Exam 1 Review PDF

Chapter 1- Introduction to Normal and Abnormal Behavior in Children and Adolescents ​ Psychological disorder- a pattern of symptoms associated with features of distress and/or disability, and/or increased risk of further suffering or harm. Historical Views and Breakthroughs ​ Historical...

Chapter 1- Introduction to Normal and Abnormal Behavior in Children and Adolescents ​ Psychological disorder- a pattern of symptoms associated with features of distress and/or disability, and/or increased risk of further suffering or harm. Historical Views and Breakthroughs ​ Historically, children were often ignored or subjected to harsh treatment because of the belief that they would die, were possessed, or were the property of their parents ​ The Emergence of Social Conscience ○​ John Locke- 17th century English philosopher and physician, advanced the belief that children should be raised with thought and care ○​ Organic disease model- the belief that children needed moral guidance and support; advances in medicine, physiology, and neurology led to a replacement of the moral insanity view ​ Early Biological Attributions ○​ Early biological explanations- view of mental disorders as being “diseases”, they were progressive and irreversible, and resistant to treatment or learning ○​ Custodial model- early part of the 20th century; prevent the transmission of mental “diseases” through sterilization and institutionalization ​ Early Psychological Attributions ○​ When did psychological influences emerge- the early 1900s ○​ Psychoanalytic theory- linked mental disorders to childhood experiences; first time the course of mental disorders was not viewed as inevitable ○​ Behaviorism- laid the foundation for studying conditioning and elimination of children’s fears (e.g., Watson) ​ Evolving Forms of Treatment ○​ Institutionalization- until the late 1940s, most children with mental disorders were institutionalized ○​ Rene Spitz research in the mid 1940s- revealed the harmful impact of institutional life on children’s physical and emotional development ○​ Rene Spitz impacts- in the following 20-year period there was a rapid decline in institutionalization and an increase in foster family and group home placements ○​ Behavior therapy- emerged in the 1950s and 1960s as a systematic approach to treatment of child and family disorders ​ Progressive Legislation ○​ Individuals with Disabilities Act (IDEA)- US mandates free and appropriate education be provided for K-12 children with special needs in the least restrictive environment ○​ Culturally appropriate tests- each child must be assessed with culturally appropriate tests ○​ Individualized Educational Plan (IEP)- each child must have an IEP tailored to his or her needs, and must be re-assessed What is Abnormal Behavior in Children and Adolescents? ​ Defining Psychological Disorders ○​ Psychological disorder traditional definition- patterns of behavioral, cognitive, emotional, or physical symptoms, which are associated with distress and/or disability and/or increased risk for further suffering or harm ○​ What do labels describe- behavior, not people ​ Competence ○​ Competence- the ability to successfully adapt in the environment; varies across culture and ethnicity ​ Developmental Pathways ○​ Developmental pathways- the sequence and timing of particular behaviors, as well as the possible relationships between behaviors over time ○​ Multifinality- developmental pathway in which similar early experiences lead to different outcomes ○​ Equifinality- developmental pathway in which different early experiences lead to a similar outcome ○​ Four things to kept in mind about child psychopathology- there are many contributors to disordered outcomes in each child; contributors vary among children who have the disorder; children express features of their disturbances in different ways; pathways leading to particular disorders are numerous and interactive Risk and Resilience ​ Risk Factors ○​ Risk factors- variables that precede negative outcomes of interest, and which increase the probability that the outcomes will occur ○​ Known risk factors- community violence, parental divorce, chronic poverty, care-giving deficits, parental mental illness, death of a parent, community disasters, homelessness, family breakup, and perinatal stress, especially in absence of compensatory resources ​ Protective Factors ○​ Protective (resilience) factors- personal or situational variables that reduce the chances for a child to develop a disorder ○​ Examples of protective factors- strong self-confidence, coping skills, ability to avoid risk situations, and ability to fight off or recover from misfortune ○​ Resilience- not a universal, fixed attribute; it varies according to the type of stress, its context, and similar factors The Significance of Mental Health Problems Among Children and Youths  ​ Mental Health Issues in Children and Adolescents ○​ Why do the majority of children not receive mental health services- limited treatment dollars, poor understanding of mental disorders and limited