Term
| What is the prevalence of children who require mental health services that do not receive them? |
|
Definition
|
|
Term
| What is the prevalence of children with a significant mental health problem? |
|
Definition
|
|
Term
| Name _ important considerations when diagnosing mental disorders in children? |
|
Definition
- Level of distress
- Level of disability
- Level of increase risk for further suffering or harm
- Environment (behavior due to unusual environmental circumstances)
- Competence (ability to adapt in environment and achieve milestones)
- Developmental appropriateness
- Culturally normative behavior
- different manifestation of adult disorders |
|
|
Term
| What outcomes are associated with poverty and socioeconomic disadvantage in children? |
|
Definition
- Learning impairments
- Academic Problems
- Conduct problems
- Chronic Illness
- Hyperactivity
- Emotional disorders |
|
|
Term
| How does sex affect child behavior? |
|
Definition
- negligible differences under age 3, but increase with age.
- boys demonstrate greater difficulties than girls in early/middle childhood
- girls' problems increase during adolesence.
- Externalizing problems decrease as boys age (less so with girls)
- Internalizing problems increase as girls age (less so with boys) |
|
|
Term
| What are conduct problems? |
|
Definition
| Age-inappropriate actions and attitudes that violate family expectations, societal norms, or persona/property rights of others. Note: often associated with unfortunate family and neighborhood circumstances. |
|
|
Term
| What is the prevalence of antisocial behavior? |
|
Definition
| 5% of children have early, persistent, and extreme pattern of antisocial behavior. (these children account for half of the US crime and 30-50% of clinic referrals). |
|
|
Term
| What are the subdimensions of externalizing behavior? |
|
Definition
Delinquent-aggressive
overt - covert
destructive-nondestructive |
|
|
Term
| Diagnostic criteria: What is fundamental requirements for ODD (criteria a)? |
|
Definition
A pattern of angry/irritable mood, argumentative/defient beahvior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibtied during interaction with a least one individual who is not a sibling.
Sum: pattern of behavior (one of 3 domains), at least 6 months, least 4 symptoms, person other than a sibling. |
|
|
Term
| Diagnostic criteria: What are the 3 behavioral domains in ODD (Criteria A)? |
|
Definition
Angry/Irritable Mood
Argumentative/Defiant Behavior
Vindictiveness |
|
|
Term
| Diagnostic criteria: What are the symptoms within Angry/Irritable Mood of ODD? |
|
Definition
Often loses temper
Is often touchy or easily annoyed
is often angry and resentful |
|
|
Term
| Diagnostic criteria: What are the symptoms within Argumentative/Defiant behavior of ODD? |
|
Definition
Often argues with authority figures or, for children and adolescents, with adults.
Often actively defies or refuses to comply with requests from authority figures or with rules.
Often deliberately annoys others.
Often blames others for his or her mistakes or misbehavior. |
|
|
Term
| Diagnostic criteria: What are the symptoms within vindictiveness of ODD? |
|
Definition
| Has been spiteful or vindictive at least twice within the past 6 months. |
|
|
Term
| Diagnostic criteria: What is criteria B for ODD? |
|
Definition
The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.
Sum: Distress and impairment in various areas of functioning |
|
|
Term
| Diagnostic criteria: What is criteria c for ODD? |
|
Definition
The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.
Sum: not better explained by other disorders or substances. |
|
|
Term
| Diagonstic criteria: Are there any specifiers for ODD? |
|
Definition
Yes, current severity.
Mild - sxs in one setting
Moderate - sxs in at least two settings
severe: sxs in three or more settings |
|
|
Term
| Diagnostic criteria: Any specific notes about behavior in ODD? |
|
Definition
Yes.
Kids younger than 5, behavior should occur for most days for at least 6 months
Kids 5 and over, behavior occurs once/week for at least 6 months.
Guidelines should be based on child's developmental level, gender, and culture. |
|
|
Term
| Diagnostic criteria: What are the fundamental requirements for IED? |
|
Definition
| A. Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either of the following. |
|
|
Term
| Diagnostic criteria: What are the symptoms under Criteria A of IED? |
|
Definition
1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression twoards property, animals or other individuals occurring twice weekly, on average, for a period of 3 months. Note: physical aggression does not result in damage or destruction of property ad does not result in physical injury of animals or other individuals.
2. Three behavioral outbursts involving damage/property destruction and or physical assault involving injury (animal or human) occur within 12 month period.
