Childhood Mental Disorders Overview

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Questions and Answers

In which developmental period must symptoms of Autism Spectrum Disorder (ASD) be present?

  • Late childhood
  • Adolescence
  • Adulthood
  • Early developmental period (correct)

Which of the following is NOT a characteristic of Autism Spectrum Disorder (ASD)?

  • Symptoms are more frequent in females (correct)
  • Symptoms must be present in the early developmental period
  • Clinically significant impairment in social functioning
  • Symptoms cannot be explained by intellectual disability

What is the estimated worldwide prevalence of Autism Spectrum Disorder (ASD)?

  • 0.5%
  • 2%
  • 5%
  • 1% (correct)

What is one indicator of deficits in social-emotional reciprocity in individuals with Autism Spectrum Disorder?

<p>Inability to maintain eye contact (B)</p> Signup and view all the answers

What factor can contribute to the underdiagnosis of girls with ASD?

<p>Less impaired nonverbal behaviors (D)</p> Signup and view all the answers

Which assessment tool is specifically mentioned for evaluating social and communication skills in ASD?

<p>Autism Diagnostic Observation Schedule (ADOS-2) (C)</p> Signup and view all the answers

Which behavior best exemplifies insistence on sameness in individuals with Autism Spectrum Disorder?

<p>Becoming distressed by small changes in routine (C)</p> Signup and view all the answers

What intervention has proven effective in improving functional communication skills in young children with ASD?

<p>Behavioural based interventions (A)</p> Signup and view all the answers

What type of behavior is characterized by stereotyped or repetitive motor movements?

<p>Fidgeting or hand-flapping (D)</p> Signup and view all the answers

Which of the following is a possible indicator of hyperreactivity to sensory input?

<p>Exhibiting distress to specific sounds (A)</p> Signup and view all the answers

Which statement regarding the co-occurrence of Autism Spectrum Disorder (ASD) and intellectual disability is correct?

<p>Intellectual disability and ASD frequently co-occur. (C)</p> Signup and view all the answers

What aspect of ASD is highlighted by the increased incidence among siblings and twins?

<p>Genetic predisposition (C)</p> Signup and view all the answers

Which statement correctly describes restricted interests shown by individuals with Autism Spectrum Disorder?

<p>Highly focused interest in unusual objects (A)</p> Signup and view all the answers

What does the absence of interest in peers signify in the context of autism?

<p>Difficulty in maintaining relationships (C)</p> Signup and view all the answers

What type of behavior includes ritualized patterns or verbal nonverbal behavior?

<p>Adhering to strict routines and rituals (C)</p> Signup and view all the answers

Which of the following behaviors does NOT relate to deficits in nonverbal communicative behaviors?

<p>Expressions of emotions through facial cues (C)</p> Signup and view all the answers

Which behavior is characteristic of Conduct Disorder (CD)?

<p>Aggression to people/animals (A)</p> Signup and view all the answers

What is a common method for assessing ADHD, ODD, and CD?

<p>Comprehensive clinical history (C)</p> Signup and view all the answers

What type of behavior may be observed in a child with Oppositional Defiant Disorder (ODD)?

<p>Argumentative behavior (B)</p> Signup and view all the answers

Children diagnosed with ADHD may struggle primarily with which symptom?

<p>Careless mistakes (A)</p> Signup and view all the answers

Which behavior is NOT associated with Conduct Disorder?

<p>Seeking attention through positive behavior (B)</p> Signup and view all the answers

What factor suggests the possibility of shared causes among ADHD, ODD, and CD?

<p>Familial clustering (C)</p> Signup and view all the answers

Which of the following is an example of a criterion for evaluating Conduct Disorder?

<p>Physical cruelty to animals (C)</p> Signup and view all the answers

How is the prevalence of co-occurrence in ADHD, ODD, and CD best described?

<p>There is high co-occurrence among these disorders. (D)</p> Signup and view all the answers

Which behavior is commonly associated with inattention in individuals with ADHD?

