by byf208


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ADHD Symptoms
Inattention
  • Careless mistakes in schoolwork, other activities
  • Trouble keeping attention on tasks
  • Doesn't listen when spoken to directly
  • Doesn't follow instructions
  • Trouble organizing activities
  • Dislikes tasks involving mental effort
  • Loses things needed for tasks
  • Distracted easily
  • Forgetful in daily activities
Hyperactivity/Impulsivity
  • Fidgets/squirms
  • Gets up from seat when inappropriate
  • Runs about or clims when not appropriate
  • Trouble playing/enjoying activities quietly
  • Talks excessively 
Types of ADHD
Predominantly Inattentive Type
  • 6+ symptoms of inattention
  • Fewer than 6 symptoms of hyperactivity/impulsivity
  • Sluggish cognitive tempo - slow retrieval of info from memory, slow processing of info, low levels of alertness
Predominantly Hyperactive-Impulsive Type
  • 6+ symptoms of hyperactivity/impulsivity
  • Fewer than 6 symptoms of inattention
Combined Type
  • 6+ symptoms of each 
Biological Factors of ADHD
  • PFC is smaller
  • Immaturity hypothesis - children with ADHD are neurologicallly immature, their brains are slower to develop than the brains of other children - this explains why in some children, symptoms of ADHD decline with age
  • Dopamine
  • Serotonin
  • Runs in families
  • Low birth weight, premature delivery, oxygen deprivation at birth
Psychological/Social Factors of ADHD
  • Families with frequent disruptions (moving/divorce)
  • Fathers more likely to be antisocial
  • Hostile interactions with mother
  • Nongenetic form of ADHD may be caused by environmental adversity
Drug Treatments for ADHD
  • Stimulants - ritalin, dexedrine, adderall
  • 70-85% of ADHD children actually respond to stimulants with a decrease in disruptive behaviors
  • Side effects can increase the frequency of tics in children with ADHD, may stunt growth
  • Atomoxetine, clonidine, guanfacine - affect norepinephrine
  • Antidepressants
Behavioral Therapies for ADHD
  • Reinforce attentive, goal-directed, prosocial behaviors and extinguish impulsive and hyperactive behaviors
  • Involves parents and teachers as well
  • Reward/punishment system
  • Stimulant therapy + psychosocial therapy is best
Conduct Disorder
  • Pattern of behavior in which basic rights of others or major age-appropriate societ norms or rules are violated
  • Chronic pattern on unconcern for basic rights of others
  • Symptoms: aggression to people/animals, destruction of property, theft, serious violations of rules
  • Adolescent-limited antisocial behavior - specific with age
  • Life-course-persistent - continual violation of social norms into adulthood
  • Comorbid with antisocial personality
  • Callous and unemotional traits - unemotional and unable to care (turns into psychopathy in adults)
Oppositional Defiant Disorder
  • Symptoms: frequently loses temper, quarrels with grownups, actively disobeys rules, intentionally irritates others, blames others for their errors, easily annoyed by others, angry and resentful, spiteful and vindictive
  • NOT aggressive towards people/animals, don't destroy property, no theft
  • Often begin during toddler/preschool years
  • Relational aggression in girls - excluding peers, gossiping
Biological Factors of Conduct Disorders
  • Antisocial parents
  • Heritable
  • NTs - dopamine, norepinephrine, serotonin
  • Abnormalities in anterior cingulate, PFC, amygdala
  • Exposure to neurotoxins and drugs in the womb
  • Signs of trouble often appear in infancy
  • Testosterone
Social Factors of Conduct Disorders
  • Low socioeconomic classes
  • Urban areas
  • Downward social drift - adults cannot maintain god jobs, so the families' social economic status declines
  • Quality of parenting
  • Quality of peer groups
Cognitive Factors of Conduct Disorder
  • Process info in ways that promote aggressive reactions
  • Self-fulfilling prophecy
  • Think the world is against them, so they retaliate and react aggressively, which makes people perceive them negatively and so on
CBT for Conduct Disorders
  • Teach children to recognize situations that trigger aggression
  • Observe children in their natural setting