Sum: 1. verbal or physical aggression w/o damage or injury at least two times within 3 months, 2. 3 outbursts involving damage or injury within 12 months |
|
|
Term
| Diagnostic criteria: What is criteria b for IED? |
|
Definition
| Magnitude of aggressiveness expressed during the recurrent outbursts is grossly out of proportion to the provocation or to any precipitating psychosocial stressor. |
|
|
Term
| Diagnostic criteria: What is criteria c for IED? |
|
Definition
| The recurrent aggressive outbursts are not premeditated (i.e., impulsive and/or anger based) and not committed to achieve some tangible outcome (e.g., money, power, intimidation). |
|
|
Term
| Diagnostic criteria: What is criteria d for IED? |
|
Definition
| The recurrent aggressive outbursts cause either marked distress in the individual or impairment in occupational or interpersonal functioning or are associated with financial/legal costs. |
|
|
Term
| Diagnostic criteria: What is criteria e for IED? |
|
Definition
| Chronological age is at least 6 years. |
|
|
Term
| Diagnostic criteria: What is criteria f for IED? |
|
Definition
| The recurrent aggressive outbursts are not better explained by another mental disorder and are not attributable to another medical condition (like head trauma) or to the physiological effects of a substance. |
|
|
Term
| Diagnostic criteria: Any notes for IED diagnosis? |
|
Definition
Yes.
Children 6-18 yo with aggressive behaviors as part of adjustment disorder should not be considered for this diagnosis.
IED can co-occur with ADD/ADHD, Conduct, ODD, and Autism spectrum when outbursts occur in excess to whawt is usually observed in those disorders. |
|
|
Term
| Diagnostic criteria: Are there any specifiers for IED? |
|
Definition
|
|
Term
| Diagnostic criteria: What is the fundamental diagnostic criteria for Conduct disorder (Criteria A)? |
|
Definition
| A. A repetitive and persistent pattern of behavior in which the basic rights for others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months? |
|
|
Term
| Diagnostic criteria: What are the 4 major symptom domains for conduct disorder? |
|
Definition
- Aggression to people and animals
- Destruction of property
- Deceitfulness or theft
- Serious violations of rules |
|
|
Term
| Diagnostic criteria: What symptoms are associated with aggression to people and animals in conduct disorder? |
|
Definition
- often bullies, threatens, or intimidates others
- often initiates physical fights
- has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
- has been physically cruel to people
- has been physically cruel to animals
- has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
- has forces someone into sexual activity |
|
|
Term
| Diagnostic criteria: What symptoms are associated with destruction of property in conduct disorder? |
|
Definition
- has deliberately engaged in fire setting with the intention of causing serious damage
- has deliberately destroyed others' property (other than by fire setting). |
|
|
Term
| Diagnostic criteria: What symptoms are associated with deceitfulness or theft in conduct disorder? |
|
Definition
- has broken into someone else's house, building, or car
- often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others)
- has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery) |
|
|
Term
| Diagnostic criteria: What symptoms are associated with serious violations of rules in conduct disorder? |
|
Definition
- often stays out at night despite parental prohibitions, beginning before age 13 years.
- has runa way from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
- is often truant from school, beginning before age 13 years. |
|
|
Term
| Diagnostic criteria: What is criterion b for conduct disorder? |
|
Definition
| The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. |
|
|
Term
| Diagnostic criteria: What is criterion c for conduct disorder? |
|
Definition
| If the individual is age 18 years or older, criteria are not met for antisocial personality disorder. |
|
|
Term
| Diagnostic criteria: Are there specifiers for conduct disorder? |
|
Definition
Yes. Age of onset, limited prosocial emotions, and severity.
- Childhood-onset at least 1 symptom prior to age 10
- Adolescent-onset, no symptoms prior to age 10
- unspecified onset, criteria met but cannot determine if onset before or after age 10
Mild - few in excess to those required to make dx
Moderate - between mild and severe
Severe - many sxs in excess or conduct cause considerable harm
Limited prosocial emotions: presence of 2 or more of following symptoms - lack of remorse or guilt, callous- lack of empathy, unconcerned about performance, and shallow or deficient affect. |
|
|
Term
| What onset for conduct disorder is prevalent in boys? |
|
Definition
|
|
Term
| What onset for conduct disorder is the prevalence the same between boys and girls? |
|
Definition
|
|
Term
| What onset for conduct disorder is more likely to result in the dxs of antisocial personality disorder? |
|
Definition
|
|
Term
| What onset for conduct disorder is behavior more aggressive? |
|
Definition
|
|
Term
| What onset for conduct disorder is less likely to commit violent offenses or persist in their antisocial behavior over time? |
|
Definition
|
|
Term
| What is the prevalence rate of ODD? |
|
Definition
|
|
Term
| What are some other considerations for ODD? |
|
Definition
- ODD often precedes diagnosis of CD, particularly childhood onset CD
- D/o more prevalent in males than females prior to adolescence |
|
|
Term
| What is the prevalence of IED? |
|
Definition
|
