Psychopathology - Neurodevelopmental Disorders

Neurodevelopmental Disorders

Developmental deficits that impair personal, social, academic and/ or occupational functioning and usually begin early in development (before the child starts school)

What are the criteria for diagnosing intellectual disability?

Deficits in intellectual functioning as determined by clinical assessment and standardized intelligence testing.

What is required for adaptive functioning in the diagnosis of intellectual disability?

Deficits in adaptive functioning that cause a failure to meet developmental and socio-cultural standards for personal independence and social responsibility.

When must deficits occur for a diagnosis of intellectual disability?

An onset of deficits during the developmental period.

How is the severity of intellectual disability indicated?

A specifier is used to indicate level of severity (mild, moderate, severe, profound) based on adaptive functioning in conceptual, social, and practical domains.

What percentage of intellectual disability cases have known causes?

The cause of intellectual disability is known in 25-50% of cases.

What are the most common prenatal factors contributing to intellectual disability?

80-85% of known cases are due to prenatal factors (chromosomal, genetic).

What percentage of intellectual disability cases are due to perinatal factors?

5-10% due to perinatal factors (e.g., asphyxia).

What percentage of intellectual disability cases are due to postnatal factors?

5-10% due to postnatal factors.

What is the most common cause of intellectual disability?

Down syndrome.

What is the second most common cause of intellectual disability?

Fragile X syndrome.

What is the most common preventable cause of intellectual disability?

Fetal alcohol syndrome.

What are the two main criteria for diagnosing Autism Spectrum Disorder (ASD)?

Deficits in social communication and social interaction across multiple contexts; Restrictive and repetitive patterns of behaviors, interests, and activities.

What are some deficits in social communication and interaction associated with ASD?

Impaired social-emotional reciprocity; Impaired nonverbal communication; Impaired ability to develop, maintain, and understand relationships.

What are examples of impaired nonverbal communication in ASD?

Eye contact, facial expressions, gestures.

What are some examples of restrictive and repetitive behaviors in ASD?

Stereotyped or repetitive motor movements; Insistence on sameness; Restricted or fixated interests; Hyper or hypo reactivity to sensory input.

When must the onset of symptoms for ASD occur?

During the early stages of development.

What factors contribute to a better prognosis for individuals with ASD?

An IQ score of 70 or above, functional language skills by age 5, and absence of comorbid health problems.

What are some associated features of ASD?

Intellectual and language impairments; Self-injurious behaviors; Motor abnormalities; Disruptive, challenging behaviors; Impaired face and emotional recognition.

What is the prevalence rate of ASD in the population?

1-2% of the population.

How much more common is ASD in males compared to females?

3-4 times more often.

What is known about the etiology of ASD?

The etiology is unknown but believed to involve multiple genetic and non-genetic factors.

What is the concordance rate for ASD in monozygotic twins?

69-95%.

What is the concordance rate for ASD in dizygotic twins?

0-24%.

What are some non-genetic risk factors for ASD?

Male gender, birth before 26 weeks of gestation, advanced parental age, exposure to certain environmental toxins during prenatal development.

What brain abnormalities are associated with ASD?

Accelerated brain growth, larger than normal head circumference, and abnormalities in the cerebellum, corpus callosum, and amygdala.

What is Attention Deficit Hyperactivity Disorder (ADHD)?

A pattern of inattention or hyperactivity/impulsivity that has persisted for at least 6 months.

What is the onset age for ADHD?

Before age 12.

In how many settings must ADHD symptoms be present?

At least 2 settings.

How does ADHD interfere with functioning?

It interferes with social, academic, or occupational functioning.

How many symptoms are required for an ADHD diagnosis?

At least 6 symptoms (5 for individuals 12 or older) of hyperactivity-impulsivity and/or inattention.

What is a symptom of inattention related to listening?

Doesn't listen when spoken to.

What is a symptom of inattention related to details?

Fails to pay close attention to details.

What is a symptom of inattention related to following instructions?

Doesn't follow through on instructions.

What is a symptom of inattention related to distractions?

Is easily distracted by extraneous stimuli.

What is a symptom of inattention related to forgetfulness?

Forgetful in daily activities.

What is a symptom of hyperactivity related to leisure activities?

Unable to engage in or play leisure activities quietly.

What is a symptom of hyperactivity related to running or climbing?

Often runs or climbs in inappropriate situations.

What is a symptom of hyperactivity related to talking?

Talks excessively.

What is a symptom of hyperactivity related to waiting?

Has trouble waiting his/her turn.

What is a symptom of hyperactivity related to interrupting?

Interrupts or intrudes on others.

What does the ADHD specifier indicate?

It indicates predominantly inattentive, hyperactivity, or combined.

What is the prevalence of ADHD among youth aged 3-17?

It is the most prevalent diagnosis among youth 3-17.

How much more common is ADHD in males than females during childhood?

2x more common.

What is the male-to-female ratio of ADHD in adulthood?

Decreased to 1.6:1.

What percentage of children with ADHD continue to have symptoms as adults?

The majority continue to have at least 1 symptom.

How do ADHD symptoms change in adulthood regarding hyperactivity?

Hyperactivity manifests as inability to relax, sit still, impatience, and restlessness.

How does impulsivity change in adulthood for individuals with ADHD?