access to intervention ○​ Expected demand for children’s mental health services in the next decade- expected to double over the next decade since the number of professionals in this area is not expected to increase at the required rate ​ The Changing Picture of Children’s Mental Health ○​ Past care of appropriate services- lack of resources and the low priority given to children’s mental health meant that children did not receive appropriate services in a timely manner ○​ Who is more likely to have more mental health problems- those from disadvantaged families and neighborhoods, those from abusive/neglectful families, those receiving inadequate care, those born with very low birth weight, and those born to parents with criminal or severe psychiatric histories What Affects Rates and Expression of Mental Disorders? A Look at Some Key Factors ​ Poverty and Socioeconomic Disadvantage ○​ How many children live in poverty- about 1 in 4 children in the US; 1 in 7 in Canada ○​ What ethnicities is poverty especially pronounced among- Native American/First Nations and African American children ○​ What is poverty associated with- greater rates of learning impairments and problems in school achievement, conduct problems, violence, chronic illness, hyperactivity, and emotional disorders ○​ Poverty’s effect on children- significant, but indirect, effect on children’s adjustment, likely due to its association with other negative influences like poor parenting and exposure to numerous daily life stressors ​ Sex Differences ○​ Boys show higher rates of what disorders- early onset disorders that involve neuro-developmental impairment (autism, ADD, conduct and reading problems) ○​ Girls show higher rates of what disorders- emotional disorders with onset in adolescence (depression and eating disorders) ​ Race and Ethnicity ○​ What children are overrepresented in rates of some disorders- minority children in the U.S. ○​ What happens when the effects of SES, gender, age, and referral status are controlled for- very few differences in the rate of children’s psychological disorders emerge in relation to race or ethnicity  ○​ What are barriers in access, quality and outcomes of care for minority children- misunderstanding and misinterpreting behaviors of minority groups have led to inappropriately placing minorities in the criminal and juvenile system ​ Child Maltreatment and Non-Accidental Trauma ○​ Reports of maltreatment in the U.S. each year- over 1 million cases; estimated more than 1/3 of 10-16 year olds experience physical and/or sexual abuse ○​ What are the adverse effects of maltreatment- particularly devastating with regard to adjustment at school, with peers, and in future relationships ​ Special Issues Concerning Adolescents and Sexual Minority Youths ○​ When is the transitional period for healthy versus problematic adjustment- early- to mid-adolescence is an especially important ○​ Sexual minority youth- victimized by their peers and family members and can experience verbal and physical abuse ○​ LGBT youth have higher rates of- mental health problems, including depression and suicidal behavior, substance abuse and risky sexual behavior ​ Lifespan Implications ○​ What percent of children will experience significant difficulties throughout their lives- 20% of children (those with the most chronic and serious disorders) ○​ How can children overcome major impediments- when provided with circumstances and opportunities that promote healthy adaptation and competence Key Terms and Concepts ​ Competence- the ability to successfully adapt in the environment; varies across culture and ethnicity ​ Equifinality- developmental pathway in which different early experiences lead to a similar outcome ​ Multifinality- developmental pathway in which similar early experiences lead to different outcomes ​ Externalizing problems- ADHD and conduct disorders; more common in boys ​ Internalizing problems- depression and anxiety; more common in girls ​ Protective factor- personal or situational variables that reduce the chances for a child to develop a disorder ​ Psychological disorder- a pattern of symptoms associated with features of distress and/or disability, and/or increased risk of further suffering or harm ​ Resilience- the ability to maintain healthy functioning in the presence of risk factors ​ Risk factor- variables that precede negative outcomes of interest, and which increase the probability that the outcomes will occur  Chapter 2- Theories and Causes ​ Etiology of childhood disorders- a consideration of how different variables interact to produce a particular outcome ​ An integrative approach allows for many different theories and models to contribute insights into human behavior ​ Developmental psychopathology perspective- general framework for studying childhood disorders; emphasizes the role of developmental processes, and the influence of multiple, interrelated events in guiding both abnormal and normal development ​ Biological perspectives- examine how children’s brain development is influenced by