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250 Cards in this Set
- Front
- Back
- 3rd side (hint)
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4 questions by parents regarding child getting tested |
1.define normal/abnormal in kid's circumstance
2.identify cause&correlations to abnormal behavior 3.predict long term outcome 4.develop&evaluate treatment/prevention method |
1.define...
2.identify... 3.predict... 4.develop&evaluate... |
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5 differences b/w kid&adolescent w a disorder |
1.kids arent self–referred.
2.identify problems require understanding of normal development 3.many problems arent abnormal 4.individual vs relational difficulty 5.intervention/treatment must go past restoring previous function |
1.kids aren't..
2.identify problems require... 3.many problems.... 4.____ vs ____ difficulty 5.interventions |
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Significance of Mental Health Problems in Kids *percent ~17. percent ~21 *funding:stats, future, who is treated *reducing financial burden |
*1/5 of Ontario kids ~17 have mental health disorder. 60% do by 21
*underfunded:20% of kids who need mental health services receive them. Demand expected to double by 2020.high treatment if behavioral *lower financial burden:mental health promotion + prevention&treatment of psychopathology |
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what is the primary purpose of labels like 'disorder'&'abnormal behaviour' *3 people they help&what they do |
1.clinician describe,summarize,organize&communicate complex features linked w behavior patterns not people.
2.parent recognize/understand kid’s problem 3.facilitate research on cause,epidemiology& treatment of specific disorders |
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H psychological disorder traditional definition *what is it associated w ********important areas of function definition |
–pattern of symptoms in important functions shown by individual
*physical *emotional *behavioral *cognitive |
important functions:
BCEP |
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Features of a disorder:definition
*Describes *balances *does not |
–describe what person does(nt) do in certain circumstance (excluding when reaction is expected/appropriate)
–balance understanding impairments w recognizing individual/situational circumstance –dont attribute cause of behavior to individual alone |
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What are the 3 features of a disorder |
1.person shows stress (fear, sadness)
2. behaviour is disability:interferes/limits activity in important areas of functioning |
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H Emergence of Social Conscience 17th century *Massachusett's stubborn child act *John Locke |
Locke:kids should be treated w kindness w education opportunities. saw them as emotionally sensitive
mid 1600s:Massachusett's stubborn child act:put kids to death for misbehaving. |
*John Locke:how kids should be seen/treated
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view on disabilities through ages:19th century *kids w mental health&educational needs described in? *kids w developmental disabilities? *blame put on? |
*kids w mental health&educational needs were described in global terms (maladjusted).
*kids w developmental disabilities termed mental defectives&caged |
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Emergence of Social Conscience 19th century leaders *Jean Marc Itard *Dorthea Dix |
*Jean Marc Itard:took Victor 'wild boy' in instead of putting him in asylum.
*Dorthea Dix:opened 32 humane mental hospitals for youth |
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view on disabilities through ages:20th century *change from 1945–1965: 2 new approaches& what they shaped |
1945-1965:institutions replaced w foster/group homes for kids w intellectual/mental disorders. New approach:shape early psychological attribution
1.psychoanalytic. 2. behavioural systematic:treat disorder in class/institution |
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Emergence of Social Conscience*late 19th, early 20th century: *Leta Hollingworth *Benjimen Rush *distinction b/w imbecile&lunatic |
Leta Hollingworth–misbehavior from poor adult treatment. led to distinction b/w imbeciles & lunatics
benjimen rush:kids incapable of insanity b/c they arent developed. *imbecile:intellectual disability *lunatic:psychiatric/mental disorders |
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H All Handicapped Act&IDEIA *What were 2 things that both wished to ensure? *What other 2 things did IDEIA also require that kids got? *What is an IEP |
1.all disabled kids get free, appropriate,least restrictive public education that meets their unique needs 2.disabled kids&parents rights are protected IDEA 1.culturally appropriate assessment 2. IEP (individualized education program) tailored to their needs&be reassessed |
1. What type of education? 4 things 2.rights are? Idea 1.what kid of assessment 2. relates to IEP |
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What 2 laws were created (in 1975&in 2004) that had a profound influence on service for kids w disabilities? *what does IDEIA stand for? |
1.IDEA:individuals w disabilities education improvement act
*also knowns as Public law 104-446 2.All Handicapped Act |
1.AHA 2.IDEA (2 other names&what it stands for) |
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ethics:5 minimum ethical standards: *what is increasing emphasis on |
1.pick treatment goal/procedure in client interest
2.make sure participations active&voluntary emphasize:kid as active partner in decision making for their medical&psychological treatment |
a)pick
b)make sure c)record/document d)protect e)ensure |
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H 10 ethical issues in clinical work w children/families |
1.gain skill to work w family,agency&system 2.boundary&role issue more prevelant&complex,monitor act/motive(3),commit to safety/wellbeing(4)&seek consultation&advise(5). *kid is more vulnerable(6),ability is variable w time(7)&rely on other/environment(8) *adult ethic principle must be modified(9)&practice/knowledge base not reliably transferable(10) |
Worker:
1.gain 2.what issue more prevelant&complex 3.monitor..., 4.commit to.... 5.seek.... (2 things) kid 6.is more... 7.ability... 8.rely on... (2) adult 9.ethic principle.... 10practice/knowledge base.... |
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Early Biological Attributions explaining abnormal behaviour: *why view emerged *How mental disorders were seen (4 things) definition of eugenics/segregation |
disease treated w success so mental illness was seen as 'disease' w biological route that was:
*progressive *irreversible *resistent to treatment *person's fault:problem's source is within them eugenics:institutionalize ppl w mental disabilities to stop procreating. |
PIRP |
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Early Psychological Attributions explaining abnormal behavior *2 focuses *concern *Define nosologies by Freud |
*focus:major psychological disorders importance&forming a illness taxonomy *concern:try to recognize&meet needs of kid/adult may lead to neglect nosologies:classify psychiatric disorders into descriptive categories |
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Early Psychological Attributions explaining abnormal behaviour:4 things it led to |
1.new diagnostic categories&criminal offences organized to differentiate, understand& control psychological problems
2.expanded deviant behavior description 3.comprehensive monitor procedures for identified ppl. |
1. new (2 things) organized to.....(3 things) 2.expanded... 3.Comprehensive |
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*Early Psychological Attributions explaining abnormal behaviour*
Psychodynamic: 1.personality&mental health outcome cause >what it depends on *changing view of child *how they gave meaning to mental disorder |
outcome:many roots.no 1 cause
*depend on interaction b/w development&situational process that change w time in unique way. >view child:shift from innocent to human struggling to control biological need for acceptance >gave meaning to 'mental disorder' by linking it to childhood experience. |
depend on interaction b/w |
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*Early Psychological Attributions explaining abnormal behaviour* Psychodynamic's *freud's belief on childf&his 'components of psyche' *what is the role of experience *what is each consciousness level associated w components of psyche |
Freud:inborn drive/predisposition effect behavior. experience play role. component of psyche: 2.ego=conscious level 3.superego=preconscious level |
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Psychodynamic: *changing view of child Frued's 5 Psychosexual stages of development *ages &focus |
1.oral–0–2
2.anal–2–3 3.phallic–3–7 (sexually aware) 4. latency–7–11 (sexual urges are quiet) 5.genital–11–adult |
OAPLG |
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Early Psychological Attributions explaining abnormal behaviour:Behaviourism
*3 big names&the name of their contribution >what is another name for the 2 types of conditioning? *who was the father of behaviorism |
for studying fears:helped w development of evidence based treatment.
1.Watson-learning theory&little albert *Father of behaviorism 2.Pavlov:classical/respondant conditioning 3.Skinner:operant conditioning=instrumental |
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Behaviourism:Watson 1. little albert description 2. new learning theory of classical condition definition *theory of emotion definition |
*little albert:11 month old orphan–scared when touch white rat b/c of noise Theory of Emotion:transference use language of conditioned emotional responses |
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Behaviorism:explain how deviant behaviours form 1.Pavlov:classical/respondant conditioning 2.Skinner:operant/instrumental conditioning *what are his 4 learning principles |
1.Pavlov:pairing neutral event w unconditioned stimuli (elicit response) cause neutral to form pair association&become conditioned.
2.Skinner:get/change behavior when learn association b/w consequence&behavior 4 learning principles:+ve/-ve reinforcement. +ve/-ve punishment |
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hallmark for abnormal child psychology: *2 points *4 assumptions |
–diversity in how kids get strength/weakness.kid/ teen disorders have no cause/effect relationship
1.many contributors to disordered outcome in individual 2.contributors vary by individual w disorder 3.individuals w same disorder express disturbance features differently 4.many interactive paths lead to particular disorder |
diversity in.... is there a cause/effect relationship b/w disorders? 1. many 2. vary by 3.ppl w same disorder 4. many... |
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adaptational failure:what it describes what it is on broadest level |
fail to master/progress to accomplish developmental milestone.
broadest level:kids w psychological disorder differ from kids on some aspect of normal development |
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Developmental Psychopathology: *what it studies *what approach it uses *2 things they look at to understand maladaptive behavior *how they organize the study (2 things) |
study:origin/course of individuals maladaptive behavior/disorder in childhood&beyond
*use integrative/multi–theoretical perspective *organize around milestone/sequence in main function&educational development. Look at: 1.maladaptive behavior vs normative for development period:intensity, frequency&duration 2.extreme/variation in developmental outcomes |
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H DevelopmentalPsychopathology: *emphasize |
*emphasize:developmental process(how they function)&task importance&role
*foster:interactive,progressive nature of kids (dis)ability understanding |
*2 things the nature of a disability is |
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Developmental Psychopathology: 3 Central Concepts |
1. abnormal development is multiply determined
2.child&environment are interdependent |
1.abnormal development... 2.child&environment 3. abnormal development involves |
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Developmental Psychopathology: 1. child&environment are interdependent * ______ view:what type of interaction b/w kid& environment contribute to the expression of a disorder? *how do they view nature&nurture *question it asks |
transactional/relational view:dynamic interaction b/w kid&environment contribute to expression
*view nature&nurture w sensitivity to individual circumstance *how can we change environment for more adaptive strategies? |
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Developmental Psychopathology: 2. abnormal development involves continuities&discontinuities |
*across time
*typical to atypical development *within same feature. |
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*discontinuity *continuity *heterotypic continuity *which is quantitative? |
*discontinuity:occur suddenly wout warning
*continuity:development change is gradual w warning&quantitative(amounts are measured numerically). *heterotypic continuity:same disorder w different expression |
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*abnormal development is multiply determined* developmental pathway definition *what they let us do (2) |
sequence,time&possible relationship b/w particular behaviors over time.
