Transcript Chapter 14, Developmental and Somatoform Disorders

Developmental Disorders and
Somatoform Disorders
Developmental Disorders
Group of disorders that involve distortions in the
development of basic psychological functions that
are involved in social skills, language, perception
or motor behavior
Usually occur/are diagnosed during infancy, childhood or
adolescence.
Autism Spectrum Disorders (ASD)
● Autistic Disorder (also called “classic” autism)
● Asperger Syndrome
● Pervasive Developmental Disorder – Not Otherwise
Specified (PDD-NOS; also called “atypical autism”)
People who meet some of the criteria for autistic disorder
or Asperger syndrome, but not all, may be diagnosed
with PDD-NOS. People with PDD-NOS usually have
fewer and milder symptoms than those with autistic
disorder. The symptoms might cause only social and
communication challenges.
Autism (Autistic Disorder)
● Typically show an unusual pattern of social and
cognitive development beginning in childhood, with
marked difficulties is social interaction and
communication
● Onset – before the age of 3, usually much earlier
(recent research has shown that if AD is “caught”
earlier, children show more success in treatment)
● More frequent in males…4 to 5 times more likely in
males than in females
● About 70% with AD also have an intellectual
disability
Autism (Autistic Disorder)
●Characteristics of AD
o Impairment in social relationship
 Show noticeable lack of awareness of existence or feelings of
others
 May not like to be touched/held, avoid eye contact and prefer
solitary play
o Impaired speech
 About ½ of autistic children do not develop speech
 Speech often is like an “echo” of what is heard
o Very narrow range of interests and activities
 May focus on objects almost obsessively
o Sameness and routine very important
 Usually become distraught/angry if change occurs
● Most engage in self-soothing behaviors to block out extra sensory info (do
not seem to have filter to block out irrelevant info…no selective attention)
Asperger’s Disorder/Syndrome
● Results in impairment of social interaction, restricted
interests and repetitive behavior, yet no significant
delays in language or cognitive development (usually
average or above IQ)…often not diagnosed until school
age
●Characteristics of Asperger’s
o Interest in objects rather than people (no eye contact,
strange body gestures/positions – not develop peer
relationships)
o Routine oriented
o No general delay in language, yet some problems with
social use of language
o Motor clumsiness – awkward way of walking, trouble
throwing/catching balls, trouble with fine motor skills,
like tying shoes
Causes of ASDs…
●Likely that both genetics and environment
play a role
oResearchers have identified a number of
genes associated with the disorder.
oStudies of people with ASD have found
irregularities in several regions of the brain &
abnormal levels of serotonin or other
neurotransmitters in the brain
ADHD
● Developmental disability involving short
attention span, distractibility, and extreme
difficulty in remaining inactive for any period
oDisorder estimated to affect some 3 to 5% of
school-age children
o3 subtypes…
 Predominantly hyperactive-impulsive
 Predominantly inattentive
 Combined hyperactive-impulsive and
inattentive
ADHD -- Inattention
● Easily distracted, misses details, forgets things, and
frequently switches from one activity to another
● Difficulty focusing on one thing
● Becomes bored with a task after only a few
minutes, unless they are doing something
enjoyable
● Difficulty focusing attention on organizing and completing
a task or learning something new
● Has trouble completing or turning in homework
assignments, often losing things (e.g., pencils, toys,
assignments) needed to complete tasks or activities
ADHD -- Inattention
● Does not seem to listen when spoken to
● Daydreams, become easily confused,
and moves slowly
● Has difficulty processing information as quickly and
accurately as others
● Struggles to follow instructions
ADHD -- Hyperactivity
● Fidgets and squirms in their seats
● Talks nonstop
● Dashes around, touches or plays with anything and
everything in sight
● Has trouble sitting still during dinner, school,
and story time
● Constantly in motion
● Has difficulty doing quiet tasks or activities
ADHD -- Impulsivity
●Very impatient
●Blurts out inappropriate comments, show
their emotions without restraint, and act
without regard for consequences
●Has difficulty waiting for things they want
or waiting their turns in games
●Often interrupts conversations or others'
activities.
ADHD
●Causes
o Research points to a combination of genetic and
environmental factors
● Treatment often involves administering stimulant
drugs like Adderall, Ritalin, Concerta
o They improve the symptoms of the disorder (often having a
calming effect) – many have adverse side effects
● Individuals with ADHD may have other disorders
such as a learning disability, oppositional defiant
disorder, conduct disorder, anxiety disorders,
depression or bipolar disorder
o One disorder does NOT cause another, but the
symptoms of one may make another more
noticeable, severe
Oppositional Defiant Disorder
● behavior typically starts by age 8, but it may start as early as
the preschool years.