genetics, neuroanatomy, and maturation rates ​ Psychological perspectives- examine emotional, behavioral, and cognitive influences on abnormal behavior ​ Behavioral and cognitive perspectives- emphasize children’s learning and interpretation of their environment What is Causing Jorge’s Problems? ​ Jorge is having trouble with schoolwork ​ To find biological influences, start with taking a pre- and post-natal history. ​ Emotional influences could include emotional regulation issues. ​ Cognitive and behavioral problems could also contribute, and regulating Jorge’s environment could help mitigate these influences. ​ Family and community issues could also play a role in Jorge’s problems. Theoretical Foundations ​ Theories- allow us to predict behavior based on samples of knowledge. ​ Etiology- considers how biological, psychological, and environmental processes interact to produce outcomes over time ​ Developmental Psychopathology Perspective ○​ Developmental psychopathology- describing and studying disorders stressing the importance of developmental processes and tasks ○​ How to understand maladaptive behavior- view it in relation to what is considered normative ​ An Integrative Approach ○​ How is abnormal child behavior best studied- from a multi-theoretical perspective Developmental Considerations ​ Adaptational failure- the failure to master or progress in accomplishing developmental milestones ​ Organization of Development  ○​ Organization of development- implies an active, dynamic process of continual change, and transformation ○​ Sensitive periods- windows of time during which environmental influences on development are enhanced ○​ How does development proceed- in an organized, hierarchical way Biological Perspectives ​ Neurobiological perspective- considers brain and nervous system functions as underlying causes of psychological disorders ​ Neural Plasticity and the Role of Experience ○​ Neural plasticity- malleability; use-dependent anatomical differentiation throughout the course of development ○​ How does experience play a role in brain development- with transactions occurring between ongoing brain development and environmental experiences ○​ Maturation of the brain- an organized, hierarchical process with brain structures changing and growing through the lifespan ○​ How do traumatic experiences affect the brain- as the brain is shaped by early experiences, consequences of traumatic experience may be difficult to change ​ Genetic Contributions ○​ Where do all traits a child has come from- an interaction of environmental and genetic factors. ○​ Underlying cause of child psychopathology- very few specific genetic causes have been isolated or identified as the cause ○​ Do genes determine behavior- no, genes produce tendencies to respond to the environment in certain ways, but do not determine behavior ○​ Conclusions from behavioral geneticists- genetic contributions to psychological disorders come from many genes that each makes relatively small contributions ​ Emotional Influences ○​ How are emotions critical to healthy adaptation- they serve as internal monitoring and guidance systems that are designed to appraise events as being beneficial or dangerous, as well as provide motivation for action. ○​ Emotion reactivity- individual differences in threshold and intensity of emotional experience, which provides clues to an individual’s level of distress and sensitivity to the environment ○​ Emotion regulation- enhancing, maintaining, or inhibiting emotional arousal, often for a particular purpose of goal ○​ Three primary dimensions of temperament that have relevance to the risk of abnormal development-positive affect and approach, fearful or inhibited, and negative affect or irritability. ​ Behavioral and Cognitive Influences  ○​ Behavioral and cognitive approaches- stress the way a child learns behaviors and thought patterns ○​ Behavioral explanations assume- the child is acting in a situation, and not that behavior is indicative of stable traits. ​ Applied Behavior Analysis (ABA) ○​ Applied Behavior Analysis (ABA)- explains behavior as a function of its antecedents and consequences (reinforcement and punishment) ○​ Classical conditioning- explains the acquisition of deviant behavior on the basis of paired associations between previously neutral stimuli and unconditioned stimuli ○​ Social learning- considers the influence of cognitive mediators on behavior, as well as the role of affect and the importance of contextual variables in the etiology and maintenance of behaviors ○​ Social cognition- how children think about themselves and others, resulting in the formation of mental representations of themselves and others Family, Social, and Cultural Perspectives ​ Ecological models- describe the child’s environment as a series of nested and interconnected structures ​ The Family and Peer Context ○​ Study of individual factors and the study of the child’s context, including family and peer relationships, are being seen as mutually compatible and beneficial to both theory and intervention. ○​ Family system theorists