Let us: -visualize development as active,dynamic process that account for different beginning/outcome –understand (ab)normal development course/nature |
definition:____,_____&____particular behaviors over time. Let us: 1.visualize development as (2 thing process) that account for_ 2.understand.... |
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Developmental Psychopathology:3. abnormal development is multiply determined
*what does it look beyond? *what does it consider >multifinality vs equifanality |
*look beyond symptoms at context
consider:event interaction&developmental pathway contribute to particular disorder expressed
equifinality:diff. factors lead to same outcome |
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*abnormal development is multiply determined* H Causal processes/multiple causes *what knowledge do you need for causal processes? *what are the 3 causes:include description&example |
*knowledge that risk/protective factors operate at different levels (society vs individual,probable vs deterministic)&phases of disorder. 1.Predisposing:make person susceptible b4 disorder onset. ex.low self confidence 2.Precipitating:immediate event bring on disorder. ex.problem in life 3.Maintaining:disorders consequence keep it going. ex.how caregiver responds |
PPM |
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etiology: -what it studies -what it considers |
–study causes of childhood disorders
–consider how biological,psychological&environmental processes interact for outcome observed overtime |
consider:interaction b/w 3 processess |
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H Risk & Resilience*explain ongoing interaction b/w protective&risk factors (3 things) *explain what the interaction is thought of &why |
1.within kid
2. b/w kid& surroundings *thought of as processes not absolutes b/c same event can function as either type depending on context. |
1.within
2. b/w 3. among |
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Variables:give definition of each
1.Risk factor: include:what do they involve? 2. protective factor |
risk:precede&increase chance of –ve outcome. involve:acute, stressful situation&chronic adversity
Protective:personal/situational variable lower chance of disorder developing |
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Resilience: 4 abilities –type of attribute |
1.ability to develop coping skill
2. avoid –ve outcomes while at risk |
1.ability to
2. avoid 3. recover 4. sustain |
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kids/teens who show resilience in face of adversity –Masten & Coatsworth
–6 individual characteristics -3 family characteristics -4 school/community characteristics |
Individual:social/easy disposition,talents,faith *high intellect function,efficacy&self confidence/esteem
Family:close w caring figure,authoritative parent *high SES Community:extended support network, *social organization,effective school *adult outside family w interest in kid's welfare |
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Factors Affecting Mental Disorders rates&expression: Culture: *what is culture? *what disorders are not culturally sensitive? *cultural syndrome definition |
culture:values, beliefs&practices characterize particular ethnocultural group
unaffected:disorders w neurobiological basis: adhd &autism cultural syndrome:pattern of co–occuring relatively invariant symptoms associated w particular cultural group |
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Factors Affecting Mental Disorders rates&expression: *gender difference in expression of disorders (male vs female) *what age does gender difference show up/disappear? *what type of role model/caregiver help each gender w resilience |
*gender difference:not in kids under 3/over 18.
Boys externalize:act out,aggressive,delinquent behavior(autism, learning&communication&disruptive behavior disorder). >male model:structure, rule, encourage emotional expressiveness *girls internalize:somatic symptom,withdrawn behavior >female model:risk taking,independence,support |
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race difference in parental practice*european *african *latin *native *asian Family structure:egalitarian vs patriarchal Parenting type:Permissive vs Authoritarian Parenting: communal vs structural(parent as manager/teacher) *other values |
White:egalitarian, authoritarian,structural
*autonomy&individualism Black:egalitarian,authoritarian,communal *race identity, communalism *family, self&mutual respect Asian:patriarchal,authoritarian,structural *self control, social courtesy, respect for old Native:patriarchal,permissive,communal *family, sharing, harmony,humility |
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developmental cascade *sensitive period |
Developmental cascade:process–childs previous interaction&experience spread across other systems&alter development course
sensitive period:windows of time where environmental influences on development are enhanced |
cascade:what spreads across symptoms to alter course of development? |
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*competence definition *what is added for developmental competence *What a developmental task tells us >what is it an important backdrop for |
competent:can successfully adapt to environment *developmental comp.:use in/external resources developmental task:tell how kids progress typically in each broad competence domain(ex.conduct&academic achievement)as they grow. –backdrop measure developmental progress/impairment |
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normal achievements onset in following ages: *ages: 0–2:(3)
*ages: 2–5:(5) 1 other competence task for infant–preschool |
–differentiation of self&environment 0-2yo:sleep,eat, attach to caregiver 2-5yo:language,toileting, self care&control, peer relations |
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H normal achievement/competence task for middle childhood(age 6-11yo)&adolescence(age 12-20yo) *what 5 achievements change? *what 2 achievements do not change? |
1.get along become relationship w both sexes
2.self control become personal/cohesive self identity 3.compliance become separation from family 4.rule governed game become extracurriculars5.school adjustment(attendance,conduct) become successful transition to secondary school dont change:responsibility&academic achievement |
1.relationships2.self3.family4.play5.education
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List clinical disorder onset in following ages: 1. aged 0–2:(4) 2. 2–5yo:(3) 3.6-11yo:(4) 4.12-20yo:(5) |
0-2yo:ID, autism, feeding disorder
2-5yo:speech/language disorder, problem from abuse&neglect, anxiety disorder 6-11yo:adhd, learning disorder, school refusal, conduct problem 12-20yo:delinquency, suicide, alcohol abuse, schizophrenia, depression |
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List common behavior problems that onset in following: 1.aged 0–2:(3) 2.2–5yo:(5) 3.6-11yo:(2) 4.12-20yo:(2) *what age is arguing common? *what age is bragging/showing off common? |
0-2yo:stubborn, temper, toilet difficulty
2-5yo:demand attention, disobedient, fears, overactivity, resist bedtime 6-11yo:can't focus, self consciousness 12-20yo:anger outburst, risk taking *arguing:2-20 years old *brag/show off:6-20 years old |
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organization of development perspective *how does behavior evolve *what does it imply *what interaction act to direct development |
early adaptation pattern(babble) evolve w structure in time into high order function(language).
*imply active dynamic process of continual change&transformation. *unfolding biological states&environment interact to (re)direct development |
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psychological perspectives *3 things it involves *focus *what is the best formula for healthy normal adjustment/self regulation |
early relationship b/w parent&child, temperament&personality styles
*focus on role of emotions. *Formula:balance b/w emotional reactivity&control (self regulation) |
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psychological perspective:emotion/affective response/expression: 6 roles it has |
1. element of human psychological experience
2. feature of infant activity & regulation. 4. signal (ab)normal development 5.assist in fight/flight response:motivate action 6.tell us what to focus on/ignore |
1.element of:
2. feature of: 3.critical to: 4. signal: 5.assist/motivate 6.tell us |
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emotion reactivity:definition *what they give clue to |
individual difference in threshold&intensity of emotional experience give clue to level of distress&sensitivity to environment
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emotion regulation *definition *2 problems |
enhance,maintain, inhibit emotional arousal for specific purpose/goal
Problems: 1.regulation:weak/absent control structures 2.dysregulation:existing control structure operate maladaptively.may be adaptive at time &maladaptive at other |
__,____&_____emotional arousal for______ |
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H psychological perspectives:Socio–emotional development. Emotion as a psychological event (3 things) |
Arousal: physiological response
Behaviour: expressive reaction Cognition: subjective experience |
CAB |
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psychological perspectives:Temperament
*what is it *how it relates to personality *what it influences *which regulatory style is associated w better self control? |
characteristic/organized behavior style vary by person. distinct brain activity underly kid's response to new situation/environment:
*appear early in development as building block& subset of personality (broader domain) *influence development of self control:associated w fearful/inhibited approach |
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Describe dimension&3 early self regulatory styles for *easy child, *slow to warm up child *difficult child *which is associated w better self control? |
1.easy:+ve affect:approachable/adapt to environment.regulate basic function:eat,sleep,eliminate
2.slow to warm up:fearful/inhibited:cautious in new situation&distressed in some. variable self regulation/adaptability. 3.difficult:–ve affect/irritability:–ve intense mood.not adaptable&arrhythmic.distressed(esp if limitation is put on them) |
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Personality *what are they *what do they determine personality disorders set of criteria *3 for adults& kids |
*enduring(pattern of)trait characterize individual
*determine how they interact w environment 1.inner experience/behavior pattern endure&deviate from culture expectation. 2.unusual thought,feeling&behavior pattern is inflexible&pervasive in range of situation 3.result=clinically significant distress/impairment |
*enduring..... 1.inner... 2.unusual.... 3.result.... |
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personality disorders set of criteria *2 for just kids |
1.categories apply if unusual:if maladaptive trait is pervasive, persistent&unlimited to development stage/disorder
2. if ~18, features present for 1+ years. |
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Childhood disorders:
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1.defined:age inappropriateness, severity&pattern of symptoms not isolated symptoms 2.characterized:interlocking network of physical, behavioral, social&learning difficulty |
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neurobiological perspective: *what do they recognize *underlying cause of psychological disorder *what is the role of biochemical&neurohormones? |
*recognize process depend on environmental factor that direct/reroute ongoing brain process.
*cause of psychological disorder:brain&nervous system biochemical&neurohormone:availability influence brain regions.interact different to affect persons psychological experiment |
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neurobiological perspective:exam of biological influence:
*explain process of neuronal growth&differentiation/brain development >what is an axon? >what is a brain circuit? >what is a synapses? |
1.few all purpose,undifferentiated cells reach destination in brain to become neurons w axons (carry electric signals)
2.neurons that're sensitive to 1 type of nts cluster to form brain circuit (path from 1 part of brain to other) 3.axons form more synapses/connections than kid needs |
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Neural plasticity/malleability *brain maturation (3 things) *anatomical differentiation is dependent on? *roles of nature&nurture *what is pruning:when it occurs |
*maturation:organized, heirarchal process that builds on earlier function *anatomical differentiation/shape is use dependent *nature give basic process&nurture give experience needed to select adaptive connection network *Pruning:gradually reduce #of connections.continue through teens |
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brain restructuring order *what is restructured 1st *what is restructured at age 5-7 *what occurs at 9-11 (2 things) *what 4 things influence young kid's brain development |
*primative areas of brain restructure 1st
*prefrontal cortex&cerrebelluum at age 5–7 *9-11:major restructure&pubertal development 1.genetic 2.constitutional 3.neuranatomy 4.rates of maturation |
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limbic system *4 parts *what 2 things it regulates *what it plays a role in It is considered a 'primitive area of brain' >what are they >what they govern |
hippocampus,cingulate gyrus, septum, amagdala
*regulate emotional experience&expression *regulate basic drive:sex,aggression,hunger, thirst *play role in learning&impulse control primitive area:perceptual/instinctive centre govern basic sensory&motor skill. |
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genes:what are they *what they make *what they influence explain gene–environment interaction/epigenetic mechanism |
*stretch of DNA w genetic info from each parent along 22 matched&1 sex pairs of chromosomes.
