Psy3032 - Abnormal Psychology - Week 3A Disorders Of Childhood- Cd, Adhd, & Odd

Front 1

Define developmental disorders.

Back 1

Developmental disorders refer to those conditions that are manifested in clinically significant ways during children's developing years and are a source of concern to families and the educational system.

Front 2

What are the three areas of controversy surrounding developmental disorders?

Back 2

1. Increase in number of children being diagnosed with a disorder.
2. The growing number of children on medication.
3. The change of reference for ASD's in the DSM-%

Front 3

What are the two main conceptual level changes being made to childhood disorders in the DSM-5?

Back 3

1. Reclassification of several disorders to ASD
2. Mental Retardation in being renamed to Intellectual Development Disorder

Front 4

Which disorders are being reclassified into ASD in the DSM-5?

Back 4

Autistic disorder
Asperger's disorder
Childhood disintegrative disorder
Pervasive developmental disorder - NOS

Front 5

What change is being made to the chapter on childhood disorders in the DSM-5?

Back 5

Splitting the chapter into two chapters; Neurodevelopmental Disorders and Disruptive, Impulse Control, and Conduct Disorders

Front 6

Why is it important to assess developmental psychopathology in the context of life-span development?

Back 6

It enable clinicians to identify behaviours that are considered appropriate at one stage but disturbed at another

Front 7

What are externallising behaviours?

Back 7

Behaviours that are outward-directed such as aggressiveness, non compliance, overactivity, and impulsiveness

Front 8

What are internalising behaviours?

Back 8

Behaviours that are inward-focused experiences such as depression, social withdrawal, and anxiety.

Front 9

In a study comparing Thai children with US children what did they find about externalising behaviours and why?

Back 9

Thai kids less externalising possible due to Buddhism and the cultural aversion to aggression.

Front 10

In diagnising ADHD what does the NIH consensus statement say?

Back 10

When hyperactive behaviours are extreme for the developmental period, persistent across conditions, and linked to significant impairments in functioning, the diagnosis of ADHD may be appropriate.

Front 11

With regards to the diagnosis of ADHD in the NIH statement what things words does Clare Anderson believe are important to remember?

Back 11

Severe, persistent and problematic

Front 12

What are the three subtypes of ADHD?

Back 12

1. Predominantly Inattentive Subtype
2. Predominantly Hyperactive Type
3. Combined Typed

Front 13

What criteria must be satisfied to meet diagnosis for ADHD

Back 13

6 of either (both for combined type) inattentive or hyperactivity signs plus B, C, and E.

Front 14

In diagnosing ADHD using the DSM-IV-TR (B) at by what age must have been present? How is this changing is the DSM-5?

Back 14

In DSM-IV-TR ADHD symptoms must have been present before age 7. Age is lifted to 12 years in DSM-5.

Front 15

How is severe, persistent and problematic managed in the criteria for ADHD?

Back 15

In criteria items B, C & D that must be met.
B - onset age.
C - persistent across different conditions.
D - evidence of significant impairment in social, school or work.

Front 16

The diagnosis of ADHD should be reserved for who?

Back 16

children with truly severe and persistent cases.

Front 17

ADHD children are usually friendly and talkative but having trouble reading what in social situations?

Back 17

social cues of others

Front 18

Describer Hoze's study on ADHD children.

Back 18

A longitudinal study with a follow up every year for 6 years. Found that poor social skills, aggressive behaviour, and self-overestimation of performance in social situations all predicted problems up to 6 years later. Hoze called the interaction of these three domains a vicious cycle.

Front 19

What did Hoze mean by a vicious cycle in ADHD children?

Back 19

Poor social skills led to aggression, which in turn led to a self-overestimation of performance in social situations and a repeat of the cycle.

Front 20

Explain what the study using IM found in interactions with ADHD.

Back 20

Children with ADHD were more likely to write IM statements that were hostile and off topic than children without ADHD. Suggesting an impairment in interacting with peers.

Front 21

Which subtype of ADHD are more likely to develop conduct problems and oppositional behaviour.

Back 21

Combined type

Front 22

Children with attentional ADHD appear to have more difficulties with what?

Back 22

focused attention or speed of information processing

Front 23

What percentage of school-age children meet the criteria for ADHD?

Back 23

3 to 7%

Front 24

Why is ADHD difficult to diagnose in 4 to 5 yr old children?

Back 24

because there needs to be a measure of persistency across conditions which is difficult when children in the care of parents only

Front 25

What gender differences are commonly found in the diagnosis of ADHD?

