SU 3 Notes on Neurodevelopmental and Childhood Disorders

Developmental Psychopathology

  • Definition of Development: Refers to specific changes occurring over a person's lifespan due to interactions with biological, psychological, and sociocultural variables.
  • Developmental Psychopathology: Explores how psychopathology develops throughout life, influenced by a person’s maturation and changing systems.
    • Assumes that psychopathology emerges gradually, not suddenly.
    • Developmental Disorders: Unique disorders originating in infancy, childhood, or adolescence, affecting specific areas of development.

Understanding Child Psychopathology in South Africa

  • Risk Factors: Environmental factors (e.g., poverty) that increase the likelihood of mental health difficulties.
  • Protective Factors: Variables that enhance resilience and mitigate risk exposure.
  • Contextual Challenges: South Africa has made progress post-Apartheid, yet many children face psychological risk factors violating their rights (e.g., violence, neglect, lack of basics such as health and nutrition).
  • Socio-Economic Factors: Many children live without both biological parents, facing issues like educational deprivation and inadequate family care.

Internalising Disorders

  • Definition: Disorders characterized by inwardly focused symptoms directed towards the self (e.g., depression, anxiety, withdrawal).
  • Symptoms in Children: Often appear shy, withdrawn, fearful, and struggle with expressing emotions externally.

Depression

  • Impact: Affects cognitive, emotional, and physical functioning; often missed in children as symptoms can resemble normal mood swings.
  • Risks of Undiagnosed Depression:
    • Major effects on current functioning and future development.
    • Disruptive mood dysregulation is prevalent.
  • Symptoms: Irritability, social isolation, loss of interest in activities, changes in appetite/sleep, feelings of worthlessness, difficulty concentrating, and physical complaints.

Anxiety Disorders

  • Characteristics:
    1. Strong negative emotions and fear.
    2. Bodily tension symptoms (e.g., heart palpitations).
  • Types:
    • Separation anxiety, specific phobias, social anxiety, generalized anxiety disorder, selective mutism, panic disorder, and agoraphobia.
  • Indicators: Physiological and cognitive difficulties, avoidance of specific situations, and developmentally inappropriate fear causing functional impairment.

Externalising Disorders

  • Definition: Disruptive behaviors directed outward, observable in interpersonal relations, causing conflict with others (e.g., parents, teachers).
  • Examples of Behaviors: Disobedience, aggression, hyperactivity.

Attention-Deficit/Hyperactivity Disorder (ADHD)

  • Overview: Chronic condition marked by inattention, hyperactivity, and impulsivity.
  • Impact: Disruptive to cognitive, emotional, and social functioning.
  • Diagnostic Criteria:
    • Symptoms must be evident before the age of 12, covering inattention and hyperactivity/impulsivity.
  • Symptoms of Inattention: Difficulty focusing, forgetting tasks, getting easily distracted.
  • Hyperactivity/Impulsivity Symptoms: Fidgeting, inability to play quietly, hyper-responsiveness to stimuli.

Conduct Disorder

  • Legal Definition: Antisocial behaviors by minors violating laws and societal norms.
  • Characterization: Continual violation of others' rights and societal rules, aggressive behaviors, and lack of remorse.
  • Symptoms Types:
    1. Aggression to people or animals.
    2. Destruction of property.
    3. Deceitfulness.
    4. Serious rule violations.

Autism Spectrum Disorder (ASD)

  • Characteristics: Difficulty with communication and social interaction; restrictive behavioral patterns.
  • Symptoms Include: Inability to engage socially, delayed speech, obsessive interests, and stereotypical behaviors.
  • Severity Levels: DSM-5 categorizes autism severity into levels 1 (some support), 2 (substantial support), and 3 (very substantial support).

Aetiology of ASD

  • Unclear Causes: Likely a combination of genetic, biological, and environmental factors.
  • Associated Medical Conditions: Maternal illness (e.g., rubella), genetic syndromes, and neurodevelopmental issues.

Enuresis (Elimination Disorders)

  • Definition: Involuntary voiding behavior in bed or clothes at least twice a week for three months, causing distress or impairment.
  • Types of Enuresis:
    • Primary: Never achieved continence.
    • Secondary: History of continence but regressed.

Comorbid Disorders with Conduct Disorders

  • Includes ADHD, mood disorders, anxiety, poor self-esteem, and learning difficulties.

Separation Anxiety Disorder

  • Definition: Excessive fear regarding separation from home or caregivers, including physical symptoms like headaches and nausea.
  • Impact: Significantly disrupts daily functioning and social development, avoiding places like school or sleepovers.