Notes/Study Guide for Exam 3
Notes/Study Guide for Exam 3 Psych 383
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This 19 page Study Guide was uploaded by Shea Repins on Thursday March 10, 2016. The Study Guide belongs to Psych 383 at Clemson University taught by Pamela Alley in Summer 2015. Since its upload, it has received 17 views. For similar materials see Abnormal Psych in Psychlogy at Clemson University.
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Date Created: 03/10/16
Disorders in Children/Adolescents: -Relatively new—didn’t start classifying until 1950 -The DSM-1 only had schizophrenia and adjustment disorders for kids -IDEA- passed in 1997, guarentees each kid with a disablilty will have a free, appropriate, public school education. Each kid will have a program that meets their needs, least restrictive environment possible, and parents have a right to be a part of it. -20% kids have some diagnosable psych problem that interfere with functioning -10% have a more severe impairment Anxiety in Children: -more common in girls than boys -any anxiety disorder an adult can get, a kid can also get -some will remit before adulthood but if they don’t it tends to be more sever and longlasting -treated with meds or with meds combined with behavior therapy -Causes? –genetic predispositions (some kids inherit a temperament that increases risk) -Environmental factors (illness, abused, protective parents( -Huge risk if exposed both genetically and environmentally Separation Anxiety Disorder: -More common in children (0-10) than adolescents (11-20) or adults -3 out of 8 symptoms must be present -Anxiety must be excessive because some anxiety when parents leave is normal (especially for the first 2 years of life) -Symptoms last for at least 4 weeks for kids and adolescents OR 6 months for adults -Occurs in close-knit families -More common in girls -Most common in elementary aged children -Waxes and Wanes School phobia: -Not in DSM-5 and not a diagnosis -Kids are not afraid of school they are afraid of going because they don’t want to leave their parents -Kids with this have average IQ -Equally distributed (5-15) with other kids -Parents are typically professionals -Considered a possible symptom of Separation Anxiety Disorder -Treatment: principles and parents work together ex.) parent sits in class until kid comfortable Parents sits in the hall Parent sits in car (slow and gradual process) Depression in Kids: Multiple Terms- 1. Period of blues -Ups and downs -All get it, pretty normal 2. Symptoms of depression -Can’t concentrate or sleep 3. Full blown case a.) MDD -Just like in adults -“Clinically depressed” -Children can become irritable (symptom which adults don’t have) -Beginning in childhood its more common in boys, beginning in adolescents its more common in girls b.) Dysthemia -Mildly and persistently depressed -Same as in adult -It must last 1 year for kids (vs. 2 years for adults) c.)Disruptive Mood Regulation Disorder -Only in boys -Onset is earlier than 10 years old -young boy with chronic, sever irritability -Temper tantrums/always angry -Significant number of kids will get depressive disprders but it is more common in adults (17%) -Fair number of kids have some symptoms but don’t meet full criteria Causes? -Genetic (mom or dad depressed=higher risk) -If mom is depressed, a child is more likely to be -Environmental (early traumatic event) Treatment: -Meds and psychotherapy -Cognitive therapy for older adolescents and play therapy for kid -Antidepressants are controversial for kids, need more research!!! Still prescribed but could be long term effects Disorders Associated with Defiant and Aggressive Behavior: -These can morph as they age but don’t always -All more common in Boys Oppositional Defiant Disorder: -Temper tantrums, annoy, don’t listen -Gradual Onset -First symptoms evident during preschool years and rarely after early adolescence -Usually limited to the home Conduct Disorder: -Violate norms (ex. Assault, run away, stealing, lying, cruelty to animals) -If they have both ODD and CDdiagnose with CD -Childhood onsetwill be more serious and more likely to morph into ADD -Emerges in middle childhood through middle adolescence -Presents in a variety of settings (ex. Home, school, with peers) -Usually preceded by ODD -May develop into APD if onset is in early childhood -More Common in urban areas -Prevalence in US is increasing Antisocial Personality Disorder: -Present in 2 different DSM categories -Must be 18 or older to be diagnosed -Inflexible and maladaptive behavior that disregards and violates rights of others -ex. Agression, stealing, harassing, recklessness, and commonly lack of remorse -Used to be called psychopathy but changed in 1980 with the DSM3 -They usually commit crimes but not all do -Not all criminals have ADP but there’s a high overlap Causes of ODD/CD- -Could be genetic (certain temperaments inherited increase risk) -Parenting techniques -Family stress (job loss, abuse, divorce) -Poor peer relationships/bad