|
Term
| What is the most typical onset for ODD? |
|
Definition
|
|
Term
| What is the typical onset for IED? |
|
Definition
| late childhood/adolescence |
|
|
Term
| What are some other considerations for IED d/o? |
|
Definition
- can continue and be diagnosed into adulthood
- may be episodic but appears to follow chronic and persistent course. |
|
|
Term
| What is the prevalence of CD? |
|
Definition
|
|
Term
| What is the typical onset for CD? |
|
Definition
| maybe childhood or adolescent; most commonly emerge in middle school |
|
|
Term
| What are other considerations for a cd dx? |
|
Definition
- can be diagnosed in adults, although onset is rare after age 16
- more common in males than females
- comparable cross-cultural prevalences
- sxs vary based on developmental capabilities (physical, cognitive, and social) |
|
|
Term
| What is the prevalence of children dxd with CD that go on to develop antisocial personality disorder? |
|
Definition
|
|
Term
| What are some of the cognitive and verbal deficits for CD? |
|
Definition
|
|
Term
| What are some peer problems associated with CD? |
|
Definition
- inflated and unstable self-esteem
- verbal and physical aggression towards peers
- often rejected by peers
- involvement with other antisocial peers
- underestimate own aggression, overestimate others' aggression
- often a lack of concern for others |
|
|
Term
| What are some family problems associated with CD? |
|
Definition
- lack of family cohesion or emotional support
- deficient parenting
-harsh discipline
- family hx of antisocial behavior and psychopathology |
|
|
Term
| What are some health related problems of cd? |
|
Definition
- rates of premature death 3-4 times higher in boys with conduct problems
- higher risk of personal injury or illness
- early onset of sexual activity, higher sex-related risks
- substance abuse, higher risk of overdose |
|
|
Term
| What are some co-morbid d/os for CD? |
|
Definition
|
|
Term
| What are gender differences for cd? |
|
Definition
- antisocial behavior 3-4 times more common in boys (in childhood)
- differences decrease/disappear by age 15
- boys remain more violence-prone through lifespan; girls use more indirect and relational forms of aggression |
|
|
Term
| What is an early sign of CD? |
|
Definition
| difficult temperament in infancy |
|
|
Term
| What are Moffit's model of cd? |
|
Definition
Two pathways
- life-course-persistent (LCP) path begins at an early age and persists into adulthood
- adolescent-limited (AL) path begins around puberty and ends in young adulthood (more common and less serious than LCP) |
|
|
Term
| What are potential causes of CD (5)? |
|
Definition
Genetic:
- predisposition due to difficult temperament and hyperactivity-impulsivity
- genetic contribution for overt behavior
- different pathways involve different genetic contributions
Neurobiological:
- overactive behavioral activiation system (BAS) and underactive behavioral inhibitions system (BIS)
- early onset CD low psychophysiological and/or cortical arousal, and autonomic reactivity (diminished avoidance learning)
- neuropsychological deficits
Social-cognitive factors:
- egocentrism and lack of perspective taking
- cognitive deficiencies
- cognitive distortions (hostile attributions)
- Crick & Dodge model - deficits in stages of social information-processing
Societal:
- more common in neighborhood with criminal subcultures
- established correlation between media violence and antisocial behavior
Cultural factors:
- associated with minority status but likely due to low SES |
|
|
Term
| What are treatment options for CD? |
|
Definition
- parent magnement training
- cognitive problem-solving skills training
- multisystemic treatment
- preventive interventions
Tx depends on risk/protective factors and type/severity of CD |
|
|
Term
| What substance is the most and 2nd most prevalent substances used and abused by adolescents? |
|
Definition
| 1. alcohol and 2. cigarettes (other substances are increasing) |
|
|
Term
| What is the age of highest prevalence of substance use/abuse? |
|
Definition
| Peak in late adolescence and begin to decline in young adulthood |
|
|
Term
| Diagnostic Criteria: What is the fundamental criterion for an alcohol use disorder (Criteria A)? |
|
Definition
A. Problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring with a 12-month period.
-Sum: 12 months, at least 2 sxs, sig. impairment and distress |
|
|
Term
| Diagnostic criteria: What is criteria A for Alcohol Use? |
|
Definition
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover fro it's effects.
- Craving, or a strong desire to use alcohol.
- recurrent alcohol use resulting in a failure to fulfill major obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol.
- Recurrent alcohol use in situations where it is physically hazardous.
- alcohol use is continued despire knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerence as defined by either 1) need for markedly increased amounts of alcohol to achieve intoxication or the desired effect, 2) a markedly diminished effect with continued use of the same amount.
- Withdrawal, as manifested by either of the following 1) the characteristic withdrawal syndrome for alcohol, alcohol (or a closely related substance such as benzies) is taken to relieve or avoid withdrawal sxs. |
|
|
Term
| Diagnostic criteria: Does alcohol use d/o have specifiers? |
|
Definition
Yes.
- Early remission: does meet criteria currently but did for at least 3 months but less than 12 month
- Sustained remission: previously met but not within past year.
