Abnormal Psychology: ch 16 (mood, anxiety, & elimination disorders)

Mood Disorders Among Children

Prevalence and Gender Differences

  • Equal prevalence of mood disorders between boys and girls, ages 0-13.

  • Increased prevalence in girls aged 16 and older.

Bipolar Disorder Controversy

  • New diagnostic criteria for bipolar disorder in children emerged in the 1990s, leading to increased diagnoses.

  • Concerns regarding over-diagnosis and inappropriate medication.

  • DSM-5 introduced Disruptive Mood Dysregulation Disorder (DMDD) as a new category.

Disruptive Mood Dysregulation Disorder (DMDD)

  • Separated from bipolar disorders; categorized under depressive disorders.

  • First line treatment for DMDD is therapy (CBT or interpersonal therapy), not medication.

Understanding Treatment Modalities

  • Importance of proper diagnosis to prevent misuse of medications such as antipsychotics or lithium.

  • Ongoing debates in the field about the appropriateness of medications for childhood mood disorders.

Anxiety Disorders

Separation Anxiety Disorder

  • Affects 4-10% of children, often concerning separation from home or parents.

  • DSM-5 acknowledges the possibility of diagnosis in adults.

  • Risk of developing other disorders later in life (panic and depressive disorders).

  • Treatment involves gradual exposure and behavioral reinforcement.

Selective Mutism

  • Affects less than 1% of children, typically diagnosed between ages 3 and 5.

  • Requires prior ability to communicate verbally; avoidant behavior in specific settings.

  • Often comorbid with social anxiety disorder.

Treatment of Anxiety Disorders

  • Coping Cat: A CBT-based approach for managing anxiety in children.

  • High prevalence of untreated anxiety disorders in children, but effective treatments are available.

  • Parent involvement is crucial in therapy to reinforce learned skills at home.

Attachment Disorders

Reactive Attachment Disorder (RAD)

  • Result of instability and insufficient care in childhood.

  • Characterized by a lack of seeking comfort when distressed and demonstrating depressed emotional responsiveness.

Disinhibited Social Engagement Disorder (DSED)

  • Impulsive sociability with strangers; potential risk for exploitation.

  • History of unstable caregiving is a significant factor in development.

Elimination Disorders

Enuresis (Bedwetting)

  • Involuntary urination occurring at least twice a week for three months in children aged 5 or older.

  • Stress can trigger bedwetting episodes; treatment may be unnecessary as symptoms often resolve with age.

Encopresis (Soiling)

  • Involuntary defecation, usually more frequent during the day than at night; diagnosis applies to children 4 and older.

  • Stress and constipation are key factors; treatment often combines medical assessment with behavioral strategies.