Childhood Psychopathology Exam 3

Childhood-Onset Conduct Disorder

CD that occurs from young age

Adolescent-Onset Conduct Disorder

CD that has a sudden onset in later developmental years

coercion theory

parent-kid interactions provide training for the development of antisocial behavior
-4 step process to escape conditioning
-attachment theories have an affect

conduct disorder

repetitive and persistent patterns of severely aggressive and antisocial acts that involve inflicting pain on others or interfering with their rights through physical means
-aggression to people/animals
-destruction of property
-deceitfulness or theft
-serious violation of rules
only need one
mild, moderate, severe

conduct problem(s)

wide range of age-inappropriate actions and attitudes of children that violate expectations, norms, and personal property of others

defiance

deliberate contradiction or provoking of others

destructive-nondestructive dimension

ranges from acts such as cruelty to animals or physical assault to nondestructive behaviors such as arguing or irritability

what are some disruptive behavior disorders

ADHD, CD, ODD

direct aggression

confronting or attacking victims directly (only aggression captured by the DSM and is most common in boys)

diversification

adding more antisocial traits to self inventory over time but not getting rid off/replacing any

general family disturbances

-parental mental health problems
- family history of antisocial behavior
- marital discord
-family instability
- limited resources
- antisocial family values

hostile aggression

intended to inflict harm (increases over time for kids with conduct disorder)

hostile attributional bias

more likely to attribute hostile and mean-spirited intent to other children
- reactive-aggressive kids are emotionally OVERaroused
- proactive-aggressive kids are emotionally UNDERaroused

intermittent explosive disorder

impulsive aggressive outbursts in response to minor provocations

instrumental aggression

intended to achieve a goal (common in early life but quickly decreases as communication and social skills grow - ex. biting another toddler to get the toy)

juvenile delinquency

kids who have broken even just one law ranging from minor to major (stealing to homocide)

life-course persistent path

kids who engage in aggression and antisocial behaviors at an early age and continue into adulthood

multisystemic therapy

intensive, empirically supported family and community-based treatment for adolescents with severe conduct problems that make out-of-home placement highly likely

oppositional defiant disorder

age-inappropriate recurrent pattern of stubborn, hostile, disorganized, and defiant behaviors
-mild, moderate, severe
-by 8yo (early stages of antisocial and aggressive behavior)
-must occur in more than one setting
-tends to emerge 2-3 years before CD

overt-covert dimension

overt = visible acts like fighting
covert = hidden acts like stealing/lying

opposition

active resistance to limitations, restrictions, or directions

parent management training

teaches parents to change their child's behavior at home and in other settings

problem-solving skills training

CBT that focuses on the cognitive deficiencies and distortions displayed by kids and adolescents with conduct problems in interpersonal situations

psychopathic features

pattern of callous, manipulative, deceitfulness, and remorseless behavior

reciprocal influence

a child's behavior in both influenced by and influences the behavior of others

indirect/relational aggression

verbal insults, gossip, ostracism, black mail (girls)

social-cognitive abilities

skills involved in attending to, interpreting, and responding to social cues (impairments can lead to ODD/CD)

social selection hypothesis

people who move into different neighborhoods differ from one another before they arrive and those who remain differ from those who left

specific disturbances in parenting practices and family functions

-excessive use of harsh discipline
-lack of supervision
-lack of emotional support and involvement
-parental disagreement about discipline

with limited prosocial emotions

specifiers for CD who display a persistent and typical pattern of interpersonal and emotional functioning involving at least 2:
-lack of remorse or guilt
-unconcerned about performance
-callousness/lack of empathy

adolescent-limited path

kids who's antisocial behavior begins around puberty and continues into adolescence but later cease the behaviors into early adulthood

adolescent-onset conduct disorder

a conduct disorder characterized by aggression, destructiveness, deceitfulness, and rule violation AFTER age 10

amplifier hypothesis

states that stress amplifies the maladaptive predispositions of parents, causing disrupting family management practices and compromising parents' ability to be supportive of their children

antisocial behaviors

tend to be negative, irritable, and resentful

antisocial personality disorder

pervasive patterns of disregard for and violation of the rights of others
-40% of CD have APD as young adults

behavioral activation system

stims behavior in response to signals of reward/non punishment (gas pedal)

behavioral inhibition system

produces anxiety and inhibits ongoing behavior in the presence of novel events, innate fear stimuli, and signals non-reward/punishment (break pedal)

callous and unemotional interpersonal style

absence of guild, lack of empathy, uncaring attitudes, shallow or deficient emotional responses and related traits of narcissism and impulsivity
-precursor for later conduct problems

conduct problem factors (genetic)

