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Disorders of Childhood and Adolescence
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Externalizing Disorders Disorders with behaviors that are disruptive and often aggressive Attention-deficit Disorder, with or without Hyperactivity (ADD/ ADHD) Tic disorders (Tourette’s) Oppositional defiant disorder (ODD) Conduct disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Internalizing Disorders Related to worries and disturbing thoughts rather than to overt behaviors Separation Anxiety Disorder Social phobia Generalized anxiety disorder Obsessive-compulsive disorder Depression Eating Disorders Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Frequency of Disorders in Children and Adolescents, aged 9-17 Type of DisorderPercent Affected Anxiety Disorders13.0 Mood Disorders6.2 Disruptive Disorders10.3 Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Attention Deficit Disorder (ADD/ ADHD) Either criteria for inattention or hyperactivity- impulsivity must be met. Attention Deficit Behaviors may include Does not seem to listen or follow through on instructions Difficulty in organizing activities and tasks Easily distracted by other stimuli Forgetful in daily activities Hyperactive Behaviors may include Fidgets, runs about excessively Hard to play quietly Talks excessively Gluts out answers Can’t wait turn Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Issues in ADHD How common? 7 out of 100 children 4 boys to 1 girl Consequences? Deficiencies in academic and social skills Poor school achievement Negative self-view Problematic interactions with parents and teachers Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Rates of ADHD Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Risk Factors for ADHD Genetic inheritance Brain functioning Neurotransmitter activity Environmental factors Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Treatment of ADHD Stimulant medication (e.g. Ritalin) Antidepressant medication Behavioral intervention Classroom intervention Parent training Combination of medications and behavioral intervention is most efficacious Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Tic Disorders Tics Involuntary, sudden, recurrent, stereotyped motor movements or vocalizations Tourette’s Syndrome Large motor ticks (shoulders, trunk, arms, legs) combined with uttering obscenities (coprolalia) Genetic basis likely Both often occur together with ADHD Treatment for Tourette’s Syndrome Antidepressant medication Relaxation therapy Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Oppositional Defiant Disorder Pattern of negativistic, defiant, hostile behavior lasting more than six months and not typical for age or developmental level Cause impairment in social, academic functioning Examples: Loses temper Argues with adults Refuses to comply with requests Deliberately annoys others Angry and resentful Spiteful and vindictive Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Oppositional Defiant Disorder Risk factors Genetic Family relationships Poor or inconsistent parenting Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Rates of Oppositional Defiant Disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Conduct Disorder More serious than ODD Aggressive behavior that violates social norms and rights of others Examples Threatens or causes harm to people and animals Property damage, theft, deceitfulness Serious violations of rules Behaviors would constitute antisocial personality disorder if child were over 18 years Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Conduct Disorder Risk Factors Negative family environment Lack of social and academic skills ADHD and ODD often associated with later development of conduct disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Treatment of Conduct Disorder Prevention Develop social, emotional, and cognitive skills Cognitive-behavioral interventions Cognitive review of situation before reacting, thinking aloud Time out; behavioral shaping Positive encounters with clinicians and other adults to develop pro-social behaviors Interventions must involve parents Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Separation Anxiety Disorder Defined by excessive anxiety or panic when absent from major attachment figures, lasting for more than four weeks, and impairing functioning Often develops after some stress (loss of parent, relative, or pet or serious family illness, parental separation or divorce) Usually from caring families Sometimes the result of failure to achieve secure attachment bond in early childhood Diminishes after the age of 10 years Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Separation Anxiety Disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Other Anxiety Disorders Commonly Seen in Children Social phobia Shun contact with unfamiliar people, especially if under pressure to perform. Generalized anxiety disorder In situations associated with pressure to perform, seek out peers to establish dependent relationships; overly eager to please peers. Obsessive-compulsive disorder Persistent intrusion of intense, unwanted thoughts with compulsions to perform ritualistic, repetitive behaviors; mostly concerned with dirt and contamination, performing washing rituals. These disorders often persist into adulthood; may also develop into agoraphobia or depression Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Treatment of Anxiety Disorders Antidepressant or anti-anxiety medication Family treatment Cognitive-behavioral interventions, as used for adults Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Symptoms of Childhood Depression Birth to 2 years Whining, withdrawal, delays in physical, cognitive, language development Nightmares, night terrors, clinginess 3 to 5 years Sadness, weight loss, tiredness, thoughts of suicide, anger, apathy, irritability 6 to 12 years Similar to adults with verbalization of thoughts and feelings; sometimes delinquent behavior; somatic problems; irritability and anger; poor school performance 13 to 18 years Similar to adults; possible volatile moods, rage, low self- esteem, sexual acting out, substance abuse, suicidal thoughts and behavior. Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Rates of Depression in Childhood Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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Other Types of Child and Adolescent Therapies Play therapy Talk and play techniques; puppetry Family therapy Family systems approach Effectiveness Unclear how effective in clinical settings, though research settings indicate some positive effects. Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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