Psychiatry Review: Childhood Disorders and Syndromes

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which areas do reading disorders primarily affect (Select all that apply)?

Writing (correct)

Reading (correct)

Spelling (correct)

Speaking

What is a common issue for children with specific developmental disorders?

Social interaction (correct)

Phonological awareness

Fluency

Rapid naming

What should be done to help preschool children with learning and developmental disabilities?

Avoid assessing them until they are older

Isolate them from other children

Early intervention (correct)

Provide special education classes

Which of the following is NOT a manifestation of reading disorders?

Expressive language difficulties Signup and view all the answers

What areas might children with specific developmental disorders struggle with?

Expressive language Signup and view all the answers

Which of the following is true about the assessment and treatment of preschool children with learning and developmental disorders?

All professionals involved should work together with parents and teachers Signup and view all the answers

What is the first group of problems described in the review of syndromes?

Problems encountered in preschool children Signup and view all the answers

In what order are the main psychiatric disorders of childhood described?

In the order they appear in the major systems of classification Signup and view all the answers

What is described directly after pervasive developmental disorders?

Main psychiatric disorders of childhood Signup and view all the answers

Which type of conditions are said to be generally similar to those of either childhood or adulthood?

Anticephaloic conditions Signup and view all the answers

What is given a brief account of at the end of the chapter?

Anticephaloic conditions Signup and view all the answers

Which factor is NOT mentioned as influencing feeding and eating in children?

Genetic predisposition Signup and view all the answers

A child consistently refusing to eat without longing for meals suggests what?

Behavioral sign of poor mental health Signup and view all the answers

What percentage of children aged 1-5 exhibit signs of wakefulness or anxiety during sleep?

25-30% Signup and view all the answers

What is essential for calming a family with sleep disruption concerns?

Regular sleep times Signup and view all the answers

Which of the following should parents do to manage sleep problems?

Consult psychologists Signup and view all the answers

Severe anxiety in children is frequently associated with which type of anxiety disorder?

Generalized anxiety disorder Signup and view all the answers

What is a common consequence of sleep deprivation in families?

Negative impact on family dynamics Signup and view all the answers

What approach is important for addressing sleep problems?

Coordinated approach Signup and view all the answers

If a child has a history of severe ailments, feeding problems might be an expression of what?

Parental anxiety Signup and view all the answers

What should parents do after taking the child to bed to manage sleep problems?

Wait until the child is sleeping Signup and view all the answers

According to DSM-5, what is the term for a disorder characterized by difficulties in reading?

Reading disorder Signup and view all the answers

Which of the following languages have the highest prevalence rates of dyslexia?

English, German, Swedish Signup and view all the answers

What skill is predominantly associated with the ability to read accurately but have comprehension difficulties?

Auditory discrimination Signup and view all the answers

Children with specific learning disorders benefit from what type of instruction?

Clinical instruction Signup and view all the answers

What disorder is classified under the DSM-5 but does not have an equivalent category in ICD-10?

Childhood-onset fluency disorder (stuttering) Signup and view all the answers

Which disorder in the ICD-10 corresponds to 'Speech sound disorder' in the DSM-5?

Specific developmental disorders of speech and language Signup and view all the answers

Reading speed in individuals with dyslexia is affected by their ability in:

Rapid auditory processing Signup and view all the answers

Which disorder is listed under both DSM-5 and ICD-10?

Mathematics disorder Signup and view all the answers

What is a key characteristic of those with reading comprehension impairment?

They have difficulty understanding what they have read Signup and view all the answers

Which disorder is associated with a significant prevalence among artists?

Dyslexia Signup and view all the answers

Which brain function may be impaired in children with a history of abuse and neglect?

Right prefrontal brain function Signup and view all the answers

Which factor does NOT influence a child's right prefrontal brain function according to the content?

Intake of vitamins Signup and view all the answers

Which genetic syndrome is mentioned as causing small affect recognition deficits?

Guillain-Barré syndrome Signup and view all the answers

What screening is typically performed for children with reading difficulties?

Special education screening Signup and view all the answers

What percentage of children show improvement in reading difficulties with early intervention?

25% Signup and view all the answers

What is a common result of mathematics disorder in individuals?

Lack of interest and motivation Signup and view all the answers

Which intervention is effective in improving independent reading decoding abilities?

Phonological awareness interventions Signup and view all the answers

What aspect of mathematics is crucial for long-term opportunities and use?

Learning math information and integrating skills Signup and view all the answers

What impacts early brain development significantly?

Play and quality of food sources Signup and view all the answers

What is a key component in assessing and treating children with reading difficulties?

Psychological intervention Signup and view all the answers

What is the Wechsler Intelligence Scale for Children (WISC) primarily used for?

Assessing children's intelligence Signup and view all the answers

At what age do 25-30% of infants typically utter their first words?

12 months Signup and view all the answers

Which factor is NOT essential for speech and language acquisition in children?

Mathematical skills Signup and view all the answers

What percentage of children will experience delays in language development?

5% Signup and view all the answers

Which classification system uses the title 'speech disorder'?

ICD-10 Signup and view all the answers

Which disorder is associated with difficulties in interpreting social cues?

Autism Spectrum Disorder (ASD) Signup and view all the answers

What is the ICD-10 classification for 'expressive language disorder' known as?

Language disorder Signup and view all the answers

Which group of children is unlikely to benefit from therapy?

Children with general learning difficulties Signup and view all the answers

Which age group frequently forms complete sentences?

24 months Signup and view all the answers

Which classification system uses the title 'speech and language'?

DSM-5 Signup and view all the answers

What is the estimated prevalence of language disorders in school-aged children?

7% Signup and view all the answers

Which of the following is NOT a criterion for language difficulties?

Eagerness to learn new words Signup and view all the answers

Which aspect is a common sign in children with difficulties in comprehending spoken language?

Difficulty in decoding spoken language Signup and view all the answers

What is the expected vocabulary acquisition rate for a young child?

5-10 words per day Signup and view all the answers

Which of the following could indicate social interaction difficulties in children?

Difficulty recognizing nonverbal cues Signup and view all the answers

What is one method used to determine the nature and severity of speech and language disorders in early investigations?

Assessment of speech sound errors Signup and view all the answers

Who are typically involved in the multidisciplinary team approach for treating language disorders?

Teachers, parents, and speech and language therapists Signup and view all the answers

At what age is it possible for a child to typically start seeing a speech therapist if their speech and language skills are significantly impaired?

4 years Signup and view all the answers

Which difficulty might affect a child's ability to acquire reading and writing skills?

Difficulty in understanding spoken language Signup and view all the answers

What is a common challenge faced by children with language disorders in academic performance?

Slowness to grasp new concepts Signup and view all the answers

At what age do 25% of adults with Autism Spectrum Disorder (ASD) typically develop autism?

Before adolescence Signup and view all the answers

What is the heritability rate of ASD in the population?

80% Signup and view all the answers

What percentage of autistic children have an IQ in the borderline range (70-84)?

25% Signup and view all the answers

What proportion of children with ASD have an IQ near or above average?

50% Signup and view all the answers

Which of the following is NOT a common finding in children with ASD?

Significantly lower IQ in all cases Signup and view all the answers

According to recent studies, what is a feature often observed in genetic vulnerability in ASD?

Higher prevalence among Black children Signup and view all the answers

Which characteristic is often seen in ASD cases involving CNV (copy number variation)?

Short stature and high weight Signup and view all the answers

Which of the following patterns is most commonly seen in individuals with ASD?

Poor language and social skills, but high IQ Signup and view all the answers

What is a characteristic of specific learning disorder?

Children have issues learning despite normal intelligence Signup and view all the answers

Which disorder is often known as a 'learning disability' but is not actually a disability?

Specific learning disorder Signup and view all the answers

Which of the following is a symptom of social pragmatic communication disorder?

Struggling to read non-verbal cues Signup and view all the answers

What is an accurate statement about autism spectrum disorder (ASD)?

Symptoms are often observed before the age of 3 years Signup and view all the answers

What is a common symptom of children with autism spectrum disorder (ASD)?

Difficulty learning in typical environments from birth Signup and view all the answers

Social communication disorder is one type of which spectrum disorder?

Autism spectrum disorder Signup and view all the answers

What percentage increase in the number of kids diagnosed with social pragmatic communication disorder was noticed in 2013?

50% Signup and view all the answers

What does a specific learning disorder often cause difficulties in?

Reading, writing, and math Signup and view all the answers

Which statement is true about children with autism spectrum disorder?

They often avoid social stimuli Signup and view all the answers

Which group of disorders is characterized by atypical development in social interaction and communication?

Autism spectrum disorder Signup and view all the answers

Which of the following disorders is listed in both DSM-5 and ICD-10 for autism spectrum disorders?

Autistic disorder Signup and view all the answers

What is one characteristic of children with autism regarding social interactions?