-50% heredity
-difficult child temperament
-partially affected BAS (overactive) and BIS (underactive)
-neuropsychological

conduct problem factors (sociocognitive)

-social information processing deficits (hostile attributional bias)
-poor social skills

conduct problem factors (family factors)

-parental psychopathology and criminality
-parenting
-family stress and instability (usually financial)
-marital conflict and family violence
BIG 3-> regular parent unemployment, poverty, multiple family transitions

conduct problem factors (contextual factors)

-poverty (violence and crime)
-tv/internet violence

CP prevention

apply parent, child, and/or family therapy components to universal ora t risk population before symptoms begin

treatment for ODD/CD

parent management training
cognitive problem solving skills training
multisystemic treatment
prevention

anhedonia

little joy in anything and loss of interest in everything

bipolar one

one or more manic episodes and one or more depressive disorders

bipolar two

hypothymic episode in combination with 1(+) MDD episode

co-rumination

the negative form of self-disclosure and discussions between peers focused narrowly on problems/emotions to the exclusion of other activities or dialogue

cyclothymic disorder

numerous and persistent hypothymia and depressive symptoms for 1(+) year that cause distress/impairment with bouts of mania

depressive ruminative style

negative cognitive schemas

depressogenic cognitions

Aaron Beck's belief of negative cognitive schemas (depressive ruminative style) and cognitive triad of self, world, and future being a cognitive psychosocial etiological factor of depression

diathesis-stress model of depression

the impact of stress is moderated by individual risk factors and the occurrence of depression depends on the interaction between the subject's personal vulnerability and life stress

disruptive mood dysregulation disorder (DMDD)

frequent and severe temper outbursts which are extreme overreactions to the situation/provocation, AND chronic, persistently irritable or angry mood that's present between outbursts
-occurs most of most days
-cannot coexist with ODD (diagnose with DMDD) or BP (diagnose with BP)
-can coexist with MDD, ADHD, CD, or SUD

double depression

dysthymia or persistent depressive disorder

dysphoria

state of prolonged bouts of sadness

dysthymia

persistent depressive disorder

emotional regulation

the ability to control when and how emotions are expressed

euphoria

feeling of extreme happiness

hopelessness theory

when continuously in depressive/anxiety ridden cycles the patient begins to believe there is no hope in becoming better --> leads to depression

hypomanic episode

a manic episode in quality but less intense and often shorter (less impairment produced)

irritability

overly sensitive to being annoyed or angry

major depressive disorder (MDD)

at least 2 weeks of depressed or irritable mood, loss of interest/pleasure, and significant distress and impairment of functioning
-mild, moderate, severe
-more common in girls
-8mos is the typical episode of MDD

mania

1(+) week period of elevated, expansive, or irritable mood AND increased goal-directed activity or energy

negative cognitive schema

a mental framework in which a person consistently interprets events negatively (depressive ruminative style)

negative cognitive triad

part of Beck's depressogenic conditions
negative cognitive thoughts of self, world, and future

persistent depressive disorder (PDD)

depressed/irritable mood with generally lower and less severe, but longer-lasting symptoms (1y)
-develops 3 years earlier than MDD
-2-5y episodes

ruminative coping styles

focusing on symptoms of distress and its causes rather than on solutions
-girls

agoraphobia

marked fear or anxiety in certain places or situations where the thought of an escape would be difficult

anxiety

mood state with strong negative emotions and bodily symptoms of tension in which the child apprehensively anticipates future danger/misfortune
-normal anxiety and fear is good and keeps us safe

