Child Psychopathology Test 4

Maltreatment

Broadly defined as any recent act or failure to act by a parent or caretaker that results in death, serious physical or emotional harm, sexual abuse, or exploitation, or poses an imminent risk of serious harm

What makes an event traumatic

A traumatic event involves exposure to actual or threatened harm, severe injury, or a fear of death

Children's caregiving environment (balancing mastery and responsiveness)

For healthy development, children need a caregiving environment that balances their need for control and direction ("demandingness") with their need for stimulation and sensitivity ("responsiveness")

What contributes to teens feeling stress

Teens experience stress from myriad developmental and situational factors, including school transitions, parental separation, medical problems, peer conflict, and bullying

Physical neglect

The refusal or delay in seeking health care, expulsion from the home, refusal to allow a runaway to return home, abandonment, and inadequate supervision

Allostatic load

The progressive "wear and tear" on biological systems caused by chronic stress, which can lead to a child's stress system being overtaxed or shutting down

Exploitation

Commercial or sexual exploitation of a child, such as forced child labor, child prostitution, and the production of pornographic materials

Emotional child neglect

The marked inattention to a child's needs for affection, refusal or failure to provide needed psychological care, spousal abuse in the child's presence, and permitting the child to use drugs or alcohol

What protects children from effects of maltreatment in part

A positive, supportive relationship with at least one important and consistent person (like a non-offending family member or peer) can provide protection and help the child cope

Reactive attachment disorder (RAD)

A disorder stemming from social neglect where a child exhibits a pattern of disturbed and developmentally inappropriate attachment behaviors

Post-traumatic stress disorder (PTSD)

Persistent anxiety following an overwhelming traumatic event

Dissociation

An altered state of consciousness (induced voluntarily or involuntarily) used to cope with extreme emotional and physical pain

Traumatic sexualization

An outcome of sexual abuse wherein a child's sexual knowledge and behavior are shaped in developmentally inappropriate ways

Trauma-focused cognitive-behavioral therapy (TF-CBT)

The most widely supported components-based treatment for trauma

Psychological first aid

A brief, early intervention delivered after acute stress or mass trauma (like school shootings or natural disasters)

Treatment for child neglect

Focuses on improving parenting skills and expectations, while also teaching parents how to organize fundamental family needs, such as home safety, finances, and medical care, sometimes alongside drug and alcohol counseling

Treatment of physical abuse

Training parents in basic, positive child-rearing skills combined with cognitive-behavioral methods targeting the parents' specific anger patterns or distorted beliefs about the child's intentions

Hypersomnolence disorder

A dyssomnia sleep disorder characterized by excessive sleepiness that is displayed as either prolonged sleep episodes or daytime sleep episodes

Narcolepsy

An uncommon dyssomnia characterized by irresistible attacks of refreshing sleep occurring daily, accompanied by brief episodes of a sudden loss of muscle tone (cataplexy)

Sleep deprivation and its impacts

Impairs the functioning of the prefrontal cortex, which is responsible for executive control

A child with insomnia disorder

Has difficulty initiating or maintaining sleep, or sleep that is not restorative

Chronotherapy

A behavioral treatment used for circadian rhythm sleep disorders that aims to advance the sleep-wake rhythm and restore the internal sleep cycle

The most effective and long-lasting treatment for enuresis

Psychological/behavioral treatments are superior to medication, specifically the use of a urine alarm combined with positive reinforcement

Optimal treatment for encopresis

Involves a combination of medical and behavioral interventions, starting with disimpacting the fecal mass followed by behavioral methods to establish healthy elimination

Somatic symptom and related disorders

A group of disorders involving distressing somatic (physical) symptoms, such as pain or dizziness, that interfere with daily activities

Morbidity

The various forms of physical and functional consequences and limitations that result from an illness

The most common chronic illness

Asthma is the most common chronic illness in childhood

The most common chronic illness in childhood

Asthma

Behavioral intervention for children with diabetes

By promoting treatment regimen adherence and metabolic control. Behavioral strategies reinforce medication use and teach self-control methods for the child to regulate dosage and monitor blood glucose, which helps reduce family conflict and stress

Acute lymphoblastic leukemia (ALL)

The most common form of childhood cancer. It is a malignancy of the bone marrow where malignant cells ("lymphoblasts") progressively replace normal bone marrow, resulting in fewer red blood cells and more white blood cells, leading to anemia, infection, and excessive bleeding

Illness parameters that play the most significant role in adjustment for children with chronic illnesses

The severity of the illness, the prognosis, and the functional status (e.g., physical or cognitive impairments that affect everyday tasks)

Parental behavior to help a child cope with a painful medical procedure

Acting as a coach who uses distraction, contingent praise, and active directives (e.g., "take a deep breath now"). Parents should avoid offering long explanations, vague commands, or criticism during the procedure

The most commonly used drug in the United States

Alcohol is the most prevalent substance used and abused by adolescents

Personality characteristics with the clearest link to adolescent substance use

Sensation seeking, which is described as a preference for novel, complex, and ambiguous stimuli