They have difficulty understanding jokes and sarcasm. Signup and view all the answers

Which condition is not specifically related to an autism spectrum disorder in ICD-10 classification?

Mental retardation Signup and view all the answers

Which of the following is a clinical clue for autistic spectrum disorders?

Strong need for routines and change aversion Signup and view all the answers

How are children with autism often described in terms of play behavior?

Lacking spontaneous play Signup and view all the answers

What is a common behavior regarding language use in children with autism?

Literal interpretation of language Signup and view all the answers

Which of the following strategies is suggested for helping children with autism?

Providing extra help with learning and social skills Signup and view all the answers

What characterizes a child's vocabulary use if they have autism?

Limited to only relevant situations Signup and view all the answers

What is a common sensory difficulty for children with autism?

Difficulty responding to sounds of changing pitch Signup and view all the answers

Which of the following is listed under ICD-10 but not DSM-5 for autism spectrum disorders?

Comorative disorder with mental retardation and stereotypical movements Signup and view all the answers

Which inheritance pattern is associated with Smith-Lemli-Opitz syndrome?

Autosomal recessive Signup and view all the answers

Which genetic mechanism is exemplified by the fragile X syndrome?

Trinucleotide repeat expansion Signup and view all the answers

What is the theory of mind's role in understanding ASD?

It attempts to identify a psychological disorder in ASD. Signup and view all the answers

Which factor is mentioned as potentially increasing the risk of ASD due to genetic changes in sperm?

Paternal age Signup and view all the answers

What does weak central coherence refer to in the context of ASD?

A psychological characteristic of ASD Signup and view all the answers

Which disorder is associated with X-linked inheritance patterns?

Duchenne muscular dystrophy Signup and view all the answers

What gene is associated with Rett Syndrome?

MeCP2 Signup and view all the answers

Which disorder is also known as Heller's disease?

Childhood Disintegrative Disorder Signup and view all the answers

Which symptom is NOT commonly associated with ADHD?

Stilted speech Signup and view all the answers

What type of movements are lost in Rett Syndrome?

Skilled hand movements Signup and view all the answers

What is a key characteristic of Asperger Syndrome?

Social and communication difficulties Signup and view all the answers

ADHD is most accurately described under which of the following terms?

A disorder with persistent and pervasive symptoms Signup and view all the answers

Which of the following is a common characteristic of Childhood Disintegrative Disorder?

Marked loss of cognitive functions after a period of normal development Signup and view all the answers

What aspect is vital to ensuring a diagnosis of ADHD?

Symptoms being functionally impairing and persistent Signup and view all the answers

What was the point prevalence rate of childhood ADHD in females according to the 2010 Global Burden of Disease Study?

0.7% Signup and view all the answers

How much did the percentage of ADHD diagnoses increase in the US from 2003 to 2011?

42% Signup and view all the answers

What percentage of children in the US receive drugs for ADHD?

6.1% Signup and view all the answers

What is ADHD often associated with in terms of cognitive function?

Higher cognitive executive function Signup and view all the answers

Which brain region is NOT typically involved in ADHD as per neuroimaging studies?

Occipital lobe Signup and view all the answers

What is the estimated heritability of ADHD according to genetic studies?

70-80% Signup and view all the answers

Which type of twins shows a higher concordance for ADHD?

Monozygotic twins Signup and view all the answers

Which of the following is a typical sign found in children with hyperkinetic disorder?

Clumsiness Signup and view all the answers

What is a primary aim of managing a child with ASD?

Reducing core symptoms Signup and view all the answers

Which intervention is most studied for preschool children with ASD?

Early intensive behavioural interventions (EIBI) Signup and view all the answers

What type of support can help enable individuals with ASD achieve their potential?

Educational and vocational support Signup and view all the answers

Which comorbid problems might children with ASD experience?

Anxiety and ADHD Signup and view all the answers

What evidence exists for the effectiveness of restricted diets for children with ASD?

Insufficient evidence Signup and view all the answers

Which medication is sometimes used to treat associated symptoms of aggression and irritability in children with ASD?

Antipsychotic medication Signup and view all the answers

What kind of programs have been shown to improve employment success for individuals with ASD?

Vocational programs Signup and view all the answers

What kind of support is important for the families of children with ASD?

Information and services for parents and caregivers Signup and view all the answers

What approach is recommended for managing psychological problems in children with ASD?

Understanding sensory sensitivities and addressing changing circumstances Signup and view all the answers

What is the main benefit of Early Intensive Behavioural Interventions (EIBI) for children with ASD?

Improving short-term outcomes Signup and view all the answers

What does the weak central coherence (WCC) theory explain in autism?

Local processing bias Signup and view all the answers

How does communication disorder differ from ASD?

Normal response to people and good non-verbal communication Signup and view all the answers

Which condition is characterized by developmental regression?

Rett syndrome Signup and view all the answers

What does a child with ASD have more impairment of compared to a child with intellectual disability?

Language Signup and view all the answers

Which disorders are more likely to occur with ASD?

ADHD, depression, anxiety, and conduct disorder Signup and view all the answers

How can deafness be excluded in the differential diagnosis of ASD?

By conducting appropriate hearing tests Signup and view all the answers

Which executive function is involved in planning and organizing?

Frontal lobe executive function Signup and view all the answers

Which theory might explain the islets of ability commonly observed in individuals with ASD?

Weak central coherence theory Signup and view all the answers

What is a common long-term negative effect of stimulant treatment for ADHD?

Irritability and depression Signup and view all the answers

Which term is used to describe the behavioral pattern in oppositional defiant disorder (ODD)?

Antisocial behavior Signup and view all the answers

What is considered a common behavior during early childhood in children with ODD and CD?

Frequent lying and stealing Signup and view all the answers

What kind of behavior is often displayed by children with conduct disorder (CD) in late childhood?

Destructiveness and involvement in delinquency Signup and view all the answers

What is a side effect of the noradrenaline reuptake inhibitor, atomoxetine, used for treating ADHD?

Could worsen symptoms in some cases Signup and view all the answers

What is the primary treatment approach for oppositional defiant disorder (ODD) and conduct disorder (CD)?

Parent training programmes Signup and view all the answers

What might be an unintentional consequence of parents giving attention to their child's antisocial behaviour?

Unintentional reinforcement of antisocial behaviour Signup and view all the answers

Which method is used by parents in some training programmes to influence other areas of their child’s behaviour?

Reading with their children Signup and view all the answers

What do anger management programmes aim to correct in habitually aggressive young people?

Misperception of hostile intentions in others Signup and view all the answers

What tools are provided to parents in training programmes to help them apply behavioural procedures?

Written information and video recordings Signup and view all the answers

What is one consequence of aggressive young people underestimating their own behaviour?

They choose inappropriate behaviours instead of verbal responses Signup and view all the answers

Which type of genes have been identified as associated with ADHD in some studies?

Dopamine system genes Signup and view all the answers

What environmental factor is mentioned as interacting with genetic risk to influence ADHD?

Maternal smoking Signup and view all the answers

Which factor is NOT associated with ADHD?

High birth weight Signup and view all the answers

What is the typical prognosis for inattention in ADHD?

Persists into adult life Signup and view all the answers

What percentage of cases diagnosed in childhood retain the full diagnosis of ADHD into adolescence?

50% Signup and view all the answers

What might the presence of ADHD in adults be attributed to?

New cases starting in adulthood Signup and view all the answers

What is a common comorbid condition in adults with ADHD?

Mood disorders Signup and view all the answers

What type of intervention is often combined with stimulant medication for severe cases of ADHD?

Psychosocial interventions Signup and view all the answers

What type of training might benefit children with ADHD who have comorbid anxiety or depressive disorders?

Cognitive behavioural training Signup and view all the answers

How can parental training for ADHD best be described?

Group-based training Signup and view all the answers

What is the main difference between Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD)?

CD involves more serious violations of social norms than ODD Signup and view all the answers

In which manual were Intermittent Explosive Disorder and Disruptive Mood Dysregulation Disorder (DMDD) included as overlapping with CD and ODD?

DSM-5 Signup and view all the answers

What percentage of overall child and adolescent psychopathology do ODD and CD constitute?

50% Signup and view all the answers

How much more common is ODD in boys compared to girls?

Twice as common Signup and view all the answers

Why was the diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) introduced in DSM-5?

To prevent overdiagnosis and medication for bipolar disorder Signup and view all the answers

How do the prevalence rates of ODD/CD change with socioeconomic status?

Lowest socioeconomic status correlates with higher prevalence Signup and view all the answers

Which factor is strongly associated with ODD/CD prevalence in children?

Experiencing maltreatment or being in foster care Signup and view all the answers

Which gene variant has been shown to predispose children to Conduct Disorder (CD) in adverse environments?

Monoamine oxidase-A (MAOA) gene Signup and view all the answers

What is a common outcome for children whose mothers consumed alcohol during pregnancy?

Increased likelihood of developing Conduct Disorder Signup and view all the answers

Which temperament traits have been associated with later conduct problems?

