Vt Abnormal Child Psyc Exam 2

Front 1

a mood state characterized by strong negative emotion and bodily symptoms of tension in which an individual apprehensively anticipates future danger or misfortune

Back 1

anxiety

Front 2

is anxiety always bad?

Back 2

no, some is necessary for adjustment

Front 3

maladaptive anxiety is....

Back 3

excessive & debilitating

Front 4

three interrelated anxiety response systems are...

Back 4

1)physical system, 2)cognitive system, and 3)behavioral system

Front 5

physical system (w/in anxiety response system)- what does it control, what is it mediated by

Back 5

-controls fight/flight response, mediated by the sympathetic nervous system and endocrine system

Front 6

cognitive system (w/in anxiety response system)- what does it deal with?

Back 6

searches for potential sources of threat; attentional shift and hypervigilance, nervousness, difficulty concentrating

Front 7

behavioral system (w/in anxiety response system)- what does it deal with?

Back 7

aggression, desire to escape/avoid, other "nervous" behaviors

Front 8

present-oriented emotional reaction to current danger

Back 8

fear

Front 9

future-oriented mood state, which may occur in absence of realistic danger

Back 9

anxiety

Front 10

sudden and unexpected flight/fight response in absence of obvious danger or threat

Back 10

panic

Front 11

many fears are ____________ and most ______ with age

Back 11

-developmentally appropriate
-decline

Front 12

age-inappropriate, excessive, and disabling anxiety about being apart from parents or away from home

Back 12

separation anxiety disorder (SAD)

Front 13

earliest onset of all anxiety disorders

Back 13

separation anxiety disorder (SAD)

Front 14

separation anxiety disorder (SAD) occurs in ___ of children & has a ____ prognosis

Back 14

10%
good prognosis

Front 15

excessive, uncontrollable anxiety & worry about numerous events & activities, occurring more days than not

Back 15

Generalized anxiety disorder (GAD)

Front 16

Generalized anxiety disorder (GAD) occurs in __ to __ of children, with onset during...

Back 16

3-6%
onset: late childhood to early adolescence

Front 17

extreme, disabling fear of specific objects or situations that pose little or no danger

Back 17

specific phobia

Front 18

5 DSM-IV types of specific phobias

Back 18

1)animal
2)natural environment
3)blood-injection-injury
4)situational
5)other

Front 19

specific phobias occur in __ to ___ of children, is more common in ____ and peak onset is between ages __ and __

Back 19

2-4% of children, more common in girls, peak onset b/w ages 10 & 13

Front 20

marked, persistent fear of being the focus of attention, or doing something humiliating

Back 20

Social phobia

Front 21

Social phobias occur in __to__ of children, slightly more in ___, age of onset is:

Back 21

1-3%
girls
early to mid adolescence

Front 22

name a form of social phobia

Back 22

selective mutism

Front 23

younger children show anxiety through

Back 23

more physical complaints

Front 24

OCD occurs in __ to __ of children, is more common in ___, age of onset is __ to __ yrs and prognosis is ___

Back 24

2-3%
more common w/ boys @ younger ages then evens out
9-12 yrs
poor prognosis (no good treatments for kids yet)

Front 25

panic attacks are ___ and panic disorder is ___________

Back 25

common
much less common

Front 26

age of onset for panic disorder is __-__ yrs (__% are post-pubertal), is more common in ___ and the prognosis is ___

Back 26

15-19 yrs. 95% post-pubertal
more common in girls
worst prognosis of all anxiety disorders

Front 27

PTSD has 3 core features

Back 27

1)persistent re-experiencing of the event
2)avoidance of associated stimuli and numbing in general
3)extreme arousal

Front 28

PTSD occurs in __ of boys and __ of girls in the US and recovery depends on (3)

Back 28

3.7% of boys & 6.3% of girls
-recovery depends on:
1)pre-existing child characteristics
2)exposure to other traumatic events
3)characteristics of the post disaster recovery environment and PTSD symptoms

Front 29

cultures that favor ____ & _____ may increase levels of fear

Back 29

inhibition & compliance

Front 30

Behavior + Lens principle

Back 30

you must view disorder in context of culture to determine if it's a disorder (may be the norm)

Front 31

classical psychoanalytic theory

Back 31

anxiety and phobias are defenses against unconscious conflicts rooted in child's early upbringing (life instinct vs. death instinct)

Front 32

behavioral and learning theories

Back 32

fears and anxieties learned through classical conditioning and maintained through operant conditioning (escape and avoidance= negative reinforcement)

Front 33

attachment theory

Back 33

early insecure attachment led children to view environment as undependable, unavailable, hostile, and threatening

Front 34

behavioral style that remains stable over time & is biological in origin

Back 34

temperament

Front 35

Temperament theory- explain & relate to parents

Back 35

children born w/ low threshold for novelty and unexpected stimuli are @ greater risk for anxiety disorders (inhibited children) --> it's dependent on parental response-- those whose parents set firm limits and teach children to cope come out better

Front 36

what gene is associated w/ anxiety level? what is it a part of?

Back 36

CRH gene--> HPA-axis

Front 37

what part of anxiety is inherited? what does the form anxiety takes a function of?

