Chapter 12 (Childhood Disorders)
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Questions and Answers

What combination of treatments for encopresis has been found to be more effective?

  • Psychological therapy only
  • Behavioral treatment only
  • Medical management and behavioral treatment (correct)
  • Dietary changes only
  • What behavioral intervention is mentioned as part of the treatment for encopresis?

  • Group therapy for children
  • Medication for anxiety
  • Reinforcement schedule for toilet use (correct)
  • Individual therapy sessions
  • In a study of 324 children treated for encopresis, what percentage showed improvement?

  • 25%
  • 42%
  • 87% (correct)
  • 100%
  • What percentage of children treated for encopresis were still experiencing soiling after treatment?

    <p>42%</p> Signup and view all the answers

    Which treatment approach for encopresis is noted to hold promise?

    <p>Internet-based interventions</p> Signup and view all the answers

    Which symptom indicates a significant weight change in a person experiencing depressive disorder?

    <p>Weight loss or gain exceeding 5% of body weight in a month</p> Signup and view all the answers

    What duration qualifies for the diagnosis of persistent depressive disorder in adults?

    <p>At least 2 years</p> Signup and view all the answers

    Which of the following is NOT a symptom of persistent depressive disorder?

    <p>Mood changes only during a specific season</p> Signup and view all the answers

    What is an example of psychomotor agitation as a symptom?

    <p>Pacing back and forth or tapping fingers</p> Signup and view all the answers

    What was a major shift in the understanding of childhood disorders in the early twentieth century?

    <p>Children were recognized as having unique psychological needs.</p> Signup and view all the answers

    What should be considered when assessing weight changes in children concerning depressive disorder?

    <p>Failure to make expected weight gains</p> Signup and view all the answers

    How were childhood disorders categorized prior to the DSM-5?

    <p>Under the category of Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence.</p> Signup and view all the answers

    Which symptom associated with depressive disorder is indicative of suicidal ideation?

    <p>Recurrent thoughts of death and a specific suicide plan</p> Signup and view all the answers

    Which of the following relates to feelings of worthlessness in depressive disorders?

    <p>Excessive or inappropriate guilt that may be delusional</p> Signup and view all the answers

    What is one criticism of the DSM-5 regarding childhood disorders?

    <p>It fails to account for the dimensional nature of many childhood conditions.</p> Signup and view all the answers

    According to the 'differential susceptibility' hypothesis, what is the primary focus of study?

    <p>The interaction of both genetic and environmental factors.</p> Signup and view all the answers

    Which of the following describes a symptom of fatigue in depressive disorder?

    <p>Loss of energy nearly every day</p> Signup and view all the answers

    What characterizes externalizing disorders in children?

    <p>Behaviors that are under-controlled and directed at others.</p> Signup and view all the answers

    What was the approach to childhood psychological disorders prior to the recognition in the early twentieth century?

    <p>Children were treated similarly to adults in psychological assessments.</p> Signup and view all the answers

    What is a common characteristic of most children in terms of coping with adversity?

    <p>Most children are inherently resilient and can manage some adversity.</p> Signup and view all the answers

    Which of the following statements reflects the evolution of childhood disorder classification?

    <p>The DSM-5 separates childhood disorders into various new categories.</p> Signup and view all the answers

    When diagnosing disruptive mood dysregulation disorder, which condition should not co-occur for the diagnosis to be valid?

    <p>Oppositional defiant disorder</p> Signup and view all the answers

    Which of the following symptoms would disqualify an individual from being diagnosed with disruptive mood dysregulation disorder?

    <p>Having a history of manic episodes</p> Signup and view all the answers

    What is a requirement for the fear or anxiety associated with specific phobias?

    <p>It typically lasts for 6 months or more</p> Signup and view all the answers

    In the context of specific phobias, what does intense avoidance behavior indicate?

    <p>A clinically significant distress response</p> Signup and view all the answers

    How is fear or anxiety in specific phobias typically expressed in children?

    <p>Via crying or tantrums</p> Signup and view all the answers

    Which of the following statements accurately describes the relationship between fear and perceived danger in specific phobias?

    <p>Fear can escalate when danger is minimal</p> Signup and view all the answers

    What characteristic is NOT a diagnostic criterion for disruptive mood dysregulation disorder?

    <p>Symptoms provoked by a specific phobic situation</p> Signup and view all the answers

    Which term describes the impact of the fear or anxiety in specific phobias on an individual's daily life?

    <p>Clinically significant distress</p> Signup and view all the answers

    What does Autism Spectrum Disorder consolidate?

    <p>Autistic disorder, Asperger’s disorder, Childhood disintegrative disorder, and Pervasive developmental disorder not otherwise specified</p> Signup and view all the answers

    Which impairment is NOT characteristic of Autism Spectrum Disorder?