Inattention and restlessness Signup and view all the answers

Which factor is a strong predictor of antisocial behaviour?

Quality of parenting Signup and view all the answers

What parenting practice is associated with the development of ODD/CD?

Harsh, inconsistent discipline Signup and view all the answers

What is a consequence of the negative reinforcement trap in parenting?

Increased oppositional behaviour Signup and view all the answers

Which attachment type is strongly associated with antisocial behaviour?

Disorganized attachment Signup and view all the answers

What environmental factor is linked to the likelihood of developing CDs?

Living in deprived areas Signup and view all the answers

What is a common influence on children with ODD/CD beyond the family?

Negative peer interchanges Signup and view all the answers

What long-term outcome is associated with adolescence CD?

Heavy drug usage Signup and view all the answers

What factor does not affect the overall long-term prognosis of CDs?

Early intervention treatment Signup and view all the answers

Which social environment factor is not commonly associated with ODD/CD?

High pupil commitment to school Signup and view all the answers

What is a typical issue faced by families of children with severe CDs?

Material deprivation Signup and view all the answers

What is wrongly equated with conduct disorder according to the content?

Juvenile delinquency Signup and view all the answers

What factor appears to be less significant in causing juvenile delinquency?

Genetic factors Signup and view all the answers

What is particularly common among those who come from broken homes?

Delinquency Signup and view all the answers

What percentage of boys with criminal fathers are convicted, according to the study?

50% Signup and view all the answers

What does the content suggest is needed when assessing a delinquent child?

Collateral sources and clear notes Signup and view all the answers

Which tool can assist in assessing adolescent violence?

Structured Assessment of Violence Risk in Youth (SAVRY) Signup and view all the answers

What is the main aim of the law as it applies to children and adolescents?

Treatment rather than punishment Signup and view all the answers

Which model focuses on the prediction of risk and classification of offenders for treatment?

Risk-Need-Responsivity (RNR) model Signup and view all the answers

For juvenile offenders, what does the treatment usually include aside from psychiatric interventions?

Improving family environment and vocational accomplishments Signup and view all the answers

What is the preferred type of program for recurrent delinquency?

Community-based programme Signup and view all the answers

Which intervention may be considered if community-based programs fail for juvenile offenders?

Custodial care Signup and view all the answers

What is the Juvenile Sex Offender Assessment Protocol II (J-SOAP-II) used for?

Assessing sexually harmful behavior Signup and view all the answers

What is a common initial legal response to minor delinquent behavior?

Minimal intervention with firm disapproval Signup and view all the answers

What are obsessions in the context of OCD?

Intruding thoughts, impulses, or images Signup and view all the answers

What is the prevalence of major depressive disorder in pre-pubertal children?

Less than 1% Signup and view all the answers

How do individuals with OCD typically perceive their obsessions?

As stemming from their own mind Signup and view all the answers

What is the ratio of females to males suffering from major depressive disorder after puberty?

2:1 Signup and view all the answers

What is the purpose of compulsions in OCD?

To respond to and reduce anxiety caused by obsessions Signup and view all the answers

Which therapy is corner stone for children with OCD?

Exposure and Response Prevention (ERP) Signup and view all the answers

Which factor is NOT mentioned as influencing the prevalence estimates of depression?

Geographic location Signup and view all the answers

Which of the following risks for child and adolescent depression is NOT mentioned?

Economic risks Signup and view all the answers

What are common feelings experienced by individuals during obsessions?

Anxiety, distress, and/or disgust Signup and view all the answers

At what rate is depression more common in adolescence compared to childhood?

More common in adolescence Signup and view all the answers

What can precipitate separation anxiety disorder?

A frightening experience Signup and view all the answers

What is a common symptom of phobic anxiety disorder in children?

Fear of school Signup and view all the answers

Which approach should parents adopt to treat minor phobic symptoms in children?

Adopt a firm and reassuring approach Signup and view all the answers

What may children with separation anxiety disorder develop into adulthood?

Generalized anxiety disorder Signup and view all the answers

Which treatment method may benefit children with separation anxiety when anxiety is particularly severe?

Anxiolytics for short periods Signup and view all the answers

What should be taken into account in the treatment of separation anxiety disorder?

The child's aetiological factors Signup and view all the answers

What may worsen separation anxiety disorder in children?

Change in the child's routine Signup and view all the answers

Which of the following is a possible response of children with separation anxiety disorder?

Excessive anxiety to everyday stressors Signup and view all the answers

What is a significant characteristic of anxiety disorders in children?

They often cause marked avoidance and significant distress. Signup and view all the answers

Which classification system includes a diagnosis of sibling rivalry disorder?

ICD-10 Signup and view all the answers

At what stage of childhood are separation anxiety and fears of animals most common?

Preschool years Signup and view all the answers

Which factor is mentioned as potentially influencing the prevalence rates of childhood anxiety disorders?

Cultural factors Signup and view all the answers

Which type of anxiety becomes more prominent during adolescence?

Social anxiety Signup and view all the answers

Which type of prevention includes parenting programmes?

Primary prevention Signup and view all the answers

What mental health condition is placed in a different section in DSM-5 compared to childhood and adult anxiety disorders?

Obsessive-compulsive disorder Signup and view all the answers

What is a common comorbid condition with childhood anxiety disorders?

Other types of anxiety disorders Signup and view all the answers

Which type of prevention includes safeguarding of children?

Secondary prevention Signup and view all the answers

Which strategy is NOT mentioned as part of tertiary prevention for youth offending?

Cognitive skills training Signup and view all the answers

What is the ICD-10 classification for separation anxiety disorder?

Separation anxiety disorder of childhood Signup and view all the answers

Which treatment approach has been found to be more effective for anxiety disorders in children than either therapy alone?

Combination treatment with SSRIs and cognitive behavioral therapy Signup and view all the answers

Which symptom is NOT typically associated with separation anxiety disorder in children?

Overwhelming need for social interactions Signup and view all the answers

What age is typically the onset for separation anxiety disorder?

Before 6 years Signup and view all the answers

Which disorder is listed under both DSM-5 and ICD-10 as 'Generalized anxiety disorder'?

Generalized anxiety disorder Signup and view all the answers

Which therapeutic approach is usually used first for treating childhood anxiety disorders?

Cognitive behavior therapy Signup and view all the answers

What physical symptoms are often manifested as anxiety in children with separation anxiety disorder?

Stomach ache and headache Signup and view all the answers

Why might parents of children with anxiety disorders need separate treatment?

They may have their own anxiety disorders Signup and view all the answers

Which of the following is NOT an anxiety disorder listed in the DSM-5?

Sibling rivalry disorder Signup and view all the answers

What is a common issue for children with separation anxiety disorder regarding sleep?

Disturbed sleep with nightmares Signup and view all the answers

What is a common cause of PTSD in children?

Natural and man-made disasters Signup and view all the answers

Which factor influences the prevalence of PTSD in children?

The amount of time since the traumatic event Signup and view all the answers

What percentage of children with PTSD continue to suffer in adulthood?

15-30% Signup and view all the answers

Which therapy has the greatest evidence base for treating PTSD in children?

Trauma-focused cognitive behavior therapy (TF-CBT) Signup and view all the answers

At what age does OCD typically develop?

Late childhood and early adolescence Signup and view all the answers

What are obsessional thoughts in childhood commonly concerned with?

Contamination and accidents Signup and view all the answers

Which neurological disorder is OCD associated with?

Tourette's disorder Signup and view all the answers

Which of the following is NOT typically a symptom of OCD in children?

Single-minded focus on a hobby Signup and view all the answers

What kind of trauma usually leads to complex PTSD in children?

Chronic trauma of an interpersonal nature Signup and view all the answers

Which repetitive behavior is considered normal in children and not compulsive?

Avoiding cracks in the pavement Signup and view all the answers

What is a common characteristic of conversion disorders in childhood?

Symptoms are usually mild and seldom last long. Signup and view all the answers

When should the diagnosis of conversion disorder be made?

After a careful search for organic disease. Signup and view all the answers

What is the recommended treatment approach for conversion disorders?

By reducing stressful circumstances and encouraging the child to talk about the problem. Signup and view all the answers

What is a common outcome for children diagnosed with conversion disorders on follow-up?

Almost a third will develop a new psychiatric disorder. Signup and view all the answers

What is the most significant risk period for major unipolar depression?

During adolescence. Signup and view all the answers

Which symptom is more common in adolescence with depressive mood?

Anger and withdrawal from social contact Signup and view all the answers

What is a major long-term consequence of depressive illness during adolescence?

Negative impact on interpersonal relationships Signup and view all the answers

Which is NOT a common symptom of conversion disorder in childhood?

High fever Signup and view all the answers

Which demographic has a higher incidence of conversion disorders?

Females Signup and view all the answers

Which of the following is a recommended management strategy for conversion disorders?

