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PSYC 168 MT 2 Part 1

The tears and procrastination

Def of Asocial you don't like being social with people- against sociality
Def of Antisocial against society
Antisocial Behavior (Types) Age-inappropriate actions and attitudes that violate family expectations, societal norms, and the personal or property rights of others
Delinquency legal term for antisocial behavior (not necessarily a mental disorder)
Key Features of Antisocial Behaviors -some decrease with age (become more responsible) and others increase with age and opportunity -more common in boys during childhood
When?: Antisocial Behavior--> Disorder -Greater # -Happen more often -More severe -Lasts longer *All compared to normal kid
Psychological Dimensions of Conduct Problems (Grid): Axes and Types -Axes: Destructive (D) vs. Nondestructive (N) & Overt (O) vs. Covert (C) -Types: property violations (DC), status (as a minor) violations (NC), oppositional behavior (NO); aggression (DO)
Types of Aggression (3) Reactive, Proactive, and Relational Aggression
Reactive Aggression (Def, Implies, and Prevalence) engaging in physical violence in response to a threat, frustrating event, or provocation (implies impulsivity, automaticity; lack of thinking about alternatives;often seen with comorbidity of ADHD, young age, and past "violence" (bullying/ abuse)
Proactive Aggression (Def, How Obtained) -deliberately engaging in an aggressive act to obtain a desired goal -learned from modeling and reinforcement
Relational Aggression -type of aggression in which harm is caused by damaging someone's relationships or social status. -more common with girls
Conduct Problem Types (2) Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)
ODD: DSM-5 Criteria -pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness (at least twice) with >= 4 "often" symptoms from above categories -exhibited during interaction with >=1 non-sibling person -specify severity (mild, moderate, severe)
ODD: DSM-5 (Timeline and More) ->= 6 months -1 per week for kids < 5 yrs for >= 6 mo. -still consider if frequency is >normal -associated with distress in the individual/others in his or her immediate social context -symptoms don't just occur during the course of another disorder
ODD Severity Classifications -mild: one setting -moderate: at least two settings -severe: three or more settings
ODD Characteristics -sees behavior as justified & demands/circumstances as unreasonable -see themselves as nonsymtomatic -possibly affected by hostile parenting (but also more likely to be hostile later) -emotion reg issues; noncompliance & negativism(not listen & do opp)
ODD Prevalence -3-5% -more prevalent in males
ODD Course -often first manifests in preschool and almost definitely by early adolescence
ODD Comorbidities -often precedes conduct disorder -comorbid with anxiety disorder, dep. disorder, and sub. abuse disorder
CD: DSM-5 Criteria repetitive & persistent pattern of behavior in which the basic rights of others / major age-appropriate societal norms/ rules r violated -presence of at least 3 /15 categorical criteria in the past 12 mo with at least 1 criterion present in the past 6 mo
CD: DSM-5 Symptom Categories Aggression to People & Animals(bullies,fights,mugging,forced sexual activity),Destruction of property (arson,vandalism), Decitfulness/Theft (breaking & entering,cons,stealing w/o confrontation), Serious Violations of Rule (truancy[ pre-13], run away, etc)
CD: Severity (& Explanations) -Mild: conduct problems are few in excess and cause relatively minor harm to others -Moderate: intermediate number and level of harm to others -Severe: many in excess and considerable harm to others
CD: Onset Type (& Explanations) -childhood onset: at least one symptom <10 yrs -adolescent onset: no symptoms prior to 10 yrs -unspecified onset: not enough info to determine onset
CD: Childhood Onset -usually male -disturbed peer relationships -frequently physically aggressive -more connection with ODD and ADHD (worst combo) -poorer prognosis w/o treatment
CD: Adolescent Onset -more gender balanced -less physically aggressive -normative peer relationships -less likely to have comorbidities -more likely to have remission before adulthood
