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Flashcards in Early Onset Disorders Part 2 Deck (16)
1

What is the definition of a mental illness?

  • Mental illness is a substantial disorder of:
    • Thought, mood, perception, or memory
    • Which grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life
    • Does not include substance abuse 

2

What are some examples of mental illness? (7)

  • Mood disorders: depression & mania
  • Psychotic disorders: Schizophrenia
  • Anxiety disorders
  • Adjustment disorders
  • Substance use disorders
  • Personality disorders
  • Behavior or mood problems caused by other neurological or medical illness 

3

Most problems of childhood & adolescence represent a _____ resulting from a strain on the child’s ______ ______ as the child grapples w/ a developmental task. 

crisis

coping ability 

4

With regards to problems of childhood & adolescence, it is important to distinguish between what is merely a ______ and a ______. 

stress

strain

5

What is the main difference between psychopathology in children vs. adults?

  • Child
    • Developing & changing
    • Pathology at one age is not pathology at another age
  • Adult
    • Norm is relatively static
    • One must know:
      • The capacity for impulse control, ego & superego
      • The state of interpersonal relationship
      • The level of drive development 

6

Certain disorders occur at certain stages of development

You can’t see obsessive-compulsive neurosis prior to age ______. 

5

7

Who will preferentially seek care? Children or adults?

  • Children do not seek help though they may become anxious
    • Will more often come for treatment b/c of discomfort on the part of the parent or community (school)
  • Suffering will prompt adults to seek care 

8

Assessment Schema of Anxiety 

  • Solutions
  • Questions
  • Communication

  • Solutions
    • Normal – developmental conflict
    • Reactive – developmental interference
    • Neurotic
    • Psychotic
    • Psychphysiologic
    • Characterologic
  • Questions
    • What is it?
    • How long has it been going on?
    • How many areas of life space are affected?
    • Prior problems
  • Communication
    • Act up
    • Test limits
    • Experiment
    • Act out 

9

What are the 4 general signs & symptoms of stress?

  • Eating
  • Sleep
  • Activity level
  • Regression

10

What are the age specific signs/symptoms of stress?

  • Infant
  • Toddler (1 - 2.5)
  • Pre-school (2.5 - 5)
  • School age (5 - pubescence) 
  • Adolescence 

  • Infant
    • Stress: stranger anxiety 
    • Fear: sudden stimulation
  • Toddler (1 - 2.5)
    • Stress: temper tantrums, soiling/wetting, stuttering 
    • Fear: animals
  • Pre-school (2.5 - 5)
    • Stress: intrusiveness, masturbation
    • Fear: monsters, mutilation, phobias
  • School age (5 - pubescence) 
    • Stress: truancy, lying, stealing, learning problems 
    • Fear: burglars, obsessions
  • Adolescence
    • Stress: identity crisis, sexual acting out, substance abuse, delinquency 
    • Fear: war, death

11

What are some Factors in Non-compliance of children/adolescents?

  • Denial or lack of acceptance of the disorder
  • Frustration w/ the outcome or nature of treatment
  • Wish to obtain parental attention or special privileges via symptoms
  • Wish to regain control
  • Rebellion against parents
  • Lack of knowledge or skills
  • Inability to resist peer pressure
  • Lack of relationship or miscommunication w/ health care time
  • Psychotherapy
    • Depression
    • Suicidal intent
    • Attention deficit hyperactivity disorder
    • Anorexia nervosa or bulimia 

12

What are some Family Factors in child/adolescent behavior?

  • Unresolved guilt, denial, anger and/or fear
  • Lack of knowledge & skills
  • Inability to encourage adolescent independence
  • Competition w/ medical personnel
  • Lack of support system
  • Other stressors on family
  • Family conflicts acted out through the child’s medical care
  • Rivalry btwn patient & health 

13

What are some Treatment-Related Factors in child/adolescent behavior?

  • Interference w/ usual activities
  • Side effects of drugs (pain, nausea, weight gain, hair loss)
  • Clarity of connection btwn non-compliance & sequelae
  • Disinterested, inconsistent medical personnel 

14

Emotional & Behavioral Actions Should Be Anticipated 

Minimize separations from parents, especially for children under ______. 


Understand that the child/adolescent needs to _____ something in the environment & arrange the milieu so that this will not interfere w/ treatment


Do not ______ or ______ the child or parents for regressive behavior 

8 years old

control 

criticize, blame

15

What are some indications for consultation with a child/adolescent psychiatrist after the initial screening assessment?

  • Physical symptoms w/ unexplained etiology or severity
  • Non-compliance w/ medical treatment
  • Developmental delays
  • Physician observation of child or parents’ report of depression, anxiety or hyperactive behavior
  • Impaired school performance
  • Problems w/ peer or family relationships
  • Suspected substance abuse
  • Parental difficulties w/ child rearing 

16

What is the difference in symptoms of medical illness?

  • Infancy (0-2)
  • Early childhood (2-6)
  • School age (6-12)
  • Adolescence 
  • Parents

  • Infancy (0-2)
    • change in routine, separation from parents, stranger anxiety, encourage parents to “live in” hospital 
  • Early childhood (2-6)
    • separation, aggressive to physicians, regressed bowel/bladder control, fear of minor procedures, fear of bodily harm
  • School age (6-12)
    • behavioral regression, oppositional, irrational explanation of illness
  • Adolescence 
    • loss of privacy & autonomy are painful
  • Parents
    • mourning, anger, resentment, guilt, denial