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Abnormal Psychology

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					Abnormal Psychology

Ch. 14: Abnormal Behavior in
 Childhood and Adolescence
Mental Health Problems Among
    Children/Adolescents
• Prevalence
  – Estimates suggest 10% of children suffer from
    some form of disorder
  – Children with externalized problems are more
    likely to be treated than those with internalized
    problems
     • i.e., problems that are easy to see (aggressive and/or
       destructive behavior) vs. issues that aren’t as visible
       (anxiety, depressive tendencies, etc.)
Mental Health Problems Among
    Children/Adolescents
• Gender differences:
  – Males: at much greater risk of developing
    childhood disorders
  – Females: in adolescence, anxiety, mood and
    eating disorders become more prevalent
• Biological factors:
  – Prenatal factors (teratogens, viral infections,
    etc.) birth complications, low birth weigh and
    premature birth increase risk of disorders
Mental Health Problems Among
    Children/Adolescents
• Cognitive factors:
  – Negative expectancies - see group of kids
    playing, think “they wouldn’t want to play with
    me”  social withdrawal  depression/aggress
• Psychosocial risk factors:
  – Stress  maladaptive behaviors (e.g.
    depression)
  – Being abused  lowered intelligence,
    depression, suicide
            Autistic Disorder
• Essential features: Presence of markedly
  – Abnormal or impaired development in social
    interaction and communication
  – Restricted repertoire of activity and interests
  – Typically is no period of normal development
  – Onset usually evident by 18-30 months;
    primarily affects males (4-5x more often);
    must manifest itself prior to age 3
             Autistic Disorder
                 (Autism)
• Impairment in reciprocal social interaction:
  May be marked impairment in use of
  nonverbal behaviors
  –   Eye-to-eye contact
  –   Facial expression
  –   Body postures
  –   Gestures
            Autistic Disorder
                (Autism)
• They may not take part in social games or
  play
  – May prefer solitary activities, involving others
    only as tools or “mechanical aids”
• Often, awareness of others is highly
  impaired:
  – May be oblivious to others
  – May have no concept of others needs
            Autistic Disorder
                (Autism)
• Impairment in communication is marked
  and affects verbal and nonverbal skills
  – May be a delay in, or total lack of, the
    development of spoken language
  – In those who do speak, there may be difficulty
    initiating or sustaining a conversation w/others
           Autistic Disorder
               (Autism)
• Tend to not engage in simple imitative play
  as infants (e.g. mimicking the faces parents
  make)
• May be a lack, or absence, of make-believe
  play
            Autistic Disorder
                (Autism)
• May display a restricted range of interests
  and are often preoccupied with one narrow
  interest
  – E.g. Amassing football statistics
• Many insist on sameness of ritual/routines
  – May show marked distress to even minor
    changes
     • E.g.: Student at ISD
             Autistic Disorder
                 (Autism)

• May demonstrate odd behaviors
  –   May clap hands, flick fingers
  –   May rock or sway
  –   Walk on tip-toe
  –   Demonstrate odd body postures
           Autistic Disorder
               (Autism)
• Tend to be preoccupied with parts of objects
  – Button or snaps on shirts
  – Body parts
• Some have a fascination with movement
  – Sit and watch a top spin for hours
  – Watch fan blades turn
• Some develop an attachment to inanimate
  objects (string, rubber band, etc.)
           Autistic Disorder
               (Autism)
• Approximately 75% of individuals with
  autism function at a retarded level, usually
  in the moderate range
• Other features:
  – May display self-injurious behaviors
  – May have temper tantrums (children)
  – Savant syndrome
     • http://www.youtube.com/watch?v=ckqDX2XpdyY
        Autistic Disorder:
      Theoretical Perspectives
• The cause of autism remains unknown
  – Seemingly a strong genetic component based
    on twin studies (60% for identical twins)
  – Brain abnormalities: males with autism have
    structural brain differences
     • Large ventricles, indicating brain cell loss, and poor
       neural pathway development)
  – Belief of the past: Emotionally cold parents
          Mental Retardation
• Essential features:
  – Delay in development of cognitive and social
    functions
  – IQ of 70 or below
  – Onset prior to age 18
          Mental Retardation:
               Causes
• Biological
  –   Chromosomal disorders
  –   Genetic disorders
  –   Infectious diseases
  –   Brain damage
• Over 50% of cases have an unknown cause
           Down Syndrome
• Most common form of mental retardation
• Result of an extra chromosome on the 21st
  pair of chromosomes (21st pair in egg or
  sperm does not divide normally)
  – Due to defect in mother’s chromosomes in 95%
    of cases
  – Becomes more prevalent when the age of
    expectant parents is in the 30’s or 40’s
            Down Syndrome
• Physical features:
  – Round face
  – Broad, flat nose; enlarged tongue
  – The appearance of slanted eyes, caused by folds
    of skins in the corner of eyes
  – Small arms and legs (in relation to size of body)
  – Small hands with short fingers
              Down Syndrome
• Physical problems:
  –   Malformed heart
  –   Respiratory problems
  –   Lack muscle tone
  –   Uncoordinated
  –   As a result of physical problems, most don’t
      live beyond middle age
           Down Syndrome
• Cognitive and affect disturbances:
  – Tend to suffer from memory deficits
  – Have difficulty processing verbal info
  – As they get older, many experience memory
    loss and demonstrate childish emotions
• Many, if given proper attention and
  schooling, can learn to read, write and do
  simple arithmetic
        Fragile X Syndrome
• Most common form of inherited mental
  retardation
  – Thought to be caused by mutated gene on X sex
    chromosome
  – More frequent and usually more severe in
    males. Why should that be expected?
