Download ABNORMAL PSYCHOLOGY, SIXTEENTH EDITION James N. Butcher

ABNORMAL PSYCHOLOGY,
SIXTEENTH EDITION
James N. Butcher/ Jill M. Hooley/ Susan Mineka
Chapter 15
Disorders of Childhood and
Adolescence
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Maladaptive Behavior in
Different Life Periods
Developmental
psychopathology
• Study of origins and course of
individual maladaptation in
context of normal growth
processes
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Varying Clinical Pictures
Some childhood
disorders shortlived and
nonspecific
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Others severely
affect future
development
Varying Clinical Pictures
Child inpatient
psychiatric
patients
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More likely than
peers to die early
in life
More likely to die
due to unnatural
causes
Varying Clinical Pictures
True or false?
Suicidal thoughts are uncommon in
children.
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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
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The Classification of Childhood and
Adolescent Disorders
Early
diagnostic
systems
No
categories for
children’s
disorders
Recent
systems
DSM-I
included only
two childhood
disorders
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More attention
paid to
developmental
factors in
creating and
using diagnoses
for children
Common Disorders of Childhood
Intellectual Disability
is included in
Neurodevelopmental
Disorders.
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3 Types of (Attention-deficit hyperactivity
disorder (ADHD)
• Predominately inattentive
• Predominately
hyperactive/impulsive
• Combined
– Associated with numerous
impairments
• Behavioral
• Cognitive
• Social and academic problems
The Causes of ADHD: Biological
Contributions
• Genetic contributions
– ADHD seems to run in families
– DAT1 - gene has been implicated
Attention-Deficit/
Hyperactivity Disorder
Medications
Treatment
methods
Behavior
therapy
Family
therapy
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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
Behavioral Treatment of ADHD
• Behavioral treatment
– Reinforcement programs
• To increase appropriate behaviors
• Decrease inappropriate behaviors
– May also involve parent training
Behavior Modification
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
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Three Subtypes of
Oppositional Defiant Disorder
• Angry/Irritable Mood
• Argumentative/Defiant Behavior
• Vindictiveness
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Oppositional Defiant Disorder
and Conduct Disorder
Biological factors
Personal
pathology
Possible causes
Family patterns
Peer relationships
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Oppositional Defiant Disorder
and Conduct Disorder
Effective treatments
= cohesive family
model and behavioral
techniques
Ineffective treatment
= Punitive treatments
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Anxiety and Depression in
Children and Adolescents
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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.
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Anxiety Disorders of Childhood
and Adolescence
Unrealistic fears
Oversensitivity
Characteristics
Self-consciousness
Nightmares
Chronic anxiety
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Anxiety Disorders of Childhood
and Adolescence
Psychopharmacologic
al treatments and
behavior therapy
Pattern of early
family
relationships
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Causes
and
treatments
Childhood Depression
and Bipolar Disorder
Depression
• Occurs with high frequency
• Depressed mood can be
replaced by irritability
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Childhood Depression
and Bipolar Disorder
Biological and
learning factors
Medication plus
psychotherapy
Causal factors
Exposure to trauma
Parental negative
emotion/behavior
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Childhood Depression
and Bipolar Disorder
Bipolar disorder
• Extreme mood swings and
aggressive, irritable behavior
• Increasingly diagnosed in
children and adolescents
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Childhood Depression
and Bipolar Disorder
Antidepressant
medications
Treatment
Supportive
emotional
environment
Cognitivebehavioral
therapy
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Symptom Disorders: Enuresis,
Encopresis, Sleepwalking, and Tics
Functional
enuresis
• Bedwetting that is
not organically
caused
• Age
• Gender
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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
• Incidence
level
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Tourette’s
disorder
• Extreme tic
disorder
involving
multiple motor
and vocal
patterns
Neurodevelopmental Disorders
Pervasive developmental
disorders
• Severely disabling conditions
that are among most difficult
to understand and treat
• Autism Spectrum Disorder
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Autism Spectrum Disorder
• Wide range of problematic behaviors
• Social deficit
• Absence of speech
• Self-stimulation
• Impaired intellectual ability
• Preoccupation with maintaining sameness
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Autism Spectrum Disorder
Precise causes
unknown
Cause
Fundamental
disturbance of central
nervous system likely
involved
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Autism Spectrum Disorder
Behavior of autistic
children not
normalized through
treatment
Treatment
behavior
modification
techniques reduce
some symptoms
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Academic Characteristics
• Deficits in:
Reading
(dyslexia)
Written
language
Mathematics
(dyscalculia)
(dysgraphia)
Dyslexia
Learning disabilities and
intellectual disability
• Occur in children
• Can persist over life spans
• Limit future development and
psychological growth
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Diagnosis of learning disorders
Learning Disorders
Clear impairment in school
performance or daily living
activities
Impairment not due to
intellectual disability or
pervasive developmental
disorder
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Causes
Causal Factors in
Learning Disorders
Possibly subtle
central nervous
system impairments
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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).
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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
Causal Factors in
Intellectual Disability
Some biological factors:
•
•
•
•
•
Genetic-chromosomal factors
Infections and toxic agents
Trauma
Ionizing radiation
Malnutrition and other biological factors
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Organic Retardation
Syndromes
Phenylketonuria
Cranial
anomalies
Down
Syndrome
Intellectual
disability
stemming
primarily from
biological causes
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Hydrocephalus
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reserved.
Trisomy 21
Treatments, Outcomes,
and Prevention
Education
and inclusion
programming
Institutionalization
Treatment
methods
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Planning Better Programs to Help Children
and Adolescents
Wide range
of treatment
procedures
Wide range
of outcomes
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Attention to
special
factors
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
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Child Advocacy Programs
International
recognition of
rights of
children
Still
confusion,
inconsistency,
and
uncertainty
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Unresolved Issues
Can society deal
with delinquent
behavior?
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