What do research studies focus on?
-defining what constitutes normal and abnormal behaviour for children of different ages, sexes, and ethnic and cultural backgrounds
-identifying the causes and correlates of abnormal child behaviour
-making predictions about long-term outcomes
-developing
What is an issue with children being referred to seek health services?
when adults seek services for children, it often is not clear whose 'problem' it is
-children enter health systems because the adult is concerned (e.g parent, teacher)
-effects how we detect children's problems and how we respond to them
How do mental health care providers view development?
Many child and adolescent problems involve failure to show expected developmental progress
-transitory (e.g bedwetting)
-initial indication of more severe problem
-compare behaviour to abnormal and normal development
Are problem behaviours abnormal or normal?
Many problem Behaviours shown by children and youths are not entirely abnormal
-most children and youth exhibit problem behaviors (e.g worrying about forgetting things)
-familiarity with know psychological disorders and troublesome problem behaviours
What is the goal of interventions?
Interventions for children and adolescents often are intended to promote further development, rather than merely to restore a previous level of functioning
-->boost the child's abilities and skills and eliminate distress
How was children's mental health originally viewed?
-children's mental problems were never discussed
-it was believed the devil possessed them, anyone who questioned that view was not taken seriously
Who was John Locke?
-changed childbirth practices and child-rearing
-believed in individual rights, children should be raised with care
-universal health care
Who is Hollingsworth?
-discovered that children who were suffering, it was due to adults treating them poorly
-this showed that there was a difference between psychiatric disorders and intellectual disorders
-->mental disorders do not correlate with lower IQ
Who is Victor of Averyon?
-he walked around like an animal and psychologist tried to reverse his retardation
-->he did learn through his training, but he did not fully recover
-->showed that we could help children with disabilities improve
What were the early beliefs of the origins of psychological disorders?
-he walked around like an animal and psychologist tried to reverse his retardation
-->he did learn through his training, but he did not fully recover
-->showed that we could help children with disabilities improve
Who is Beers?
-Beers, wanted to raise the standards of care and disseminating reliable information
-->detection and intervention methods began to flourish, even though mental illness was feared
What was an early issue of seeing psychological diseases as biological diseases?
-since the paradigm was based on a biological disease model only visible disorders were focused on (e.g psychoses)
-you couldn't reverse mental illness or significantly improve
-->strict punishment and protect those who are not affected
What is Psychoanalytic theory?
-freud brought back optimism by tracing mental disorders roots to early childhood
-experiences play a role in psychopathology, children could be cured or illness could be prevented if the child was raise in a proper environment
psychoanalytic theory advan
What is behaviourism?
-pavlov's experiment: classical conditioning
-watson: conditioning and elimination of children's fears
-watson's theory of emotions, talked about normal and abnormal behaviour
What is the modern thinking of child rearing?
part skill, part wisdom, and part luck
Why were foster homes created?
-we had to take children out of institutions
-babies who did not have physical contact had emotional and behavioural problems
-->introduction of foster homes
What is behaviour therapy?
-treatment of child and family disorders
-based on operant and classical conditioning
-focused initially on children with intellectual disability or severe disturbances
What is progressive legislation?
-free and appropriate public education for any child with special needs in the least restrictive environment for that child
-each child with special needs regardless of age must be assessed with culturally appropriate tests
-each of these children must ha
What are childhood disorder consisted of?
-childhood disorders are accompanied by various layers of abnormal behaviour or development
-->range from visible and alarming to more subtle yet critical (e.g teasing, peer rejection), to more hidden and systemic (e.g depression, or parental rejection)
What is a psychological disorder?
-psychological disorder: pattern of behavioural, cognitive, emotional, or physical symptoms shown by an individual
What are the three main features of psychological disorders?
-the person shows some degree of distress, such as fear or sadness
-his/her behaviour indicates some degree of disability, such as impairment that substantially interferes with or limits activity in one or more important areas of functioning, including ph
What is stigma? What does it lead to?
-stigma, refers to a cluster of negative attitudes and beliefs that motivates fear, rejection, avoidance, and discrimination with respect to people with mental illnesses
-->leads to prejudice and discrimination
-->stigma results in low self-esteem, isolat
What is competence?
-competence: the ability to successfully adapt in the environment
What influences a child's ability to adapt in the environment?
-competence: the ability to successfully adapt in the environment
-successful adaptation varies across culture and ethnicity: traditions, beliefs, languages, and value system need to be taken into account
-minority children must cope with racism and segre
How can deviancy be judged?
-deviancy judgments require knowledge of a child's performance relative to their peers, and knowledge of a child's development and cultural context
-normal developmental milestones
-deviancy, defining competence can be specific and narrow or plentiful and
What are developmental tasks?
developmental tasks: broad domains of competence such as conduct and academic achievement
What is conduct?
Conduct, indicates how well a person follows rules of a particular society
-young age, children should control their behaviour
-enter school, follow classroom rules
-adolescence, follow the rules set by school, home, and society without supervision
What is self-domain?
-children start to differentiate themselves from the environment and the develop self-identity and autonomy
What does one consider with developmental pathways?
-need to determine when a child's behaviour starts to become a problem
-->will these concerns, lead to problems later on
What is a developmental pathway?
developmental pathway: the sequence and timing of particular behaviours and possible relationships between behaviours over time
-->development is active and dynamic process that can account for different beginnings and outcomes
-->helps us understand the
What is multifinality?
multifinality, the concept that various outcomes may stem from similar beginnings
-maltreatment can alter the child's initial course of development resulting in unpredictable outcomes
What is equifinality?
equifinality, the concept that similar outcomes stem from different early experiences and developmental pathways
children have different strengths and weaknesses, but later will both have the same disorder
What are contributors?
-there are many contributors to disordered outcomes in each individual
-contributors vary among individuals who have the disorder
Explain how disorders come about.
-individuals with the same specific disorder express the features of their disturbance in different ways (e.g some children with a conduct disorder are aggressive, whereas others may be destructive to property or engage in theft or deceit)
-the pathways l
What is a risk factor?
-risk factor, a variable that precedes a negative outcome of interest and increases the chances that the outcome will occur
What is a protective factor?
-protective factor, a personal or situational variable that reduces the chances for a child to develop a disorder
Which type of stress puts a child at risk?
acute stressful situation and chronic adversity put children's successful development at risk
-chronic poverty, serious caregiving deficits, parental mental illness, divorce, homelessness, and racial prejudice are risk factors that increase children's vul
Why do children who are at risk not develop a disorder?
-survive using strong self-confidence, coping skills, and abilities to avoid risk situations may be considered resilient
-fight off or recover from their misfortune
-sustained competence under stress, or rebound to a previously healthy level of competence
What is resilience?
resilience is not a universal, categorical, or fixed attribute of the child
-it varies according to the type of stress, its context, and similar factors
-may be resilient to some specific stressors but not others and resilience may vary
-resilience is see
What are direct causal pathways?
-direct causal pathway rarely lead to a particular outcome
What interaction affects the expression of mental disorder?
-ongoing interactions exist between protective and risk factors within the child, between the child and his or her environment, and among risk factors
What are protective and risk factors?
-protective factors are personal or situational variables that reduce the chances for a child to develop a disorder
-risk factors do the opposite, they increase the child's likelihood of developing a problem
-risk and protective factors are processes not
How many resources predict good outcomes?
-not all three resources are necessary
-for some children a supportive teacher or grandparent can change their course of development and some children need more resources
Why do kids not see mental health care?
-many children do not receive mental health care due to poor understanding of mental disorders and limited access to intervention
What are the main changes of children's mental health?
-we are able to recognize earlier mental health problems
-we detect mental disorders more often
-children still do not receive proper care
How are mental problems unevenly distributed?
-children from disadvantaged families and neighbourhoods
-children from abusive or neglectful families
-children receiving inadequate child care
-children born with very low birth weight due to maternal smoking, diet, or abuse of alcohol and drugs
-childr
What Affects Rates and Expression of Mental Disorders?
-new pressures and social changes may place children at risk for the development of disorders at younger ages
-->chronic stressors: poverty, inequality, family breakup
-->new stressors: homelessness, immigrant families, inadequate child care availability,
What are environemental stressors?
-the manner in which one's circumstances affect the course of a disorder should be distinguished from how they may initially contribute to the problem
-->e.g environmental stressors: e.g child abuse that bring about poor adaptation or the onset of a disor
Why is poverty a disadvantage?
-growing up with poverty has an effect on the well-being of children and adolescents, especially with learning ability and school achievement
-low income is tied to disadvantages: less education, low-paying jobs, inadequate health care, single-parent stat
How is the poverty disadvantage expressed in children?
-children who live in poverty suffer from more conduct disorders, chronic illness, school problems, emotional disorders, and cognitive/learning problems
-effect on prefrontal cortex development stemming from the social inequalities
-the greater the degree
What is poverty associated with?
-poverty is associated with negative influences-harsh parenting, exposure to acute and chronic stressors
What is the effect of witnessing community violence?
-kids who witness community violence are more likely to develop PTSD and cognitive delays and impairments that affect learning and mental healt
Which disorders are more common in girls and boys?
-hyperactivity, autism, childhood disruptive disorders, and learning and communication disorders are more common in boys
-anxiety, depression and eating disorders are more common in girls
What are the gender differences based on age?
-after the age of three you start to see the differentiation between the genders
-boys show higher rates of early=onset disorders that involve neurodevelopmental impairment
-girls show emotional disorders with a peak age of onset in adolescence
-boys have
What are internalizing problems?
internalizing problems: anxiety, depression, somatic symptoms and withdrawn behaviou
What are externalizing problems?
externalizing problems: encompass more acting-out behaviours (e.g aggressio
What is the expression of internalizing and externalizing problems?
-externalizing problems are higher in boys in preschool and elementary years and these problems decrease for both boys and girls until the rates coverage at 18
-internalizing problems show similar rates in childhood, but girls outpace boys over time
Which type of boy is likely to display resilience?
-resilience in boys is associated with household in which there is a male role model, structure, rules, and encouragement of emotional expressiveness
Which type of girl is likely to display resilience?
-girls who display resilience come from households that combine risk taking and independence with support from a female caregiver
What is the effect of race and ethnicity and expression of mental disorders?
-certain mental disorders are overrepresented in certain ethnic groups (e.g substance abuse)
-->this more due to SES
-likely due to misunderstanding of their culture and poor treatme
What is marginalization?
-minority children face poverty and exclusion from society's benefits (marginalization)
-->result of alienation, loss of social cohesion, and rejection of the norms of the larger society
How can a person not succumb to marginalization's effects?
-resisting the effects of poverty and marginalization takes personal strength and family support
Why can abnormal child behaviour not be generalized across cultures?
-meaning of children's social behaviour is influenced by cultural beliefs and values, express their problems differently across cultures
-shyness is linked to social rejection in western cultures
-shyness is linked to leadership and academic achievement i
What is a concern for homosexuals and transgender?
-lesbians, gays, bisexuals and transsexuals youths are more likely to be victimized
-more bullying, harassment and physical assault
-higher rates of mental health: depression, suicidal behaviour, substance abuse, and risky sexual behaviour
What is abnormal behaviour in youth?
patterN: is it just a one time event?
distress: is anyone upset about it? often the person who is doing the action
disability: does it get in the way? interfere with children's ability to go to school, make friends
risk: could it lead to problems in the f
Explain how disability and risk can be defined by adaptational failure.
-failure to reach developmental milestones
-lack of progress along adaptive developmental trajectories
What is developmental psychopathology framework?
-broad approach to disorders of youth
-stresses importance of developmental processes and tasks
-to understand maladaptive behaviour, one must view it in relation to what is considered normative
What are the two main issues around children's mental health?
1 in 8 children has a significant mental health service
Inadequate services
less than 10% receive services
effectiveness is often unknown
How does gender affect the expression of mental disorders?
-differences in timing
-males show higher rates of disorders in childhood, females show higher rates of disorders in adolescence
-differences in form
-males show higher levels of externalizing problems
-females show higher levels of internalizing problems
What is a cause of many disorders?
-poverty linked with higher rates of many disorders
How does culture affect the expression of disorders?
-meaning of behaviours and expression of symptoms varies: e.g fire setting, differences in expression
-impact varies by disorder: less cultural impact on more neurobiological based disorders
How does ethnicity and race affect mental disorders?
Ethnicity and Race: effects generally better accounted for by SES and culture
What is a diathesis?
diathesis: vulnerability (biological, contextual or experience-based) or tendency toward disorder
What is stress?
stress: situation or challenge that class on resources, typically thought of as external, negative events
What is an interaction?
-under stress, diathesis increases likelihood of disorder
What does an interaction mean?
even if you have a diathesis and a stressor it does not necessarily mean you will develop a disorder the stressor just mental disorder the likelihood
What are the positive aspects of the diathesis stress model?
-behaviour and emotions are complicated
-almost no disorders caused by 'just' genes
-almost no disorders caused by 'just' stress
-brain changes (neural plasticity) in response to environment
-->neural connections are strengthened or eliminated based on en
What are the general rules of the diathesis model?
-diathesis doens't equal disorder
-stress doesn't equal disorder
-interaction: makes disorder more probable
-could have multiple interacting diatheses and stressors
What is Science?
systematic method for investigating questions
What is the process of science?
Theory and prior research, you realize what is left to discover, what don't we know
research question
hypotheses/predictions, how will I test my hypotheses
methods of measurement
research design
data collection/findings
inferences/interpretation, interpre
Why are people skeptical of research?
-fraud: people make false data and draw 'common sense' interpretations
-common sense,
-findings change, one recommendation in 2000, ten years later another recommendation
-conclusions are often complicated
-->different parenting styles effective depending
Why Bother?
-fraud is not common. It receives a lot of attention but doesn't happen that often
-sometimes common sense is wrong
-->babies should sleep on their stomachs....they wouldn't vomit on themselves. But when they sleep on the back less cases of SIDS
-findings
Why is science necessary?
Science is a best available method for accumulating knowledge and correcting errors and personal biases
How is the DSM organized?
-diagnostic and statistical manual of mental disorders DSM 5
-outlines diagnoses and associated criteria
-categorical system
-disorders are viewed to be discrete categories
-->depression, social anxiety, oppositional defiant disorder
-professional consens
What are the advantages of categorical measurement advantages?
-synthesis of information, it helps psychologists organize information, all clinicians are using the same framework and it acts as a common language
What are the disadvantages to the DSM?
-children often do not fit into categories
-->comorbidity, more than one diagnosis (e.g bulimia and depression), this is very common it is the rule not the exception. We might not have organized it correctly because people are not fitting in it
-impaired
What is a modern approach to mental illnesses?
-rather than using diagnostic categories, move towards assessing key dimensions
-negative affect, difficulty with negative affect across different diseases
-anger regulation
What is dimensional Measurement?
-independent traits or dimensions of behavior exist
-people are higher and lower on these dimensions and they are present in everyone
What are the advantages of dimensional measurement?
-allows us to retain valuable information
-provides a measure of severity
What are the disadvantages of dimensional measurement?
-which dimensions?
-->becomes very complicated very quickly, this can interrupt communication
What is the main differences between categorical and dimensional?
-categorical
-->someone who has that disorder is fundamentally different than someone who does not
Dimensional
-present in everyone to varying degrees, they are not fundamentally different just different variations
What are you interested in studying?
-need to define construct
-depression, disorder versus symptoms
-friendship, reciprocal or not
-social competence perceived by self or someone else
--> are you asking them who they like versus who likes them
-different definitions = different results?
How will you measure this construct?
-need to find or develop method
What are rating scales and interviews?
-ask people knowledgeable about the child to answer questions about their behaviour and emotions
-interviews are longer and administered to the person
-rating scales are briefer and are (typically) completed by the person on their own
What is behavioural observation?
-actually see the behaviour of interest
-->ask the kids to talk about a disagreement they had together, watch family dinner
What are Objective indices?
-cortisol
-heart rate
highlight areas of impairment not physical 'cause'
-->cortisol is not causing the behavioural issue
What is inter-rater reliability?
-inter-rater reliability
-agreement between two people judging whether something is present or occurring
-diagnosis-->can two clinicians agree that a child has ADHD?
-behaviour-->e.g children's responses to peer provocation (e.g pretend a person spread a
What is internal consistency?
-are reports of the symptoms consistent, both verbal and questionnaires
What is test-retest reliability?
-do we get the same answer on different measurement occasions?
-be careful, some constructs should change over time, even over very short intervals. e.g mood should stay the same ADHD without treatment should be consistent
What is convergent validity?
-are scores on the measure related to other measures or indicators of the same construct
-my new scale of depression should be correlated with other scales of depression
What is discriminant validity?
-are scores on the measure different from scores of other constructs
-mu new scale of depression should now incredibly high correlations with a scale of anxiety
Who are you interested in studying?
-need to define sample
-inclusion criteria
-->who can be in a study?
-exclusion criteria
-->who should not be in a study?
WHo is in your study affects the conclusions you can draw?
Sampling will change your findings and your interpretations
-->e.g boys versus girls
--->e.g teenagers versus preschoolers. They are at different developmental periods
-->e.g children from middle-income families versus children from low-income families
Explain what happened to the Canadian census.
-20% of Canadians required to fill out a long form of the census (50 questions)
-government wanted to make it optional
What is an ideal sample?
-population is the group in which you are really interested
-sample is the group you are studying
-sample represents the population, no meaningful differences between the sample and population
What is random selection?
-everyone in the population of interest has an equal chance of being chosen
-e.g census, until harper let it be optional because everyone had a shot of getting the long form of the census
-e.g ontario child health study
What is a sample of convenience?
-school, working with them because they are willing to work with me
-clinic, work with the clinics that want to work, clinics that say no and yes differ in meaningful ways
-you need to think about the group you are not studying and how that affects your r
What is epidemiolgoy? What quesitons do they ask?
How common is a given problem?
Who has a given problem? are certain people at risk
these are their two main questions
What is random assignment?
-all participants have an equal probability of being in either the experimental or control group
What is internal validity?
-want to ensure that groups d o not differ in any other way than the experimental manipulation
What is an RCT?
-if designed carefully, it allows us to establish cause
-the intervention
-randomly assigning participants to treatment and control groups
-internal validity (can conclude your intervention caused the change)
-construct validity
-what about my interventio
What is a control group?
-careful choice, allows you to establish construct validity
What is no treatment control group?
-no treatment control group (something in the intervention was better than nothing)
-->good starting point
What is wait-list control?
-wait-list control group, a control group that will not initially get it but they will later on
-->usually due to ethical reasons
What is attention-only control group?
-attention-only control group, attention from the person administering it, seeing someone every week who is empathetic might be enough, it might not be be the therapy they use. The control group would meet with a therapist but he would not use a specific
What is treatment as usual?
-treatment as usual, randomly assigned to get a new treatment or a treatment that they would have typically received (e.g cancer, chemotherapy was the control group)
-->often due to ethical reasons, but we want to know that the new intervention does bette
What is another effective treatment?
-another,effective treatment, if we have a treatment we want to know our treatment does better than the previous one. The bar is higher for this one because they are comparing it to evidence based therapy
What are the advantages of RCT?
