Ch#15#Psych#Disorders#Part#III#Childhood#Disorders#and#Controversies#• Autistic'Disorder'• ADHD'• Early'onset'Bipolar'Disorder''Autism#• Autistic#Disorder:'disorder'm a rke d 'by 'se ve re 'de fic its'in '______________,'s o c ia l'bondin g 'a n d 'imagina tio n '• Diagnostic#Criteria:''Soc ia l'Deficits''Commun ic a t io n 'Deficits''Res tri ct e d 'a n d 'Repetitiv e 'B e h a v iors''On se t 'e a rly 'in 'l ife '( b y 'a b o u t 'a ge '3 ) 'Autism'________________:'• Astronomical'rise'in'autism'rates'in'a'span'of'a'decade'• Reasons?''199 8 :'Wakefie ld 'publishe d'a'study 'in 't h e 'Lancet'that'demon stra ted 'a'link'be tw ee n'autism'symptoms'and'the'MMR'vaccine''201 0 :'Lancet'retracted'the'article'due'to'ethical'concerns'and'false'claims'about'subject'recruitment''Lots 'o f'r e se a r c h 'h a s 'sh own'no 'r e la tionship 'between'autism'and'vaccinations''languageEpidemicThe'correlation'that'people'perceive'between'vaccines'and'autism'is'probably'an'illusory'correlation,'because'there'may'be'no'epidemic'after'all:''Other'possible'causes:''Cha n g e s 'in '_____________ 'pr a c tices''Lots 'o f' _________'f o r'a u t is m'treatm e nt''Sch o o ls 'manda te d 't o 'id e ntify'child r e n 'with'autism''Less'stig ma'assoc ia t e d 'with'the'diagnos is '#ADHD:#• _________________‐deficit/______________'disord e r :'c o n d it io n 'marked 'b y 'e x c e ss iv e 'inattentio n 'an d /o r'impulsivity'a n d'a ct ivity ,'w ith 'ch ild h oo d 'o n se t''Pred ominantly'Inatte ntive'Subtype''Pred ominantly'Hyp e ra c ti ve / Impulsive'S ub ty p e''Combined 'S ubtype '• Concerns'of'________‐______________'– Often'a'fine'line'between'highly'energetic'and'mild'ADHD'Early#onset#Bipolar#Disorder:#• Difficult'to'distinguish'between'_________'and'Early'b ip olar'• Early'onset'bipolar'diagnosis'when:'– Rapid'changes'in'mood'– Reckless'behavior'– Aggression''• But'these'are'identical'to'severe'ADHD'as'well!'Summary:'• Anxiety'Disorders'• Mood'Disorders'diagnosticfundingAttention Hyperactivityover diagnosisADHD• Schizophrenia'• Childhood'Disorder'and'Controversies'• Now:'how'do'we'treat'these?'='Ch'16'#Ch#16:#Psy chologica l#a n d #Biologica l#T r e a tments#–#Guided#Note s #Outline:'• Psychotherapy'• Behavioral'Approaches'• Biomedical'Treatments'Psychotherapy:#• A'psychological'intervention'designed'to'help'people'resolve'______________,'behavio r a l,'a n d '___________________'prob le ms'and 'improve 'th e 'quality'o f'li fe 'o f 'th e ir 'liv e s 'Who'seeks'and'benefits'from'therapy?'• Newsweek'poll'(2006):'20%'of'Americans'over'lifetime'• ____________'seek'tr e a tment'm ore'than '___________ '– Though'men'and'women'benefit'equally'• Racial'and'ethnic'minorities'less'likely'to'seek'treatment'– Especially'Hispanic'and'Asian'Americans'– SES'and'cost'of'therapy'– All'likely'to'benefit'from'therapy'Culturally'sensitive'therapy:'• Intervent ion 'in 'co n te xt'o f'c ult ur al'v alu e s'• Minorities'prefer'to'see'_________‐ethnicity'therapist'– But'ethnicity'and'gender'matching'do'not'predict'outcome'• Many'things'predict'benefit:'– Initial'adjus tment'emotionalinterpersonalWomenmensame– Insight'into 'co n trib u tio n 'to 'pro b le m s '– Motivation'to'work'on'problems'– Experience'anxiety'– Temporary/situational'problems'Who'practices'Psychotherapy?'• _____________________:'person 'w ith 'n o 'pr of es sio n al'tra in in g'w h o 'p ro vid e s'mental'hea lth 'services'• “Therapist”'isn’t'legally'protected'• Professional'training'and'years'of'experience'not'always'necessary'to'be'effective'• Advantages'of'a'professional:'– Understand'how'to'operate'effectively'within'mental'health'system'– Appreciate'complex'ethical,'professional,'and'personal'issues'– Can'select'treatments'of'demonstrated'effectiveness'Effective'Psychotherapists:'• _________,'respe ct fu l ,'ca r in g '• Direct'and'___________'• Establish'positive'working'relationship'• Select'important'session'topics'• Match'treatments'to'client'characteristics'and'needs''Behavioral#Approaches#Behavior'Therapy:'• Behavior'therapists:'focus'on'specific'problem'behaviors'and'current'variables'that'maintain 'problematic'thoughts,'feelings,'and'behaviors'• Behavior'change'stems'from'principles'of'_______________'• Behavioral'assessment:'focus'on'____________'and'________________behaviors'Paraprofessionals Warm engagedcurrentspecificlearningSystematic'Desensitization:'• ____________'expo sure'to'______________'in 's te p wise'ma nner,'oft e n 'with'______________'• Type'of'____________'therapy:'c o nf ro nt s'clie n ts'w it h'what'they'fe a r'w ith 'go a l'o f'red u c ing 'fe ar '• ______________'inhibition:'clients'can’t'exper ien c e'2 'co n flict ing 're sp o ns es 'simultaneo u sly '– Counterconditioning:'pair'_____________response 'with '_______________'condition'more'adaptive'response'to'stimulus'• Start'with'relaxation'• Construct'anxiety'hierarchy'• ______________'and/ o r'___'_________'e x p o s u r e '• Evaluating'the'effectiveness'o f'S D:'– ___________________'approach:'examine'effectiveness'of'isolated'components'of'a'broader'treatment'(this'applies'to'ev a luations'of'any'tre a tment,'n o t'j u st 'S D ) '– Results'show'no'single'component'is'essential'– Credible'treatment''Positiv e 'e x p e c ta t io n 'Placebo'effect?''Flooding'• Jump'to'_____'top'o f'fear'hie rarch y'( i.e .,'e x p ose'them'to'the 'w orst'of'the i r'fe a r s'f o r'prolong e d 'durations)'• Based'on'idea'that'fears'are'maintained'by'_____________'(remember'the'fear'of'dog'example'where'avoiding'dogs'='negative'reinforcement'due'to'the'removal'of'anxiety)'• Single‐session'treatment'for'specific'phobias'• ______________'_____________:'techniq u e'in 'w h ich 'th e ra pis t'p rev e nt s'clie n t'fro m'perform in g'typical'avoidan ce 'beh av iors'– OCD'• Virtual'reality'exposure'therapy'–'sim u la te 'a i rp la ne'flights ,'h e ig h t s,'etc.'Fringe'Exposure'Therapies:'• Thought'Field'Therapy'GradualfearrelaxationexposureReciprocal relaxationanxietyImaginaryin vivoDismantlingtheavoidanceResponse Prevention• Eye'Movement'Desensitization'and'Reprocessing'(EMDR )''Modeling#in#Therapy:#Learning#by#Watching#• Observational/___________'learning'•