Childhood Disorders & Adolescent Eating Disorders – PSYC3102

Flashcards summarise diagnostic criteria, prevalence, aetiology, course, and evidence-based treatments for externalising disorders (ADHD, ODD, CD), internalising disorders (depression, anxiety), and adolescent eating disorders (AN, BN, BED), as presented in Associate Professor Karen Turner’s PSYC3102 lecture.

What are the three main categories covered in this lecture?

Externalising disorders, Internalising disorders, and Adolescent eating disorders.

Give three examples of externalising disorders.

Attention-deficit/hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD), Conduct disorder (CD).

Give two examples of internalising disorders discussed.

Depression and Anxiety (e.g., separation anxiety disorder, selective mutism).

How do externalising disorders primarily manifest?

Through problems directed toward the external world such as rule-breaking, anger, aggression, and impulsivity.

How do internalising disorders primarily manifest?

Through problems in the internal world such as anxiety and sadness.

What is the minimum number of inattention symptoms required for an ADHD diagnosis in children?

Six inattention symptoms for at least six months (five if aged 17+).

What age must several ADHD symptoms be present by?

Before 12 years old.

Name the three DSM-5-TR ADHD presentations.

Combined (ADHD-C), Predominantly Inattentive (ADHD-PI), and Predominantly Hyperactive-Impulsive (ADHD-HI).

List three inattentive symptoms of ADHD.

Often fails to give close attention to details, often easily distracted, often forgetful in daily activities (any three of nine).

List three hyperactive/impulsive symptoms of ADHD.

Often fidgets or squirms, talks excessively, has difficulty waiting turn (any three of nine).

What is the average male-to-female ADHD ratio in children?

Approximately 4 : 1.

About what percentage of Australian children/adolescents are diagnosed with ADHD?

7.4 %.

By adolescence, ADHD persists into adulthood in roughly what proportion of cases?

50–65 %.

Name two neurobiological findings associated with ADHD.

Delayed brain maturation or reduced prefrontal activity, and dopamine/serotonin deficiencies.

First-line ADHD treatment for preschoolers (4–5 yrs) according to AAP?

Behavioural interventions; stimulants only if impairment remains moderate-to-severe.

What class of medication is methylphenidate (Ritalin)?

Psychostimulant that increases norepinephrine and dopamine.

Give two common psychostimulant side effects.

Decreased appetite and sleep difficulties (others: ↑heart rate, unmasking tics).

What parenting programme is evidence-based for ADHD, ODD, and CD?

Triple P – Positive Parenting Program (also PCIT, Incredible Years).

What coping strategy compensates for poor working memory in ADHD?

Making mental information physical (e.g., lists, cues, visual charts).

Minimum duration and symptom count for an ODD diagnosis?

At least four symptoms for 6 months with someone other than a sibling.

Name the three ODD symptom clusters.

Angry/irritable mood, Argumentative/defiant behaviour, Vindictiveness.

How is ODD severity specified?

Mild (1 setting), Moderate (2 settings), Severe (3+ settings).

State the core criterion for Conduct Disorder.

Persistent pattern violating others’ rights or age-appropriate norms with ≥3 of 15 symptoms in past 12 months (one in past 6 months).

List the four CD symptom groupings.

Aggression to people/animals, Destruction of property, Deceitfulness or theft, Serious violations of rules.

What CD specifier indicates severe callous traits?

“With limited prosocial emotions” (lack of remorse, empathy, concern, or affect).

Typical onset ages for ODD and CD?

ODD: 2–3 years; CD: late childhood or early adolescence.

What proportion of children with ODD/CD develop adult problems in multiple domains?

About 50 %.

Give two parenting risk factors linked to ODD.

Harsh/coercive discipline or inconsistent/neglectful parenting.

What multi-component treatment targets family, school, peers, and legal system for CD?

Multisystemic Therapy.

How many depressive symptoms are required for a major depressive episode?

Five or more of nine symptoms during the same two-week period.

Which depressive symptom often presents as irritability in children?

Depressed mood.

Duration requirement for Separation Anxiety Disorder in childhood?

At least four weeks.

Define selective mutism.

Consistent failure to speak in certain social situations despite speaking in others.

Australian prevalence of anxiety disorders in 6–17 year-olds?

6.9 % (with separation anxiety disorder 4.3 %).

What CBT components are standard for child anxiety treatment?

