Term
| Internalizing problems are more common in ______. |
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Definition
| Girls are more likely to develop depression, anxiety, and eating disorders than boys. |
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Term
| Externalizing problems are more common in ______. |
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Definition
| Boys are more likely to develop ADHD and early onset conduct problems. |
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Definition
An underlying vulnerability or tendency towards a disorder.
Could be biological, contextual, or experience-based.
EX. "I have a tendency to see things negatively" |
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Definition
Situation or challenge that calls on one's resources. Events that are usually negative and external to the person.
EX. Child maltreatment |
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Definition
| Having both the diathesis and the stressor make the development of psychopathology more likely. |
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| Neural connections are strengthened or eliminated based on our environmental experiences. Nurture can act on nature. |
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Definition
The idea that the same experience can lead to multiple different outcomes.
EX. the experience of being maltreated can lead a child to develop an eating disorder, mood disorder, CD, or nothing at all. |
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Definition
The idea that there are multiple ways to get to the same end point.
EX.five adults who are all experiencing depression, likely had different pathways that got them there. |
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Definition
The classification of disease.
The major nosological framework in developmental psychopathology is the DSM-5. |
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Term
| Categorical approach to nosology |
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Definition
EX. DSM 5
Says someone who has the disorder is fundamentally different from someone who doesn't (assumes that depressed and non depressed people are being drawn from completely different populations)
Pros: Helps us to synthesize huge amount of information efficiently
Helps you to code behavior ("Im too sad to get out of bed" -> depression)
Aids communication between clinicians / researchers, categories bring mutual understanding.
Cons: Children often do not fit into categories
Co morbidity is so common that it could suggest that the way categories have been chosen is flawed
Some people don't quite meet diagnosis, but are still experiencing substantial impairment.
Categories themselves are very heterogeneous, and presentations of disorders can vary dramatically.
Categories don't adequately incorporate genetic and neuroscience research. |
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Term
| Dimensional approach to nosology |
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Definition
RDoC (research domain criteria)
Rather than thinking about categories, we think of there being independent traits or dimensions, on which people fall higher or lower.
Pros: allows us to retain more information
Cons: We don't have a good handle on which dimensions to uses
It gets complicated really quickly |
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Definition
| allows you to actually see the behavior of interest |
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Term
| Biological indicators/ physiological measurements |
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Definition
Highlight areas of impairment, don't necessary indicate cause.
EX. heart rate or cortisol levels |
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Term
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Definition
Good measures will consistently yield the same results over and over again
** you can have reliable measures that are not valid |
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Definition
It it measuring what you want to measure
** in order for a measure to be valid, it must also be reliable |
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Definition
Agreement between two people judging whether something is present or happening.
EX. Two clinicians should agree that a child has ADHD. |
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Term
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Definition
All reports of the symptoms are consistent with one another
IE. If you have a measure with 15 questions, the participant's answers to these questions should be related to one another.
IE. If someone has ADHD, they should score high on all of them, If someone doesn't then they should score low on all of them. |
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Term
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Definition
Do we get the same answers on different measurement occasions?
IE. you should get the same answer from parent on a questionnaire today, and two weeks from now.
BUT. Some constructs (like measures of daily mood) SHOULD vary over time. |
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Term
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Definition
Is your measure related to other measures of the same construct?
EX. If I develop a new scale to assess depression, my scale should be highly related to other scales of depression, otherwise it is not valid. |
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Definition
Your measure should NOT be related to other measures of DIFFERENT constructs.
EX. If I develop a new scale to assess depression, and I have a very high correlation with a scale of anxiety, its likely that I'm measuring the wrong thing, and that this scale is not valid. |
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Definition
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Term
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Definition
| Who can't be in the study |
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Definition
| The group in which you are interested |
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Term
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Definition
the group that you actually study that represents the population
IE. there should be no meaningful difference between the population and the sample |
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Term
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Definition
| Everyone in the population has an equal chance to be chosen for this sample. This is the best way to get a representative sample of a population of interest. |
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Definition
| Whether the findings generalize to the population of interest, or to other populations. |
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Definition
| The number of NEW cases in a given time period. |
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Definition
| The TOTAL number of case in a given time period. |
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Definition
| Changing A should then lead to changes in B. |
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Definition
| If A causes B, A must precede B. |
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Term
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Definition
Variables that are associated at a given point of time.
We look at these using natural experiments or case-controlled designs in which we compare children WITH the disorder to children WITHOUT. |
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Term
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Definition
A type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute.
EX. Mental health in homeless families vs. not homeless families.
Its mportant that groups are equivalent on all other factors to help establish internal validity.
