Test 2 Study Guide PDF - Developmental Psychopathology

Test 2 Study Guide Developmental Psychopathology (ABSC/PSYC 535) Test 2 will focus on material covered in chapters 10, 11, and 12 of the textbook and in lecture. The exam will include 49 multiple-choice questions and you will have 1 hour and 15 minutes to complete it. Below is...

Test 2 Study Guide Developmental Psychopathology (ABSC/PSYC 535) Test 2 will focus on material covered in chapters 10, 11, and 12 of the textbook and in lecture. The exam will include 49 multiple-choice questions and you will have 1 hour and 15 minutes to complete it. Below is a list of the most important topics and concepts to know for the test. You should be able to apply these concepts to hypothetical situations. The multiple-choice quizzes you have completed, as well as the samples questions provided in another document, are good examples of the types of multiple-choice questions that will be on the test. Chapter 10 1. Know the definitions of dysphoria, anhedonia, and mania Dysphoria - prolonged sadness Anhedonia - loss of interest, pleasure, and joy Mania - abnormally elevated and expansive mood, increased goal-directed activity and energy, feelings of euphoria 2. Know what sets mood disorders apart from typical fluctuations in mood Most people’s moods come and go Mood disorders are different: More severe alterations, much longer, distress or impairment is present Main feature is extreme mood: Depression - extraordinary sadness and dejection Mania - Intense and unrealistic excitement and euphoria 3. Know the defining features of unipolar and bipolar depressive disorders Unipolar depressive disorder - Only depressive episodes - Depression or loss of interest for at least 2 weeks Bipolar depressive disorder - Manic and depressive episodes - Markedly euphoric mood, often interrupted by intense irritability, for at least 1 week 4. Understand how depression looks different at different stages of development In children under age 7 (as young as 3-5) - Tends to be diffuse and less easily identified Anaclitic depression (Spitz) - infants - Infants raised in clean but emotionally child institutional environment show depression-like reactions - Similar symptoms can occur in infants raised in severely disturbed families Preschoolers - May appear extremely somber and tearful, lacking exuberance  - May display excessive clinging and whiny behavior School-aged children - The above, plus increasing irritability, disruptive behavior, and tantrums Preteens - The above, plus self-blame, low self-esteem, persistent sadness, and social inhibition 5. Know that irritable mood is a common symptom in child and adolescent depression 6. Know the major symptoms of major depressive disorder (MDD), persistent depressive disorder, and disruptive mood dysregulation disorder and be able to identify these disorders in short case studies Major Depressive Disorder - Depressed mood most of the day, nearly every day (feels sad, empty, hopeless) or observation made by other - Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day - Significant weight loss when not dieting or weight gain - Insomnia/hypersomnia nearly everyday - Fatigue or loss of energy nearly every day - Feelings of worthlessness or excessive or inappropriate guilt Persistent Depressive Disorder (P-DD)(Dysthymia) - Symptoms of depressed mood that occurs on most days, and for at least one year - Child with P-DD also displays at least two somatic or cognitive symptoms - Symptoms are less severe, but more chronic than MDD - Poor emotion regulation - Constant feeling of sadness, of being unloved and forlorn, self-deprecation, low self-esteem, anxiety, irritability, anger, and temper tantrums Disruptive Mood Dysregulation Disorder - Chronic, severe, persistent irritability - Temper outbursts - Irritable or angry mood - Increased focus on irritability as an important clinical feature 7. Know that MDD rates increase dramatically in adolescence, particularly for girls, and understand why that might be Internalizing problems when puberty hits 8. Understand the recurrent nature of MDD Most children eventually recover from the initial episode, but the disorder does not go away - Chance of recurrence is 25% within one year, 40% within two years, and 70% within five year  9. Know the common cognitive biases and distortions associated with youth depression - Selective attentional biases - Feelings of worthlessness, negative beliefs, attribution of failure, self-critical and automatic thoughts - Depressive ruminative style; pessimistic outlook; and negative self-esteem - Negative thinking and faulty conclusions generalized across situations, hopelessness, and suicidal ideation 10. Know that youth suicide is at its highest level in nearly two decades 11. Understand the basis of behavioral theories of depression Emphasize the importance of learning, environmental consequences, and skills and deficits during the onset and maintenance of depression - Depression is related to a lack of response-contingent positive reinforcement 12. Know Beck’s negative cognitive triad and cognitive theory of depression Depressed individuals make negative interpretations about life events