<p>Easily distracted (B)</p> Signup and view all the answers

What distinguishes hyperactivity from impulsivity in the context of ADHD?

<p>Talking excessively is a sign of hyperactivity. (A)</p> Signup and view all the answers

Which of the following is NOT a criterion for diagnosing Oppositional Defiant Disorder (ODD)?

<p>Excessive running or climbing (D)</p> Signup and view all the answers

Which symptom is indicative of Conduct Disorder (CD)?

<p>Bullies, threatens, or intimidates others (D)</p> Signup and view all the answers

Which of the following scenarios would likely worsen performance in individuals with ADHD?

<p>Tasks that require greater organization skills (A)</p> Signup and view all the answers

What is a common emotional behavior found in children with Oppositional Defiant Disorder?

<p>Often touchy or easily annoyed (B)</p> Signup and view all the answers

How many symptoms must be present for a diagnosis of Oppositional Defiant Disorder?

<p>At least 4 symptoms (B)</p> Signup and view all the answers

Which of these characteristics describes impulsivity in ADHD?

<p>Interrupts others during conversations (A)</p> Signup and view all the answers

What is a common symptom of separation anxiety disorder?

<p>Severe anxiety about separation (B)</p> Signup and view all the answers

Which symptom is required for the diagnosis of depressive disorders according to DSM-5-TR criteria?

<p>Feeling worthless or guilty (A)</p> Signup and view all the answers

Which characteristic is associated with borderline personality disorder?

<p>Frantic efforts to avoid abandonment (C)</p> Signup and view all the answers

What is NOT a function of self-harm?

<p>Financial gain (D)</p> Signup and view all the answers

Which of the following is a risk factor associated with self-harm?

<p>Personal mental health problems (B)</p> Signup and view all the answers

Which condition involves a distorted body image and a dread of fatness?

<p>Anorexia nervosa (A)</p> Signup and view all the answers

What is a common method of engaging in self-harm?

<p>Wrist cutting (D)</p> Signup and view all the answers

What BMI indicates severe anorexia nervosa?

<p>15-15.99 kg/m² (D)</p> Signup and view all the answers

Which of the following is a common symptom of Attention-Deficit/Hyperactivity Disorder (ADHD) in children?

<p>Inattention and distractibility (A)</p> Signup and view all the answers

Which of the following is a common characteristic of Autism Spectrum Disorder (ASD) in children?

<p>Difficulty with social interactions (D)</p> Signup and view all the answers

Which of the following behaviors is commonly associated with Oppositional Defiant Disorder (ODD) in children?

<p>Persistent argumentative behavior (B)</p> Signup and view all the answers

Which of the following is a common behavior associated with Conduct Disorder in children?

<p>Aggressive behavior towards people or animals (C)</p> Signup and view all the answers

What percentage of children and adolescents worldwide is estimated to have a diagnosable mental disorder?

<p>10-20% (D)</p> Signup and view all the answers

What impact can untreated psychiatric disorders have in adolescence?

<p>Increased antisocial behavior (A)</p> Signup and view all the answers

Which disorder is characterized by difficulty in bonding with parents in infants and young children?

<p>Attachment disorder (D)</p> Signup and view all the answers

Which of the following is NOT a category under Child & Adolescent Psychiatric disorders?

<p>Physical Fitness (D)</p> Signup and view all the answers

Flashcards

Social Communication Deficits

Problems with social interactions, including trouble understanding social cues, sharing interests, and initiating interactions.

Nonverbal Communication Issues

Difficulties with nonverbal communication like eye contact, body language, and gestures, impacting social interaction.

Relationship Difficulties

Challenges in developing, maintaining, and understanding friendships or relationships.

Repetitive Behaviors

Recurring, specific patterns of behavior or interests, such as repetitive movements, routines, or obsessions.

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Stereotyped Movements

Repetitive motor actions, like hand flapping or lining up objects.

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Insistence on Sameness

Rigid adherence to routines and aversion to changes in things like daily schedules.

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Restricted Interests

Strong, unusual interests that can be obsessive or extreme.

