Disorders of Childhood and Adolescence (Neurodevelopmental Disorders)

Children are not merely "short adults"; they possess unique psychological needs and are undergoing major psychological development.
Developmental Psychopathology: A field focused on determining what is considered abnormal at any specific point in the maturation process.
Young Children's Vulnerability: Children are highly dependent on adults and often lack the experience to view problems realistically, making immediate threats seem disproportionately insurmountable.
Prevalence: Approximately $49.5\%$ of children and adolescents meet the criteria for at least one mental disorder by age $18$ .
Onset Ages: Average age of onset is $6$ for anxiety disorders, $11$ for behavior disorders, $13$ for mood disorders, and $15$ for substance use disorders.

Anxiety Disorders: These are the most common mental disorders among youth ( $32\%$ prevalence), with higher rates in girls than boys.
Separation Anxiety Disorder: Characterized by excessive anxiety regarding separation from major attachment figures; often presents with a lack of self-confidence and apprehension in new situations.
Prevalence Rates: Specific phobias ( $19\%$ ), social anxiety disorder ( $9\%$ ), separation anxiety disorder ( $8\%$ ), and $PTSD$ ( $5\%$ ).
Childhood Depression: Affects approximately $12\%$ of children and adolescents; irritability is frequently a major symptoms substituted for depressed mood.
Causal Factors: Genetics, in utero alcohol exposure, and insensitive or hostile home environments.
Treatments: Cognitive-behavior therapy ( $CBT$ ) and exposure-based therapies are effective. Medical treatments include antidepressants, though they are associated with an increased risk of suicidal thoughts and behaviors.

Oppositional Defiant Disorder (ODD): A pattern of negativistic, defiant, and hostile behavior toward authority figures lasting at least $6\text{ months}$ . Average prevalence is $3.3\%$ .
Conduct Disorder (CD): Persistent violation of rules and the rights of others (e.g., aggression, property destruction, theft). Median prevalence is $4\%$ .
Onset Subtypes: - Childhood onset: Symptoms appear before age $10$ ; more common in males and carries a poorer prognosis. - Adolescent onset: No symptoms present before age $10$ .
Racial Disparities: African American boys are $2.4 \times$ more likely to receive a diagnosis of Conduct Disorder than $ADHD$ compared to White children with similar behaviors, often due to implicit bias.
Recidivism: Youth in detention are more likely to recidivate than those in community-based alternatives.

Enuresis: Involuntary discharge of urine after age $5$ ; affects $5-10\%$ of $5\text{-year-olds}$ .
Encopresis: Inappropriate toileting for bowel movements after age $4$ ; often associated with anxiety or constipation.
ADHD (Attention-Deficit/Hyperactivity Disorder): Characterized by inattention and/or hyperactivity-impulsivity. Prevalence is $9.5\%$ in the $U.S.$ , with a $2:1$ male-to-female ratio in children.
Autism Spectrum Disorder (ASD): Involves social deficits, language impairments (e.g., echolalia), and self-stimulation. Prevalence is $2.4\%$ ; research shows no link between vaccinations and $ASD$ .
Tic Disorders: Intermittent muscle spasms (e.g., blinking). Tourette’s disorder ( $.06\%$ ) involves multiple motor and vocal patterns, including Coprolalia (uttering obscenities).

Specific Learning Disorders: Delays in cognitive development (reading, writing, or math) that interfere with school performance. Dyslexia involves problems with word recognition and reading comprehension.
Intellectual Disability (IDD): Deficits in general mental abilities with onset before age $18$ . Classified by IQ ranges: - Mild: IQ $50-55$ to approximately $70$ . - Moderate: IQ $35-40$ to $50-55$ . - Severe: IQ $20-25$ to $35-40$ . - Profound: IQ below $20-25$ .
Causal Factors: Genetic-chromosomal factors (e.g., Trisomy 21/Down Syndrome), prenatal infections, trauma, and malnutrition.
Education: Public Law 94-142 ( $1975$ ) requires individualized education or treatment plans (IEP or ITP) for all children with disabilities.

Question: What percentage of children and adolescents meet the criteria for at least one mental disorder by the time they reach $18$ years of age?
Response: $49.5\text{ percent}$ .
Question: Some studies of the effectiveness of antidepressant medication in children have __________.
Response: Shown that these drugs are associated with an increased risk of suicidal thoughts and behaviors.