Encouraging the child to talk about their problems Signup and view all the answers

What factor is associated with increased mood lability and greater attention to negative emotional cues?

Sleep deprivation Signup and view all the answers

Which antidepressant has a favorable risk-benefit ratio for adolescents?

Fluoxetine Signup and view all the answers

What is a key environmental risk factor for depression onset and recurrence in children?

Child maltreatment Signup and view all the answers

How many times higher is the risk of depression for children with sexual minority status?

Three times Signup and view all the answers

Which of the following is a vulnerability factor related to depression in children?

Cognitive distortion and rumination Signup and view all the answers

Which therapy combination showed significantly higher response rates in the Treatment for Adolescents with Depression Study (TADS)?

Fluoxetine and CBT combined Signup and view all the answers

What is a potential impact of parental depression on children?

Increased risk of depression Signup and view all the answers

What additional consideration is important when using fluoxetine in adolescents?

Monitoring for suicidal ideation and self-harm Signup and view all the answers

Which of the following is identified as a resilience factor in children with depressive disorders?

High IQ Signup and view all the answers

Which comorbid condition is associated with depression in children?

Poor physical health Signup and view all the answers

What is the primary goal of treatment approaches for selective mutism?

To lower the child's anxiety for speaking in certain situations Signup and view all the answers

What is the common intervention for selective mutism?

General behavioral treatments, cognitive behavior therapy, and/or play therapy Signup and view all the answers

What is the remission rate for selective mutism 13 years after the first referral?

58% Signup and view all the answers

What term does DSM-5 use to describe stammering?

Child-onset fluency disorder Signup and view all the answers

Which gender is more frequently affected by stammering?

Boys Signup and view all the answers

What is the approximate prevalence of school refusal in the general population?

1-2% Signup and view all the answers

Which of the following symptoms is NOT commonly associated with school refusal?

Skin rash Signup and view all the answers

What is a common characteristic of stammering?

Repetitions of syllables or words Signup and view all the answers

What percentage of school refusers referred to clinics have a diagnosable anxiety disorder?

50% Signup and view all the answers

Which of the following anxiety disorders is NOT commonly found among school refusers?

Obsessive-compulsive disorder Signup and view all the answers

A child's sudden refusal to attend school can follow what kind of event?

Change of class Signup and view all the answers

In what percentage of children referred to mental health services is school refusal observed?

11-15% Signup and view all the answers

Which factor is NOT involved in the aetiology of school refusal?

Genetic factors Signup and view all the answers

What type of problem frequently follows an enforced absence for another reason, like illness, in relation to school refusal?

Dramatic refusal to attend school Signup and view all the answers

Which symptom must be present in childhood bipolar disorder diagnosis along with 'B symptoms' of mania?

Irritability Signup and view all the answers

Which medication group has the strongest efficacy data for treating mania in young people with bipolar disorder?

Second-generation antipsychotics Signup and view all the answers

Which medication is licensed by the FDA to treat mania or mixed states in children aged 10-17 years?

Quetiapine Signup and view all the answers

What is a key distinguishing feature between mania and the overactivity of ADHD?

Decreased need for sleep Signup and view all the answers

What condition is introduced in the DSM-5 as a key differential diagnosis for childhood bipolar disorder?

Disruptive Mood Dysregulation Disorder Signup and view all the answers

Which is NOT a 'B symptom' of mania?

Eating disturbances Signup and view all the answers

What is the weakest supported treatment for childhood bipolar disorder?

Antiepileptic drugs Signup and view all the answers

Which of the following is the most common reason for repeated school absence?

Physical illness Signup and view all the answers

What is school refusal most commonly associated with?

Anxiety and depressive disorder Signup and view all the answers

Which factor is suggested to elevate the risk of manic induction on antidepressant treatment in young children?

Prepubertal status Signup and view all the answers

Which of the following is NOT a main group considered in the context of associations between physical and psychiatric disorders in children?

genetic vulnerabilities linked to psychiatric disorders Signup and view all the answers

Which of the following is an example of a psychiatric disorder presenting with physical symptoms without an identified underlying organic cause?

Abdominal pain Signup and view all the answers

What is an example of a physical complication of psychiatric disorders?

Eating disorders Signup and view all the answers

Which disorder is associated with a strong desire to be of another gender?

Gender dysphoria Signup and view all the answers

What is commonly seen in children with medical illnesses and treatments?

Psychiatric manifestations of medical illnesses Signup and view all the answers

What is required for a diagnosis of schizophrenia in children with other communication disorders?

Prominent hallucinations or delusions for at least 1 month Signup and view all the answers

How does the prognosis of early-onset schizophrenia generally appear?

Chronic and especially poor with insidious onset Signup and view all the answers

What has recent emphasis in the treatment of early-onset schizophrenia focused on?

Early detection and intervention Signup and view all the answers

What criticism surrounds the treatment of self-harm and suicidal behavior in adolescents?

Controversy over the effectiveness of antidepressants Signup and view all the answers

Which gender is more commonly affected by schizophrenia in adolescence?

Boys Signup and view all the answers

What aspect of anti-psychotic treatment for early-onset schizophrenia is compared to adults?

Less favorable balance of risks and benefits Signup and view all the answers

What major mental health issue is mentioned as a key public health problem in adolescents?

Self-harm and suicide Signup and view all the answers

Which of the following factors are important in preventing self-harm and suicide?

Restricting access to means for suicide Signup and view all the answers

What is often associated with gender dysphoria in children?

A strong desire to be of the other gender Signup and view all the answers

What percentage of children hospitalized for medical illnesses are at increased risk for emotional disorders?

20% to 35% Signup and view all the answers

What factors influence parents' responses to a child's chronic physical illness?

The child's temperament Signup and view all the answers

What kind of emotional reactions might parents experience when their child has a chronic physical illness?

Reactions similar to bereavement Signup and view all the answers

How might siblings of children with chronic illnesses feel?

Neglected Signup and view all the answers

What is an important aspect of hospital care for children?

Frequent visits from family and friends Signup and view all the answers

Why is it important to have educational facilities associated with hospitals for children?

To help children transition back to school easier Signup and view all the answers

What role can primary caregivers play in the care of hospitalized children?

Primary caregivers can participate in the child's care Signup and view all the answers

How can hospitals prepare children for admission?

By explaining what will happen Signup and view all the answers

What can some siblings of children with chronic illnesses inadvertently gain?

Increased abilities to cope with stress Signup and view all the answers

Which age group has the highest prevalence of nocturnal enuresis occurring once a week or more in the UK?

5 years of age Signup and view all the answers

Which gender has a higher frequency of nocturnal enuresis?

Boys Signup and view all the answers

What is a common cause of nocturnal enuresis as stated in the content?

Delayed nervous system maturation Signup and view all the answers

What percentage of children with enuresis have a first-degree relative who was also enuretic?

70% Signup and view all the answers

What is a risk factor associated with bedwetting in later childhood?

Early childhood difficult temperament problems Signup and view all the answers

Which of the following has not been shown to improve outcomes in managing enuresis?

Rigid or particular kinds of training Signup and view all the answers

What approach is typically required when assessing young adolescents?

Similar to that used for children Signup and view all the answers

Which children are reported to have a higher frequency of enuresis?

Children from large families Signup and view all the answers

How are stressful events related to enuresis?

They are associated with secondary enuresis Signup and view all the answers

Why might older adolescents be better treated in an adult clinic?

They have reached a higher maturity level Signup and view all the answers

When is it better to see the adolescent before interviewing the parents?

When the adolescent needs to be seen as an independent person Signup and view all the answers

What particular attention should be paid to during the psychiatric history of an adolescent?

Their functioning at home, in school, or at work Signup and view all the answers

What factor is important in establishing a relationship with adolescents?

Showing interest in their points of view Signup and view all the answers

Who can refer adolescents to psychiatric units besides doctors?

Senior teachers, social workers, and the courts Signup and view all the answers

What should be done when a referral to an adolescent unit is non-medical?

Inform and discuss the case with the general practitioner Signup and view all the answers

What kind of behavior in adolescents may be stressful for others with mental disorders?

Dangerous behavior due to personality and circumstances Signup and view all the answers

What type of problems may warrant admission to a health service inpatient unit for adolescents?

Severe or unusual mental symptoms requiring close monitoring Signup and view all the answers

What is a necessary element in adolescent psychiatric care?

Maintaining close links with child and adult psychiatry services Signup and view all the answers

During which age range is early adolescence characterized?

10-14 years Signup and view all the answers

What significant brain development occurs during late adolescence?

Development of the prefrontal cortex Signup and view all the answers

Which of the following is a characteristic of psychological development in adolescence?

Low resistance to peer influences Signup and view all the answers

In terms of psychiatric disorders, what is especially challenging to distinguish during adolescence?

Psychiatric disorder from normal emotional reactions Signup and view all the answers

Which type of therapy has been shown to be valuable for treating anorexia nervosa in adolescents?

Systemic family therapy Signup and view all the answers

When does the incidence of substance use disorders typically peak?