Impulsivity decreases slightly, leading to behaviors like driving recklessly and abruptly quitting jobs.

What are some symptoms of inattention in adulthood?

Inability to meet important deadlines, making careless mistakes, and procrastination.

What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity.

What is the most common comorbidity with ADHD in children?

Oppositional defiant disorder.

What are some other common comorbidities with ADHD?

Conduct disorder, anxiety disorder, and depressive disorder.

What brain abnormalities are linked to ADHD?

Impaired response inhibition, working memory, and sustained attention.

Which brain regions are associated with executive functioning impairments in ADHD?

Prefrontal cortex, striatum, and thalamus.

What is impaired temporal information processing in ADHD?

The inability to perceive and organize sequences of events and anticipate future events.

Which brain regions are associated with impaired temporal information processing in ADHD?

Prefrontal cortex and cerebellum.

What is emotional dysregulation in ADHD?

Difficulty in managing emotions, linked to abnormalities in the prefrontal cortex and amygdala.

How does ADHD affect total brain volume?

ADHD is associated with reduced total brain volume and activity.

Which brain structures are smaller in individuals with ADHD?

Prefrontal cortex, striatum, corpus callosum, and cerebellum.

What neurotransmitters are found at lower levels in individuals with ADHD?

Dopamine and norepinephrine.

How do low levels of dopamine and norepinephrine affect ADHD symptoms?

They contribute to impairments in impulse control, attention, and executive functioning.

What is the heritability rate of ADHD according to twin studies?

76% (71% for monozygotic twins and 41% for dizygotic twins).

What prenatal factors are linked to ADHD?

Low birth weight, premature birth, and maternal smoking or alcohol use during pregnancy.

What is the primary treatment approach for preschool-aged children with ADHD?

Parent-teacher administrative behavior interventions and evidence-based parent training in behavioral management.

When are medications used in preschool children with ADHD?

Only when behavioral interventions do not provide improvement.

What treatment approach is recommended for elementary and middle school children with ADHD?

Combined behavioral and medication interventions at home and school.

What is the treatment approach for adolescents with ADHD?

Medication with assent, combined with behavioral instruction interventions when available.

What psychosocial interventions are beneficial for adults with ADHD?

Cognitive Behavioral Therapy (CBT) is the strongest.

What is a risk associated with ADHD in childhood?

Increased risk for substance use.

What are tic disorders?

Sudden, rapid, recurrent, non-rhythmic motor movement or vocalization.

What are some examples of motor tics?

Eye blinking, facial grimacing, shoulder shrugging, echopraxia.

What is Tourette's disorder?

At least one vocal tic and several motor tics that may occur together or at different times.

What is the duration requirement for Tourette's disorder?

Tics must wax and wane but have persisted for more than one year.

What is the age of onset for Tourette's disorder?

Onset before 18 years of age.

What defines persistent (chronic) motor or vocal tic disorder?

One or more motor or vocal tics that are persistent for more than one year, with onset before age 18.

What is provisional tic disorder?

One or more motor/vocal tics present for less than one year, with onset before age 18.

What is the typical age range for the onset of tics?

Onset of tics is usually between 4-6 years of age.

At what age does the severity of tics typically peak?

Severity peaks between 10-12 years of age.

What psychiatric disorder commonly co-occurs with tic disorders?

ADHD is the most common co-occurring disorder.

What are some biological factors linked to tic disorders?

Dopamine overactivity, small caudate nucleus, and heredity.

What is a common treatment for tic disorders?

Antipsychotic drug (haloperidol) and medication for comorbid conditions.

What is Comprehensive Behavioral Interventions for Tics (CBIT)?

A treatment that includes psychoeducation, social support, habit reversal, competing response, and relaxation training.

What are communication disorders?

Deficits in language, speech, and communication

What is child onset fluency disorder commonly known as?

Stuttering

What is a key characteristic of child onset fluency disorder?

Disturbance in normal fluency and time patterning of speech

What are some symptoms of stuttering?

Sound syllable repetitions, sound prolongations, broken words, audible or silent blocking, circumlocutions, excessive physical tension, monosyllabic whole word repetitions

What is the typical age range for the onset of child onset fluency disorder?

Between 2-7 years of age

What percentage of children recover from dysfluency?

65-85%

What is a good indicator of the persistence of recovery from stuttering?

Severity of symptoms at age 8

What is one treatment method for stuttering?

Habit reversal training

What is one strategy used in habit reversal training for stuttering?

Regulated breathing

What are the difficulties related to Specific Learning Disorder?

Difficulties related to academic skills.

What is the duration of symptoms for Specific Learning Disorder?

At least 6 months.

What is the prevalence of Specific Learning Disorder in the population?

5-15%.

What percentage of individuals with a specific learning disability have a reading disorder?

80%.

What is the most common type of reading disorder associated with Specific Learning Disorder?

Dyslexia.

What are some specific difficulties associated with reading in Specific Learning Disorder?

Inaccurate and slow or effortful word reading.

What difficulty is associated with understanding text in Specific Learning Disorder?

Difficulty with understanding the meaning of what was read.

What writing difficulties are associated with Specific Learning Disorder?

Difficulty with spelling and difficulty with written expressions.

What mathematical difficulties are associated with Specific Learning Disorder?

Difficulty mastering number sense, number facts, or number calculation and difficulty with mathematical reasoning.