Psychoeducation, emotion regulation skills, cognitive restructuring, in-vivo exposure, contingency management.

Give two biological or temperamental risks for childhood anxiety.

High behavioural inhibition/crying to novelty and heritable anxiousness (e.g., 73 % twin heritability for SAD).

Which rumination process predicts future depression in early adolescence?

Repeatedly focusing on distress without problem solving.

Diagnostic criterion A for Anorexia Nervosa (AN).

Restriction of energy intake leading to significantly low body weight.

Name the two anorexia nervosa sub-types.

Restricting type and Binge-eating/Purging type.

What BMI specifier denotes ‘Severe’ anorexia nervosa?

BMI < 15.

Give criterion A for Bulimia Nervosa (BN).

Recurrent episodes of binge eating (large amount + loss of control).

Frequency requirement for BN binge/purge cycle?

At least once per week for three months.

Key difference between Bulimia Nervosa and Binge Eating Disorder (BED).

BED lacks regular compensatory behaviours (purge, fasting, excessive exercise).

List three behavioural indicators used in BED criterion B.

Eating rapidly, eating until uncomfortably full, eating when not hungry, eating alone due to embarrassment, feeling disgusted/depressed/guilty after binge (any three).

Typical age of onset for anorexia and bulimia.

AN: 14–19 years; BN: late adolescence/early 20s.

What percentage of AN cases begin between ages 13–20?

Approximately 85 %.

How common are comorbid diagnoses in eating disorders?

Up to 95 % of individuals have at least one comorbid disorder.

Which three comorbidities are especially common with AN and BN?

Major depressive disorder, anxiety/PTSD, and substance/alcohol abuse.

Female:Male prevalence ratio for anorexia nervosa.

Between 7 : 1 and 10 : 1.

Ten-year mortality rate for anorexia nervosa post-diagnosis.

About 10 %.

List three medical complications associated with eating disorders.

Heart failure, loss of bone density/osteoporosis, organ damage (others: brain shrinkage, infertility, gut paralysis).

Name two social/environmental risk factors for eating disorders.

Cultural emphasis on thinness and high-risk occupations favouring specific body shapes (models, dancers, athletes).

Define negative body image.

Highly critical evaluation of one’s weight/shape leading to disordered eating when combined with low self-esteem and need for control.

What concept states there are many pathways to develop an eating disorder?

Equifinality.

Primary goal of Family Based Treatment (FBT) for anorexia.

Weight restoration through parental re-feeding and eventual return of control to adolescent.

Three phases of FBT.

1) Weight restoration, 2) Transition of responsibility to adolescent, 3) Address developmental issues and termination.

Core principle of FBT regarding the disorder’s role in the family.

Externalise the anorexia nervosa so the family unites against the illness, not the adolescent.

Ideal suitability criteria for FBT.

Adolescent under 19, living at home, AN duration < 3 years.

What therapy is ‘transdiagnostic’ and evidence-based for all eating disorders?

Enhanced Cognitive Behaviour Therapy (CBT-E).

Two overall goals of CBT-E.

Remove eating-disorder psychopathology and correct maintaining mechanisms to sustain change.

How do patients often perceive CBT-E and why?

They like it because it matches their need for control and is highly structured.

Which medication class is most commonly used for anxiety in children?

Selective Serotonin Reuptake Inhibitors (SSRIs).

Why is antidepressant medication less effective in child depression compared to adults?

Differences in neurodevelopment and pharmacodynamics; SSRIs preferred but benefits are modest.

Name two psychological factors associated with risk for eating disorders.

Perfectionism/anxiety and low self-esteem/depression.

What is the recommended duration of FBT treatment?

Typically 12–18 months.

When is hospitalisation indicated in eating disorders?

For medical compromise, suicide risk, severe comorbidity, or treatment resistance.

Which externalising disorder is most strongly linked to genetic heritability?

ADHD (stronger genetic contribution than ODD or CD).

What is the role of ‘delay of gratification’ in the aetiology of externalising disorders?

Poor ability to delay gratification contributes to impulsivity and rule-breaking behaviour.

Describe ‘multimodal’ ADHD treatment.

Combination of psychoeducation, medication, behavioural strategies, school accommodations, and personal coping skills.

Which anxiety disorder criterion entails refusing to go out or sleep away from attachment figures?

Separation Anxiety Disorder.

Percentage of Australian 14-year-old females estimated to have any eating disorder.

About 8.5 %.