Post on 11-Jan-2016
Disorders of Childhood and Adolescence
Externalizing Disorders
Disorders with behaviors that are disruptive and often aggressive
Attention-deficit Disorder, with or without Hyperactivity (ADD/ ADHD)
Tic disorders (Tourette’s) Oppositional defiant disorder (ODD) Conduct disorder
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Internalizing Disorders
Related to worries and disturbing thoughts rather than to overt behaviors
Separation Anxiety Disorder Social phobia Generalized anxiety disorder Obsessive-compulsive disorder Depression Eating Disorders
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Frequency of Disorders in Children and Adolescents, aged 9-17
Type of Disorder Percent Affected
Anxiety Disorders 13.0
Mood Disorders 6.2
Disruptive Disorders 10.3
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Attention Deficit Disorder (ADD/ ADHD) Either criteria for inattention or hyperactivity-
impulsivity must be met. Attention Deficit Behaviors may include
Does not seem to listen or follow through on instructions Difficulty in organizing activities and tasks Easily distracted by other stimuli Forgetful in daily activities
Hyperactive Behaviors may include Fidgets, runs about excessively Hard to play quietly Talks excessively Gluts out answers Can’t wait turn Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Issues in ADHD
How common? 7 out of 100 children 4 boys to 1 girl
Consequences? Deficiencies in academic and social skills Poor school achievement Negative self-view Problematic interactions with parents and
teachers
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Rates of ADHD
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Risk Factors for ADHD
Genetic inheritance Brain functioning Neurotransmitter activity Environmental factors
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Treatment of ADHD Stimulant medication (e.g. Ritalin) Antidepressant medication Behavioral intervention
Classroom intervention Parent training
Combination of medications and behavioral intervention is most efficacious
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Tic Disorders Tics
Involuntary, sudden, recurrent, stereotyped motor movements or vocalizations
Tourette’s Syndrome Large motor ticks (shoulders, trunk, arms, legs)
combined with uttering obscenities (coprolalia) Genetic basis likely
Both often occur together with ADHD Treatment for Tourette’s Syndrome
Antidepressant medication Relaxation therapy
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Oppositional Defiant Disorder Pattern of negativistic, defiant, hostile behavior
lasting more than six months and not typical for age or developmental level
Cause impairment in social, academic functioning
Examples: Loses temper Argues with adults Refuses to comply with requests Deliberately annoys others Angry and resentful Spiteful and vindictive Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Oppositional Defiant Disorder
Risk factors Genetic Family relationships Poor or inconsistent parenting
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Rates of Oppositional Defiant Disorder
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Conduct Disorder More serious than ODD Aggressive behavior that violates social
norms and rights of others Examples
Threatens or causes harm to people and animals Property damage, theft, deceitfulness Serious violations of rules Behaviors would constitute antisocial personality
disorder if child were over 18 years
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Conduct Disorder Risk Factors
Negative family environment Lack of social and academic skills
ADHD and ODD often associated with later development of conduct disorder
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Treatment of Conduct Disorder
Prevention Develop social, emotional, and cognitive skills
Cognitive-behavioral interventions Cognitive review of situation before reacting,
thinking aloud Time out; behavioral shaping Positive encounters with clinicians and other
adults to develop pro-social behaviors Interventions must involve parents
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Separation Anxiety Disorder Defined by excessive anxiety or panic when absent
from major attachment figures, lasting for more than four weeks, and impairing functioning
Often develops after some stress (loss of parent, relative, or pet or serious family illness, parental separation or divorce)
Usually from caring families Sometimes the result of failure to achieve secure
attachment bond in early childhood Diminishes after the age of 10 years
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Separation Anxiety Disorder
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Other Anxiety Disorders Commonly Seen in Children Social phobia
Shun contact with unfamiliar people, especially if under pressure to perform.
Generalized anxiety disorder In situations associated with pressure to perform, seek out peers
to establish dependent relationships; overly eager to please peers.
Obsessive-compulsive disorder Persistent intrusion of intense, unwanted thoughts with
compulsions to perform ritualistic, repetitive behaviors; mostly concerned with dirt and contamination, performing washing rituals.
These disorders often persist into adulthood; may also develop into agoraphobia or depression
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Treatment of Anxiety Disorders
Antidepressant or anti-anxiety medication Family treatment Cognitive-behavioral interventions, as used
for adults
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Symptoms of Childhood Depression Birth to 2 years
Whining, withdrawal, delays in physical, cognitive, language development
Nightmares, night terrors, clinginess 3 to 5 years
Sadness, weight loss, tiredness, thoughts of suicide, anger, apathy, irritability
6 to 12 years Similar to adults with verbalization of thoughts and feelings;
sometimes delinquent behavior; somatic problems; irritability and anger; poor school performance
13 to 18 years Similar to adults; possible volatile moods, rage, low self-
esteem, sexual acting out, substance abuse, suicidal thoughts and behavior.
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Rates of Depression in Childhood
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Other Types of Child and Adolescent Therapies
Play therapy Talk and play techniques; puppetry
Family therapy Family systems approach
Effectiveness Unclear how effective in clinical settings, though
research settings indicate some positive effects.
Abnormal Psychology, 11/e by Sarason & Sarason © 2005