Abnormal Child Psych Exam 3

Major Depressive Disorder (MDD)

Characterized by at least one of the first two symptoms: depressed or irritable mood, loss of interest or pleasure; must have at least 5 symptoms for two weeks.

MDD is characterized by

one or more depressive episodes with remission of symptoms between episodes; the symptoms must also be present for 2 weeks and must cause significant impairment (social, school)

Co-occurring Difficulties of MDD

anxiety, disruptive behavior disorder, eating disorders, substance use, and ADHD

Persistent Depressive Disorder (Dysthymia)

Shares symptoms of depression but is a less severe form and more chronic (long-lasting), lasting at least one year with a depressed mood and at least two more symptoms.

Disruptive Mood Regulation Disorder (DMDD)

A childhood disorder marked by persistent irritability and frequent outbursts (extreme temper outbursts, physical aggression), aiming to address the problem of overdiagnosis of bipolar disorder in children.

DMDD symptom pattern/etiology

The child’s irritable/angry mood remains present between temper outbursts and is present throughout the day; age of onset is before age 10 & diagnosis can only be given to ages 6-18. Children with DMDD are more likely to develop co-occurring anxiety or depressive disorders.

Co-occuring disorders of DMDD

Anxiety disorders, such as separation anxiety disorder, conduct disorder, and oppositional defiant disorder, also occur among depressed youth

Epidemiology of Depression

Major Depressive Disorder is the most common mood disorder among children (80%), (10%) experienced dysthymia without MDD, and (10%) double depression— less prevalent in younger children than in adolescents.

Pharmacological Treatments for Depression

Though highly debated for effectiveness, antidepressants such as Tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and escitalopram are commonly prescribed for treating major depressive disorder in children and adolescents.

Dysphoria (Sad affect)

the central characterisitic of most defintions of depression

Double Depression

The occurrence of both Persistent Depressive Disorder (dysthymia) and Major Depressive episodes at the same time.

Cognitive Distortions

Errors in thinking that contribute to depression, as described in Beck's theory.

Bipolar Disorder

A mood disorder characterized by alternating periods of depressive symptoms and mania.

Mania

A period of abnormal, persistent elevated or irritable mood and increased energy or activity that is also persistent

Euphoric Mood

The elevated mood that is experienced during mania; such as inflated self-esteem, high rates of activity, speech, and thinking, distractibility, and exaggerated feelings of physical and mental well-being.

Criteria for Manic Episodes

must last a week or more & at least three additional symptoms must be present (4 if only irritable mood), including increased talkativeness, decreased need for sleep, racing thoughts, distractibility, and inflated self-esteem.

Bipolar I

Characterized by one or more manic episodes, often accompanied by depressive episodes.

Hypomania

Euphoric mood that is of shorter duration and less severe than a manic episode.

Bipolar II

Characterized by major depressive episodes and hypomania.

Cyclothymia

Chronic (long-lasting), but mild fluctuations between distinct periods of hypomanic and depressive symptoms that don’t meet the criteria for major depressive episodes.

Co-occuring Disorders of Bipolar Disorder

Co-occurs with ADHD, conduct disorder, oppositional defiant disorder, substance abuse/dependence

Treatment of Bipolar Disorder

CBT and DBT

Dialectal Behavioral Therapy (DBT)

Focuses on reducing emotional dysregulation. This intervention contains both psychoeducation and cognitive-behavioral strategies.It aims to teach mindfulness techniques, include parents and focus on awareness/gain control over thoughts and emotions.

The General Behavioral Inventory (GBI)

Designed to assess symptoms associated with mood disorders, including episodes of mania, hypomania, depression, and mixed mood states to help in diagnosis. Primarily used for parent-report.

Suicide

The act of intentionally causing one's own death, often associated with mental health disorders such as depression.

Risk factors for Suicide

a family history of suicidal behavior, poor familial/peer relations/circumstances, a history of previous suicidal attempts, high levels of stress, and access to firearms

Contagion

“Imitation” or increased suicidal behavior following media presentations, due to stories of youth suicide

Internal Disorders

Young people have emotional difficulties that they take out on themselves

Anxiety

Future-oriented emotion characterized by perceptions of uncontrollability and underpredictability over potentially aversive events & one’s response to these events; accompanied by an elevated level of apprehension and lack of control.

Fear

A reaction to an immediate/present threat characterized by an alarm reaction.

Tripartite Model of Anxiety

Overt behavioral responses, cognitive responses, & physiological responses

Overt behavioral responses

running away, trembling voice, eyes closing

Cognitive responses

thoughts of being scared, self-deceprecatory thoughts, images of bodily harm

Physiological responses

changes in heart rate, muscle tension, upset stomach

Worry

Thoughts about possible negative outcomes that are intrusive and hard to control

Specific Phobias

Persistent marked fear of a specific object or situation (animals, heights); must cause significant distress, and interfere with daily functioning.

Social Anxiety Disorder (Social Phobia)

Persistent fear of acting in an embarrassing way in social or performance situations with peers & adults; Anxiety is related to social or evaluative situations rather than a specific object or nonsocial situation.

School Avoidance

These young ppl try to avoid social situations and may miss school, birthday parties, and other activities.

Selective Mutism (SM)

A child does not talk in specific social situations, such as at school or with playmates, despite speaking in other contexts like at home.

Separation Anxiety Disorder (SAD)

Anxiety regarding separation from a major attachment figure/and or home, including concerns about separation from, being alone without, or worry of harm befalling major attachment figures.

School Refusal from SAD

involves a child avoiding school due to anxiety related to separation from caregivers, leading to distress and reluctance to attend.

Truancy

Failure to attend school without a valid excuse or parental knowledge, often linked to underlying issues such as behavioral problems.

Generalized Anxiety Disorder (GAD)

Characterized by excessive anxiety about a number of events or activities, and worry that is not confined to a specific type of situation.

Panic Disorder

Recurrent unexpected panic attacks that are unqued

Panic Attacks

A discrete period of intense fear or terror that has sudden onset and reaches a peak quickly—within a few minutes

Agoraphobia

Anxiety about being in a situation in which escape may be difficult or embarrassing or where help may not be available in the event of a panic attack. This can lead to avoidance of places or situations associated with such anxiety.

Effortful Control

A temperament characteristic that refers to an individual's ability to regulate their emotional responses.

Selective Mutism (SM)

A condition where children do not speak in specific social situations despite talking in others, often comorbid with social phobia.

Obsessive-Compulsive Disorder (OCD)

Involves obsessions (unwanted thoughts) and compulsions (repetitive behaviors) that interfere with daily functioning.

Childhood-Onset Schizophrenia (COS)

A rare form of schizophrenia with symptoms such as delusions and hallucinations, typically diagnosed before age 13.

Trauma

An event outside of everyday experience that would be distressing to almost anyone; can lead to risk for various disorders.

Post-Traumatic Stress Disorder (PTSD)

Diagnosis requires exposure to a traumatic event and symptoms from four clusters: reexperiencing, avoidance, negative alterations in cognitions and mood, and arousal.

Cognitive Behavioral Therapy (CBT)

A treatment modality with strong evidence for success in addressing PTSD symptoms, involving parental involvement and a combination of child and parent sessions.

Neglect

The most common form of child maltreatment, involving the failure to provide for a child's basic physical, emotional, and educational needs.

Suicidal Ideation

High prevalence among adolescents, where females report higher rates of ideation and attempts compared to males.

Disattachment and Social Engagement Disorders

Disorders stemming from experiences of social neglect, leading to lack of stable attachments and potential behavioral issues.