    <p>Increased verbal aggression</p> Signup and view all the answers

    What is the estimated prevalence rate of Autism Spectrum Disorder?

    <p>1 per cent</p> Signup and view all the answers

    Which statement about the outcome for children with Autism Spectrum Disorder is true?

    <p>Approximately 75 per cent have a poor outcome</p> Signup and view all the answers

    What factor is critical for improving outcomes in Autism Spectrum Disorder?

    <p>Early intervention</p> Signup and view all the answers

    How do the diagnoses of Autism Spectrum Disorder vary across clinics?

    <p>They are not consistently applied across different clinics and treatment centers</p> Signup and view all the answers

    In terms of gender prevalence, how does Autism Spectrum Disorder affect boys compared to girls?

    <p>Boys outnumber girls by 2:1</p> Signup and view all the answers

    What type of programs can be helpful for children with Autism Spectrum Disorder?

    <p>Behaviour modification programs and pharmacotherapy</p> Signup and view all the answers

    What describes the individual's fear in social situations?

    <p>Fear of being negatively evaluated or embarrassed</p> Signup and view all the answers

    How do children typically express fear or anxiety in social situations?

    <p>By crying, tantrums, or freezing</p> Signup and view all the answers

    What is a common response of individuals with social anxiety disorder to social situations?

    <p>Avoiding or enduring the situation with fear</p> Signup and view all the answers

    What characteristic of fear or anxiety in social anxiety disorder is noted about its duration?

    <p>It typically lasts for 6 months or more</p> Signup and view all the answers

    What is the significance of the fear or anxiety regarding functioning in daily life?

    <p>It causes clinically significant distress or impairment</p> Signup and view all the answers

    What must be ruled out for a diagnosis of social anxiety disorder?

    <p>Symptoms of another mental disorder</p> Signup and view all the answers

    Which of the following is NOT a symptom of social anxiety disorder?

    <p>Complete disinterest in social relationships</p> Signup and view all the answers

    How is the intensity of fear or anxiety assessed in social anxiety disorder?

    <p>By its proportionality to the actual threat of the situation</p> Signup and view all the answers

    Study Notes

    BEHL 3004 Week 12, 2024

    • Rieger, Chapter 14 (Disorders of Childhood) will be reviewed for the exam.
    • This week's tutorial will be a review for the exam, particularly the tutorials.
    • A separate recording regarding the exam will be posted.
    • Assessment #5 is due this week (Thursday-Friday).

    Learning Objectives

    • Describe key behavioral and emotional child problems identified by parents, along with challenges in assessing mental health.
    • Describe key themes in classifying childhood psychological disorders.
    • Describe the main characteristics of neurodevelopmental disorders.
    • Describe key features and factors contributing to externalizing disorders, and evidence-based treatment approaches.
    • Describe the key characteristics and treatment of separation anxiety and selective mutism.
    • Describe various elimination disorders and their treatments.

    Disorders of Childhood

    • Overview (myths, history, etc.)
    • Internalising Disorders
    • Externalising Disorders
    • Neurodevelopmental Disorders
    • Elimination Disorders

    Psychological and Behavioural Disorders in Children

    • Myths, realities, and research challenges: Psychological and behavioral problems are very common in children.
    • Few children receive help.
    • Traditionally, childhood disorders research relies on adult models.
    • It's critical to consider both risk and protective factors.

    Prevalence of Childhood Problems

    • A table detailing the prevalence of various disorders (anxiety, depressive, ADHD, Conduct) among 4-17-year-olds and severity levels.

    Classification of Childhood Disorders

    • Prior to the 20th century, there was little recognition of psychological disorders in childhood.
    • Children were viewed as miniature adults.
    • Early 20th century saw increased recognition of childhood disorders.
    • Separate childhood disorders weren't included in the DSM-III until 1980.
    • A critical aspect of DSM-5 is its lack of considering the dimensional nature of childhood conditions.
    • Externalising disorders in children involve under-controlled behaviors directed at others.
    • Internalising disorders in children involve over-controlled, inner-directed behaviors.
    • Examples of disorders that don't neatly fit these categories include ADHD and disruptive mood dysregulation disorder.

    Specific Phobias (DSM-5-TR)

    • Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, injections, seeing blood).
    • The phobic object or situation almost always evokes immediate fear or anxiety.
    • The phobic object or situation is actively avoided or endured with intense fear or anxiety.
    • The fear or anxiety is out of proportion to the actual danger and sociocultural context.
    • The fear, anxiety, or avoidance is persistent (typically 6+ months).
    • Causes clinically significant distress or impairment in social, occupational, or other important areas.

