Psychopathology Final 1

Which age group experiences the highest rate of child victimization?

Children younger than 1 year old.

Which children have the highest rates of victimization/maltreatment?

AI/AN children, followed by Black/AA children.

What is child maltreatment?

Acts of aggression, exploitation, or omission such as abandonment or failure to provide care.

What are the four major types of child maltreatment?

Neglect, physical abuse, sexual abuse, and emotional/psychological abuse.

What is neglect?

Failure to meet a child’s physical, emotional, educational, or medical needs.

What is the most common form of child maltreatment in the U.S.?

Neglect.

What is educational neglect?

Failure to enroll a child in school, chronic absenteeism, ignoring special education needs, or interfering with education.

What are common signs of neglect in a child?

Poor hygiene, lack of food/clothing, frequent absences, lack of medical care, or stating no caregiver is home.

What are common parent signs associated with neglect?

Indifference, apathy, bizarre behavior, or substance abuse.

What is physical abuse?

Non-accidental physical force causing or risking injury.

What should clinicians pay attention to when identifying physical abuse?

“Accidental” or unexplained injuries.

What is sexual abuse?

Engaging a child in sexual activity they cannot legally consent to.

What is contact sexual abuse?

Touching, sexual assault, rape, or forced physical engagement.

What is non-contact sexual abuse?

Exposure, voyeurism, child pornography, or online grooming.

What are signs of sexual abuse in children?

Difficulty walking, nightmares, unusual sexual knowledge, sudden appetite changes, or attaching quickly to strangers.

What is emotional/psychological abuse?

Behaviors that damage a child’s self-worth through criticism, threats, rejection, or emotional deprivation.

Is exposure to domestic violence considered emotional abuse?

Yes.

What are signs of emotional abuse in children?

• Shows extremes in behavior, such as overly compliant behavior, extreme passivity, or aggression

• Is either inappropriately adult-like (e.g., parenting other children) or inappropriately infantile (e.g., frequently rocking or head-banging)

•  Is delayed in physical or emotional development

• Displays suicidal behaviors

• Reports a lack of attachment to the parent(s)

What types of maltreatment have the highest PTSD risk?

Sexual assault, chronic abuse, and coercive abuse.

How does childhood trauma affect the brain?

It keeps the brain in chronic survival mode and disrupts threat, memory, and reward systems.

How does trauma affect the autobiographical memory system?

It causes:

• Fragmented or disorganized memories

• Difficulty recalling events in sequence

• Intrusive trauma memories

• Overgeneral memories 

How does trauma affect the reward system?

Trauma can lead to the reward system becoming underactive or dysregulated because the child learns that the environment is unsafe or unpredictable.

• This can lead to:

  • Reduced ability to experience pleasure

  • Emotional numbness

  • Difficulty trusting relationships,

  • Increased risk for depression or substance use,

  • Seeking unhealthy rewards or risky behaviors to cope.

What is hypervigilance?

Excessive alertness and scanning for danger following trauma.

Why is hypervigilance adaptive?

It helps children survive dangerous environments.

When must mandated reporters report child abuse?

When there is reasonable cause to suspect abuse or maltreatment.

How can bias affect mandated reporting?

Race-based and economic biases may increase reports against marginalized families.

What is the DSM-5 trauma criterion for PTSD?

• Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: Direct experience, witnessing it happen to others, learning that an experience happened to someone close, and repeated exposure to details of a traumatic event

What are intrusion symptoms in PTSD?

• Involuntary memories that repeat, including dreams without recognizable content for those over 6

• Distressing dreams that reflect the traumatic event

• Dissociative reactions (flashbacks). For children, trauma reenactment may happen during play

• Psychological reactions to cues that remind of the traumatic event

What are avoidance symptoms in PTSD?

Avoiding trauma-related thoughts, feelings, people, or places.

What are negative cognition/mood symptoms in PTSD?

Negative beliefs, guilt, emotional numbness, detachment, and inability to feel positive emotions.

What are hyperarousal symptoms in PTSD?

Hypervigilance, irritability, sleep problems, concentration issues, and exaggerated startle response.

How long must PTSD symptoms last?

More than 1 month.

What is different about PTSD in preschool children?