  – Course varies: no symptoms, mild learning
    disabilities or profound retardation
      Other Factors in Mental
            Retardation
• Teratogens crossing the placenta:
  – Substance abuse during pregnancy
  – Diseases (Rubella, syphilis, genital herpes, etc.)
• Premature birth
• Brain infections during infancy or
  childhood
• Trauma to the head
• Ingesting toxins (e.g. lead paint)
          Learning Disorders
• Essential features: impairment in the
  development of reading, writing and/or
  math skills
  – Impairs performance in school or daily
    activities
  – Approximately 5% of children in U.S. public
    schools are diagnosed with a learning disorder
   Types of Learning Disorders
• Mathematics Disorder: characterized by
  – Difficulty understanding terms or operations
    (how to add, subtract, etc.)
  – Difficulty deciphering symbols (+, -, =, etc.)
  – Difficulty in copying numbers or figures
    correctly
  – Difficulty with mathematical skills (counting,
    learning multiplication tables)
  – Usually evident by age 8
   Types of Learning Disorders
• Disorder of Written Expression: Extreme
  deficiency in writing skills
• Usually recognized by age 7
• Characterized by errors in:
  –   Spelling
  –   Grammar
  –   Punctuation
  –   Sentence structure and writing paragraphs
   Types of Learning Disorders
• Reading Disorder (Dyslexia):
• Essential features: difficulty recognizing
  words and understanding written text
• Characterized by:
  – Reading difficulty; when reading aloud they
    tend to omit or substitute words (burn = bun)
  – May see letters upside down (n = u) or reversed
    (d = b)
     Theoretical Perspectives:
       Learning Disorders
• Genetics:
  – 70% of identical twins develop dyslexia if the
    other twin has developed it
• Brain abnormalities:
  – Defective brain circuitry in the area of the brain
    between the retina and the visual cortex 
    impaired visual processing. May explain
    omission of words and seeing letters reversed
    or upside down
    Communication Disorders
• Expressive Language Disorder: Involves
  impairment in spoken language
  – Slow to build vocabulary
  – Demonstrate errors in tense
  – Difficulty producing age-appropriate sentences
    Communication Disorders
• Mixed receptive/expressive language
  disorder
  – Difficulty understanding and producing speech
  – May have difficulty understanding similar
    descriptive words (small, tiny, little) or terms
    related to space (here/there; near/far)
    Communication Disorders
• Phonological disorder
  – Individual has difficulty uttering certain types
    of sounds (eg. ch, sh, th, r sounds)
  – May omit or substitute sounds for the
    phonemes they cannot pronounce
 Attention-Deficit Hyperactivity
            Disorder
• Essential features: persistent pattern of
  inattention and/or hyperactivity-impulsivity
  that is more severe than typical for the age
  or developmental level
  – Symptoms must be present prior to age 7
  – Must demonstrate impairment in at least 2
    settings (e.g. home, school, work)
 Attention-Deficit Hyperactivity
            Disorder
• Inattention:
  – May fail to give close attention to details
  – Work is often messy, performed carelessly and
    without a great deal of thought
  – Find it hard to see task through to the end
  – Tend to not follow through on requests or
    instructions given
 Attention-Deficit Hyperactivity
            Disorder
• Typically avoid activities that require
  sustained mental effort
  – E.g. Homework or paperwork
• Easily distracted by irrelevant stimuli
 Attention-Deficit Hyperactivity
            Disorder
• Hyperactivity manifested by:
  – Fidgetiness or squirming in one’s seat
  – Difficulty remaining seated
  – Running or climbing in inappropriate situations
    (e.g. jumping on furniture, run through house)
  – Excessive talking
  – Difficulty participating in sedentary activities
 Attention-Deficit Hyperactivity
            Disorder
• Impulsivity manifests itself in:
  – Impatience; interrupting/intruding on others
  – Difficulty in delaying responses
  – Blurting out answers before questions have
    been completed
  – Difficulty waiting one’s turn
  – Engage in dangerous behaviors w/out thinking
    of consequences
 Attention-Deficit Hyperactivity