EX If considering the association between depression and social skills, your groups should be (1) Children referred for depression (2) Children referred for CD RATHER THAN (1)Children referred to an outpatient clinic for depression (2) Kids in school
Pros: Often the only ethical way to address a question.
Cons: Does not establish temporal order or responsiveness. |
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Term
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Definition
Identify sample of interest and follow it over time to see who goes on to develop a particular problem.
Pros: Establishes temporal order.
Allows you to identify risk and protective factors.
Cons: Takes a long time.
Attrition.
Doesn't establish causality.
Low internal validity. Difficult to determine if other factors were driving change.
EX Aging effect; People in the study were also getting older. Perhaps the changes were a result of aging, rather than the variable of interest. |
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Term
| Criteria for determining a treatment as effective. |
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Definition
| 9+ single case studies OR 2 RCTs demonstrating its efficacy. |
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Term
| Single Case Experimental Design |
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Definition
Used to examine the effect of a treatment on a single child's behavior.
ABAB reversal designs:
A = baseline
B = intervention
A = return to baseline
B = reintroduction of intervention
Pros: Establishes temporal order.
High internal validity; When you remove the intervention show should stop seeing improvement, so this makes you confident that it is your intervention specifically that is accounting for the change.
Allows you to observe responsiveness.
Cons: Low external validity; you're only working with one child.
May be challenging to interpret findings.
Change may be stable, and is unaffected by the removal of intervention.
May be unethical to remove intervention. |
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Term
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Definition
RCT = Randomized Control Trial
Random assignment, control groups.
PROs: High internal validity
High construct validity if control groups are carefully designed
Establishes causality.
Cons: As internal validity increases, external validity decreases.
Screens out for co morbidity, which makes experimental conditions more unlike those that clinicians experience in real life.
Treatment may also not be feasible. Researchers are far more specialized and trained than most practitioners.
Also uses manualized treatment which make not provide enough flexibility.
Considers averages, which may neglect to acknowledge the variability within the treatment group. |
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Term
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Definition
All participants have equal probability of being assigned to experimental or control groups.
Good for internal validity. |
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Term
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Definition
What specifically about my intervention is causing the change?
EX. In studying the effect of social skills intervention on depression, is it the social skills workshop or interaction with a warm adult that's causing the improvement? |
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Term
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Definition
| Drop out. Lowers internal validity rates. |
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Term
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Definition
Clinician asks questions and arrives at diagnosis, no script/rubric/ very informal (MOST COMMON PRACTICE).
Cons: Less comprehensive
Confirmatory bias
Availability heuristic |
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Term
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Definition
| Clinician selectively collects information to confirm their opinion. |
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Term
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Definition
Bases decisions on expels that come easily to mind.
EX. Saw child with depression yesterday so now everyone who comes into the door looks like they might be depressed. |
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Term
| Semi-Structured Interviews |
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Definition
Interviewer has a pre-determined set of questions.
Comprehensiveness is improved.
Reduced bias.
Interviewer still has a lot of latitude in questions they ask; can follow up on things. |
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Definition
Questions are Fixed and Interviewer has no Flexibility.
Can also be administered by a computer. |
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Definition
Much shorter than structured/ semi-structured interviews.
Don't need interviewer to administer them, so they can be sent via email / done online, which makes them much more feasibly.
Reliable and Valid. |
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Term
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Definition
Observe child in their natural environment.
Pros: Provides rich information about what happens before and after the behavior of interest occurs.
Cons: May be difficult to see some low-base-rate or covert behaviors.
Not hugely feasible. |
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Term
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Definition
Want to see how the child manages a specific task or situation. Can be don in a lab or a clinic.
Pros. Because this is so controlled, it allows us to observe situations that are hard to stumble upon naturalistically.
Cons: Low external validity. |
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Term
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Definition
A way to use conflicting data to inform diagnostic decisions.
For symptoms: Symptom is present if any of the informants state that it is .
for diagnoses: look at symptoms as a whole (# of symptoms checked) and determine whether they meed diagnostic threshold based on either informant |
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Term
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Definition
A way to make use of conflicting data to inform diagnostic decisions.
For symptoms: Symptom is present only if all informants agree on that particular symptom.
For diagnosis: both informants have to check of 4 symptoms each (diagnostic threshold) for us to meet a diagnosis |
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Term
| ADHD: Core Inattentive Symptoms |
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Definition
Inattention, particularly sustained attention.
EX. Fails to pay close attention to details, makes careless mistakes in hw, work, etc.
Difficulty sustaining attention in tasks or play activities.
EX. unlikely to read books, or stay with the same puzzle for long
Doesn't seem to listen when spoken to directly, as if not present.
Difficulty organizing tasks or activities
EX. Can't figure out in what order to do their HW.
