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103 Cards in this Set
- Front
- Back
a mood state characterized by strong negative emotion and bodily symptoms of tension in which an individual apprehensively anticipates future danger or misfortune
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anxiety
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is anxiety always bad?
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no, some is necessary for adjustment
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maladaptive anxiety is....
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excessive & debilitating
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three interrelated anxiety response systems are...
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1)physical system, 2)cognitive system, and 3)behavioral system
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physical system (w/in anxiety response system)- what does it control, what is it mediated by
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-controls fight/flight response, mediated by the sympathetic nervous system and endocrine system
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cognitive system (w/in anxiety response system)- what does it deal with?
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searches for potential sources of threat; attentional shift and hypervigilance, nervousness, difficulty concentrating
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behavioral system (w/in anxiety response system)- what does it deal with?
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aggression, desire to escape/avoid, other "nervous" behaviors
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present-oriented emotional reaction to current danger
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fear
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future-oriented mood state, which may occur in absence of realistic danger
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anxiety
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sudden and unexpected flight/fight response in absence of obvious danger or threat
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panic
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many fears are ____________ and most ______ with age
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-developmentally appropriate
-decline |
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age-inappropriate, excessive, and disabling anxiety about being apart from parents or away from home
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separation anxiety disorder (SAD)
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earliest onset of all anxiety disorders
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separation anxiety disorder (SAD)
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separation anxiety disorder (SAD) occurs in ___ of children & has a ____ prognosis
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10%
good prognosis |
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excessive, uncontrollable anxiety & worry about numerous events & activities, occurring more days than not
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Generalized anxiety disorder (GAD)
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Generalized anxiety disorder (GAD) occurs in __ to __ of children, with onset during...
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3-6%
onset: late childhood to early adolescence |
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extreme, disabling fear of specific objects or situations that pose little or no danger
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specific phobia
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5 DSM-IV types of specific phobias
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1)animal
2)natural environment 3)blood-injection-injury 4)situational 5)other |
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specific phobias occur in __ to ___ of children, is more common in ____ and peak onset is between ages __ and __
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2-4% of children, more common in girls, peak onset b/w ages 10 & 13
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marked, persistent fear of being the focus of attention, or doing something humiliating
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Social phobia
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Social phobias occur in __to__ of children, slightly more in ___, age of onset is:
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1-3%
girls early to mid adolescence |
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name a form of social phobia
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selective mutism
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younger children show anxiety through
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more physical complaints
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OCD occurs in __ to __ of children, is more common in ___, age of onset is __ to __ yrs and prognosis is ___
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2-3%
more common w/ boys @ younger ages then evens out 9-12 yrs poor prognosis (no good treatments for kids yet) |
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panic attacks are ___ and panic disorder is ___________
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common
much less common |
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age of onset for panic disorder is __-__ yrs (__% are post-pubertal), is more common in ___ and the prognosis is ___
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15-19 yrs. 95% post-pubertal
more common in girls worst prognosis of all anxiety disorders |
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PTSD has 3 core features
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1)persistent re-experiencing of the event
2)avoidance of associated stimuli and numbing in general 3)extreme arousal |
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PTSD occurs in __ of boys and __ of girls in the US and recovery depends on (3)
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3.7% of boys & 6.3% of girls
-recovery depends on: 1)pre-existing child characteristics 2)exposure to other traumatic events 3)characteristics of the post disaster recovery environment and PTSD symptoms |
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cultures that favor ____ & _____ may increase levels of fear
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inhibition & compliance
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Behavior + Lens principle
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you must view disorder in context of culture to determine if it's a disorder (may be the norm)
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classical psychoanalytic theory
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anxiety and phobias are defenses against unconscious conflicts rooted in child's early upbringing (life instinct vs. death instinct)
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behavioral and learning theories
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fears and anxieties learned through classical conditioning and maintained through operant conditioning (escape and avoidance= negative reinforcement)
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attachment theory
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early insecure attachment led children to view environment as undependable, unavailable, hostile, and threatening
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behavioral style that remains stable over time & is biological in origin
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temperament
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Temperament theory- explain & relate to parents
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children born w/ low threshold for novelty and unexpected stimuli are @ greater risk for anxiety disorders (inhibited children) --> it's dependent on parental response-- those whose parents set firm limits and teach children to cope come out better
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what gene is associated w/ anxiety level? what is it a part of?
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CRH gene--> HPA-axis
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what part of anxiety is inherited? what does the form anxiety takes a function of?
