1. Chapter 15 Disorders of Childhood and Adolescence
ABNORMAL PSYCHOLOGY, SIXTEENTH EDITION James N. Butcher/ Jill M. Hooley/ Susan Mineka
Chapter 15
Disorders of Childhood and Adolescence
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

2. Maladaptive Behavior in Different Life Periods
Developmental psychopathology
Study of origins and course of individual maladaptation in context of normal growth processes
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

3. Varying Clinical Pictures
Some childhood disorders short-lived and nonspecific
Others severely affect future development
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

4. Varying Clinical Pictures
Child inpatient psychiatric patients
More likely than peers to die early in life
More likely to die due to unnatural causes
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

5. Varying Clinical Pictures
True or false?
Suicidal thoughts are uncommon in children.
Suicidal thoughts are common in children.
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

6. Special Psychological Vulnerabilities of Young Children
They do not have as complex and realistic view of themselves and their world as they will have later
They have less self-understanding
They have not yet developed stable sense of identity
They have not yet developed a clear understanding of what is expected of them and what resources they might have to deal with problems
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

7. The Classification of Childhood and Adolescent Disorders
No categories for children’s disorders
DSM-I included only two childhood disorders
Early diagnostic systems
More attention paid to developmental factors in creating and using diagnoses for children
Recent systems
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

8. Common Disorders of Childhood
Intellectual Disability is included in Neurodevelopmental Disorders.
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

9. 3 Types of (Attention-deficit hyperactivity disorder (ADHD)
Predominately inattentive
Predominately hyperactive/impulsive
Combined
Associated with numerous impairments
Behavioral
Cognitive
Social and academic problems
Technology Tip: Attention Deficit Disorder. This site contains a wealth of scholarly information and links related to ADHD.

10. The Causes of ADHD: Biological Contributions
Genetic contributions
ADHD seems to run in families
DAT1 - gene has been implicated
DAT1 – dopamine transporter gene – ritalin inhibits this gene and increases amount of dopamine

11. Attention-Deficit/ Hyperactivity Disorder
Treatment methods
Medications
Behavior therapy
Family therapy
Treatment methods
Medications (such as Ritalin, Pemoline, and Strattera)
Behavior therapy
Family therapy
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

12. Biological Treatment of ADHD
Goal of biological treatments
To reduce impulsivity and hyperactivity and to improve attention
Stimulant medications
Reduce core symptoms in 70% of cases
Examples include Ritalin, Pemoline, Focalin, Cylert, Vyvanse, Adderall, Strattera
Strattera = atomoxetine = selective norepinephrine-reuptake inhibitor – doesn’t produce the same highs when used in larger doses
Side effects – insomnia, drowsiness, eating changes, irritability, dryness of mouth

13. Behavioral Treatment of ADHD
Reinforcement programs
To increase appropriate behaviors
Decrease inappropriate behaviors
May also involve parent training
Technology Tip: CH.A.D.D. (Children and Adults with Attention Deficit Disorders). CH.A.D.D. is a non-profit organization devoted to educating the public about attention deficit and hyperactivity disorders. This site includes information on the symptoms of ADDHD, treatments, and as well as CH.A.D.D. chapters throughout the country.

14. Behavior Modification

15. Oppositional defiant disorder
Recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least six months
Conduct disorder
Persistent, repetitive violation of rules and disregard for rights of others for at least 1 year
Aggression to people and animals
Destruction of property
Theft
Serious violations of rules
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

16. Three Subtypes of Oppositional Defiant Disorder
Angry/Irritable Mood
Argumentative/Defiant Behavior
Vindictiveness
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

17. Oppositional Defiant Disorder and Conduct Disorder
Possible causes
Biological factors
Personal pathology
Family patterns
Peer relationships
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

18. Oppositional Defiant Disorder and Conduct Disorder
Effective treatments = cohesive family model and behavioral techniques
Ineffective treatment = Punitive treatments
Punitive treatments appear to intensify rather than correct behavior
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

19. Anxiety and Depression in Children and Adolescents
Childhood Depression and Bipolar Disorder
Anxiety Disorders of Childhood and Adolescence
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

20. Anxiety Disorders of Childhood and Adolescence
Separation anxiety disorder
Excessive anxiety about separation from major attachment figures, such as their mother, and from familiar home surroundings.
Most common of childhood anxiety disorders
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

21. Anxiety Disorders of Childhood and Adolescence
Characteristics
Unrealistic fears
Oversensitivity
Self-consciousness
Nightmares
Chronic anxiety
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

22. Anxiety Disorders of Childhood and Adolescence
Causes and treatments
Pattern of early family relationships
Psychopharmacological treatments and behavior therapy
A likely cause of childhood anxiety disorder is a pattern of early family relationships that generates anxiety and prevents the child from developing more adaptive coping skills
Psychopharmacological treatments and behavior therapy are common treatment methods
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

23. Childhood Depression and Bipolar Disorder
Occurs with high frequency
Depressed mood can be replaced by irritability
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