-internal validity
-construct validity - with a carefully chosen control group
What are the disadvantages of RCT?
-external validity
-findings may not generalize to real world clinical samples
-->very specific population: often people recruited from advertisements, not found in clinics
-->difference in people who are actively seeking it out than those who are not
-->
Why can you often not generalize your findings?
-often done in university clinics, manualized treatment, very well-trained therapists
-->often these aren't how people practice psychology outside these settings
-->they are highly trained, they are motivated because they want it to work, they have a lot
What is the issue with people dropping out?
-drop out, participants often don't like to be randomly assigned, it is difficult to make a control in psychology an illusion, the participants know if they are getting therapy or not
-may drop out of the control group
-threaten internal validity (groups
What do RCTs look at with their findings?
-RCTs are looking at averages
-within the treatment group, some people will not have improved
-in the treatment group there will be people who do not get better, it will be significant usually
-->we want to figure out why this group did not improve
How do you determine a causation between A and B?
Theoretical expectation that A would cause B
A and B have to be related empirically (correlation)
Elimination of other possible causes
-case-control design, prospective design, single-case designs, RCT
What is temporal ordering?
-temporal ordering: A occurs before B
-->prospective design, single case designs, RCT
What is responsiveness?
-responsiveness: Changing A leads to change in B
-single-case designs, RCT
What should you consider when reading research?
-internal validity
-->allows you to attribute differences to the variable of primary interest
-->e.g differences in outcome are due to depression
-->e.g differences in symptoms are due to my treatment
-external validity
-->do the findings generalize
-->wo
Why do we do it?
-clinical
-->in order to arrive at a diagnosis
-->to plan a treatment, when does this child struggle, when are these symptoms coming out
-->treatment monitoring and progress, do we need to start with medication right away or could we start with therapy. Y
What are interviews?
-ask person knowledgeable about child's behaviour (e.g parent, child) to answer questions
What are unstructured interviews?
-clinician asks questions and arrives at diagnosis
-most clinicians use this approach, and many rely on it entirely
Why are unstructured interview less comprehensive?
-clinicians tend to make diagnostic decisions before they have collected all of the relevant information
-biases
What is the confirmatory bias?
-confirmatory bias: tend to selectively collect information to confirm diagnostic decisions
-tend to ignore information that is disconfirmatory
How do they use availability heuristic in interviews?
-combine information in idiosyncratic ways
-use an availability heuristic where they base decisions on examples that come to mind easily
-->e.g if they just diagnosed a child with depression, may be more likely to do it again
What are structured interviews?
-interviewer has a set of questions that are presented to the respondent
-->they use them for every patient
-improves comprehensiveness
-reduce bias
-questions are fixed and interviewer as almost no flexibility
-these can be administered by a computer
What are semi-structured interviews?
-->interviewer has a lot of latitude in asking the questions
-->clinical judgment involved in determining when a symptom is present
Which interview style is more reliable and valid?
Data suggest that structured and semi-structured are more reliable than unstructured
-unstructured, two clinicans could come to different conclusions
Data suggest that structured and semi-structured are more valid than unstructured
Which interview style is used in research?
Structured and semi-structured interviews are the standard instruments in psychopathology research
-unstructured interviews are not used in research
Why are structured interviews not used in clinical practice?
feasibility
-length, comprehensive coverage you need to ask a lot of questions
-can take two hours or more to administer
-patients might only have a few sessions, you might not want two waste two on assessment
-training
-->semi-structured interviews requi
What are rating scales and why are they used?
Questions about behaviours and Feelings
-e.g children's depression inventory
-->first one describes you best: all bad things are my fault, many bad things are my fault, and bad things are usually not my fault
-shorter compared to structured/semi-structure
What is the validity and reliability of rating scales compared to structured interviews?
-->some evidence suggests that rating scales/checklists yield comparable diagnoses
-->perform just as well for researchers who are measuring symptoms
-raises the possibility that clinicians could use shorter assessments
Why do informants not agree?
-but, different informants provide reliable and valid reports
-->one informant is not giving bad reports
-some exceptions e.g children's report of ADHD
-teachers and parents show limited agreement, but both are providing good reports
different perspective
How do different perspective influence reports?
-rater-specific factors that lead to systematic differences in reporting
-some evidence for bias in reports of some informants
-maternal depression associated with a tendency to overreport behavioural problems
-may see difference between mother and teache
How are the differences in meaning of behaviours across settings?
-parents and teachers interact with children in very different contexts, and these contexts may change the interpretation of behaviour
-for the latter, behaviours often considered assertive (e.g appropriately questioning rules, why do I have to do this) m
Explain how situation specificity of children's behaviour.
-children's behaviour varies markedly across different situations and settings
-different demands: some people struggle in large lecture classes, but they do well in conferences where it is smaller. Some people do better in large lectures and not small co
Which hormones affect children with fears and anxiety?
-children with fears and anxiety are affected by levels of stress hormones circulating in the body, have parents who had similar problems during childhood
What do children with fears and worries develop?
-children with fears and worries sometimes develop a belief system that can be self-defeating, leading them to believe that they will fail at everything
What type of parenting do children need?
-children require a parenting style that is sensitive to their unique needs and abilities and that places appropriate limits on them to help them develop self-control
What is acculturation?
children from cultural minority groups face challenges in adapting to their receiving culture
What is biculturalism?
where the child strive to adapt to both their heritage and their receiving cultures, is the most adaptive approach to acculturation
What is a basic quality of life?
children require a basic quality of life: safe community, good schools, proper health and nutrition, access to friends, and opportunities to develop close relationships with extended family and members of the community
What is etiology?
causes of childhood disorders, considered biological, psychological and environmental processes interactions
What are biological determinants?
brain damage, brain dysfunction, neurotransmitter imbalances, and genetic influences
What do psychological and environmental models stress?
-psychological and environmental models stress environmental toxins, early experiences, learning opportunities, disciplinary practices, family systems and sociocultural contexts
-->risk factors and correlates with certain disorders
What is developmental psychopathology?
describing and studying disorders of childhood, adolescence, and beyond in a manner that emphasizes the importance of developmental processes and tasks
-organizes childhood milestones and sequences in physical, cognitive, social-emotional, and educational
How is maladaptive behaviour viewed?
-maladaptive behaviour must be viewed as what is normative for a given period of development
-highlighting developmental processes (eg language acquisition), look at variations and extremes in developmental outcomes
How is a mental disorder viewed?
-complexity of biological, familial, and sociocultural factors in order to understand developmental changes
-knowledge from several disciplines: psychology, psychiatry, sociology
How can abnormal development by multiply determined?
-look beyond the child's symptoms and consider developmental pathways and interacting events that could contribute to the expression of the disorder
-similar risk factors lead to different outcomes and a disorder can be caused by multiple causes
-consider
How is the child and the environment interdependent?
-interdependent, they influence each other
-children influence their own environment and the environment influences the child
-nature and nurture are interconnected
-different children elicit different reactions from the same environment
-different enviro
What is transaction?
-transaction, dynamic interaction of child and environment
-the child and the environment contribute to the expression of a disorder and one cannot be separated from the other
-environment and children are active contributors to adaptive and maladaptive b
How is abnormal development continuous and discontinuous?
-impairments or psychological disorders do not suddenly emerge, they have warning signs or connections to earlier developmental issues
-abnormal child development may be continuous or discontinuous across childhood, adolescence, and adulthood
What is continuity?
continuity: developmental changes are gradual and quantitative (e.g expressed as amounts that can be measured, e.g weight)
-future behaviour patterns can be predicted from earlier patterns
-seen in conduct disorders (evolves into serious antisocial acts)
What is discontinuity?
discontinuity: developmental changes are abrupt and qualitative (e.g can't be measured, e.g mood)
-future behaviour is poorly predicted by earlier patterns
-seen is eating disorders (occurs suddenly, few predictors, a child can show normal development and
Do positve or negative factor influence continuity or discontinuity?
-positive and negative factors influence the continuity or discontinuity of development over time
-some behaviour problems show both continuities and discontinuities
When do continuity and discontinuity vary?
-continuity and discontinuity vary as a function of changing environmental circumstances and transactions between the child and environment
What are developmental cascades?
process where a child's previous interactions and experiences spread across other systems and alter his/her course of development like a chain reaction
Why do we need to use an integrative approach?
-biological, psychological models are not enough to see the whole picture
-need to use both to understand the causes
-explanation is limited if you use one
What are the cause of children's psychological disorders?
-children's psychological disorders are the result of failure in one or more areas of development
What is an adpatational failure?
failure to master or progress in accomplishing developmental milestones
-->children with disorders differ from some aspects of normal development
-->rarely due to a single cause
What is organizaiton of development?
early patterns of adaptation (e.g infant eye contact) evolve with structure over time and transform into higher-order functions (e.g lip reading)
-prior patterns of adaptation are incorporated into successive reorganizations at subsequent period of develo
What are sensitive periods?
-windows of time where environmental influences development, both good and bad are enhanced
-->e.g infants are sensitive to proximity with their caregiver which forms secure attachment
-often learning occurs
-development is a process of increasing differe
How is development hierarchical?
-child's current abilities or limitations are influenced by prior accomplishments
What is neurobiology?
brain and nervous system function
What is brain development?
genetic and constitutional factors, neuroanatomy, and rates of maturation
How is the brain influenced?
-brain regions are influenced by biochemicals and neurohormones
-environmental factors direct or route ongoing brain processes
What is the process of brain development?
-begins with neuronal growth and differentiation
-fetal brain develops from a few all-purpose cells into interconnected neurons
-the speed and distance of emerging neurons is fast
What is the function of the brain stem
heartbeat and breathing
What is the function of the cerebellum?
sensorimotor integration
What is the cortex
thought and perception originate
Explain embryonic development.
-generates an initial abundance of neurons
-undifferentiated cells, and develop axons once they reach their destination
-their synapses lay the foundation for further growth and differentiation
-genes determine the main highways axons travel
-axons follow
What occurs at the fifth month of prenatal development?
-axons reached their general destination, more axons than the target cells can accommodate
-during childhood synapses multiply; then selective pruning reduces the connected
-fosters healthy growth of different areas
-eliminates connections that serve to r
What is neural plasticity?
-neural connections often are not stable and regress or disappear
-some are strengthened and become established
-this occurs throught experience
Explain how nature and nurture affect neural plasticity.
neural plasticity: the brain's anatomical differentiation is use-dependent
-nature provides the basic processes
-nurture provides the experiences to select adaptive network connections
-environment influences brain structural differentiations
-child's bra
Which types of experiences can influence neural plasticity?
-prenatal environment
-childhood illness and diet
-maltreatment and inadequate stimulation
-caregiving experiences: design parts of the brain involved in emotion, personality, and behaviour
-child rearing (normal), increase child's ability to cope with st
What is brain maturation?
-organized, hierarchical process that build on earlier function
-restructuring and growing throughout the lifespan
-primitive areas of the brain, mature first and undergo most dramatic restructuring during the first
What are perceptual centres and instinctive centers affected by?
-perceptual centres and instinctive centers (e.g limbic system) are affected by early childhood experiences and set the foundation for further development
-occurs at three years
What is the prefrontal cortex
planning decision making
What is the cerebellum
motor skills
What are the major restructurings of the brain?
-prefrontal cortex and cerebellum are not rewired until 5-7 years
-major restructuring occurs between 9 and 11 due to puberty
-during adolescence the brain prunes
-brain is always going through restructures
What is the role of genes and development?
-genes contain genetic infor from each parent
-distributed on 22 matched pairs of chromosomes and a single pair of sex chromosomes
-male (XY) female (XX)
-genetic influences is malleable and responsive to the social environment
-positive environmental cir
What do genes do?
-a gene produces protein
-these proteins are vital for the brain to function, and rarely cause a behaviour to happen
-produce tendencies to respond to the environment in certain ways
-each person has genetic vulnerabilities, tendencies and predisposition:
What is the gene-environment interaction?
-genes influence how we influence how we respond to the environment and the environment influences our genes
What is epigenetic mechanism?
epigenetic mechanism: involve changes in gene activity resulting from a variety of environmental factors, such as toxins, diet, stress and others
-->environment can turn genes on and off
-epigenetic alterations can be reversible through pharmacological an
What is behavioural genetics?
-a branch of genetics that investigate possible connections between a genetic predisposition and observed behaviour, taking into account environmental and genetic influences
What are familial aggregation studies? What can't you control for?
look for a cluster of disorders within a given family and compare to a normal distribution
-cannot control for environmental variables
What are twin studies?
-twin studies control for the contribution of genetic factors
-compare identical or monozygotic twins to dizygotic or fraternal twins
-studies of twins provide powerful research to demonstrate the genetic role
What is molecular genetics?
-association between variations in DNA sequences and variations in a particular trait or traits
-variation in genetic sequences are thought to cause the variations in the trait(s)
-search for specific genes
-determine how genetic mutations alter how the g
What type of gene combination is the cause the disorders?
-often similar and multiple interactive genes are the cause than a single gene
What is the brain stem?
-brain stem, base of the brain handles automatic functions necessary to stay alive
-lowest part is known as the hindbrain and it contains the medulla the pons and cerebellum
What is the hindbrain?
-essential regulation of autonomic activities (e.g breathing, heartbeat)
What is the midbrain?
-coordinates movement with sensory input
Midbrain houses the reticular activating system (RAS), contributes to processes of arousal and tension
What is the diencephalon?
-very top of the brain stem below the forebrain
-contains the thalamus and hypothalamus, regulate behaviour and emotion
-relay between forebrain and the lower areas of the brain stem
What is the forebrain?
-base has the limbic system, contains areas that cause psychopathology
-->hippocampus, cingulate gyrus, septum, and amygdala
-->regulate emotional experiences and expressions and play a role in learning and impulse control
What is the limbic system?
-limbic system regulate basic drives of sex, aggression, hunger and thirst
What is the basal ganglia?
-includes the caudate nucleus
-regulates, organizes, and filters information related to cognition, emotions, mood, and motor function
-could contribute to ADHD, disorders affecting motor behaviour (tics and tremors) and OCD
What is the cerebal cortex?
-largest area of the forebrain
-gives us distinct human qualities and allows us to plan as well as to reason and to create
-two hemispheres
-left hemisphere: verbal and other cognitive processes
-right hemisphere: social perception and creativity
What happens to the brain during puberty?
-brain develops new brain cells and neural connections
-reorganizes and consolidates, further matures the lobes of the brain
What is the frontal lobe? What does it mature?
-underlies our thinking and reasoning abilities
-memory
-make sense of social relationships and customs and relate to the world and people
-functions continue to mature into adolescence and early adulthood
What is the endocrine system?
-regulatory system,
-result of anxiety and mood disorders (children and adults)
-endocrine glands release specific hormones into the bloodstream
-adrenal glands produce epinephrine (adrenaline) in response to stress
-epinephrine, energizes us and prepares
What is the hypothalamus?
hypothalamus carries out commands it receives from the adjacent pituitary gland and other hormones (e.g regulating hunger and thirst)
-the pituitary gland stimulates the adrenal gland to produce epinephrine and stress hormone: cortisol
What is the hypothalamic-pituitary-adrenal?
-hypothalamic-pituitary-adrenal (HPA): hypothalamus control center and the pituitary and adrenal glands
-->related to disorders related to stress response, emotion regulation (e.g anxiety and mood disorders)
How does HPA regulate stress?
-hypothalamus secretes corticotropin-releasing hormone (CRH), stimulates the pituitary gland to secrete the ACTH into the bloodstream
-ACTH, causes the adrenal glands to release cortisol
-works on a feedback loop, cortisol modulates the stress response by
What are neurotransmitters?
-make meaningful connections that serve larger functions such as thinking and feeling
-brain circuits are paths from one part of brain to another
-brain circuits are created when neurons are more sensitive to one type of neurotransmitter than another and
What do psychoactive drugs do to neurotransmitters?
-psychoactive drugs increase or decrease the flow of neurotransmitters
-changing neurotransmitter activity that make people more likely or less likely to exhibit certain kinds of behaviour
What is Benzodiazepine-GABA? Which disorder is it related to?
-reduces arousal and moderates emotional responses, such as anger, hostility, and aggression
-is linked to feelings of anxiety and discomfort
-disorder: anxiety disorder
What is dopamine?
-act as a switch that turns on various brain circuits, allowing other neurotransmitters to inhibit or facilitate emotions or behaviour
-is involved in exploratory, extroverted, and pleasure-seeking activity
What is Norepinephrine? Which disorder is it related to?
-facilitates or controls emergency reactions and alarm responses
-plays a role in emotional and behavioural regulation
-disorder: acts generally to regulate or modulate behavioural tendencies, no a specific disorder association
What is serotonin? Which disorder is it related to?
-plays a role in information and motor coordination
-inhibits children's tendency to explore their surroundings
-moderates and regulates a number of critical behaviours, such as eating, sleeping, and expressing wange
-disorder: schizophrenia and mood diso
What are emotions?
-emotions and affective expression are core elements of human psychological experience
-central features of infant activity and regulation
-emotions tell us what to pay attention to and what to ignore
-emotions are critical to healthy adaptation
How do emotions influence children?
-children's emotional experiences, expressions, and regulation affect the quality of their social interactions and relationships
-->foundation of personality development
-emotions are internal monitoring and guidance systems that appraise events as benefi
Which emotions do children pay attention to?
Children attend to emotional cues from others, which allows them to learn an interpret and regulate their own emotions
-infants learn the importance of emotions for communication and regulation
-by two, they can attribute cause to emotional expression
How do young children rely on emotions?
children look to the emotional expression and cues of their caregivers to provide them with information needed to formulate a basic understanding of what is going on
-for young children, emotions are a form of communication that permits them to explore th
What is emotion reactivity?
-individual differences in the threshold and intensity of emotional experiences, which provide clues to an individual's level of distress and sensitivity to the environment
What is emotion regulation?
-enhancing, maintaining, or inhibiting emotional arousal which is done for a specific purpose or goal
-some emotion dysregulation may be adaptive in on environment and maladaptive in another
What are emotion regulation problems?
Regulation problems involve weak or absent control structures (e.g trouble concentrating in class)
What is emotion dysregulation?
dysregulation, existing control structures operate maladaptively (e.g a child is fearful for no reason)
How should parents deal with emotion regulation?
authoritative parents establish limits that are both sensitive to the child's individual development and needs and demanding of the child to foster self-control and healthy regulation
What is temperament?
the child's organized style of behaviour that appears early in development
-->e.g fussiness or fearfulness
-->shapes the child's approach to his or her environment
What is the positive affect and approach?
-describes the 'easy' child who is approachable and adaptive to his or her environment
-possesses the ability to regulate basic functions of eating, sleeping and elimination relatively smoothly
Who is fearful or inhibited?
-'slow-to-warm-up' child who is cautious in his or her approach to novel or challenging situations
-these children are more variable in self-regulation and adaptability and may show distress or negativity toward some situations
Who is negative affect or irritability?