Around age 20 years Signup and view all the answers

What percentage of 16-year-olds have 'ever' used alcohol on average, according to a 36-country survey?

87% Signup and view all the answers

Which substance is NOT commonly used by adolescents?

Prescription antibiotics Signup and view all the answers

Which of the following factors increases the likelihood of excessive drinking in adolescents?

Presence of conduct disorder Signup and view all the answers

What behavior is often a group activity among adolescents?

Occasional drug taking Signup and view all the answers

At what age do only 1% of children soil themselves with faeces once a month or more?

11 years Signup and view all the answers

Which term is used in a narrower sense to denote repeated deposition of formed faeces in inappropriate places?

Encopresis Signup and view all the answers

Which of the following is a common cause of constipation leading to faecal soiling?

Low-fibre diet Signup and view all the answers

Why might a child fear using the toilet according to the chapter?

Due to fear that a harmful creature lives there Signup and view all the answers

What approach is typically used to manage chronic constipation as a cause of faecal soiling?

Laxatives and behavioural interventions Signup and view all the answers

Which behavioural technique is suggested for improving inadequate toilet training?

Using achievable targets and rewards Signup and view all the answers

What complicates the treatment of soiling as a form of rebellion?

It is part of wider social and psychological difficulties Signup and view all the answers

What factor contributes to stress-induced regression in bowel control?

Highly stressful experiences Signup and view all the answers

Who should be closely involved in the treatment if a child is admitted to the hospital for faecal soiling management?

Parents Signup and view all the answers

Which of the following is not typically a cause of constipation leading to faecal soiling?

Frequent use of laxatives Signup and view all the answers

What is typically the first step in managing children with psychosocial short stature syndrome (PSSS)?

Ensuring the child's safety Signup and view all the answers

Which factor is usually associated with non-organic failure to thrive (NOFTT)?

Emotional deprivation Signup and view all the answers

What symptom might an infant with non-organic failure to thrive (NOFTT) exhibit?

Reduced height and weight Signup and view all the answers

Which activity is excluded from the term 'sexual abuse'?

Consensual relationship between adults Signup and view all the answers

What percentage of females report forced intercourse or rape?

13% Signup and view all the answers

Which factors are considered common indicators of childhood sexual abuse?

Drug and alcohol misuse later in life Signup and view all the answers

What has research shown about the long-term mental health effects for adult survivors of childhood sexual abuse?

Higher incidence of mental health issues compared to the general population Signup and view all the answers

What is an important consideration during the assessment of a child for sexual abuse?

Conducting a thorough psychological and physical examination Signup and view all the answers

Which psychological effects are associated with childhood sexual abuse?

Depression, anxiety, and PTSD Signup and view all the answers

At what percentage do adult survivors of childhood sexual abuse require long-term mental health services?

60% Signup and view all the answers

Which type of child maltreatment includes body rocking and dissociation as clinical indicators?

Emotional abuse Signup and view all the answers

What is a key factor at the community level that can contribute to child maltreatment?

Neighbourhoods with high rates of physical violence Signup and view all the answers

Which age group is especially vulnerable to child maltreatment?

Children under 5 Signup and view all the answers

Which behaviour is a clinical indicator of neglect?

Failure to thrive Signup and view all the answers

Which of the following is an individual factor that contributes to child maltreatment?

Chronic illness Signup and view all the answers

In which type of abuse are anogenital injuries and sexualized behaviour clinical indicators?

Sexual abuse Signup and view all the answers

A history of what can be a family factor contributing to child maltreatment?

Past child abuse or neglect Signup and view all the answers

Which clinical feature is associated with physical abuse?

Bruises Signup and view all the answers

What might parents present with as a clinical feature associated with child maltreatment?

Inconsistencies in rationale for seeking help Signup and view all the answers

Which clinical indicator strongly suggests emotional abuse?

Encopresis Signup and view all the answers

In the UK, which sector holds the responsibility for child protection in cases of abuse?

Social services Signup and view all the answers

What is the principle guiding decisions in cases of conflicts of interest in child psychiatry?

The child's interests take precedence over those of the parents Signup and view all the answers

What is one of the first steps in the assessment and management of child sexual abuse?

Referral to child protection services Signup and view all the answers

Which is NOT a typical measure involved in the management of child abuse cases?

Excluding parents from all decision-making Signup and view all the answers

How should issues of confidentiality be handled in the care of children?

Consider collaborating with relevant medical and social services Signup and view all the answers

What does emotional abuse typically lead to?

Failure to thrive physically Signup and view all the answers

Which of the following is NOT a form of child neglect?

Overprotection Signup and view all the answers

Who might detect child neglect?

All of the above Signup and view all the answers

What is a common reason for a child to need foster care?

Child neglect Signup and view all the answers

Which of the following is a likely outcome for adults who were abused as children?

Difficulties in rearing their own children Signup and view all the answers

What can help improve the outcome for abused children?

Establishing a good relationship with an adult from outside the family Signup and view all the answers

What is the first step once non-accidental injury has been confirmed in a child?

Establish the child's safety Signup and view all the answers

Why should parents of emotionally abused children be offered help with their problems?

To improve their day-to-day interactions with the child Signup and view all the answers

What is the reported prevalence rate of physical abuse in childhood according to most studies?

5-15% Signup and view all the answers

Which of the following is NOT a common form of injury in physically abused children?

Sprained ankle Signup and view all the answers

Which of the following psychological characteristics is associated with abused children?

Fearful responses to the parents Signup and view all the answers

What is a red flag that may arouse suspicion of physical abuse?

Delayed seeking help Signup and view all the answers

If a doctor suspects child abuse, what should they do next?

Refer the child to hospital Signup and view all the answers

Which of the following is a risk factor for child maltreatment related to the parent?

Social isolation Signup and view all the answers

What should be done for all children in whom non-accidental injury is suspected?

Arrange inpatient admission Signup and view all the answers

What type of photographs should be taken during the assessment at the hospital?

Formal photographs of injuries Signup and view all the answers

Which factor associated with the child can lead to weak attachment to the parents?

Prematurity Signup and view all the answers

What should doctors do to ensure they are aware of the risks and needs of abused children?

Receive regular child protection training Signup and view all the answers

Study Notes

Feeding Problems

Feeding and eating difficulties in preschool children are influenced by physical factors, maturational changes, social relationships, emotional state, sensory integration, and feeding skills.
Difficulty managing food intake distribution may be due to delayed development of feeding habits and refusal to eat, often with underlying medical factors.
Constant refusal to eat and not showing interest in meals may be a behavioral sign of poor mental health.
Feeding problems can be a way for the child to become the focus of parental anxiety, especially if there is a history of severe and persistent illness.

Sleep Problems

Wakefulness, anxiety, and sleep problems are common difficulties in children aged 1-5 years (25-30%).
These issues may be related to the child's worries, concerns, and fears.
Regular sleep times are essential for calming the family, and a coordinated approach is necessary to address sleep problems.
Psychologists should be involved in assessing and treating sleep problems, and parents should establish a bedtime routine to help the child sleep.

Underlying Medical Issues

Medical issues can be associated with behavioral syndromes and should be considered in diagnosis.
Case studies can help identify significant problems and develop a diagnosis.
It is essential to consider the child's behavior patterns and developmental areas to understand their needs.

Concerns Relating to Anxiety Disorders

Anxiety disorders can manifest in children as severe anxiety, social, shy, or cautious behaviors.
Experiences of fear are directly related to anxiety, and anxiety may be a term for a "generalized anxiety disorder" or "separation anxiety disorder."

Specific Learning Disorders

Reading Disorder: A learning disability that affects reading, writing, and spelling skills, with difficulties in phonological awareness, rapid naming, fluency, and comprehension.
Specific Developmental Disorders: Disorders that affect specific developmental domains, such as expressive language, receptive language, and motor development.
Early intervention is crucial to help children with learning and developmental disabilities succeed.

Assessment and Treatment of Problems in Preschool Children

Parents, teachers, and other professionals should work together to assess and treat children with learning and developmental disabilities.
A comprehensive approach to assessment and treatment is necessary to address the child's needs.

Psychology of Reading Difficulties

Reading is a complex skill that depends on cognitive function and develops gradually.
Reading difficulties can be due to a range of factors, including phonological awareness, language experience, and cognitive effort.
Analytical skills are essential for reading, and rapid auditory processing is a key factor in reading speed.

Progress

The prognosis for reading difficulties varies with the severity of the condition.
Some children with mild reading difficulties may improve by adolescence, while others may require ongoing intervention.
It is essential to understand how to accommodate children with reading difficulties and provide early intervention to improve outcomes.

Mathematics Disorder

Mathematics disorder is a specific learning disorder that affects arithmetic skills.
It is a pervasive, lifelong problem that can lead to a lack of interest and motivation, failures, and struggles in math.
The ability to learn and integrate math skills is critical for mathematical proficiency.