            Disorder
• Theoretical perspectives:
  – Genetics seems to play a key role
  – May be brain abnormalities in the part of the
    brain that controls attention, arousal and
    communication between hemispheres
  – The brain may be less mature in these
    individuals  impulsive, less restrained
    behaviors
  – Maternal substance abuse and/or smoking
           Conduct Disorder
• Essential features: repetitive, persistent
  pattern of behavior in which the basic rights
  of others, societal norms or rules are
  violated
• Three or more characteristic behaviors had
  to occur in past 12 months, one of which
  had to occur in the past 6 months
           Conduct Disorder
• Behaviors fall into 4 main groupings:
  – Aggressive conduct (causes/threatens harm to
    other’s or animals)
  – Nonaggressive conduct that causes property
    loss or damage
  – Deceitfulness or theft
  – Serious violations of rules
           Conduct Disorder
• Aggressive conduct: may display
  – Bullying, threatening or intimidating behavior
  – Initiate physical fights
  – Use a weapon that can cause serious harm
  – Be physically cruel to people or animals
  – Steal while confronting a victim (mugging,
    purse snatching, armed robbery, etc.)
  – Force someone into sexual activity
           Conduct Disorder
• Deliberate destruction of other’s property:
  – Arson
  – Vandalism
• Deceitfulness or theft:
  – Frequent lying
  – Breaking into homes/buildings/cars; shoplifting
           Conduct Disorder
• Serious violation of rules: Pattern of
  behavior usually starting before age 13
  – Staying out late (breaking parent’s curfew)
  – Running away from home overnight (not due to
    problems at home)
  – Truancy
           Conduct Disorder
• Other symptoms:
  – May have little empathy/concern for others
    feelings, wishes and well-being
  – May lack appropriate feelings of guilt/remorse
  – Any remorse shown may be a means of
    reducing/preventing
  – High rate of suicidal thoughts/attempts/deaths
  Oppositional Defiant Disorder
• Essential features: recurrent pattern of
  defiant, disobedient and hostile behavior
  toward authority figures (persists at least 6
  months)
  Oppositional Defiant Disorder
• Characterized by at least 4 of the following:
  – Losing temper
  – Arguing with adults
  – Actively defying or refusing to comply with
    requests or rules set by adults
  – Deliberately doing things to annoy others
  – Blaming others for one’s mistakes/misbehavior
  – Being angry and resentful, vindictive or spiteful
  Oppositional Defiant Disorder
• Defiant behaviors expressed via:
  – Persistent stubbornness
  – Resistance to directions
  – Unwillingness to compromise, give in or
    negotiate with adults or peers
  – Persistent testing of limits
  – Hostility demonstrated by deliberately
    annoying others or by verbal aggression
   Separation Anxiety Disorder
• Essential feature: excessive anxiety
  concerning separation from home or from
  those whom the person is attached
  – Anxiety is beyond that which is expected for
    the person’s developmental level
  – Must last for at least 4 weeks
  – Onset must be prior to age 18
   Separation Anxiety Disorder
• Children with this disorder:
  – Often express fear of being lost and never being
    reunited with parents
  – Are uncomfortable traveling independently
    away from the house/familiar areas  may
    avoid going places by themselves
     • May be reluctant or refuse to go to school, camp,
       visit or sleep at friends home, go on errands, etc.
   Separation Anxiety Disorder
• Children with this disorder (cont):
  – May be unable to stay in a room by themselves
     • Are often “clingy”
  – May insist that someone stay in their bedroom
    until they fall asleep
     • If they awake during the night they often climb into
       parents bed; if door is locked they may sleep
       outside the parents’ door
   Separation Anxiety Disorder
• Children with this disorder (cont):
  – May experience nightmares that express their
    fears (e.g. their family being killed)
• When separation occurs/anticipated:
  –   Stomachaches
  –   Headaches
  –   Nausea/vomiting
  –   Rare - Palpitations, dizziness, feeling faint

				
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