*make proteins for brain function *influence how we respond to environment GXE:environmental factors (toxin, diet, stress) cause underlying biological change in genetic structure.*environment turns genes on&off. |
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behavioural genetics: *what it investigates *what it accounts for 2 studies:what they compare *names&describe what both compare |
investigate possible link b/w genetic predisposition&observed behavior:account for environment/genetic influence.
*study:compare disorder characteristics/trait cluster b/w 2 groups 1.familial aggregation:nonrandom in family vs random distribution in general pop.cant control for environment. 2.twin:monozygotic vs fraternal/dizygotic twins to control genetic factor contribution |
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molecular genetics *supports *Searches for *research method role *goal *potential |
support gene influence kid's psychopathology
*methods directly assess link b/w variations in DNA sequence&in particular trait(s). *look for specific genes for childhood disorders. *goal:find how genetic mutations in genes causally influence form of psychology&alter how genes function in brain/behavior development for different psychopathologies. *potential to enhance understanding of a disorder&its specific components. |
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neurotransmitters *similar to *how it organizes *what increases/decreases their flow |
*similar to biochemcal currents in brain.
*organize to make meaningful connection for large function (thought/feeling). *psychoactive drug increase/decrease their flow |
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benzodiazepine–gaba:nts normal function linked |
*function:reduce arousal&moderate emotional response(angry,hostility&aggression).
link to discomfort. |
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NTS
*normal function *linked 2.norepinephrine 3. serotonin |
1.dopamine:turn on brain circuit for other nts to inhibit/facilitate emotion/behavior
*exploratory,extrovert&pleasure seeking activity 2.norepinephrine:control emergency reaction/ alarm response. *regulate/moderate behavior tendency/emotion 3.serotonin:inhibit tendency to explore,moderate /regulate critical behavior(sleep,anger,hunger: feeling full)link:info&motor coordination |
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implicated role in psychopathology 1.dopamine:1 2.gaba:1 3.serotonin:2 4.norepinephrine *which 2 relate to mood disorders&schizophrenia |
1.dopamine:ADHD 2.gaba:anxiety disorder 3.serotonin:regulatory problems (eat&sleep disorders),OCD 4.norepinephrine:not directly involved w specific disorders *mood disorder&schizophrenia:serotonin&dopamine |
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cerebral cortex *what it is *what it allows us to do (3) *2 things it consists of |
*biggest part of forebrain.
*gives us human qualities *allow us toplan, reason&create. 1.left hemisphere for verbal&cognition. 2.right for social perception. |
*include what each hemisphere does |
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H endocrine regulatory system *what its linked to *3 glands&what they do |
linked to anxiety&mood disorders.
1.Adrenal:produce epinephrine/adrenaline to energize body in response to threat 2.thyroid produce thyroxine for energy motabolism&growth 3.pituitary:regulatehormones like estrogen&testosterone. |
A T P |
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HPA:hypothalamic pituitary adrenal axis
*What is it? * stages:3 *cortisol definition |
*central component to brain's neuroendocrine response tostress.
1.CRH stimulatepituitary to release ACTH 2.ACTH stimulate adrenal gland to produceepinephrine&cortisol. Cortisol:stress regulating hormone backs up emotions |
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hindbrain:what it consists of(3) *what it regulates (3 examples) *cerebellum definition |
*medulla,pons, cerebellum
*regulate autonomic activities like breathing, heartbeat&digestion. cerebellum: center for motor skills |
regulate______ activities like ___,____&___ |
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family, social, cultural perspective: understanding context requires *define proximal&distal |
proximal (close by)&distal (further removed)events&those that impinge directly on child in particular situation/time
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*____&___ events&____ |
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family, social, cultural perspective: environment influences:define shared vs nonshared
*how do you calculate shared/nonshared environment influences |
1.shared:developmental outcomes similarity among siblings in same family.
*estimate indirectly from correlations b/w twins: heritability estimate-mz correlation 2.nonshared:siblings behavioral difference *1-mz twin correlation. contribute to large portion of variation |
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attachment theory *how instinctive behaviours are formed *how are they organized (2 things) |
instinctive behaviors from learning&corrected feedback not rigidly predetermined.
*organize in flexible,goal oriented systems |
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attachment theory:Bowlby
1.infant caregiver relationship *what is the internal working model of relationships *when does the emotional bond start? *what does it help kids do *what kids are motivated to do *what are the behaviours infants&adults are equipped/preadapted with |
*help kid regulate behavior/emotion in stress condition. *motivated to balance desire to preserve familiarity&desire to seek&explore new info internal WM:1st step:what they expect/how they relate w other bond starts b/w .5-1years
*baby:relationship enhance behavior to survive *adult:attachment promote behavior.respond to kid needs |
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Ainsworth strange paradigm attachment styles
Secure description in strange situation: possible influence on relationships |
readily separate from caregiver&explore.wary of stranger/distressed by separation: seek contact&proximity w caregiver then explore relationships:seek&make effective use of supportive relationships disordered outcome:relationship strategy protect from disorder from psychological distress |
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Insecure: anxious / avoidant: description in strange situation possible influence on relationships |
description:explore wout affective interaction w caregiver.wary of stranger&upset only if alone.stress increase avoidance relationship:mask emotional expression.untrusting.believe they're vulnerable |
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Insecure: anxious / resistant: description in strange situation possible influence on relationships |
disinterest/resistant to explore.wary of new ppl.cant settle if reunite w caregiver.mix active contact seeking w crying/fussiness relationships:cant manage anxiety. exaggerate emotions&maintain –ve belief on self |
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Disorganized / disoriented: description in strange situation possible influence on relationships |
no coherent attachment strategy/ consistent pattern regulate emotion in new situation relationship:cant form close attachment, indiscriminate friendliness (selective attachment |
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family system focus *difficulty *compatibility |
difficult to understand/predict behavior of family member in isolation from others.
*abnormal development relationships not individuals are focus. *compatible w developmental process not other views |
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H core story of development:7 things |
1.development=community/economic development foundation.kids=society foundation
2.brain architecture constructed w ongoing process.quality=sturdy/fragile capability/behavior foundation 3.brains built hierarchical from bottom up.simple circuit skills are built on 4.GXE interaction shape brain circuitry.return process is fundamental to brain wiring.kids interact w adults who are (un)responsive 5.cognitive, emotional&social capacity intertwined. learning behavior&physical/mental health interrelated over life course 6.manageable stress levels are normative&promote growth. toxic levels in early years damage brain architexture&cause problems later 7.brain plasticity&change behavior decrease w time |
1.development=foundation for
2.brain architecture 3.brains built in 4. interaction of gene/experience shapes 5.___,_____&____ capacities are intertwined. 6.manageable levels of stress are _____ toxic levels _____ 7.brain plasticity&ability to change behavior_____ |
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behavioral/cognitive influence *emphasize *what they are based on *difference *cognitive behavioral model |
emphasize learning/cognition principles which shape kids behavior&interpretation of things around them.
*based on classical/operant conditioning *CBM:cognitions, behaviour&mood interact in event/schema |
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behavioral influence methods *focus *when kid is best understood/described *what they reject |
focus on observable behavior:pragmatic parsimonious explanation for particular problem behavior.
*kid is best understood by behavior in particular situation not traits. |
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behavioral influence:applied behaviour analasysis:ABA
*based on *examines relationship b/w (5 things) *dual learning explanation for undesirable behavior *controlling variables:what don't they assume |
based on 4 operant learning principles. *describe&test functional relationship b/w stimuli, response&ABC *no implicit assumption on knowledge of origin(underlying need/motive) from changing problem behavior. dual learning explanation:more than 1 learning paradigm/causes occur at same time |
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H cognitive influence Emphasis on (7 processess) *interest *consider |
*Emphasis perception, attention, memory, attitudes, beliefs, judgement&thought process.
*interest:how certain thought patterns develop w time&relate to particular behavior strategies. |
Emphasis:PAMABJT Interest:how..... develop....&.... |
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cognitive influence:Social learning theory *associated person *3 ways behavior is learned *what 2 things influence behavior? Vicarious/observational learning definition |
bandura:consider overt behavior/cognitive mediators that influence behavior (in)directly
*behavior is learned by operant&classical condition&vicarious learning vicarious learning:role of social cognition on getting (un)desirable behavior |
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*social cognition definition:what are they *what they form (3 things) |
how kids think about themselves&others formmental representation of self,relationships&social worlds.
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DSM–5:Diagnostic&Statistical Manual *3 changes |
1.nonaxial system
2.more specifiers added. |
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DSM–5–history:multiaxial system consisting of 5 axes (DSM–IV–TR) >what are the axis for |
*way to describe disorders 1.clinical disorders2.personality disorders&mental retardation 5.global assessment of functioning (GAF) |
1.c
2.p&m 3. g 4. p&e 5.g |
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H
DSM–5 criticisms:4 |
–dont capture complex adaptation,transaction&situational/contextual influence to understand&treat kid/comorbidity among many childhood disorders
–less focus to kids disorders –sometimes improperly used:culture/sex bias –define disorder based on observable signs&fail to map underlying cause |
-dont capture 4 things
-dont focus on? -sometimes.... -what they define disorder based on |
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DSM–5:history–where it began *ICD-6 *DSM 1 |
1. international classification of disease:ICD–6 added mental disorder section in 1948
2.1952:american psychiatric association developed DSM–1. |
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H DSM–5 history:DSM–3&DSM–3–R (3 changes) *categorization of child disorders in DSM 1&2 |
1980–1987:
*discard psychodynamic assumption of ideology *approached based on signs/symptoms. *less focus on child alone&more on surroundings **most child disorders put in adult categories in 1st 2. |
*discarded...
*approach based on... *less focus on...&more on.... |
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DSM–5:specifiers:4 things they are used for H |
1.describe homogenous subgrouping of individuals w disorder who share particular features.
2.communicate info relevant to treatment. 3. rate disorder subtypes, cooccuring conditions, course&severity. |
1.describe...
