figures
- at least 4 weeks BEFORE age 18 - must have at least 3 of: - excessive distress when sep - presistent fear of alone - physical complaints when sep - often come from close, warm families - precipated by major life stress - often school refusal + physical symptoms - best to send back (BUT if this seen in adolecent = most likely sign of depression or dx) |
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...............ABNORMAL
CHILD DX - Reactive Attachment Dx |
- disturbed and dev inapprop social relatedness in most sessions BEFORE age 5
- evidence of pathogenic care (neglect, freq change) - Inhibited Type = fail to initiate/respond to social, beh is inhibited, hypervigilant, ambilvalent - Disinhibited Type = indiscriminate social; lack of choice of attachment figure |
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...............ABNORMAL
CHILD DX - disclosure with medical conditions to children |
- use open comm and early in med condition
- use dev-approp lang and procedures |
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...............ABNORMAL
CHILD DX - talking about med procedures to children |
- use cog-beh tech to reduce anxiety and pain caused
- provide info on procedure - modeling, reinforcement, breathing, emotive imagery, beh rehearsal |
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...............ABNORMAL
CHILD DX - stats on children hospitalized |
- at risk for emotional/beh dx
- dx due to child's sep from family - best to increase visitation and roomg-in for families |
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...............ABNORMAL
CHILD DX - when hard to get compliance from children for medical procedures |
- lack of compliance due to
- lack of knowledge/skill - parent-child conflict - comm diff - dev issues - more in adolescents - due to concerns of peer acceptance, reduced conformity to rules, ? credibility of med staff, reduced parental supervision - |
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...............ABNORMAL
CHILD DX - types of school prob for children with medical conditions |
- more school prob
- for cancer treatments - found deficits in both neurocognitive functioning and learning disabilities |
