Psychopathology - disorders of childhood

Disorders of Childhood

Overview

• Brain development is crucial during infancy, childhood, and adolescence.

• Development of the social brain is significant in adolescence.

• Introduces concepts:

  • Mirror neurons

  • Theories of attachment

  • Types of developmental disorders:

    • Attachment disorders

    • Autism spectrum disorders (ASD)

    • Attention deficit hyperactivity disorder (ADHD)

    • Conduct disorders

    • Learning disabilities

    • Intellectual developmental disorders (IDD)

Brain Development

• Critical periods:

  • Importance of timing in developmental processes (e.g., concussion impacts).

• Development stages:

  • Gestation and Infancy: Initial growth of neural structures.

  • Adolescence: Continued growth and fine-tuning of brain areas.

• The brain remains dynamic; early experiences can profoundly affect mental health and behavior (aligned with Freud's theories).

Sensitivity and Order of Development

• Ability development order:

  • Vision, symbols, and ideas

  • Hearing, touch

  • Social relationships, inquiry, mathematics, critical thinking, reflective thinking

  • Language skills evolve through various stages:

    • Birth

    • Infancy

    • Childhood

    • Adolescence

Age of Greatest Risk for Psychopathology

• Significant periods for onset of various disorders:

  • Reactive attachment disorder

  • Infantile anorexia

  • Onset of autism

  • School phobia

  • Oppositional disorder

  • Visual statistics mapping age range correlating with each condition.

The Social Brain and Mirror Neurons

• Mirror neurons activate during the observation of actions and their execution.

• Discovered in monkeys initially; vital for imitation and observational learning.

Brain Development: Infancy

• Basic sensory and motor functions develop pre-birth.

• Movement and vision areas develop first.

• Brain growth pattern: posterior to anterior.

• Frontal lobes mature into early adulthood (impacting decision making, impulse control).

Brain Development: Childhood

• Social brain develops:

  • Theory of Mind: Understanding mental states of oneself and others.

  • Skills measured by false belief tasks; essential for empathy and shared attention.

The Social Brain

• Development of social relations includes:

  • Face recognition (e.g., fusiform face area)

  • Early preferences for familiar faces (e.g., mothers)

  • Adolescents show heightened sensitivity to emotional expressions due to rewiring of the limbic system.

Adolescence Development

• Neurological changes during this phase are correlated with:

  • Hormonal shifts

  • Evolving social relationships

  • Increased impulsivity and risk-taking linked to frontal cortex development.

Attachment Theories

Bowlby

• Central idea of parent-child interactions being fundamental for interpersonal relationships.

• Mother-infant relationships establish a secure base for emotional development.

Harlow

• Conducted studies on attachment mechanisms in non-human primates:

  • Preferences revealed through interactions with surrogate mothers (cloth versus wire).

Ainsworth

• Developed the Strange Situation Paradigm to classify attachment styles:

  • Secure: Healthy attachment; fosters resilience.

  • Avoidant: Relates to aggression in middle childhood.

  • Anxious/Ambivalent: Leads to passive withdrawal and potential mood disorders.

  • Disorganized attachment: Linked to personality and dissociative disorders.

Developmental Disorders

Attachment Disorders

• Reactive Attachment Disorder (RAD): results from inadequate care (abuse, neglect); characterized by:

  • Emotionally withdrawn type

  • Indiscriminately social type (now DSED).

• Disinhibited Social Engagement Disorder: marked by acceptance of strangers, indicative of poor caregiving history.

Autism Spectrum Disorders (ASD)

• A neurodevelopmental disorder characterized by:

  • Difficulties with social interaction, communication, and repetitive behaviors.

  • Symptoms may manifest as early as 6-7 months.

• Genetic factors play a significant role; autism is not linked to vaccinations.

Understanding ASD Symptoms

• Smaller head size at birth; increases in cerebral volume by ages 1-4.

• Issues with developing theory of mind and social processing.

ADHD Overview

• Common developmental disorder marked by:

  • Inattention

  • Hyperactivity and impulsivity

• Symptoms often persist into adulthood and may reflect dysfunction in specific brain regions.

Treatment Modalities for ADHD

• Recommendations:

  • Stimulant medications (e.g., Ritalin, Adderall)

  • Cognitive/behavioral therapy

  • EEG biofeedback as an intervention

Conduct Disorders (CD)

• Defined by violations of others' rights and societal norms; behaviors may escalate over time, include violence and property destruction.

Oppositional Defiant Disorder (ODD)

• Children exhibit defiance and anger but do not engage in violence or destruction like CD. Symptoms include frequent arguments and blaming others.

Disruptive Mood Dysregulation Disorder (DMDD)

• Characterized by severe temper outbursts and chronic irritability.

• Symptoms must persist in multiple settings and cannot coincide with other disorders like ODD or bipolar disorder.

Intermittent Explosive Disorder (IED)

• Defined by recurrent aggressive outbursts that are impulsive, with disproportionate reactions to provocations.

Summary of Developmental Disorders

• Attachment Disorders: RAD, Disinhibited Social Engagement Disorder.

• Developmental Disorders: ASD, ADHD, ODD, DMDD, IED, Conduct Disorder.

• Learning and Intellectual Developmental Disorders: Challenges in school achievements, defined by specific learning disabilities, and limitations in cognitive abilities.

Additional Considerations

• Including biological and environmental factors in the discussion of IDD.

• Gender dysphoria and its clinical manifestations related to gender identity.

• Other relevant health concerns prevalent in children and adolescents.