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CHAPTER 14
DISORDERS OF CHILDHOOD
AND
ADOLESCENCE
MENTAL DISORDERS IN CHILDREN AND
ADOLESCENTS AGES 9-17
Disorder
Percent Affected
Anxiety Disorders
13.0
Mood Disorders
6.2
Disruptive Disorders
10.3
EXTERNALIZING DISORDERS
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Disorders with behaviors that are
disruptive and often aggressive
Attention-deficit/hyperactivity disorder
(ADHD)
Tic disorders (Tourette’s)
Oppositional defiant disorder (ODD)
Conduct disorder
INTERNALIZING DISORDERS
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Related to worries and disturbing
thoughts rather than to overt
behaviors
Separation anxiety disorder
Social phobia
Generalized anxiety disorder
Obsessive-compulsive disorder
Depression
ADHD
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Either criteria for inattention or hyperactivityimpulsivity must be met.
Inattention – Behaviors include
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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
Hyperactivity- Behaviors include
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Fidgets, runs about excessively
Hard to play quietly
Talks excessively
Gluts out answers
Can’t wait turn
ADHD
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How common?
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Consequences?
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7 out of 100 children
4 boys to 1 girl
Deficiencies in academic and social skills
Poor school achievement
Negative self-view
Problematic interactions with parents and teachers
Causes?
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Genetic inheritance
Environmental factors
Brain functioning
Neurotransmitter activity
RATES OF ADHD
ADHD TREATMENT
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Stimulant medication
Antidepressant medication
Behavioral intervention
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Classroom intervention
Parent training
Combination of medications and
behavioral intervention is most
efficacious
TIC DISORDERS
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Tics
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Tourette’s
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Involuntary, sudden, recurrent, stereotyped motor
movements or vocalizations
Large motor ticks (shoulders, trunk, arms, legs)
combined with uttering obscenities (coprolalia)
Genetic basis
Both often occur together with ADHD
Treatment for Tourette’s
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Antidepressant medication
Relaxation therapy
OPPOSITIONAL DEFIANT DISORDER
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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:
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Loses temper
Argues with adults
Refuses to comply with requests
Deliberately annoys others
Angry and resentful
Spiteful and vindictive
Causes
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Genetic
Family relationships
FREQUENCY OF OPPOSITIONAL DEFIANT
DISORDER
CONDUCT DISORDER
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More serious than ODD
Aggressive behavior that violates social norms and
rights of others
Examples
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Causes
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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
Negative family environment
Lack of social and academic skills
ADHD and ODD often associated with later
development of conduct disorder
DEVELOPMENTAL MODEL OF CONDUCT
DISORDER
TREATMENT FOR CONDUCT DISORDER

Prevention
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Develop social, emotional, and cognitive skills
Cognitive-behavioral interventions
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Cognitive review of situation before reacting,
thinking aloud
Positive encounters with clinicians and other
adults to develop prosocial behaviors
Interventions must involve parents
SEPARATION ANXIETY DISORDER
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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
SEPARATION ANXIETY DISORDER
OTHER ANXIETY DISORDERS
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Social phobia
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Generalized anxiety disorder
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Shun contact with unfamiliar people, especially if under
pressure to perform.
In situations associated with pressure to perform, seek out
peers to establish dependent relationships; overly eager to
please peers.
Obsessive-compulsive disorder
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Persistent intrusion of intense, unwanted thoughts with
compulsions to perform ritualistic, repetitive behaviors;
mostly concerned with dirt and contamination, performing
washing rituals.
Causes – Genetic; serotonin imbalance
TREATMENT OF ANXIETY DISORDER
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Family treatment
Cognitive-behavioral interventions
Antidepressant or antianxiety medication
Children with obsessive-compulsive
disorder report that they treat themselves
by exposure to feared situation and
refraining from performing ritual
DEPRESSION SYMPTOMS
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Birth to 2 years
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3 to 5 years
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Sadness, weight loss, tiredness, thoughts of suicide, anger,
apathy, irritability
6 to 12 years
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Whining, withdrawal, delays in physical, cognitive,
language development
Nightmares, night terrors, clinginess
Similar to adults with verbalization of thoughts and
feelings; sometimes delinquent behavior; somatic
problems; anger; poor school performance
13 to 18 years

Volatile moods, rage, low self-esteem, sexual acting out,
substance abuse, suicidal thoughts and behavior.
RATES OF DEPRESSION
IN BOYS AND GIRLS
CHILD AND ADOLESCENT THERAPY
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Play therapy
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Behavioral
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Teaching child coping skills – identifying problems,
planning responses, thinking aloud
Family therapy
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Time out
Operant conditioning
Cognitive-behavioral
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Talk and play techniques
Family systems approach
Effectiveness
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Unclear how effective in clinical settings, though research
settings indicate positive effects.