2.communicate ... 3. rate....(4 things) 4. note.... |
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DSM–5:other considerations *culture H |
*consider environment/psychosocial problem that affect diagnosis,treatment&prognosis.
culture:framework form formula of kid disorder based on family's cultural identity, concept of distress,psychological stressors,vulnerability&resilence&aspects b/w relationship of kid, parent&clinician&treatment |
*consider how___&____ affect 3 things
*what cultural framework does |
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normative info *what are they (3 things) *why are they crucial *where does the biggest consideration go? |
*knowledge, experience&basic info on norms of development&behavior problems crucial to understanding how kids problem/need come to attention of professionals
*biggest consideration is placed on symptoms that impair function |
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H
Research domain criteria:RDoC launched by national institute of mental health: *goal on how they classify mental disorders *how they define various domains of functioning *what are the units of analysis for functional domains (4 levels) |
classify based on biological origins&research findings for function domains that map onto underlying disorder pathophysiology *define function domains in specific constructs that have units of analysis at genetic, molecular, neural&behavioral level |
GMNB |
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Interventions *what it encompasses *what it is directed at |
broad concept encompass theory&practice directed at helping kid&family adapt more effectivey to their current&future circumstance
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intervention:problem–solving strategies involve: *include definition *what is their relationship? |
1.treat current problem:correct action for adaptation success.reduce undesired outcome impact
2.maintain treatment effect:effort increase treatment adherence w time.stop relapse 3.prevent future problems. |
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outcomes of treatment goals *crucial to child functioning (3) *societal importance (6) |
child:less impaired symptoms.more social competence&academics
family:less dysfunction,stress&care burden.more support,marital/sibling relation&life quality society:better mental/physical health&school (less truancy, dropouts&more attendance) participation, less juvenile justice system, special service, accidental injury&substance abuse. |
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multidisciplinary/eclectic approach: *what is it? *who/when is it used *define combined treatment |
*more than 70% of clinicians take draw from #of diff types of intervention.experts work together for complete picture *combined treatment:use of 2+ interventions. |
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approaches to treatment:behavioral approaches *emphasize *assume *based on |
emphasizes re–education w behavior principle.assume abnormal behaviors are learned
*based on operent& classical conditioning principle(modify undesirable&shape desirable) *Examples:Token economy (set up contigency. give token/reinforce +ve behavior), parent management training |
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approaches to treatment:cognitive treatment *when does behavior change H |
abnormal behavior from though deficit/distortion:perceptual bias, irrational belief&faulty interpretation.
*behavior change w cognition |
3 things that constitute thought deficit
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approaches to treatment:Structural Family Therapy (Minuchin):boundary problems:enmeshment vs isolation
*who is the problem |
isolation:noone knows what happens w each other
enmeshment:each family member's problems are too close *parents more problem then child |
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approaches to treatment:3 Boundary problems: H |
1. Detouring:isolation b/w parents
2.Stable coalition:enmeshment b/w parent&1 kid. 1 parent is isolated 3. Triangulation:parents try to bring kid onto their side |
D....
S... T... |
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approaches to treatment:cognitive behavioural therapy:how they help kids:5 things H |
*teach kid to
1.use cognitive&behavior coping strategies in specific situation 2.learn to regulate behavior 3.detect when emotional experience occurs 4.what goes on in thought 5.what can they do/award self. |
1.____strategies
2. learn 3.detect 4.what goes on 5.what they |
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approaches to treatment:cognitive behavioral therapy: *what they understand *targets of change *goal H |
*understand connection b/w thought&behavior.
*target of change:faulty thought patterns:distorted content (erroneous belief)&cognitive process (irrational thought&problem solving). *goal:identify&replace maladaptive cognition w adaptive ones. |
*what are the 2 fault thought problems?
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approaches to treatment:client centered:what causes the disorder(+other effects) how they relate to child *what do they respect H |
*social/environment circumstance imposed on kid interfere w basic capacity for growth&adaptive function cause kid to experience loss/impaired self esteem&emotional wellbeing *relate to kid in empethetic way w unconditional, unjudgemental&genuine acceptance. respect kids capacitiy to achieve goal wout them having major role |
*social/environment circumstance interfere w 2 things to cause 2 things.
*relate to kid w 4 things: 1.un 2.un 3.gen 4.emp |
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approaches to treatment:neurobiological treatment: what is child psychopathology from? *2 things they rely on |
child psychopathology from neurobiological impairment&rely on pharmacological&biological approaches for treatment.
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approaches to treatment:psychodynamic treatment approaches *focus *include 2 methods |
focus:developing underlying unconscious/internal&conscious conflicts awareness
*sand tray to see whats going on in their world. *play help externalize therapy. can use cbt play therapy too. not technically psychodynamic |
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Models of Delivery: 1.conventional care model *how is kid seen, how common is it? 2.continuing care model+2 types:when/how is kid seen for each 3.Family model:what is focus to modify 4.final model type |
1.conventional care:kid seen individually by therapist for limited # of sessions.most common
2.continuing care model:a)dental care:each week b)chronic care:regular treat chronic condition 3.family model:focus on family issue underlying problem behavior. modify family dynamics |
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Treatment Effectiveness:best practice guidelines *what are they *what do they assist in? *'dodo bird verdict':description, where its from |
systematically developed statements assist practitioner&patient pick appropriate effective treatment for clinical condition.
**dodo bird verdict:all treatment has common underlining benefit. from alice in wonderland |
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H Treatment Effectiveness:scientific approach:*treatment scientific approach *what it involves (3 things) *how its evaluated What is expert consensus? what is good research (3 things) |
involve: >scientific evidence/research standards:empirically support(EST)&evidence–based [EBT] >clinical expertise consensus:use opinions of experts to fill in gaps. >consumer choice&culture. *evaluate on large scale: 1.randomize controlled trial-w specific pop. 3.2 independent research settings |
>What is EST&What is EBT 1.ran 2.tre 3.2 in |
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H new directions/initiatives:directed towards children's mental health *goal >3 new directions |
goal: translate evidence based practice to real world to reduce cost of kids mental health issues at individual&societal level
1.increase need recognition 2.develop larger range of service delivery models 3.broaden frame/delivery of multiple disciplines, systems&coordination for assessment/intervention |
1.increase2.develop3.broaden
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new directions:develop larger range of child mental health service delivery models based on: 5 things H |
a)use of new technologies
b)non traditional service providers c)self help interventions d)the media e) special settings where youth in need of mental health service are present |
a)use ofb)nonc)selfd)thee) special
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treatment(&assessment) planning *what treatments are determined/recommended (3 things) *what is combined *what do you use assessment info for *what may you need&why |
*combine most effective approach to particular issue w ongoing development sensitive manner
*use assessment info to generate treatment plan&evaluate its effectiveness. *may need further specification/measurement of possible contributors,resources/motive for change *determine&recommend treatments likely to be feasible, acceptable&effective for kid&family. |
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treatment planning:cultural compatibility hypothesis
*when treatment is most effective *issue w generalization *what must clinician recognize while negotiating assessment&treeatment plan |
*treatment effective if compatible w cultural family pattern. *clinician must recognize family's cultural context wout community generalization(don't capture regional, generational, ses &lifestyle difference). |
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The Decision Making Process classification:definition 2 strategies/case formation to determine plan for individual *cons to 1st strategy H |
*system for child psychopathology:major categories/dimensions,boundaries&relations
1.idiographic:detail family/kid as unique individual entity:what experience,circumstance,personality,culture&factor lead to it?con:no research/direction into cause/treatment 2.nomothermatic:general inference on broad group.classify on existing scale like dsm–5 |
system for....:looks at 3 things
*Idiot&no |
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classification:
1.Categorical (discrete dimensions): *what it assumes *example *2 benefits 2.Dimensional(continuim): *what it assumes *2 benefits *3 limits |
1.categorical:diagnoses has clear underlying cause (from informed professional consensus)so individuals can be categorized.ex. DSM-5 *pro:dominate psychopathology field.is practical 2.dimensional:many independent behavior trait /dimensions exist&all kids have varying degrees. *pro:more objective&reliable *limit:hard to integrate informant's info. -depend on sample,method,informant/kid traits -insensitive to contextual difference. |
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H 8 common identified dimensions of child psychopathology: |
1.social prob:dependent,dont get along, teased
2.thought prob:hear/see stuff,odd behavior/idea 3.attention problem:can't focus/sit still, confused 4.rule break behave:no guilt,bad pal,lie,run away 5.aggressive behave:argue,attack ppl,break stuff 6.anxious D:cry,worry,worthless, nervous, tense 7.withdrawn/depressed:loner,refuse to talk, secretive, shy, timid 8.somatic symptoms:dizzy, overtired, aches |
1.social
2.thought 3.attention 4.rule 5.aggressive 6.anxious 7.withdrawn 8.somatic |
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checklist/rating scale:
2 benefits con:1 con w 3 causes *what can be done to fix con H: Pro:standardization&administer/score Con: validity 1.kid 2.1+inf. 3.scale |
1.standardize w wide reference group:kid’s behavior compared to normative sample.
2.economical to administer&score. *validity depend on informant credibility.observer differ in view:use many:teacher,parent&kid 1.kid change behavior based on situation/set, 2.1+inf. isn't reliable/has diff reporting style. 3.problem w scale:inf. have no comparison:hard to answer about internal states |
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what is a test?
*inter vs intraindividual comparison |
test:task/set of tasks given under standard conditions w purpose of assessing aspect of child's knowledge, skill/personality.
inter–how they do compared to other kids. intra–how they do in diff situations |
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Checklists used to assess behavior:
what each does 2.child behavior checklist:what its used for 3.brief problem checklist |
GBC:adjustment report rate behavior presence, frequency&intensity
CBCL:make profile/picture of behavior problem variety/degree for clinician BPC:assess ongoing progress in small # of important problems family identified&consider modifying treatment. |
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child behavior checklist:CBCL: *who invented it *its status:validity, reliability, who/country its done *where its done/by whom |
CBCL:thomas achenback.leading checklist:reliable&valid.
*used in treatment setting&schools. *1 by parent.other by combo *assess behavior problems in kids aged 6-18 in 80+different cultural groups. |
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brief problem checklist: *what its based on *who does it *what is the format *2 benefits |
based on CBCL scale given to kid&caregiver in rating scale/interview format.
*practical&cost effective |
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behavior observation/recording: *what kids is it done for? *when is direct clinician observations a valid&beneficial step for decision making process?3 things regarding family |
>for kids not old/skilled enough to report on their own.