Often avoids tasks that require sustained mental effort or attention.
Often loses things necessary for tasks or activities. |
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Term
| ADHD: Core Hyperactive Symptoms |
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Definition
Fights with hand/feed or squirms
Leaves seat in situations where remaining headed is expected
Often runs about or climbs excessively in situations where it is inappropriate
Is often on the go or acts as if "driven by a motor"
Often talks excessively, verbal hyperactivity
Answers question before question is completed, cannot inhibit themselves.
Difficulty awaiting their turn. |
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Term
| ADHD: PI Diagnostic Criteria |
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Definition
ADHD-PI : Primarily Inattentive
At least 6 inattentive symptoms, but fewer than 6 hyperactivity symptoms.
For ages 17+, only 5 symptoms needed.
IE. Symptoms tend to come down with age.
* Behavior must go on for more than 6 months
* Several symptoms must be present before the age of 12
* Several symptoms must be present in at least 2 settings |
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Term
| ADHD: HI Diagnostic Criteria |
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Definition
ADHD-HI: Primarily Hyper Active
At least 6 hyperactive symptoms, fewer than 6 inattentive symptoms.
Ages 17+, only 5 symptoms needed.
* Behavior must go on for more than 6 months
* Several symptoms must be present before the age of 12
* Several symptoms must be present in at least 2 settings |
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Term
| ADHD: C Diagnostic Criteria |
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Definition
ADHD-C: Combined
At least 6 of each (6 inattentive, 6 combined)
For age 17+, 5 of each needed.
* Behavior must go on for more than 6 months
* Several symptoms must be present before the age of 12
* Several symptoms must be present in at least 2 settings |
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Term
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Definition
50% of children with ADHD also meet criteria for ODD or CD
25% of children with ADHD also meet criteria for and anxiety disorder.
20-30% of children with ADHD also meet criteria for depression. |
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Term
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Definition
ADHD affects 5-9% of school-age children.
Boys are 2-3x more likely to be diagnosed than girls. |
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Term
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Definition
Usually assessed with a rating scale or interview.
Children are not generally asked to self-report as their ratings are unreliable.
Incredibly important that reports are collected from a variety of sources.
Continuous Perfomance Task: Have to respond to stimulus (letter x) only after seeing another stimulus (letter a)
Errors of omission: missing letter x, used to be thought of as an indicator of inattention
Errors of commission: Responding to x when you should not have, used to be thought of as a an indicator of impulsivity
Classroom observation: Ideally conducted over several days across several classroom situations. Looking for off-task behavior, excessive gross motor activity, negative vocalizations.
Clinic Observation: Have them complete a standardized exam, mimic school setting. |
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Term
| ADHD Treatment: Medication |
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Definition
Methylphenidate (Concerta, Ritalin)
Increases activity in PFC.
Important to hit optimal dosage that maximizes therapeutic benefit with minimal side effects (find through titration process).
20% of children find it to be ineffective. |
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Term
| ADHD Treatment: Behavioural Interventions |
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Definition
BPT: Behavioural Parent Treatment
Teaching parents the basic principles of contingency management
IE setting clear rules, rewarding positive behaviors, and punishing negative behaviors
BCM: Behavioral Classroom Management
Contingency management in the classroom; helps teachers to manage disruptive behaviors at school; sometimes child gets an educational aid who accompanies them to class and uses this contingency management technique throughout the day.
BPI: Behavioral Peer Interventions
Social skills training didn't seem to be helpful for kids with ADHD, so contingency management done within the peer group.
EX Summer programs or day long programs that target peer relationships in recreational settings. |
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Term
| ADHD Treatment: MTA Study |
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Definition
MTA = Multimodal Treatment of ADHD
Participants: ADHD C only
Conditions: Medication Only, Psychosocial (behavioral) treatment only, Combined Medication and Psychosocial Treatment, Assessment and Referral (TAU, Community Control)
Results: When considering core symptoms, Combination and Medication out performed Psychosocial and TAU
When considering parent-child conflict, Combination and Psychosocial outperformed TAU. Medication did no better than TAU.
Longterm outcomes: gains ultimately converged, treatment groups looked the same after 6 yrs.
Limitation: there was no no-treatment control group, so we don't actually know if change is due to treatment affects or the passage of time. |
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Term
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Definition
a variable that influences the direction or the strength of the relationship between 2 variables.
EX. If we say "gender moderates the association between depression and social skills", this means that the relationship between depression and social skills is different for boys than it is for girls.
EX. In MTA study, symptom severity, comorbidity, parental health, poverty, ethnicity moderated the association between treatment and outcome. |
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Term
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Definition
A variable that explains the relationship between two other variables.