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Sensory Sensitivities

Unusual reactions to sensory input like sounds, sights, or textures.

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ASD Prevalence

Autism Spectrum Disorder (ASD) affects approximately 1% of the global population.

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Gender Differences in ASD

While ASD is more prevalent in boys, girls often go undiagnosed due to differences in symptom presentation.

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ASD and Intellectual Disability

ASD and intellectual disability can occur together. To diagnose both, social communication skills must be below what's expected for developmental level.

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Why are girls underdiagnosed?

Girls with ASD are often able to mask their challenges better due to higher intellectual ability and less impairment in nonverbal communication.

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Multidisciplinary Assessment

Evaluating ASD requires a team of professionals like doctors, therapists, and educational specialists.

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Developmental History

Gathering information about a child's development, including early signs of ASD, is crucial in diagnosis.

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Assessment Tools

Specialized tools like the ADI-R and ADOS-2 are used to assess communication and behaviors specific to ASD.

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Behavioral Interventions

Structured therapy programs help individuals with ASD build functional skills and reduce challenging behaviors.

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ADHD Inattentiveness

Difficulty paying attention to details, staying focused, following instructions, and organizing tasks. This can lead to careless mistakes, trouble completing work, and losing things.

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ADHD Hyperactivity & Impulsivity

Excessive movement, fidgeting, talking excessively, difficulty waiting turns, and blurting out answers before the question is finished. This can make it hard to sit still, follow rules, and control impulses.

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ADHD Performance Variability

People with ADHD often perform differently depending on the task and context. They may struggle with tasks that require sustained attention, organization, or behavioral restraint.

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Oppositional Defiant Disorder (ODD)

A pattern of angry, defiant, and argumentative behavior towards authority figures. This includes losing temper, refusing to follow rules, deliberately annoying others, and blaming others for their mistakes.

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ODD Symptoms

ODD involves at least 4 of these symptoms: frequent temper tantrums, touchiness, easily annoyed, anger, arguing with authority figures, defiance of rules, deliberate annoyance, blaming others, and vindictiveness. These behaviors should occur at least once a week for 6 months.

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ODD Impact

ODD causes distress for both the child and the people around them. It negatively affects social, educational, and occupational functioning, making it hard to build healthy relationships, succeed in school, or hold down a job.

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Conduct Disorder (CD)

A more serious behavioral disorder than ODD involving actions that violate rights of others or social norms. This includes aggression towards people or animals, property destruction, deceitfulness, and theft.

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CD Aggression & Deceit

CD involves two main categories of behavior: aggression towards people and animals (bullying, threatening, intimidation) and deceitfulness or theft. These behaviors are considered more serious and potentially harmful than ODD.

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Conduct Disorder (CD) Criteria

A child must exhibit at least 3 out of 15 behaviors in the past year, including at least one behavior in the past 6 months.

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CD: Breaking into a House/Car

Intruding into someone's property without permission, including stealing, damaging, or simply entering without consent.

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CD: Serious Violations of Rules

Behaviors that break significant rules, such as running away from home, staying out past curfew, or skipping school.

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CD: Destruction of Property

Intentionally damaging property through actions like arson, vandalism, or breaking belongings.

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ADHD, ODD, CD Overlap

The same child may show symptoms of two or all three disorders, either at the same time or over time.

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ADHD, ODD, CD Co-occurrence

These disorders often occur together, suggesting shared causes.

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Assessment for ADHD/ODD/CD

Diagnosis relies primarily on a comprehensive clinical assessment, not just lab tests.

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Child's Perspective

Understanding the child's own experience of their behaviors and challenges is crucial.

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Mental Disorders in Children

About 10-20% of children and adolescents worldwide have a diagnosable mental disorder, with the number increasing with age.

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Impact of Mental Disorders

Mental disorders in childhood can persist into adulthood, affecting various aspects of life like education, relationships, and work.

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Domains of Child Psychiatric Disorders

Child and adolescent psychiatric disorders encompass a wide range of mental health areas, including cognitive and learning, social communication, emotional and behavioral, and neurological and physical.