Disorders of Communication, Speech, and Language

Communication is the transmission of information and ideas using a system of signaling and instruments.
Language is a form of communication that balances a developed, agreed-upon systematic way to convey a message.
Speech emerges widely in its development, with 25-30% of infants reaching 12 months of age able to utter first words.
Language development is a continuous process, with estimates of up to 25,000 words in 2-3 years.

Classification of Speech and Language Disorders

The classifications of speech and language disorders differ between ICD-10 and DSM-5.
ICD-10 uses the title "speech disorder," while DSM-5 uses "speech and language."
The wider title in both classifications includes similar categories.

Language Disorders

Language disorders are general difficulties in comprehension and use of language across modalities.
They are a common reason for primary school children to receive special educational support.
The prevalence of language disorders is estimated to be 7% of school-aged children.
The criteria for language difficulties include delayed language development, significant delay in acquiring new words, difficulties expressing thoughts and ideas, and difficulties understanding spoken language.### Multidisciplinary Teams in Child Development
Multidisciplinary teams, including speech and language therapists, teachers, parents, and educational psychologists, work together to support children with impaired speech and language skills.
These teams tailor treatment and educational support to the child's needs, especially if the child has received early intervention services.

Specific Learning Disorder

Children with specific learning disorders have difficulties learning despite normal intelligence.
They may struggle with one specific area, such as reading, writing, or math.
The disorder is often referred to as a "learning disability," but it is not a disability.
Children with specific learning disorders are assessed, and only a specific diagnosis can be applied.

Children with social pragmatic communication disorder struggle to communicate effectively.
They have difficulty with the social uses of communication, reading non-verbal cues, and having conversations.
They need extra support at home and have difficulties adjusting to social expectations of school.
Interventions can help children with social pragmatic communication disorder navigate difficult social settings.

Autism Spectrum Disorder (ASD)

ASD is a group of disorders characterized by atypical development in social interaction and communication.
Children with ASD have difficulty learning in typical environments from birth.
They show a wider range of autistic and neurodevelopmental symptoms, often observed before the age of 3 years.
There are three types of ASD, each with its own specific symptoms.
Individuals with ASD typically appear aloof when around people.
ASD affects 1 in 58 children, with a 5:1 male-to-female ratio.
It is a complex neurological disorder, not a mental illness, and can be hereditary.

Characteristics of Autism Spectrum Disorder

Children with ASD may lack social skills, have difficulty with communication, and appear to lack interest in other people's feelings.
They may have difficulty with social play, imitation, and adapting to new situations.
They may have preoccupations with unusual items, difficulty with eye contact, and a tendency to avoid physical contact.
They may also have difficulty with understanding language, managing change, and responding to sounds.

Dealing with Autism

Providing extra help with learning and social skills can support children with ASD.
Creating a calm and structured environment can help them develop.
Encouraging children with ASD to take part in social activities can help them develop their strengths and interests.
Many children with ASD have difficulty with change, routines, and sensory overload.

Autism Spectrum Disorders (ASD)

Genetic Architecture

Inheritance pattern: complex-additive risk from multiple genes, autosomal recessive, autosomal dominant, and X-linked
Mechanism: single nucleotide polymorphisms, copy number variation, chromosomal translocation, and trinucleotide repeat expansion

Understanding ASD

Theory of mind: attempts to identify a basic psychological disorder in ASD, with normal children forming an idea of what others are thinking by age 4
Executive dysfunction and weak central coherence

Factors that may increase ASD risk

Maternal stress, low immunity, and maternal and paternal age
Exposure to drugs and toxins

Impairment of Frontal Lobe Executive Functions

Involved in planning and organization, with implications for personality and extracting meaning from diverse sources
Weak central coherence (WCC) theory explains enhanced performance in neurocognitive tasks and islets of ability in ASD

Differential Diagnosis

ASD must be distinguished from neurodevelopmental disorders, communication disorders, intellectual disability, and mental and behavioral disorders
Comorbidities: ADHD, depression, anxiety, and conduct disorder/challenging behaviors

Managing a Child with ASD

Reducing core symptoms and behaviors through behavioral therapies and support groups
Enabling individuals to achieve their potential through educational and vocational support
Treating comorbid or co-occurring problems
Supporting the family through provision of information and services

Child Psychiatry

Chapter 16

Rett syndrome: rare, X-linked disorder characterized by arrest of cognitive development, loss of skills, and stereotyped movements
Childhood disintegrative disorder: rare condition with a marked loss of cognitive functions and social behavior
Asperger syndrome: denoting a group of children with ASD who have no cognitive or language retardation
Atypical autism and pervasive developmental disorder not otherwise specified: encompassing a continuum of behavior ranging from normal to severe

ADHD

Characterized by inattention, hyperactivity, and impulsivity
Symptoms are pervasive, occur across situations, and vary in different circumstances
Clinical features: inattention, hyperactivity, and impulsivity
Associated with learning difficulties, antisocial behavior, and social disinhibition

Review of Syndromes

ADHD: 2.2% prevalence in males, 0.7% in females
Due to both heritable and non-heritable factors
Neurological findings: signs of neurodevelopmental impairment or delay, and abnormalities of neurotransmission
Neuroimaging studies: reduction in volume and cortical thickness in certain areas of the brain
Genetic studies: investigations suggest genetic factors are important, with heritability estimates of 70-80%

Prognosis

Inattention and impulsiveness often persist into adult life, while overactivity usually lessens
About 50% of cases diagnosed in childhood retain the full diagnosis in adolescence
Prognosis for associated learning difficulties is less good, and antisocial behavior has the worst outcome

Treatment

Psychosocial interventions: parental support, educational interventions, and special education provision
Dietary advice: some children with ADHD may benefit from free fatty acid supplementation

Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD)

Clinical Features

Characterized by persistent patterns of behavior that violate age-appropriate social norms
Commonly considered "externalizing disorders"
CD is more severe than ODD and involves more serious violations of social norms

Aetiology

Many different factors influence the development of ODD/CD
Individual-level influences: genetic factors, CD clusters in families, and shared environmental factors
Family-level influences: quality of parenting, along with gender, is the strongest predictor of antisocial behavior### Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD)
CD/ODD is frequent among children from broken homes, those with poor family relationships, and those who have been in residential care in their early childhood.
CD/ODD is also linked to adverse factors in the wider social environment of the neighbourhood and school.

Child-rearing Practices and Attachment

Less than optimal parenting practices, such as harsh discipline, low warmth, and high criticism, are associated with ODD/CD.
Insecure attachment, particularly of the disorganized type, is strongly associated with antisocial behaviour.
Poor circumstances can affect parenting quality, leading to ODD/CD.

Child Maltreatment and Exposure to Interparental Conflict and Violence

Physical abuse is strongly linked to conduct problems, and children exposed to domestic violence are more likely to become aggressive.
Corporal punishment can increase the likelihood of experiencing physical maltreatment.

Other Influences Beyond the Family

Children with ODD/CD have more negative interactions with other children and are more likely to associate with deviant peers.
Peer influences are most evident in adolescence, and school effects, such as attending schools with high delinquency rates, contribute to ODD/CD.

Prognosis

The long-term outcome of CD varies considerably, with almost 50% of people showing some form of antisocial behaviour in adulthood.
Antisocial behaviour in adulthood may include violent offending, heavy drug usage, teenage pregnancy, leaving school without qualifications, and receiving state benefits.

Management

Mild CDs often subside without treatment, while more severe disorders require treatment for the child and social support for the family.
Parent training programmes, which use behavioural principles, are a mainstay of treatment for ODD/CD.
Anger management programmes seek to correct misperceptions of hostile intentions and aggressive behaviour in young people.

