Abnormal Psychology: Childhood Depression and Disorders

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Questions and Answers

Which of the following is NOT a cause of childhood depression?

Family history of mood disorders

Stressful events

Chronic or severe medical conditions

Lack of interest in homework (correct)

Which of the following is a physiologic sign of depression in children?

Constipation (correct)

Improved sleep patterns

Weight gain

Increased energy levels

What is a characteristic of a child with depression?

Increased interest in social activities

Solitary play or work (correct)

Increased appetite

Improved grades in school

What is a risk factor for childhood depression?

Having a family history of mood disorders Signup and view all the answers

Which of the following is a behavioral sign of depression in children?

Withdrawal from previously enjoyed activities Signup and view all the answers

What is a internal sign of depression in children?

Sense of hopelessness Signup and view all the answers

What is a characteristic of depression in childhood?

Difficult to detect Signup and view all the answers

Which of the following is NOT a risk factor for childhood depression?

Participating in regular exercise Signup and view all the answers

What is the primary method of identifying a depressed child?

Through a complete history including healthy growth and development, and social family health Signup and view all the answers

What is the primary goal of admitting suicidal children to a hospital?

To provide protection if the family is unable to provide constant monitoring Signup and view all the answers

What is a key factor in managing children with depression?

A health team especially prepared in the care of children with mental disorder Signup and view all the answers

What is a common side effect of suddenly stopping antidepressant medication?

Significant side effects Signup and view all the answers

What is the primary symptom of enuresis?

Urgency accompanied by acute discomfort and restlessness Signup and view all the answers

What is the typical age range for the cessation of nocturnal bed wetting?

Between 6-8 years Signup and view all the answers

What is a common cause of enuresis in children?

Neurological defect or urinary tract infection Signup and view all the answers

How often must incontinence occur to be considered enuresis?

At least twice a week for at least three months Signup and view all the answers

What is the primary cause of enuresis according to emotional factors?

Anxiety and fear of school Signup and view all the answers

What is the goal of bladder techniques and training in the treatment of enuresis?

To reduce fluid intake after evening meal Signup and view all the answers

What is a common characteristic of children with school phobia?

They are more anxious than others Signup and view all the answers

What is the result of punishment in the treatment of enuresis?

It has a negative emotional impact Signup and view all the answers

What is the primary goal of the pediatric nurse in the treatment of enuresis?

To help the child and parents understand the problem and develop a treatment plan Signup and view all the answers

What is the common symptom of school phobia?

Physical illness at the thought of going to school Signup and view all the answers

What percentage of children is affected by school phobia?

2% to 5% Signup and view all the answers

What is a risk factor for developing school phobia?

Having a caregiver who is overprotective Signup and view all the answers

Which of the following is a home-related cause of school phobia?

Lack of attention from their parent or caregiver Signup and view all the answers

What is the relationship between school phobia and other anxiety disorders?

School phobia is a symptom of other anxiety disorders Signup and view all the answers

What is a common symptom of school phobia during transitional times?

Nausea and vomiting Signup and view all the answers

What type of therapy helps children identify unhelpful or untrue thoughts?

Cognitive behavioral therapy Signup and view all the answers

Which of the following is a school-related cause of school phobia?

Fear of criticism from a teacher Signup and view all the answers

What is a physical symptom of school phobia?

Stomach aches Signup and view all the answers

What is the primary goal of exposure therapy in managing school phobia?

To slowly introduce a specific fear into daily life Signup and view all the answers

What type of medication may be helpful in managing school phobia, especially if a child has an underlying anxiety disorder?