-'difficult child', is negative or intense in mood, not adaptable and arrhythmic
-show distress when faced with novel or challenging situations, and others are prone to general distress or irritability, including when limitations are placed on them
-is re
When does temperament establish? What does it contribute to?
-temperament is established during early brain development
-temperamental styles can be related to a particular disorder (e.g anxiety) or due to closely related to the temperament
What the connection between self-control and temperament?
-temperament influences later development by affecting a child's development of self-control
-fearful temperament is linked to better self-control
What are personality disorders?
-rarely diagnosed until late adolescence or early adulthood
-antisocial, borderline, histrionic, paranoid, schizoid, schizotypal, narcissistic, avoidant, dependent, and obsessive-compulsive
-enduring pattern of inner experience and behaviour that deviates
What are behavioural and cognitive influences?
-emphasize learning and cognition shape children's behaviour and their interpretation
-applied behaviour analysis, observable behaviour and rejects cognition effects
-social learning theory, focuses on cognitive processes and explanations
What are behavioural exlplanations?
behaviour is understood based on the situation rather than stable traits
What are cognitive explanations?
certain thought patterns develop over time and relate to behavioural strategies (e.g problem solving
What is applied behaviour analysis?
-relationships between behaviour and its antecedents and consequences, known as functional approach
-functional relationships between stimuli, responses and consequences
-behaviours are acquired or changed as a result of particular consequences
-->positiv
What is social learning?
-social learning, not only overt behaviours but also the role of possible cognitive mediators that may influence the behaviours directly or indirectly
-behaviours may be learned not only by operant and classical conditioning, but also indirectly through o
What is social cognition?
-relates to how children think about themselves and others, results in the formation of mental representations of themselves, their relationships and their social world
-representations are continually updated based on maturation and social interaction
-c
What is the attributional bias?
-attributional bias about their ability or the intentions of others leads them to reinterpret the event in a way that fits their preexisting belief
How do children process information?
-desire to evaluate their behaviour in various circumstances, especially involving possible failure or harm
-these self-appraisals can be on faulty beliefs or distortions
What are proximal and distal?
-proximal: close-by events
-distal: further-removed events
-e.g river is affected by proximal events (e.g rainstorm) and distal events (e.g seasons)
What is a shared environment?
-environmental factors that produce similarities in developmental outcomes among siblings in the same family
-if siblings are more similar than expected from only their shared genetics, implies an effect of the environment
-identical twins, shared environ
What is a non=shared environment?
-environmental factors that produce behavioural differences among siblings
-calculated by subtracting the MZ twin correlation from 1.0
-creates differences among siblings
-includes: differential treatment by parents, peer influences, and school environmen
How can social settings be indirect?
social settings affect the child even when they do not directly experience them
-e.g parent's friends and jobs, availability of family support
-culture affects how children are affected (e.g gender differences)
What is attachment?
attachment: process of establishing and maintaining an emotional bond with parents or other significant individuals
-infants are preadapted to engage in relationship-enhancing behaviours such as orienting, smiling, clinging
-in order to survive infants ne
Why is attachment important?
-infant caregiver relationships helps the infant regulate her/his behaviour and emotions, especially under conditions of threat or stress
-attachment serves an important stress-reduction function
-infant balances preserving the familiar but exploring new
What is secure attachment?
-infant readily separates from caregiver and likes to explore
-wary of a stranger or distressed by separation, the infant seeks contact and proximity with caregiver and will return to exploration and play after contact
-seek out and make effective use of
What is insecure attachment? anxious avoidant
-infant engages in exploration, but with little effective interaction with caregiver
-little wariness of strangers and is upset only if left alone
-as stress increases avoidance increase
-avoidant pattern of early attachment tend to mask emotional express
What is insecure attachment? anxious, resistant type
-shows disinterest or resistant to exploration and play, wary of novel situations/strangers, difficulty settling when reunited with caregiver and may mix active contact-seeking with crying and fussiness
-resistant pattern of early attachment have difficul
What is disorganized attachment?
-infant lacks a coherent strategy of attachment
-appears disorganized when faced with a novel situation and has no consistent pattern of regulating emotions
-inability to form close attachment to others; may show indiscriminate friendliness
-disorders: pe
Why do we need to view an individual in their family and peer context?
-an individual's problem needs to be seen in perspective to their social situation
-stress the is positive or tolerable, often bring about change, growth and reorganization of families and it is not usually harmful to children's development
-some stress i
What makes scientific finds murky?
-parents and professional interpret and relate information according to their own belief system
-people believe a study more if it is accompanied with a photo of a brain
-often studies in abnormal child psychology conflict with one another
-->some studies
Explain the facilitated communication study.
-facilitated communication, assistants guided children's hands to type messages, but the autistic kids couldn't type, the people were typing for them
-when they gave different questions to the assistants than the autistic persons, the answers corresponded
What is pseudoscience?
demonstrations of benefit are based on anecdotes or testimonials, the child's baseline abilities and the possibility of spontaneous improvement are ignored, and related scientific procedures are disavowed
-not based on evidence
-spontaneous improvement
How is science distinguished from pseudoscience?
science is distinguished from pseudoscience because scientists play by the rules of science, are prepared to admit when they are wrong and are open to change
What is the process of research?
-multistage process involving key decisions at various points
-research questions are often based on atypical development and behaviour
-studies can use one theory, multiple theories, or no theory if there isn't one
-if you don't use a theory, you often d
What is epidemiological research?
epidemiological research, study of the incidence, prevalence, and co-occurrence of childhood disorders and competencies in clinic-referred and community samples
What is incidence rates?
incidence rates: reflect the new cases of a disorder appear over a specified period (e.g the number of youths who develop a depressive disorder during the school year)
What are prevalence rates?
prevalence rates: refer to all cases, whether new or previously existing, observed during a specified period of time (e.g the number of teens with conduct disorder in the general population during 2012 and 2013)
What is lifetime prevalence?
lifetime prevalence: if a person has had the disorder at any time in their lives
What are two critical components of a disorder?
knowing the risk and expression of a disorder in an individual helps us determine the nature of the disorder and ultimately to prevent and treat it
How does epidemiological research classify disorders?
-classify disorders as single symptoms, multiple symptoms, or patterns of symptoms
How can prevalence differ?
-prevalence varies depending on which way you classify it
-single symptoms: high prevalence, patterns: low prevalence
-prospective yields higher prevalence (e.g observing the sample and determining if they have the disorder) than retrospective recall due
Why do you need to consider situational factors?
-you need to consider situational factors and other factors so you make the right conclusion
-a disorder might not be linked to an ethnicity but it has a high prevalence in a particular ethnicity because they have low SES
What are correlates?
-variables that are associated at a particular point in time with no clear proof that one precedes the other
-->is her sadness preventing her from making friends, or is she said because she doesn't have friends
When would a risk factor appear on a timeline?
-precedes an outcome of interest and increases the chances of a negative outcome
-->e.g divorce increases the likelihood of the child becoming depressed
-doesn't mean it will occur, its occurrence depends on other factors
When would a protective factor occur on a timeline?
-positive variable that precedes an outcome of interest and decreases the chances that a negative outcome will occur
-->e.g positive relationships
Why does abnromal psychological research need a large sample size?
-only a small proportion of children at risk for a problem will develop the disorder
-the areas of child functioning that will be affected and how they will be affected are not known in advance
-the ages when a disorder may occur or re-occur are also not
What are causes?
-influence either directly or indirectly through other variables
-the occurrence of a behaviour or disorder of interest
What are mediating variables?
-mediating variables have an independent effect on the existing relationship between two variables,
What are mediators?
mediators account for some or all of the apparent relationship between two variables
What are moderator variables?
moderator variables: influence the direction or strength of the relationship of variables of interest
-the association between two variables depends on a function of moderating variable (e.g child's age or sex)
-->e.g physical abuse resulted in internaliz
What are mediator variables?
mediator variables: refer to the process, mechanism, or means through which a variable produces a particular outcomes
-describe what happens at the psychological or neurobiological level to explain one variable results from another
-->when mothers experie
What is treatment efficacy?
the treatment can produce changes under well-controlled conditions
-careful control is exercised over the selection of cases, therapists, and delivery and monitoring of treatment
What is treatment effectiveness?
treatment effectiveness: the treatment can be shown to work in clinical practice not just in well-controlled research settings
-treatment is evaluated in clinical settings, clients are referred rather than selected and therapists provide services without
What is standardization?
-standardization is a process that specifies a set of standards or norms for a method of measurement that are to be used consistently across different assessments of the construct of interest
-these standards and norms relate to the procedures that must b
What is reliability?
reliability: consistency or repeatability of results obtained using a specific method of measurement
What is internal consistency?
-internal consistency: all parts of a method of measurement contribute in a meaningful way to
What is interrater reliability?
-interrater reliability: the information obtained not on a single observer or, various people must agree on what they see
What is test-retest reliability?
-test-retest reliability: the results you obtain should be consistent if the tests are repeated within a short time
What is validity?
validity: the extent to which the test actually measures the dimension or construct that the researchers sets out to measure
-not all or none, but rather a matter of degree
What is face validity?
the extent to which it appears to assess the construct of interest
-->e.g a questionnaire (do you get nervous before a test, measure of test anxiety)
What is construct validity?
construct validity: scores on a measure behave as predicted by theory or past research
-->e.g test of intelligence if children who score high have good grades in school
-convergent validity: the correlation between measures that are expected to be related
What is discriminant validity?
discriminant validity: degree of correlation between measures that are not expected to be related to one another
-->e.g scores on a measure designed to assess depression and another designed to assess intelligence should not correlate
What is criterion-related validity?
how well a measure predicts behaviour in settings where we would expect it to do so at the same time (concurrent validity) or in the future (predictive validity)
-->e.g a child's scores on social anxiety should predict that the child would display anxiety
What is observation?
-structured or unstructured
-vary from very inclusive observation of all behaviours to highly selective coding of very specific behaviours (e.g number of smiles)
-extensive time needed for observing and for coding and summarizing observations
-does not re
What are psychophysiological methods?
-assess the relationship between physiological processes and behaviour to identify which nervous system structures and processes contribute to children's atypical development and behaviour
-measure autonomic nervous system: blood pressure, breathing
-->ve
What is an EEG?
-the brain's measurable electrical activity with ongoing thinking, emotion, or state of arousal
-records electrical brain activity using electrodes attached to the surface of the child's scalp
Explain how EEG detects states of arousal.
-EEG waves are related to different states of arousal, differential patterns of EEG activation may suggest sleep disturbances or various emotional states
-greater amount of electrical activity in the right frontal lobe of the brain
-left frontal lobe is a
What are neuroimaging methods?
-examine the structure and/or function of the living brain
-identify abnormalities in the structure or functioning of specific brain regions or in how regions of the brain communicate with one another
-magnetic resonance imaging (MRI) and computed tomogra
What is fMRI?
fMRI registers neural activity in functioning areas of the brain
-shows which brain areas are active during mental operations (e.g mental math)
What is PET?
-PET scans assess cerebral glucose metabolism
What is dMRI?
-magnetic imaging that produces images showing connections between brain regions
-->key to the human connectome, which is the structure that organizes connections through the central nervous system
What can abnormal mental disorders show?
Abnormal mental disorders can show abnormal structural differences, abnormal activity in certain areas, or abnormal brain connectivity
What is unstructured observation?
- unstructured observation in the child's natural environment (naturalistic observation)
-sometimes the child is video recorded
What is structured observation
- structured observation:structured situations involving specific tasks or instructions carried out in the clinic or laboratory
-sets up a situation or provides instructions to elicit behaviours of a particular interest
-strange situation ~ attachment
What are advantages and disadvantages of observation?
-cost-effective, focus on the phenomena of interest: ideal for infrequent behaviour in everyday life
-might not be representative of the real-world: knowing they are being observed
-should be as 'behaviour in the presence of an observer", the observer inf
What does internal validity control for?
internal validity reflects how a particular variable, rather than extraneous influences, accounts for the results, changes, or group differences
What are extraneous influences?
-extraneous influences that could explain the results are called threats to internal validity
-->e.g maturation, effects of testing (how the test changes behaviour), subject-selection biases
What are threats to external validity?
external validity: degree to which findings can be generalized, or extended to people, settings, times, measures and characteristics other than the ones in a particular study
-threats to external validity include characteristics of the participants, react
What is comorbidity? Why is this disadvantageous in an experiment?
comorbidity: simultaneous occurrence of two or more childhood disorders that is far more common than would be predicted from the general population
-the treatment might treat one disorder better than the other and this could lead to false conclusions
-som
What is the independent and dependent variable?
independent variable is manipulated by the researcher, causes change in another variable
dependent variable, influenced by the independent variable
What is a true experiment?
true experiment: researcher has maximum control over the independent variable or conditions of interest and can use random assignment of subjects to groups, control conditions and control bias
What are correlational studies?
correlational studies, examine relationships among variable
What is a correlation coefficient? What can this tell us?
correlation coefficient, a number that describes the degree of association between two variables
-the size of the correlation indicates the strength of the association
-positive, as one variable increase so does the other
-negative, as one variable decrea
Why is random assignment protective?
random assignment of participants to treatment conditions protects against individual characteristics being the reason for the results
What are natural experiments?
natural experiments, comparisons are made between conditions or treatments that already exist
What is a retrospective design?
-retrospective design, a sample of people is identified at the current time and asked for information relating to an earlier time
-they select people who already have the outcome and compare them to people who do not
What are disadvantages to retrospective design?
-susceptible to bias and distortion in recall
-fail to identify the individuals who were exposed to certain earlier experiences but did not develop the problem (e.g people who experienced sexual abuse but did not develop an eating disorder)
What are real-time prospective designs?
real-time prospective designs: research sample is identified and then followed over time, data is collected at specific time intervals
-detect who develops and doesn't develop a disorder
What are the advantages and disadvantages to prospective design?
-loss of participants over time and long time to collect data
-less susceptible to bias and distortions
What is analogue research?
-specific variable of interest under conditions that only resemble or approximate the situation for which one wishes to generalize
-focus on circumscribed research questions under well-controlled conditions
-illuminate a specific process that would otherw
Explain the ADHD and college social drinker experiment.
male and female single college students who were social drinkers were randomly assigned to interact with boys who were trained to perform behaviours characteristic of either typical children (friendly and cooperative) or children with ADHD
-participants r
What are Case study?
-involves an intensive anecdotal, observation and analysis of an individual child, long tradition in the study of abnormal development and behaviour
-bring together a wide range of information about an individual child
-understand the child's psychologica
What is a single case experimental design?
-used to evaluate the impact of clinical treatment
-assessment of behaviour over time, the replication of treatment effects within the same subject over time
Explain the A-B-A-B design.
-a baseline of behaviour is first taken (A), followed by an intervention phase (B), then a return-to-baseline phase where the intervention is removed (A), and a phase where the intervention is reintroduced (B)
-if changes occur during the intervention pha
What is the problem with A-B-A-B?
-if the intervention really works, the behaviour may not reverse during the return-to-baseline phase
-not ethical to stop treatment if the child will be placed in harm
How is the baseline determined?
multiple-baseline designs across behaviours, different responses of the same individual are identified and measured over time to provide a baseline against which changes may be evaluated
How does the researcher determine if there is an effect?
-if behaviour changes when it is specifically stated, a cause-and-effect relationship between the treatment and the behaviour change is inferred'
-don't have to return to baseline when treating dangerous behaviours
How is the single-case replicated?
-successive introduction of treatment for the same behaviour in the same individual across situations or for the same behaviour across several individuals in the same situation
What are the advantages of single case?
-lower the amount of other possible alternative explanations such as maturation and reactivity
What are the disadvantages?
-specific treatments will interact with unique characteristics of a particular child
-limited generalizations
-subjectivity involved
What is a between-group comparison designs?
-experimental group and control group
-use this when we want to know whether it is better than the best available alternative treatment
What is cross-sectional research?
cross-sectional research: different children at different ages or period of development are studied at the same point in time
-don't lose participants, practice effects don't occur or general changes in the field
What is longitudinal research?
longitudinal research: the same children are studied at different ages or periods of development
What was the relationship between physical abuse and social relations?
kids who were physically abused were more disliked, less popular and socially withdrawn, as they aged they were disliked more
-maltreatment disrupts relationships with adults which impairs the child's social abilities
What is prospective longitudinal design?
-patterns that are common to all children and tracks differences in developmental paths
-causal interpretations can made be made the prior events caused later events
What are the problems with longitudinal effects?
-aging effects are general changes that occur because as participants age there are increases in physical prowess, impulse control or social opportunity
-cohort effects are influences related to being a member of a specific cohort
-being repeatedly studie
What is a cohort?
-cohort: a group of individuals who are followed during the same time and experience the same cultural or historical events
-->teens you live in a worn torn country differ from north american teenagers
What is qualitative research?
-focuses on narrative accounts, descriptions, interpretation, context and meaning
-describes, interpret, and understand the phenomenon of interest in the context where it is experienced
-intensive and intimate understanding of the situation
What are the advantages and disadvantages for qualitative research?
-biased by the researcher's values and preferences
-findings cannot be generalized
-identify important dimensions and theories that can be tested
-illuminate the meaning of quantitative studies
What is IPA?
-IPA, qualitative research approach that captures the richness and diversity of participants accounts by uncovering central themes that emerge from their talk
What is Quantitative Research?
-operational definitions, careful control of subject matter, isolation of variables
-quantification of dimensions of interest and statistical analysis
Can we use harmful procedures?
-can't use harmful procedures but occasionally mildly stressful conditions and anxiety-producing stimuli are used
What is informed consent?
informed consent: all participants are fully informed of the nature of the research: risks, benefits and expected outcomes and alternatives, they can withdraw at any time
What is assent?
assent: child shows some form of agreement to participate without understanding the full significance of the research
-you need to obtain this from school age children (7 years old)
-consider age, developmental maturity, psychological state and family fac
What is voluntary participation? WHy do we have to be careful with it?
-families can feel that their treatment or quality of care will be threatened if they do not participate in the research
-parents who mistreat their children may feel that their failure to participate in research could result in the loss of their child, a
What do we have to consider when using harmful procedures?
-procedures that are the least stressful to the child and family
-if it is harmful, the gains must significantly outweigh the risks
-the time and resources a research project will require should match the knowledge that it will obtain
-if it is harmful an
Which types of research has ethical concerns?
ethical concerns are important when research involves invasive procedures, deception, the use of punishment, the use of participant payment or other incentives, or possible coercion
What do researchers need to keep in mind when developing experiments for kids with mental disorders?
-motivating the children
-keeping within the time limitations
-ensuring instructions are well understood
-coping with boredom
-distraction
-fatigue
What is a clinical assessments?
clinical assessments: systematic problem-solving strategies to understand children with disturbances and their family and school
-assess the child's emotional, behavioural, and cognitive functioning as well as the role of environmental factors
-hypothesiz
What is idiographic case formulation?
idiographic case formulation: obtain a detailed understanding of the individual child or family as an unique entity
What is nomothetic formulation?
nomothetic formulation: emphasizes broad general inferences that apply to large groups of individuals (e.g children with a depressive disorder)
What is nomothetic knowledge?