Juvenile Delinquency

Genetic factors are less significant in causing delinquency compared to other factors
Assessing adolescent violence: tools used include Structured Assessment of Violence Risk in Youth (SAVRY) and Juvenile Sex Offender Assessment Protocol II (J-SOAP-II)
Interventions for juvenile offenders should follow the risk-need-responsivity (RNR) model, focusing on predicting risk and classifying offenders for treatment
Psychiatrists treating juvenile offenders need to understand the legal system and treatment of psychiatric disorders, such as conduct disorders, mood disorders, ADHD, substance misuse, and intellectual disability

Anxiety Disorders

Anxiety disorders are the most common mental disorders in childhood, affecting 5-10% of children
Symptoms:
- Fear of strangers in infants
- Separation anxiety and fears of animals, imaginary creatures, and the dark in preschool years
- Social anxiety and fears of personal inadequacy in early adolescence
- Generalized anxiety disorder and panic disorder in later adolescence
Comorbidity is common, especially with other anxiety disorders
Aetiology:
- Interactive factors, including cooperation between authorities, intensive supervision, assertive treatment of mental disorders, restorative justice, and victim support
- Interventions:
  - Primary prevention (parenting programmes, preschool programmes, etc.)
  - Secondary prevention (family-focused therapies, mentoring, etc.)
  - Tertiary prevention (multidimensional treatment foster care)

Separation Anxiety Disorder

Often precipitated by a frightening experience or stressful events
Symptoms:
- Excessive anxiety when separated from attachment figures
- Unrealistic concerns about harm to attachment figures
- Physical symptoms, such as stomach ache and headache
Treatment:
- Account for aetiological factors
- Involve the family in understanding and addressing anxiety
- Help the child feel more secure
- Anxiolytics may be used occasionally for severe anxiety

Phobic Anxiety Disorder

Corresponds to specific phobia in adults
Minor phobic symptoms are common in childhood
Treatment:
- Firm and reassuring approach by parents
- Behavioral techniques used for phobias

Corresponds to social anxiety disorder in adults
Symptoms:
- Fear of social situations and personal inadequacy
- Avoidance of social situations
Treatment:
- Cognitive-behavioral therapy
- Selective serotonin reuptake inhibitors (SSRIs)

Post-Traumatic Stress Disorder (PTSD)

Caused by exceptionally severe stressors, such as disasters, war, physical or sexual abuse
Estimates of PTSD in children who have experienced traumatic events: 16%
Prevalence varies with factors like gender, age, type of trauma, and time since the traumatic event
Treatment:
- Trauma-focused cognitive behavior therapy (TF-CBT)
- Eye-movement desensitization and reprocessing (EMDR)
- Narrative exposure therapy (NET)
- Supportive counseling

Obsessive-Compulsive Disorder (OCD)

Characterized by obsessions and compulsions
Symptoms:
- Intruding thoughts, impulses, or images
- Recognized as stemming from one's own mind
- Experiencing intense anxiety, distress, and/or disgust
- Repetitive behaviors or mental acts
Treatment:
- Cognitive-behavioral therapy
- Medications like selective serotonin reuptake inhibitors (SSRIs)

Conversion Disorders

More common in adolescence than in childhood
Symptoms:
- Paralyses
- Abnormalities of gait
- Inability to see or hear normally
Management:
- Directed at reducing stressful circumstances
- Encouraging the child to talk about the problem
- Graded physiotherapy and behavioral methods

Mood Disorders

Depression

Major unipolar depression is a significant global health problem, especially in adolescence
Symptoms:
- Low mood
- Loss of interest
- Concentration difficulties
- Changes in appetite and sleep
Treatment:
- Cognitive-behavioral therapy
- Selective serotonin reuptake inhibitors (SSRIs)### Vulnerability Factors for Depression
Genetic factors contribute to the development of depressive disorder in childhood
Cognitive distortion and rumination can lead to depression, as biased attention to negative emotional cues and rumination can influence the onset of depression
Difficulty in emotional regulation can lead to depressive symptoms, as individuals may be less able to shift attention away from negative cues in their environment
Children with behavioural disorders, such as ADHD, and their parents are at increased risk of depression
Sleep deprivation can contribute to depression, leading to increased mood lability and greater attention to negative emotional cues

Environmental Risk Factors

Parental depression and family discord can negatively impact children, possibly leading to depression
Child maltreatment is a potent risk factor for the onset and recurrence of depression
Peer victimization can lead to depression, with higher rates of depression in both bullies and their victims
Sexual minority status is associated with a 3x higher risk of depression
Bereavement can increase the risk of depression, with a 3x increased risk immediately after the bereavement and if a past history of depressive symptomatology exists

Comorbid Medical Illness

Poor physical health is associated with depression

Resilience

High IQ can serve as a resilience factor

Treatment of Depression

Fluoxetine is the only antidepressant with a positive risk-benefit ratio for adolescents
Studies have shown that fluoxetine alone and combined fluoxetine and cognitive behaviour therapy can be effective in treating depression in adolescents
Important considerations include the increased risk of suicidal ideation and self-harm with fluoxetine, and the need for close monitoring
It is recommended that antidepressants are used in conjunction with psychological therapy, and that adolescents have a confirmed diagnosis of moderate or severe depression before being prescribed an SSRI

Bipolar Disorder

Childhood-onset bipolar disorder is a significant psychiatric illness with significant morbidity and mortality
Mania in children is rare before puberty, but recent diagnostic changes have led to estimates of bipolar disorder in paediatric populations of about 1%
Diagnostic criteria are similar to those in adults, with a focus on distinguishing mania from ADHD and other disorders
Treatment requires a complex approach, including targeted pharmacotherapy and psychotherapy
Medications such as second-generation antipsychotics, lithium, and antiepileptic drugs have been licensed for treating mania or mixed states in 10-17-year-olds
Depression associated with bipolar disorder in childhood is poorly studied, with some suggestion of higher risk of manic induction on antidepressant treatment in prepubertal children

School Refusal

School refusal is a pattern of behavior, not a psychiatric disorder, and has various causes
It is associated with anxiety and depressive disorders
Common causes include physical illness, truancy, and emotional distress
Around 1-2% of the general population and up to 15% of mental health referrals experience school refusal
Clinical picture includes sudden or gradual refusal to attend school, often with somatic symptoms and anxiety
Aetiology involves individual, family, school, and community factors
Treatment depends on the underlying cause, and may involve addressing anxiety or depressive disorders, improving communication with parents and teachers, and developing coping skills

Nocturnal Enuresis

Nocturnal enuresis is a common problem in children, affecting around 100% at 5 years, 49% at 8 years, and 19% at 14 years
It is more common in boys and often co-occurs with daytime wetting
Aetiology involves physical factors (e.g., delayed maturation of the nervous system), family influences (e.g., stress, parenting style), and individual temperament
Treatment involves assessing and addressing underlying causes, such as constipation, and using behavioral interventions (e.g., laxatives, toilet training)

Faecal Soiling

Faecal soiling affects around 6% of children at 3 years, 1.5% at 7 years, and 1% at 11 years
It is more common in boys and can have various causes, including constipation, fear of using the toilet, failure to learn bowel control, stress-induced regression, and rebellion
Treatment depends on the cause and may involve addressing underlying conditions, improving toilet training, and using behavioral interventions

Selective Mutism

Selective mutism is a persistent failure to speak in certain situations, despite speaking in other situations
It is often associated with anxiety and social phobia
Treatment involves lowering anxiety and increasing the contexts in which the child feels comfortable speaking
Behavioral therapies, such as cognitive-behavioral therapy and play therapy, are often the first choice of intervention

Stammering

Stammering (or child-onset fluency disorder) is a disturbance of the rhythm and fluency of speech
It affects around 0.3%-1% of children, more commonly in boys
Causes are unknown, but may involve genetic, neurological, and environmental factors
Treatment involves addressing underlying causes and using speech therapy to improve fluency and communication skills

Schizophrenia in Childhood

Schizophrenia can occur in childhood, with similar diagnostic criteria as in adults
It is more common in boys, and often involves a decline in school performance and social withdrawal
Treatment involves a combination of anti-psychotic medications, psycho-educational, and psychotherapeutic interventions

Gender Dysphoria

Gender dysphoria is a strong desire to be of the other gender or an insistence that one is the other gender
It is discussed in detail in Chapter 13
Classification and diagnosis have changed dramatically in recent years

Suicidal Behavior and Self-Harm

Self-harm and suicide are major public health problems in adolescents
Important contributors include genetic vulnerability, psychiatric, psychological, familial, social, and cultural factors
Prevention involves universal measures aimed at young people in general and targeted initiatives focused on high-risk groups

Psychiatric Aspects of Physical Illness in Childhood

The associations between physical and psychiatric disorders in children resemble those in adults
There are three main groups to consider: psychiatric manifestations of medical illnesses and treatments, psychiatric disorders presenting with physical symptoms, and physical complications of psychiatric disorders
The impact of childhood physical illness on parents and siblings is significant, and requires a multidisciplinary approach to support the whole family### Educational Facilities in Hospitals
Many hospitals have educational facilities to support children with prolonged hospital stays, helping them catch up on schoolwork and making the transition back to school easier.

Special Considerations for Adolescent Populations

Adolescence (10-19 years) is a dynamic period of brain development, with significant changes in neural systems.
Early adolescence (10-14 years) is biologically dominated by puberty, affecting body morphology and sexual and brain development.
Adolescence is characterized by low resistance to peer influences, low risk perception, and poor self-regulation.
School and family environments are critical social contexts during this period.
Late adolescence (15-19 years) involves continued pubertal maturation and brain development, especially in the prefrontal cortex and increased connectivity between brain networks.

Clinical Features of Psychiatric Disorders of Adolescence

There are no specific disorders of adolescence, but special experience and skill are required to apply general principles of psychiatric diagnosis and treatment to patients at this stage.
Clinical features of adolescent depression, anxiety, psychosis, and other disorders are discussed in relevant sections.

Eating Disorders

Eating disorders are common in adolescence and closely resemble those in adulthood.
Systemic family therapy has been shown to be valuable for anorexia nervosa in adolescents.