Biased and negative beliefs are used as interpretive filters for understanding events - Negative automatic thoughts and dysfunctional beliefs (core beliefs and schemas) Becks negative cognitive triad The self → the world → the Future 13. Know what a pessimistic attributional style is Attribute negative events to causes that are internal, global, and stable Pessimistic Attribution Style + Uncontrollable negative events = depression 14. Know the various constructs that play a role in the developmental framework for depression  15. Be able to distinguish between the CBT and IPT-A treatment approaches for youth depression CBT - psychosocial intervention combining behavioral and cognitive therapies IPT-A - focus is on depressive symptoms and social context in which they occur Identify a specific problem area - Grief - Interpersonal role disputes (parent child conflict) - Role transitions (high school to college) - Interpersonal deficits Identify effective communication and problem-solving techniques to use within the problem area Practicing in session and eventually experimenting outside the session with the use of these techniques in the context of significant relationships 16. Know the main takeaways from the results of the TADS study After 36 weeks, CBT and Medication had the same effect on patient with lower suicidal events for CBT Overall, CBT is better for treating depression alone, but with medication as well can be slightly more effective 17. Know the major symptoms of bipolar I and bipolar II and be able to identify these disorders in short case studies Bipolar I - manic episode cycle with MD episode (Mania and depression) Bipolar II - hypomanic episode cycle with MD episodes (hypomania and depression) Chapter 11 1. Know the difference between fear and anxiety Anxiety - apprehension about a potential future threat Fear - response to an immediate threat  2. Know the three components of fear and anxiety and be able to identify them in an example Fear: - Cognitive/subjective - “I'm going to die” - Physiological - Heart rate - Breathing - Sweating - Behavioral - Strong urge to escape Anxiety: - Cognitive/subjective - Negative mood/worry - Self-preoccupation - Unable to predict and control threat - Physiological - Muscle tension - Chronic over-arousal - Behavioral - Avoid situations that might be dangerous 3. Understand the role of the sympathetic nervous system in the fear response Fight or flight response 4. Know the common fears and anxieties at different stages of development Early Infancy: Loss of physical support, loss of physical contact with caregiver, intense sensory stimuli (loud noise) Late Infancy: Shyness/anxiety with strangers, sudden, unexpected, or looming objects Toddlerhood: - 12–18 months: separation from parent, injury, toileting, strangers - 2–3 years: fears of thunder and lightening, fire, water, darkness, nightmares Early Childhood (4–5 years): Separation from parents, fear of death or dead people Primary/Elementary School Age - (5-7): Fear of specific objects, fear of germs or of getting a serious illness, fear of natural disasters, fear of traumatic events - (5-11): social anxiety, performance anxiety, physical appearance, social concerns Adolescent (12-18): personal relations, rejection from peers, personal appearance, future, natural disasters, safety 5. Know the major symptoms of separation anxiety disorder, specific phobia, social anxiety disorder, selective mutism, panic disorder, agoraphobia, generalized anxiety  disorder, and obsessive-compulsive disorder and be able to identify these disorders in short case studies Separation Anxiety Disorder (SAD): - Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following: - Recurrent excessive distress when anticipating or experiencing separation - Persistent/excessive worry about losing a major attachment figure or possible harm to them - persistent/excessive worry about untoward event (getting lost) - Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation - Persistent and excessive fear of or reluctance about being alone without major attachment figures - Persistent, lasting at least 4 weeks in children and adolescents and 6 months in adults - Distress or impairment Social Anxiety Disorder (Social Phobia) - Marked fear or anxiety about one or more social situations involving exposure to possible scrutiny by others - Concern about humiliation, embarrassment, rejection, or offending others - Situations almost always provoke fear or anxiety - Avoidance or endured with intense fear - Out of proportion of actual threat - Persistent, at least 6 months - Significant distress or impairment Selective Mutism - Failure to talk in specific social situations, even though they may speak loudly and frequently at home or other settings Generalized Anxiety Disorder (GAD) - Excessive anxiety and worry, more days than not, for at least 6 months, about numerous events or activities - Difficulty controlling the worry - At least one of: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance - Significant distress or impairment - Not attributed to psychological effects of a substance or medical condition - Not better explained by another mental disorder Specific