Back 37

-general disposition to become anxious is inherited
-environmental influences

Front 38

what parts of brain associated with anxiety disorders? (overall system & 4 parts of it)

Back 38

-behavioral inhibition system: HPA axis, brain stem, limbic system, frontal lobe

Front 39

neurotransmitters associated w/ anxiety disorders?

Back 39

norepinephrine, GABA, neuropeptides, serotonin

Front 40

some cases of OCD develop due to

Back 40

PANDAS- pediatric autoimmune neuropsychiatric disorders and associated symptoms

Front 41

brain differences that lead to predisposition for anxiety (2)

Back 41

1) more pronounced right brain
2)an over-excitable amygdala

Front 42

right side of brain is associated with ___ behaviors, left is associated with ___ behaviors

Back 42

right-> avoidance behaviors (withdrawal)
left->approach behaviors

Front 43

family influences that lead to predisposition to anxiety

Back 43

1)excessive parental control, rejection, overprotection
2)low parental expectations for children's coping abilities
3)low SES
4)insecure early attachments (esp. ambivalent attachment)

Front 44

most effective treatment for anxiety disorders

Back 44

combined treatment- cognitive-behavioral therapy etc.

Front 45

medications can reduce symptoms, espeically for _____

Back 45

OCD

Front 46

_______ may result in more dramatic and long-lasting effects of treatment

Back 46

family interventions

Front 47

exposure to feared stimulus, often combined with relaxation (and types)

Back 47

Behavior therapy
-graded exposure
-flooding (unethical)
-systematic desensitization (graded combined w/ relaxation)

Front 48

behavioral therapy is most effective when it is _______

Back 48

in-vivo (live)

Front 49

teaches modification of maladaptive thoughts

Back 49

cognitive-behavioral therapy

Front 50

philip kendal's program

Back 50

cognitive behav. therapy-->FEAR:
-Feeling frightened?
-Expecting bad things to happen?
-Actions and attitudes to help
-Reinforce and evaluate

Front 51

participant modeling is.....and reinforced practice is....

Back 51

-show child appropriate way to act
-reinforcing every step of the way

Front 52

a boy with 2 bipolar parents has a ___ risk of developing it

Back 52

70%

Front 53

today we realize depression exists in children (as opposed to past views) however it is frequently overlooked because...

Back 53

it often co-occurs with other more visible disorders

Front 54

one of the most disabling childhood disorders

Back 54

depression

Front 55

prevalence of depression in young people is _____ and age of onset is ______

Back 55

increasing
decreasing

Front 56

the way which depression is experienced and expressed...

Back 56

changes with age

Front 57

depression in children under age ___ tends to be diffuse and less easily identified

Back 57

7

Front 58

DSM-IV criteria for major depressive disorder

Back 58

-depressed mood most of the day, most days (or irritable in kids)
-diminished interest in activities
-changes in appetite/weight
-sleep disturbances
-psychomotor retardation or agitation
-fatigue
-feeling worthless or guilty
-difficulty concentrating/thinking
-thoughts of death/suicide

Front 59

prevalence of Major Depressive disorder? more rare in....? comorbidity?

Back 59

-2-8% of children
-preschool & school aged children
-anxiety disorders, dysthymia, conduct problems, ADHD, substance abuse

Front 60

age of onset for first episode of major depressive disorder

Back 60

13-15 yrs

Front 61

participant modeling is.....and reinforced practice is....

Back 61

-show child appropriate way to act
-reinforcing every step of the way

Front 62

a boy with 2 bipolar parents has a ___ risk of developing it

Back 62

70%

Front 63

today we realize depression exists in children (as opposed to past views) however it is frequently overlooked because...

Back 63

it often co-occurs with other more visible disorders

Front 64

one of the most disabling childhood disorders

Back 64

depression

Front 65

prevalence of depression in young people is _____ and age of onset is ______

Back 65

increasing
decreasing

Front 66

the way which depression is experienced and expressed...

Back 66

changes with age

Front 67

depression in children under age ___ tends to be diffuse and less easily identified

Back 67

7

Front 68

DSM-IV criteria for major depressive disorder

Back 68

-depressed mood most of the day, most days (or irritable in kids)
-diminished interest in activities
-changes in appetite/weight
-sleep disturbances
-psychomotor retardation or agitation
-fatigue
-feeling worthless or guilty
-difficulty concentrating/thinking
-thoughts of death/suicide

Front 69

prevalence of Major Depressive disorder? more rare in....? comorbidity?

Back 69

-2-8% of children
-preschool & school aged children
-anxiety disorders, dysthymia, conduct problems, ADHD, substance abuse

Front 70

age of onset for first episode of major depressive disorder? average episode lasts? after recovery children still have...?

Back 70

-13-15 yrs
-8 months (almost all recover but recurrence is highly probable)
-adjustment and health problems and chronic stress

Front 71

major depressive disorder: males vs. females

Back 71

-no diff until puberty, after which girls are 2-3x more likely
-girls may have more symptoms that forecast later depression by age 10
-symptoms similar
-risk heightened for girls

Front 72

dyshthymic disorder

Back 72

-less severe but more chronic (at least 1 YEAR) than MDD
-less anhedonia, social w/drawal, anger, anxiety, death thtoughts, etc.