EX. Child abuse may mediate the relationship between SES and conduct. |
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Term
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Definition
Angry/Irritable Mood
(1) Often loses temper
(2) Is often touchy or easily annoyed
(3) Is often angry or resentful
Argumentative/Defiant Behavior
(4) Often argues with authority figures or, for children and adolescents, with adults.
(5) Often actively defies or refuses to comply with requests form authority figures or with rules.
(6) Often deliberately annoys others.
(7) Often blames others for his or her mistakes or misbehavior.
Vindictiveness
(8) Has been spiteful or vindictive at least twice within the past 6 months. |
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Term
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Definition
A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting *** at least 6 months *** as evidences by ***at least 4 symptoms*** from any of the core features, and exhibited during interaction ***with at least one individual who is not a sibling***
For a child <5, the behavior should occur on most days for a period of at least 6 months
For a child >5, the behavior should occur at least once per week for 6 months
Severity: Mild: Symptoms are confined to only one setting (i.e. at home, at school, etc)
Moderate: Some symptoms are present in at least two settings.
Severe: Some symptoms are present in three or more settings. |
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Term
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Definition
Lifetime prevalence estimate is 12% for ODD (13% for males, and 11% for females)
ODD is more prevalent than CD during childhood, but by adolescence the two occur about equaly.
During childhood, conduct problems are about 2-4x more common in boys than girls. This difference narrows greatly in early adolescence, du mainly to a rise in covert nonaggressive antisocial behavior in girls, and then increase again in late adolescence and beyond. |
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Term
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Definition
Lifetime incidence rate 8%
During childhood, conduct problems are about 2-4x more common in boys than girls. This difference narrows greatly in early adolescence, du mainly to a rise in covert nonaggressive antisocial behavior in girls, and then increase again in late adolescence and beyond. |
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Term
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Definition
A repetitive and persistent patern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least THREE of the 15 criteria IN THE PAST TWELVE MONTHS from any of the categories, with at LEAST ONE present in the PAST SIX MONTHS.
Specify whether:
CHILDHOOD ONSET TYPE: Individuals show at least ONE symptom characteristic of conduct disorder prior to age 10.
ADOLESCENT ONSET TYPE : Individuals show NO symptom characteristic of conduct disorder prior to age 10.
UNSPECIFIED ONSETt: Criteria for a diagnosis of conduct disorder are met, but there is not enough information available to determine whether the onset of the first symptom was before or after age 10
Specify if:
WITH LIMITED PROSOCIAL EMOTION - To qualify for this specifier, an individual must have displayed AT LEAST TWO of the following characteristics persistently over AT LEAST TWELVE months in MULTIPLE RELATIONSHIPS/SETTINGS. These characteristics reflect the individual's typical pattern of interpersonal and emotional functioning over this period and not just occasional occurrences in some situations. Thus, to assess the criteria for the specifier, multiple information sources are necessary (parents, teachers, coworkers, extended family members, peers).
LACK OF REMORSE OR GUILT: Does not feel bad or guilty when he or she does something wrong, shows a general lack of concern about the negative consequences of his or her actions.
CALLOUS-LACK OF EMPATHY - Disregards and is unconcerned about the feelings of others. The individual is described as cold and uncaring. The person appears more concerned about the effects of his or her actions on himself or herself, rather than their effects on others.
UNCONCERNED ABOUT PERFORMANCE: Does not show concern about poor/problematic performance at school, at work, or in other activities. Does not put the necessary effort forth to perform well, even when expectations are clear. Typically blames others for his or her poor performance.
SHALLOW OR DEFICIENT AFFECT: Does not express feelings or show emotions to others, except in ways that seem shallow, insincere, or superficial, or when emotional expressions are used for gain.
Specify severity:
MILD: Few if any conduct problems in excess of those required to make the diagnosis, conduct problems cause relatively minor harm to others.
MODERATE: The number of conduct problems and the effect on others are intermediate between those specified in mild and sever.
SEVERE: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others |
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Term
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Definition
Aggression to People and Animals
(1) Often bullies, threatens, or intimidates others
(2) Often initiates physical fights
(3) Has used a weapon that can cause serious harm
(4) Has been physically cruel to people
(5) Has been physically cruel to animals
(6) Has stolen while confronting a victim
(7) Has forced someone into sexual activity
Destruction of property
(8) Has deliberately engaged in fire setting, with intention of causing damage
(9) Has deliberately destroyed others' property
Deceitfulness or Theft
(10) Hs broken into someone's home, building, or car
(11) Often lies to obtain goods or favors or to avoid obligations
(12) HAs stolan items of substantial value without confronting a victim
Serious Violation of Rules
(13) Often stays out at night despite parental prohibitions, beginning before age 13
(14) Has run away from home overnight AT LEAST TWICE while living in parental home, or ONCE without returning for a lengthy period
(15) Is often truant from school, beginning before age 13 years |
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Term
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Definition
Interviews and checklists most commonly used.
