Transcript Depression
CHAPTER 16 DEVELOPMENTAL PSYCHOPATHOLOGY Abnormality Maladaptiveness Interferes with personal and social life Poses danger to self or others Personal distress DSM-IV diagnostic criteria (APA) Statistical deviance Developmental Aspects Development, not disease A pattern of maladaption, not defects Social and Age Norms Developmental Issues Nature/Nurture & Continuity/Discontinuity Risk factors Prediction The Diathesis-Stress Model Interaction of genes and environment Example: Depression Genetic vulnerability Environmental trigger(s) Not specific stressors for specific disorders “Bad things have bad effects for some people some of the time” Autism Begins in infancy, more boys Several autistic spectrum disorders Impaired social interaction, communication Repetitive, stereotyped behaviors 80% retarded: savant syndrome common Severe cognitive impairment Biologically based Concordance: MZ=60%, DZ= 0% Depression Infancy Somatic symptoms Depressive-like states Related to poor attachment “At risk” if mother depressed “Failure to thrive” syndrome may occur Childhood Externalizing Problems “Undercontrolled” disorders Acting out Aggressive, out of control Internalizing Problems “Overcontrolled” disorders Inner distress, shyness More girls • Relationships between behavior at age 3 and psychological disorders at age 21. Part A shows that children with uncontrolled, externalizing behavioral styles are more likely than other children to show antisocial behavior and repeated criminal behavior at age 21. Part B shows that inhibited, internalizing children are at high risk of depression, but not anxiety disorders, at 21. Attention-Deficit Hyperactivity Disorder DSM-IV Criteria, some combination of the following: Inattention, Impulsivity, Hyperactivity More boys; 3-5% of US kids Comorbidity common Overactive behavior wanes with age Attentional, adjustment problems remain Most well-adjusted in adulthood ADHD-Causes and Treatment Neurological: Low Dopamine, other NT’s Differential processing Underactivity in motor area Genetic predisposition; Environmental stress 70% helped by stimulants (like Ritalin) Overprescription a problem Most successful if combined with behavioral treatment Depression Childhood Somatic symptoms; school, social also Psychotherapy, medication effective Nature/Nurture question Adolescence Often related to childhood symptoms Adolescence Storm and Stress? Only about 20% Heightened vulnerability to psych disorders Alcohol and drug problems Eating Disorders Anorexia nervosa; more girls (3/1) Bulimia nervosa; binge-purge Some genetic predisposition; stress also Psychological treatment usually successful Adolescent Depression and Suicide 35% depressed; 7% diagnosable Cognitive symptoms Behavioral acting out Genetic link Environmental triggers Suicide: Third leading cause of death Males commit 3/1; girls attempt 3/1 Adulthood Rates of disorder decrease after age 18 Depression Concern with elderly Elderly less vulnerable to major depression Depression often related to health 15% have some symptoms 1-3% diagnosable Difficult to diagnose from other conditions More women (2/1) Depression and Dementia Many undiagnosed and untreated Elderly can benefit, should NOT be excluded from treatment Dementia: Progressive Deterioration Not normal aging (Senescence) Alzheimer’s Disease Leading cause of dementia Progressive and irreversible Causes of Cognitive Impairment Genetic: e.g., Alzheimer’s Disease Vascular dementia -multi-infarct Minor strokes: Deficits accumulate Related to lifestyle: Diet and exercise Reversible dementia, about 20% Delirium: Reversible, often drug related Depression: Treatable Critical to distinguish for proper treatment • Alzheimer’s disease emerges gradually over the adult years; brain cells are damaged long before noticeable cognitive impairment results in old age. Changes in brain functioning are significantly different from those associated with normal aging.