Exam 3 Study Guide Ch 12 Gender Dysphoria used to be gender identity disorder o Gender Identity Our sense of ourselves as being either male or female Gender identity o Relatively new label in DSM V brought controversy disorder negative connotation good almost always reflects physical anatomy taking serious bad negative o Gender Dysphoria sense of discomfort with one s anatomical sex sense of self is mismatched with anatomical transsexualism not psychotic rare in comparison to most of the other disorders male to female transsexuals are more common than female to male o Josie boy to girl anxiety at age 9 because worried about puberty too young to decide effects life long infertile if get sex change hormone therapy blockers are reversible o Pro of label people like having DSM give medical label allows them to get treatment o Con of label including it in DSM implicitly calls it an illness on medical record and stigma o Symptoms convinced their anatomy does not match aware of feelings in early childhood wear clothing and adopt sex role behavior of other gender intensity varies more intense during adolescence when secondary sex characteristics develop more difficult to pass preoccupied with surgery not always homosexual o Different from transvestic disorder form of paraphilia dress to receive sexual arousal o Comorbidities depression anxiety o causes risk factors very little is known genetic symptoms of gender identity during childhood are at least moderately heritable neurobiological factors exposure to high levels of sex hormones in utero Social and psychological reinforcement of cross gender behaviors psuedohermaphrodite male but not right hormones to have penis o treatment options psychotherapy 1 change identity to match anatomy can be more harmful 2 change anatomy to match identity sex reassignment surgery results generally positive and decrease anxiety and depression o sex roles what you do masculine or feminine Ch 16 Psychological Disorders of Childhood Developmental Psychopathology emphasizes importance of developmental norms age graded averages to understanding influences on abnormal behavior look at duration severity and context 1 Exam 3 Study Guide Considerations of what constitutes abnormal need to understand typical behavior to define atypical only concerned if behavior deviates from developmental norms presence of abnormality may change over time Terms Internalizing Disorders versus Externalizing Disorders externalizing creates difficulties for the child s external world failure to control their behavior according to expectations of parents peers teachers or legal authorities Internalizing psychological problems that primarily affect the child s internal world for example excessive anxiety or sadness Internalizing Disorders general symptoms Fears and Anxiety Children often have trouble identifying their anxiety but they are more aware of their fears Somatic symptoms are common Depressive Symptoms Less common in young children More irritability Comorbid with both externalizing problems and anxiety Troubled peer relationships Childhood anxiety disorders with a focus on separation anxiety social phobia school refusal Separation anxiety Persistent and excessive worry about safety of caregiver and self Refusal to be alone School Phobia School Refusal Severe and pervasive reluctance to go to attend school Somatic symptoms often present May be related to When children are afraid of social situations in which they have to interact with people Other Neurodevelopmental Disorders Specific Learning Disorder learning disability Specific aspect of school environment e g academic failure Social phobia Selective Mutism inability to speak and communicate effectively students who perform substantially below their ability in a specific area of learning Tic Disorders tourettes rare characterized by repeated motor and verbal tics Developmental Coordination Disorder slowness and inaccuracy of performance of motor skills Trauma and Stressor Related Disorders Reactive attachment disorder withdrawn behavior among very young children around adult caregivers observed following neglect 2 Exam 3 Study Guide fail to seek comfort Disinhibited social engagement disorder reaction to neglect indiscriminant toward caregivers willing to go off with anyone Elimination Disorders Encopresis inappropriately controlled defecation and enuresis inappropriately controlled urination age 5 5 5 year olds wet bed encopresis less common 1 Prevalence of internalizing disorders 32 of youth 35 young women 19 young men depression by 19 Course of internalizing disorders Depends on the disorder specific fears usually short lived depression anxiety usually more permanent Causes of internalizing disorders biological psychological social family systems Few behavioral genetic studies have been conducted Evidence of heritability Social factors Focus on attachments refer back to attachment styles Early adversity Family Conflict Bi directionality Biological factors Depressed parent Unable to make parents happy Feel guilty and responsible Psychological Factors Rumination repeatedly focusing on distress Poor form of emotion regulation Foreshadows future depression in early adolescence Caretaking children Course and Outcome Some but not all problems persist over time childhood depression predicts 6x increase in risk for suicide among young adults Treatment for Internalizing disorders Children are NOT little adults Family involvement is often essential Anxiety Disorders 3 Exam 3 Study Guide Exposure to feared object CBT Kendall s Coping Cat program Cognitive restructuring Psychoeducation Modeling and exposure Depressive Disorders Skills training Treatment for Adolescents with Depression Study TADS a multisite clinical trial of 439 depressed adolescents randomly assigned to receive either Fluoxetine Prozac alone Cognitive behavior therapy CBT Combined medication and CBT Placebo Externalizing Disorders general Symptoms Adolescent limited ends along with teen years life course persistent continues motivation key in relational aggression designed to hurt others in more subtle ways girls Violate rules at a younger age 19 adolescents less than internal angry aggressive argumentative Inattentive Symptoms Can t focus consistently sustained attention Not including television or videogames Classified as a neurodevelopmental disorder Characterized by hyperactivity attention deficit and impulsivity ADHD inattentive and hyperactive impulsive