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DH Lecture Seven
Internalizing Disorders 1: Anxiety
| Question | Answer |
|---|---|
| What anxiety disorder is the only in Childhood (before the age of 18)? | Separation Anxiety Disorder (SAD) |
| What are the features of SAD used o describe it? | Excessive anxiety concerning separation form attachment figure, Preoccupation with returning home to attachment figure, Inability to remain in a room alone or displays "clinging" behaviour. |
| What is first part of the DSM-4 diagnostic criteria for SAD? | Must be inappropriate and excessive anxiety concerning separation from home or those to whom the individual is attached as evidenced by 3 or more of the eight criteria for at least 4 weeks. |
| What is the rest of the DSM -4 diagnostic criteria for SAD? | Disturbance must cause significant distress or impairment in social, academic or other important areas of functioning and symptoms must not occur solely within another mental disorder or be better explained by another disorder |
| In terms of developmental features, what age group does this description relate to in SAD? "They still feel distressed about separation but will begin to try and regulate their feelings and wil not tantrum when dropped off at school" | Children aged 9-12 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "It is normal for them to be clingy to parents and not want to go to other adults. Normal for them to develop SAF. If they didn't then this would be a concern" | At 9 months of age |
| In terms of developmental features, what age group does this description relate to in SAD? "They will have tantrums and not want to go to school. Their behaviour will be overt. Will get nightmares about bad things happening & try go in parents room" | Children aged 5-8 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "Because they have started to regulate their feelings and not have tantrums when dropped to school, their stress will turns into physical symptoms instead" | Children aged 9-12 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "The phase of separation anxiety should be over because they should have learnt about object permanence and know that mum is not going to disappear forever" | At 18 months of age |
| In terms of developmental features, what age group does this description relate to in SAD? "They get physical symptoms such as headaches and stomach aches instead of tantruming" | Children aged 9-12 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "If they did not develop separation anxiety at this age then they would not be developing properly" | At 9 months of age |
| In terms of developmental features, what age group does this description relate to in SAD? "They will be scared and will talk about bad things happening such as Dad being in a car accident on his way home" | Children aged 5-8 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "Will use their physical symptoms to avoid going to school. The first few times it will work but the rest of the times they wont actually be sick" | Children aged 9-12 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "Learning about object permanence is important to overcome SAD. If they dont learn this then they will continue to develop SAD and it will be abnormal at this age" | At 18 months of age |
| In terms of developmental features, what age group does this description relate to in SAD? "They will refuse to go to school and instead of going to school they will bunk and go home to be with parents" | Adolescents aged 13-16 years old |
| In terms of developmental features, what age group does this description relate to in SAD? "The whole time they are at school they'll be focused on getting back home so will be withdrawn and unhappy, antisocial & lack of concentration so impacts learning. | Children aged 9-12 years old |
| What does it mean when they learn about object permanence? | It means that they have learnt that even though something is hidden, it has not disappear permanently. |
| There are three types of causes for SAD. What are they? | Genes, Neurotransmitters and Family environment |
| If a distant family member who the child hardly sees has SAD what does this show? | Shows that it is not just environmental as the family member has not been able to model the behaviour so there is some genetic link |
| There are a number of neurotransmitters that cause SAD such as serotonin (____-regulation), nondrenalin (______ hormone), _____ (relaxant) and HPA (controls reaction to _____) | mood, stress, GABA, stress |
| What is the most common environment that causes risk of developing SAD? | A closed family |
| Why does a closed family increase risk of developing SAD? | Because they do not socialize or have people visit the home which means that the child is not exposed to separation so gets used to it and therefore develops SAD |
| Why is maternal stress another environment that can cause SAD? | Because if the mother is anxious about leaving her child then they will feed off each other and reinforce each others behaviours. |
| Why is SAD being caused by maternal distress more difficult to treat? | Because you have to treat both the mother and the child |
| SAD is often an early ______ to later anxiety disorders. SAD is usually the _____ internalizing disorder that you get. About _/_ of SAD aslo get depression | precursor, first, 1/3 |
| There are three core reasons for school refusal, what are they? | SAD, School phobia and Social phobia |
| If it is a school phobia that is causing school refusal then it will be a fear of something _____ at school such as being asked questions in class or the school t______. | specific, toilets |
| If it is a social phobia causing school refusal then it is much broader. The child is ______ sensitive to how other people judge them (a _______ threat). They fear that they will be bullied or teased and that others judge them ________. | overly, non-real, negatively |
| Fear for a non-rela threat is the d_______ that makes it anxiety because if they were actually getting bullied then it would not be ________. | distinction, anxiety |
| Social phobia is linked to school refusal because school is a ________ environment, thus the child might not want to go to school because they dont feel as if they ____ in s_______. | social, fit, socially |
| There are three types of interventions for anxiety, what are they? | Cognition Behavioural Therapy, Family therapy and Medication |
| There are five types of Cognitive Behavioural Therapy, what are they? | Anxiety is normalized, Body alarm, Relaxation training, Thought-response connection, Coping self-talk. |
| With 'Anxiety is normalized' you would challenge the child's beliefs and ask them to think about how ______ it actually is that Mum will have an accident on way home | likely |
| With 'body alarm' children with anxiety's body alarm is going off ___% of the time which is waaaay too much. It is going off all the time when there are ____ threats. | 90%, low |
| What can you do to prevent the body alarm going off so much? | Teach them how to identify the early warning signs and teach them relaxation techniques to stop themselves from getting anxious. |
| Relaxation is a way of _______________ calming down the body. Anxiety has a lot to do with this ___________ aspect. What two techniques can you use to relax? | physiologically, physiological, deep breathing, muscle tension |
| 'Though-respons connection teaches child to ______ their thoughts. You teach them that thoughts/interpretations influence how you feel so you teach them this relationship between...? | thoughts and its influence on mood. |
| Coping self-talk is specific to the child - what the child can ___ or ___ to make them feel better. The child can be taught to use self-rewards such as __________ themselves or giving themselves actual ________. | do or say, congratulating, rewards |
| What is the acronym "FEAR" used for? | Facilitating recall of the steps for coping with anxiety |
| What are the four steps that 'FEAR' stands for that child uses to cope? | F = feeling frightened? E = expecting bad things to happen? A = actions and attitudes that will help? R = results and rewards? |
| What is this referring to? "Hierarchy of anxiety provoking situation is developed, Hierarchy is worked through gradually and systematically, Exposure is done in therapists office and in natural environment" | Exposure strategies |
| What type of family therapy involves teaching the parents to not respond, to ignore the child when they are having a tantrum? | Behavioural Management Strategies |
| Use medication in severe cases because non-medication interventions are more __________ as you are teaching them the skills and techniques so is more effective and long term while with medication if child forgets to take it, the they dont know how to ____ | long-lasting, cope |
| What are the three types of medication for anxiety for children? | SSRIs, Benzodiazapines, Beta Blockers |
| SSRIs are ______________. Down sides to them is that they are a________ and the child has to use them long-term | anti-depressant, addictive |
| Benzodiazapines calms them down and is the _______ a_______ so used less and only used for very sever cases. | more addictive |
| Beta Blockes block....? | receptors associated wit anxiety |
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