Back 25

1. More prevalent in males
2. Males tend to show externalising behaviours where females tend to show internalising behaviours

Front 26

Which internalising disorders are commonly comorbid with ADHD?

Back 26

30-40% with depression & anxiety, and 15-30% with an intellectual disability

Front 27

Which externalising disorders are commonly comorbid with ADHD?

Back 27

Oppositional Defiant Disorder 39.9% and Conduct Disorder 14.3%

Front 28

What are some of the limitations with evidence on cross-cultural prevalence of ADHD?

Back 28

diagnostic criteria used and the cultural applicability of its use

Front 29

Why are boys more likely to be referred to assessment for ADHD than girls?

Back 29

because of the tendency for boys to display more externalising behaviours that can be aggressive and antisocial

Front 30

By adolescence girls with ADHD are more likely to have symptoms of what two other disorders than girls without ADHD? And by age 22 girls with ADHD showed higher lifetime prevalence rates for what three disorders?

Back 30

1. eating disorder and substance abuse.
2. mood disorders, anxiety disorders and substance use disorders

Front 31

What percentage of children with ADHD still meet criteria for the disorder in adolescence? What percentage in adulthood?

Back 31

Adolescence 65-80%
Adulthood 15%

Front 32

What is the current heritability estimate of ADHD?

Back 32

70-80%

Front 33

What two genes are implicated in the aetiology of ADHD?

Back 33

1. DRD4 (dopamine receptor gene)
2. DAT1 (dopamine transporter)

Front 34

Which gene has more evidence in the aetiology of ADHD?

Back 34

DRD4 (dopamine receptor gene)

Front 35

Explain epigenetics?

Back 35

the study of heritable changes in gene expression or phenotypes

Front 36

Brain structure and function differ in ADHD children in areas linked to which neurotransmitter?

Back 36

dopamine

Front 37

What have studies of brains in children with and without ADHD revealed about the about the structure of the dopaminergic areas?

Back 37

the Caudate Nucleus, Globus Pallidus, and Right Pre-frontal Cortex are smaller in size in the children with ADHD.

Front 38

Which three parts in the structure of the dopaminergic area of the brain have been found to be smaller in children with ADHD?

Back 38

1. Caudate Nucleus
2. Globus Pallidus
3. Right Pre-frontal Cortex

Front 39

Studies of brain function have found that children with ADHD exhibit less activation in frontal areas of the brain while performing what types of tasks?

Back 39

cognitive tasks and neuropsychological tests that rely on frontal lobes such as inhibiting behavioural responses

Front 40

The Caudate Nucleus and the Global Pallidus form part of what sub-cortical structure?

Back 40

Basal Ganglia

Front 41

What role does the Basal Ganglia play in relation to behaviour?

Back 41

It is responsible for the selection of appropriate behaviour and the inhibition on inappropriate behaviour.

Front 42

What neural differences are found in children with ADHD?

Back 42

They have less neural activation in the frontal areas during tasks and reduced striate activation during inhibition tasks.

Front 43

Low birth weight has been found to predict ADHD but can be mitigated by what?

Back 43

a greater amount of maternal warmth

Front 44

22% of ADHD children compared to 8% of non-ADHD children had mothers who did what in the perinatal period?

Back 44

Smoked one pack of cigarettes per day during pregnancy

Front 45

What does the evidence say about the impact of food preservatives on children with ADHD?

Back 45

there is limited evidence that food preservatives impact on behaviour of ADHD children

Front 46

What is the most commonly prescribed medication used to treat ADHD since the 1960's and what is it's common name?

Back 46

Methylphenidate, commonly known as Ritalin

Front 47

What percentage of 10 year boys in the US were taking ADHD medication in 2006?

Back 47

10%

Front 48

What behavoural improvements were found in 75% of children taking stimulant medication for ADHD? (7)

Back 48

1. Reduce disruptive behaviour
2. Improve concentration
3. Improve goal-directed activity
4. Improve classroom behaviour
5. Improve social interactions
6. Reduce aggression
7. Reduce impulsivity

Front 49

What are the four main side effects of stimulant medication for the treatment of ADHD?

Back 49

1. transient loss of appetite
2. weight loss
3. stomach pain
4. sleep problems

Front 50

The FDA issued the strongest possible safety warning on stimulant medication for the treatment of ADHD for what type of risk?

Back 50

cardiovascular risk eg heart attack

Front 51

Explain the paradoxical effect of stimulant medication on children with ADHD?

Back 51

It would stimulate behaviour in adults but has the opposite effect of children.

Front 52

Explain the participants and conditions of the Multimodal Treatment of ADHD (MTA) study of children with ADHD.