    Social Anxiety Disorder (DSM-5-TR)

    • Marked fear or anxiety about one or more social situations.
    • Fear that the individual will act in a way or show anxiety symptoms negatively evaluated.
    • Social situations almost always evoke fear/anxiety.
    • Social situations are avoided or endured with intense fear.
    • Markedly out of proportion to the actual threat and sociocultural context.
    • The fear or avoidance persists typically for 6+ months.

    Generalised Anxiety Disorder (DSM-5-TR)

    • Excessive anxiety and worry (apprehensive expectation) about numerous events/activities for at least 6 months.
    • Difficulty controlling worry.
    • Associated with at least three of six symptoms (e.g., restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance).
    • The anxiety causes significant distress/impairment.

    Posttraumatic Stress Disorder (DSM-5-TR)

    • Presence of one or more intrusion symptoms related to a traumatic event(s) beginning after the event(s).
    • Intrusive memories, distressing dreams, dissociative reactions, intense psychological distress at exposure to cues that symbolize or resemble the event, marked physiological reactions.
    • Marked impairments in arousal and reactivity (e.g., irritability, anger outbursts, recklessness/self-destructiveness).
    • Symptoms persist in multiple settings.

    Separation Anxiety Disorder (DSM-5-TR)

    • Inappropriate and excessive anxiety surrounding separation from attachment figures.
    • Occurs in approximately 3-5% of children, more common in girls.
    • The disturbance occurs in 4+ weeks for adolescents/children, and 6+ months in adults.

    Aetiology of Separation Anxiety Disorder

    • Evidence of genetic vulnerability for separation anxiety.
    • Parental anxiety plays a role.
    • Insecure attachment and parental absence also contribute.

    Treatment of Separation Anxiety

    • Cognitive behavioral therapy is the primary treatment.
    • Includes psychoeducation, coping skills, relaxation, exposure and reinforcement

    Selective Mutism (DSM-5-TR)

    • Consistent failure to speak in specific social situations while speaking in other situations.
    • Disturbance interferes with social or educational functioning.
    • The failure to speak is not connected to language knowledge or comfort levels.
    • The disturbance is not attributed to autism, schizophrenia, etc.

    Aetiology and Treatment of Selective Mutism

    • Possible manifestation of shyness or inhibited temperament.

    • Some evidence suggests it's a form of social anxiety disorder.

    • Treatment targets high anxiety in social situations, limited speaking experience, and reinforcement for non-verbal communication.

    Disruptive Mood Dysregulation Disorder (DSM-5-TR)

    • Severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation.
    • Temper outbursts inconsistent with developmental level.
    • Average of three or more temper outbursts per week.
    • Mood between outbursts—persistently irritable or angry most of the day.
    • Criteria have been present for 12+ months, without 3+ consecutive symptom-free months.
    • Present in at least two of three settings (home, school, peers).
    • Diagnosis shouldn't occur before age 6 or after age 18.
    • Symptoms began before age 10.

    Conduct Disorder (DSM-5-TR)

    • Persistent pattern of violating the rights of others or societal norms.
    • Demonstrated through 3+ of a specified list of behaviours, present during the past 12 months, with at least one present during the past 6 months.
    • Includes actions such as aggression toward people or animals and property damage to deceitfulness and theft.

    Oppositional Defiant Disorder (DSM-5-TR)

    • Pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting 6+ months, with 4+ symptoms from any category, during interactions with at least one person who is not a sibling.

    • Includes symptoms like frequently losing temper, being touchy/easily annoyed, being angry/resentful.

    Attention Deficit Hyperactivity Disorder (ADHD)

    • Defined by symptoms of inattention and/or hyperactivity-impulsivity.
    • Symptoms present prior to age 12, and in multiple environments.
    • Prevalence approximately 7.2%.

    Treatment of ADHD

    • Stimulant medications (e.g., Ritalin) may improve behaviour, interaction with others, and concentration.
    • Medication plus behavioral treatment may yield better results than medication alone.

    Specific Learning Disorder (DSM-5-TR)

    • Characterised by difficulties in acquisition and use of specific academic skills demonstrated by ongoing difficulties for 6 months, despite interventions.
    • Difficulties with accuracy, fluency and comprehension of reading, written expression, and/or mathematical reasoning, which are not explained by a general intellectual disability.

    Elimination Disorders

    • Enuresis: Involuntary urination; either nocturnal or diurnal (daytime) and can be primary or secondary.
    • Encopresis: Repetitive soiling (involuntary or intentional); either constipation-related or not.

    Treatment of Enuresis & Encopresis

    • Enuresis typically treated with conditioning approaches (e.g., bell-and-pad method).
    • Encopresis is often treated with a combination of medical management and behavioral strategies, encompassing psychoeducation for parents and children, reinforcement schedules for using the toilet, and other targeted interventions.

    Any Questions?

    • If any questions arise, post online.

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