study- children’s behavior in relation to other family members Key Terms and Concepts: ​ Behavioral genetics- genetic contributions to psychological disorders come from many genes that each makes relatively small contributions ​ Developmental psychopathology- describing and studying disorders stressing the importance of developmental processes and tasks ​ Emotion reactivity- individual differences in threshold and intensity of emotional experience, which provides clues to an individual’s level of distress and sensitivity to the environment ​ Emotion regulation- enhancing, maintaining, or inhibiting emotional arousal, often for a particular purpose of goal ​ Etiology- consideration of how different variables interact to produce a particular outcome ​ Family systems- children’s behavior in relation to other family members  ​ Gene–environment interactions (GXE)- genetic predispositions and environmental factors interact to influence the development of psychological disorders in children ​ Social learning- considers the influence of cognitive mediators on behavior, as well as the role of affect and the importance of contextual variables in the etiology and maintenance of behaviors ​ Temperament- organized style of behavior that shapes a child’s approach to the world ​ Nature- mental illness viewed as a biological disease ​ Nurture- emphasized early childhood experiences and psychological conflicts Chapter 4- Treatment ​ Three main purposes of assessment- diagnosis, prognosis, and treatment planning. ​ DSM-5- helps professionals classify patients ​ Intervention for childhood disorders- includes prevention, treatment, and maintenance, and involves a range of solutions and strategies ​ Treatment goals and outcomes- focused on areas of child functioning, family functioning, and societal importance Clinical Issues ​ The Decision-Making Process ○​ Clinical assessment- directed at differentiating, defining, and measuring the child’s behaviors, cognitions, and emotions that are of concern, as well as the environmental circumstances that may be contributing to these problems ​ Developmental Considerations ○​ What must be considered when making judgments about abnormality- age, gender, and culture ○​ A child’s age has implications for what- judgments about deviancy and for selecting most appropriate assessment and treatment methods ○​ Important to study both boys and girls as what- as distinct groups in their own right ○​ Why is cultural information necessary- to establish a relationship with the child and family, motivate the family for change, diagnosis accurately, and make recommendations for treatment ○​ Why is awareness of SES and acculturation crucial on measurement- cultural customs and values can affect behaviors, perceptions, and reactions to assessment and treatment ○​ Normative information that must be considered- need to have a good understanding of normal development of children to make decisions about abnormal development; and age inappropriateness and patterns of symptoms typically define childhood disorders ​ Purposes of Assessment  ○​ Clinical description- summarizes the child’s unique behaviors, thoughts, and feelings that together make up the features of a given psychological disorder ○​ Diagnosis- involves analyzing information and drawing conclusions about the nature or cause of the problem ○​ Prognosis- generating predictions regarding future behavior under specified conditions ○​ Treatment planning involves- making use of assessment information to generate a treatment plan and evaluating its effectiveness Assessing Disorders ​ Clinical assessment relies on- a multi-method assessment strategy ​ Multi-method assessment strategy- emphasizes obtaining information from different informants, in a variety of settings, using a variety of procedures ​ Clinical Interviews ○​ What are the most universally used and why- clinical interviews because this assessment procedure can provide a large amount of information in a brief period of time ○​ Unstructured interviews- questions are pursued in an informal and flexible manner ○​ Cons of unstructured interviews- lack of standardization may result in low reliability and selective or biased gathering of information ○​ Semi-structured interviews- specific questions are asked to elicit information in a consistent and thorough manner ○​ Cons of semi structured interviews- may be susceptible to a loss of spontaneity between the child and clinician, and reluctance to volunteer important information that is not directly related to the particular questions ​ Behavioral Assessment ○​ Behavioral assessment- emphasis on observing a child’s behavior directly; involves observing the antecedents, the behaviors of interest, and the consequences of the behaviors ○​ Behavior analysis- the goal is to identify as many factors as possible that could be contributing to a child’s problem behaviors, and to develop hypotheses about which ones are the most important and/or most easily changed ○​ Checklists and rating scales- often allow for a child’s behavior to be compared