DISORDERS OF CHILDHOOD AND ADOLESCENCE (Child Psychopathology)Most of what we have studied historically has had to do with adults—children are a new study- In 1900s, we thought as children as miniature adults- Did not differentiate between child and adult disorders- Mirrored in classification systemChildren in the DSM and Government- 1952: DSM came out, only 2 disorders that were specific to childreno Adjustment reaction of childhood and childhood schizophrenia (Neither are included now—recognizing it as other disorders)o As the DSMs advance, we have added more and more diagnoses that are specific to children- Federal gov’t recognize that children with special needs need to have special accommodations within school system. 1997—Government passed “Individuals with Disabilities Education Act” (IDEA) o Ensured a free public school education for all children with some identified disability o As part of this act, we created individualized program for each of thesechildren, based on specific needso Ensures that each child is placed in least-restrictive environmento Encourages parental participation- Estimated that 1/5 children have a diagnosable disorder within the DSM that interferes to some extent with their everyday functioning- 1/10 children in adolescence have a disorder that causes more significant functional impairment (i.e., autism)Reorganization of Childhood and Adolescent Disorders in the DSM (See pg. 70)- In DSM IV-TR category called “Disorders usually first diagnosed in infancy, childhood, or adolescence”  No longer exists in DSM 5, so now all these disorders have to move to another category such as Neurodevelopmental Disorders, Anxiety Disorders, Disruptive, Impulse-Control, and Conduct Disorders- Asperger’s part of Autism spectrum disorder- The personality disorder of Antisocial Personality Disorder  dually coated, meaning it falls in both the Disruptive, Impulse-Control, and Conduct Disorder AND Personality Disorders- Sleep Disorders like Sleep Terror and Sleepwalking  Organized under Sleep-Wake disorders under the name “Non-Rapid eye movement sleep arousal disorder”Anxiety Disorders in Children and Adolescents- In DSM 5—classified in same category as anxiety disorders for adults- Diagnoses that apply to adults apply to children- Fairly common—more common in girls than boys- Children can develop a full-blown anxiety disorder- The disorder they develop will remit before they go into adulthood, and if it continues into adulthood, it is likely to be chronic- Treatments: o Medication and o Same kinds of behavioral techniques (systematic desensitization, assertiveness training)Why do some children develop symptoms of anxiety/anxiety disorders?- Temperamental predisposition//Behavioral Inhibition—anxiety disorders in children are most likely to occur in those who are born with the temperamental disposition called behavioral inhibitiono Behaviorally inhibited infants are easily distressed by unfamiliar stimuli  They are increasingly fearful and anxious in childhood  They are at risk of developing an anxiety disorder in childhood- Environmental factors—early serious sickness makes a child more vulnerable- Abused—more likely to become anxious and fearful - Parents who are overly anxious and protective—child is more likely to be anxious OR if parents are indifferent to child’s development increases child’s level of anxiety - Divorce is a risk factorSeparation Anxiety Disorder: Diagnostic Criteria[In DSM 4 TR- one criteria for Separation Anxiety Disorder, onset of disorder had to be prior to age 18, and fell into different category. This category disappeared in DSM 5—now in category called anxiety disorders. Also changed criteria]A) Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attacked, as evidenced by three of the following:1. Recurrent excessive distress when separated from home2. Persistent and excessive worry about losing major attachment figures3. Persistent and excessive worry that an event will lead to separation from ones major attachment figures4. Persistent reluctance or refusal to go away from home5. Persistently and excessively fearful or reluctant to be alone6. Persistent reluctance or refusal to go to sleep alone7. Repeated nightmares involving the theme of separation8. Repeated complaints of physical symptoms when anticipating or following separation from major attachment figuresB) The duration of the disturbance is at least 4 weeks in children and adolescents and 6 months in adultsC) The disturbance causes clinically significant distress or impairment in functioningStatistics- More common in girls than in boys- Seems more often times to be present in children from very close-knit families- Onset—can be as early as preschool, mostly elementary school aged children- Decreases in prevalence as we get to adolescence and even more when weget to adulthood- Symptoms wax and waneSeparation Anxiety Disorder VS Normal Separation Anxiety in Children - Separation anxiety is NOT an extension of normal separation anxiety that children experience in the first few years of life- Children are not more likely to develop separation anxiety if they experience normal separation anxiety from a young age—actually they’re less likelySchool Phobia (Not a psychological disorder, not in DSM)- Used to be defined as an unrealistic fear that keeps children away from school- Now, defined as the fear of having one’s parents, not the fear of school itself- Considered a possible symptom of Separation Anxiety Disorder- Not truant—the parents know they’re not at school, bc they’re home- Tend to have average or above average IQ or grades - Can be diagnosed in elementary—high school students- Tend to have professional parents - Treatment:o Gradually re-integrate them into classroom as quickly as possibleo Best done if principal, teacher, parents can all work together as teamo Mom and Dad accompany child into classroom at first until child is comfortable, then parents sit outside classroom, and gradually get farther and farther awayDepression in Children and Adolescents - Multiple uses of the term depression: period of the blues, symptoms of depression, full-blown case of depression- Diagnosed in same category as adults:- Major Depressive Disorder (Clinical Depression)—child will need to meet same diagnostic criteria as an adult, WITH ONE