Phobia - Marked fear or anxiety about specific object or situation - object/situation almost always provokes immediate fear - Actively avoided or endured with intense fear  - Out of proportion to the actual danger posed - Fear is persistent, lasting at least 6 months - Significant distress or impairment Panic Disorder - Recurrent, unexpected panic attacks - A month or more of one of the following after at least one of the attacks - (a) persistent concern about having additional attacks or consequences of the attack - (b) significant change in behavior related to the attack - Not attributed to physiological effects of a substance or medical condition - Not better explained by another mental disorder Agoraphobia - Marked fear or anxiety about 2 (or more): - Public transportation - Open spaces - Enclosed spaces - Standing in line or in a crowd - Being outside the home alone - Person is afraid because escape might be difficult or help unavailable, if panic-like or other embarrassing symptoms may occur - Situations almost always provoke fear - Actively avoided, required companion, or endured with intense fear - Out of proportion to actual danger - Persistent, at least 6 months - Significant distress or impairment Obsessive Compulsive Disorder - Recurrent obsessions, compulsions or both - Time consuming (more than 1 hr/day) or significant distress or impairment - Not attributed to psychological effects of a substance or medical condition - Not better explained by another mental disorder 6. Know that separation anxiety disorder has the earliest age of onset of the anxiety disorders 7. Know which anxiety disorders are more common in girls, which are equally common in boys and girls, and which are more common in boys SAD - More prevalent in girls Social Anxiety Disorder - twice as common in girls GAD - equally common in boys and girls Specific Phobia - more common in girls Panic attack - more common in adolescent girls OCD - twice as common in boys 8. Know what a panic attack is and how it differs from panic disorder 9. Know the cognitive theory of panic people with panic attacks have a tendency to misinterpret normal bodily sensations as signs of an impending catastrophe. 10. Understand the difference between obsessions and compulsions - Obsessions - Recurrent and persistent thoughts, ideas, impulses, or images that are experienced as intrusive and unwanted (cause anxiety or distress) - Attempts to ignore, suppress, or neutralize with thought or action - Compulsions - Repetitive behaviors or mental acts that feel driven to preform in responses to obsession or according to rigid rules - Aimed at preventing or reducing anxiety or distress, or preventing dreaded situation; however, not connected in a realistic way or clearly excessive 11. Understand the OCD cycle – obsessions cause anxiety, which is alleviated by compulsions, thereby negatively reinforcing the compulsion and making it more likely that the person will engage in the compulsion the next time an obsession makes them feel anxious 12. Know the tripartite model of anxiety and depression 13. Know the two-factor theory of anxiety Fears and anxieties learned through classical conditioning and maintained through operant conditioning 14. Understand the role of temperament in risk for anxiety - Variations in behavioral reactions to novelty results in part from inherited differences in the neurochemistry of certain brain structures - Amygdala - primary function is to react to unfamiliar or unexpected events - Behavioral inhibition (BI): a low threshold for novel and unexpected stimuli - Places and individual at greater risk for anxiety disorders 15. Know the family and SES factors associated with risk for anxiety - Parenting practices - Parents of anxious children are seen as over-involved, intrusive, or limiting child’s independence  - Prolonged exposure to high doses of family dysfunction associated with extreme trajectories of anxious behavior - Low SES - Insecure early attachment 16. Understand how exposure works in the treatment of anxiety disorders and how exposure and response prevention works in the treatment of OCD Chapter 12 1. Know the difference between traumatic events and stressful events Traumatic events: exposure to actual or threatened harm or fear of death or injury, considered “uncommon” or extreme stressor Stressful events: more common and less extreme than traumatic events 2. Understand the differing ways that stress can affect children, including examples of hyperresponsive and hyporesponsive reactions and the definition of allostatic load Allostatic load: progressive “wear and tear” on biological systems due to chronic stress Hyperresponsive reaction: exaggerated response to sensory or emotional stimuli Hyporesponsive reaction: decreased responsiveness to verbal or other stimuli 3. Be able to distinguish between the 4 different types of maltreatment and know which is the most common Neglect - most common (78.3%) Physical abuse (10.8%) Sexual abuse (7.6%) Emotional (psychological) abuse (7.6%) 4. Know the kind of environment children need to thrive, and what knowledge/resources caregivers need to have in order to provide that environment - Children