Front 73

can you have both MDD and DD? how do they relate?

Back 73

yes, called "double depression"
-DD often a precursor to MDD

Front 74

prevalence of dysthymic disorder in children? teens? most common comorbid disorder? most common age of onset? avg. episode length?

Back 74

1% children, 5% teens
MDD
11-12yrs.

Front 75

average episode length of dysthymic disorder? prognosis?

Back 75

2-5 yrs
most recover but are then @ risk for other disorders

Front 76

cognitive effects of depressive disorders

Back 76

-interference w/ academics but no apparent intellectual difficulties
-feelings of worthlessness, failure, self-criticism, etc.
-low or unstable self esteem

Front 77

social effects of depression

Back 77

-few close friends, loneliness, isolation, withdrawal
-poor relations w/ parents & siblings

Front 78

suicidal thoughts in most youth with depression with ____ to ___ actually trying

Back 78

16-30%

Front 79

psychodynamic theory of depressive disorders

Back 79

depression results from actual or symbolic loss of love object

Front 80

attachment theory of depressive disorders

Back 80

parental separation and disruption of a secure attachment bond are predisposing factors for depression

Front 81

behavioral theory of depressive disorders

Back 81

emphasis on importance of learning, environmental consequences, skills, and deficits in the onset and maintainence of depression

Front 82

cognitive theory of depressive disorders

Back 82

-depressogenic cognitions, which include:
1)internal, stable, global attribution for cause of negative events
2)negative automatic thoughts
3)negative outlook regarding oneself, world, and future (cognitive triad)
4)negative cognitive schemata

Front 83

the cognitive triad is.... and consists of:

Back 83

a cognitive theory of depression
-negative outlook of oneself, the world, and the future

Front 84

self-control theory of depressive disorders

Back 84

see depression as associated with difficulties in organizing behavior in relation to long-term goals

Front 85

interpersonal theory of depressive disorders

Back 85

disruptions in relationships as the basis for the onset and maintainence of depression

Front 86

neurobiological theory of depressive disorders

Back 86

emphasize the role of genetic vulnerabilities and neurobiological abnormalities

Front 87

socioenvironmental theory of depressive disorders

Back 87

focus on relationship b/w stressful life events and depression

Front 88

heritability range of depression

Back 88

.35-.75

Front 89

neurobiological influences on depression

Back 89

-heightened stress reactions
-frontal love, amygdala and hippocamus, HPA axis, sleep architecture, growth hormone, serotonin

Front 90

primary symptom of depressive disorders

Back 90

withdrawal/loss of interest in activities

Front 91

cognitive behavioral therapy has shown ___ long and short term success, with ___ of children responding to treatment

Back 91

most
70%

Front 92

example of CBT: kendall's taking ACTION program

Back 92

-Always find something to do to feel better
-Catch the positive
-Think of it as a problem to be solved
-Inspect the situation
-Open yourself to the positive
-Never get stuck in the negative muck

Front 93

example of CBT: primary and secondary control enhancement training (what are pri./sec. control?)

Back 93

primary control: change things you can
secondary control: accepting things you can't change & modifying thinking

Front 94

how do tricyclic antidepressents work in children?

Back 94

failure to demonstrate advantage over placebo

Front 95

how to SSRIs work in children? which is FDA approved for kids?

Back 95

-effective but increase in suicidal thoughts (tho not attempts)
-prozac

Front 96

symptoms of bipolar disorder

Back 96

over-excitement, restlessness, agitation, sleeplessness, pressured speech, flight of ideas, sexual disinhibition, inflated self esteem, reckless behavior

Front 97

subtypes of manic episode (3)

Back 97

1)manic episode: 1 week
2)mixed episode: depressive & manic moods w/in 1 week
3)hypomanic: not quite as severe as manic episode

Front 98

types of bipolar disorder (4)

Back 98

1)bipolar I: traditional, periods of manic episodes alternating w/ depressive episodes
2)bipolar II: depressive episodes and hypomanic episodes
3)cyclothymia: alternating b/w hypomanic and depressive but not full blown criteria (@ least 1 yr, never 2 months' w/out episode)
4)NOS- not otherwise specified

Front 99

prevalence of bipolar disorder- for a lifetime; in youngsters; male vs female

Back 99

.4-1.2% lifetime
rare in youngsters, milder bipolar disorders more common than bipolar I
-early onset more common in boys, but equal otherwise

Front 100

first episode of bipolar ?
what usually appears first?
prognosis?

Back 100

15-19yrs
depression occurs 1st
poor prognosis, chronic and resistant to treatment

Front 101

red flags for bipolar disorder (3)

Back 101

1)psychomotor retardation
2)rapid onset of depression
3)any psychotic features

Front 102

very few studies about causes of ___ in children; studies suggest it is a result of...

Back 102

bipolar
genetic and environmental factors

Front 103

treatment for bipolar includes (3)

Back 103

1)education- of family and patient
2)medication- usually lithium
3)psychotherapeutic interventions- to help get back on track