influences from friends -Lower SES=higher risk Treatments of ODD/CD- -Family therapy and teaching parents to have more authoritative style -Behavior therapy and teaching parents to reinforce childs good behavior instead of punishing the bad behavior -Modify/set limits for child (Homework, bedtime, dinner, etc) Sleep-Wake Disorders: Normal Sleeping Patters: -3-6 year oldsbegin sleeping deeply through the night -After 5 years olddon’t want to go to be so parents establish an elaborate bedtime routine -Transitional object(blanket or teddy)- will ease separation from parents during bedtime, research finds kids with a transistional object were more outgoing and better at adjusting Sleep over lifetime: -As we age we need less sleep Newborns: 18 hours of sleep total but wake every 2-3 hours 3 months old: sleep through night 6-7 hours 6 months old: sleeping at night/less naps 5 years old:11 hours of sleep 7 years old: 10 hours of sleep 13 years old: 9 hours of sleep Late adult-65+ need 6 hours -Each sleep stage last 90 min -More REM as you go through the night Classifying disorders: -Must be recurrent and cause distress/impairment -isolated/infrequent episodes are common Nightmares= bad dreams during REM sleep that have many causes Night Terrors=Abrupt awakening during stage 4 sleep which begins with a panicky scream/cry and usually lasts 1-10 minutes Sleepwalking=Rising from bed during stage 4 sleep that usually lasts only a few minutes Nightmare disorder; -Occurs during REM -Occurs during second half of sleep -Vivid dreams and can be awoken easily NREM Sleep arousal Disorders: -Occurs during stage 4 -Occurs in first third of sleep -Typically doesn’t awaken fully -Has amnesia for the episode -If you have terrors or sleepwalking, you have this Enuresis: -Elimination disorder category of the DSM -2x a week for at least 3 months OR less than that if it causes distress or impairment in social and academic areas recurrently -Must be at least 5 years old (younger are expected to have accidents sometimes) 2 types: -Primary=child never established urinary continence (occasionally wet bed/pants) -Secondary=Child had continence for at least a year but then started wetting bed again Prevalence: 5-10% of kids in early childhood are enuretic (5 years old) 3-5% of kids in middle childhood are enuretic (10 years old) 1% are enuretic in adolescence (15 years old) 1% continutes into adulthood -Most become continent over time -More common in boys -can negatively impact self esteem, potential to limit social activities (ex. Camp or sleepovers) -Some parents are frustrated bc don’t realize the child doesn’t have control and child will try not to be difficult Causes: -Do not get diagnosed if on medication that can cause it -Not an emotional problem -Strong genetic component (high concordance rate in monozygotic>dizygotic twin) -Maturational problem-child has not fully matured yet -Learning problem-child has not yet learned to recognized when bladder is full and need toilet Treatment: -Sometimes medication -Learning based plans more effective -Bell and pad method developed by Mowrer- Child sleeps on pad connected to alarmfirst drops of urine set off alarm and wake childchild associated full bladder with awakening -Needs to be treated bc it negatively effects childhood Intellectual Disability: -IQ is less or equal to 70 -used to be called mental retardation -impairment with functioning in communication, classwork, dressing self, grooming, daily tasks (not up to par for their age) -Symptoms are onset during developmental period (before 18 years old) -ex. 26 year old gets in crash and now IQ is less than 70--- cannot be diagnosed with ID because was normal before age 18 Prevalence: -More common in boys -2% of population have IQ less than 70 and only 1% meet all criteria -4 levels of severity that used to be based on IQ but now based on functioning mild, moderate, severe, profound -Large majority with ID are only mildly impaired (perform at 6 grade level) -More severe=less common and lower lifespan Treatment: Special Education- tutoring, special classes Rehabilitative Measures- Skill training programs for older people that help learn simple tasks and repeat it Community-based Programs- aim to teach them to function somewhat alone, ex. ClemsonLIFE Institutionalization- Last resort for sever cases, most wont need this Causes: Heredity, chromosomal aberrations, prenatal/pregnancy problems, medical conditions acquired in childhood, environmental influences Functional ID- born normal and something caused it after birth Prenatal Alcohol exposure: -Most common cause of ID and most preventable cause in the US -FASD is the disorder associated with prenatal alcohol exposure -Small, ID, facial/body abnormalities -More likely to develop learning disorder or ADHD -1 out of 100 born in US with some degree of FASD -Not sure how much alcohol/when its drank causes this Specific Learning Disorder 3 types: Reading: difficulty sounding out words correctly, slow at reading, hard to