need both control and direction and stimulation and sensitivity - Protective and nurturing adults - Opportunities for socialization - Supportive family and peer contact - Opportunities to master their environment - In order to provide that environment, parents need: - Knowledge of child development and expectations - Adequate coping skills for parental stress - Opportunities to develop attachment and communication - Adequate parental knowledge of home management - Provision of necessary social and health services 5. Know the major risk factors that put caregivers at risk for maltreating their children  - Little exposure to positive parental models and support - Greater degree of stress - Information processing disturbances - Lack of knowledge of development - Chronic social isolation - more common in neglectful families - Neglectful parents disengage under stress, abusive parents become emotionally reactive - Racism and inequality - Substance abuse, personality disorders - Long-held social customs that endure the use of physical force to resolve child conflict 6. Know the major symptoms of reactive attachment disorder, disinhibited social engagement disorder, post-traumatic stress disorder (PTSD), acute stress disorder, and adjustment disorder and be able to identify these disorders in short case studies Reactive attachment disorder (RAD) - Criterion A: Failure to show consistent effect to seek comfort from their caregiver and failure to respond to caregivers’ efforts to provide comfort - Criterion B: 1.) minimal social and emotional responsiveness to others; 2.) limited positive affect; 3.) unexplained irritability, sadness, or fearfulness even during nonthreatening interactions with caregivers - Criterion C: experienced a pattern of extremes of insufficient care - Criterion D: Emotional disturbances developed following the lack of adequate care Disinhibited social engagement disorder (DSED) - Criterion A: Shows a pattern of overly familiar and culturally inappropriate behavior with strangers - Criterion B: behaviors are not limited to impulsivity (as in ADHD) but include socially disinhibited behavior - Criterion C: Experienced a pattern of extremes of insufficient care Post-traumatic Stress Disorder (PTSD) (Adults and Children Over the Age of 6) - Criterion A: Exposure to actual or threatened death, serious injury, or sexual violence - Directly experiencing, witnessing, or learning about - Experiencing repeated or extreme exposure to details of a traumatic event (usually work-related) - Criterion B: Re-experiencing - Criterion C: Avoidance - Criterion D: Negative cognition or mood - Criterion E: Arousal PTSD Symptom Expression in Children - Separate diagnostic criteria for children under 6 - Criterion A: Repeated exposure to details removed - Criterion B: Reexperiencing  - For children, trauma themes or trauma reenactment may occur in play - More likely to experience nightmares vs. flashbacks - Criterion C: avoidance and negative cognition or mood Acute Stress Disorder - Similar to PTSD, but earlier onset (within 1 month of trauma) and shorter course - Occurs following trauma in 10% to 20% of children - Diagnostic category for use when symptoms develop shortly after traumatic event and last for at least 2 days - Enables people to receive treatment immediately - Diagnosis can change to PTSD if symptoms persist Adjustment Disorder - Psychological response to common stressor - Can be in response to single or multiple events - Occurs within 3 months of stressor - Results in clinically significant behavioral or emotional symptoms - Must be greater than expected - Symptoms disappear when stressor ends or person adapts 7. Understand how a child’s emerging view of self and others can be impacted by trauma - Maltreated children’s emerging views of self and their surroundings are not fostered by healthy parental guidance and control - Emotional and behavioral problems are likely to appear - Negative representational models of self and others develop based on the sense of inner “badness”, self-blame, shame, or rage - Feelings of powerlessness and betrayal are internalized as part of the child’s self-identity 8. Understand how the HPA axis can be altered in response to trauma and the effect it has on the developing brain - Children and adults with history of child abuse show long-term alternation in the hypothalamic-pituitary-adrenal (HPA) axis and norepinephrine systems - These alterations have a significant effect on responsiveness to stress - Affected brain areas: - Hippocampus (learning and memory) - Prefrontal cortex (planning and decision-making) - Amygdala (emotion regulation) - Acute and chronic forms of stress associated with maltreatment may cause changes in brain development and structure from an early age - The neuroendocrine system becomes highly sensitive to stress - Release of cortisol to produce fight or flight response - Elevated levels of stress hormones can impact brain development. Structure, and function - With chronic exposure to stress, cortisol levels can become depleted and the stress response system cab behave unpredictably - Causes neurobiological changes that may account for later psychiatric problems