Back 52

576 children aged 7-9 years across 6 different sites for 14 montsh.
Four conditions:
1. Medication alone
2. Psychosocial treatment
3. Community standard care
4. Combined medication & Psychosocial treatment.

Front 53

What were the findings of the MTA study on children with ADHD across the 14 months period?

Back 53

The medication and combined treatment groups were superior to the community-based care group and the psychosocial treatment group.

Front 54

In the MTA study on children with ADHD what were the benefits of the combined treatment (medication and psychosocial) over the medication alone?

Back 54

The combined treatment required lower doses of medication and showed slightly superior results.

Front 55

In the MTA study on children with ADHD what was found at the 3-, 6- and 8- year follow ups?

Back 55

no significant differences between the groups

Front 56

What is the main psychological intervention for the treatment of children with ADHD?

Back 56

Parent-teacher training

Front 57

What type of conditioning is parent-teacher training based on?

Back 57

Operant conditioning - reinforcing appropriate behaviour and not challenging inappropriate behaviours

Front 58

What are some of the techniques used in parent-teacher training for chidlren with ADHD?

Back 58

1. Points system
2. Teacher understanding needs of the child
3. Peer tutoring
4. Daily report cards

Front 59

In parent-teacher training what are five changes in classroom structure can teachers implement to accommodate the limitations imposed on children with ADHD?

Back 59

1. vary the presentation and format of materials used for tasks
2. keep assignments brief and provide immediate feedback
3. have an enthusiastic and task-focused style
4. provide breaks for physical exercise
5. schedule academic work during the morning hours

Front 60

In the long term what type on intervention did the MTA study on children with ADHD provide most support for?

Back 60

Intensive behavioural interventions such as parent-teacher training

Front 61

What is the estimated percentage of children have inadequate amounts of sleep?

Back 61

30-40%

Front 62

What should children not be exposed to at bedtime?

Back 62

light, particulary from electronic devices.

Front 63

Describe Paavonene et al's study on sleep in children?

Back 63

280 children aged 7.4 to 8.8 years measuring sleep and ADHD rating scale. Findings showed that children who obtained less than 7.7 hours of sleep scored higher on hyperactivity/impulsivity, and attention deficit

Front 64

What are the three disorders that form the chapter for Disruptive, Impulse Control, and Conduct Disorders chapter of the DSM?

Back 64

1. ADHD
2. Conduct Disorder
3. Oppositional Defiant Disorder

Front 65

What is the DSM criteria for Conduct Disorder?

Back 65

1. Repetitive and persistent behaviour pattern that violates the basic rights of others, or conventional social norms indicated by 3 or more of the following over last 12 months:
a) Aggression/cruelty towards animals/other people
b) Damage to property
c) Deceitfulnees or theft
d) Serious violation of rules
2. Significant impairment in social, academic or occupational setting
3. If older than 18y, criteria for Anti-Social Personality Disorder not met

Front 66

What are the proposed changes to the criteria for Conduct Disorder

Back 66

Criteria 1 includes the requirement for at least one indicative behaviour to be present within the previous 6 months.

Front 67

What three conditions are most commonly comorbid with ODD?

Back 67

ADHD, learning disorders and communication disorders

Front 68

Explain ODD?

Back 68

Oppositional Defiant Disorder is diagnosed if a child does not meet the criteria for CD especially with regards to extreme physical aggressiveness. ODD children often exhibit such behaviours as losing their temper, arguing with adults, repeatedly refusing to comply with requests from adults, deliberately doing things to annoy others, and being angry, spiteful, touchy, or vindictive.

Front 69

What is the current controversy regarding ODD?

Back 69

There is debate as to whether ODD is distinct from CD, a precursor to it, or an earlier and milder manifestation of it.

Front 70

At what age does the incidence and prevalence of serious lawbreakingpeak?

Back 70

17 y/o

Front 71

What is the prevalence rate of CD?

Back 71

9.5%

Front 72

Explain the two different courses of Conduct Disorder?

Back 72

1. Life-course-persistent - pattern of antisocial behaviour with onset of conduct problems by age 3 and continued transgressions into adulthood.
2. Adolescence-limited - typical childhood, engage in high levels of antisocial behaviour during adolescence, and have typical non-problematic adulthoods

Front 73

What does researcher Moffitt propose that the adolescence-limited for of CD is a result of?

Back 73

a maturity gap between the adolescents physical maturation and his or her opportunity to assume adult responsibilities and obtain the rewards usually accorded such behaviour

Front 74

What is the prevalence range of CD in boys and girls?