understand what they read Math: difficulty understanding how numbers work, slow at math problems, memorizing facts, word problems Written: Least known about this and difficult to assess. Bad at spelling, grammar, and organizing essays -Can have 1 or all 3 of these specifiers -Dyslexia is different because they can comprehend -Not diagnosed until elementary school -Reading is diagnosed before math and math before writing -Can be diagnosed late in life because they’ve been compensating for it -5-15% have a SLD in US -DSM4 says equal in both genders but DSM5 says more common in boys -Usually will have normal vision and hearing -40% drop out rate -Don’t outgrow just learn to compensate -can function normal and be successful if learn alternative ways to learn -Tutoring and being taught methods will help -Diagnosed when achievement test score is much lower than expected from their IQ score (they have more potential than theyre reaching) ADHD: -6 or more symptoms from inattention category or hyperactivity category for 6 months -Some symptoms must be present before age 12 but not usually diagnosed until elementary school -ADD is now called ADHD-predominantly inattentive presentation -5% of US school kids have ADHD -more common in boys -is not the same as a specific learning disorder but they tend to go together -Most frequent reason kids are referred for testing Causes: -Symptoms tend to get better during adulthood -Some adults will still have full blown ADHD but they’re the exception -Strong genetic components -ADHD brains look different in parts than normal brains -Many env. Factors (ex. Alcohol use during pregnancy, premature, car crash) -No evidence that sugar causes ADHD but it can exacerbate it Treatment: -Stimulants (Ritalin) nut sure why they work -Effective in short term but not sure about long term effecrs -Teachers could use certain techniques in class (orally administer test. Break down big projects) Autism Spectrum Disorder: -Includes a variety of severity of the disorder -Part of Neurodevelopmental category in DSM5 -Combines Autistic disorder and Asperger’s into the spectrum disorder Main deficits: -Nonverbal comm. (no eye contact or gestures or facial expressions) -Relationship development (hard to retain/establish them) (baby wont smile at mom) -Understand others emotions(recognize emotion but do not understand it. Have not developed a theory of mind- undertadning others have thoughts/emotions different than yours) -Conversation (bad at initiating/sustaining) Autistic Disorder is on the more severe end of the spectrum -Normal language/cognitive skills are not present, bad social interactions, onset prior to age 3 Asperger’s is less severe end of the spectrum -Main difference is that there are normal language/cognitive skills present Specifiers: -Many cases will co-ccur with ID and individual must meet criteria for both disorders -If they have it with ID they tend to be better at visual/special tasks than verbal tasks -Overall IQ is lower -Can also occur with language impairment -If no ID or language impairment, more mild end of the austim spectrum and better prognosis -Can also co-occur with Savant Syndrome (will have an isolated and exceptional ability which is not consistent with their overall abilities) Prevalence: -Increasing but its hard to know how much because its easier to diagnose now and the diagnosis is more broad -All SES levels experience it -1% of population somewhere on the spectrum -More common in boys -More likely to be hyperactive, impulsive, short attention, and have aggressive behavior -No cure and prognosis varies depending on severity of social, behavior, intellectual, and language impairment. Causes: -Used to think it was a mothers fault during pregnancy “refridgerator mom” -Most heritable form of psychopathology in the DSM -More research needs to be done about environmental factors (maybe obesity or high sugar in mom) Treatment: -No medication helps -Behavior therapy: eliminate self-stimulation activity, slow progress and takes patience Feeding and eating Disorders: -Obesity is not a disorder but it could lead to one Anorexia Nervosa: -Name is misleading: person is very thin bc afraid they will gain weight and become fat -Will be very thin, be afraid of gaining weight, denial of weight issue, and warped views of their body Age of onset: 17 is average age but usually during high school age Prevalence: -1% for females and much less for males -More common today than in the past -Much more common in girls 2 types: 1. Binging/purging type: -Most do this -Vomiting (most common), laxatives, enemas, or diuretics 2. Restricting type: -Doesn’t engage in binging/purging -will fast and exercise excessively -30% who start as this type morph into binging/purging type Features: -Pre-occupied with food (talk about it, watch others eat) -Depressive symptoms-Socially withdrawn, low interest, sleep problems -OCD symptoms -Some will get better, some will fluctuate, and some will be chronic -10% mortality rate for severe cases