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-general disposition to become anxious is inherited
-environmental influences |
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what parts of brain associated with anxiety disorders? (overall system & 4 parts of it)
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-behavioral inhibition system: HPA axis, brain stem, limbic system, frontal lobe
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neurotransmitters associated w/ anxiety disorders?
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norepinephrine, GABA, neuropeptides, serotonin
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some cases of OCD develop due to
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PANDAS- pediatric autoimmune neuropsychiatric disorders and associated symptoms
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brain differences that lead to predisposition for anxiety (2)
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1) more pronounced right brain
2)an over-excitable amygdala |
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right side of brain is associated with ___ behaviors, left is associated with ___ behaviors
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right-> avoidance behaviors (withdrawal)
left->approach behaviors |
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family influences that lead to predisposition to anxiety
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1)excessive parental control, rejection, overprotection
2)low parental expectations for children's coping abilities 3)low SES 4)insecure early attachments (esp. ambivalent attachment) |
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most effective treatment for anxiety disorders
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combined treatment- cognitive-behavioral therapy etc.
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medications can reduce symptoms, espeically for _____
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OCD
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_______ may result in more dramatic and long-lasting effects of treatment
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family interventions
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exposure to feared stimulus, often combined with relaxation (and types)
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Behavior therapy
-graded exposure -flooding (unethical) -systematic desensitization (graded combined w/ relaxation) |
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behavioral therapy is most effective when it is _______
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in-vivo (live)
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teaches modification of maladaptive thoughts
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cognitive-behavioral therapy
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philip kendal's program
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cognitive behav. therapy-->FEAR:
-Feeling frightened? -Expecting bad things to happen? -Actions and attitudes to help -Reinforce and evaluate |
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participant modeling is.....and reinforced practice is....
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-show child appropriate way to act
-reinforcing every step of the way |
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a boy with 2 bipolar parents has a ___ risk of developing it
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70%
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today we realize depression exists in children (as opposed to past views) however it is frequently overlooked because...
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it often co-occurs with other more visible disorders
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one of the most disabling childhood disorders
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depression
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prevalence of depression in young people is _____ and age of onset is ______
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increasing
decreasing |
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the way which depression is experienced and expressed...
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changes with age
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depression in children under age ___ tends to be diffuse and less easily identified
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7
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DSM-IV criteria for major depressive disorder
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-depressed mood most of the day, most days (or irritable in kids)
-diminished interest in activities -changes in appetite/weight -sleep disturbances -psychomotor retardation or agitation -fatigue -feeling worthless or guilty -difficulty concentrating/thinking -thoughts of death/suicide |
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prevalence of Major Depressive disorder? more rare in....? comorbidity?
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-2-8% of children
-preschool & school aged children -anxiety disorders, dysthymia, conduct problems, ADHD, substance abuse |
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age of onset for first episode of major depressive disorder
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13-15 yrs
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participant modeling is.....and reinforced practice is....
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-show child appropriate way to act
-reinforcing every step of the way |
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a boy with 2 bipolar parents has a ___ risk of developing it
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70%
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today we realize depression exists in children (as opposed to past views) however it is frequently overlooked because...
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it often co-occurs with other more visible disorders
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one of the most disabling childhood disorders
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depression
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prevalence of depression in young people is _____ and age of onset is ______
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increasing
decreasing |
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the way which depression is experienced and expressed...
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changes with age
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depression in children under age ___ tends to be diffuse and less easily identified
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7
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DSM-IV criteria for major depressive disorder
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-depressed mood most of the day, most days (or irritable in kids)
-diminished interest in activities -changes in appetite/weight -sleep disturbances -psychomotor retardation or agitation -fatigue -feeling worthless or guilty -difficulty concentrating/thinking -thoughts of death/suicide |
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prevalence of Major Depressive disorder? more rare in....? comorbidity?
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-2-8% of children
-preschool & school aged children -anxiety disorders, dysthymia, conduct problems, ADHD, substance abuse |
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age of onset for first episode of major depressive disorder? average episode lasts? after recovery children still have...?
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-13-15 yrs
-8 months (almost all recover but recurrence is highly probable) -adjustment and health problems and chronic stress |
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major depressive disorder: males vs. females
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-no diff until puberty, after which girls are 2-3x more likely
-girls may have more symptoms that forecast later depression by age 10 -symptoms similar -risk heightened for girls |
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dyshthymic disorder
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-less severe but more chronic (at least 1 YEAR) than MDD
-less anhedonia, social w/drawal, anger, anxiety, death thtoughts, etc. |
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can you have both MDD and DD? how do they relate?
