FINAL Week 10: Youth and Older Adults

Key factors that promote menta health in children 7

positve adult relationships, secure attachement, supportive enivornment, general health, social networks, positive childhood experiences

Role of community

social support and connections

Role of family and siblings

important as protectors, nuterurrs, and mediators

Secure attachment

bond between parent and child

Common childhood challenges 6

attachment disrupted, grief, family seperation, sibling relationships, physical illness, risk taking

Developmental considerations for pre-school aged

react more to patents distress, avoid euphimisms like he went to sleep

Developmental considerations for school aged

express grief through somatic complaints, regression, hostitlity

Developmental considerations for adolescents

may have an idealized romantic idea of death, may assume parental role

What are protective factors

Indidivudal atttritbutes (problem solving, sense of self efficacy, accurate processing of cues), supportive family, environmental supports

Risk factors for poor mental health

poverty, child abuse, children in care, parents have substance use

Schzio[hrenia

pften in early adolecense as predome

Brief psychotic diosrder

related to substance use or other illness

Treatment for schizos

anti-psychotics like rispirdone, olanzapine

Bipolar in children

presents during adolescence, can be manic

Treatment for bipolar

lithium and mood stablizers (carbamazepine)

GAD

excessive anxiety, there is genetic predispositiuon, treatment is CBT and pharm

Seperation anxeity disorder

from seperation with home ot major attachement figures, environmental and genetic factors

It is well documents that early chronic stress or trauma affects how the

developing brain grows and evolves

For child abuse

are immediate circumstances unsafe

For current child abuse

what is risk of repeat

For ongoing abuse

what extent are interventions working

Reactive attachement disorder identifies

prior to age 5

4 types of reactive attachement disorders

secure, insecure avoidant, insecure ambivalent, disorganized

Secure

child feels safe with caregiver, explores freely, and is easily comforted after separation

Insecure avoidant

child shows little emotion when caregiver leaves or returns, and avoids closeness

Insecure ambivalent

hild is very distressed at separation and difficult to soothe on return, caregiver is inconsistent

Disorganized

child displays confused or fearful behaviour with not clear pattern

Disinhibited social engagement disorder

blatant disregard of social inhibition when approaching strangers

Neurodevelopmental disorders

delays in attention, cognition, language, affect, social/moral behaviours

Autism in children

delayed and divergent language development, echolocia, and tenancy to be extremely concurrent in interpretatio n of language

Specific learning disorders

most common in children and are difficulties in learning and using academic skills, focus on confidence and family support

Communication disorders

speech and language, interventions focus on fostering social skills, addressing low self esteem, and making referrals

Attention deficit hyperactivity disorer

associated with school challenges, peer problems, and family conflict

Treatment for ADHD

psychoeducation, behavioural interventions, support, school accomodations, medication management

Touretts motor disorder

coordination disorder, sterotypic movements, and tics

Touretts treatment

behaviour therapy and alpha 2 angregeric antagoists

Enuresis

involantary or intentional voiding in inappropriate places, nocturnal or diurnal

DSM5 for enurisis

betwetting 2x per week for 3 months, child is 5, no medications

Intweveiwing techniques

child and parent separate, children give internalizing symptoms (mood, sleep, suicide), parent give behavioural

Interviewing preschool aged

use play

Interviewing school aged

use competitive games

Interviewing adolescents

they feel shame so let them know what is disclosed to parents, be direct and candid

Pharmacolgogical intervention in children

SSRIs (fluoxetine, setraline), SARI (trazodone), antipshycitics (rispiradone, olanzepine), lithium, benzodiazepines (lorazepam)

Stimulants used in ADHD

amphetamines and methyphenidate simulants increase norepinephrine and domapine release in sinuses and block reuptake

Short acting amphetamines

amphetamine + dextroamphaetamine (adderall), dextroamphetmanine (dextrodine), lasts 4-6 hours

Short acting methylphenidate

methylphenidate (ritalin lasts 3-4), dexmethlyphenidate (focalin lasts 4-6)

Intermediate acting methylphenidate

extended release (iltalin, duration 8-10 hours)

Long acting methylphenidate

extended release concreta, 10-12 hours

Long acting amphetamines

extended release adderaal, lisduzedetamine (vvyvanse) lasts 10-12

Side effects of stimulants

appetite suppression, insomnia, weight loss, headache, palpitations, blurred vision, dry mouth

Side effects spsecfic to amphetamines

BP changes, tachycardia, tremors

Vvyanse interactions

hypertension with MAOIS, bupropion

Ritalin interactions

warfirm decreases breakdown, increase effects of SSRIs

Adderall

ssris increased risk of serotonin syndrome, SNRI hypertension risk, and caffeine

Young old

65-74

Middle old

75-84

Old old

85+

Appearance

dressed appropriately for weather

Behaviour

calm vs agitated

Mood

described by person

Affect

facial expression

Sppech

clear, coherent

Thought process

logical, organized

Thought content

logical, goal directed vs paranoid

Perceptions

no hallucinations

Cognition

memory, attention, orientation

Insight

awareness of self

Judgement

good vs bad

Delirium

fluctuating consciousness and attentions because of medical condtion, should be reversible

Diagnostic criteria for delirum

impairement in consciouness

Delirium features

memory and language loss, disorientation

Types of dementia

alxhziemrs, frontal tempeoral, lewy body, vascular

Other medical causes of dementia

HIV, TBI, huntingtons, prions diseases, substance induced

Alziemers types

degeerative, progressive nuero disorder that results in congtivie impairement

Early onsent vs late alzheimers

65 and younger late 65+

Early alziermers

forgetfulness, limited attentions, communication difficulties, not learning new, changes in mood

Middle alzihmers

memory problems obvhous, treslessness, spatial problems, language understanding, delusions

Late stage alzheimers

severe impairment, losses capacity for speech, incntentn, cannot walk

End of life alzheimers

changes in blood circulation, no eating, increased sleepiness, fever

AD etiology

neural plaques, tangles, oxidative stress, inflammation, genetics

10 absolutes

never argue, never reason, never shame, never lecture, never remember, never i told you, never you cant, never command, never codencend, never force

Cholinerserase inhibitors

block enzyme ACHase to increase ach levels and improve communication between nerve cells

N-methyl-d-asperatae

block NMDA receptors to inhibit excessive glutamate mediatated excitatory activity, reducing calcium influx, dampens overactions