to a normative sample, are typically economical to administer and score, lack of agreement between informants is relatively common, which in itself is often informative. ○​ Behavioral observations and recordings- provide information about behaviors of interest in real-life settings  ○​ Cons of behavioral observations- children often know when they are being watched and may react differently as a result ​ Psychological Testing ○​ Psychological testing- tests are tasks given under standard conditions with the purpose of assessing some aspect of the child’s knowledge, skill, or personality. ○​ How are tests standardized- on normative groups that are representative of the population; test items are free from cultural bias as much as possible. ○​ Scales and tests- assess children’s difficulties; most commonly used assessment methods with children ○​ Intelligence and Educational Testing- a central component in clinical assessments for a wide range of childhood disorders ○​ Wechsler Intelligence Scale for Children (WISC-V)- well-standardized, reliable, and valid; it provides measures of verbal comprehension, perceptual reasoning, working memory, and processing speed ○​ Projective Testing- presenting the child with ambiguous stimuli and asking the child to describe what he or she sees; believing the child projects his or her own personality, including unconscious fears, needs, and inner conflicts, on the ambiguous stimuli ○​ Personality Testing- whether a child or adolescent is timid or bold, agreeable or disagreeable, dependable or undependable, tense or relaxed, and reflective or unreflective Classification and Diagnosis ​ Classification- a system for representing the major categories or dimensions of child psychopathology, and the boundaries and relations among them ​ Diagnosis- the assignment of cases to categories of the classification system ​ Categories and Dimensions ○​ Categorical classification systems- based primarily on informed professional consensus ○​ Categorical approach- assumes that every diagnosis has a clear underlying cause and that each disorder is fundamentally different from every other disorder ○​ Dimensional classification approach- assume that a number of independent dimensions or traits of behavior exist and that all children possess these to varying degrees ​ The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ○​ DSM-5- introduces the category of neurodevelopmental disorders which include intellectual disabilities, ADHD, and other childhood issues. ○​ Criticisms of DSM-5- doesn’t capture the complex adaptations, transactions, and setting influences; gives less attention to disorders of infancy and childhood than to those of adulthood; fails to emphasize the situational and contextual factors ;  focuses on observable signs and symptoms rather than underlying etiology; contains large numbers of diagnostic categories of little validity. ○​ ICD-11- a global classification system that includes all diseases, including mental disorders ○​ Pros of diagnostic labels- help clinicians summarize observations, facilitate communication among professionals, aid parents by providing more recognition and understanding of their child’s problem, and facilitate research on the causes, epidemiology, and treatment of specific disorders ○​ Cons of diagnostic labels- may lead to negative perceptions and reactions by others and can influence children’s views of themselves Treatment and Prevention ​ Intervention ○​ Interventions- problem-solving strategies that involve treatment of current problems, maintenance of treatment effects, and prevention of future problems ○​ Targeting risks and existing problems- the combination of prevention and treatment reaches a diverse range of youths and families across a range of settings ​ Cultural Considerations ○​ Cultural considerations- parents from different ethnic groups parent their children differently and have different beliefs about child problems, mental health services, how they describe symptoms, when they seek help, and what interventions they prefer ​ Treatment Goals ○​ Treatment goals- outcomes related to the child and family, as well as those of societal importance ​ Ethical and Legal Considerations ○​ Ethical and legal considerations- required to think about the impact that their actions will have on the children they see, but also on the responsibilities, rights, and relationships that connect children and parents ​ General Approaches to Treatment ○​ Psychodynamic approaches- view child psychopathology as determined by underlying unconscious and conscious conflicts; treatment focuses on developing an awareness of these conflicts ○​ Behavioral approaches- assume that most abnormal child behaviors are learned through operant and classical conditioning; treatment emphasizes re-education using behavioral principles ○​ Cognitive approaches- view abnormal child behavior as the result of deficits and distortions in the child’s thinking, including perceptual biases, irrational beliefs, and faulty interpretations; the emphasis in treatment is on changing