- controlled environment
- severity: mild (2-3 sxs), moderate (4-5 sxs), and severe (6+ sxs) |
|
|
Term
| What is a problem with the criteria for Alcohol use disorder? |
|
Definition
| Not developmentally sensitive (increased use in college age). |
|
|
Term
| What are some comorbidities with substance use disorder? |
|
Definition
- Polydrug use/abuse
- Conduct and ODD
- ADHD (5-10x as likely to have CD, ODD, or ADHD than nonusers)
- Less strong link for depression and GAD and in females |
|
|
Term
| What are the core characteristics of ADHD? |
|
Definition
| Inattention (deficit in sustained attention), and hyperactivity-impulsivity |
|
|
Term
| What is the fundamental criteria for ADHD (criteria A)? |
|
Definition
| A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by 1 or 2. |
|
|
Term
| What are the symptoms A1 for ADHD? |
|
Definition
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
- Often has difficulty sustaining attention in tasks or play activities
- often does not seem to listen when spoken to directly
- often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace.
- often has difficulty organizing tasks and activities
- often avoids, dislikes, or is reluctant to engage in tasks that requires sustained mental effort.
- often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities |
|
|
Term
| What are the fundamental requirements for A1 for ADHD? |
|
Definition
Six or more inattention symptomss that have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note for older adolescents and adults at least five symptoms are required. |
|
|
Term
| What are the symptoms A2 for ADHD? |
|
Definition
- Often fidgets with or taps hands or feet or squirms in seat.
- Often leaves seat in situations when remaining seated is expected.
- Often runs about or climbs in situations where it is inappropriate (for older adolescents and adults - restlessness)
- Often unable to play or engage in leisure activities quietly.
- Is often "on the go," acting as if "driven by a motor"
- Often talks excessively
- Often blurts out an answer before a question has been completed
- Often has difficulty waiting is or her turn.
- Often interrupts or intrudes on others. |
|
|
Term
| What are the fundamental requirements for A2 for ADHD? |
|
Definition
| Hyperactivity and Impulsivity: Six or more symptoms have persisted for a least 6 months to a degree that is inconsistent with developmental level and negatively impacts directly on social and academic/occupational activities. (5 sxs for adolescents and adults). |
|
|
Term
| What is criterion b for ADHD? |
|
Definition
| Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years |
|
|
Term
| What is criterion c for ADHD? |
|
Definition
| Several inattentive or hyperactive-impulsive sxs are present in two or more settings |
|
|
Term
| What is criterion d for ADHD? |
|
Definition
| There is clear evidence that the sxs interfere with, or reduce the quality of social, academic, or occupational functioning. |
|
|
Term
| What is criterion e for ADHD? |
|
Definition
| The sxs do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder |
|
|
Term
| Diagnostic criteria: Does the ADHD dx have specifiers? |
|
Definition
Yes, presentation, remission and severity.
Combined presentation
Predominately inattentive presentation
Predominately hyperactive/impulsive presentation
In partial remission - full criteria previously met, fewer than the full criteria met for past 5 months and sxs result in impairment in social, academic or occupational functioning.
Mild: few in excess to those required to make dx
Moderate: between mild and severe
Severe: many sxs in excess to those required to make dx |
|
|
Term
| What is the prevalence of ADHD? |
|
Definition
| 5% of children, more prevalent in lower SES |
|
|
Term
| What are some gender issues with ADHD dx? |
|
Definition
- Dx more frequently in boys
- Criteria may be more of a male manifestation
- Referral rates differ |
|
|
Term
| What are some associated cognitive deficits of ADHD? |
|
Definition
- deficits in executive function
- difficulties in applying intelligence
- academic delays
- learning d/o (especially in reading, spelling and math)
- distorted self-perceptions |
|
|
Term
| What are some associated medical concerns of ADHD? |
|
Definition
- sleep disturbances
- associated with accident-proneness and risky behavior |
|
|
Term
| What are some associated social problems of ADHD? |
|
Definition
- profoundly rejected by peers
- difficulties with social interactions
- increased aggression and fixed social reputation
- missed social cutes and poor attribution |
|
|
Term
| What are some problems in adolescence that may be due to ADHD? |
|
Definition
- behavioral disinhibition
- greater number of car accidents
- higher rates of teen pregnancy
- earlier age of sexual intercourse
- less likelihood of completing high school and college
- clinically meaningful relationship w/substance use |
|
|
Term
| What are some comorbidities with ADHD? |
|
Definition
|
|
Term
| Name the 4 theories of ADHD. |
|
Definition
Motivational deficits: diminished sensitivity to rewards and punishment, resulting in deterioration of performance when rewards are infrequent.
Arousal level deficits: low arousal, resulting in excessive self-stimulation in order to maintain an optimal level of arousal.
Self-regulation deficits: inability to use thought and language to direct behavior, resulting in impulsivity, poor maintenance of effort, deficient modulation of arousal level, and attraction to immediate rewards.