24. Childhood Depression and Bipolar Disorder
Causal factors
Biological and learning factors
Medication plus psychotherapy
Exposure to trauma
Parental negative emotion/behavior
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

25. Childhood Depression and Bipolar Disorder
Extreme mood swings and aggressive, irritable behavior
Increasingly diagnosed in children and adolescents
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

26. Childhood Depression and Bipolar Disorder
Treatment
Antidepressant medications
Supportive emotional environment
Cognitive-behavioral therapy
Research on the effectiveness of antidepressant medications with children is both limited and contradictory
It is important to provide a supportive emotional environment for children to learn more adaptive coping strategies and emotional expression
Studies have shown reduced symptoms with cognitive-behavioral therapy
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

27. Symptom Disorders: Enuresis, Encopresis, Sleepwalking, and Tics
Functional enuresis
Bedwetting that is not organically caused
Age
Gender
Children over 4 who have not learned appropriate toileting for bowel movements may be diagnosed with functional encopresis
Both are far more common in boys than girls
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

28. Symptom Disorders: Enuresis, Encopresis, Sleepwalking, and Tics
Parasomnias
Sleepwalking
Incidence level
Tics
Persistent, intermittent muscle twitches or spasms, usually limited to a localized muscle group
Tourette’s disorder
Extreme tic disorder involving multiple motor and vocal patterns
10-30% of children will have at least one incident of sleepwalking.
Persistent, intermittent muscle twitches or spasms, usually limited to a localized muscle group occurring most frequently between the ages of 2 and 14
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

29. Neurodevelopmental Disorders
Pervasive developmental disorders
Severely disabling conditions that are among most difficult to understand and treat
Autism Spectrum Disorder
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

30. Autism Spectrum Disorder
Wide range of problematic behaviors
Social deficit
Absence of speech
Self-stimulation
Impaired intellectual ability
Preoccupation with maintaining sameness
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

31. Autism Spectrum Disorder
Cause
Precise causes unknown
Fundamental disturbance of central nervous system likely involved
Most investigators agree that a fundamental disturbance of the central nervous system is involved
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

32. Autism Spectrum Disorder
Treatment
Behavior of autistic children not normalized through treatment
behavior modification techniques reduce some symptoms
Newer instructional and behavior modification techniques have been helpful in improving the ability of less severely-impaired autistic children to function
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

34. Academic Characteristics
Reading
(dyslexia)
Deficits in:
Written language
(dysgraphia)
Technology Tip: Learning Disabilities Association of America. This web site provides information and news updates on learning disabilities. This site is aimed at parents, teachers, and other professionals.
Mathematics
(dyscalculia)

35. Dyslexia
OBJECTIVE 5-7| Describe the five brain areas that would be involved if you read this sentence aloud.

36. Learning disabilities and intellectual disability
Occur in children
Can persist over life spans
Limit future development and psychological growth
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

37. Learning Disorders
Diagnosis of learning disorders
Clear impairment in school performance or daily living activities
Impairment not due to intellectual disability or pervasive developmental disorder
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

38. Causal Factors in Learning Disorders
Causes
Possibly subtle central nervous system impairments
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

39. Intellectual Disability
Characterized by deficits in general mental abilities, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience (APA 2013, p. 31).
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

40. DSM-V Levels of Intellectual disability (ID)
Mild ID
IQ score between 55 and 70
Moderate ID
IQ range of 40 to 54
Severe ID
IQs ranging from 25 to 39
Profound ID
IQ scores below 25

41. Causal Factors in Intellectual Disability
Genetic-chromosomal factors
Infections and toxic agents
Trauma
Ionizing radiation
Malnutrition and other biological factors
Some biological factors:
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

42. Organic Retardation Syndromes
Intellectual disability stemming primarily from biological causes
Down Syndrome
Phenylketonuria
Cranial anomalies
Cranial anomalies
Macrocephaly
Microcephaly
Hydrocephaly
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

43. Hydrocephalus
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

44. Trisomy 21

45. Treatments, Outcomes, and Prevention
Treatment methods
Institutionalization
Education and inclusion programming
Treatment methods
Institutionalization (usually a last resort)
Education and inclusion programming
Mainstreaming involves attending regular classes for much of the day
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

46. Planning Better Programs to Help Children and Adolescents
Wide range of treatment procedures
Wide range of outcomes
Attention to special factors
Currently, there is a very wide range of treatment procedures
Wide range of outcomes as well
Attention to special factors can enhance programs designed to help children and adolescents
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

47. Special Factors Associated with Treatment of Children and Adolescents
Special factors associated with treatment for children and adolescents
Child’s inability to seek assistance
Vulnerabilities that place children at risk
Need for treating parents as well as children
Using parents as change agents
Problems with placement outside family
Intervening before problems become acute
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

48. Child Advocacy Programs
International recognition of rights of children
Still confusion, inconsistency, and uncertainty
International recognition of the rights of children can potentially have great impact
Despite some gains, a great deal of confusion, inconsistency, and uncertainty still persists in the child advocacy movement as a whole
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

49. Can society deal with delinquent behavior?
Unresolved Issues
Can society deal with delinquent behavior?
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.