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Attachment Disorder

Young children with attachment disorder struggle to bond with caregivers, regulate emotions, and develop social skills, showing insensitivity to others.

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Pervasive Developmental Disorders

These disorders, including autism, are characterized by significant developmental delays in communication, social interaction, and behavior. These challenges make it difficult for the child to function effectively in social situations and may lead to social isolation.

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Hyperkinetic Disorders

These disorders, such as ADHD, involve difficulties with attention, impulsivity, and hyperactivity. These behaviors can negatively impact school performance and social relationships, leading to challenging interactions with peers and difficulty learning and participating in class.

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Conduct Disorders

These disorders are characterized by aggressive, defiant, and rule-breaking behaviors. They involve violating the rights of others and social norms, leading to conflicts with authority figures and problems with the law.

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Emotional Disorders in Childhood

Mood and anxiety disorders are common in children. These conditions can manifest as excessive sadness, fear, worry, anger, and irritability, interfering with everyday functioning and social well-being.

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Separation Anxiety Disorder

A childhood anxiety disorder characterized by excessive fear of separation from primary caregivers. Symptoms include refusal to attend school, somatic complaints, severe anxiety, and worry about harm to the caregiver.

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Depressive Disorders (DSM-5-TR)

Characterized by a persistent low mood and loss of interest or pleasure in activities, along with at least 5 other symptoms, such as weight loss, insomnia, fatigue, feelings of worthlessness, and suicidal thoughts.

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Borderline Personality Disorder

A personality disorder involving instability in relationships, self-image, and emotions. Individuals experience intense fear of abandonment, impulsive behaviors, and difficulty controlling anger.

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What are common forms of self-harm?

Self-harm can manifest in various ways, including wrist cutting, drug overdose, head banging, and hair pulling. It's important to note that severity can range from superficial to deep wounds.

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Functions of self-harm

Self-harm serves different purposes, such as communication, tension release, addiction, and suicidal intent. The specific function often depends on the individual's circumstances and emotional state.

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Risk Factors of Self-Harm

Personal factors, such as mental health conditions, previous self-harm, and poor coping skills, increase the risk. Environmental factors, including family history, peer pressure, and traumatic experiences, can also contribute.

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Anorexia Nervosa

An eating disorder characterized by extreme food restriction, intense fear of gaining weight, and distorted body image.

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Treatment for Self-Harm

Treatment typically focuses on addressing underlying mental health issues, removing access to self-harm tools, and teaching coping mechanisms. Validation and emotional regulation skills are crucial.

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Study Notes

Care of Individuals with Childhood Mental Disorders

  • Learning outcomes include identifying common childhood/adolescent mental disorders, understanding their causes, and describing therapeutic management.

  • A common ADHD symptom is inattention and distractibility.

  • A common characteristic of ASD is difficulty with social interactions.

  • Persistent argumentative behavior is a common ODD behavior.

  • Aggressive behavior towards people or animals is a common Conduct Disorder behavior.

Overviews of Child & Adolescent Psychiatric Disorders

  • Globally, 10-20% of children and adolescents have a diagnosable mental disorder; this percentage increases with age.

  • Mental disorders in children and adolescents cover a broad range of domains, including cognitive/learning, social/communication, emotional/behavioral, and neurological/physical.

  • Typical age ranges for presentation of selected disorders (some examples) vary.

  • The caseload of child and adolescent psychiatric services increased by over 50% in a specific period cited in the data provided.

Causes of Mental Disorders in Children & Adolescents

  • Biological risk factors, psychosocial risk factors, psychological and cultural risk factors contribute to mental disorders.

Biological Risk Factors

  • Genetic factors contribute to the etiology of disorders like autism, conduct disorder, and ADHD.

  • Biochemical factors, like decreased levels of norepinephrine and serotonin, are linked to depression; elevated testosterone levels may correlate with aggressive behaviors.