Behavioral inhibition deficits: inability to control behavior, which is the basis for the many cognitive, language, and motor difficulties associated with ADHD |
|
|
Term
| What are some causes of ADHD? |
|
Definition
- Genetics (runs in families)
- DAT and DRD4 genes
- Birth complications
- Maternal substance abuse (esp. stimulants)
- Neurobiological: smaller cerebral volumes and cerebellum, frontostriatal circuitry. |
|
|
Term
| What are treatment options for ADHD? |
|
Definition
- Medication (stimulants): most common are dextroamphetamine and methlyphenidate
- Parent management training
- Educational intervention |
|
|
Term
| Diagnostic criteria: What is the fundamental criterion for MDD (Criterion A)? |
|
Definition
| Five or more sxs present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either depressed mood or loss of interest or pleassure |
|
|
Term
| Diagnostic criteria: What are the criteria A of mdd? |
|
Definition
1. Depressed mood most of the day, nearly every day (irritable for children and adolescents)
2. Anhedonia
3. Sig. weight loss or gain (change of more than 5% of body weight) or decrease/increase in appetite nearly every day (in children failure to make expected weight gain).
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day
6. Fatigue or less of energy nearly every day
7. Feelings of worthlessness or excessive inappropriate guilt nearly every day
8. Diminished ability to think or concentrate or indecisiveness nearly every day.
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. |
|
|
Term
| Diagnostic criteria: What are the criteria b of mdd? |
|
Definition
| The sxs cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
|
|
Term
| Diagnostic criteria: What are the criteria c of mdd? |
|
Definition
| The episode is not attributable to the physiological effects of a substance or to another medical condition. |
|
|
Term
| Diagnostic criteria: What are the criteria d of mdd? |
|
Definition
| The occurrence of a mde is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. |
|
|
Term
| Diagnostic criteria: What are the criteria e of mdd? |
|
Definition
| There has never been a manic episode or a hypomanic episode. |
|
|
Term
| Are there specifiers for MDD? |
|
Definition
Yes.
Mild (few in excess), Moderate (btwn mild and severe), Severe (many in excess).
Single vs. Recurrent
With psychotic features
in partial remission
in full remission
unspecified
with anxious distress
with mixed features
with melancholic features
with atypical features
with mood-congruent psychotic features
with mood-incongruent psychotic features
with catatonia
with peripartum onset
with seasonal pattern |
|
|
Term
| What are some clinical features of MDD in children? |
|
Definition
- depressed appearance
- hopelessness is unlikely
- more somatic complaints
- irritability
- uncooperativeness
- apathy
- disinterest
- separation anxiety
- psychotic features
- suicide ideation (60%)
- social withdrawal |
|
|
Term
| What is the prevalence of MDD? |
|
Definition
|
|
Term
| What age group is there a higher prevalence of MDD? |
|
Definition
|
|
Term
| What is the age of onset for MDD? |
|
Definition
|
|
Term
| What is the average length of an MDE? |
|
Definition
| 8 months with almost all recovering, w/major experiencing recurrence. |
|
|
Term
| Are there gender differences in MDD? |
|
Definition
| Yes, but not until after puberty. 2:1 - 3:1 MDD in girls |
|
|
Term
| What are the 5 potential causes of MDD? |
|
Definition
- Genetic and family risk
- Neurobiological influences: amygdala and hippocampus, HPA axis, sleep architecture, growth hormone, and neurotransmitters (serotonin, dopamine, and norepinephrine).
- Family influences: more conflict, over controlling, poor communication, less warmth, stress
- Stressful life events
- emotional regulation: difficulties with neg. emotion regulation |
|
|
Term
| What is the clinical course of DMDD? |
|
Definition
|
|
Term
| What is the criteria A for DMDD? |
|
Definition
| A. Severe recurrent temper outbursts manifested berbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation. |
|
|
Term
| What is the criteria B for DMDD? |
|
Definition
| Temper outbursts are inconsistent w/developmental level |
|
|
Term
| Diagnostic criteria: What are the criteria c of dmdd? |
|
Definition
| Temper outbursts occur, on average, 3 or more days/week. |
|
|
Term
| Diagnostic criteria: What are the criteria d of dmdd? |
|
Definition
| Mood between temper outbursts is persistently irritable or angry most of the day, nearly every day and is observable by others) |
|
|
Term
| Diagnostic criteria: What are the criteria e of dmdd? |
|
Definition
| Criteria A-D present for 12 + months (has not had 3 or more months w/o sxs) |
|
|
Term
| Diagnostic criteria: What are the criteria f of dmdd? |
|
Definition
| Criteria A-D are present in 2+ settings and are severe in at least one setting |
|
|
Term
| Diagnostic criteria: What are the criteria g of dmdd? |
|
Definition
| Diagnosis should not be made for the first time before age 6 or after 18 |
|
|
Term
| Diagnostic criteria: What are the criteria h of dmdd? |
|
Definition
| Age of onset for criteria A-E is before 10 years |
|
|
Term
| Diagnostic criteria: What are the criteria i of dmdd? |
|
Definition
| No distinct period lasting more than 1 day where the full criteria for manic or hypomanic episode is present |
|
|
Term
| Diagnostic criteria: What are the criteria j of dmdd? |
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Definition
| Behaviors do not occur exclusively during a MDE and not better explained by another disorder. |
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Term
| Diagnostic criteria: What are the criteria k of dmdd? |
|
Definition
| The sxs are not attributable to the physiological effects of a substance or to another medical or neurological condition. |
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Term
| What d/os CAN co-occur with DMDD? |
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Definition
| MDD, CD, ADHD/ADD, and SUDs |
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Term
| What d/os CANNOT co-occur with DMDD? |
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Definition
|
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Term
| What is the prevalence of DMDD? |
|
Definition
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Term
| What is the fundamental criteria for BPI? |
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Definition
Must meet criteria for at least one manic episode: Neither psychosis or MDE is needed for dx but many individuals have one or both in addition to mania.