-nomothetic knowledge about principles of psychological assessment, normal and abnormal child and family development, and specific childhood disorders can result in better hypotheses to test at the idiographic level
How do boys and girls suffer differently?
-girls suffer silently whereas boys express hyperactive behaviour and are more likely to be brought in to a psychologist with their parent
What is relational aggression?
-relational aggression: gossip, insults, ostracism
-->girls express this more
How is aggression gendered?
-children who engage in forms of social aggression that are not typical of their sex (e.g girls punching) are more maladjusted than are children who engage in gender-normative forms of aggression
Why does the DSM-5 include culture criteria?
-assessment, diagnosis and treatment of children with emotional and behavioural problems needs to be culturally sensitive
-information about the impact of culture on the child's presenting problems and implications for treatment
-cultural patterns reflect
Which types of disorders are blacks and white most likely to get diagnosed with?
African American adolescents were more often diagnosed with organic/psychotic disorders and less often with mood/anxiety disorders
white children are more likely to receive treatment than hispanic and african children
What do you need cultural formulation for?
cultural formulation is necessary to establish a relationship with the child and family, motivate family members to change, obtain valid information, arrive at an accurate diagnosis, and develop meaningful recommendations for treatment
What are cultural syndromes?
cultural syndromes: a pattern of co-occurring, invariant symptoms associated with a particular cultural group, community, or context
-culture affects the expression of symptoms and disorders
-cultural syndromes are not always seen as a disorder in the cul
When are mental health issues difficult to treat?
-difficult to engage parents from cultures if mental health issues are taboo, interventions into personal family matters by strangers is viewed negatively or if the causes of the illness in the culture are seen as physical or spiritual
Why is it difficult to determine whether a behaviour is normative?
-difficult for parents to determine if their child's behaviour is normal, especially if it is immigrant parents
-age inappropriateness, severity, and pattern of symptoms rather than individual symptoms define abnormal childhood disorders
-->impair functio
What are clinical descriptions?
clinical descriptions: summarizes the unique behaviours, thoughts, and feelings that together make up the features of the child's psychological disorder
-establish basic information about the child's concerns at presentation, how their behaviour or emotio
What is a diagnosis?
diagnosis: analyzing information and drawing conclusions about the nature or cause of the problem, or assigning a formal diagnostic label for a disorder
What is taxonomic diagnosis?
taxonomic diagnosis: focuses on the formal assignment of cases to specific categories drawn from a system of classification such as the DSM-5 or from empirically derived traits or dimensions
What is problem solving analysis?
much broader meaning of diagnosis is similar to clinical assessment and views diagnosis as a process of gathering information to understand the nature of an individual's problem, its possible causes, treatment options, and outcomes
What is prognosis?
prognosis: formulation of predictions about future behaviour under specified conditions
clinicians must consider: if the circumstances will remain the same, improve or deteriorate with or without treatment
What is the goal of treatment?
-treatments want to enhance a child's development rather than removing symptoms
What is treatment planning and evaluation?
using assessment information to generate a plan to address the child's problem and to evaluate the effectiveness of the treatment
What is multimethod assessment approach?
multimethod assessment approach: emphasizes the importance of obtaining information from different informants in a variety of settings and using a variety of methods that include interviews, observations, questionnaires, and tests
-which assessment to use
What is a clincal interview?
-often kids do not understand why they are seeing mental health, since they are not experiencing distress only those around them are
-interviewer observes nonverbal communications by the child and parent (e.g facial expressions, body posture, voice manner
What do intial assessments consider
developmental and family history
What do they consider in child's birth and related events?
-pregnancy and complications
-maternal drug use during pregnancy
What do they look at in the child's developmental milestones?
-age they started to walk, talk, bladder control and self-help skills
What do they look at in the medical history?
-including injuries, accidents, operations, illnesses, and prescribed medications
What do they look at in family characteristics and history?
-age, occupation, cultural background and marital status of family members and the medical educational and mental health history of parents and siblings
What do they look at in the child's interpersonal skills?
-relations with adults and other children and play and social activities
What do they look at in the child's educational history
-school attended, academic performance, attitudes toward school, relations with teachers and peeres and special services
What do they look at in the child's work history and relationships
-relationships with the same and opposite sex
What do they look at in the child's parent's expectations?
-assessment and treatment of their child and themselves
What do they look at in the description of the presenting problem?
-detailed description of the problem and surrounding events and how parents have attempted to deal with the problem in the past
What is an interactive interview?
-interactive interview (e.g using hand puppets) provides information about the child's emotional, behavioural, and peer problems
What is behavioural assessment?
-strategy for evaluating the child's thoughts, feelings, and behaviours in specific settings and using this information to formulate hypotheses about the nature of the problem and treatment
-more direct, rather than inferring how children think
What are target behaviours?
primary problems of concern, with the goal of then determining what specific factors may be influencing these behaviours
Why is good to have the observer from the same cultural background?
-when teachers rate youths from another cultural background, they rate them higher on behavioural and emotional problems
-a child's presenting problem can be different from the one eventually identified as the target for intervention
What are the ABCs?
A = Antecedents, or the events that immediately precede a behaviour
B = Behaviour(s) of interest
C = Consequences, or the events that follow a behaviour
A = whenever felicia's mother asks her to go to school (antecedent)
B = Felicia complains that she has
What is behaviour analysis?
behaviour analysis or functional analysis of behaviour: general approach to organize and use assessment information in terms of antecedents, behaviours and consequences
What is the goal of behaviour analysis?
-identify wide range of antecedents and consequences
-goal: identify as many factors as possible that contribute to a child's problem behaviours, thoughts, and feelings and to develop hypotheses
How can antecedents confirm hypotheses?
-some hypotheses can be confirmed or rejected by changing the antecedents and consequences to see whether the behaviour changes
What are the advantages of child behaviour checklist?
-can assess children in 80 or more cultural groups, able to evaluate immigrants, refugee and minority children
-assess progress in treatment and consider modifying treatment
-assess problem behaviours not specific disorders
What is behavioural observation with recording?
-parents or other observers record baseline (prior to intervention) on one or two problems they wish to change
-often use portable electronic device to cue parents to record and rate the intensity of specific symptoms
-parent's recordings are ongoing info
What are the indirect benefits of behavioural observation?
-->indirect benefits, observation skills, assessing parental motivation and providing parents with realistic estimate of their child's rate of responding and feedback with regards to the treatment
-->the parent gains these through observing their child
Explain role-play and parents who have abused their children.
-clinician could set up a role-play simulation in the clinic to see how the child and family might behave in daily situations encountered at home or school or in a problem-solving situation (e.g figuring out a game)
-when observing families who have physi
What are the advantages of observation?
-beneficial for decision making process
-families understand what may be required to conduct a thorough assessment and treatment plan
-helpful in assessing less motivated families
What is psychological testing?
-a test is a task or set of tasks given under standard conditions with the purpose of assessing some aspect of the child's knowledge, skill or personality
-tests are standardized on a defined referenced group (e.g SES, sex) referred to as a norm group
-an
What are disadvantages of psychological tests?
-often the normed sample was a limited sample and it might not be able to generalize to the entire population
-some standardization tests are culturally biased
-test scores need to be interpreted in the context of other assessment information
-observation
How have the disadvantages improved tests?
-selected normative groups that are representative of the population
-test items that are free from cultural bias
-provide tests that are fair to all test takers regardless of age, gender, disability, race, ethnicity, national origin, religion, sexual ori
What are developmental tests?
-used to assess infants and young children, screen, diagnosis, and evaluate early development
What is screening?
-screening: identify children at risk, who are referred for thorough evaluation
-young children at risk for developing later mental health problems are now being assessed more frequently
-growing recognition of the importance of early identification, inte
What are intelligence tests?
-evaluating a child's intellectual and educational functioning is key for many disorders
-some impairments in earning may result from their behavioural or emotional problems
-->e.g doing poorly in school because you don't want to go and you don't go
What is the Wechsler test?
defines intelligence as the 'overall capacity of an individual to understand and cope with the world around him'
-they help predict who will struggle in school
-represent different types of intelligence, emphasis on fluid-reasoning abilities, higher-order
What are projective tests?
-present the child with ambiguous stimuli (e.g picture of people) and the child describes what they see
-predicts personality
-the person says their unconscious thoughts that a clinician could not discover wit direct questions
-controversial with respect
What are personality tests?
-personality is an enduring trait that describes how a person interacts with the environment
-child's early temperament is the foundation of personality
What is a neuropsychological assessment?
-links brain functioning with objective measures of behaviour known to depend on an intact central nervous system
-behavioural measures can be used to make inferences about central nervous system dysfunction and the consequences of this dysfunction
-use t
What is classification?
-classification: system for representing the major categories or dimensions of child psychopathology, and the boundaries and relations among them
-idiographic strategy to highlight a child's unique circumstances, personality, cultural background and other
What is a nomothetic strategy?
-nomothetic strategy: determine the general category for the presenting problem
-DSM does not generalize well to children: different disorders, and its insensitivity to the developmental complexities that characterize the problem
What is categorical classification systems?
categorical classification systems: DSM-5 is an example, they are based primarily on informed professional consensus, an approach that has dominated and continues to dominate the field of child (and adults) psychopathology
What is classical categorical approach?
-classical categorical approach assumes that every diagnosis has a clear underlying cause such as an infection or a malfunction of the nervous system
-->each disorder is different from other disorders
What is an issue with the DSM-5?
-children's behaviour seldom falls into a category
What does dimensional classification assume?
dimensional classification approaches assume that many independent dimensions or traits of behaviour exist, and that all children possess them to varying degrees
What are dimensions?
-dimensions provide a useful estimate of the degree to which a child displays certain traits and not others, yet they often have to be tailored to the child's unique circumstances and developmental opportunities
What are externalizing and internalizing behaviours?
externalizing behaviour, aggressive/rule-breaking behaviours
internalizing behaviours, anxious/withdrawn/depressed behaviors
What is perferred dimensional or categorical?
dimensional approach is preferred for research
categorical approach is better for clinical purposes
-->good for communication among clinicians
What are DSM-specifiers?
-specifiers: describe more homogeneous sub groupings of individuals with the disorder who share particular features and to communicate information that is relevant to treatment of the disorder
-rate subtypes of disorder, co-occurring conditions, or the co
What are other considerations of the DSM?
-specify psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of clinical disorders
-note events that have been present over the past year
-unless a prior event (e.g car crash caused brain damage) still affects t
What are criticisms of DSM-5?
-fails to capture the complex adaptations, transactions, and setting influences that are crucial to treating psychopathology in children
-less attention to disorders of infancy and childhood than adulthood
-fails to capture the interrelationships and over
Explain how the DSM considers the visible not the invisible.
-large numbers of diagnostic categories of limited validity particularly with improving outcomes
-disorders are defined on observable signs and symptoms that fail to map closely onto the underlying causes for these disorders
What are pros and cons of diagnostic labels?
-labels help clinicians summarize and order observation, which enhances communication between clinicians
-descriptive terms, clinician can locate relevant research on the causes, epidemiology and treatment
-public stigma and media messages allow negative
What is intervention?
-many theories and practices that help children and families adapt to their current and future circumstances
-->not one clear intervention, different problems require different approaches
What is prevention?
-decreasing the chances that undesired future outcomes will occur
-better to promote health and prevent future problems
What is treatment?
-corrective actions that will permit successful adaptation by eliminating or reducing the impact of an undesired problem or outcome that has already occurred
What is maintenance?
-increase adherence to treatment over time to prevent relapse or recurrence
What do we need to consider about cultural views and practices?
-different ethnic groups have different parental values and use different child-rearing practices
-different beliefs in childhood problem, how mental health services are provided, how to describe their children' problems, and preferred interventions
What is cultural compatibility hypothesis?
-cultural compatibility hypothesis: treatment is likely to be more effective when it is compatible with the cultural patterns of the child and family
-certain treatments are better for certain ethnic groups
-might be good to match the clinician's ethnicit
How can treatments be adapted?
-treatments can be adapted: change in surface structure (e.g mode of service delivery, treatment setting) and deep structure changes (factors unique to a particular racial group, e.g cultural beliefs regarding how trauma affects health)
What are treatment goals?
-building on children's adaptation skills to facilitate long-term adjustment, rather than eliminating problem behaviours or briefly reducing subjective distress
What outcomes do you want with regard to child functioning?
-reduction or elimination of symptoms, reduced degree of impairment in functioning, enhanced social competence, improved academic performance
What outcomes do you want with regard to family functioning?
-reduction in family dysfunction, improved marital and sibling relationships
-reduction in stress, improvement of quality of life
-reduction in burden of care
-enhanced family support
What outcomes do want with regards to societal importance?
-improvement in the child's participation in school-related activities (e.g increased attendance)
-decreased involvement in the juvenile justice system
-reduced need for special services
-reduction in accidental injuries or substance abuse
-enhancement of
What role does medicine play in psychosocial interventions?
-children often require medication or medical intervention that must be coordinated with psychosocial interventions
-integration with effective teaching strategies
What are ethical standards?
-selecting treatment goals and procedures that are in the best interests of the client
-making sure that client participation is active and voluntary
-keeping records that document the effectiveness of treatment in achieving its objectives
-protecting the
How have laws helped children with mental disorders?
-children with disabilities have public education that emphasizes special education and related services to meet their needs and prepare them for employment and independent living
-the rights of children with disabilities and of the parents of such childr
What is the eclectic approach?
use different approaches is valuable
What are psychodynamic treatments?
-child psychopathology is caused by underlying unconscious and conscious conflicts
-help the child develop an awareness of unconscious factors that may contribute to his or her problems
-use play therapy (younger children) verbal interactions (older child
What are behavioural treatments?
-abnormal child behaviours are learned
-re-educating the child: positive reinforcement, time-out, modeling and systematic desensitization
-change the child's environment by working with parents and teachers
What are cognitive treatments?
-abnormal child behaviour as the result of deficits and/or distortions in the child's thinking
-perceptual biases, irrational beliefs and faulty interpretations (e.g thinking you are ugly)
What are Cognitive-behavioural treatments?
-the way children and parents think about their environment determines how they will react to it
-faulty thought parents: distortions in cognitive content and processes (e.g faulty problem solving)
-identify maladaptive cognitions and replace them with ad
What are client-centered treatments?
-child psychopathology as the result of social or environmental circumstances that are imposed on the child and interfere with his/her basic capacity for personal growth and adaptive functioning
-interference causes the child to experience a loss in self-
What are family treatments?
-psychopathology does not only reside within the individual, psychopathology is determined by variables operating in the larger family system
-manifestations of disturbances in family relations
-therapists interacts with the entire family
-adapt the famil
What are neurobiological treatments?
-pharmacological and other biological approaches for treatment
What are combined treatments?
-use of two or more interventions
What is treatment effectiveness?
-evidence-based treatment, shown to be effective in controlled research with specific populations
-expert-consensus approach, uses the opinions of experts to fill in the gaps in the scientific literature
What are best practices guidelines?
developed statements to assist practitioners and patients with decisions regarding appropriate treatments for specific clinical conditions
What is one pitfall of treatment?
-might reduce symptoms but not improve overall functioning
What is ADHD?
ADHD, persistent age inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life activities
inattentive: not focusing and behaving carelessly
hyperactive: constantly in motion
impulsive: acti
What are the core characteristics of ADHD?
-neurodevelopmental disorder, early onset and persistent course
What must be met for a diagnosis of inattention to be made?
Inattention: six (or more) of the following symptoms have persisted for at least 6 months that is inconsistent with developmental level and that negatively impacts social and academic/occupational activities
note solely manifestation of oppositional behav
What are the symptoms of inattention?
a) often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities
b) often has difficulty sustaining attention in tasks or play activities (e.g has difficulty remaining focused during lectures,
What must be met in order for a diagnosis of hyperactivity and impulsivity?
Hyperactivity and Impulsivity: six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and negatively impacts social and academic/occupational activities
-17 or older, 5 sympto
What are the symptoms of hyperactivity and impulsivity?
a) often fidgets with or taps hands or feet or squirms in seat
b) often leaves seat in situations when remaining seated is expected
c) often runs about or climbs in situations where it is inappropriate
Note: in adolescents or adults, may be limited to fee
When must symptoms of hyperactivity occur in order for a diagnosis to be made?
Several inattentive or hyperactive-impulsive symptoms were present before age 12 years Several inattentive or hyperactive-impulsive symptoms are present in two or more settings
symptoms interfere with, or reduce the quality of, social academic, or occupat
What are the different types of presentation of ADHD?
Combined Presentation: both inattention criteria and hyperactivity-impulsivity criteria are met for the past six months
predominantly inattentive presentation: inattention criteria is met but not hyperactivity criteria for the past 6 months
predominantly
What is partial remission?
partial remission: when full criteria were previously met, fewer than the full criteria have been met for the past six months, and the symptoms still result in impairment in social, academic or occupational functioning
What are the different types of severity?
mild: few, if any, symptoms in excess of those required to make the diagnosis are present and symptoms result in no more than minor impairments in social or occupational functioning
moderate: symptoms or functional impairment between mild and severe are p
What do the different dimensions predict?
-inattention leads to academic problems and peer neglect
-hyperactivity-impulsivity tend to predict aggressive behaviour and peer rejection, among other problems
What is attentional capacity?
attentional capacity: the amount of information we can remember and attend to for a short time
-Children with ADHD do not have a deficit in their attentional capacity
-they can remember the same amount of information for a short time as do other children
What is selective attention?
selective attention: ability to concentrate on relevant stimuli and ignore task-irrelevant stimuli in the environment
-->e.g voices distract you when you are studying for a test
What is distractibility?
distractibility: a deficit in selective attention
-ADHD children are distracted by stimuli that are highly salient and appealing
-all children find distractions disruptive to a certain extent
What is sustained attention?
sustained attention: ability to maintain a persistent focus over time on unchallenging, uninteresting tasks or activities or when fatigued
-->children with ADHD struggle with uninteresting or repetitive task, they do poorer than other children
-->even if
When do children with ADHD have optimal performance?
-they perform best on self-paced tasks that they chose, and what they find interesting and do not require sustained attention
What is alerting?
-an initial reaction to a stimulus
-the ability to prepare for what for what is about to happen
-helps the child achieve and maintain an optimally alert attentional state
-respond too quickly in situations requiring a slow and careful approach and too slo
What is hyperactivity-impulsivity?
under control of motor behaviour, poor sustained inhibition of behaviour, the inability to delay a response or defer gratification, or an inability to inhibit dominant responses in relation to ongoing situational demands
What is a sluggish cognitive tempo?
a cluster that includes symptoms such as daydreaming, trouble staying awake/alert, mentally foggy/easily confused, slow processing of information, stares a lot, spacey, forgets what was going to say, lethargic, hypoactive
ADHD-HI and ADHD-C
-struggle to inhibit behaviour
-more aggressive, defiant, rejected by peers, and suspended from school
What you need to make a diagnosis?
-developmental history
-parent and teacher reports
-normed assessment instruments
-behavioural observations
How is the DSM developmentally insensitive?