Only one avoidance symptom is required and intrusive memories may not appear distressing.

Why is exposure important in PTSD treatment?

Repeated exposure helps reduce fear and emotional intensity over time.

What are examples of trauma-focused PTSD treatments?

TF-CBT, EMDR, prolonged exposure, DBT-PE, and cognitive processing therapy.

What are the behavioral goals of PTSD treatment?

Returning to normal activities and reducing avoidance.

What are the physiological goals of PTSD treatment?

Regulating hyperarousal.

What are the cognitive goals of PTSD treatment?

Restructuring dysfunctional thoughts and restoring safety/control.

What are common PTSD assessment tools?

CAPS-5, UCLA PTSD Reaction Index, PCL-5, CPSS-5, and CATS.

Why should clinicians assess for comorbidity in PTSD?

PTSD commonly co-occurs with anxiety, depression, ADHD, substance abuse, and disruptive disorders.

What are the three symptom clusters of ODD?

Angry/irritable mood, argumentative/defiant behavior, and vindictiveness.

How long must ODD symptoms persist?

At least 6 months.

What is a key criterion for ODD diagnosis?

Symptoms must occur with at least one person who is not a sibling.

What symptom cluster of ODD predicts emotional disorders later in life?

Angry-irritable mood symptoms.

What are risk factors for ODD?

Harsh parenting, abuse/neglect, poor emotion regulation, and inconsistent discipline.

What is Conduct Disorder (CD)?

A repetitive pattern of violating others’ rights or societal norms.

What are the four categories of CD symptoms?

Aggression, destruction of property, deceit/theft, and rule violations.

What is childhood-onset CD?

CD with at least one symptom before age 10.

What characterizes adolescent-onset CD?

•  Less likely to display aggressive behaviors 

• Tend to have more normative peer relationships 

•  Exhibit functional impairments in adulthood, including substance-related problems, financial difficulties, physical health problems

•  Less likely to have CD that persists into adulthood

•  More balanced ratio of males to females

What is the “limited prosocial emotions” specifier in CD?

• at least 2 traits over at least 1 year and in various relationships and settings:

  • Lack of remorse or guilt

  • Callous- lack of empathy

  • Unconcerned about performance

  • Shallow or deficient affect

What is the coercive cycle?

A pattern where negative parent-child interactions reinforce oppositional behavior.

What is the failure model of CD?

Repeated failures from CD behaviors contribute to depression development.

How does ADHD affect prognosis in CD?

Comorbid ADHD predicts more severe aggression and poorer long-term outcomes.

What is relational aggression?

Harming relationships through rumors, exclusion, or social manipulation.

What contributes to racial disparities in ODD/CD diagnosis?

Implicit bias, adultification bias, trauma and ADHD misdiagnosis, Educational System Disparities, and structural racism.

What are important components of ODD/CD assessment?

Clinical interviews, rating scales, observations, and FBA.

What is the purpose of an FBA?

To determine the function maintaining behavior.

What are the four functions of behavior?

Escape, attention, tangible rewards, and sensory stimulation.

What is Check-In/Check-Out (CICO)?

A Tier 2 intervention that provides students with daily structure, frequent adult feedback, monitoring, and positive reinforcement to improve behavior and school engagement.

• an evidence-based school intervention where a student checks in daily with a trusted adult to review behavioral expectations and receive positive reinforcement

What is Check & Connect?

An intervention that focuses on building a supportive mentoring relationship to increase school engagement, attendance, persistence, and connection to school.

What is PCIT?

Parent-Child Interaction Therapy for young children with disruptive behavior.

• Parents are taught skills to increase child’s prosocial behaviors and decrease negative behaviors

• ➢ Two distinct phases of treatment:

  • ➢ Child-Directed Interaction (CDI) – resembles traditional play therapy

  • ➢ Focus: strengthen parent-child attachment, increase positive parenting and communication using PRIDE skills (Praise,Reflection, Imitation, Description, Enjoyment), where the parent follows the child’s lead.

What are PRIDE skills in PCIT?

Praise, Reflection, Imitation, Description, and Enjoyment.

What is PMT?

Parent Management Training focused on improving parenting strategies.

What is Anger Control Training (ACT)?

