Disorders of Childhood and Adolescence part 3

Diagnostic criteria for Enuresis

• Repeated voiding of urine into bed or clothes 

• Behavior must be clinically significant as manifested by either a frequency of twice a week for at least three consecutive weeks or the presence of clinically significant distress or impairment in social, academic, or other important areas of functioning.

• Chronological or developmental age is at least 5 years of age

• The behavior is not due exclusively to the direct physiological effect of a substance or a general medical condition 

Diagnostic criteria for Encopresis

• Repeated passage of feces into inappropriate places

• At least one such event a month for at least 3 months

• Chronological age of at least 4 years 

• The behavior is not exclusively due to a physiological effect of a substance or a general medical condition, except through a mechanism involving constipation.

DS5M Childhood Disorders

Intellectual Disability, Specific Learning Disorder, Autism Spectrum Disorder, Motor Disorders, Communication Disorders, ADHD. feed and eating disorder, Conduct Disorder and Anxiety Disorder

• Externalizing disorders

• Characterized by outward-directed behaviors

  • Noncompliance, aggressiveness, overactivity, impulsiveness

    • Includes attention-deficit/hyperactivity disorder, conduct disorder, and oppositional defiant disorder

  • More common in boys

Internalizing disorders

• • Characterized by inward-focused behaviors

    • Depression, anxiety, social withdrawal

  • Includes childhood anxiety and mood disorders

  • More common in girls

Attention-Deficit/Hyperactivity Disorder

• Excessive levels of activity

• Fidgeting, squirming, running around when inappropriate, incessant talking

Attention-Deficit/Hyperactivity Disorder- Distractibility and difficulty concentrating

Makes careless mistakes, cannot follow instructions, forgetful

• May have difficulty with peer interactions

example of Attention-Deficit/Hyperactivity Disorder

Three specifiers in DSM-5 to indicate which symptoms predominate

1. Predominantly inattentive type

2. Predominantly hyperactive-impulsive type

3. Combined type

ADHD 

More off-task behavior, cognitive and achievement deficits

Conduct Disorder

More aggressive, act out in most settings, antisocial parents, family

• ADHD often

• comorbid with anxiety and depression

• Public policy can affect diagnosis rates

• More common in boys than girls

  • May be because boys’ behavior more likely to be aggressive

• Prevalence for ADHD

• estimates 8 to 11% worldwide

Symptoms persist beyond childhood for ADHD

• Numerous longitudinal studies show 65 to 80% still exhibit symptoms

• 60% of adults continue to meet criteria for ADHD in remission

• Hinshaw et al. (2006) large, ethnically diverse study of girls

  Combined type had: 

• More disruptive behaviors than inattentive type

• More comorbid diagnoses of conduct disorder or oppositional defiant disorder than girls without ADHD

• Viewed more negatively by peers than inattentive type or girls without ADHD

• Hinshaw et al. (2006) large, ethnically diverse study of girls

  • Inattentive type

• • Viewed more negatively by peers than girls without ADHD

• Girls with ADHD more likely to:

• Be anxious and depressed

• Exhibit neurological deficits (e.g., poor planning, problem-solving)

• Have symptoms of eating disorder and substance abuse by adolescence