Transcript Models in Psychopathology

Disorders
of
Childhood
and
Adolescence
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
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
Frequency of Disorders in Children and
Adolescents, aged 9-17
Type of Disorder
Percent Affected
Anxiety Disorders
13.0
Mood Disorders
6.2
Disruptive Disorders
10.3
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Attention Deficit Disorder (ADD/ ADHD)
 Either criteria for inattention or hyperactivityimpulsivity 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
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
Rates of ADHD
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Risk Factors for ADHD




Genetic inheritance
Brain functioning
Neurotransmitter activity
Environmental factors
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
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
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
Oppositional Defiant Disorder
 Risk factors
 Genetic
 Family relationships
 Poor or inconsistent parenting
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Rates of Oppositional Defiant Disorder
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
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
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
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
Separation Anxiety Disorder
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
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
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 selfesteem, sexual acting out, substance abuse, suicidal
thoughts and behavior.
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Rates of Depression in Childhood
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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