Informants are typically parents and teachers.
For CD, its important to obtain self-report measures from the kids themselves since may of the behaviors they are engaging in are hard for others to observe.
Disruptive Behavior Diagnostic Observation Schedule: preschoolers interact with researcher in three different contexts:
(1) The examiner is there and interacting with child
(2) The examiner is theree but is busy and ignores them, so child must play alone
(3) the parent is present
Allows us to see if the behaviors are limited to one specific relationship, or across all relationships.
In each context there is a task assigned to see if the child will comply, a task set up to be deliberately frustrating to see how kid regulates emotion, a task that presses for rule breaking behavior |
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Term
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Definition
Interviews and checklists most commonly used.
Informants are typically parents and teachers.
Not much is learnt from interviewing the child.
Disruptive Behavior Diagnostic Observation Schedule: preschoolers interact with researcher in three different contexts:
(1) The examiner is there and interacting with child
(2) The examiner is theree but is busy and ignores them, so child must play alone
(3) the parent is present
Allows us to see if the behaviors are limited to one specific relationship, or across all relationships.
In each context there is a task assigned to see if the child will comply, a task set up to be deliberately frustrating to see how kid regulates emotion, a task that presses for rule breaking behavior |
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Term
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Definition
the idea that you can change rates of behavior through consequences
A stimulus can be either POSITIVE or NEGATIVE.
And it can be either ADMINISTERED or REMOVED. |
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Term
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Definition
Administering a positive stimulus -> behavior will INCREASE
Ex. Sheldon throwing chocolate at Penny |
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Definition
Administering a negative stimulus -> behavior will DECREASE
EX. Administering electric shocks, squirting water in the face |
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Definition
Removing a positive stimulus -> behavior will DECREASE
EX. time out, taking away a kids cell phone |
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Definition
Removing a negative stimulus -> behavior will INCREASE
E. telling a child they can skip their horse if they keep up their good behavior |
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Term
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Definition
What can happen between parent and child, a cycle of increassingly negative interactions that build off of one another
the child uses obnoxious behaviors to get out of unwanted situations -> parent reaches breaking point and tries to punish child -> child refuses -> parent is punished for trying to set limits
Negative reinforcement for child, punishment for parent.
The cycle will repeat and escalate.
The child learns "I just need to get louder". |
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Term
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Definition
Interested in MAOA: an enzyme that metabolizes neurotransmitters like dopamine and norepinephrine, making them inactive.
Low MAOA activity has been linked to behaviors such as aggression.
Participants: only looked at males, as they were interested in extreme antisocial behavior which is more prevalent in boys
Prospective study, almost no attrition -> high external validity.
Outcomes: a significant main effect of maltreatment
no main effect found for MAOA activity
significant interaction between the two factors
MAOA mediates the relationship between abuse and behavioral problems. |
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Term
| The role of cognitive factors in disruptive behavior |
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Definition
Encoding: Research inconclusive.
Interpretation: Hostile attribution bias
IE kids more likely to assume that others were being aggressive towards them, and on purpose
Response search: come up with fewer responses, and those that they do generate are likely to be more aggressive and less prosocial
Response Decision: More likely to think that good things will come out of aggressive strategies, that they'll be able to effectively carry those out
Enactment: Research inconclusive. |
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Term
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Definition
Problem solving skills training: STEPS; based of social information processing model
Anger coping program: addresses hostile attribution bias, kids' tendency to label any arousal as anger
Social Agression Prevention Program (SAPP): Recognizing emotions that may lead to social aggression, social problem solving, social skills
Parent management training: basically operant conditioning
Multi Systemic Therapy (MST): include the parent, neighborhood, school, or even justice system. Intensive and comprehensive. |
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Term
| Alcohol Use Disorder: Diagnostic Criteria and Core Features |
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Definition
Problematic pattern of alcohol uses leading to clinically significant impairment or distress as manifested by at LEAST TWO of the following occurring WITHIN A TWELVE MONTH period:
Alcohol is often taken in larger amounts or over a longer period than was intended
There is a persistent desire or unsuccessful efforts to cut down or control alcohol use
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
Craving, or strong desire or urge to use alcohol
Recurrent alcohol uses despite having persistent or recurrent social or interpersonal problems caused or exacerbated by use
Important social, occuational, or recreational activités are given up or reduced because of alcohol use
Recurrent use in situations in which it is physically hazardous
Use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol |
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Term
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Definition
| A need for markedly increased amounts of alcohol to achieve same effect |
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Term
| Substance Use Disorder: Prevalence |
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Definition
12% of adolescents meet criteria for a substance use disorder
Prevalence rates increase across adolescence
Rates are much higher (about 33%) among youth experiencing other mental health problems / psychiatric disorders |
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Term
| Substance Use Disorder: Treatment |
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Definition
High rate of relapse
Norm-based interventions: presents information about how much the individual drinks relative to the norm. Study shows that this is successful, as perceived norms mediated the association between the intervention and reduced drinking.