-the same symptoms apply to all ages, even though they are normative at certain ages
-it is categorical, however there are kids below the criteria requirements who experience impairment in function
How does the DSM not consider executive functions?
-cognitive processes in the brain that activate, integrate and manage other brain functions
-underlie the child's capacity for self-regulation functions such as self-awareness, planning, self-monitoring, and self-evaluation
-help us focus on multiple stre
What processes do children with ADHD have deficits in?
cognitive, language, motor, emotional
How do kids with ADHD have intellectual deficits?
-average intelligence
-difficulty in applying their intelligence to everyday life situations
-they don't live up to their potential
-lower IQ scores, might be due to lack of test-taking abilities
How do kids with ADHD have impaired academic functioning?
-children with ADHD experience difficulty in school, especially those with co-occurring disorders
-lower productivity, grades and test scores
-placed in special education classes
-may not finish post-secondary education or expelled or fail high school
What other disorder is common with kids with ADHD?
-many children with ADHD have a specific learning disorder, trouble with certain academic skills: reading, spelling, and math
What are distorted self-perceptions of ADHD kids?
-belief that these children must suffer low self-esteem
-they report higher self-esteem than warranted by their behaviour
-perceive strong relationships with their parents, teachers and peers (even when the peers see things in a negative light)
-kids with
What is positive bias?
positive bias: exaggeration of one's competence is referred to as a positive bias
What are distortions of quality of life?
distortions of quality of life, person's subjective perception of their position in life evidenced by their physical, psychological and social functioning
-->rate it higher than others do
Explain speech and language impairments in kids with ADHD.
-the type of speech and language impairment may be related to the child's specific ADHD symptoms
-preschoolers with hyperactivity-impulsivity related to poor language skills those inattention were correlated with weaker receptive and expressive vocabulary
What are health related problems linked to kids with ADHD?
-higher rates of enuresis and encopresis, and asthma
-asthma early in life increased the risk of developing ADHD
-dental health problems, poor fitness, obesity and eating problems and disorders (in females)
-sleep disturbances: resistance going to bed, di
Explain how kids with ADHD are accident prone.
-3x more likely to experience serious accidental injuries (e.g broken bones, bruises, burns)
-risk factor of cigarette smoking, substance-use disorders, video and internet game use problems, and addictions, and risky sexual behaviours such as multiple par
When are kids with ADHD more likley to develop conduct disorder?
-8 year old boys with ADHD but not conduct disorder were found to have more risky behaviours
-risky driving behaviours, STDs, head injuries and emergency department admissions
-more deaths not related to medical conditions
-the relationships between ADHD
What does impulsive behaivour predict?
-impulsive behaviour in childhood predicts reduced life expectancy
-accident-prone, auto accidents, risk taking, reduced concern for health-promoting behaviours (e.g proper diet, safe sex)
What social problems are linked to ADHD?
-most severe social disability are at greatest risk for poor adolescent outcomes and other disorders such as depression and conduct disorder
-they don't listen, hostile, argument, often in conflict with adults and children
-don't follow social rules, don'
What family problems are linked to ADHD?
-negativity, noncompliance by the child, excessive parental control, and sibling conflict
-parents experience distress, depression (mothers) and anti social behaviour, substance abuse in fathers
-parents of children with ADHD may have ADHD this can be a b
What are typical traits of parents with kids with ADHD?
-less parenting competence, fewer contacts with extended family, greater caregiver strain, less instrumental support, and higher rates of marital conflict, separation and divorce
-higher levels of parenting stress: fluctuations in the day as the child's b
How do siblings of children with ADHD feel?
-siblings of children with ADHD feel victimized by their ADHD sibling and that this experience is often minimized or overlooked
Why is ADHD linked to family problems?
often due to the child's co-occurring conduct problems rather than to ADHD symptoms
What peer problems are linked to ADHD?
-in boys and girls with ADHD show social interaction impairments
-bothersome, stubborn, socially awkward, and socially insensitive
-socially conspicuous, loud intense and quick to react
-socially active, usually 'off the mark': poor style, content, or tim
Why don't ADHD kids not have many friends?
-low social support from peer and have few friends
-can't recognize emotions in others and regulating their own emotions and behaviour and the aggressiveness that frequently accompanies ADHD often leads to social conflict and a negative reputation
-girls
What are there poor social skills?
-not deficient in social reasoning or understanding, they don't use what they know
-continue to be dominant or assertive even when the situation changes and requires accommodation, negotiation or submission
-their social agenda may differ from their peers
What is a theme that appears in ADHD friendships with peers?
-some adolescents with ADHD may meet their social needs by maintaining one or two positive close friendships
-the friendship might be based on 'having fun' rather than seeking 'emotional support'
What are accompanying psychological disorders and symptoms with ADHD?
-many people with ADHD have more than one psychological disorder
-->conduct disorders, anxiety disorders, mood disorders, and motor coordination and tic disorders, substance use disorders,
-many children with ADHD meet criteria for ODD, occurs more often
What are anxiety disorders?
-children who have ADHD are more likely to experience anxiety
-worry about being separated from their parents, trying something new, taking tests, making social contacts, or visiting the doctor
-they feel tense and constantly seek reassurance that they ar
What happens when a child has co morbidity with ADHD and anxiety?
-children with co-occurring ADHD and anxiety display social and academic difficulties and experience greater long-term impairment and mental health problems than those with either condition alone
What are mood disorders?
-depression is common, and increases as the children age
-they feel hopeless that they are unable to cope with everyday life
-depression lowers self-esteem, reduces pleasure, increases irritability, disrupts sleep, appetite, and the ability to think
-high
Why do many people with ADHD have developmental coordination?
-motor coordination difficulties (e.g poor handwriting, clumsy)
-impairments in motor skills domain of strength, visual motor coordination, adjusting speed, and dexterity
-many children with ADHD have developmental coordination disorder (DCD)
-DCD): motor
What are tic disorders?
-tic disorders: sudden, repetitive, non rhythmic motor movements or sounds such as eye blinking, facial grimacing, throat clearing and grunting
-experience more behavioural, social, and academic difficulties
Which gender is more at risk and why?
-occurs more frequently in boys
-boys are most likely referred more due to their overt defiance and aggression or because parents and teachers think that learning assistance is less effective for girls
Why is ADHD diagnosis baised?
-ADHD might go unrecognized if teachers fail to report inattentive behaviour unless it is accompanied by the disruptive symptoms demonstrated by boys
-DSM criteria were developed and tested with boys, and the criteria is more common in boys
Which symptoms are more likely to result in a referral?
-when girls display defiance and aggression they are referred at a younger age than boys, lower tolerance by adults or greater concern for their behaviours
-girls are more likely than boys to display inattention/disorganized symptoms characteristic of slu
What are the differences in symtpoms between girls and boys?
-girls and boys are quite similar with respect to their expression and severity of symptoms, brain abnormalities, deficits in response inhibition and executive functions, level of impairment, family correlates, response to treatment and outcomes
-female a
How is DSM culturally sensitive?
different criteria for diagnosis in different culture
-cultures that value reserved and inhibited patterns of child behaviour, symptoms of ADHD are less common
-if ADHD symptoms occurred in those cultures, the teachers view them as problematic due to the
What do symptoms of ADHD look like in preschoolers?
-ADHD is now visible and a problem
-act suddenly and without thinking, dashing from activity to activity, grabbing at immediate rewards, bored easily and react negatively to routine activities
-talk excessively and disrupt other children's activities
-if
What do symptoms of ADHD look like in elementary schoolers?
-inattention becomes evident
-->classroom demands sustained attention and persistence
-often referred for special assistance
-results in low academic productivity, distractibility, poor organization, trouble meeting deadlines, and an inability to follow t
What do symptoms of ADHD look like in adolescence?
-hyperactivity-impulsive declines, they still occur
-impairments in their emotional, behavioural, and social functioning
-symptoms of hyperactivity-impulsivity relate to poor adolescent outcomes
What do symptoms of ADHD look like in adulthood?
-some children outgrow their disorder or learn to cope with it (mainly those with mild and no comorbidity)
-children have better outcomes if their symptoms are less severe and who receive good care, supervision, and support from their parents and teachers
What are possible causes of ADHD?
-deficits in cognitive functioning, reward and motivation, arousal level, and self-regulation
-ADHD children show similar symptoms but different kinds of problems
-appears it is a neurodevelopmental disorder, genetic contributor
-environment affects the e
What have genetic studies found about ADHD?
-runs in families
-ADHD is higher in biological parents of children with ADHD compared with adoptive parents of children with ADHD
-twin studies, twins are a lot more likely to have ADHD
-specific genes may contribute to the expression of ADHD
What role does dopamine play in ADHD?
-dopamine is involved in psychomotor activity and reward seeking
-brain structures implicated in ADHD are rich with dopamine innervation: there is dopamine dysregulation in these brain structures
-primary medications reduce ADHD symptoms act by blocking t
What prenatal teterogens influence ADHD?
-maternal use of tobacco and more psychosocial stress, higher rates of ADHD
-->especially if they carry a genetic risk and female offspring
-mothers of children with ADHD use more alcohol, tobacco and drugs than do control parents
-cocaine use during preg
What neurobiological factors are altered in ADHD children?
-differences on psychophysiological measures (e.g galvanic skin response, heart rate), diminished arousal or arousability
-difference on brain activity during vigilance tests, under responsiveness to stimuli and deficits in response inhibition
-difference
What brain abnormalities are seen in children with ADHD?
-frontostriatal circuitry of the brain: prefrontal cortex and interconnected areas of gray matter located below the cerebral cortex
-associated with attention, executive functions, delayed responding and response organizations
-->impaired function in this
Explain the twin study for brain abnormalities.
-discordant twins, only the twin with ADHD shows abnormalities in these brain structures
What is the effect of the smaller cerebellum in ADHD?
-default mode network operates abnormally in ADHD, active at rest but shuts off during task engagement but not as effectively in those with ADHD
Where is delayed brain maturation in children with ADHD?
-delayed brain maturation in children with ADHD, especially the prefrontal regions
-brain development differences between those who had ADHD in adulthood and those who did not
What are the neurochemical findings in ADHD?
-norepinephrine, epinephrine, dopamine and serotonin are involved
-selective deficiency in the availability of dopamine and norepinephrine
Explain the kool Aid experiment
they gave kids kool-aid with aspartame and they told have the moms it had sugar
-the moms who were told their kids had sugar rated their behaviours more hyperactive
-moms who thought their kids had sugar were more critical of them, hovered more, and talke
What element could be a risk factor for ADHD?
-lead exposure could be a risk factor (unlikely)
How can family influence ADHD?
family influences may lead to ADHD symptoms or to a greater severity of symptoms
-symptoms can be the result of interfering and insensitive caregiving practices, especially if the child has a genetic risk for ADHD
-family conflict can raise the severity o
What is goodness of fit?
goodness of fit: match between the child's temperament and the parent's style of interaction
-->bad match higher risk for ADHD
-parents' ADHD symptoms may disrupt early parent-child interactions
-mothers with variants in DAT1 were more likely to be negati
How can interacting with a child who is impulsive lead to family problems?
-children with ADHD received stimulant medications showed a decrease in their symptoms
-produced a reduction in the negative and controlling behaviours that parents previously displayed when their children were not medicated
What is family conflict linked to with ADHD?
Family Conflict is likely related to the presence, persistence, or later emergence of associated oppositional and conduct disorder
-family conflict heightens the emergences of early ODD and later comorbid ADHD and CD
What is parent management training?
-managing disruptive child behaviour at home, reducing parent-child conflict, and promoting prosocial and self-regulating behaviours
What is education intervention?
-managing disruptive classroom behaviour
-improving academic performance
-teaching prosocial and self-regulating behaviours
Summer Treatment Programs
-enhancing present adjustment at home and future success at school by combining many of the primary and a
What is family counseling?
-coping with individual and family stresses associated with ADHd
-including mood disturbance and marital strain
What are support groups?
-connecting adults with other parents of children with ADHD
-sharing information and experiences about common concerns
-and providing emotional support
What is individual counseling?
-providing a supportive relationship in which youth can discuss personal concerns and feelings
What are stimulants?
-treat symptoms of ADHD since the chance discovery of their effectiveness
-dextroamphetamine, amphetamine-dextroamphetamine (Adderall), and methylphenidate (Ritalin) -most commonly used
What do stimulants do?
-stimulants produce increases in sustained attention, impulse control, and persistence of work effort and decreases in irrelevant activity
-may improve academic productivity: cooperation and social interactions with parents, teachers, and peers and physic
What are parent management training?
-manage their child's oppositional and noncompliant behaviours
-cope with the emotional demands raising a child with ADHD
-contain the problem so that it does not worsen
-keep the problem from adversely affecting other family members
Explain the education portion of parent management training.
-the parents are informed about ADHD so they understand the disorder
-->removes guilt
-use immediate, frequent and powerful consequences; strive for consistency; planning ahead; not personalizing the child's problems and practicing forgiveness
Explain the behaviour management portion of parent management.
behaviour management principles and techniques, identifying behaviours they wish to encourage or discourage, using rewards and sanctions to achieve specified goals, establishing a home token program, noticing when the child does well and praising their ch
What are parents encouraged to do?
-parents are encouraged to spend time with their child once a day
-parents learn to reduce their levels of arousal or anger and respond calmly to their child's behaviour
What are educational interventions?
-it is good to keep kids with ADHD with their peers when possible
-reward systems are ideal, for disruptive behaviour the behaviours can be punished with response-cost procedures that involve the loss of privileges, activities, points, or tokens
-posting
What is the Summer Treatment Program?
-engage in classroom and recreational activities with other children
-advantages: maximizes opportunities to build effective peer relations in normal settings and provides continuity to academic work to ensure that gains made during the school year are no
What is the most costly mental health problem?
CD
What is the legal perspective of conduct disorder?
-conduct problems are defined as delinquent or criminal acts
-delinquent acts include property crimes (e.g vandalism, theft) and violent crime
-excludes anti social behaviour of very young children that occur at home or school
What is juvenile delinquency?
-juvenile delinquency: children who broke a law, ranging from sneaking into a movie without paying to homicide
What is overt and covert behaviour?
-overt-covert: overt visible acts (e.g fighting) to covert hidden acts such as lying or stealing
-destructive and nondestructive categories
Which traits to overt children display?
-children who display overt antisocial behaviour tend to be negative, irritable, and resentful in their reactions to hostile situations and higher levels of family conflict
Which traits do covert children display?
-covert antisocial behaviour, less social, more anxious, and more suspicious of others and come from homes that provide little family support
Which type of behaviour are children with CD more likely to display?
children with CD usually display overt and covert problems
-in conflict with authority
-severe family dysfunction
-poorest long-term outcomes
What type of CD is likely to lead to later psychiatric problems?
children who display outvert-destructive behaviour are persistent physical fightings, are at high risk for later psychiatric problems and impairment in functioning
What is the public health view of CD?
-blends all the perspectives with public health concepts of prevention and intervention
What are people with ODD at risk for?
-at risk for developing impulse-control, substance use, and mood and anxiety disorder
What does ODD negatively affect?
-extreme ODD have negative effects on parent-child interactions
-child and adolescent ODD, predict social and interpersonal difficulties in early adulthood: poor functioning with peers and romantic relationships
What is the DSM definition of ODD?
A pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness lasting at least six months as evidenced by at least four symptoms from any of the following categories and exhibited during interaction with a least one individual who
What are the symptoms of ODD?
Angry/Irritable Mood
1) often loses temper
2) if often touchy or easily annoyed
3) is often angry or resentful
Argumentative/Defiant Behaviour
4) often argues with authority figures or, for children and adolescents, with adults
5) often actively defies or
What criteria must be met with regards to the symptoms?
Note: symptoms must correspond with age group. For children younger than 5 years, the behaviour should occur on most days for a period of at least six months unless otherwise noted. Individuals 5 years or older the behaviour should occur at least once per
What must we consider about the behaviour?
B) the disturbance of behaviour is associated with distress in the individual or others in his/her immediate social context (e.g family peer group, work colleagues) or it impacts negatively on social, educational, occupational, or other important areas of
What are the types of severity for ODD?
Mild: symptoms are confined to one setting (e.g at home, at school, at work)
Moderate: some symptoms are present in at least two settings
Severe: some symptoms are present in three or more settings
What are co-occurring problems with CD?
-co-occurring problems, such as ADHD, academic deficiencies and poor relations with peers
-parents often use harsh punishment that contribute to the problem and often have their own problems and stresses (e.g marital discord
-their parents feel these chil
What are the characteristics of early and adolescent onset for CD?
-children diagnosed with childhood-onset are more likely to be boys, show more aggressive symptoms, account for a disproportionate amount of illegal activity and persist in their antisocial behaviours
-adolescent onset, more likely to be girls, and do not
What is the DSM definition for conduct disorder?
A repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any
What are the symptoms of conduct disorder?
Aggression to People and Animals
1) often bullies, threatens, or intimidates others
2) often initiates physical fights
3) has used a weapon that can cause serious physical harm to others (e.g bat, knife, brick)
4) has been physically cruel to people
5) ha
What are the two types of CD?
-childhood-onset type: individual show at least one symptom characteristic of conduct disorder prior to age 10 years
-adolescent-onset type: individuals show no symptom characteristic of CD prior to age 10 years
-unspecified onset: criteria for a diagnosi
What are the two branches of CD?
with limited prosocial emotions: an individual must have displayed at least two of the following characteristics persistently over at least 12 months and in multiple relationships and settings. These characteristics reflect the individual's typical patter
What are severities of CD?
mild: few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause minor harm to others (e.g staying out after dark, truancy, lying)
moderate: the number of conduct problems and the effect on others
What is the ODD and CD connection?
-symptoms of ODD emerge 2-3 years before CD, at about age 6 as opposed to age 9
-ODD could be a precursor for CD, not a guarantee but it does happen
What is antisocial personality disorder?
-APD: pattern of disregard for, and violation of, the rights of others, including repeated illegal behaviours, deceitfulness, failure to plan ahead, repeated physical fights, or assaults, disregard for the safety of others, failure to sustain work behavio
How do adolescents show APD?
-adolescents with APD display psychopathic features, which are defined as a pattern of callous, manipulative, deceitful and remorseless behaviour
youths who display psychopathic features are aware of their aggressive behaviour causes others to suffer, but
What does callous and unemotional predict?
CU interpersonal and affective traits predict persistent delinquency, future recidivism and symptoms of APD in early adulthood
What are the IQ deficits in CD?
-score lower on IQ tests by about 8 points, greater for child-onset CD and is not accounted for SES, race or detection by the police
-related to the co-occurrence of ADHD
How is the verbal IQ lower in children with CD?
-verbal IQ is lower than performance IQ in children with CD; deficit in language
-affect the child's receptive listening, reading, problem solving, pragmatic language, expressive speech and writing, and memory for verbal material
-poor language ability pr
Why might verbal deficits be present?
-children with verbal deficits and family adversity display more aggressive behaviour
-->verbal deficits may make it more difficult for parents to understand their child's needs which leads to parents' frustration, fewer positive interactions, more punish
What are verbal abilities linked to?
