Chapter 17- Childhood Disorders- Childhood Anxiety Disorderso Adult vs. Childhood Kids show less cognitive symptoms and more physical symptoms Kids show irritability rather than sadness Kids cannot have a personality disordero Separation Anxiety Disorder (SAD)  Diagnosis- 3+ symptoms before age 18 and last for 4 weeks Symptoms- distress and impairment when separated, worry about losing parent, reluctance to go to school or to have sleepovers, fearful to be aloneo Causes: Parental Anxiety: child picks up on parental tension Genes Stressful Life Events: moving homes, changing schoolso Treatments- exposure, parental involvement, not allowing avoidance, teach to worry less Anti-Anxiety medications- in combination with psychotherapy- Childhood Mood Disorderso Major Depressive Disorder (MDD)  Adult vs. Childhood- more common in adolescence Female vs. Male- no difference at age 13 but by age 16, girls are 2x more likely to have MDD compared to guys due to hormonal changes, emotional investments Symptoms:- Irritability> Sadness, easily annoyed, angered- Anhedonia: less interest in playing with toys- Physical> Cognitive- headache, tummy ache, sleep problems Causes- genes, stressful life events Treatments:- Cognitive Behavioral Therapy: with adult involvement- Medications: Prozac, Zolaf- antidepressants initially increases suicide thoughts but overall is not effective- TADS Study: comparing CBT versus Medso CBT+Meds is most effective, Meds alone are better than CBT aloneo In adolescents, if combination is not in use, there wil be no effecto If adults go off meds, new CBT is better than the past medso If adults stay on meds, their results will be equal as if they had CBTo Bipolar Disorder  Diagnosis- symptoms can be present but not diagnosed in childhood because the symptoms may overlap with other disorders and the DSM has no correct category Treatment- both meds+cbt, however none of the meds have been tested- Oppositional Defiant Disorder (ODD) “acting like a 2 year old”o Female vs. Male- more common in boys until after puberty then they are equalo Causes- same as conduct disorder but has a larger focus on environmental (parental)o Diagnosis: at least 4+ symptoms for at least 6 months and causing impairmento Symptoms: loses temper, argues with adults, ignores the rules, disrespecto Treatments: Behavioral Parent Training- teach parents operant conditioning (award and punishment) and teach them to reinforce and reward when appropriate Parent-Child Interaction Therapy- modeling in a therapy session teaching how to praise good behavior and show the parents what they can do to improve symptoms- Conduct Disorder- more severe than ODD b/c they are violating rightso Female vs. Male- more common in boyso Age of onset: early onset is possible but high remit caseso Diagnosis: need 3+ symptoms in the past year and at least 1 in the past 6 monthso Symptoms: initiates physical fights, uses weapons, cruel to people, violate basic rightso Causes:  Genetic and biological factors- different temper levels Environmental- Community factors- high violence areas increase risk- Family factors- living in poverty, ineffective parenting and/or punishmento Types of Conduct Disorder- overt (hidden- lying, stealing), covert (obvious- yelling, fighting) destructive (going to harm someone- property damage, fight), non-destructive (non-physical)o Types of Aggression Instrumental: purpose of getting something (cutting in line for food) Hostile: intended to harm someone else (common in males) Relational: aimed at peer relationships and social environment (common in females)o Treatments: Socio-cultural Treatments- parental therapy and training in operant conditioning Juvenile Training Centers- rehabilitate kids who have the same symptoms Child-Focused Treatments- Problem-Solving Skills Training: teaching them to do something else rather than the aggressive attack- Anger Coping/ Coping Power Program: other things to do when you’re angry Combination- parent training + teaching kids how to cope Prevention- get rid of the bad community and decrease parental tensions- Attention Deficit Hyperactivity Disorder (ADHD)- said to cause conduct disordero Female vs. Male- more common in boys, 90%o Age of onset- more common in childhood, symptoms decrease as age increaseso Diagnosis: must be present in more than one setting, causing impairment, 6+ symptomso Symptoms: need 6 of each type of 6 combination Inattentive- does not pay close attention to details, doesn’t listen, doesn’t finish tasks Hyperactive/Impulsive- cannot stay in seat, talks excessively, always on the goo Risks: bad communication, poor school performances, mood/ anxiety problems However they do not realize that they have bad interaction skillso Causes Biological- genetics, frontal lobes (decision making) show less activationo Treatments Biological- Stimulant Medication: adderal, vivanse- Short term side effects- loss of appetite, sleep problems- Long term side effects- heart problems, involuntary movements- Overprescribed? Pediatricians do not complete correct assessment MTA Study- behavioral therapy vs. medication vs. combination- Meds is better than CBT to cure symptoms- Pervasive Developmental Disorders (PDDs) o Symptom Clusters Social Interaction- nonverbal behaviors, limited peer relationships, no shared enjoyment, not continuing conversations or responding to their emotions Communication Symptoms- delay of developmental language, cant hold conversation, out of place words, cant play make believe Repetitive, Restrictive, Stereotyped Interested/ Behaviors- only care about one feature, no flexibility in their schedules, atypical hand gestureso Autistic Disorder- 2+ social, 1+ communication, 1+ other= 4 symptoms total Symptoms occur before age 3, males> femaleso Asperger’s Disorders- 2+ social, 1+ other, no language delay!!! Less symptoms than autismo Causes:  Biological- genetic, brain abnormalities, prenatal problems (exposed to certain diseases and complications during process) Theory of Mind: being able to take on others perspectives, they lack thiso Treatments Biologically- no cure, goal is to help adapt a better environment Behavioral Therapy- Early Intensive Behavioral Intervention (EIBI)- focus on teaching new skills by using modeling and reinforcement- Mental Retardation o Diagnosis: IQ- 70 or