>clinician observes if family is: 1.unmotivated 2.voluntarily seek assistance 3.understand whats needed for assessment/ treatment plan. |
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H
Behavioral Assessment:direct observation by clinician *3 steps *main goal *what it must account for |
1.evaluate kid's thought,feeling&behavior in specific set
2.record baseline data&identify target behavior(1-2 primary problem of concern) 3.hyp. treatment *goal:determine what factor influence behavior *account for:distorted finding:informant,kid& problem nature,family/cultural context |
1.evaluate2.record 3.hyp
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behavior observation/recording real life setting *Primary&secondary benefits (5) Role play simulation:when its used H |
*give ongoing behavior info in life settings
1.teach parent observation skills 2.assess parental motivation 3.give parent real estimate of kids response rate 4. give parent feedback on treatment effect *role play:see how kid/family act in daily(home,school)&problem solving situation. |
1.teach 2.assess 3.give 4. give5.give
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Behavioral Assessment/test:4 types H |
–developmental testing –personality test |
DPPN
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developmental testing *when its used *definition of screening |
used to assess infants&young kids for screening, diagnosis&evaluation of early development.
screening:identify kids at risk to refer them for thorough evaluation more frequently |
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behavior analysis/functional analysis of behavior *what general approach does *What A,B,C stand for *how behaviours occur *what it identifies *how is a hypothesis tested |
*organize/use behavior assessment info on kids behavior from many sets
1.A=antecedents/events that precede behavior. 2.B=behavior of interest 3.C=consequence/events that follow behavior *behavior occur in sequence:b&c may repeat after a *identify range of factors as A&C possibly contributing to B.test hypothesis by changing A&C to see if B change. |
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Personality Testing
*big 5 assessment *2 commonly used techniques |
*Big 5 Factors:timid–bold, (dis)agreeable,(un)defendable, tense–relaxed, reflective–unreflective, Various techniques:
1. minnesota multiphasic personality inventory–adolescent:MMPI–A 2.personality inventory for children second edition:PIC–2 |
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9 self report personality scale definitions: H |
1.anxiety:nervous, worry, fear&overwhelmed
2.attitude to school:alienated,hostile,unsatisfied 3....teacher:resent/dislike teacher(unfair,uncare& demand).4.atypicality:bizarre thought&behaviors 5.depression:sad&dejection:nothing goes right 6.interpersonal relation:see peer social relation 7.relation w parent:+ve regard.feel esteemed 8.control locus:external event/ppl control reward /punish 9. self esteem:self acceptance |
1.a2.attitude to 2 things4.at5.de6.int7.rel8.co9. s
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–IQ/educational test: *central to &what it identifies/does *index of WISC-IV:what is it&who administers it *what it used to focus on *what attention is now on |
*central in clinical assessment for wide range of childhood disorders:identify kids (in clinical set)w trouble in regular class to plan for intervention
WISC–IV:10 mandatory& 5 suppliment individually administered tests. *past emphasized fluid/high order reasoning& info processing speed. now attention on culture. |
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4 Indexes of WISC–IV:names *canle&lamp sample questions of 1. vocab 2.verbal comprehension 3. info |
Verbal Comprehension (VCI)
Perceptual Reasoning (PRI) Working Memory (WM) Processing Speed (PSI) 1.vocab:what does apprehensive mean 2. comprehension:why do we wear shoes 3.info:whats capital of france |
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projective test: hypothesis *inkblot test *thematic picture test *2 views |
*hyp:kid project personality(need,unconscious fear&inner conflict)onto stimuli.1.inkblot:ask kid to describe what they see in ambiguous stimuli 2.thematic picture:ask kid to tell story/respond to image of kid in daily sit. w parent,peer, alone >>its info source on coping style,affect,self concept, interpersonal function&way of processing >>its inadequate w meeting standards for reliability/validity |
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Neuropsychological Testing: *premise *what it tries to do *how it uses clinical info:5 things &what it consists of H |
*try to link brain function w objective measure of behavior known to depend on intact CNS. *premise:behavioral measure is used to infer cns&dynamic dysfunction consequence for kid.
*use info clinically to determine diagnosis, plan treatment,document course of recovery,measure subtle sig. improvements&preform followup care. consist of comprehensive batteries |
Tries to link....
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Neuropsychological Testing:5 comprehensive batteries/functions *include examples H |
1.psychological:verbal, nonverbal
2.cognitive:language, abstractreason&problem solving 4.kinesthetic motor:strength, speed, coordination&dexterity |
1.psy
2.co 3.per 4.kin 5.em/ex |
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diagnosis *2 meanings |
1.formally assign cases to specific category from classification system like dsm–5/empirically derived trait/dimension 2. problem solving analysis is broader&similar to clinical assessment.process to gather info to understand individuals problem nature&potential cause, treatment&outcome |
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diagnosis:clinical description: *1st step to understand child's problem *find (4 things) *convey? H |
1st step:summarize unique behavior,thought& feeling that are psychological disorder features
*convey picture of different symptoms&their configuration. find: 1.basic info of kid/parent concern at presentation 2.assess intensity, frequency&severity to sense how excessive/defiant behavior is 3.appraise behavior/emotion differ from other 4. age of onset&duration of difficulties |
find:
1.basic 2.assess 3.appraise 4. ____&___of difficulties |
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Prognosis:
*what it involves *what clinicians decide |
involve:generate future behavior predictions under specified conditions.
*clinicians must weigh probability that circumstances will stay same, improve/deteriorate w(out) treatment&what treatment should be used |
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8 Principles of Psychological Assessment (Cates, 1999) H |
1.Art rests on science. 2.Info is power
*assessment is snapshot not film(3),appropriate if tailored to clients needs&referral source(4), 5.interpretation beyond past description 6.integration not data accumulation *psychologist is: 7.responsible to client,not computer 8.projected in report wout apology |
1.Art rests
2.Info is *Assessment is (4 things) *psychologist is (2 things) |
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psychological tests *how its normed/standardized *relationship w assessment? *what does purpose depend on |
*normed on narrow limited sample¬ be appropriate to use w ppl outside norm.
*Standardized conditions that consistent for all test–takers *Testing ≠Assessment. *Purposes depend on referral question. |
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Clinical Interviews: *popularity *2 things it does *what they want from kid |
*most universally used assessment procedure.
1.gets basic info from ppl close to kid. 2.set stage for collaboration/cooperation w family:done separate w kid&parent/family interview for good working relationship. *want kids opinion,info on their self/others perception&how they respond to others in social situation |
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Clinical Interviews:
*unstructured *structured >description&cons |
unstructure:informal/flexible:pick format&knowledge to get picture w minimal guidance.clinical hyp. source.bias&unreliable.
semistructured:specific questions elicit info consistently regardless of interviewer(computer for old,puppet for young). ensure important disorder aspects are covered.rigid interview/no spontaneity may lose coverage. |
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Potential interview problems 1.halo effect 2.confirmatory bias 3.fundamental attribution error *professional jargon H |
1.Halo effect:assume other characteristics are similar to ones they convey.
2.Confirmatory b:interpret evidence to favor your belief 3.fundamental attribution bias:explain behavior by internal trait not situation determents *avoid professional jargon |
1.Halo effect:assume
2.Confirmatory b:interpret 3.fundamental attribution bias:explain |
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assessing disorders:big decision making process. approach used(2) *what does it do/decide best case based on (3 things) |
multidisciplinary&method:get info from different informants in variety of set&methods:interview,observation,test&questionnaire.
*decide case based on:if assessment for diagnosis, treatment planning&observation is internal/external, family characteristic, cost |
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decision making process:assessment *Clinical/initial assessment:what is it&what does it seek to understand *what guides assessments *what it includes *what is it used in accordance w (4) *what is a comprehensive assessment H |
*systematic problem solve strategy/procedures understand family,school environment&kid (thought,feeling&behavior in specific situation). *guide by:1+purposes *comprehensive:evaluate kid strength/weakness. other assessment not done if some functions arent a problem *use in accordance:behavioral assessment, checklist, rating&psychological scale |
__________strategy/procedures understand___._____&___*include 3 things about kid
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9 development/family history:steps H |
kids birth&related events(1),developmental milestones(2), medical history (3), interpersonal skills (4)&educational history(5)
6.adolescents work history&relationships 7. presenting problem description 8.parents expectation for kids assessment/treatment 9.family characteristics&history |
*5 relate to child
*1 to adolescent *2 family |
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Wakefield(1992, 1999): “harmful dysfunction” *harmful definition *dysfunctional definition *why harmful is considered social |
Harmful:Causes harm/deprivation of benefit to kid, as judged by social norms
*social b/c it varies by culture Dysfunction:Results from failure of some internal mechanism to perform natural function |
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pediatric health related disorders: *what it is *2 things it covers H |
*distinct area of specialization
*stress interaction b/w physical&mental health 1.any adjustment problems directly linked to impact of physical illness 2.wide range of concerns from minor (ex. enuresis, encopresis) to chronic (cancer,diabetes) illnesses. |
1.any.....
2. wide range of.... |
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explain early distinction b/w disorders caused by psychological factors& physical factors *why this is no longer used H |
psychosomatic/psychophysiological:psychological/social factors affected somatic/physical function
*no longer used b/c it implies physical symptoms are caused by mental issue |
define psychosomatic/psychophysiological
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normative sleep requirements:
newborns:0–2months |
newborns:12–18 hours
infants:14–15 hours |
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sleep functions: brain development at 2yo example |
sleep=primary brain function of young child.
2yo's brain reaches 90% of adult size&kid attains complexity in cognitive skill, language, concept of self, socioemotional development &physical skills |
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Why babies sleep more |
babies sleep more b/c needs are met by caregiver.adults favour arousal, which is adaptive&necessary
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Regulatory function of sleep *what 4 things intertwine in dynamic regulatory system. *explain CNS role in wake *what happens in sleep &what is uncoupling? *regulation has little do w 2 psychological processes (list them):why? |
sleep, arousal,attention&affect intertwine in dynamic regulatory system.
*CNS increase arousal to respond to danger *sleep:CNS takes break, system recovers:specific sleep stages produce active uncoupling/disconnection of neurobehavioral systems. lack of awareness show regulation has little to do w psychological processes(emotions& behavior). |
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prefrontal cortex:4 things it does *what is it H |
brain's executive control center
*processes emotional signals *governs planning&decision making |
*processes
*makes *integrates *governs |
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prefrontal cortex:sleep deprivation effect: 3 symptoms *what is the 1st function lost from sleep deprivation relating to prefrontal cortex H |
*decreased focus
*decreased ability to inhibit/control basic drives:emotions/impulses 1st function lost:complex tasks that integrate cognitive, emotional&social input rapidly&accurately |
*decreased
*decreased *emotion *1st function lost:complex tasks that involve |
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sleep/wake disorder&elimantion disorder: *original believed cause *known cause (2 things) *how they are classified |
*poorly understood physical symptoms misattributed to psychological cause. kids blamed for inherent stubborness&laziness.