-verbal abilities were negatively related to physical aggression but positively associated with theft, and their inductive reasoning was negatively associated with increases in theft across adolescence
What can children with CD not think of?
-children with conduct problems don't consider future consequences of their behaviour
-fail to inhibit impulsive behaviour, keep social values or future rewards in mind or adapt their actions to changing circumstances
-suggests deficits in executive funct
What are cool and hot executive functions?
cool executive functions: attention, working memory, planning and inhibition
hot executive functions: incentives and motivation
What is relation between cool and hot executive function in CD and ADHD?
-cool and hot executive functions are associated with distinct but interconnected brain networks
-cool EF are associated with deficits in ADHD
-hot EF deficits are associated with CD
-if the child has CD and ADHD they show both deficits
Explain the school and learning problem in children with CD.
-children with CD display school difficulties: underachievement, grade retention, special education placement, dropout, suspension and expulsion
-demoralization and frustration from school can lead to antisocial behaviour
-early language deficits may lead
Explain the family problems in children with CD.
general family disturbances: parental mental health problems, a family history of antisocial behaviour, marital discord, family instability, limited resources and antisocial family values
specific disturbances in parenting practices and family functioning
What is the realtion of maternal depression and CD?
-maternal depression leads to poor parenting practices that can lead to antisocial behaviour and feelings of parental incompetence that may lead to increased maternal depression
What are issues with parents and kids with CD
-high levels of conflict, poor parenting practices (e.g ineffective discipline, negative control, inappropriate use of punishment and rewards, failure to follow through on commands, and a lack of involvement in child rearing
-parent could exhibit social-c
What are households like with kids who have CD?
-lack of family cohesion, reflected in emotional detachment, poor communication and problem solving, low support and family disorganization
-household chaos, high noise levels, crowding, people coming and going all the time, lack of predictability and fam
What are sibling relations like between siblings and CD siblings?
-conflict is high among siblings
-non-referred siblings sometimes display as much negative behaviour as their referred siblings, even when the sibling with conduct problems is not present
-not immediate reactions to the annoying behaviours of their antiso
What are common peer problems?
-verbal and physical aggression toward other children and poor social skills
-preschoolers who show poor self-regulation have difficulty understanding the perspectives of others, experience corporal punishment from their parents, and display higher levels
What are the child's friendshps like? When are criminal offenses likley to occur?
-they can become bullies, continue conduct problems into adolescence
-they often friendships with like-minded antisocial individuals, associating with deviant peers is a powerful predictor of conduct problems
-they transition into criminal acts (e.g steal
What is bullying?
bullying: one or more children intentionally and repeatedly expose another child who cannot readily defend himself to negative actions
-->involves imbalance of power
-youths with a particular genotype were found to be less likely to suffer adverse effects
What are typical characteristics of victims?
-anxious and submissive behaviour
-low self-esteem
-physical weakness (boys)
-signal to others that they are attacked or insulted, they won't retaliate
What are typical characteristics of bullys?
-impulsive, need to dominate other people
-stronger than other boys
-little empathy for their victims
-derive satisfaction and material gain from inflicting injury on their victims
-later convicted of criminal offenses
What are friendships between antisocial boys like?
-abrasive, unstable, short duration and not productive
-positive exchanges are extinguished by bossy and coercive behaviours
-deviant talk: reward each other about talking about rule breaking
-don't talk about prosocial items
-predictor of substance use
What is a problem with group counseling?
-there are programs to help people with CD, but clumping them all together and allowing them to form friendships may lead to poor outcomes
How do CD kids misinterpret agression?
aggressive children have distortions in their thoughts about social situations
-underestimate their own aggressiveness and its negative impact and overestimate the amount of aggression directed at them
What is hostile attributional bias? Who displays this?
-reactive-aggressive children (show angry, defensive response to frustration or provocation) display a hostile attributional bias,
-hostile attributional bias: attribute hostile and mean-spirited intent to other children, especially when the intentions of
Who are proactive-aggressive children?
-proactive-aggressive children: aggressive behaviour deliberately to obtain a desired goal, view their aggressive actions as positive and value social goals of dominance and revenge rather than affiliation
-->lack of concern for others, and their solution
What is maternal hostile attribution bias?
-maternal hostile attributions were related to psychosocial adversity, poor parenting, hostile attributions of the child and child aggression at five years of age
What is relation between CD and self-esteem?
-kids with CD have low self-esteem
-low self-esteem does not cause CD
-CD is related to an inflated, unstable view of self
-overestimate their social competence and acceptance by other children
-threat to their biased view, may lead to aggressive behaviou
What are health related problems with CD?
-high risk for personal injuries, illnesses, drug overdoses, STDs,
-premature death
-antisocial behaviour predicts early sexual activity, and risky sex
-->increases pregnancy and disease
What are youths who have sold drugs more likley to do?
youths who have used or sold drugs are more likely than nonusers to carry a handgun, belong to a gang, use alcohol, or engage in antisocial behaviours
Why do kids with CD also have ADHD?
-a shared predisposing vulnerability such as impulsivity, poor self-regulation, or temperament may lead to both ADHD and CD
-ADHD may be a catalyst for CD by contributing to its persistence and escalation to more severe forms, particularly when shaped by
What are the difference between CD and ADHD?
-ADHD is less associated with cognitive impairments, neurodevelopmental abnormalities, inattentiveness in the classroom, and higher rates of accidental injuries
Which two disorders are linked to ODD?
-50% receive a diagnosis of anxiety or depression
-ODD might be the precursor for depression or anxiety, due to the negative mood ODD produces rather than defiant behavoiur
What are the outcomes of CD for girls and boys?
-boys with CD and internalizing problems have poor outcomes in early adulthood
-highest risk of psychiatric disorders and criminal offenses
-girls with CD develop depression or anxiety by early adulthood
-both sexes, increasing severity of antisocial beha
How is anxiety protective?
-co-occurring anxiety has been identified as a protective factor that inhibits aggressive behaviour
-anxiety increases their risk for later antisocial behaviours
What is unique about boys with CD and anxiety disorder?
-boys with CD and anxiety disorder show higher cortisol associated with a greater degree of behavioural inhibition, anxiety is a protective factor
boys with CD, lower cortisol and is associated with aggressive and disruptive behaviour
What is the prevalence of ODD and CD?
-ODD is more prevalent than CD during childhood
-by adolescence prevalence is equal
-ODD either declines or stays constant from early childhood to adolescence
-CD increases over the same period
-prevalence is equal across countries and cultures
What are the gender differences in ODD and CD?
-boys use more physical aggression than girls
-girls can behave aggressively but they are less likely to
-early symptoms for girls are sexual misbehaviours
-early symptoms for bossy is aggression and theft
-antisocial girls develop relationships with anti
Why do boys show overt aggression?
-conduct problems have more emphasis on physical aggression and minimal emphasis on less physically aggressive forms of antisocial behaviours shown by girls
-girls show relational aggression, e.g gossip
-girls become more upset than boys by aggressive soc
What are referred boys and girl characteristics?
-referred boy and girls show the same amount of externalizing behaviour
-referred girls are more deviant than boys in relation to their same-age, same-sex peers
-girls' behaviour is more covert and overt is more common in boys
How does menarche affect oDD and CD?
-early onset of menarche predicts increased delinquency particularly girls in mixed-gender schools
-boys model antisocial behaviour and pressure girls for early sexual relations may interact with the early physical maturation of girls
-girls reaching mena
What is a risk of early maturing boys and girls?
-early maturing boys and girls are more at risk of being exposed to peers who may draw them into delinquent behaviour
-early maturing children who had been maltreated, exposure to abuse had a greater effect on the development of delinquency than did expos
What are the first signs of CD?
-earliest indication of conduct problems is a difficult temperament, not strong
-fussiness was a stronger predictor for boys
-fearfulness was a stronger predictor for girls
What are characteristics of ODD in preschoolers?
-preschoolers with ODD display stubbornness, temper tantrums, irritability, and spitefulness--remain stable from 2 to 5 years
-discipline problems, poor self-control, and emotion regulation, especially when accompanied by harsh parenting and high levels o
What is diversification?
-diversification: they add new forms of antisocial behaviour over time rather than replacing old behaviours
Explain how kids with ODD have bad social skills.
-poor social skills and social-cognitive deficits often accompany early oppositional and aggressive behaviours, predisposing the child to poor peer relationships, rejection by peers and social isolation and withdrawal
-when the child enters school, impuls
What is the snowballing negative cycle?
-snowballing negative cycle, one defect or problem behaviour produces changes in others
-->e.g peer rejection leads to social-cognitive deficits and aggression; social-cognitive deficits lead to peer rejection and aggression; aggression leads to peer reje
Who improves with early onset?
children with early onset who improve are those with mild symptoms
What are the paths of CD?
-children who display antisocial behaviours and then desist at a young age
-problems may emerge in young adulthood
-children may display a chronic low level of persistent antisocial behaviour from childhood or adolescence through adulthood
What is the life-course persistent path?
-life-course-persistent path : small group that shows them their whole life
-children who engage in aggression and antisocial behaviour at an early age and continue to do so into adulthood
Explain how CD behaviours change with age.
-disposition remains constant, expression changes due to new opportunities
-psychological deficits that may interfere with their development of language, memory, and self-control resulting in cognitive deficits and a difficult temperament by age 3 or youn
What is adolescent-limited path?
-adolescent-limited path: majority display antisocial behaviour that occurs during adolescence
-doesn't continue into adulthood
-less severe antisocial behaviours
-less likely to drop out of school
-stronger family ties
-related to situational factors (e.
What is the affect of adult privileges?
-attraction of forbidden adult privileges may motivate youths with previous risk signs to engage in antisocial behaviours as they enter adolescence
-they see their LCP peers obtaining adult privileges, they may mimic them
-when adult privileges become ava
What are snares?
persistence in early adulthood is often the result of snares, outcomes of antisocial behaviour that close the door to getting a good job,
-common snares include unplanned parenthood, dropping out
What are adult outcomes of CD?
-crimes decreases as ages increases
-adult outcomes depend on the type of CD and other risk and promotive factors
-some go on to display criminal behaviour, psychiatric problems, social maladjustment, health problems, lost productivity and poor parenting
What is the genetic influence?
-50% of variance of antisocial behaviour is attributable to heredity for both males and females
-higher for aggressive versus nonaggressive CD in childhood versus adolescence
-genetic increase the likelihood that a child will be exposed to environmental r
What is the affect of MAOA?
-a variant of the gene that encodes the neurotransmitter metabolizing enzyme monoamine oxidase A (MAOA) is related to neural systems involved in aggression
-activation of the MAOA enzyme helps us inhibit an aggressive response, regulates behaviour
-maltre
What are prentaal and birth complications?
-low birth weight are related to CD
-malnutrition during pregnancy, might be due to protein deficiency
-exposure to lead before and after birth
-nicotine, marijuana or other substances during pregnancy
-alcohol use
-these are correlations, good parents wo
What are neurobiological factors?
-behavioural activation system (BAS) stimulates behaviour in response to signals of reward or nonpunishment
-behavioural inhibition system (BIS) produces anxiety and inhibits ongoing behaviour in the presence of novel events, innate fear stimuli and signa
What is the BIS and BAS connection to CD?
-antisocial patterns of behaviour may be a result of an overactive BAS and an underactive BIS
-CD children fail to respond to punishment and continue to respond under conditions of no reward, consistant with underactive BIS
What is the role of HPA and CD?
-variations in stress-regulating mechanisms, including the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS)
-children with CD (early onset) display low psychophysiological cortical arousal and low reactivity of the ANS (e.g
What is the connection between low arousal and autonomic reactivity and CD?
-low arousal and autonomic reactivity leads to diminished avoidance learning in response to warnings or reprimands, a poor response to punishment, and a fearless, stimulus-seeking temperament
-could lead to antisocial behaviour, failure to develop the ant
Which brain regions are involved in CD?
-amygdala, prefrontal cortex, posterior and anterior cingulate and insula, and interconnected regions
-->psychopathic features, seen in CD
-reduced activation in some of these areas when viewing emotional stimuli (e.g angry faces) or during tasks that req
WHich three neural systems influence CD?
-subcortical neural systems abnormalities lead to aggressive behaviours
-prefrontal cortex decision making circuits and socio emotional information-processing circuits that assess social cues and evaluate the consequences of aggressive or not aggressing
-
What social cognitve factors are influenced by CD?
-skills involved in attending to, interpreting, and responding to social cues
-social cognitive deficits and antisocial behaviour across all types of conduct problem trajectories especially early onset
-CD kids show social-cognitive impairments
-egocentri
How is the expression of CD explained by parenting factors?
-positive parenting practices may reduce the influence of the child's genotype on later antisocial behaviour
-negative parenting practices can have the opposite effect
-a combination of individual child risk factors and extreme deficits in family manageme
What is the relation between abuse and CD?
-physical abuse is a strong risk factor for later aggressive behaviour
-deficits in the child's social information processing result from physical abuse
-contact with an absent father after the divorce can be a risk or protective factor for antisocial beh
Why do parent often lash out on their kids with CD?
-cruel and aggressive child behaviours can evoke strong reactions (e.g anger, harsh punishment)
-negative parenting practices may lead to antisocial behaviour, but they may be the reaction to the aggressive behaviours of their children
Explain the experiment of mothers with and without CD kids.
-mothers with or without a child with CD interacted with three boy
-a son, a boy with CD and a boy without CD
-all mothers were more demanding and negative when interacting with a child with CD
-->child to parent effect
-mothers of boys with CD responded
What is the coercion theory?
-coercive parent-child interactions are made up of well-practiced actions and reactions, which may occur with little awareness
What is the reinforcement trap?
-reinforcement trap: all family members become trapped by the consequences of their own behaviours
How does CU affect parenting?
-relationship between parenting and conduct problems also appear to be affected by a child's callous-unemotional traits
-ineffective parenting was related to conduct problems, but only in children who were rated low on CU traits
-children with CU traits d
What is the best form of discipline for kids with CD?
-the relationship between parental discipline and conduct problems may be affected by discipline - too much or too little can be adverse effects
-discipline may be most effective in same gender parent-child pairs: discipline of daughters by mothers and so
What are the attachment theories for kids with CD?
-children with CD show little internalization of parental and societal standards
-even when they comply with parental requests; they may do so because of perceived threats to their freedom or physical safety
-when the threats are not present (when the chi
What is relation between instable families and CD?
-children with CD are often in unstable families with frequent transitions (e.g residence and parents)
-risk for antisocial behaviour, academic problems, anxiety and depression, association with deviant peers and criminal conviction
What is the relation between family stress and CD?
-high family stress is associated with negative child behavior in the home, may be a cause and an outcome of antisocial behaviour
-poverty is a strong predictor of childhood CD and high rates of criminal activities
What is the amplifier hypothesis?
amplifier hypothesis: stress amplifies the maladaptive predispositions of parents (e.g poor mental health), disrupting family management practices and compromising parents' ability to be supportive of their children
What is the connection between parent's criminality and psychopathology and CD?
-children's aggression is correlated with their parents' childhood aggression is correlated with their parents' childhood aggression at the same age
-parents of antisocial children have higher rates of arrests, violations, license suspensions, and substan
What is the affect of neighbourhood and on CD?
-antisocial people tend to select neighbourhoods populated by other people who are like them
-social selection hypothesis: the people who move into different neighbourhoods differ from one another before they arrive, and those who remain differ from those
What is the affect of schools on CD?
-poor quality school is associated with antisocial and delinquent behaviour
-positive school experience can be a protective factor for the development of these behaviours
-->can compensate for poor family circumstances
-promoting positive school character
Is there a connection between media violence and CD?
-a short term precipitating factor for aggressive and violent behaviour that results from priming excitation, or imitation of specific behaviours
-a long term predisposing factor for aggressive behaviour acquired via desensitization to violence and observ
What is the effect of media violence?
exposure to media violence may reinforce pre-existing antisocial tendencies in some children
-children with CD viewed large amounts of violent material, prefer aggressive characters and believe fictional content to be true
-childhood exposure to media vio
How do cultural factors affect aggression?
-socialization of children for aggression has been found to be one of the strongest predictors of aggressive acts such as homicide and assault
How do minorities affect aggressive behaviours?
minority status is related to antisocial behaviour in USA
-however, race doesn't cause antisocial behaviour other factors do
-economic hardships, limited employment opportunities, residence in high-risk urban neighbourhoods and membership in antisocial ga
Who was CD highest in?
-migration status affects CD risk
-CD was highest among Mexican American children of U.S born parents compared to children of Mexican-born immigrants raised in the united states or the general population of Mexico
What often needs to be included in the treatment?
-often you need to treat related family problems (e.g maternal depression, abuse)
What is parent management training?
-teaches parents to change their child's behaviour in the home and in other settings using contingency management techniques
-the focus is on improving parent-child interactions and enhancing other parenting skills (e.g parent-child communication, monitor
What are the advantages and disadvantages of PMT?
-short-term effectiveness
-reductions in problem behaviours of siblings and reduced stress and depression in the parents
-most effective with parents of children younger than 12
-very demanding (must attend meetings) used smartphones to alleviate some of
What is problem-solving skills training?
-identifies the child's cognitive deficiencies and distortions in social situations and provides instruction, practice and feedback to teach new ways of handling social situations
-the child learns to appraise the situation change his or her attributions
What is multisystemic therapy?
-an intensive approach that draws on other techniques such as PMT, PSST, and marital therapy
-specialized interventions such as special education, and referral to substance abuse treatment programs or legal services
-good for severe cases
-often youths yo
What are preventive interventions?
-conduct problems can be treated more easily and effectively in younger children
-by counteracting risk factors and strengthening promotive factors, it is possible to limit or prevent the developmental trajectory
-preventive interventions will reduce the
What are prevention programs?
-uses videotapes for training: child management skills
-addresses antisocial individual, family and school difficulties
-parents are taught personal self-control for managing anger, depression and blame
-learn effective communication skills and coping str
What is gambling consider?
addictive disorder
What is a substance use disorder?
-substance use disorders during adolescence involve self-administration of any of the substances that alters mood, perception or brain functioning, resulting in substance abuse or substance dependence
What is psychological dependence?
the subjective feeling of needing the substance to adequately function
What is physical dependence?
occurs when the body adapts to the substance's constant presence
What is tolerance?
requiring more of the substance to experience an effect once obtained at a lower dose
What is a substance disorder according to the DSM?
-a problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12 month period:
What are the symptoms of substance use disorder?
1) substance is often taken in larger amounts or over a longer period than was intended
2) there is a persistent desire or unsuccessful effort to cut down or control substance use
3) a great deal of time is spent in activities necessary to obtain substanc
Specify which type of remission the person is at.
in early remission: none of the criteria have been met for at least 3 months but for less than 12 months (with the exception of 'craving')
in sustained remission: none of the criteria have been met at any time during a period of 12 months or longer (with
What do you need to consider about the environment?
in a controlled environment: this additional specifier is used if the individual is in an environment where access to substance is restricted
Specify which type of severity.
mild: two to three symptoms
moderate: four to five symptoms
severe: six or more symptoms
Which symptoms are more common in adolescents?
physiological dependence and symptoms are less common in adolescents
-adolescents experience withdrawal symptoms
-more likely to show cognitive and affective features associated with substance abuse and/or withdrawal, such as disorientation or mood swings
Why is SUDS expressed differently in youths?