  • Discuss hypothetical situations and ask children how they would react
  • Teach adaptive problem-solving skills
  • Some therapies include parents
Drug Therapies for Conduct Disorder
  • Stimulants - conduct disorder often comorbid with ADHD
  • Antidepressants - SSRIs, SNRIs
  • Antipsychotics - Haldol, Mellaril
  • Mood stabilizers - lithium, anticonvulsants
Separation Anxiety Disorder
  • Excessive anxiety concerning separation from home or from people to whom the individual is attached
  • Likely to be categorized within anxiety disorders in DSM
  • Duration for at least 4 weeks
  • Onset before 18 years
  • Extreme anxiety, distress, relutance to go anywhere, physical symptoms
Biological Factors of SA
  • Families with anxiety, depressive disorders
  • More heritable in girls than boys
  • High behavioral inhibition - shy, fearful, irritable, cautious, quiet
Psychological and Sociocultural Factors
  • Modeling from parents
  • Parents who are more intrusive, controlling, critical, negative
  • Primate studies - some rhesus monkeys seem to be born behaviorally inhibited, but the extent to which they developed serious signs of anxiety depended on the parenting
Treatments for SA
  • CBT - coping skills, challenging cognitions, introduce periods of separation
  • Drugs - antidepressants, antianxiety meds, stimulants
Elimination Disorders
  • Control over bladder/bowel movements
  • Experiences of shame/distress for losing control
  • Enuresis
  • Encopresis
Enuresis
  • Bed wetting at least 2x/week for 3 months
  • Most only wet bed at night
  • Some wet during the day, at school - socially anxious about using public toilets
  • Runs in families
  • Caused by distress from disruptions of family dysfunction
  • Due to inappropriate/lax toilet training
  • Treated with antidepressants
  • Synthetic antidiuretic - desmopressin - concentrates urine to reduce urine output
  • Bell and pad method - sleeps on a pad with a sensory device that detects uring, if child wets bed, bell rings and wakes child - uses CC to help child learn when it has a full bladder and needs to urinate
Encopresis
  • Repeated defecation into clothing or onto floor
  • One event a month for at least 3 months, at least 4 years old
  • Rarer than enuresis
  • Usually begins after one or more episodes of severe constipation
  • Conspitation can cause distention of colon - decreasing child's ability to detect urge to have a bowel movement
  • Treated by medications to clear colon - laxatives, increase in dietary fiber
  • Behavioral treatment - relaxation techniques and rewards
Learning Disorders
  • Significantly below expected performance on standardized tests
  • Reading disorder - defecits in reading, apparent by 4th grade - renamed dyslexia
  • Mathematics disorder - apparent by 2nd/3rd grade - renamed dyscalculia
  • Disorder of written expression - trouble writing legibly, constructing sentences - renamed learning disability
Motor Skills Disorder
  • Developmental coordination disorder - deficits in walking, running, holding objects
Communication Disorder
  • Trouble communicating verbally
  • Expressive language disorder - limited vocabulary, difficulty learning new words
  • Mixed receptive-expressive language disorder - problems understanding language produced by others
  • Phonological disorder - use wrong speech sounds for their age (wabbit for rabbit, bu for blue)
  • Stuttering - repetition of sounds, syllables, whole words, or short phrases
Causes for Disorders of Cognitive, Motor, and Communication Skills
  • Broca's area - ability to articulate and analyze words
  • Occipitotemporal region
  • Parietotemporal region
  • Environmental factors - lead poisoning, birth defects, low socioecoomic status

Treatments for Disorders of Cognitive, Motor, and Communication Skills
  • Therapies designed to build missing skills
  • Individualized Education Plan (IEP)
  • Specialized instruction can actually change brain functioning
Mental Retardation
  • Deficits in a wide range of skills
  • Significantly sub-average intellectual functioning
  • Mild mental retardation - can feed/dress themselves without help, can talk and write in simple terms, IQ betwen 50 and 70