CBT-based intervention teaching anger management and problem-solving skills.

What are the two symptom domains of ADHD?

Inattention and hyperactivity/impulsivity.

How long must ADHD symptoms persist?

At least 6 months.

Before what age must ADHD symptoms appear?

Before age 12.

In how many settings must ADHD symptoms occur?

Two or more settings.

What are the three ADHD presentations?

Combined, Predominantly Inattentive, and Predominantly Hyperactive/Impulsive.

What is ADHD partial remission?

Symptoms decrease but impairment remains.

What brain region is associated with executive functioning deficits in ADHD?

The prefrontal cortex.

What neurotransmitters are associated with ADHD?

Dopamine and norepinephrine.

What are common emotional dysregulation symptoms in ADHD?

irritability, low frustration tolerance, emotional overreactivity, mood swings, difficulty controlling emotions, intense emotional responses, impulsive emotional reaction

When are ADHD symptoms often worse?

Later in the day, during difficult tasks, or in low-stimulation settings.

How should psychoeducational testing be adjusted for ADHD?

• Test earlier in the day when possible, give breaks, use shorter/varied tasks, provide encouragement/reinforcement, reduce distractions to get the most accurate picture of cognitive and academic abilities

Which ADHD symptoms often decrease with age?

Hyperactivity and impulsivity.

What are common ADHD comorbidities?

ODD, CD, anxiety, depression, learning disorders, and substance use disorders.

Why do inattention symptoms lead to peer neglect?

Children may appear withdrawn or disengaged socially.

Why do hyperactive/impulsive symptoms lead to peer rejection?

Children may interrupt, intrude, or act aggressively.

What are common ADHD assessment tools?

Conners-4, BASC-3, BRIEF-2, BOSS observations, and clinical interviews.

What are antecedent-based ADHD interventions?

Strategies that change the environment before behavior occurs.

What are examples of antecedent-based strategies?

Reducing distractions, shortening tasks, and scheduling difficult tasks earlier.

What are the two major DSM-5 domains for ASD?

Social communication deficits and restricted/repetitive behaviors.

What are examples of deficits in social-emotional reciprocity?

Poor conversation skills and reduced sharing of emotions/interests.

What are examples of nonverbal communication deficits in ASD?

Poor eye contact and limited gestures/facial expressions.

What are examples of relationship deficits in ASD?

Difficulty making friends and understanding social rules.

What are examples of repetitive behaviors in ASD?

Hand flapping, rocking, echolalia, and lining up toys.

What is insistence on sameness in ASD?

Rigid routines and distress over changes.

What are examples of restricted interests in ASD?

Intense focus on narrow topics or objects.

What are examples of sensory symptoms in ASD?

• sensitivity to sounds/lights/textures

• fascination with spinning/moving objects

• unusual smelling/touching of objects

• indifference to pain/temperature

• sensory-seeking behaviors

What is the prevalence of ASD among 8-year-olds in the U.S.?

About 1 in 31 children.

Which gender is more likely to be diagnosed with ASD?

Males.

What is the most common co-occurring condition with ASD?

Intellectual disability.

What factors contributed to increased ASD prevalence?

• broader diagnostic criteria (DSM-IV → DSM-5 spectrum)

• inclusion of milder cases

• improved awareness and screening

• earlier identification

• better detection in underserved groups

• reduction in stigma

• diagnostic substitution

• advanced parental age

• increased survival of preterm infants

• environmental exposures (e.g., pollution, pesticides)

What are ASD risk factors?

Genetics, prematurity, low birth weight, parental age, and environmental exposures.

At what ages does the AAP recommend ASD screening?

18 months and 24 months.

What are red flags for ASD?

Poor eye contact, lack of gestures, delayed speech, and repetitive behaviors.

What is Discrete Trial Training (DTT)?

• an ABA teaching method that breaks skills into small, structured steps and teaches them one at a time using repeated trials.

  • Each trial usually includes:

    • instruction/discriminative stimulus (“Touch red”)

    • child response

    • consequence/reinforcement

    • brief pause before next trial

What are social stories?

Simple stories that teach social expectations and appropriate behaviors.

Why is developmental history important in ASD assessment?

It helps identify early symptoms and differentiate ASD from other disorders.