  • Prenatal and postnatal factors, such as exposure to drugs, infections, and fetal malnutrition, can contribute to disordered brain function.

Psychosocial Risk Factors

  • Familial risk factors include discordant family relationships, lack of emotional warmth, parental mental illness, criminality, and large family size.

  • Parenting styles, such as authoritarian (autocratic, unaffectionate), and permissive (laissez-faire, indulgent) parenting, can contribute to mental health issues in children.

Psychological and Cultural Risk Factors

  • Family adversity, such as the loss of a parent or significant life events, can affect a child's development.

  • Attachment difficulties due to separations from attachment figures can impact future relationships, social skills development.

  • Cultural issues, like culture shock or cultural conflicts, can affect immigrant children's mental health and wellbeing.

Protective Factors for Mental Health of Children & Adolescents

  • Biological factors like age-appropriate physical development, good physical health, and good intellectual function.

  • Psychological factors like ability to learn from experience, good self-esteem, and high level of problem-solving ability, and well-developed social skills are factors for well-being.

  • Family Attachment, and opportunities for positive involvement in family, rewarding involvement, and academic reinforcement are protective factors for social well-being.

Adverse Childhood Experiences (ACE)

  • ACEs are intensive and frequent sources of stress impacting childhood and future well being.

Common Mental Disorders of Childhood and Adolescence

  • Neurodevelopment disorders: Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD).

  • Disruptive behavior disorders: Conduct Disorder (CD), Oppositional Defiant Disorder (ODD).

  • Mood disorders: Anxiety disorders, Depression. Borderline Personality Disorder.

  • Eating disorders: Anorexia nervosa, Bulimia nervosa, Binge eating disorder.

  • Substance abuse disorders (list provided).

  • Psychosis (discussed in different slide).

Autism Spectrum Disorder (ASD)

  • ASD is a neurodevelopmental condition causing social communication and restricted/repetitive behaviors, impacting communication, interaction and information processing.

  • Key DSM-5-TR criteria for ASD include: Social communication and interaction deficits, and restricted/repetitive patterns of behavior, interests, or activities (e.g., stereotyped movements, insistence on sameness, fixated interests, hyper- or hyporeactivity to sensory input).

  • Prevalence, presentation (gender differences), incidence among siblings/twins, and IQ considerations (above 90 in many cases) are details about ASD.

  • Assessment (using specific tools) and training (behavioral interventions, and social skills training) are important treatment strategies.

Attention Deficit Hyperactivity Disorder (ADHD)

  • Symptoms include trouble paying attention, controlling impulsive behaviors, and being overly active.

Disruptive Behavior Disorders (ODD, CD)

  • Oppositional Defiant Disorder (ODD) is characterized by argumentative and defiant behaviors towards authority figures.

  • Conduct Disorder (CD) involves aggression, destruction of property, and serious rule violations.

  • Treatment emphasizes parent training, improving family interaction and communication, and addressing coexisting conditions.

General Principles When Interacting With ADHD

  • To minimize distraction, use preferential seating.
  • Structure the environment providing schedules and other support that is easy to understand.
  • Give clear and concise directions and break tasks into smaller steps.

Eating Disorders

  • Anorexia Nervosa (restriction of energy intake), Bulimia Nervosa (binge eating and compensatory behaviors), and Binge eating disorder.

Substance Abuse Disorders

  • List of substance use disorders included.
  • Stages of drug use (from curiosity and experimentation to dependence).
  • The importance of treatment options is included.

Psychosis

  • Psychosis symptoms can manifest as early as age 13 and are characterized by different stages (early, attenuated, and late).

Treatment Approaches (in broader context)

  • Addressing co-occurring conditions, medication approaches for addressing symptoms, as well as therapies for long-term assistance are detailed in the slides.

Assessments

  • Methods for screening, diagnostic evaluations and tools for evaluating children and adolescents with specific considerations for factors that might lead to bias. Assessment in context of co-occurring conditions.

Medications

  • Medications (for various disorders) as appropriate.

Learning Outcome

  • List of learning outcomes based on presented slides and data.

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