Psych 3B03 Oct 24 lecture

Self-Esteem in Children vs. Adults

• Inflated Self-Esteem in Children

  • Children may overestimate their abilities significantly.

  • Example: A child believes they can run faster than a train or dodge a car while crossing the street.

  • This outlook can lead to engaging in physically dangerous activities, reflecting an overestimation of abilities.

• Self-Esteem in Adults

  • While adults can also exhibit inflated self-esteem, it tends to be more apparent and articulated through language.

  • Adults possess greater cognitive awareness of their self-assessment.

ADHD vs. Bipolar Disorder in Children

• Overestimation of Abilities

  • Overestimation can be misconstrued as symptoms of ADHD, where symptoms appear hyperactive.

  • ADHD is characterized as a chronic disorder that affects children consistently across situations.

  • Contrast with Mania:

  • Mania associated with bipolar disorder is episodic rather than chronic.

  • Mania episodes can occur suddenly, rather than being consistent traits of the child.

Bipolar Disorder in Childhood vs. Adulthood

• Challenges with Bipolar Diagnosis in Children

  • Diagnosis for bipolar disorder in children is complicated by the introduction of Disruptive Mood Dysregulation Disorder (DMDD).

  • Historically, children previously diagnosed with DMDD would have been labeled as bipolar if they had certain traits for at least five or three weeks.

  • Concern: DMDD does not share characteristics with bipolar disorder.

  • Current standards in the DSM (Diagnostic and Statistical Manual of Mental Disorders) don’t adequately address treatment for adolescents and children, leading to misdiagnosis and inappropriate criteria use from adult assessments.

• Bipolar Disorder in Adults

  • Typically presents as episodic:

  • Periods of extreme mood elevation (mania) alternated with depression.

  • Possible experiences of different levels of depression, including major depression.

  • Presence of euthymia, defined as a stable mood state that isn't especially elevated or depressed; clips authentic functioning.

• Bipolar Disorder in Children and Youth

  • More chronic in nature, featuring a sustained dysregulation of mood.

  • Euthymia appears less frequently, implying a less episodic character of mania and depression.

  • Interventions for elevated mood episodes often must be longer than traditional adult standards to qualify;

  • Mania: symptoms last at least 7 days.

  • Hypomania: symptoms last at least 4 days.

• Symptoms in Youth

  • Youth may experience shorter mood episodes lasting even half a day, complicating diagnosis under adult criteria.

  • Frequent mood shifts with patterns of mixed moods occur, where emotions can rapidly transition from happiness to irritability and back.

Concerns Regarding Bipolar Diagnosis in Youth

• If Youth Present Differently from Adults

  • Raises the issue of whether these youth truly experience bipolar disorder.

  • DMDD has lessened the incidence of bipolar diagnoses in children, redirecting focus toward DMDD.

  • However, some children continue to face severe dysfunction in academic and social contexts without receiving complete diagnostic insight.

Behavioral Observations in Youth

• Signs of Possible Mania or Hypomania

  • Extreme silliness or goofiness.

  • Irritable or explosive outbursts.

  • Excessive talking without regard for social cues, similar to adult behaviors related to mania.

  • A decreased need for sleep; restless behaviors throughout the day.

• Interpretations of Behaviors

  • These symptoms may also reflect typical developmental deviations or can hint at autism spectrum disorders when chronic.

  • Conversely, if behaviors are more episodic, they could align more closely with mania.

Considerations for Diagnosis and Treatment

• Phonics Criteria

  • Introduction of new evaluative criteria intended to refine diagnosis standards for conditions like bipolar disorder in youth, though not yet definitive as a treatment solution.

• Contextual Considerations

  • Careful analysis of behavior in children, such as excessive talking or hyperactivity, should consider contextual factors and developmental appropriateness before attributing behaviors to a psychiatric condition.