Antidepressants Signup and view all the answers

Study Notes

Childhood Depression

Childhood depression is difficult to detect because children may not express their feelings and tend to act out their problems and concerns.
Some states of depression are temporary and acute, precipitated by traumatic events.
Causes of childhood depression include:
- Physical health: chronic or severe medical conditions, such as obesity, diabetes, cancer, and chronic renal failure.
- Stressful events: changes at home, school, or with friends.
- Environmental factors: stressful home life.
- Family history: mood disorders or depression in family members.
- Biochemical imbalances: uneven levels of certain hormones and chemicals.
Characteristics of a child with depression:
- Behavioral signs:
  - Predominant sad facial expression.
  - Solitary play or work.
  - Disinterest in play.
  - Withdrawal from previously enjoyed activities or relations.
  - Lower grades in school.
  - Lack of interest in homework or achieving in school.
  - Diminished motor activities.
  - Tearfulness or crying.
  - Being dependent or aggressive.
- Internal signs:
  - Statements reflecting low self-esteem.
  - Sense of hopelessness, guilt.
  - Suicidal ideation.
- Physiologic signs:
  - Constipation.
  - Not feeding well.
  - Change in appetite resulting in weight loss or gain.
  - Alteration in sleep patterns, sleepiness, or hypersomnia.

Nursing Considerations for Childhood Depression

Identification of depressed children requires a complete history, including:
- Healthy growth and development.
- Social family health.
- Interviews with the child and family.
- Observation by the nurse, parent, and teacher.
Instruct parents about the importance of early treatment.
Depressed children are managed by a healthcare team prepared in the care of children with mental disorders.
Suicidal children may be admitted to the hospital for protection if the family is unable to provide constant monitoring.
Pharmacological management may involve antidepressant drugs, with consideration of the child's age and close monitoring by parents and caregivers.

Enuresis

Definition: intentional or involuntary passage of urine into bed or clothes during the day, usually in children beyond the age of bladder control.
Inappropriate voiding of urine must occur at least 2 times a week for at least 3 months.
Signs and symptoms:
- Urgency.
- Acute discomfort.
- Restlessness.
- Urinary frequency.
Incidence: more common in boys, usually nocturnal bedwetting ceases between 6-8 years.
Causes:
- Organic causes: structural disorders in the urinary tract, urinary tract infections, neurological defects, and disorders that increase normal urine output.
- Emotional causes: emotional factors, fear, anxiety, and stress.
Therapeutic techniques:
- Medications: tricyclic antidepressants, anti-diuretics, and anti-spasmodics.
- Bladder techniques and training: scheduled bathroom visits, restriction and elimination of fluids after evening meal, and interruption of sleep to void.

Nursing Considerations for Enuresis

Help children and parents understand enuresis as a problem that needs a treatment plan.
Provide constant support and encouragement to both the child and parents during the treatment process.
Advise parents that punishment is contraindicated due to its negative emotional impact and limited success in reducing behavior.
Provide the child with a feeling of confidence.

School Phobia

Definition: an overwhelming fear of school, often a symptom of other anxiety disorders.
School phobia is more likely to affect children during times of transition, such as starting middle school or high school.
Children with school phobia often become physically ill at the thought of going to school.
Incidence: affects about 2-5% of all children, most common in young children ages 5-6 or middle school-age children ages 10-11.
Children at risk:
- Those with an overprotective caregiver.
- Those who are naturally more anxious.
- Those who are an only child, the youngest child, or chronically ill.
Causes:
- Home-related causes: violence, financial instability, food insecurity, lack of adequate housing, lack of attention from parents, and significant family changes.
- School-related causes: bullying, fear of criticism or punishment, learning difficulties, and worry about terrible events.

Symptoms of School Phobia

Physical symptoms:
- Diarrhea.
- Headaches.
- Nausea and vomiting.
- Stomach aches.
- Tremors or uncontrollable shaking.
Psychological symptoms:
- Being afraid to leave caregivers.
- Fear of the dark.
- Nightmares.
- Thoughts about their safety or the safety of others.
- Tantrums.

Management of School Phobia

Talk therapy: cognitive behavioral therapy helps children identify unhelpful or untrue thoughts and replace them with rational ones.
Exposure therapy: gradually introducing the fear of school into daily life, eventually facing the fear in real life.
Medication: particularly if a child has an underlying mental health condition, such as an anxiety disorder, antidepressants like selective serotonin reuptake inhibitors (SSRIs) may be helpful.

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Description

This quiz covers the concepts of childhood depression, enuresis, and school phobia, as discussed in the nursing program MCH 223 lecture. It tests the student's ability to define and describe these psychological disorders.