Child psych disorders exam 1

What is a clinical disorder?

A constellation of symptoms that significantly impairs an individual’s ability to function, and is characterized by a particular symptom picture with a specifiable onset,  course, duration, outcome, response to treatment, and associated familial, psychosocial, and biological correlates.

Categorical Approach

• Discrete categories of disorders

• Yes/No decision based on presence of symptoms and impairment - receive a diagnosis 

• Carve nature at its joints 

• Based on informed professional consensus

Dimensional approach

A number of independent dimensions or traits of behaviors exist and that all children possess these to varying degrees (ex worrying, crying, etc)

advantages of providing a child with a diagnoses (categorical approach)

parsimony, professional communication, prediction, treatment planning, to obtain services, to help parents, to facilitate scientific discovery

Limitations of providing a child with a diagnosis

 loss of detailed information, normality is sometimes arbitrary, high comorbidity, subjective criteria, stigma, non pathognomonic sx

Equifinality definition and example

multiple causes, one outcome (classroom inattention can be caused by ADHD, unsafe environment, acute stressors, learning disability, etc.)

Multifinality definition and example

one cause, multiple outcomes (maltreatment during childhood could end up causing depression, anxiety, aggression, resilience, etc.)

Describe/give example of Unconditioned stimulus, unconditioned response, neutral stimulus, conditioned stimulus, conditioned response

• Unconditioned stimulus: the food in pavlov's dog experiment

• Unconditioned response: salivation at the sight of the food

• Neutral stimulus: bell 

• Conditioned stimulus: bell (after learning) 

• Conditioned response: salivation at the sound of the bell 

Positive reinforcement

Giving a child a dessert for eating her vegetables (adding something to increase likelihood of behavior)

Negative reinforcement

 Allowing child to leave the table for finishing her vegetables (taking away something (usually undesirable) to increase likelihood behavior)

Positive punishment

 Scolding a child for disrupting class (adding something (usually undesirable) to decrease likelihood of behavior)

Negative punishment

putting a child in “time out” or making her miss recess for disrupting class (remove something (desirable like recess or being apart of activity) to decrease likelihood of behavior)

Psychoanalytic theory (how does psychopathology arise and is treated)

Believed that roots of psychopathology are in the first years of life and have no conscious memory of this. Type of problems in adulthood are dependent on which phase a person is fixated in as a child (oral, anal, phallic, oedipus/electra complex, latency phase, genital phase). Proposed that defense mechanisms keep distressing thoughts and feelings from reaching the conscious. Goal of psychoanalysis is insight through free-association, dream analysis, and interpretation.

Behavioral theory (how does psychopathology arise and is treated)

Believed that all behavior is learned and includes interactions with the environment. Believes that psychopathology is classically conditioned may be cured, or extinguished, using behavioral principles. Wolpe uses extinction-based treatment to unlearn classically conditioned responses. (Operant conditioning believes that behavior could be acquired or changed by events that happen afterward and is based on reinforcers and punishers. Vicarious conditioning can also happen by watching others like the bobo doll. )

Cognitive theory (how does psychopathology arise and is treated)

Psychopathology is the result of distorted cognitive processes. Cognitive therapy goals: challenge negative thoughts, assess situations more realistically, generate alternative, positive thoughts. Often used with behavior therapy in cognitive-behavior therapy (CBT). Negative cognitive triad: people with depression experience distorted cognitions of self, world, future.

Humanistic theory (how does psychopathology arise and is treated)

People strive to self-actualize and psychopathology develops when people fail to do so. Carl Rogers believed that psychopathology starts when one’s self image and actual self are incongruent, thus limiting a person’s ability to achieve their full potential. Use client-centered therapy that has genuineness- open and honest, doesn’t hide behind the therapist's mask. Empathic understanding - reflection, and unconditional positive regard.

Case studies (describe experimental design and when you would use it)

comprehensive description of individuals. Usually involves a detailed narrative. Pros: focus on assessment or treatment when the case is complex, generate hypotheses for group studies, allow practitioners to be involved in research, useful for rare illnesses. Cons: can’t draw conclusions about cause as there no experimental or control variables

Single case designs (describe experimental design and when you would use it)

 experimental studies at the individual level. Involves quantitative measurement and control conditions to provide evidence of causal relationships, each subject participates in both the treatment and control groups. Limitations: not generalizable

Longitudinal studies (describe experimental design and when you would use it)

Studies participants over time. Examines whether causes are present before disorder develops. High-risk, high-cost method: include only those who are at greatest likelihood of developing a disorder.

Cross-sectional designs (describe experimental design and when you would use it)

measured at the same time, provides snapshot in time

Controlled group designs (describe experimental design and when you would use it)

experimental and control conditions, includes an IV and DV

Moderator definition and examples

variable that influences the direction or strength of relationships (Is it more true for men vs women) (who)

Mediators definition and examples

 a variable that explains or brings about an outcome by indirect means (says younger siblings request info less because of the teaching behaviors of older siblings.) (why) 

Incidence rate definition

number of new cases that emerge in specific time

prevalence rate

total number of cases at a given time

Reliability definition and types (inter-rater and test-retest)

• is a test consistent?