Prevention Programs: DARE found to be ineffective, no conclusive evidence suggests otherwise.
Syringe-Exchange Program: Harms reduction approach. Advocated exchanging new, sterile needles, and include other services such as HIV testing, counseling, condom distribution, and beds for people to stay in while they go through withdrawal.
IE associated with decreases rate of HIV, no increase in drug use rates |
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Term
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Definition
| How much others approve or disapprove of drinking |
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Term
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Definition
| How much others actually drink |
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Term
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Definition
Only 14% with non-severe anxiety are seeking help
A certain amount of anxiety is normal as well as adaptive. Furthermore, Anxiety amy not be as distressing for the adults around them, by nature of being an internalizing disorder. |
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Term
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Definition
Focused on threat or danger; Future oriented.
IE as opposed to fear, which is present oriented.
Strong negative emotion or tension, displayed as:
PHYSICAL SENSATIONS: increased heart rate, queasy felling in stomach
COGNITIVE SHIFTS: negative images they can't get out of their heads, keep worrying about the same thing while trying to do homework
BEHAVIORAL PATTERNS: try very hard to avoid the task that causes anxiety
CRYING: when they inevitably have to confront what they are stared of, clinging to parents |
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Term
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Definition
Intense fear of specific situations or things
EX. needles, dogs, water
Prevalence: 19%
DSM 5 Criteria: The phobic object or situation almost always provokes immediate fear or anxiety.
The phobic object or situation is actively avoided or endured with intense fear or anxiety.
The fear or anxiety is out of proportion to the actual danger imposed by the specific object or situation.
The feel, anxiety, or avoidance is persistent, typically lasting SIX MONTHS OR MORE.
Specify if: Animal, Natural, Blood, Situational, Other. |
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Term
| Anxiety: Separation Anxiety |
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Definition
Fear of separation from loved ones or harm coming to them
Kids don't want to be separated from parents
Spend a lot of time worrying about events that might separate them
EX I'm gong to be kidnapped, my parents might die in a horrible accident. etc
Prevalence: 8%
Age of onset: 7-8 years
DSM 5 Criteria: Developmentally inappropriate and excessive fear or anxiety concerning separation from those whom the individual is attached, as evidenced by at least THREE of the following:
(1) Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures
(2) Persistent or excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death
(3) Persistent and excessive worry about experiencing an event that causes separation form major attachment figure
EX. getting lost, being kidnapped, having an accident, becoming ill
(4) Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere for fear of separation
(5) Persistent and excessive fear of being alone
(6) Persistent reluctance or refusal o sleep away from home or go to sleep without being near a major attachment figure
(7) Repeated nightmares involving the theme of separation
(8) repeated complains of physical symptoms when separated from major attachment figures
This fear is persistent, lasting AT LEAST 4 WEEKS in children and adolescents |
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Term
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Definition
Fear of negative evaluation by others
Fear of social situations in which the person will be evaluated
EX extreme fear of public speaking, eating in front of others
For children, these behaviors must occur in peer settings, not just with adults
Prevalence: 9%
Age of onset: Adolescence
DSM 5 Criteria:
The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated
The social situation is almost always provokes fear or anxiety
the social situations are avoided or endured with intense fear or anxiety
The fear is out of proportion to the actual danger posed by the social situation
The fear is persistent, typically lasting SIX MONTS +
Specify if: performance only: the fear is restricted to speaking or performing in public |
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Term
| Anxiety: Generalized Anxiety Disorder |
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Definition
Worry about multiple threats; Chronically worried all the time without it being centered on one specific thing.
EX. worried about how they're doing in schoo, that something will happen to their loved ones, whether their friends really like them.
Prevalence: 2%
Age of onset: 10-14 years
DSM 5 Criteria: Excessive anxiety and worry occurring more days than not for AT LEAST SIX MONTHS about a number of events or activities
The individual finds it difficult to control the worry
The anxiety and worry are associated with THREE+ of the following symptoms, with at lease some symptoms present for more days than not for the past SIX MONTHS:
(1) Restlessness or feeling keyed up or on edge
(2) Being easily fatigued
(3) Difficulty concentrating or mind going blank
(4) Irritability
(5) Muscle Tension
(6) Sleep disturbance |
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Term
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Definition
Fear of panic attacks.