*cause:from abnormality in body's ability to regulate sleep–wake mechanisms *timing of sleep *10 disorders in diagnostic manual. 2 categories:dyssomnias& parasomniassomnias |
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explain bidirectional relationship b/w sleep deprivation (sleep/wake disorders)&disorders *what it can cause/be caused by *what it mimics/worsens |
*can cause other psychological problems(emotional/behavioral)
*can result from disorders/conditions(common factor in disorders) |
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diagnostic for sleep related disorders emphasize H |
1. presence of clinically significant stress/impairment in social, occupational/other area of functioning
2. sleep disturbance not accounted for by another mental disorder, direct physiological effect of substance/a general medical condition |
1. presence of
2. sleep disturbance not |
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Dyssomnias:what are they 6 characteristics H |
disorder initating/maintaining sleep
1.cant get enough sleep 6.may resolve self as child matures |
1.cant
2.not 3.not 4.disruption 5.disturbance in 3 things 6.may |
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5 Dyssomnias types in order of commonality -include age most commonly seen for |
1.insomnia:1–3yo.
2.hypersomnolence 5.narcolepsy:kids&adolesence. |
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*insomnia:description(3 things) *hypersomnolence:description(3 things) Treatment:2 types:3 things it does *what other disorder can be treated w this intervention H |
insomnia:can't initiate/maintain sleep
*sleeps not restorative hypersomnolence:excessive sleepiness *prolonged/daily sleep episode behavior intervention,family guidance:identify suspected disrupted sleep cause,eliminate sleep deprivation&restore normal sleep/wake routine *circadian rhythm disorder:effective if teen&family are motivated |
1.identify
2.eliminate 3.restore |
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Description&treatment of dyssomnias
1.narcolepsy:description,treatment:4 things 2.breathing related sleep disorder:description,treatment:2 things H |
narcolepsy:irresistible refreshed sleep daily,brief muscle tone loss(cataplexy)episodes.treat:anti-depressant,structure,support,psychostimulant
BRD:sleepy/insomnia from sleep related breathing difficultytreat:remove tonsils&adenoids |
Define cataplexy (which is it for?)
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circadian rhythm sleep disorder:description treatment:2 things *explain 3 issues w circadian rhythm H |
CRD:sleepy/insomnia persist from sleep–wake schedule in environment&internal sleep cycle (circadian rhythm:late onset past midnight,can't wake in morning, resists change) mismatch
treat:behavioral treatment, chronotherapy |
circadian rhythm
1.late 2.cant 3.resist |
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parasomnias *what type of event are they/what event does *what type of arousal&when *what is the complaint *when it occurs *2 types (list which apply to each) |
behavioral/physiological event intrude on sleep.
*physiological/cognitive arousal at inappropriate time. 1.REM–2nd 1/2 of sleep period-Nightmares 2.non rem:deep sleep in 1st 3rd of sleep cycle when person is soundly asleep&hard to wake-night terrors&sleep walking |
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Rem Parasomnias
*age *description, *gender difference *the 3 listed in order of prevelance |
1.nightmares:mainly girls.3-8 to adulthood. *repeated wakenings w frightening dreams you remember. usually involve threat of survival 2.sleep walking:age:4–12. 3.sleep terror:18 months–6 years.abrupt awakening w autonomic arousal but no recall. |
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treatments for parasomnias:4 treatments *how long is treatment needed H |
1.extinction:comfort kid but withdrawl quicker from room at night
2. Reduce stress |
1.ext.
2. reduce 3.reduce 4. describe sleep hygiene:5 things |
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Frued's view on toileting difficulty *source *what it could lead to |
*could turn into troublesome personality styles. *source was seperation anxiety, pregnancy wishes, traumatic seperation from mom
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view&treatment for toileting difficulty *1920s *1940s *3 old beliefs on its cause |
1920s:strict toileting schedule to finish training by 8 months. if kid wasnt trained, stick soap up rectum.
1940s:focused on natural toileting b/w 12–30 months old cause:aggressive/early toileting,family disturbance/stress&child psychopathology |
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elimination disorder 3 early treatments:18th century |
*yokes made of iron(covered in velvet) prevented urination.
*steel spikes put on kids back to stop kid from sleeping on back (encourage peeing). |
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elimination disorder:treatment *how can it be fixed *importance of early referral/treatment *3 long term consequences *age most outgrow it naturally |
most outgrow by 10. can fix w education&retraining effort for kid&parent
*early treatment stop long term consequence in kid wout oppositional defiant/conduct disorder Long term consequence: 1.distressing&chronic difficulty affect education&social (social ostracism) participation. 2.cause physical abuse:anger,punishment&reject 3.strong implication in self competence |
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elimination disorder *types&description *DSM-5:3 criteria H |
primary:never go 1/2year w continuous control. most common
secondary:in control for 1/2 year(trouble w initial night control,many stressful events)&relapse 1.repeated in inappropriate place (in)voluntary 2.clinically sign. stress/impairment for 3 months 3.not attributed to physiological substance effect |
primary vs secondary
1.repeated 2.clinically:include time span3.not attributed |
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enuresis DSM–5:3 things *3 types in order of commonality:description&gender *chronological age/developmental level that it is seen |
age:5 if primary.5-8 for secondary.most common DSM-5 1.involuntary discharge of urine in day/night 2.2x/week 3.diuretic=drug reduces water retention nocturnal:in REM:kid dreams about peeing.mainly boys. diurnal:mainly girls.uncommon after 9. nocturnal&diurnal |
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enuresis causes *4 causes (1 specific to diurnal) |
1.antidiuretic hormone (ADH):concentrates urine for sleep.urine still made w deficiency.
2.no brain development to signal wake up 4. diurnal:usually from social anxiety/preoccupation w event |
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enuresis Treatment: *3 standard behavioral interventions:how long they take&what they involve,&what they are based off of *bell&pad:inventors, date, what it was *synthetic ADH nasal spray desmorpressin H |
1.classical condition:alarm goes if detect pee.kid wake from alarm in 4–6 weeks&fixed by 12
*bell&pad:mowrer in 1938.battery operated.1st alarm for if pee touched electric circuit 2.operant condition:dry bed training.reward system/token done nightly for 1–2 weeks. *ADH spray:1980:works for 70% in few days.10% show reduction.80% relapse if treatment stops. |
1.classical
2.operant |
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encopresis Types *encopresis DSM–5 *2 types&description *chronological age/developmental level that it is seen (&common gender |
age:4 years old:mostly boys DSM-5: 1.pass feces in inappropriate places. 2.1x/month 3.laxitives exclude constipation wout constipation&overflow incontinence:no evidence |
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encopresis 3 causes *4 things it leads to |
causes: *avoid stopping activity.
*kids w big stools find it frightening *constipation&abnormal defecation dynamics leads to: *megacolon *1/2 get defecation dynamics(contract not relax). *chronic constipation *1/5 have psychological problems |
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encopresis Treatment: medical&behavioral intervention:what it helps w *stats for getting/maintaining improvement *medical&behavioral example *another therapy shown to help |
*help colon return to size& kid use washroom. improve in 2 weeks&75% keep improvements.
medical:fiber,laxatives behavioral:healthy elimination pattern,practice tensing&relaxing. *Internet based behavioral treatments show some success after behavioral&biofeedback intervention |
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metabolic rate:what it does/balances
*4 things that relate to it *why it makes maintaining weight loss hard |
balance energy expenditure established based on individual genetics&physiological makeup,diet&exercise.
*self monitor/regulate behavior so we have trouble keeping change in weight/exercise |
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hypo caloric malnutrition:what is it?
what physical attempts to adapt to it lead to (3 things:elaborate) *when does long term consequence occur H |
chronic -ve energy balance by burning more energy than took in.
1.behavioral&psychological effect:emotion change (lethargy, depression, apathy)&lose circadian rhythm 2.biological effect:more GH,dermatological change&lose fatty tissue/hair pigment *long term consequence if occur in development/cognitive stages |
1.behavioral&psychological effect
2.biological effect |
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set point:what is it/what does your body do for it
>what happens if you gain weight >what happens if you lose weight |
*body regulate,defend&maintain weight around point thats comfortable
*compensates for fat decrease by slowing metabolism so we increase sleep. fight weight gain w increased temperature&metabolism to burn extra calories. * weight loss:rapid for 1st few weeks but 90-95% regain within several years |
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BMI:
what is it? How is it calculated? What is considered obese? what is considered overweight *what is definition of low body weight? ************** |
height–weight ratio percentile based on norms for kids age/sex.
formula:child's weight in pounds/height in inches/height in inches(again)x 703 *obese:body mass index above 95th percentile *overweight:85–95 low body weight:weight less than minimally normal/expected |
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'why thin people arent fat'
*describe study >>whats 1 possible explanation in the 2nd documentary? |
*naturally thin participants took in 5000 calories a day for a month w no exercise
*ate things like chocolate *some gained no weight. *all returned to normal weight when experiment ended *less micro bacterial in fatter ppl. |
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Overweight/Obesity:relation to DSM–5
*Is it a mental disorder *whats it listed as&why *what are the rates/prevalance: >% of 2-19 year olds. how much its increased since 1970s >fattest country&province. skinniest province |
DSM-5:not a mental disorder diagnosis.
*listed as 'Other Conditions Focus of Clinical Attention' b/c it significantly affects children’s psychological and physical health Prevalence: *1/6 of 2–19 year old.rise of 5–17% since 1970s *USA is fattest country. *Province:Newfoundland is fattest. Alberta is thinnest |
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childhood obesity:what is it characterized by/not characterized by?
*What is it considered? *difference in persistence by onset *what are the 5 consequences of it H |
chronic medical condition *more likely to persist as adult than infant onset. *characterized by excessive body fat&elevated set point.still regulate weight normally 1.Cardiovascular problems 2.diabetes 3.elevated cholesterol& triglycerides(4) 5.reduced life expectancy |
*similar listed as diabetes&hypertension
1.c 2.d 3.e 4.t 5.r |
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eating pattern development in kids ~12 *general prevalence *what is normal for 7-10 year olds *what is a significant developmental landmark&why *diet stats&emotions of for 5-8year olds *what occurs at 9years old *%that are picky eaters **** |
enter school:sign. development landmark b/c of social pressure to conform to desired body type.