Factors that increase the risk of substance abuse

An early age of first use (early onset), associating with deviant or substance-using peers, perceiving oneself to be physically older than peers, positive attitudes about substance use, school disconnectedness, low parental monitoring or positive parental attitudes toward alcohol, and a family history of alcoholism (genetic and neurobiological vulnerability)

Influences on eating disorders in children and teens

A complex mix of biological, sociocultural, and psychological factors. Culturally, the Western ideal of thinness and mass media portrayals highly influence a drive for thinness

Binge-purge cycle

A vicious cycle that starts with strict dieting to lose weight, which leads to physical tension and intense cravings. This triggers binge eating, which brings on immense shame, disgust, and fear of weight gain, ultimately leading to purging (e.g., vomiting) to compensate, which then restarts the strict dieting

Metabolic rate

The balance of energy expenditure established by an individual's genetic and physiological makeup, as well as eating and exercise habits. It serves to self-monitor and self-regulate the body's natural weight "set point"

What happens when a person engages in severe dieting and caloric intake decreases below the body's normal range?

The hypothalamus compensates by slowing the metabolism to conserve energy, thereby resisting the weight loss. Lowered leptin levels from dieting also tell the brain to slow metabolism

Avoidant/restrictive food intake disorders (ARFID)

Characterized by avoidance or restriction of food intake (sometimes due to sensory characteristics like texture or smell), leading to significant weight loss, failure to maintain normal growth, nutritional deficiency, or dependence on tube feeding/supplements, with marked interference with psychosocial functioning

Failure to thrive (FTT)

Serious growth and nutritional problems in infants where weight falls significantly below normal (less than the 5th percentile). It is a final common pathway for multiple biological and psychosocial factors, most notably contributed to by a deprivation of maternal stimulation and love, poor caregiver attachment, poverty, family disorganization, social isolation, and maternal eating disorders

Early onset of feeding disorder

When onset occurs during the first 2 years of life, it can lead to malnutrition and serious developmental consequences. It is strongly associated with poor caregiving, abuse, neglect, and family disadvantage

PICA

The ingestion of inedible, nonnutritive substances (e.g., hair, insects, paint chips) for a period of at least one month

Obesity

Defined as excessive body fat with a body mass index (BMI) above the 95th percentile. It is categorized as a chronic medical condition, not a psychiatric disorder

Leptin

A hormone that carries instructions to the brain (hypothalamus) to regulate energy and appetite. Deficiencies or resistance to leptin are found among children and adults with severe obesity

Treatment methods for obesity in children

Interventions focus on addressing parents' knowledge of nutrition and increasing the child's physical activity. Treatments instill active, less sedentary routines (e.g., less TV time), alter the environment by removing high-calorie snacks from the home, and use self-control procedures where children learn to monitor their own diet and exercise. Treatments do not involve strict, energy-restricted dieting

Anorexia

An eating disorder characterized by a refusal to maintain a minimally normal body weight, an intense fear of gaining weight or becoming fat, and a significant disturbance in the individual's perception and experience of their own body size

Bulimia

An eating disorder characterized by recurrent binge eating, followed by compensatory behaviors (like purging) intended to prevent weight gain. Individuals with bulimia are usually within 10% of their normal weight, but are unduly influenced by body shape and weight

Vomiting as a compensatory technique

It is the most common compensatory (purging) technique used voluntarily to counteract the perceived effects of binge eating. It produces immediate relief from physical discomfort and reduces the individual's intense fear of gaining weight

Binge eating disorder (BED) vs. Bulimia

BED does not involve the compensatory purging behaviors (such as vomiting or extreme exercise) seen in bulimia. Additionally, individuals with BED are often overweight or obese, whereas those with bulimia are usually within normal weight ranges

Population at greater risk for behavioral symptoms of eating disorders

Adolescent females are at the highest risk. Gay and bisexual men also appear to be at a greater risk for behavioral symptoms of eating disorders and body dissatisfaction compared to heterosexual men

Cross-cultural evidence regarding eating disorders

Anorexia occurs around the world in both Western and non-Western regions, suggesting it may not be purely "culture-bound". Conversely, bulimia appears to be a culture-bound syndrome, arising predominantly in Western regions or where individuals have been exposed to Western ideals of thinness

Treatments for anorexia

For younger patients living at home, family-based interventions are the initial treatment of choice to restore weight and correct healthy communication patterns. Brief inpatient hospitalization may be necessary to restore weight and monitor medical complications. Once weight is restored, cognitive-behavioral methods focus on rigid beliefs and self-esteem

Treatment for bulimia

Cognitive-behavioral therapy (CBT), delivered individually or with the family, is the standard and most effective treatment. It involves self-monitoring, changing eating behaviors via rewards, and modifying rigid cognitions about body shape. Interpersonal therapy is also effective. Antidepressants (SSRIs like Prozac) have a useful corollary role in treating bulimia, especially given the comorbidity with mood disorders