Back 74

4-16% for boys
1.2-9% for girls

Front 75

What are the four main outcomes int he prognosis for people diagnosed with life-course-persistent CD?

Back 75

1. psychopathology
2. Lower education
3. Partner/child abuse
4. Violent behaviour

Front 76

What is the prevalence range of ODD?

Back 76

1-16%

Front 77

What is the gender difference in onset of ODD between boys and girls?

Back 77

While in pre-puberty it is mostly boys, post puberty is exclusively boys.

Front 78

What is the rate of comorbidity of OD with ADHD?

Back 78

50-65%

Front 79

What does the evidence say about genetic influences in the aetiology of CD?

Back 79

study of 3,000 twins found no evidence however Australian study of 2,600 twins found substantial genetic evidence. A meta analysis of twin and adoption studies of anti-social behaviour indicated that 40-50% of anti social behaviour was heritable.

Front 80

What did the study by Caspi et.al. examine in the exploration between genes and the environment and what were the findings?

Back 80

It studied the link between the MAOA gene and child maltreatment. The study found that MAOA alone and maltreatment alone did not predict the development of conduct disorder, however children who were both maltreated and had low MAOA activity were more likely to develop conduct disorder.

Front 81

What does MAOA stand for? And what is it?

Back 81

Monoamine Oxidase A.
It is a gene on the X chromosome that releases MAO enzyme which metabolises a number of neurotransmitters including dopamine, serotonin, and norepinephrine

Front 82

What neurological deficits are commonly found in children with CD?

Back 82

poor verbal skills, difficulty with executive functioning (the ability to anticipate, plan, use self control, and solve problems), and problems with memory.

Front 83

What had been found in IQ scores for people diagnosed with life-course-persistent CD?

Back 83

IQ scores typically 1 standard deviation below the norm

Front 84

What ANS abnormalities are associated with antisocial behaviour in adolescents? Why does this matter?

Back 84

Lower levels of resting skin conductance and heart rate. It matters because it indicates low arousal suggesting that they may not fear punishment as much and require higher levels of stimulation.

Front 85

In what three ways may imitation contribute to the development of CD?

Back 85

1. Imitate aggressive parents who physically abused them
2. Imitate TV and video game violence
3. Imitate persistent antisocial behaviour of peers whoa re seen to enjoy high-status possessions and sexual opportunities.

Front 86

In what three ways are psychological factors implicated in the aetiology of CD?

Back 86

1. Behaviour imitation
2. Reinforcement of aggressiveness
3. Social-cognitive framework of aggressive behaviour (Kenneth Dodge)

Front 87

How is aggression reinforced?

Back 87

Aggressive behaviour is rewarded through operant conditioning.

Front 88

What parenting characteristics are consistently associated with conduct problems in children?

Back 88

harsh and inconsistent discipline and lack of monitoring

Front 89

Explain Kenneth Dodge social-cognitive framework of of aggressive behaviour.

Back 89

Children interpret the ambiguous acts of others as evidence of hostile intent, they react towards others aggressively, this inturn causes aggressive retaliation from others and further angers the already aggressive child, perpetuating the vicious cycle.

Front 90

In what two broad ways can peers influence aggressive behaviour in children with CD?

Back 90

1. being rejected by peers can predict later aggressive behaviour
2. associating with other deviant peers increases the likelihood of delinquent behaviour

Front 91

What two factors predict early criminal arrests?

Back 91

1. early antisocial behaviour in the child, and
2. socioeconomic disadvantage in the family

Front 92

What are the two main approaches in the the treatment of conduct disorder?

Back 92

1. Family intervention (Parent Management Training and Family Checkup with toddlers)
2. Multisystemic Treatment

Front 93

What is FCU and what were the results of the study looking at its efficacy?

Back 93

FCU is Family CheckUp an early intervention for families with toddlers identified to be at risk of developing conduct problems. It is a brief, three session intervention to know assess, and provide feedback to parents regarding their children and parenting practices. It was associated with less disruptive behaviour compared to no treatment 3 years after the intervention.

Front 94

Explain Parent Management Training and it's approach to the treatment of CD and ODD?

Back 94

In PMT parents are taught to modify their responses to their children so that pro social rather than antisocial behaviour is consistently rewarded. It includes techniques such as positive reinforcement, time-out and loss of privileges for aggressive or antisocial behaviours.

Front 95

Explain the Multisystemic treatment juvenile offenders?

Back 95

It based on the view that conduct problems are influenced by multiple factors within the family as well as between the family and other social systems. MST emphasises individual and family strengths, social context, present focused and action-oriented interventions, and interventions that require daily or weekly efforts by family members.