*25%(mostly girls) ~12 are picky eaters.unknown link to eating disorders *7-10yo:concerned w weight,diet&physique. *5-8yo:60% diet in past week.many depressed from over eating&restrict diet for weight control. *9yo:girls are anxious about losing weight. |
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eating pattern development
>>transition to adolescence *3 things promote body dissatisfaction&perceived loss of control&why *what effect dieting behaviour |
interaction b/w pubertal weight gain, start of dating&threat to achievement status occur cumulatively in short time to cause body dissatisfaction&perceived loss of control
*timing of maturation effect diet behavior b/c girls that mature early are heavier. |
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eating pattern development
>>adolescence:statistic *desirable body *diet stats for teens >>weight concern: *what it relates to *what is it *what person worries about (4 things) |
*25% of teens show signs of eating problem.
*desirable body become obsession. *2/3 of mid-teen girls dieted in past year. 10% are chronic dieters. weight concern:weight gain fear link to eating disorder onset in teens. *worry about body shape, diet history&percieved fatness&body image |
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drive for thinness
*what it underlies *how it forms *3 ways it increases risk of eating disorder |
*key motivation for diet&body image in girls.
*fat kids get teased/rejected:see weight loss as way to gain success,acceptence&+ve body image *increase risk of eating disorder through -ve side effect:weight preoccupation, concern w appearance&restrained eating |
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eating pathology:
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continuum that ranges from dieting to clinical syndromes across all development periods
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disturbed eating attitude
H |
belief that cultural standard for attractiveness, body image&social acceptance are tied to ones ability to control diet&weight gain.
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belief that:3 things
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biological regulators:growth:
*what is it *what works together for healthy balance >3 circulating hormones: *what is their significance *what they interact w *what are their names |
*well orchestrated system of feedback loops *messenger signals&major organs work together for healthy balance.
circulating hormones:interact w available nutritional resources for change in skeletal system *most sig. growth rate determinant in childhood 1.growth hormone 2.thyroid hormone 3.additional gonadal steroids in adolescence. |
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Growth hormone:GH *hypothalamus role *what 2 growth controlling hormones are released&what do they do? |
*hypothalamus:sense need to release more/less GH in body via pituitary gland. *release 2 growth controlling hormones: 1.GH inhibiting factor:somatostatin inhibits gh response to internal signal of hunger.
2.GH releasing factor:tell body when,where& how to grow by releasing gh&higher brain structures that affect it. |
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*what may explain why sleep&eat disorders co-exist in kids? *what may explain why emotional&eat disorders co-exist in kids? |
eat&sleep disorders:50-75% of production occur after onset of deep sleep in kids/young adults emotion&eat disorders:limbic cortex&amygdala |
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causes of obesity:leptin deficiency *what is it:what it regulates (2) *how obese kids respond *what decreases it *how it may explain dieting failure |
hormone carries instructions to brain to regulate energy&appetite.
*obese kids are resistent to its effect. *levels decrease w dieting so less likely to give feedback to hypothalamus. connection may explain why diet is useless |
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causes of obesity:
1.Low SES 2. Culture Disparity w latinos 3.genetic predisposition/pedigree |
1.low SES wout transportation:access cheap processed food not healthy, affordable food
2.cultural disparity:latin moms identify familial pressure&cultural influence favor chubby kids. 3.pedigree:by 17, kid w 2 obese parents is 3x more likely to be obese.40% chance w fat sibling. |
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causes of obesity: parental influence
1.modeling/unhealthy lifestyle.*1 thing 2.family disorganization *2 things 3.abuse 4. Utero |
*modelling&unhealthy lifestyle:30% of american kids eat fast food daily
*Family disorganization:Poor communication& lack perceived family support *sexual& physical abuse *utero:tastebuds develop. eat more carrots=like carrots later on |
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obesity treatment self control training *what they do *what it helps w *what is self control for diet |
*make kid's behavior eating&physical activity pattern more adaptive&self managed.
*self control=set own goals for diet, weight&exercise &teach them skills to achieve goals w minimal outside directive from others. *help w percieved sense of control even if weight loss isnt achieved |
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obesity treatment:focus on family function
*its importance *what parents must do (3 things) *3 steps to treatment to be addressed:what is considered 'healthy' each day |
*instrumental to prevention/treatment.
*parent must anticipate&address problem w weight control plan,alter kids environment/routine&encourage kid 1.parent's knowledge on nutrition:5+ fruits/veggies,no soda,more water&3-4 skim milk servings 2.less sedentary lifestyle:cut screen to 2 hours 3.increase physical activity routine for parent&kid to 1+hours a day |
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obesity treatment:diet restriction&school boards
H |
*restricting diets not usually recommended *awareness/education in schools:as of sept. 2011, kids werent able to buy junk food at school.
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2011
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feeding disorders: Pica *description:include how long it last *prevelance+consequence of no treatment *where name came from *who it is seen in (3 groups) *when its most serious vs normal |
Ingest inedible, nonnutritive substances (hair, insect, paint) for 1+ month.also eat normal food
prevalance:seen in adults w ID(retardation)&normally developing kids (at 1-2 years old). *less serious if young b/c kids explore w taste&smell. *life-threatening if continues:risk lead poison&intestinal obstruction *from latin magpie-bird that eats everything |
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feeding disorders: Pica
*what is not to blame -causes (3) H |
no isolated cause/evidence of genetic factor.
*severity relate to degree of environmental deprivation&ID:more common (9-25%)in institution than community (.3-14.4%).seen in kids w poor stimulation&supervision *may have vitamin/mineral deficiency *encouraged in past. ex. 18-19th century:girls ate coal, lime, chalk&vinegar for pale skin |
*severity relate to
*may have *encouraged in |
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pica:treatment:what its based on *2 steps H |
based on operant conditioning procedure(+ve attention, additional stimulation)
*teach caregivers to keep environment tidy *remove dangerous substances. |
1.teach
2.remove |
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feeding disorder: Avoidant/Restrictive Food Intake Disorder:key features
*how many must be present? *4 features descriptions H |
1+key features must be present:
1.significant weight loss:fail to maintain normal growth 2.significant nutritional deficiency: 3.dependence on eternal feeding (tube)/oral nutritionalsupplements 4. marked interference w psychosocial function:slow/disrupted emotional&social development prior to age 6 |
1.significant
2.significant 3.dependence 4. marked *prior to what age? |
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Avoidant/Restrictive Food Intake Disorder
*what it describes *prevalence *what leads to initial problem *what is significance of onset b4 2 *what early onset is linked to |
*avoid/restrict food intake(due to sensory characteristics). *affect 1/3 of young boys&girls. *Many interacting factors lead to problem/influence adaptation to certain level of caloric intake *if before age of 2, can lead to malnutrition& have developmental consequence.early onset linked w abuse, neglect&poor caregiving (FTT). |
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Failure to thrive:description (2 things)
failure to thrive outcome *result typicality *3 factors that lead to severe problems in time H |
weight ~5th percentile for age&deceleration in weight gain rate from birth to present of 2+ SDs
no typical result:effect physical growth w unknown affect on cognition 1.degree/chronicity of malnutrition 2.degree& chronicity of developmental delay 3.severity&duration of problem in infant-caregiver relationship |
weight ~&deceleration
1.degree/chronicity 2.degree& chronicity 3.severity&duration |
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failure to thrive:focus of etiology *controversy H |
*controversy w significance of emotion deprivation vs malnutrition. 1.parent:mental illness&inadequate care-giving 2.mom:no stimulation/love,insecure attachment&eating disorder 3.circumstance:low SES,social isolation 4.kid:difficult temperament,physical illness&can't feel hunger |
*2 causes relate to parent
*4 causes relate to mom *2 causes relate to circumstance*3 causes relate to kid |
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*home environments role *assessment *how parent plays role H |
*considered final common pathway for many biological, psychological&social factors that influence growth&viability of kid
*detailed assessment of feeding behavior&parent-child interactions. *let parents play role in infant’s recovery |
Considered_____ for 3 things that influence ____&_____ of kid
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Rumination Disorder
*5 things H |
*Repeated regurgitate food for period 1+ month
*food re-chewed, re-swallowed/spit out. *not due to medication condition *behavior not exclusive to Anorexia, Bulimia, BED, Avoidant/Restrictive Food Intake disorder. *If in presence of other mental disorder (ID),its severe enough to warrant independent clinical attention. |
*Repeated
*food *not due to *behavior not exclusive |
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unspecified feeding/eating disorder:what is it&5 examples *orthorexia: *what are eating disorders usually associated w (3 things) |
clinically significant eating disorder that doesnt meet subthreshold for eating disorders *Atypical anorexia, low frequency/duration Bulimia/BED,purging disorder&night eating syndrome orthorexia:non diagnostic term.righteous eating fixation/healthiness obsession.obsess w food quality not quantity, weight restriction/thinness. |
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4 levels of severity for BED&bulemia *weight associated w each *commonality |
*BED:normal/fat. most common *Bulemia:normal 1. mild:1-3 episodes a week 2. moderate:4-7episodes per week 3. severe:8-13episodes per week 4.extreme:14+episodes a week |
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4 levels of severity for Anorexia *weight associated w it *commonality |
*markedly low:least common 1.Mild:BMI>17 2.moderate:BMI 16-16.99 3.severe:BMI15-15.99 4.extreme:BMI<15 |
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diagnostic criteria: BED:what recurrent episodes of binge eating are characterized by
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*eat in discrete period of time(ex.in 2hr period) *eat more than most eat in similar circumstance *sense lack of control over eating during episode |
*eat in...
*eat more than... *sense.... |
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diagnostic criteria: other 3 characteristics of BED
H |
c)distress regarding binge eating
d)occur once a week for 3 months e)not associated w recurrent use of inappropriate compensatory behavior |
c)emotion
d)frequency e)not associated w |
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diagnostic criteria: BED.what bing episodes are associated w
H |
3+of following:
1.eat more rapid than normal 2.eat until unfomfortably full 3.eat large amount when not hungry 4.eat alone b/c of embarrassment 5.feeling disgusted, depressed/guilty afterwards |
1.eat...