CD: Criteria for Limited Prosocial Emotions (LPE) Specifier ->=2 over >=12 months & in many relationships & settings: no remorse/guilt(cept when caught/facing punishment),no empathy,unconcerned about performance,& shallow/deficient affect (emotions 4 manip,quick switching) -lots info sources 4 good prognosis
CD: LPE Specifier Characteristics -childhood onset, severe, violent, & chronic -traits are relatively stable -boys are less responsive to parenting intervention via discipline/punishment (no effect on response to + reinforcement -behavioral therapy on its own is less effective
CD: LPE Specifier Characteristics Continued -traits are more heritable -problems are more strongly related to dysfunctional parenting practices -amygdala hyporeactivity--> deficits in processing fear and distress signals in others
CD Prevalence -5-10% boys; 2-4% girls -prevalence increases going to adolescence -few children receive treatment
Differentiating ODD and CD and ADHD and Dep. and Bipolar (sleep/food/energy issues) Disorder -ODD != have: significant physical aggression, significant property destruction, theft/deceit -CD != have emotion regulation issues -ADHD people != mean to cause harm -ODD/CD != disturbances with sleep/appetite(energy and activity levels about constant
ODD and CD: Assessment -open-ended interview questions that give you info about characteristics for disorder
Antisocial Behavior(AB) Causes: Biology -decreased NTs (serotonin and dopamine) -increased horomones (like TTT) -low levels of autonomic arousal (HPA Axis)
AB/Conduct Problems Causes: Temperamental and Psychosocial -difficult temperament -high emotion reactivity (ineffective emotion regulation, inapp. parent response, impulsive decisions, peer rejection, affiliation with deviant peers and truancy training) - thrill seeking and reckelssness (esp with CD)
AB Causes: Cognitive-Behavioral -rewards for aggression (reinforcement trap) -hostile attribution bias(think of others' ambig. behavior as hostile) -perceive & label their own arousal as anger -social learning -focus on + aspects of aggression -doesn't respond to emotional stimuli
AB Treatment: Parent Management Training -inform on casues & how to deal w/ behav.(attend & praise good B often &quickly; time out 4 bad B) -Help children behave well w/ env. -Generalize to other settings -good for >=3 yr -less skilled clinicians & doesn't work for adol. and stressed 'rents
AB Treatment: Parent-Child Interaction Therapy (PCIT) -parents and children attend therapy together -parents PRIDE: praise, reflect, imitate, describe, and entusiasm (for results) -more realistic expectations for child (identify shortcomings and give effective and clear commands -advances kept for 1-2 yrs
Multisystemic Treatment -Targets family, school, and peers (to help them all help and remove obstacles) -Therapists work in teams of 3-5 and are available 24/7 -Usually lasts 3 months -effective but expensive and largely inavailable
CD Causes: Thrill Seeking and Recklessness Details -as parents switch btw overly permissive and hostile/angry disciplinary tactics -great predictor of CD and progression of ODD to CD -parents feel powerless connected to high crime neihborhoods, maternal dep, and paternal sub. abuse
Substance Use Disorder (SUD): DSM 4 Status -had SAbuse Disorder ad SDependence Disorder
SUD: DSM-5 Criteria clinically significant impairment/distress w/ 2(+) of following within 12 month period *Tolerance, Withdrawal (withd. itself and responding with more drugs), Larger amounts or longer periods, can't stop, time waste, craving, obligation failure,
SUD: Severity Levels -Mild: 2-3 symptoms -Moderate: 4-5 symptoms -Severe: 6+ symptoms
SUD: Prevalence -Generally, tends to be at peak around college years and then decrease around 26 (post college) -Alcohol UD is the most common
SUD: Brain Characteristics -on average, less left hippocampal volume -brains have to work a lot harder (more acivation under fMRI) for things like spatial memory tasks despite same behavioral results
SUD: Age of Onset -alc before 14: stronf predictor of SUD -escalation often predicted by: parent modeling, histories of impulsive/disruptive behavior, friends' SU
SUD: Gender Differences -boys>girls -boys: alcohol, weed, phencyclidine, opiods, cocaines -girls: anxiolytics, sedatives, hypnotics, amphetamines
SUD: Comorbidities -comorbidity-->more severe, poorer prognosis, less responsive to treatment -polydrug UD, CD, ADHD (50-75%), Dep. D (25-50%), Anx. D, Bipolar D