Prevalence: 2%
Age of onset: adolescence
DSM 5 Criteria: Recurrent unexpected panic attacks.
At least one of the attacks has been followed by 1 month + of one or both of the following
(1) Persistent concern or worry about additional panic attacks or their consequences
(2) Significan maladaptive change in behavior related to the attacks
EX. behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations |
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Term
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Definition
Prevalence: affect 12% of teenagers
A period of intense fear or discomfort that develops abruptly and is accompanied by at least four of the following symptoms:
Palpitations, pouring heart or accelerated heart rate
Sweating
Tremblin or shaking
Sensations of shortness of breath or smothering
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, light headed, or faint
Chills or heat sensations
Numbness or tingling
Derealization (feelings of unreality) or depersonalization (being detached from oneself)
Fear of losing control or "going crazy"
Fear of dying |
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Term
| Anxiety: Overal Prevalence and Gender Differences and Prognosis |
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Definition
1/3 of children will have an anxiety disorder at some point
2:1 female to male ratio for anxiety disorders
Except for OCD, which has th opposite ration of 2:1 male to female
These gender differences remain constant across development, unlike depression where it starts out even between genders and then girls spike
Studies indicate that anxiety predicts further anxiety (homotypic continuity), as well as other disorders such as depression (heterotypic continuity) |
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Term
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Definition
Prevalence: 2%
DSM 5 Criteria : Marked fear or anxiety about TWO + of the following situations
(1) Using public transportation
EX. automobiles, buses, trains, planes
(2) Being in open spaces
EX. parking lots, marketplaces, bridges
(3) Being in enclosed spaces
EX. shops, theaters, cinemas
(4) Standing in line or being in a crowd
(5) Being outside of the home alone
The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic like symptoms or other incapacitating or embarrassing symptoms
The agoraphobic situations almost always provoke fear or anxiety
The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety
The fear is out of proportion to the actual danger posed by the agoraphobic situations
The fear typically lasts SIX+ MONTHS |
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Term
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Definition
Recurrent, persistent thoughts, impulses, or images that are experienced as intrusive, inappropriate, and that cause marked anxiety or distress.
-> These thoughts are not voluntary
-> These thoughts are NOT simply excessive worries about real life problems
-> The person attemtps to ignore or suppress the thoughts or to neutralize them with another thought or action
-> The person recognizes that the thoughts are a product of their own mind
EX. Contamination, "I'm covered in germs"
Harm to self or others, "I'm going to hurt myself or tab my mom"
Symmetry, lights have to be on/off in certain order, have to touch all the furniture when walking into room, etc.
These obsessions become bigger over time. |
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Term
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Definition
Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession , or according to rules that must be applied rigidly.
The behavior or mental acts are aimed at preventing or reducing distress or preventing some dreaded events or situation.
->If I do this, I'll feel better.
->If I do this, my mom won't get hurt.
However, these behaviors or mental acts are likely not connected in a realistic way with what they are designed to neutralize or prevent, and are excessive.
EX. Counting, checking, washing. |
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Term
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Definition
Prevalence: 1-2%
Age of Onset: 9-12 yrs
DSM 5 Criteria: Presence of obsession, compulsions, OR both.
The obsessions or compulsions are time-consuming
IE taking more than 1 hours a day
or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
Specifiy if:
With good or fair insight: The individual recognizes that OCD beliefs are definitely or probably not true or that they may or may not be true.
With poor insight: The individual thinks OCD beliefs are probably true.
With absent insight/delusional beliefs: The individual is completely convinced that OCD beliefs are true.
Specify if: Tic related |
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Term
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Definition
| do anxiety disorders predict subsequent anxiety disorders? |
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Term
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Definition
| does the anxiety disorder predict other types of disorders that are not anxiety related in the future) |
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Term
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Definition
| When children will not talk in specific social settings |
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Term
| Links between Anxiety and Depression |
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Definition
Comorbidity up to 75%
Significan symptom overlap between GAD and MDD (fatigue, sleep disturbance, irritability, concentration difficulties)
Negative affectivity may be a core underlying dimension that cuts across both anxiety and depression
Difference: Positive affect is effected by depression but not anxiety.