Manic episode can be preceded or followed by hypomanic or MDE. |
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Term
| What is the fundamental criteria of BPII? |
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Definition
- No evidence of manic episode hx.
- Criteria = 1+ hypomanic episodes, 1+ MDE |
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Term
| What is criteria A for Manic episode? |
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Definition
| A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting 1 week (or any duration of hospitalization). |
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Term
| What is the fundamental criteria (criteria B)for Manic episode? |
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Definition
| During the period of mood disturbance, three (or more) of the following sxs have persisted (four if the mood is only irritable) and have been present to a significant degree. |
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Term
| What is criteria B for manic episode? |
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Definition
- inflated self esteem or gradiosity
- decreased need for sleep
- more talkative than usual or pressure to keep talking
- flight of ideas or subjective experience that thoughts are racing
- distractability
- increased goal-directed activity or psychomotor agitation
- excessive inolvement in pleasurable activities that have a high potential for painful consequences. |
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Term
| What is criteria C for manic episode? |
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Definition
| The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. |
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Term
| What is criteria D for manic episode? |
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Definition
| Episode not attributable by effects of a substance or to another medical condition. |
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Term
| What is criteria A for Hypomanic episode? |
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Definition
| A distinct period of abnormally and persistently elevated, expansive, or irritable mood and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. |
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Term
| What is the fundamental criteria (criteria b) for hypomanic episode? |
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Definition
| During the period of mood disturbance and increased energy/activity, three (or more) of the following sxs have persisted (four if irritable) and have been persistent for a significant degree. |
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Term
| What is criteria b for hypomanic episode? |
|
Definition
- inflated self-esteem or grandiosity
- decreased need for sleep
- more talkative than usual or pressure to keep talking
- flight of ideas or racing thoughts
- distractibility
- increase in goal-directed activity or psychomotor agitation
- excessive involvement in pleasurable activities that have a high potential for painful consequences |
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Term
| What is criteria c for hypomanic episode? |
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Definition
| Episode is associated with unequivocal change in fucntioning that is uncharacteristic of the individual when not symptomatic. |
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Term
| What is criteria d for hypomanic episode? |
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Definition
| Disturbance in mood and change in functioning is observed by others |
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Term
| What is criteria e for hypomanic episode? |
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Definition
| Episode not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization (psychotic features = mania) |
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Term
| What is criteria f for hypomanic episode? |
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Definition
| Episode is not attributable to effects of substance. |
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Term
| What are the BP specifiers? |
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Definition
Severity: Mild, moderate, severe
Current episode characteristics: manic, hypomanic, depressed, unspecified.
With anxious distress
rapid cycling
psychotic features
mood-congruent psychotic features
mood-incongruent psychotic features
with catatonia
with paripartum onset
with season pattern
in partial and full remission |
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Term
| What are some clinical features of juvenile BP? |
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Definition
- BPII is milder and cyclothymic d/o more common, rapid cycling also common
- rare in young children but increases in puberty
- May include exacerbations of mood states or ultrarapid mood shifts
- 1/3 to 1/2 of adolescent bipolar pt. have psychotic features
- no gender differences
- |
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Term
| What is the prevalence of BP? |
|
Definition
|
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Term
| What dx is comorbid with BP? |
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Definition
-ADHD
- anxiety
- Conduct
- Substance use |
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Term
| What age is the peak of BP onset? |
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Definition
|
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Term
| What are some Bp clinical features of BP? |
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Definition
- chronic and resistant to treatment, with poor long-term prognosis
- 25% of bp patients had onset before 20
- depression appears first. |
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Term
|
Definition
| - strong genetic contribution |
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Term
| What are treatments for BP? |
|
Definition
- multi-model
- psychoeducation
- medications
- psychotherapeutic interventions to address sxs related psychosocial impairments |
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Term
|
Definition
Rett's D/o: decelerated head growth between ages 5 and 48 months
Childhood Disintegrative D/O: regression of skills, rare, |
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Term
| What is criteria A for ASD? |
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Definition
A. Persistent deficits in social communication and social interaction across multiple contexts as manifested by:
- deficits in social-emotional reciprocity
- deficits in nonverbal coomunicative behaviors used for social interactions
- Deficits in developing, maintaining and understanding relationships ranging from difficulties adjusting behaviors to social context to absence of interest in friends. |
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Term
| What is criteria B for ASD? |
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Definition
Restricted, repetitive patterns of behaviors, interests or activities as manifested by 2 or more of the following:
- Stereotyped or repetitive movements
- Insistence of sameness, inflexible adherence to routine or ritualized verbal or nonverbal behavior.