faulty cognitions  ○​ Cognitive–behavioral approaches- view psychological disturbances as partly the result of faulty thought patterns, and partly the result of faulty learning and environmental experiences; treatment focuses on changing maladaptive cognitions, teaching the child to use cognitive and behavioral coping strategies, and helping the child learn self-regulation. ○​ Client-centered approaches- view psychopathology as the result of social or environmental circumstances that are imposed on the child and interfere with his or her basic capacity for personal growth and adaptive functioning; the therapeutic setting provides a corrective experience for the child through unconditional positive regard. ○​ Family models- view psychopathology as determined by variables operating in the family system; treatment often focuses on the family issues underlying problem behaviors. ○​ Interpersonal Psychotherapy for Adolescents- emphasizes changing /improving interpersonal relationships in order to reduce depression or anxiety ○​ Biological/medical models- view psychopathology as resulting from biological impairment or dysfunction and rely primarily on pharmacological and other biological approaches to treatment ○​ Combined treatments- make use of two or more interventions, each of which can stand on its own as a treatment strategy ​ Treatment Effectiveness ○​ Best practice guidelines- systematically develop statements to assist practitioners and patients with decisions about treatment for specific clinical conditions; intended to offer most clinically- and cost-effective treatments ○​ Evidence-based approach- derives guidelines from a comprehensive review of current research findings ○​ Expert-consensus approach- uses the opinions of experts to fill in the gaps in literature when research is inconclusive or when there is lack of information about multicultural issues ○​ Positive findings regarding the effectiveness of treatments with children- therapy leads to significant and meaningful improvements for children, treatments have been shown to be equally effective for internalizing and externalizing disorders, treatment effects tend to be long-lasting, specific problems are more amenable to treatment than nonspecific problems, the more outpatient therapy children receive, the more symptoms improve ○​ Treatment ineffectiveness- community-based clinic therapy for children has been found far less effective than structured research therapy Key Terms and Concepts: ​ Behavior analysis- the goal is to identify as many factors as possible that could be contributing to a child’s problem behaviors, and to develop hypotheses about ​ Behavioral assessment- evaluation of child’s thoughts, feelings, and behaviors in specific settings ​ Categorical classification- assumes that every diagnosis has a clear underlying cause and that each disorder is fundamentally different from every other disorder ​ Classification- a system for representing the major categories or dimensions of child psychopathology, and the boundaries and relations among them ​ Clinical assessments- directed at differentiating, defining, and measuring the child’s behaviors, cognitions, and emotions that are of concern, as well as the environmental circumstances that may be contributing to these problems ​ Clinical description- summarizes the child’s unique behaviors, thoughts, and feelings that together make up the features of a given psychological disorder ​ Developmental history- comprehensive account of a child’s growth and development across various domains ​ Diagnosis- involves analyzing information and drawing conclusions about the nature or cause of the problem ​ Dimensional classification- assume that a number of independent dimensions or traits of behavior exist and that all children possess these to varying degrees ​ Evidence-based treatments (EBTs)- derives guidelines from a comprehensive review of current research findings ​ Intervention- problem-solving strategies that involve treatment of current problems, maintenance of treatment effects, and prevention of future problems ​ Maintenance- efforts to increase adherence with treatment over time to prevent relapse or recurrence of a problem ​ Multimethod assessment approach- emphasizes obtaining information from different informants, in a variety of settings, using a variety of procedures ​ Prevention- decreasing the chances of undesired outcomes ​ Prognosis- generating predictions regarding future behavior under specified conditions ​ Projective tests- presenting the child with ambiguous stimuli and asking the child to describe what he or she sees; believing the child projects his or her own personality, including unconscious fears, needs, and inner conflicts, on the ambiguous stimuli ​ Semi-structured interviews- specific questions are asked to elicit information in a consistent and thorough manner ​ Target behaviors- problems of concern ​ Treatment- corrective actions that will permit successful adaptations by eliminating or reducing the impact of an undesired outcome that has occurred