  • Inter-rater reliability : is one clinician gonna give the same diagnosis as another

  • Test-retest reliability : are changes due to treatment or due to error

Validity definition and types (construct, criterion, concurrent, predictive)

• Does a test measure what it claims to? 

  • Construct validity : is this test a good assessment of this construct? 

  • Criterion validity : how well does this measure predict something

    • Concurrent validity : does this measure actually relate to if you have depression

    • Predictive validity : can it predict something in the future

sensitivity definition and types

can a measure detect a problem if it is there, true positive rate (is a covid test able to detect a positive covid case)

specificity definition and types

can a measure detect the absence a problem if none exist; true negative rate (does a negative covid test mean you actually don’t have covid)

Structured interview (definition and pros and cons)

all interviewers ask the same questions in a predetermined order. pros: increased interrater reliability, cons: limited flexibility, over diagnose cases

Unstructured interview (definition and pros and cons)

clinician decides what questions to ask and how, open ended questions. pros: rapport building, flexibility. cons: reliability, miss comorbid diagnosis

semi structured interview (definition and pros and cons)

allows more clinical interpretation while still following set order to discuss with the client or with set initial questioning. Interviewer attends to how the questions are answered. Pros: increased interrater reliability, flexibility, rapport building. Cons: over diagnose cases, skill level

Intellectual disability onset, course, duration, and outcome

onset: during developmental period (usually childhood)

Course: chronic

Duration: usually life long

Outcome: treatment can help symptoms but not curable

Intellectual disability key symptoms and treatments

A: deficits in intellectual functioning confirmed by clinical assessment and standardized intelligence test

B: deficits in adaptive function

C: Onset in developmental period

3 broad categories of adaptive deficits: conceptual skills, social skills, practical skills

Treatments: ABA therapy uses functional behavioral analysis (ABC), alters environmental contingencies to change behavior. Also uses shaping and changing. Can also use psychotherapy and pharmacological treatments

Specific learning disorder onset, course, duration, and outcome

onset: during school age

Course: chronic

Duration: learning problems often persist into adulthood, particularly if they are not targeted for treatment in early elementary school

outcome: if untreated, these deficits persist over time

Specific learning disorder key symptoms and treatment

A: difficulties learning and using academic skills that has persisted for 6 months

B: affected academic skills are below those expected for the individuals chronological age, and cause significant interference with academic performance or daily living confirmed by individually administered standardized achievement measures and clinical assessment

C: begins during school-age,

D: Learning difficulties are not better accounted for by intellectual disability or other problems

Problems with reading, writing, or math

Treatments: use different interventions depending on problem area, basic reading treatment, guided oral reading, for example

Describe cognitive therapy and targets of this intervention

• Goals: challenge negative thoughts, assess situations more realistically, generate alternative positive thoughts. 

• Best for people with distorted cognitive processes

Diathesis stress model definition and example

• diathesis: biological and/or psychological vulnerability 

• stress: environmental factors 

• Diathesis+stress= distress and/or dysfunction = psychological disorder 

  • Ex: someone with family history of depression becomes depressed after a divorce 

Behavioral genetics definition

uses family, twin, and adoption studies to examine whether family members of someone with a disorder are more likely to have the disorder

Molecular genetics definition

directly assess the association between DNA sequences and behavior, used to identify specific genes for childhood disorders including Autism, ADHD, and learning disability

Gene-environment interaction

• expression of genetic influences is malleable and responsive to social environment. 

  • epigenetics, rubberband environment (some traits are malleable (like a stretchy rubber band, personality), height doesn’t have a lot of give (nutrition can affect, but genetics are pretty strict)) 

• Genes influence environment 

  • biological parents determine early environment 

  • genetically influenced phenotypes determine environment

Benefits and limitations of rating scale

benefits : Ease of administration and scoring, cost efficiency 

limitations: not real quantitative measures (are subjective), rely on retrospective recall, subject to rater expectation biases & halo effects, weak or non-significant correlations with objective measures of the same construct

ABC model definition and example

• A: Antecedent: child doesn’t understand assignment, cannot read directions, does not know what to do 

• B: Behavior: Child leaves seat, talks with classmates, disrupts teacher 

• C: Consequences: Child is positively reinforced by teacher’s attention and classmate’s giggles; child is negatively reinforced by avoiding the assignment 

Intellectual disability symptoms (know the three broad criteria)

• A: deficits in intellectual functioning confirmed by clinical assessment and standardized intelligence test B: deficits in adaptive function C: onset in developmental period 

  • 3 broad categories of adaptive deficits: conceptual skills, social skills, practical skills 

Why is intellectual disability not diagnosed based on IQ alone?

Intelligence test have limitations such as cultural, gender, SES, race/ethnicity bias

What is shaping? give example

Take a complex behavior, break it down and teach each step individually (using baby steps) and rewarding each step. Ex: washing hands video

Three broad areas of Specific learning disability

• Reading: word reading accuracy, reading rate of fluency, reading comprehension 

• Writing: Spelling accuracy, grammar and punctuation accuracy, clarity or organization of written expression

• Mathematics: number sense, memorization of arithmetic facts, accurate fluency calculation, accurate math reasoning