  • Moderate mental retardation - significant delays in language development, physically clumsy, do not achieve beyond 2nd grade level in academic skills, IQ between 35 and 50
  • Severe mental retardation - very limited vocabulary, significant deficits in motor development, cannot travel alone as adults or cook for themselves, IQ between 20 and 35
  • Profound mental retardation - require full-time custodial care, don't interact with others socially, suffer from frequent illnesses, IQ under 20
  • DSM5 will rename mental retardation to intellectual disability
Biological Causes of Mental Retardation
  • Phenylketonuria (PKU) - unable to metabolize phenylalanine, an amino acid - leads to brain damage
  • Tay-Sachs disease - progressive degeneration of nervous system
  • Down syndrom - chromosome 21 is triplicate rather than in duplicate (trisomy 21)
  • Fragile X syndrom - when tip of X chromosome breaks off, affects primarily males and they have large ears, a long face, and enlarged testes
  • Fetal alcohol syndrome
  • Shaken baby syndrome
Sociocultural Factors of Mental Retardation
  • Low socioeconomic backgrounds
  • Parents are likely to also be mentally retarded
  • Social disadvantages to being poor
Treatment for Mental Retardation
  • Behaioral strategies - learn new vocational, social, communication skills as part of a comprehensive program designed to maximize individual's ability to function in community
  • Drugs to reduce seizures - neuroleptics, atypical antipsychotics
Social Programs for Mental Retardation
Early Intervention Programs
  • Infant Health and Development Program (for underweight/premature babies) - train mother in good parenting practices, sent child to daily development center, created parent support groups

Group Homes
  • For adults with mental retardation
  • Work in sheltered workshops to develop skills 
Pervasive Developmental Disorders
  • Severe and lasting impairment in several areas of development, including social interactions, communication with others, and everyday behaviors, interests, activities
  • Most thoroughly researched - autism
  • DSM5 - all of these disorders will be classified under autism spectrum disorder
Diagnosis of Autism
  • Three types of deficits: social interaction, communication, activities and interests
  • Social interaction - failure to develop peer relationships, lack of emotional reciprocity, impairment in nonverbal behaviors, lack of spontaneous seeking to share enjoyment with others
  • Communication - delay in development of spoken language, impairment in ability to sustain conversation with others, stereotyped and repetitive use of language, lack of varied make-believe play 
  • Activities/interests - preoccupation with a restricted pattern of interest, preoccupation with parts of objects, repetitive motor mannerisms, inflexible adherence to specific, nonfunctional routines
  • Onset before age 3
  • Best predictor of outcome of autism is a child's IQ and amount of language development before 5 years - children with IQs higher than 50 have a much better prognosis 
Asperger's Disorder
  • Deficits in social interactions and activities and interests
  • Similar to autism - but no significant delays or deviance in language and children usually have average IQs
  • Difficulty in social relationships
  • Little professor syndrome - formality of speech
  • Prevalence is unclear - many individuals with the disorder are able to function well in daily life and go undiagnose
Rett's Disorder/Childhood Disintegrative Disorder
  • Children develop normally
  • Then show apparently permanent loss of basic skills in social interactions, language, movement
Contributors to Autism
  • Genetics
  • Neurological factors - many children with autism develop seizure disorders, suggesting neurological dyfunction
  • Cerebellum, cerebrum, amygdala, hippocampus
  • Perform poorly on tasks requiring theory of mind - the ability to understand that people and onself have mental states
  • Deficits in medial PFC and amygdala when performing theory of mind tasks
Treatments for Autism
  • SSRI - Naltrexone
  • Stimulants to improve attention
  • Psychosocial therapies - operant conditioning to reduce repetitive behaviors and rituals
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