anxiety disorders

excessive and debilitating anxieties

behavior lens principle

child psychopathology reflects a mix of actual child behavior and the lens through which it is viewed by others in a child's culture

behavioral inhibition system (BIS)

enduring trait for some and predisposing factors for social reticence and the development of later anxiety disorders (especially social.) overactive in those with anxiety

body dysmorphic disorder

severe disconnect between mental image of self and physical self

compulsions

repetitive, purposeful, and intentional behaviors or mental acts that are performed in response to obsessions in an attempt to suppress or neutralize them
* young kids might be unable to articulate purpose of compulsions *

excoriation disorder (dermatillomania)

skin picking

exposure

type of therapy that continues to expose the patient to their anxiety-induced items, phobias, and situations so that they can learn to cope with the anxieties that arise

flooding

rapid and excessive stimulation of big stressors without ways of coping so that the patient can see that they'll be okay

generalized anxiety disorder (GAD)

excessive and UNCONTROLLABLE anxiety and worry for more days than not for 6(+) months
worry about a number of different things, events, or activities (3+ domains) with 1(+) associated feature
-overestimate bad things and underestimate ability to cope with them
-low self-esteem
-perfectionism
-excessive need for reassurance

graded exposure

type of CBT that has patients rank their fears in a hierarchy and then work from bottom to top
-systematic desensitization

hypervigilance

kids with anxiety selectively attend to information that may be potentially threatening/dangerous

negative affectivity

depressiona nd anxiety
persistent negative mood as reflected as nervousness, sadness, anger, and guilt

neurotic paradox

pattern of self-defeating behavior

obsessions

recurrent and persistent anxiety-provoking thoughts, urges, or images (intrusive!)
cognitive aspect!

OCD

presence of obsessions and compulsions
-mentally and emotionally exhausting
-school refusal and oppositional behavior because of debilitating compulsions

panic

sudden, overwhelming fright or terror

panic attack

sudden onset of intense panic in which multiple physical symptoms of stress occur, often with feelings that one is dying

panic disorder

recurrent, unexpected panic attacks followed by about a month of worry of another attack

positive affectivity

anxiety
persistent positive mood that includes state of joy, enthusiasm, and energy

response prevention

part of CBT that helps the patient come up with new responses to previously anxious inducing experiences

school refusal behavior

the refusal to attend classes or difficulty remaining in school for an entire day
*due to anxieties, not ODD*

selective mutism

fail to speak in specific social situations in which there's an expectation to speak, even if they speak normally at home

separation anxiety disorder (SAD)

child-specific displays of age-inappropriate excessive and disabling distress to separation from their parents/caregivers and fear of being alone
- young kids are clingy and unconsolable until reunited
-older kids call home and have concentration issues at school due to separation

must have 3(+) for SAD

must have 3(+):
excessive stress when separated or anticipation of separation
persistent worry about losing attachment figure
persistent worry about untoward events causing separation
persistent reluctance or refusal to go out because of fear
excessive fear or reluctance about being alone
refusal to sleep alone
repeated nightmares about separation
repeated complaints of physical symptoms when separated

social anxiety disorder (social phobia)

marked fear about 1(+) social situation involving possible scrutiny (MUST OCCUR IN PEER SETTINGS). Fear of negative evaluation, social situations are avoided or endured with intense fear/anxiety
-tend to be inhibited, sad, and lonely but WANT FRIENDS!
-fear of doing most things in front of others
-begin to avoid all social activities

top specific phobias

animals, natural accidents, blood, situational, other (clown/vomit)

systematic desensitization

desensitizing the patient of their fear, phobia, or anxiety triggers gradually over time

two factor theory

physiological arousal determines the strength of the emotion, while cognitive appraisal identifies the emotion label

ODD diagnosis criteria

-by 8yo (show early stages of antisocial and aggressive behavior)
4 symptoms from any 3 categories for 6 months
-angry/irritable mood
-argumentative/defiant behavior
-vindictiveness (plotting)
behavior must occur with someone other than siblings

what are the 4 dimensions of CD

aggression to people/animals
deceitfulness or theft
destruction of property
serious violation of rules

cognitive and verbal deficits of conduct problems

average to below averrage IQ scores