needing hospitalization Causes: -Biopsychosocial model -Defect in hypothalamus -Strong genetic component (monozygotic>dizgotic concordance rate) -Chemical imbalance, puberty, feelings of no control -Bad family dynamic, overly critical parents, stress, societal pressure Treatment: -Biggest obstacle is most don’t think they have a problem so don’t think they need help -1/3 will drop out if they enter therapy -in severe cases they will be tube fed -No meds found -family therapy is the treatment of choice Bulimia Nervosa: -Newer than anorexia, only been around 25 years Age of onset: 20-24 years Prevalence:1.5% for females and much less for males -frequency has remained stable -More common in girls Criteria: -All bulimics must binge -They binge until very full and most common triggers are feeling sad/interpersonal problems -Most common ways to compensate for the binge is to vomit -Usually ashamed of the binge and do it in seceret -Usually binge with sweet and high calorie foods -Must occur once a week for at least 3 months -will sometimes plan a binge -Anorexia takes precedence -Usually normal to overweigh -Most will have tooth decay, skin problems, and hair loss -Depressive symptoms or disorder is common Prognosis: -Not quite as serious as AN -More chronic and can wax/wane -Seldom incompasitating -Not as strong a genetic component as anorexia -Most common predictor is when parents make critical comment about her looks Treatment: -Antidepressants will help reduce the binge frequency and depressive symptoms -Cognitive behavioral therapy is best -Change meal habits and eat healthier AN vs. BN Similarities: -Both involve disturbance of eating (same category) -Both afraid of weight gain/want to lose weight -Both dissatisfied with their bodies Differences: -AN will be very thin and BN will be normal/overweight -BN usually know they have a problem while AN doesn’t -All BN will binge but only some AN will binge Binge-eating disorder: -New in DSM5 -Involves binging but no compensatory behavior after -Usually overweight/obese Neurocognitive disorders: -Dementia is no longer a disorder -Senility is not a true medical term/diagnosis -Must meet general diagnostic criteria and specific diagnostic criteria -All share similar symptoms but are categorized by cause Deficits -Must have a decline in cognition and be a big change from how they were before Aphasia- deterioration of language shown by difficulty producing names Ex. Cant remember the name of a cup or daughter but recognize it Apraxia- cant do something even though motor, sensory, and comprehension to do it are intact Ex. Cannot wave hand even though they are able and want to Agnosia-cant recognize something even though intact sensory function Ex. Cant remember a person or thing at all Disturbance in executive functioning- cannot plan, initiate, sequence, or stop complex behavior Ex. Cant make a sandwhich bc so many steps Etiology: -Etiology is part of the name (alziemers, Parkinson’s, Huntington’s, concussion) -all caused by a general medical condition or use of drug or combo of both -At least 50 different causes- Alzheimer’s contributes to 2/3 of them Age of onset: -Usually late adulthood (65 and older) but depends on cause -Highest prevalence in people over 85 (increases with age) -Uncommon in younger people (unless caused by brain injury) -Gradual development -Can be reversible only if caused by interaction of drugs but most are chronic Alzheimer’s: -More common now because lifespan is longer -Degenerative and irreversible but can be slowed Onset: 1% of people between 60-64 40% of people over age 85 -Early onset is less common, more rapid, and has a higher genetic link Prevalence: -More common in North America and Western Europe, possibly because of longer life expectancy -Slightly more common in girls, maybe because they live longer Symptoms: -First symptom is deficit in recalling events and new info -Confusion, agitiation, restlessness come before inability to function or recognize people -most older people will experience some memory problems Etiology: -relatively strong genetic component (high concordance for identical twins) -Something in environment will trigger it Diagnosis: -Difficult to diagnose because so many reasons/causes of a neurocognitive disorder -Family history, physical, blood tests, brain scans are used to rule out all other possible causes -Only way to diagnose is by doing autopsy (can only guess before) Treatment: No cure so quality of life must be improved -Some CBT- “leave pad/pencil to write down where they put keys” -always put things in same spot -Some drugs will slow down the progression -Antidepressants help alleviate depressive symptoms -Treat family and make sure person has a support system -Try to prevent it!! Ways to prevent: more nuts/seeds/eggs, take ibuprofen, exercising, engage in mentally stimulating activities Possible risk factors: obesity, inactivity, depression, type 2 diabetes, smoking, low ses, head trauma
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