Dr van Widenfelt PSYC 307 100 FALL 2015 Agenda TODAY AND FRIDAY Developmental psychopathology childhood disorders ADs ADHD ASD Developmental psychopathology Developmental Pschopathology About 20 of children will show symptoms of psychosocial problems Developmental psychopathology Key principles Multifinality One cause can have many multiple final manifestations Equifinality One symptom can have many causes Given the Principles of multifinality and equifinality we are cautious with drawing conclusions about what is going on with a child in regard to diagnosis and treatment Some disorders can be mitigated with early and targeted treatment or interventions Environment Stress and Resilience Resilience Involves capacity to adapt well to significant adversity and to overcome serious stress Suggests differential sensitivity Important components Resilience is dynamic Resilience is a positive adaptation to stress Adversity must be significant ie something that some people would be overwhelmed by Cumulative Stress Repeated stress Makes resilience difficult Is more devastating than isolated one major stress event Includes such things as frequent moves changes in caregivers disruption of schooling What factors might reduce impact of stress and increase coping well and resilience to negative impact of stressors Resilience and Stress Coping Some factors reduce impact of repeated stress Family situation Development of friends activities and skills Participation in school success and afterschool activities Involvement in community church and other programs Also child s interpretation of event Anxiety Anxiety in childhood normal transient common related to another disorder Parents are concerned Jesse 9 is afraid of dogs he didn t want to go to his uncle s house for his birthday party because he has two german shepherds we made him go and then he sat in the car for the entire time I always have to nag and yell to get Lola 10 to go to school in the morning sometimes I just let her stay hom if I will be home anyway Parents Tessa 6 doesn t want to sleep over at her friends house she says then there is no one to kiss her good night and read her a story I am worried that she will miss out on the fun Jack 11 really clams up when he has to talk to new people I wish he was more outgoing like his father Parents are usually advised don t worry your child will outgrow their fears it is just a phase he ll grow out of it it s normal at her age just talk to her everyone is shy sometimes some kids just like being home more than others just be a little stricter don t accept it Examples of normal fears Infancy 1 2 yrs 3 5 yrs alone 6 9 yrs 9 12 yrs 13 yrs sudden intense noise strangers getting injured animals dark being school personal safety tests personal health social interaction But some children do not outgrow their fears and anxieties Sometimes their fears or anxieties are part of a more serious disorder The fear or anxiety can sometimes be very impairing socially emotionally academically Having a childhood anxiety disorder Anxiety disorders are among the most prevalent forms of psychopathology in childhood and adolescence Most anxiety disorders do not last longer than 3 4 years though a subset have a chronic course or change form many adult anxiety disorders and depression have their roots in child or adolescent onset Prevalence rates of anxiety disorders in childhood Studies range from 5 7 to 20 2 Most common in middle childhood separation anxiety disorder and simple phobia and generalized anxiety disorder More common in girls than boys Age of onset examples depending the study Separation Anxiety Disorder 7 5 years old Phobias usually 6 8 years old OCD onset usually 11 years old Social Anxiety Disorder teen years onset 11 years old intake 14 years old Panic Disorder usually older teens onset 15 6 years old Once have an anxiety disorder Likely to be maintained Likely to be intensified BY BOTH CHILD AND ENVIRONMENT Multiple causal influences Equifinality Single cause unlikely Risk and protective factors Not merely additive but likely to influence each other interact with each other So child can develop a phobia without traumatic experience Child can experience a trauma without developing PTSD but if already have anxious coping style and then experience a trauma more likely to develop PTSD Cumulative risk predisposing and protective factors Genetic moderate Neurobiological increased stress hormones Temperament behavioral inhibition Emotion regulation skills deficient Cognitive biases and distortions Early control experiences mastery experiences Parental responses eg overprotectiveness Extent of experience with stimulus safe controllable Level of exposure to feared stimulus limited experience or avoidance Maintenance factors avoidance as excessive coping style worry and cognitive biases overprotection by parents and others incompetence deficits social emotional academic punishment and failure parental rejection and criticism What kind of thoughts anxious kids have Dominant schema or way information is internally represented THREAT of loss of harm of criticism etc This is the filter that screens experiences In ambiguous situations anxious kids expect bad things to happen catastrophize expect others to be critical What kind of role might parents have Parent reassures and comforts child in response to his or her fear or anxious reaction to a negative stimuli parents give child a great deal of attention for separation anxiety or school refusal behavior parents make special exceptions for child due to their anxiety may not have to do things that don t like or are stressful like chores Parents continued Parents may play a role in avoidance but parent CAN play a role in facilitating change parents often find it hard to balance how hard to push and how supportive to be or when to ignore anxious behavior Helping parents Help parents be better observers of their child e g to see small improvements Help parents with their expectations of their child often view as fragile He or she can do what others can Help with not being overinvolved and letting child individuate Helping parents continued Help parents be aware of their own anxiety and stress Encourage parents to role model e g social and courageous behavior Help parents problem solve and to help child see alternatives Help parents by giving feedback and tips reward child ignore child saying don t worry doesn t help Help parents stimulate child s social contact What