SUDS in youth differ in the pattern of use: function of the restrictions on availability
-->adolescents drink less frequently but larger quantities
-substance use is influenced by peers, the desire for autonomy and experimentation with adult privileges an
What is the prevalence of SUDS?
-alcohol is most prevalent substance used and abused by adolescents
-cigarette smoking has decreased
-marijuana use is increasing
How does the age of onset affect the course?
-alcohol use before age 14 is a strong predictor of subsequent alcohol abuse or dependence
-age at first use is a widely used risk factor
What is the prevalence across genders and ethnicity?
-girls use fewer types of drugs and less often
-rates of diagnoses for SUDs is equal across genders
-african american youths lower illicit drug use
What is the course of SUDS?
-rates of substance use peak around late adolescence, and decline during young adulthood
-early-onset risk taking may signal a more troublesome course
What do teens use? What is the effect of these substances?
-substance use is common among teenagers, it can be harmful: lowers inhibitions, reduces judgment, and increases the risk of physical harm and sexual assault
-alcohol use lead to unsafe sexual activity, smoking, and drinking and driving
-girls in violent
What is the critical neurocognitive abilities?
-adjustments in the sleep-wake cycle that occur during adolescence can lead to a misalignment between teens' sleep-wake schedules and their internal circadian timing
-alters the adolescent's reward-related brain functions
-critical neurocognitive abilitie
What is sensation seeking?
sensation seeking: preference for novel, complex and ambiguous stimuli, it has been linked to high-risk behaviors including substance use
What does sensation seeking predict?
sensation seeking had a strong predictive value for both current and future marijuana and alcohol use
-->stronger for marijuana than alcohol
-males are more likely to be sensation seekers as well as whites
-sensation seeking is not stable over time, sugge
What personal views affect substance use?
positive attitudes about substance use (e.g high perceived benefit) and having friends who hold similar views is associated with substance use
-perceiving oneself to be physically older than same age peers and striving for adult social roles are risky att
What family background is predictive of substance use?
-positive family history for alcoholism may inherit certain brain structures and functional abilities
-greater activation in the frontolimbic areas of the brain, as compared with teens without such family histories, this activation is associated with poor
Explain the effect of alcoholic parents.
-children who have alcoholics as parents , these parents are less involved, less affectionate, inconsistent parenting, poor monitoring, and negative parent-child and interparent interactions which increase the risk of substance use
Explain how parental expectations influence substance use.
-if teens held positive expectancies and parents hold low expectations of their children, they are more likely to drink
-whereas if they held these beliefs but their parents had clear expectations they would not use alcohol, they are not likely to use it
What is the affect of low parental monitoring?
low parental monitoring (e.g don't know where there adolescent is) is a predictor of adolescent substance use
-the perception of parental monitoring is important
-a significant protective effect of perceived parental monitoring in predicting lower levels
What is the effect of deviant peers?
-associating with deviant and substance-using peers causes youths to adopt beliefs supporting drug use
-affiliation with these peers also increases access to substances
What is false consensus?
-false consensus (e.g the belief that everyone is doing it) exerts pressure on youths to engage in substance use
-the extent to which youths believe their group is using substances is related to the individual's decision to use or not use substances
-peer
What is treatment for SUDS?
-relapse is common
-most effective treatment involve the larger systems affecting the adolescent's behaviour (e.g peers, family, and school climate)
-focus on personality factors linked to alcohol abuse (e.g hopelessness, anxiety sensitivity, impulsivity,
What is multisystemic therapy?
multisystemic therapy, involves intensive intervention that targets family, peer, school and community systems
-effective treatment of SUDs among delinquent adolescents
-parents are provided step by step guidelines for implementing contingency management
What is motivational interviewing?
motivational interviewing uses a patient-centered and directive approach and addresses the ambivalence and discrepancies between a person's current values and behaviours and their future goals
-type of treatment depends on levels of use and home environme
What is life skills training?
life skills training, program that emphasizes building drug-resistance skills, personal and social competence and altering cognitive expectancies around substance use
What is incidence?
new cases over a time period
What is prevalence
all cases during a timer period
What is critical for epidemiology?
-sampling and measurement of disorder are critical for this type of study
Why is sampling important?
-random sampling is required
-need random sampling for prevalence otherwise you cannot generalize
-need to be able to generalize to the population of interest
What is the ontario child health study?
-childhood psychiatric disorders and how common they were
-population of interest is all children in Ontario
-need a sample that allows for generalization to all children in Ontario
-->random sampling approach
-->percentage of people who are contacted who
How can measures very?
-e.g prevalence rates shift depending upon who the informant is (e.g parent, teacher talking on behalf of the kid)
Who has a certain problem?
Assess factors that influence rates and distribution of a disorder in a population
-Demographic factors: age, gender, SES
What are issues in determining causality?
-low SES is associated with child psychopathology
-does that mean SES causes child psychopathology? no
-factors associated with poverty (e.g high crime) may lead to disorder
-it may be the parents with psychological problems that are more likely to be poo
What does correlation not determine? Who makes this mistake often?
-stay-at-home more violent sons
-they think if you stay at home you are more likely to be violent
-media often makes this mistake
What are the possibilities with A and B?
A and B are related to each other
-but A could cause B or B could cause A
-or there is a third variable causing them
How do we establish causality?
-theoretical expectation that A would cause B
-A and B have to be related empirically (correlation)
-elimination of other possible causes
-temporal ordering: A occurs before B (A needs to occur first)
-responsiveness: Changing A leads to change in B
What are correlates?
Correlates
-variables associated at a given point in time
-not clear that one precedes the others
What are natural experiments or case-control designs?
-compare children with disorder or experience to children without
-common approach
-rates of psychopathology in children who have or have not experienced abuse
-school attendance in depressed versus non-depressed teens
-health in homeless families versus
Is psychopathology linked to abuse?
-abuse is more likely to occur in lower income families, psychopathology might be linked to SES and not abuse
What are case-control designs?
-association between depression and social skills
-children on an inpatient unit for depression and children attending school
-->these two groups differ in a lot of ways than depression
-->inpatients are not going to school, school fosters social skills
-
What are the advantage of case-control designs?
-allows us to answer important questions
-often the only ethical way to address a question (can't assign children to an abuse and non-abuse group)
-helps us to establish internal validity
-making groups equivalent on other factors helps to establish that
What weaknesses are associated with case-control desgins?
-does not establish temporal order (does depression cause poor social skills, do poor social skills cause depression)
-does not establish that A changes B (responsiveness)
What are prospective designs?
-identify children and follow them over time
-->establishes temporal link
What are risk and protective factors?
-occur before the disorder and either increase or decrease the likelihood of the disorder
-child abuse is a risk factor for conduct disorder
-high-quality intimate relationship protects them against depression
What do prospective studies show us?
Prospective studies also allows us to determine what happens to children with a particular difficulty
-follow children with a particular disorder and find out what happens to them
-are psychological symptoms stable over time? get more severe, weaken, no c
Explain the experiment of psychological symptoms and SES functioning.
-examples: Association between psychological symptoms in childhood and SES functioning in adulthood (would you make less money, less educated)
-measured psychological symptoms in 1983
-->ADHD, CD, anxiety and depression
-in 2001, re-interviewed the childr
What are advantages of prospective designs?
-establishes temporal order
-not relying on retrospective report
What are disadvantages of prospective designs?
empirically-supported or evidence-based treatments
-is there scientific evidence that the treatment
-improve symptoms and functioning
-reduces impairment and suffering?
what are best practice guidelines?
-research findings
-identify treatments for which there is scientific evidence for their efficacy
What is expert-consensus approach?
-experts fill in the gaps in the research literature
-we don't know a lot, so we have to do the best we can
-little research in treatment for depressed preschoolers
What is evidence-based treatments?
-well established treatments:
-a large series (>=9) of single-case study designed demonstrating efficacy
-or, at least two between group-design experiments
-need either one of these to determine it is effective
What is a single-case experimental design?
-examine the effect of a treatment on a single child's behaviour
-->repeated measure of behaviour, remove the treatment and see the progression of treatment. However, when you pull out it could be due to your intervention was really good and it solved the
What is A-B-A-B reversal design?
-A-baseline of behaviour
-B-intervention phase
-A return to baseline (remove intervention)
-B reintroduce intervention
What is the ideal outcome in A-B-A-B reversal design?
A: stable behaviour
B: decreases behaviour
A: increases behaviour
B: decreases behaviour
What are the advantages of A-B-A-B reversal design?
-external event happened at the same time as the onset of the intervention - father had been working nights but switched back to days and was able to spend more time with Bob after school
-unlikely this event would also stop at the exact time as you withd
What are the disadvantages of A-B-A-B reversal design?
-external validity, may not generalize to all the children, this is way we need 9 single cases
-can be hard to interpret the findings, it might come down a little but not clear
-stable change, you might not be able to re-establish baseline when you withdr
What is a group-based design?
-randomized Control Trials (RCTs)
-A therapy experiment
-experimental and control conditions
-experimental condition is your treatment
What is random assignment (midterm question)
-all participants have an equal probability of being in either the experimental or control group
-internal validity: random assignment, assures other factors are not influencing the results
-want to ensure that groups do not differ in any way other than t
What does random assignment control for?
-randomly assigning participants to treatment and control groups
-internal validity (can conclude your intervention caused the change)
What do control groups allow you to do?
-careful choice, allows you to establish construct validity
What are the four types of control groups?
-no treatment control group (something in the intervention was better than nothing)
-->good starting point
-wait-list control group, a control group that will not initially get it but they will later on
-->usually due to ethical reasons
-attention-only co
What are the advantages of RCTs?
-internal validity
-construct validity - with a carefully chosen control group
What are the disadvantages of RCTs?
-external validity
-findings may not generalize to real world clinical samples
-->very specific population: often people recruited from advertisements, not found in clinics
-->difference in people who are actively seeking it out than those who are not
-->
What is the issue of dropping out?
-drop out, participants often don't like to be randomly assigned, it is difficult to make a control in psychology an illusion, the participants know if they are getting therapy or not
-may drop out of the control group
-threaten internal validity (groups
What do RCTs look at?
-RCTs are looking at averages
-within the treatment group, some people will not have improved
-in the treatment group there will be people who do not get better, it will be significant usually
-->we want to figure out why this group did not improve
How can you determine if A causes B?
A and B have to be related empirically (correlation)
Elimination of other possible causes
-case-control design, prospective design, single-case designs, RCT
-temporal ordering: A occurs before B
-->prospective design, single case designs, RCT
-responsiven
What should you consider when you read research?
-internal validity
-->allows you to attribute differences to the variable of primary interest
-->e.g differences in outcome are due to depression
-->e.g differences in symptoms are due to my treatment
-external validity
-->do the findings generalize
-->wo
Why do we do assessments in clinical practices?
-->in order to arrive at a diagnosis
-->to plan a treatment, when does this child struggle, when are these symptoms coming out
-->treatment monitoring and progress, do we need to start with medication right away or could we start with therapy. You want to
Why do we do assessments in research?
-epidemiology
-determining correlates
-assessing predictors and outcomes
-examining interventions
What is an interview?
-ask person knowledgeable about child's behaviour (e.g parent, child) to answer questions
-Three types: unstructured, semi-structued, structured
What is an unstructured interview?
-clinician asks questions and arrives at diagnosis
-most clinicians use this approach, and many rely on it entirely
How is an unstructured interview less comprehensive? What is the confirmatory bias?
-clinicians tend to make diagnostic decisions before they have collected all of the relevant information
-biases:
-confirmatory bias: tend to selectively collect information to confirm diagnostic decisions
-tend to ignore information that is disconfirmato
What is a semi-structured or structured interview characterized by?
-interviewer has a set of questions that are presented to the respondent
-->they use them for every patient
-improves comprehensiveness
-reduce bias
What is a semi-structured interview?
-semi-structured
-->interviewer has a lot of latitude in asking the questions
-->clinical judgment involved in determining when a symptom is present
What is a structured interview?
-questions are fixed and interviewer as almost no flexibility
-these can be administered by a computer
Which style of interview is more reliable?
Data suggest that structured and semi-structured are more reliable than unstructured
-unstructured, two clinicians could come to different conclusions
Data suggest that structured and semi-structured are more valid than unstructured
Which style of interview do researchers use?
Structured and semi-structured interviews are the standard instruments in psychopathology research
-unstructured interviews are not used in research
Why are unstructured interviews used in clinical practice?
feasibility
-length, comprehensive coverage you need to ask a lot of questions
-can take two hours or more to administer
-patients might only have a few sessions, you might not want to waste two on assessment
-training
-->semi-structured interviews requir
What is a rating scale?
Questions about behaviours and Feelings
-e.g children's depression inventory
-->first one describes you best: all bad things are my fault, many bad things are my fault, and bad things are usually not my fault
Are rating scales reliable?
-assumption has been that they are less good than interviews
-trade-off between higher validity/reliability of interviews and feasibility of checklists
-data are not consistent with this
-->some evidence suggests that rating scales/checklists yield compar
Do children answer the questions in interviews and rating scales?
-rating scales and interviews rely on someone's report of symptoms
-parents, children, teachers
Why did people think informants disagree?
-historically, researchers have thought that this was error
-->e.g teachers are giving bad reports
-but, different informants provide reliable and valid reports
-->one informant is not giving bad reports
-some exceptions e.g children's report of ADHD
-tea
Why do informants disagree?
different perspectives of informants
situation specificity of children's behaviour: higher ADHD behaviour at school
Explain how different perspectives affect raters.
-rater-specific factors that lead to systematic differences in reporting
-some evidence for bias in reports of some informants
-maternal depression associated with a tendency to overreport behavioural problems
-may see difference between mother and teache
Explain how there is legitimate differences in the meaning of behaviours across settings.
-parents and teachers interact with children in very different contexts, and these contexts may change the interpretation of behaviour
-for the latter, behaviours often considered assertive (e.g appropriately questioning rules, why do I have to do this) m
Explain how children's behaviour can be specific to a situation.
-children's behaviour varies markedly across different situations and settings
-different demands: some people struggle in large lecture classes, but they do well in conferences where it is smaller. Some people do better in large lectures and not small co
How are data from multiple informants used to make a diagnosis? - midterm question
-'or' rule
-->symptom is present if any informant (e.g teacher or parent) says it is
-'and' rule
-->symptom is present only if all informants agree
-two different approaches, there will be a different answer, the 'and' rule is more restrictive and you wil
What does the and and or rule leave out?
-both of the and and the or rules do not capture the fact that differences between informants are valuable
-diagnosis identified by teacher is likely different than one identified by a parent
-think about maintaining ratings separately
-->parent-reported,
What is observation?
-interviews and rating scales rely on someone's report of behaviour
-may want to observe behaviour directly
-in some cases, may be difficult for someone without clinical training to tell when a behaviour is normative or clinically concerning
-->tantrums i
What is naturalistic observation?
-occur in child's natural environment
-classroom, home
-provides rich information about what happens prior and after behaviour
-->often children are rewarded after doing a bad behaviour
-->antecedent-behaviour consequence
What is structured observation?
-laboratory or clinic based
-designed to see children's response to a task or situation
-->e.g provocation by another peer (e.g mess up their drawing)
Is observation feasible?
-hard for clinicians to use this approach as it is very labour intensive
-you need to see them in different environments, times, different people
Is observation valid?
External validity - extent to which findings will generalize
-presence of an observer may change behaviour
-->particularly a problem for older children and adults, starts around 10 or 11
-may not see the same results in the 'real world'
-->computer stimul
What should we continue to focus on in measuring behaviour?
-developing standardized approaches that are easy to use in clinical practice
-determining when 'more is better'
-->not clear that interviews are more reliable or more valid than rating scales
-->not clear that adding observational procedures always confe
many have argued that ADHD is a product of Western culture?
-unrealistic expectations concerning children's behaviour
-people have an ideal in their head and any deviation is not normative
-pharmaceutical industry, a lot of people make money prescribing ADHD medication
Note that prevalence of ADHD is similar world
What is the life of a child with ADHD?
-you always need to keep your eyes on the kid with ADHD
-their behaviour is dangerous, running into traffic and running off
-strain on the family, the parents argue about how they will manage it, different expectations and beliefs
-sibling relations are s
What is the DSM type?
DSM treats it as categorical
-research evidence suggests it may be dimensional
What rating scales and interviews are used in assessing ADHD?
-parent report
-teacher report is critical for diagnosis of ADHD
-->parent report of symptoms/impairment at school shows higher correlation with parent report of symptoms at home than with teacher report of symptoms at school and vice versa
-->to know abo
What are we able to conclude after we have combined reports?
-situational versus pervasive ADHD
-situational identified by parent or teacher
-pervasive ADHD identified by both
-research does not clearly suggest that pervasive is more severe than situational
-parent-report only may be different than ADHD identified
What diagnosis are more common depending on which type of rule you use?
-when you look at parent or teacher alone, you see more diagnoses of PI and PH
-when parent and teacher are combined using the 'or' rule for symptoms (symptom present if identified by either informant) most of those cases became combined
What does the DSM leave out in ADHD?
-DSM does not specify how to combine information from different informants
-DSM-IV fields trials used the 'or' rule for symptoms
How can one assess ADHD with neuropsychological tests?
-Neuropsychological tests of cognition, attention
-at present, these are not used in diagnosis, but can provide valuable information about functioning/symptoms that are not observable
Why do we need to us biological tests when testing for ADHD?
-Neuropsychological/biological methods
-->No blood test equivalent, however, it is important to rule out biological causes
-->sudden ADHD symptoms could be due to head trauma
What is the continuous performance task?
-respond to a stimulus (e.g the letter X) only after seeing another stimulus (e.g the letter A)
-missing the letter X when you should have responded is thought to be a measure of inattention
-responding to X when you should not have is thought to be a mea
What does stop-signal task?
-requires quick execution of an action, and the occasional inhibition of this action
-participants are asked to respond as fast as they can to symbols on a computer screen
-on some trials, they will get a signal to inhibit their response (e.g tone will pl
Explain the classroom observation for ADHD.
-typically want to do it over several days
-different classroom situations e.g not only math class, might do well in free play or they might do well if they have one on one attention
-specific context impacts behaviour in a given setting
-off task behavio
Explain clinic observation for ADHD.
-observations in clinics may have low external validity
-when they have one on one attention from a novel clinicians they often do a lot better
-testing, IQ test, lag in spatial skills, difficult time sitting for IQ tests (difficult, a lot of concentratio
What medication is used for ADHD. What does it do?
-stimulants
-methylphenidate (Ritalin)
-increase activity in the prefrontal cortex
-very fast acting: 30 minutes
-effects stop when the drug wears off
What are the side effects of stimulants?