Anxiety often precedes depression, may be a risk factor. |
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Term
| Two-Stage Model of Fear Acquisition |
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Definition
Etiological and maintenance model for specific phobia
IE how fears start and are maintained over time
STAGE 1: Classical conditioning
EX. Conditioned stimulus (CS): DOG
(a previously neutral stimulus that gets paired with US)
Unconditioned stimulus (US): Danger (the dog is not usually outside
(A stimulus that leads naturally to the response)
Unconditioned response (UR): Fear (natural to respond to danger with fear)
(a response to the unconditioned stimulus)
Conditioned response (CR): Fear to dogs
(Response to the CS that results from reliably pairing the CS and the US)
STAGE 2: Operant conditioning
EX. "If I feel so much better after not having to get on the plane, it must be dangerous or I wouldn't feel so relieved" |
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Term
| Family Factors that Contribute to Anxiety |
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Definition
Modeling: parents may demonstrate anxious responses to their children
Informational transmission: being constantly told that something is dangerous can make your fear it
EX. Study with australian animals, stories about their scariness, and kids sticking their hands into boxes.
Low expectations: Some parents may have low expectations of their anxious children, expecting that they are unable to cope; this becomes a self-fulfilling prophesy.
EX study of child with anxiety discussing possible solutions with family -> after family discussion, the number of avoidant solutions doubled
*** inclusion of both clinic groups in this study (anxious youth and kids with ODD) shows specificity |
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Term
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Definition
Try CBT first (effective in 50-75% of children) and then build in medication (SSRIs Praxil, Prozac, Zoloft, Celexa)
1) We have to focus on reducing cognitive biases that may be present
2) We must also teach coping self talk
Children with anxiety show a bias towards threat in their environment, and cognitive interventions focus on helping people identify their negative thoughts and then finding adaptive alternatives.
Dot-probe tasks
3) And also reduce bodily tension
Breathing exercises
Progressive muscle relaxation
Graded Exposurs (practice each graded exposure until habituation, SUDs scores (Subjective Units of Distress) |
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Term
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Definition
Hierarchically expose patient to feared stimulus and allow for habituation to occur naturally
Pediatric OCD Treatment Study (POTS)
Conditions: CBT, CBT+SSRI, SSRI, Pill placebo
All experimental conditions led to improvement
Combined treatment was best
CBT and pills alone were equally effective
BUT results called into question bc therapists seemed to be more effective at penn (effect size cbt vs placebo much more dramatic there, effect size meds vs placebo was bigger at duke) |
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Term
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Definition
| Physical abuse, Neglect, Physical neglect, Emotional neglect, Sexual abuse, Emotional abuse |
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Term
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Definition
Asking adults to report what they experienced as children
Cons: May be difficult to remember, memories can be biased by current events, there may be few details |
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Term
| Developmental Course of Maltreatment |
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Definition
Maltreated children must learn to cope with challenges in the environment
EX. children who are maltreated experience long term change in their physiological reactivity to stress. May become more reactive to stress or become less reactive.
EX. Maltreatment may shape the child's understanding of emotion. Experience more anger than other children, and this anger carries significant meaning.
EX. Missing out on parental positive affect impacts emotionality over time.
STUDY found that neglected children were less sensitive to differences between facial expressions than were children in other groups
IE may be explained by the fact that getting less emotional input translates into children being less able to identify facial expressions accurately
STUDY Emotion discrimination task, emotion differentiation task
Percieved more distinction between anger and negative meotions
Suggests that the experience of abuse changes children's understanding of emotion |
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Term
| Post Traumatic Stress Disorder (PTSD) |
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Definition
Characterized as anxiety after an extremely traumatic experience that involves actual or threatened death, serious injury, sexual violation.
Can occur for children who have experienced maltreatment.
In order to be diagnosed, you must have:
DIRECT EXPERIENCE: must be something that happened to you spefically
WITNESSED IN PERSON: You could develop PTSD after witnessing a car crass, learned that it happened to a close family member or friend
EXPERIENCED REPEATED EXPOSURE TO DETAILS OF EVENT ( not through media): first responders who are at horrible events, jurors who are exposed to extreme descriptions of violence
Core features:
Symptoms must persist for at least one month after trauma experienced
At least one symptom of INTRUSION
(recurrent, involuntary memories; flashbacks, nightmares, intense physical distress to reminders of the event, marked physiological reactivity to stressor)
At least one symptom of AVOIDANCE:
(avoiding thoughts or feelings or stimuli related to the trauma)
Two symptoms of EXTREME AROUSAL
(difficulty falling or staying asleep, irritable/aggressive behavior, hypervigiliance, easily startled, difficulty concentrating, self-destructive behavior)
Two NEGATIVE COGNITIONS/MOODS
(inability to recall key features of the event, persistent negative beliefs about self or world, distorted blame of self or others, persistent negative trauma related emotions (horror, shame), diminished interest in activities, alienation from others, inability to experience positive emotions)
For young kids, symptoms are more behaviorally anchored |
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