2.eat... 3.eat ... 4.eat .... 5.feel.... |
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Bulimia *what is the primary feature *describe The Binge-Purge Cycle (5 stages) |
*binging=primary feature 1.strict dieting 2.tension&cravings 3.binge eating 4. purging to avoid weight gain 5.shame&disgust >repeat |
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bulimia:diagnostic criteria:5 things
H |
a)recurrent binge eating characterize by:eatingin discrete period of time&sense lack of control.
b)recurrent compensatory behavior prevent weight gain. c)binge eat/inappropriate compensatory behavior atleast once a week for 3months. d)view self unduly influenced by body shape e)disturbance doesnt occur exclusively during episode of anorexia |
a)recurrent
b)recurrent c)binge d)view e)doesn't |
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bulimia *6 Medical consequences (less severe for bulimia. all apply to anorexia as well) |
1.puffy cheeks from enlarged salivary gland 2.significant/permanent loss of dental enamel 3.menstral irregularity/amenorrhea. 4.fluid&electrolyte imbalance from purging 5.mortality per decade:~2% 6.fatal complications:gastric rupture&cardiac arrhythmias |
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anorexia
*10 Medical consequences |
1.most lethal mental disorder:Mortality rate:5% per decade
2. Emaciation Growth retardation 3.Pubertal delay 4.arrest Constipation&abdominal pain (acute gastricdilation, infarction, perforation) 5. Cold intolerance &hypothermia 6.Lethargy 7,Reduction of peak bone mass/Osteoporosis 8.Hypotension& bradycardia 9.Hepatic steatosisseizure 10. tremors |
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psychological dimension:personality anorexia:6 common traits bulimia:8 common traits *1 less common trait |
*anorexia:perfectionistic,obsessive,rigid,emotional restraint, high need for approval,bipolar,suicidal&can't adapt to change/unfamiliar. *bulimia:moody,rigid absolute thought (all/ nothing:completely in/out of control)impulsive,conflict/obsessive compulsive&druggy. *suicidal uncommon |
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compensatory behaviours:what are they?
*what is their prevalence in each of the disorders? |
intend to stop weight gain:vomit,fast,exercise& misuse diuretics, laxitives, enemas&diet pills
*not done in BED.worst in anorexia |
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anorexia:
*3 diagnosis criteria History *what anorexia means *names of people who discovered it (&date) H |
a)restrict/refuse energy (food) intake lead to sig. low body weight. b)fear/interfere w weight gain.behavior persist at low weight. c)disturbed self percieved weight/shape(distort body perception). History:anorexia means 'loss of appetite.' *1873: by william gull&charles lasegue |
a)restrictb)fearc)disturbed
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anorexia:2 types |
1.Restrictive:in past 3 months, weight loss accomplished through fasting,dieting&excessive exercise
2. binge eating/purge:in past 3 months, individual has engaged in recurrentepisode of bing eating/purging (enemas, vomit) |
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Remission of the disorders:What is the definition of 'full remission'&'partial remission' *specific partial remission for anorexia & for BED |
1. full remission:after criteria were met, none have been met for sustained time period.
2. partial remission:after full criteria, some (not all) have been met for sustained period of time *anorexia:criteria A(low weight) persist.criteria b (fear gain)/C (disturb self perception)is met. *BED:avr. frequency of ~1 episode/week for sustained time period |
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psychological dimension:personality
*what are eating disorders usually associated w (2 things) *what disorders are comorbid w it *what are nervosa's the result of/how does person feel |
*associated w:-ve mental health, low body satisfaction
*excessive control over eating in misguided effort to manage stress&physical change,gain control over life&be better person *90% have othermental disorders (old Axis I):depression, anxiety, OCD |
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social dimension:eating disorders
*western culture:5 prerequisites for eating disorder *who's most at risk in our society: race, SES:dangerous belief. terms they use to describe themselves |
*prerequisite:personal freedom, emphasis instant gratification, food available any time, no supervision, cultural diet/exercise ideal
*white ppl in mid-upper class:use super woman terms to describe self:self worth,autonomy, happiness&success are determined by physical appearance. |
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Eating disorders:ED&eating related problems
*what 2 periods in adolescent development they appear in *3 disorders:age of onset *include gender difference for bulimia |
1.early passage into adolescence.
*anorexia:early-mid ado. (14-18)from stressful event 2.movement from late adolescence to young adulthood. *BED:late adolescence *Bulimia:mid-late adolescence. >girl:14-16 increase then decrease >boy:decrease in mid ad.&increase by early 20s. |
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3 types of factors&their description |
*predisposing:individual, familial, cultural dissatisfaction w body weight&shape
*precipitating:diet increase feeling of self worth&control *perpetuating:starvation symptoms&reaction from others |
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eating disorder amoung young men:
similarities&differences b/w men &women >preoccupation >behaviour they engage in >self perception as teen *who is most vulnerable |
same clinical feature in both. *preoccupied w muscles not food&drive for thinness *engage in excessive exercise&overeating not purging behavior *self perception as teen:boy see self in terms of academics, self assertions&body image vs girl see self as fat&unattractive. *gay men&women (90%) vulnerable |
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factors that increase eating disorder risk: 1.genetic/constitutional factors:how much more likely are you to get nervousa w family member w it 2,neurobiological factor:tryptophan explanation/role 3.Family role:5 parent factors that increase risk |
*inherit personality traits:4-5x more likely to get nervousa if relative w it.
*tryptophan:precursor to serotonin.minor role decreased by protein/low carbs which increase hunger *parent who drinks, abuses, does drugs, is absent/uninterested&demanding/critical |
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psychosocial eating disorder treatment
*who treatment team consists of (4) *what clinician does *2 issues w treatment |
*treatment team:internist,nutritionist,psychotherapist&psychopharmacologist
*clinician:decide if individual can be treated as outpatient(most teens)/inpatient(anorexia) 1.patients seek help for weight loss&disguise eating disorder symptoms 2.pressure psychological treatments to be effective in short time b/c patients released too soon (~normal body weight)to reduce cost. |
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treatment of eating disorders pharmacological which 2 are often used? *how effective are they:what 4 things can't they do? *What they are used to do |
assist in managing disorders.not treatment of choice.
*no drug has proved usefull for treating anorexia in teens/consistently proved in long term weight maintanence, changed distorted image&prevent relapse 1. selective seretonin reuptake inhibiters 2.antidepressents |
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treatment of eating disorders
*pharmacological: 1.SSRI:how researched/used it is *what 2 benefits do they have 2.Antidepressants:when have they been proven effective:what for? |
1.SSRI:most extensively studied&used to treat eating disorders. weight loss benefits found in trial to see how they regulate mood. regulate serotonin levels increase sense of wellbeing.
2.antidepressant:proven effective for bulimia if used for 6 months w psychosocial treatments |
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Treating Bulimia:
*bulimia outcome&best treatment psychosocial eating disorder treatment:CBT *2 things that its expanded to include/address *goal |
*maybe chronic/intermittent w remission period.best treated w psychological treatment CBT:goal:modify abnormal cognition(body shape /weight importance)&replace dietary restraint& purging effort w normal eating&activity pattern w rewards&modeling 1.specific cues that trigger urge to vomit/binge 2.underlying interpersonal/situational issue bothering patient. |
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Therapies/Treatment for Anorexia *how effective is it:2 things about it *when are most in remission? *how many fully recover vs show improvement vs continue w chronic course *historical treatment *2 less common treatments that are useful *what is the initial face |
>Treatment effect is modest:fluctuate w relapse. >highly variable course/outcome >most in remission after 5 years. *~50% recover *1/3 improve *1/5 are chronic parentectomy:remove kid from home&force feed by any means necessary *CBT&specialist supportive clinical management treatments are useful *Initial phase:restore weight&monitor medical complications |
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Treatments for Anorexia *Family Therapy:psychosocial eating disorder treatment >focus >what 3 things must be fixed for recovery >blame >3 things to encourage >who is engaged, how&why >what isn't challenged |
focus:illness nature&treatment
crucial to recover:fix parental psychopathology, family isolation&poor parent child relationship blame:family members not kid *encourage parent to mobilize family resource, control teen's eating pattern&raise morals *engage all members in further therapy apart/together to treat client fear&cooperation *don't challenge family's -ve interaction pattern (ex.conflict avoidance&alliances). |
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Ways of Thinking in Body Dissatisfaction-Rosen (1995) and Cash (1991)
1.Beauty/Beast 2.Unreal Ideal 3.Unfair to Compare 4.Blind Mind 5.Beauty Bound |
1.Beauty/Beast:appearance in extremes
2.Unreal Ideal:use societal standard as acceptable appearance 3.Unfair to Compare:bias comparison w ppl youknow 4.Blind Mind:ignore good/neutral appearance feature 5.Beauty Bound:can’t do something b/c of looks |
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Ways of Thinking in Body Dissatisfaction-Rosen (1995) and Cash (1991)
1.Magnifying Glass:focus on disliked imperfect self aspects 2.Mind Mis-Reading 3. Misfortune Telling |
1.Magnifying Glass:focus on disliked imperfect self aspects
2.Mind Mis-Reading:assume others judge same way you do 3.Misfortune Telling:-vely predict how appearance will cause bad things in future |
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Theoretical model for understanding body dissatisfaction/disordered eating(Streigel-Moore & Cachelin)
* Restraint Pathway :3 stages H |
1.Internalization of societal ideals ofbeauty / thinness 2.Discrepancy between actual and ideal bodyshape (from society) 3.Dieting/binging/purging |
1.Internalization 2.Discrepancy3.DBP
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Theoretical model for understanding body dissatisfaction/disordered eating(Streigel-Moore & Cachelin) Restraint Pathway
*Interpersonal Vulnerability Pathway:4 stages H |
1.Inadequate nurturing 2.Disturbance in self-image and socialfunctioning 3.Feelings of ineffectiveness 4.Body dissatisfaction and disorderedeating |
1.Inadequate 2.Disturbance in 3.Feelings 4.Body
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Pro Ana and Pro Mia Websites&webpages
*what is their view *what 7 things they consist of H |
*view nervosa as lifestyle choice
1.message/discussion boards 2.chat rooms 3. Journaling/blogging progress 4.Triggers:thinspiration pictures 5.Reverse trigger:pictures of what not to look like 6.Quotes 7.Tips & tricks |
1.md
2.c 3. Jb 4.T 5.R 6.Q 7.TT |
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Stigma: what is it a cluster of (2)
What does it motivate (4 things) |
cluster of –ve attitudes/beliefs motivate fear, rejection, avoidance&discrimination w respect to ppl w mental illness
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CBT 7 steps *example of what +ve&-ve reinforcement do H |
1.sociocultural influence&vulnerability 2.schemata over concern weight/shape 3.behavior vigilant to stimuli related to weight 4.motive fear of weight gain 5.behavior:ex.food restriction 6.biological deprivation 7.binge eating >+ve reinforcement=self control >-ve reinforcement=less anxiety |
1.sociocultural 2.schemata 3.behavior 4.motive 5.behavior 6.biological 7.binge
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