Child Psychopathology Exam 4

Emerging Personality Disorders?

Personality pathology has its roots in childhood and adolescence, rather than emerging suddenly in adulthood.

What are the general features of personality disorders?

They are characterized by enduring, pervasive, and inflexible patterns of thinking, feeling, behaving, and relating to others that cause significant distress or functional impairment.

What model does the chapter emphasize for diagnosing personality disorders?

The Alternative Model of Personality Disorders (AMPD) from the DSM-5, which views personality pathology on a spectrum.

What does Criterion A of the AMPD assess?

The level of personality functioning, specifically self and interpersonal dysfunction.

What does Criterion B of the AMPD focus on?

Pathological personality traits that are specific and maladaptive.

What are the two core areas of dysfunction in personality disorders?

Self Dysfunction (identity, self-direction, self-worth) and Interpersonal Dysfunction (empathy and intimacy issues).

What symptoms are more common in childhood and adolescence?

Emotional lability, identity instability, irresponsibility and impulsivity, and separation insecurity.

What symptoms are characteristic of established adult pathology?

Pervasive rigid perfectionism, restricted affectivity, intimacy avoidance, callousness, and deceitfulness.

What are key risk factors for developing personality pathology?

Genetic predisposition, childhood maltreatment, invalidating family environments, parental psychopathology, and peer victimization.

What is the prevalence of personality disorders in adolescents?

Estimated to be around 10-15%, similar to adults, with Borderline Personality Disorder traits around 1-3%.

What is the likelihood of remission for adolescents with personality disorders?

Around 50-60% may no longer meet full diagnostic criteria after 2-5 years, with higher rates of remission over longer periods.

What distinguishes Substance Use Disorder from Substance Dependence?

Substance Use Disorder involves harmful use patterns, while Substance Dependence indicates physiological and psychological addiction.

What were the criteria for Substance Abuse in the DSM-IV?

Failure to fulfill major role obligations, use in hazardous situations, recurrent legal problems, and continued use despite social problems.

What criteria defined Substance Dependence in the DSM-IV?

Tolerance, withdrawal, larger amounts than intended, persistent desire to cut down, time spent on substance activities, and giving up important activities.

What is emotional lability, and when is it most common?

Intense and shifting emotions, most common during adolescence due to neurobiological changes.

What is identity instability, and why is it significant in adolescence?

It refers to problems with identity formation, which is expected during adolescence but can become pathological if severe and persistent.

What role does the prefrontal cortex play in adolescent behavior?

It is still developing, leading to poorer judgment and planning, contributing to impulsivity and irresponsibility.

What is separation insecurity, and how can it manifest in adolescents?

It involves frantic efforts to avoid being alone or extreme dependency on peers, often linked to childhood experiences.

What are the neurobiological factors associated with personality pathology?

Differences in brain structure and function, especially in areas related to emotion regulation and impulse control.

What is the impact of an invalidating family environment on children?

It can increase the risk of developing personality disorders by consistently dismissing or criticizing a child's emotional experiences.

How does peer victimization contribute to personality pathology?

Bullying and social rejection are significant risk factors for developing personality disorders.

What is the significance of parental psychopathology in the risk of personality disorders?

Having a parent with a personality disorder, depression, or substance use increases risk through genetic and environmental pathways.

What is the difference between remission and full recovery in personality disorders?

Remission means symptoms may improve, but underlying personality structures often remain stable, leading to continued functional impairment.

What are the indicators of substance use in physically hazardous situations?

Use in physically hazardous situations, such as driving a car.

What characterizes recurrent legal problems related to substance use?

Experiencing repeated legal issues due to substance use.

What does continued use despite social problems indicate?

Continued use despite persistent social or interpersonal problems caused by the substance.

What defines Substance Dependence?

A severe diagnosis indicating physiological and psychological addiction, defined by three or more criteria occurring in a 12-month period.

What is tolerance in the context of substance use?

Needing more of the substance to achieve the same effect.

What does withdrawal refer to in substance use disorders?

Experiencing physical or psychological symptoms when use is reduced or stopped.

What is meant by taking a substance in larger amounts than intended?

Using the substance in greater quantities or over a longer period than planned.

What does persistent desire to cut down on substance use indicate?

Unsuccessful efforts to reduce or control substance use.

What does spending a great deal of time on substance-related activities imply?

Investing significant time in activities necessary to obtain, use, or recover from the substance.

What does giving up important activities due to substance use signify?

Reducing or abandoning important social, occupational, or recreational activities because of substance use.

What is the current unified diagnosis for substance-related issues in DSM-5-TR?

Substance Use Disorder (SUD), which combines Abuse and Dependence into a single diagnosis.

What are the core symptoms included in the 11 criteria for SUD?

Symptoms from both Abuse and Dependence are now included in the criteria for SUD.

How is the severity of Substance Use Disorder determined?

By the number of criteria met from the list of 11 within a 12-month period.

What qualifies as mild severity in Substance Use Disorder?

The presence of 2-3 symptoms.

What qualifies as moderate severity in Substance Use Disorder?

The presence of 4-5 symptoms.

What qualifies as severe severity in Substance Use Disorder?

The presence of 6 or more symptoms.

What new criterion was added to the DSM-5 for SUD?

Craving, a strong desire or urge to use the substance.