-reduced appetite, weight loss, slowing of growth, increase in heart rate, difficulty falling asleep
-careful to hit the right dose: maximum therapeutic benefit and lowest amount of side effects
-you start low and increase slowly, otherwise if you go to h
Are stimulants helpful?
-stimulant medications have large, beneficial, acute effects on multiple key domains of functioning in ADHD
-but, 20% of children may not improve
-for children who do improve, behaviour is better but may still be problematic
-may not help academic perform
What is parent management training?
-contingency management
-clear rules, rewards for behaviours you want to see, consequences for behaviours you do not want to see
-setting up situations to minimize problems
-a number of studies have demonstrated that this treatment results in improved beh
What is behavioural classroom management?
-contingency management in the classroom
-studies have demonstrated effectiveness
-studies have demonstrated effectiveness
What are behavioural peer interventions?
-traditionally, social skills training is done in the office or clinic
-discussion and role-playing
-studies have suggested that these types of interventions are not effective for children with ADHD
-you need to have them interacting with kids in order fo
What is the summer program treatment?
-social skills training followed by coached group play
-contingency management: e.g if you use your new skill, you earn a reward. Group management if the entire group needs a certain amount of points to get a reward, this leads to kids managing each other
What are cognitive interventions?
-cognitive techniques that children can use to control their attention and behaviour
-e.g verbal self-instruction, problem solving
-not supported, they are not beneficial
What were the objectives of MTA?
-compare long-term medication and behavioural treatments for ADHD
-determine if there are additional benefits if meds and behavioural treatment are combined
-compare systemic administration of treatment to treatment as delivered in community settings
What was the medication management condition?
-stimulant medication
-28 day titration period (where they are determining the optimal dosage)
What was the psychosocial treatment condition?
-parent training
-27 group sessions and 8 individual sessions
-educational interventions
-16 to 20 sessions of teacher consultation
-12 weeks of half-time classroom behavioural specialist
-summer treatment program
What was the combination treatment condition?
-received medication and psychosocial treatment
What was the community treatment as usual?
-could be nothing, could include any of the above
What were the core outcomes?
-note that all four groups showed a reduction in ADHD symptoms over time
-combination and medication were better than psychosocial and TAU
-psychosocial = TAU
What were the results of MTA?
compare long term medication and behavioural treatments for ADHD
note that for improving ADHD symptoms (as rated by both parents and teachers), medication outperformed behavioural treatment
but this was not true for many other outcomes (e.g observed class
What was interesting about the medication and the TAU group?
-combined treatment and meds outperformed TAU for most ADHD outcomes
-many children in TAU, were on medication
-there is a difference between the group that got medication in a systematic way
-behavioural treatment did not outperform TAU
-note that behavi
What did the long term follow up of MTA show?
-followed participants up 6 years later
-there were no differences between any of the treatment groups on any of the outcomes assessed
-on average, children in MTA showed gains relative to baseline
-functioning worse than a community control group without
How can you view the MTA data differently?
composite measure encompassing all outcomes, reflection of the whole child
-main finding: we need medication, it is the best treatment
-when you analyze the data differently, the combined treatment is better than medication
Why might a person not respond to stimulants?
-symptom severity, if you are much worse than the group, you might not respond as well
-youth comorbidity, ADHD and conduct problems they may not respond as well, they might not participate
-parental psychopathology, parent is not functioning well
-->pare
What were MAT moderators?
excellent responder: if you were not having problems or minimal
bad responder: you were still showing problems
medication management or medication and behavioural treatment, those children were more likely to be excellent responders
behavioural treatment
How is CD and ODD assessed?
Interviews and Checklists
-parents, teachers, youth
-CD - youth are an important informant, because behaviours may be hard for other people to see
-ODD - not clear how much youth report adds to parent and teacher report
e.g Brief Child and Family Phone In
How is limited prosocial emotions assessed?
-assessments in development
-clinical assessment of prosocial emotions
-semi-structured interview
What is difficult wit observation and ODD?
-hard to determine what is typical and not for children
-lots of the items are not as applicable to preschoolers, what is the three year old equivalent of staying out all night
-what is concerning and what is not
Explain the 3 examiners and child experiment.
-->with an interactive examiner
-->with a busy examiner, they can't interact with the child tell the child they have to play by themselves
-->with their parent
-are we only seeing this with mom?
-'presses' for disruptive behaviour, present the child with
What is the prevalence of ODD and CD?
10% for ODD
9% for CD
What context is CD often seen in?
-strongly associated with poverty
-strongly associated with exposure to violence
-certain behaviours might be linked to conduct disorder but they might be doing it to survive: need to eat, don't have enough money, they could get really hurt if they don't
What is social causation?
-stress of poverty leads to an increase in childhood psychopathology
What is social selection?
-families with genetic predisposition drift down towards poverty
-with certain genes that result in psychopathology it results in you drifting down to poverty
-removing poverty condition may not help psychopathology because it was already there
Explain the experiment of determing the temporal order of CD and poverty.
-longitudinal study of epidemiology of childhood psychiatric disorder
-sample included a significant number of Aboriginal People
-significant positive association between poverty and disruptive behaviour
-partway through the study, a casino opened on the
What would social causetion and social selection's hypotheses be?
Social Causation
-increase in income should reduce children's symptoms
Social Selection
-increase in income should have no effect on children's symptoms
-->poverty is the consequence of psychopathology
What were the results?
-higher levels of disruptive behaviour for people who were living in poverty
-after the casino group, persistently poor still have disruptive behaviour
-ex-poor group decreased their disruptive behaviour symptoms
-the people who were never poor consistent
Explain Costello et al experiment of mediators.
-examined possible mediators of the association between increase in income and decrease in behavioural symptoms
-found that it was increased parental supervision
-increase in income led to improved parental supervision, which in turn led to decreased beha
What are the differences in prevalence between genders?
-conduct problems are 2-4 times more common in male children
-smaller differences in early teens
-->increase in girls engaging in covert, non aggressive behaviour
-early-onset persistent CD
-10 male: 1 female ratio
-adolescent-limited CD
-2 male: 1 female
Explain aggression in grils.
-relational aggression, girls harm each other's relationships, exclude girls, rumour spreading
-for girls, this is more common than physical
-available evidence suggests that boys and girls engage in comparable rates of relational aggression
-boys' antiso
What are signs of ODD in infants?
-difficult temperament: fussy, irritable
-not limited to CD/ODD and no reliable/valid way to test conduct problems in infants
What are symtpoms of CD in preschoolers?
-two diagnostic challenges
-impossible or improbable symptoms for young children (e.g truancy from school)
-adapting symptoms to younger age group
-chronic rule violations and disregard for other's rights and needs
-verbal aggression, physical aggression,
How can you determine if a behaviour is normative?
-noncompliance, temper loss, and aggression are common
-75% of children exhibit aggression and tantrums by 2 years of age
-these are also symptoms of ODD
-how do we distinguish typical misbehaviour from that representing a significant problem
-->severity,
What is operant conditining?
-changing rates of behaviour through consequences
-what happens after a behaviour determines whether you will see more or less of it
What are the types of reinforcement and punishment?
positive reinforcement: increases behaviour by adding a stimuli
negative reinforcement: increases behaviour, take away stimuli
positive punishment: decreases behaviour by adding a stimuli
negative punishment: decreases behaviour by taking away a stimuli
Are reinforcers general?
-reinforcers are personal and developmental
-differ things are rewarding for different children
-different things are going to be more or less rewarding in different periods
What is coercion theory?
-cycle of increasingly negative interactions
-delay and escape strategies by child
-->using really obnoxious behaviour to get out of doing things he/she doesn't want to do (e.g chores, homework)
-inconsistency and explosions from
-parent ends up being pun
Explain the experiment by Caspi and maltreatment.
-childhood maltreatment is universal risk factor antisocial behaviour
-50% increased risk for boys to develop CD, antisocial personality, and to become violent offenders (esp early life abuse)
-most boys who are maltreated do not develop severe anti-socia
What is MAOA?
MAOA is an enzyme that metabolizes neurotransmitters such as dopamine and norepinephrine (makes them inactive)
-low MAOA activity has been linked to aggression
-individual differences in MAOA activity linked to a particular gene
Combination of low-MAOA ac
What were the strengths of the study?
-representative general population sample
-well characterized adversity histories btw age 3-11: 8% severe maltreatment
-more than one indicator of maltreatment (including harsh parenting, retrospective report of abuse when participants are adults)
-28% pr
What main effects were seen in this study?
-main effect of maltreatment on antisocial behaviour, if they experience maltreatment they are more likely to show antisocial behaviour
-no main effect of MAOA on antisocial behaviour
-there is an interaction between MAOA and maltreatment, the association
What is social information processing?
-social information processing
-a series of cognitive steps that take a person from situation to action
-what do I pay attention to? (encoding)
-what does it mean? (interpretation)
-what can I do? (response search)
-what will I do? (response decision)
-ho
What is encoding?
-very little is know about encoding
What is interpretation?
-hostile attribution bias, did the other kid mean to do it?
-very robust evidence linking hostile attribution bias and aggressive behaviour (more than 40 studies)
-children with aggressive behaviour problems are more likely to think the other child did it
What is response search?
-What could I do?
-children who are aggressive generate fewer responses
-when you give them a hypothetical situation they generate few strategies and aggressive strategies, and fewer prosocial strategies
What is response decision?
-evaluate response on a number of different dimensions
-outcome expectancies - what will happen if I do this?
-children who are aggressive are more likely to think that good things will happen if they use aggressive strategies
-they are less likely to thi
How do these Patterns Develop?
Parents
-mothers of aggressive boys also show the hostile attribution bias
-parents may reinforce or approve of behaviours
-may see aggression as a competent response to peer provocation
Peers
-may be reinforcing behaviours
-children with aggressive behav
What is attrition?
-internal validity
-are groups comparable
-RCTs
-external validity, might not generalize to the greater population when people drop out
-is sample representative?
-attrition can compromise your internal and external validity
What is Bronfenbrenner's ecological model of human development?
-children live in families who live in neighbourhoods live socioeconomic systems
-treatment intervenes at one of these levels
-systems may reinforce problematic behaviour
-interventions for disruptive behaviour consider these systems otherwise their treat
What is problem solving skills training?
-work with the child to reduce behaviour problems
-targeting upstream cognitive processes
-underlying theory: social-information processing
What is steps?
S say what the problem is (encoding and interpretation)
T think of solutions (response search)
E examine each one (response selection)
P pick one and try it out (response decision
S see if it worked (evaluation)
What do you need to consider when you look at a person's situation?
You need to identify what the patient thinks the problem is
What is the anger coping program?
-treatment for aggressive behaviour designed by John Lochman and colleagues
-focuses on specific cognitive biases
-interpretation: hostile attribution bias
-distorted perceptions of aggressiveness: aggressive youth underestimate their own aggressiveness a
How are children taught in the anger program?
Children taught
-inhibit early angry and aggressive reactions
-to cognitively relabel stimuli perceived as threatening
-to solve problem by generating alternative coping responses and choosing adaptive, nonaggressive alternatives
What are three goals of anger coping program?
-goal: to inhibit early angry and aggressive reactions
-sample activities:
-building domino towers while being verbally distracted by peers
-learn to identify bodily cues that signal angry arousal and identify thoughts that contribute to greater or reduce
Explain the effectiveness experiment of anger coping.
-aggressive boys randomly assigned to one of four groups:
-anger ocping
-anger coping + goal setting
-goal setting
-no treatment
what were the results of anger coping?
compared to other two conditions, anger coping and anger coping + goal setting both led to reductions in disruptive and aggressive off-task behaviour in the classroom
-note that ratings were done by observers who were blind to treatment condition
What is the social aggression program?
-program designed by Elise Cappella to reduce socially/relationally aggressive behaviour
-several key components
-recognition of emotions that may lead to social aggression
-social problem-solving
-social skills
What were the conditions in the socal aggression study?
grade five girls randomly assigned to one of two conditions
-SAPP
-reading group
-->identical to SAPP in length and number of sessions
What were the results of SAPP?
group who received SAPP had improved social problem solving abilities at the end of the intervention
-offered more assertive/prosocial solutions to problematic social situations
-among girls who were very socially aggressive prior to starting the program,
Why might SAPP not be enough?
in the real world, problematic behaviours may be reinforced
children are unlikely to change such behaviours that are working for them
parents, changing the reinforcing contingencies
Explain the education portion of parent management training.
-reasonable expectations for child's behaviour
-behaviour will get worse before it gets better (e.g throwing tantrums gets them what they want, so they will get louder and escalate)
What do they teach parents about communication?
-"say what you mean"
-be direct
-give directions in manageable chunks (start with turn off the wii, get your coat)
-tell child what to do, rather than what not to do (e.g stop jumping on the couch, sit quitely)
-->when you say no, it leaves wide amount of
What do they teach parents about consequences?
-pick consequences that are:
-doable: it has to be in your power to do what it is (e.g you can't make it rain), also it has to be something that you will actually do (e.g you are not going to take away the wonderland tickets because they were expensive)
-
What is the ABC model?
Antecedent-Behaviour-Consequence
-in which situations does this behaviour occur?
-what happens next? what happens after the behaviour occurs
After observing the behaviour what should you do?
Modify the contingencies
-if the child is being rewarded for the behaviour, you need to stop the reward
Monitor changes in behaviours when you modify the contingencies
What do you do if you want to see more of a behaviour?
If you want to see more of a behaviour
-reward it with something positive
-pay attention to it, so that you reward it
-remove something negative
-if you want to see less of a behaviour
-consequence it with something negative
-remove something positive
What do you need to consider when you are parenting?
-think about which quadrant you are in in
-think about whether a reinforcer is pos/neg
-are you inadvertently providing reinforcement for a behaviour you do want to see
-remember that attention is a very powerful reinforcer
Is parent management training effective?
in general, studies have shown that parent management training results in a significant reduction in problem behaviours, relative to no-treatment control groups and wait-list control groups
-stronger effects for preschoolers and elementary-school aged chi
What is Multisystemic therapy?
based on research evidence
-combines treatments: problem solving skills training, PMT, change global reinforcement context
-->association with deviant peers
What does MST target?
-children
-parent
-neighbourhood
-school
-probation, work with probation officer
-very intensive
-->therapist available 24/7, services in home and directly other setting
-->typically 4 months of treatment
Is MST valid?
-statistical versus clinical significance
-statistical significance: there is a difference between the groups
-clinical significance: is the difference meaningful, does an intervention help people
-functional outcomes, it is clinically significant
Explain the delinquent youth study and days out of jail.
-their functional outcome: days you stay out of jail
-at the end of the assessment, kids in MST 74% were not arrested compared to the control group, 29% were not arrested
MST: Cost
-estimated cost for an average participant in MST is $4743
-$87 961 for on
What were the results of MST?
increase dose of MST delinquent behaviour decreases
-more MST, better family functioning after treatment
-family functioning decreases delinquent behaviour and decrease in peer affiliation
-more delinquent peer affiliation results in more delinquent behav
What is tolerance?
Tolerance, defined by: a need for markedly increased amounts of alcohol to achieve same effect
-a diminished effect with continued use of the same amount of alcohol
What is withdrawal?
-withdrawal, as manifested by either of the following: alcohol withdrawal syndrome
-alcohol or a related substance is taken to relieve or avoid withdrawal symptoms
What is the prevalence of SUDS?
in community based samples, 12% of adolescents (aged 12 to 17 years) meet criteria for a substance use disorder
-prevalence rates increases across adolescence
-rates are more higher among youth experiencing other mental health problems
-experimentation is
What is treatment for SUDS?
-in-patient treatment
-short duration (4 to 6 weeks)
-range of treatment programs
-individual counselling, family therapy, treatment for comorbid disorders
-often followed by outpatient
outpatient programs
-less intensive than inpatient but longer
-group
What is treatment efficacy?
-little research on effectiveness of treatments for substance use in adolescents
-historically have been methodological problems in these studies
-lack of randomized controlled trials
-analyzing only people who complete the treatment
-difficulty getting p
What is relapse prevention?
-very important
-many youth improve when they are away from home, but relapse when they return
-one half of adolescents receiving treatment for substance use relapse within 3 months
-only 20% to 30% are not using at 1 year
What is the focus of relapse prevention?
-identifying high risk situations, e.g if you are with your high school friends at a party, you might not want to go
-developing skills for refusing, how will you tell your friends no
-developing interests that would help them stay away from high risk sit
Explain the norm drinking experiment.
norm-based interventions for college students
norms about drinking
injunctive norms: how much others approve or disapprove of drinking
descriptive norms: how much others actually drink
-norms share a stronger association with college student drinking beha
What do american students overestime?
american university students overestimate how much their peers drink
What was the feedback in the alcohol study?
Individualized feedback about:
-actual drinking norms
-comparisons between individual's drinking pattern and the norm
this is how much you drink
this is how much you think others drink
this is how much others actually drink
percentile ranking showing wher
What was the baseline in the alcohol study?
-perceived drinking norms, how much you thought others were drinking
-drinking behaviour, how much you drink
What was the intervention in the alcohol study?
-received feedback immediately
-presented on screen for a minute and given a print out to take home
-no interpersonal interaction, they saw it on the screen and no one talked to them about their drinking
-follow ups at three and six months
-control group
What are the results of the alcohol study?
-at both 3 and 6 months, amount of drinking in the intervention groups was reduced, relative to the control group
-at both 3 and 6 months perceived norms were reduced (intervention group was reporting that peers drink less than control group)
-changes in
How does the media try to prevent poor outcomes?
-inconsistent results about effectiveness
-hard to study, hard to randomly assign people to get access to media
-Information and fear
What is D.A.R.E?
-drug abuse resistance education
-developed in the 1980s during Reagan's 'war on drugs'
-zero tolerance approach to drug use
-happens in schools
-police officers deliver substance-use prevention curriculum to students
-->teachings students skills needed t
Is D.A..R.E effective?
-none
-meta-analysis
-quantitative synthesis of different studies
-do we see a significant difference between students who got the intervention and those who did not across studies
-found no effect of D.A.R.E on extent to which participants report using d
What are syringe-exchange programs?
-increase in rates of HIV infection among intravenous drug users
-harm-reduction approach
-no expectation that use will stop completely
-trying to limit the negative effects on the individual and society that are associated with using
What is the usefulness of syringe-exchange programs?
-sharing of needles contributing to the spread of HIV among IV drug users and their sexual partners
-exchanging news, sterile needles and syringes for used ones
-most programs also include other services:
-hiv testing and counseling
-condom distribution
-
Are syringe-exchange programs effective?
evidence for effectiveness played a key role in the dissemination of syringe-exchange programs
-large pharmacy stopped selling injection equipment, making it much more difficult to get clean needles
-the local health department and a drug-users group set
Are they effective?
-all found that syringe-exchange programs were associated with reductions in rates of HIV infections
-note that none of these studies were randomized clinical trials
-->case control designs, pre- and post-comparisons
Do Syringe Exchange Programs Increasing Use?
-participants randomly assigned to a) syringe-exchange programs and b) instructions about how to buy syringes at the pharmacy
-they people who had access to syringe-exchange programs were not using more
-1988, US government forbid any federal dollars bein