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yes, called "double depression"
-DD often a precursor to MDD |
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prevalence of dysthymic disorder in children? teens? most common comorbid disorder? most common age of onset? avg. episode length?
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1% children, 5% teens
MDD 11-12yrs. |
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average episode length of dysthymic disorder? prognosis?
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2-5 yrs
most recover but are then @ risk for other disorders |
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cognitive effects of depressive disorders
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-interference w/ academics but no apparent intellectual difficulties
-feelings of worthlessness, failure, self-criticism, etc. -low or unstable self esteem |
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social effects of depression
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-few close friends, loneliness, isolation, withdrawal
-poor relations w/ parents & siblings |
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suicidal thoughts in most youth with depression with ____ to ___ actually trying
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16-30%
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psychodynamic theory of depressive disorders
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depression results from actual or symbolic loss of love object
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attachment theory of depressive disorders
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parental separation and disruption of a secure attachment bond are predisposing factors for depression
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behavioral theory of depressive disorders
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emphasis on importance of learning, environmental consequences, skills, and deficits in the onset and maintainence of depression
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cognitive theory of depressive disorders
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-depressogenic cognitions, which include:
1)internal, stable, global attribution for cause of negative events 2)negative automatic thoughts 3)negative outlook regarding oneself, world, and future (cognitive triad) 4)negative cognitive schemata |
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the cognitive triad is.... and consists of:
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a cognitive theory of depression
-negative outlook of oneself, the world, and the future |
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self-control theory of depressive disorders
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see depression as associated with difficulties in organizing behavior in relation to long-term goals
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interpersonal theory of depressive disorders
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disruptions in relationships as the basis for the onset and maintainence of depression
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neurobiological theory of depressive disorders
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emphasize the role of genetic vulnerabilities and neurobiological abnormalities
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socioenvironmental theory of depressive disorders
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focus on relationship b/w stressful life events and depression
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heritability range of depression
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.35-.75
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neurobiological influences on depression
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-heightened stress reactions
-frontal love, amygdala and hippocamus, HPA axis, sleep architecture, growth hormone, serotonin |
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primary symptom of depressive disorders
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withdrawal/loss of interest in activities
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cognitive behavioral therapy has shown ___ long and short term success, with ___ of children responding to treatment
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most
70% |
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example of CBT: kendall's taking ACTION program
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-Always find something to do to feel better
-Catch the positive -Think of it as a problem to be solved -Inspect the situation -Open yourself to the positive -Never get stuck in the negative muck |
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example of CBT: primary and secondary control enhancement training (what are pri./sec. control?)
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primary control: change things you can
secondary control: accepting things you can't change & modifying thinking |
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how do tricyclic antidepressents work in children?
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failure to demonstrate advantage over placebo
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how to SSRIs work in children? which is FDA approved for kids?
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-effective but increase in suicidal thoughts (tho not attempts)
-prozac |
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symptoms of bipolar disorder
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over-excitement, restlessness, agitation, sleeplessness, pressured speech, flight of ideas, sexual disinhibition, inflated self esteem, reckless behavior
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subtypes of manic episode (3)
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1)manic episode: 1 week
2)mixed episode: depressive & manic moods w/in 1 week 3)hypomanic: not quite as severe as manic episode |
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types of bipolar disorder (4)
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1)bipolar I: traditional, periods of manic episodes alternating w/ depressive episodes
2)bipolar II: depressive episodes and hypomanic episodes 3)cyclothymia: alternating b/w hypomanic and depressive but not full blown criteria (@ least 1 yr, never 2 months' w/out episode) 4)NOS- not otherwise specified |
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prevalence of bipolar disorder- for a lifetime; in youngsters; male vs female
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.4-1.2% lifetime
rare in youngsters, milder bipolar disorders more common than bipolar I -early onset more common in boys, but equal otherwise |
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first episode of bipolar ?
what usually appears first? prognosis? |
15-19yrs
depression occurs 1st poor prognosis, chronic and resistant to treatment |
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red flags for bipolar disorder (3)
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1)psychomotor retardation
2)rapid onset of depression 3)any psychotic features |
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very few studies about causes of ___ in children; studies suggest it is a result of...
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bipolar
genetic and environmental factors |
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treatment for bipolar includes (3)
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1)education- of family and patient
2)medication- usually lithium 3)psychotherapeutic interventions- to help get back on track |