What is the general trajectory of substance use across ages?

Substance use is rare in childhood, increases during adolescence, peaks in early adulthood, and then declines.

What is the first substance typically tried by adolescents?

Alcohol.

What is a critical risk period for substance initiation?

Adolescence.

What is the externalizing pathway to substance use?

A developmental trajectory where early vulnerabilities lead to externalizing disorders, escalating to substance use disorders.

What are externalizing disorders characterized by?

Disruptive, impulsive, aggressive, and non-compliant behavior directed outward towards the social environment.

What are common disorders included in externalizing disorders?

Attention-Deficit/Hyperactivity Disorder (ADHD), Conduct Disorder (CD), and Oppositional Defiant Disorder (ODD).

What difficulties are associated with externalizing disorders?

Academic failure, social rejection, family conflict, comorbidity with other disorders, and legal problems.

What are Executive Cognitive Functions (ECF)?

Higher-order neurocognitive processes essential for goal-directed behavior and self-regulation.

What are key components of Executive Cognitive Functions?

Inhibitory control, working memory, cognitive flexibility, planning and organization, and emotional self-regulation.

How do deficits in Executive Cognitive Functions relate to externalizing disorders?

They are core vulnerabilities that can lead to disruptive behaviors in children.

What is Anorexia Nervosa characterized by?

A relentless pursuit of thinness, an intense fear of gaining weight, and a distorted body image.

What is Anorexia Nervosa (AN)?

A disorder characterized by a relentless pursuit of thinness, intense fear of gaining weight, and a distorted body image, involving conscious restriction of intake.

What are the key features of Anorexia Nervosa?

1. Restriction of energy intake leading to significantly low body weight. 2. Fear of weight gain despite being underweight. 3. Disturbance in body experience affecting self-evaluation.

What are the subtypes of Anorexia Nervosa?

Restricting type (dieting, fasting, excessive exercise) and Binge-Eating/Purging type (recurrent binge eating or purging behaviors).

What is the prevalence of Anorexia Nervosa in young women?

Approximately 0.3-0.6%, more common in females with a female-to-male ratio of about 10:1.

What characterizes Bulimia Nervosa (BN)?

A cycle of recurrent binge-eating episodes followed by inappropriate compensatory behaviors to prevent weight gain.

What are the key features of Bulimia Nervosa?

1. Binge eating with a sense of loss of control. 2. Compensatory behaviors like self-induced vomiting or misuse of laxatives. 3. Self-evaluation influenced by body shape and weight.

What is the prevalence of Bulimia Nervosa in young women?

Approximately 1-2%, more common in females with onset typically in late adolescence or early adulthood.

What defines Binge-Eating Disorder (BED)?

Recurrent binge-eating episodes without regular use of compensatory behaviors seen in Bulimia Nervosa.

What are the key features of Binge-Eating Disorder?

1. Binge eating large amounts of food rapidly, often until uncomfortably full. 2. Absence of purging behaviors. 3. Associated feelings of guilt, shame, and disgust.

What is the prevalence of Binge-Eating Disorder?

The most common eating disorder, with a prevalence of 1-3% in the general population, more balanced gender distribution.

What biological changes during adolescence can trigger eating disorders?

Natural increases in body fat during puberty can lead to body dissatisfaction, compounded by hormonal changes affecting mood and impulse control.

How does identity formation relate to eating disorders in adolescents?

Adolescents may use eating disorders as a means of establishing identity and control during a time of uncertainty.

What role do social influences play in the development of eating disorders?

Peer relationships and social media amplify pressures to conform, fear of negative evaluation, and teasing about weight, increasing risk factors.

What is binge eating?

Consuming a larger amount of food than most people would in a similar period, accompanied by a feeling of loss of control.

What is purging in the context of eating disorders?

Using inappropriate methods, such as self-induced vomiting or misuse of laxatives, to eliminate calories or prevent weight gain.

What does restricting refer to in eating disorders?

Severely limiting the type and amount of food consumed, often below caloric needs, involving strict rules and avoidance of food groups.

What is Russell's Sign?

Physical signs of calluses, scars, or abrasions on the knuckles caused by self-induced vomiting, indicating purging behavior.

What are some physical risks associated with eating disorders?

General malnutrition, cardiovascular problems, gastrointestinal issues, endocrine and metabolic disturbances, neurological changes, and dental erosion.

What are common risk factors for developing eating disorders?

Genetic predisposition, low self-esteem, sociocultural pressures for thinness, adverse experiences like trauma, and certain personality traits.

What resilience factors can protect against eating disorders?

High self-esteem, body appreciation, strong social support, positive family relationships, and critical thinking towards media messages.

What is homotypic continuity in eating disorders?

The persistence of the same type of disorder over time, such as an adolescent with Anorexia Nervosa continuing to have symptoms in adulthood.

What is heterotypic continuity in the context of eating disorders?

The evolution of a disorder into a different but related disorder over time, reflecting shared underlying vulnerabilities.

How can an individual with Anorexia Nervosa transition to Bulimia Nervosa?

An individual with the restricting type of Anorexia may later develop binge-purge behaviors, leading to a diagnosis of Bulimia Nervosa.

What is the relationship between eating disorders and other mental health issues?

Eating disorders often share risk factors with other disorders like anxiety, depression, and substance use, indicating a broader vulnerability.