- Hyper- or hypoactivity to sensory input or unusual interest in sensory aspects of environment. |
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Term
| What is criteria C for ASD? |
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Definition
| Sxs must be fully present in the early developmental period. |
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Term
| What is criteria D for ASD? |
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Definition
| Sxs cause clinical significant impairment |
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Term
| What is criteria E for ASD? |
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Definition
| Disturbances not better explained by intellectual disability or global developmental delay |
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Term
| What are specifiers for ASD? |
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Definition
Severity for social communication or restricted/repetitive behavior difficulties: requiring support (level 1), requiring substantial support (level 2), and requiring very substantial support (level 3).
With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental or behavioral disorder
With catatonia |
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Term
| What are some related sxs? |
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Definition
-sleep distubances
- eating disturbance
- abnormal fears
- over or under sensitive to sensory stimuli
- abnormal posture and movementsof the face, head, trunk, and limbs
- abnormal eye movements
- repeated gestures and mannerisms
- self injurious behaviors
- movement d/o (risk greatest during adolescence).
- deficits in executive function
- difficulty understanding social situations
- 25% epilepsy
-abnormally large head circumference in 20%
- no theory of mind |
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Term
| What are some notes about intellectual functioning in ASD? |
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Definition
- 75% of individuals with ASD have an IQ below 70
- verbal and reasoning skill s are difficult, though about 25% have splinter skills and 5% have savant abilities |
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Term
| when is ASD most often dxd? |
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Definition
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Term
| What is normative age vs. autistic child age for looking at faces? |
|
Definition
| birth vs. sig less at 12 mo |
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Term
| What is normative age vs. autistic child age for following gaze? |
|
Definition
| 6-9 months vs. less at 18 mo |
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Term
| What is normative age vs. autistic child age for responding to name? |
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Definition
| 6-9 mo vs. less at 9-12 mo |
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Term
| What is normative age vs. autistic child age for showing objects to other? |
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Definition
| 9-12 mo vs. less at 12 mo |
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Term
| What is normative age vs. autistic child age for pointing? |
|
Definition
| 9-12 mo vs less at 12, 18 mo |
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Term
| What is normative age vs. autistic child age for symbolic play? |
|
Definition
| 14 mos vs. absent at 18 mo |
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|
Term
| What is normative age vs. autistic child age for theory of mind? |
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Definition
|
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Term
| What are possible causes for deterioration from prior level of functioning? |
|
Definition
| Rett for girls, head injury or other trauma process, other neurological issue |
|
|
Term
| What is the pravalence of ASD? |
|
Definition
|
|
Term
| Are there gender differences in ASD? |
|
Definition
| ASD 304 more common in boys, more severe intellectual impairments with girls |
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Term
| What are risk factors for ASD? |
|
Definition
- advance parental age
- low birth weight
- fetal exposure to valproate (depakote) |
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Term
| What are NOT risk for ASD? |
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Definition
parental involvement
vaccinations
environmental toxins
food allergies |
|
|
Term
| What are treatments for ASD? |
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Definition
- early intervention
- teaching social and communication skills
- techniques to reduce disruptive and self-injurious behaviors
- parent training
- 20-45 hrs of intervention per week |
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Term
| What are the 4 criteria for PICA? |
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Definition
A. Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month
B. Eating of nonnutritive, nonfood substances is inappropriate to the developmental level of the individual
C. The eating behavior is not part of a culturally supported or socially normative practice.
D. If the eating behavior occurs in the context of another emotional disorder it is sufficiently severe to warrant additional clinical attention. |
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Term
| What is the onset for PICA? |
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Definition
- chilldhood, but can begin at any age
- onset during pregnancy |
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Term
| What are the 4 criteria for rumination disorder? |
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Definition
A. Repeated regurgitation of food over period of a least 1 month
B. No attributable to a GI condition
C. Does not occur exclusively during the course of anorexia, bulimia, binge-eating d/or, or avoidant/restrictive food intake disorder.