Alcohol and Substance Use Disorders

Substance use disorders are among the most prevalent psychiatric disorders in adolescents (9-21 years) and are similar to those in adulthood.
The number of adolescents with substance use disorders rises rapidly, peaks around age 20, and declines after age 25.
Adolescent substance use disorders often persist into adulthood and become leading causes of adult deaths.
Excessive drinking is common among adolescents, especially those with conduct disorder.

Assessment of Adolescents

Special skills are needed when interviewing adolescents, including:
- Establishing a relationship with the adolescent patient
- Showing interest in the adolescent's life and respecting their points of view
- Communicating in a way that the adolescent can understand
- Collecting systematic information and describing symptoms in detail
- Adopting a flexible approach to the interview

Services for Adolescents

The proportion of adolescents seen in psychiatric clinics is lower than other age groups.
Specialized adolescent services can provide care for the majority of adolescents, with close links to child and adult psychiatry services and pediatricians.
Services may include individual and family psychological treatment, drug treatment, and close work with schools and social services.
Inpatient facilities are limited, and agreement with social services is necessary to determine which cases require admission to a health service unit.

Child Maltreatment

Child maltreatment is a broad term that includes physical abuse, emotional abuse, sexual abuse, and neglect.
The definition of child maltreatment has changed over the past decade to include more categories of physical and emotional abuse.
Child maltreatment is a global issue, but is more frequently reported in high-income countries.
Prevalence rates vary greatly, with global estimates ranging from 5 to 159 per 100,000 people.
There are many interacting causes of child maltreatment, categorised at individual, family, and community levels.

Individual Factors

Younger age (especially under 5)
Physical and intellectual disabilities
Chronic illness
Temperamentally difficult children
Children who require more support and care from those around them

Family Factors

Young age of parents
Poor capacity for empathy
Low levels of education
Psychiatric disorders
Family dysfunction
Substance misuse
A criminal record
Social isolation
A history of child abuse or neglect

Community Factors

Neighbourhoods with high rates of physical violence
Low community involvement in housing, school, and employment

Prevention of Child Maltreatment

Consider the environment in which the child lives
Factors associated with the child's parents
Risk factors associated with the child

Key Clinical Indicators

Emotional abuse: age inappropriate behaviour, aggression, body rocking, eating and feeding difficulties, encopresis, wetting, dissociation, cutting, and other forms of self-harm
Physical abuse: abrasions, teeth marks, bruises, burns and scalds, cuts, eye injuries, fractures, intra-abdominal injuries, oral injuries, petechiae, retinal haemorrhage, subdural haemorrhage
Sexual abuse: anal symptoms and signs, anogenital injuries, dysuria, genital symptoms and signs, sexualized behaviour, pregnancy
Neglect: abandonment, failure to thrive, lack of supervision, poor hygiene, persistent infestations, poor medication adherence

Physical Abuse

Prevalence rates vary according to criteria used, ranging from 5-15%
Lower rates of significant violence
Clinical features include:
- Multiple bruising, burns, abrasions, bites, torn upper lip, bone fractures, and subdural or retinal haemorrhages
- Suspicion of physical abuse should be aroused by pattern of injuries, previous history, vague or inconsistent account, delay in seeking help, and incongruous parental reactions
- Psychological characteristics of abused children include fearful responses, anxiety, unhappiness, social withdrawal, low self-esteem, and aggression

Assessment and Management

Doctors should be alert to the possibility of physical abuse
Professionals should receive regular child protection training
Doctors who suspect abuse should refer the child to hospital and inform a paediatrician or casualty officer of their suspicions
Inpatient admission should be arranged for all children in whom non-accidental injury is suspected
Social services should become involved early, and doctors' concerns should be discussed with the parents

Risk Factors for Child Maltreatment

The Parent(s):
- Young age
- Low education or intelligence
- Social isolation
- Breakdown of relationship with partner
- Poor parenting skills
- Experience of maltreatment as a child
- Criminal record
- Impaired emotional regulation
- Psychiatric problems
The Child:
- Factors leading to weak attachment to the parents
- Separation from mother during early life
- Difficult temperament
The Environment:
- Problem neighborhood
- High rates of physical violence

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz reviews psychiatric disorders and syndromes that affect preschool children, including pervasive developmental disorders and other childhood psychiatric disorders.

Psychiatry Review: Childhood Disorders and Syndromes

Choose a study mode

Podcast

Questions and Answers

Which areas do reading disorders primarily affect (Select all that apply)?

What is a common issue for children with specific developmental disorders?

What should be done to help preschool children with learning and developmental disabilities?

Which of the following is NOT a manifestation of reading disorders?

What areas might children with specific developmental disorders struggle with?

Which of the following is true about the assessment and treatment of preschool children with learning and developmental disorders?

What is the first group of problems described in the review of syndromes?

In what order are the main psychiatric disorders of childhood described?

What is described directly after pervasive developmental disorders?

Which type of conditions are said to be generally similar to those of either childhood or adulthood?

What is given a brief account of at the end of the chapter?

Which factor is NOT mentioned as influencing feeding and eating in children?

A child consistently refusing to eat without longing for meals suggests what?

What percentage of children aged 1-5 exhibit signs of wakefulness or anxiety during sleep?

What is essential for calming a family with sleep disruption concerns?

Which of the following should parents do to manage sleep problems?

Severe anxiety in children is frequently associated with which type of anxiety disorder?

What is a common consequence of sleep deprivation in families?

What approach is important for addressing sleep problems?

If a child has a history of severe ailments, feeding problems might be an expression of what?

What should parents do after taking the child to bed to manage sleep problems?

According to DSM-5, what is the term for a disorder characterized by difficulties in reading?

Which of the following languages have the highest prevalence rates of dyslexia?

What skill is predominantly associated with the ability to read accurately but have comprehension difficulties?

Children with specific learning disorders benefit from what type of instruction?

What disorder is classified under the DSM-5 but does not have an equivalent category in ICD-10?

Which disorder in the ICD-10 corresponds to 'Speech sound disorder' in the DSM-5?

Reading speed in individuals with dyslexia is affected by their ability in:

Which disorder is listed under both DSM-5 and ICD-10?

What is a key characteristic of those with reading comprehension impairment?

Which disorder is associated with a significant prevalence among artists?

Which brain function may be impaired in children with a history of abuse and neglect?

Which factor does NOT influence a child's right prefrontal brain function according to the content?

Which genetic syndrome is mentioned as causing small affect recognition deficits?

What screening is typically performed for children with reading difficulties?

What percentage of children show improvement in reading difficulties with early intervention?

What is a common result of mathematics disorder in individuals?

Which intervention is effective in improving independent reading decoding abilities?

What aspect of mathematics is crucial for long-term opportunities and use?

What impacts early brain development significantly?

What is a key component in assessing and treating children with reading difficulties?

What is the Wechsler Intelligence Scale for Children (WISC) primarily used for?

At what age do 25-30% of infants typically utter their first words?

Which factor is NOT essential for speech and language acquisition in children?

What percentage of children will experience delays in language development?

Which classification system uses the title 'speech disorder'?

Which disorder is associated with difficulties in interpreting social cues?

What is the ICD-10 classification for 'expressive language disorder' known as?

Which group of children is unlikely to benefit from therapy?

Which age group frequently forms complete sentences?

Which classification system uses the title 'speech and language'?

What is the estimated prevalence of language disorders in school-aged children?

Which of the following is NOT a criterion for language difficulties?

Which aspect is a common sign in children with difficulties in comprehending spoken language?

What is the expected vocabulary acquisition rate for a young child?

Which of the following could indicate social interaction difficulties in children?

What is one method used to determine the nature and severity of speech and language disorders in early investigations?

Who are typically involved in the multidisciplinary team approach for treating language disorders?

At what age is it possible for a child to typically start seeing a speech therapist if their speech and language skills are significantly impaired?

Which difficulty might affect a child's ability to acquire reading and writing skills?

What is a common challenge faced by children with language disorders in academic performance?

At what age do 25% of adults with Autism Spectrum Disorder (ASD) typically develop autism?

What is the heritability rate of ASD in the population?

What percentage of autistic children have an IQ in the borderline range (70-84)?

What proportion of children with ASD have an IQ near or above average?

Which of the following is NOT a common finding in children with ASD?

According to recent studies, what is a feature often observed in genetic vulnerability in ASD?

Which characteristic is often seen in ASD cases involving CNV (copy number variation)?

Which of the following patterns is most commonly seen in individuals with ASD?

What is a characteristic of specific learning disorder?

Which disorder is often known as a 'learning disability' but is not actually a disability?

Which of the following is a symptom of social pragmatic communication disorder?

What is an accurate statement about autism spectrum disorder (ASD)?

What is a common symptom of children with autism spectrum disorder (ASD)?

Social communication disorder is one type of which spectrum disorder?

What percentage increase in the number of kids diagnosed with social pragmatic communication disorder was noticed in 2013?