● Symptoms:
o must last for at least 6 months & be more than “normal”
childhood misbehavior
 Actively does not follow adults' requests
 Angry and resentful of others
 Argues with adults
 Blames others for own mistakes
 Has few or no friends or has lost friends
 Is in constant trouble in school
 Loses temper
 Spiteful or seeks revenge
 Touchy or easily annoyed
Oppositional Defiant Disorder
●The pattern of behaviors must be different
from those of other children around the
same age and developmental level.
●The behavior is thought to be caused by a
combination of biological, psychological,
and social factors.
Conduct Disorder
●Conduct disorder has been associated with:
o child abuse -- family conflicts
o genetic defects -- poverty
o Parental drug addiction or alcoholism
●The diagnosis is more common among boys.
●Children with conduct disorder tend to be
impulsive, difficult to control, and unconcerned
about the feelings of others.
Conduct Disorder
●Symptoms:
o Antisocial behaviors, such as bullying and fighting
o Breaking rules without apparent reason
o Cruel or aggressive behavior toward people and animals (fights,
using dangerous weapons, forced sexual activity, mugging, or
purse snatching)
o Destruction of property (deliberately setting fires, breaking and
entering, destroying other people's property)
o Heavy drinking and/or heavy illicit drug use
o Lying to get a favor or avoid obligations
o Running away
o Truancy (beginning before age 13)
o Vandalism
Conduct Disorder
●Children with conduct disorder may go on
to develop personality disorders as adults,
particularly antisocial personality disorder.
●If their behaviors worsen, these individuals
may also develop significant drug and
legal problems.
Somatoform Disorders
Characterized by physical symptoms that
seem to suggest a physical disorder, yet have
no physical causes or evidence suggests that
the symptoms are linked to psychological
factors
Also includes:
1.Conversion Disorder
Munchausen Syndrome,
Munchausen by proxy, and
2.Hypochondriasis
Ganser Syndrome
3.Body Dysmorphic Disorder
Conversion Disorder
●Unexplained symptoms or deficits affecting
voluntary motor or sensory function that suggest
a medical condition, yet no medical condition
exists
●Onset is usually after a stressful event
●Common symptoms are paralysis, blindness,
deafness and difficulty walking
oMany of the symptoms are anatomically
impossible…i.e. glove anesthesia – inability
to feel the hand, yet has sensation in the
arm
Conversion Disorder
One of the most significant indicators of
Conversion Disorder…
La Belle Indifference (beautiful indifference)
● The person has extreme anxiety in other areas of
life, but lack of concern about what appears to be
an incapacitating physical ailment
●Often such symptoms allow the individual to
escape from current frustrating situations and
sometimes lead to a “secondary gain” such as
attention or affection
Hypochondriasis
● Preoccupation with the idea that one has or might get
a serious disease, along with misinterpretation of
bodily systems or functions
● 3 major characteristics…
1.Physiological arousal (worried, anxious and often have sleep
disturbances)
2.Bodily focus (close monitoring of bodily features & preoccupied
with physical complaints)
3.Behaviors designed to avoid or check for physical illness
(avoids those who have a disease and engages in repeated
self-inspection or medical consultation)
Body Dysmorphic Disorder
●Preoccupation with an imagined or
exaggerated defect in personal
appearance
● Essential feature of BDD is the belief in an
imagined defect in appearance
● This preoccupation is time consuming
o Often being about the shape/size of facial
features, acne/spots on skin, wrinkles, thinning
hair and scars
Body Dysmorphic Disorder
● Individuals with BDD experience marked
distress over their supposed deformity
●feelings of self-consciousness about their
“defect” may lead to avoidance of work or
public situations
●individuals with BDD experience
higher rates of Major Depression
& suicidal tendencies
● BDD typically becomes evident in adolescence
& affects males and
females equally
Body Dysmorphic Disorder
●Some examples of what individuals with BDD
“see” when they look in the mirror…
“Human Barbie”
●Sarah Burge…
o50 years old – from the UK
ohas had over 100 procedures, costing $1.4
million for the various cosmetic enhancements
oRecently in the news for allowing her 16-yearold daughter to begin Botox treatments
“Human Barbie”
Sarah – now
after 100+
surgeries
Sarah & her daughter
Sarah prior to beginning surgeries
Heidi Montag
in 2006
in 2008
in 2010