D. If the eating behavior occurs in the context of another emotional disorder it is sufficiently severe to warrant additional clinical attention. |
|
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Term
| What is the onset for rumination d/o? |
|
Definition
3-12 months
usually remits in infancy but can be fatal |
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Term
| What are the 4 criteria for avoidant/restrictive food intake d/o? |
|
Definition
A. Lack of interest, avoidance of sensory characteristics of food, concern about aversive consequences of eating as manifested by persistent failure to meet apprpriate nutritional and/or energy needs. Mst has one or more of the following:
- significant weight loss
- sig. nutritonal deficiency
- dependence on enteral feeding or oral nutritional supplements
- marked interference in psychosocial functioning
B. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
C. same as other eating d/o
D. same as other eating d/o with medical condition as well |
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Term
| What is the onset of avoidant/restrictive food intake d/o? |
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Definition
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Term
| What is criteria a for anorexia? |
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Definition
| Restriction of energy intake relative to requirements, leading to a sig. low body weight in the context of age, sex, developmental trajectory, and physical health. Sig. low eight is defined as a weight that is less than minimally normal or for children and adolescents, less than that minimally expected. |
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Term
| What is criteria b for anorexia? |
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Definition
| Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low eight. |
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Term
| What is criteria c for anorexia? |
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Definition
| disturbance in the way in which one's boy weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight. |
|
|
Term
| what are specifiers for anorexia? |
|
Definition
Type: Restricting type (with last 3 months, has not had recurrent episodes of binge eating or purging behavior), binge-eating/purging type (within last 3 months has engage in compensatory behaviors).
In partial remission or full remission
Severity: mild: bmi 17 and above, moderate: 16-16.99, severe: 15-15.99, and extreme: less than 15 |
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|
Term
| What is the most common type of anorexia? |
|
Definition
| binge-eating/purging type (50%) |
|
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Term
| What are co-morbid d/o with anorexia? |
|
Definition
Anxiety
OCD
Mood d/o (33-60%)
Insomnia
SUD
Suicide |
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|
Term
| What is criteria a for bulimia? |
|
Definition
Recurrent episodes of binge eating
- during a discrete period of time eating an excessive amount of food.
- lack of control over eating during this episode. |
|
|
Term
| What is criteria b for bulimia? |
|
Definition
| Recurrent inappropriate compensatory behaviors in order to prevent weight gain. |
|
|
Term
| What is criteria c for bulimia? |
|
Definition
| Binge eating/compensatory behaviors occur on average at least once/week for 3 or more months. |
|
|
Term
| What is criteria d for bulimia? |
|
Definition
| self evaluation unduly influenced by body shape and weight |
|
|
Term
| What is criteria e for bulimia? |
|
Definition
| disturbance does not happen exclusively during episode of anorexia. |
|
|
Term
| What are specifiers for bulimia? |
|
Definition
severity: mild (1-3 episodes), moderate (4-7 episodes), severe (8-13 episodes), extreme (14 plus)
types: purging, nonpurging |
|
|
Term
| What is the most common subtype of bulimia? |
|
Definition
|
|
Term
| What are comorbid d/o with bulimia? |
|
Definition
anxiety, social phobia and GAD
mood disorders
sud
borderline personality disorder
suicide risk |
|
|
Term
| What is criteria a for BED? |
|
Definition
Recurrent episodes of binge eating
- during a discrete period of time eating an excessive amount of food
- lack of control over eating during this episode. |
|
|
Term
| What is criteria b for BED? |
|
Definition
Binge eating episodes associated with 3 or more of the following:
- eating much more rapidly than normal
- eating until feeling incomfortably full
- eating large amounts when not feeling physically hungry
- eating alone because of embarrassment over how much one is eating
- feeling disgusted with oneself, depressed, or very guilty afterward. |
|
|
Term
| What is criteria c for BED? |
|
Definition
| Marked distress regarding binge eating is present |
|
|
Term
| What is criteria d for BED? |
|
Definition
| Binge eating occurs, on average 1 or more times/week for 3 or more months. |
|
|
Term
| What is criteria e for BED: |
|
Definition
| Not associated with recurrent use of inappropriate compensatory behaviors or occur exclusively during course of bulimia or anorexia. |
|
|
Term
| What are specifiers for BED? |
|
Definition
|
|
Term
| What is the prevalence of anorexia? |
|
Definition
0.4% (12 month to adult)
1.1% lifetime
6-8% college age |
|
|
Term
| What is onset for anorexia? |
|
Definition
| adolescent (associated with stressor) |
|
|
Term
| Are there gender differences for anorexia? |
|
Definition
|
|
Term
| What is the prevalences of bulimia? |
|
Definition
| 1-1.5% (13 month to adult) |
|
|
Term
| Are there gender differences for bulimia? |
|
Definition
|
|
Term
| What is the onset for bulimia? |
|
Definition
young adulthood
male onset: caucasian, middle to upper SES, gay or bisexual, athlete with weight restrictions. |
|
|
Term
| What is the prevalence for BED? |
|
Definition
1.6% for females
0.6% for mailes |
|
|
Term
| Arere there gender differences for BED? |
|
Definition
|
|
Term
| What are causes of eating d/o? |
|
Definition
- Cultural imperatives
- ideal body size standards
- media standards
- social and gender standards
- dieting trends
- perceptions of fat
- social and peer groups
- dietary restraint
- hx of dieting and eating d/o in mothers or other family
- low sense of control
- low self-confidence
- perfectionistic attitudes
-distorted body image
- preoccupation with food and appearance
- mood intolerance |
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