SUD Causes: Biophysical -enhanced reinforcement pathway (due to biological sensitivity to drugs) -parent with SUD -negative affect pathway (SU for alleviating/dealing with problems) -deviance prone pathway (larger context of ABs or CD specifically)
SUD Causes: Social -peer relationships: expectation of social facilitation, peer influence, peer selection, perceived norms (media tends to overrepresent/underrepresent it but appealing to personal values does seem to work against SU)
SUD: Protective Factors -positive, self-concerned, non-deviant personality -parenting: authoritative, monitoring, disapproval of SU -env: positive relationships with adults, regulatory controls -beh: prosocial -social: healthy peer models
SUD Treatment: 28 day inpatient treatment -Detox and attend to medical needs -Help the person realize the harmful effects of the substance -Improve the quality of relationships
SUD Treatment: CBT -operant conditioning (remove reinforcement) -classical conditioning (remove triggers) -social learning -ways of thinking: challenge distorted beliefs -5 sessions is enough
SUD Treatment: Motivational Enhancement Therapy -therapist- very kind,understanding, oncerned towards client(C) -show mistmatch btw C's goals&SU -supports any commitment 4 change (BUT could still be allowing bad B & liability for clinician) -promotes self-efficacy -5 sessions is enough
SUD Treatment: Relapse Prevention -make plan for relapse -avoid stimulus cues-people, situations, neg. mood states -think about abstinence violation effect (shame and guilt-> continues bad B-->temper internal, stable, global attributions & challenge these ideas -see SU as problematic
SUD: Substance Egs. Alcohol, Cannabis, Hallucinogens (such as phencyclidine), Inhalant, Opoid, Sedative, Hypnotic, Anxiolytic, Stimulant, Tobacco, Other *each substance can be its own SUD (many at once--> polydrug UD)
SUD: DSM-5 Criteria Continued -giving up important things, continued use despite people problems, SU in dangerous situations, continued SU despite relate physical or psych problem
Intellectual Disability (aka Intellectual Developmental Disorder): DSM-4 Status -called mental retardation
ID: DSM-5 Criteria -onset during the developmental period -intellectual & adaptive functioning deficits in conceptual, social, and practical domains -3 criteria must be met (on diff flashcard)
ID: IQ Test History and Test Valiity/Reliability -IQ: intelligence quotient -ratio of mental age to chronological A(compares you to norm) -past: =MA/CA x100 -now: no firm cutoff but usually about 2 std devs below the mean -reliable (test-retest; better w/ lower IQ) but not good corr. w/ adaptive fn
Adaptive Functioning (AF) -determines level of support required -coping w/ common tasks of life (conceptual, social, practical) -Meeting standards of personal independence and social responsibility expected for someone of this age, sociocultural background, and community setting
ID: AF Domains (3) -conc: competence in memory, reading, lang., math reasoning, gaining practical knowledge, etc. -social: people skills, theory of mind -practical: self-mngmt across life settings)
ID: Mild -most common -difficulty in learning acadmeic skills (conc) -immature in social interactions -difficulties w/ emotion reg. or behav. reg. -need some support w/ complex living tasks
ID: Severe -generally has little understanding of written language/concepts involving #s,quantity,time,& $$. -limited speech: 1 word/phrase -focused on the present w/in everyday events -requires support for all activities of daily living & constant supervision
ID: Moderate -conceptual skills lag markedly behind those of peers - marked differences from peers in social and communicative behavior across development -can handle personal tasks but this requires time, training, and reminers
ID: Profound -Conceptual skills generally involve the physical world -doesn't get symbolic processes -may understand simple instructions/gestures & expresses themselves through nonverbal, nonsymbolic ways -fully dependent & exacerbated by other impairments
ID: Prevalence -~1% of pop -boys> girls
ID: Physical Problems -shorter life span -other medical disorders (like cardiac issues, kidney disease, cerbral palsy
Id: Emotional & Behavioral Problems -stereotyies(repeated B) -self-injurious behavior(SIB) -aggression(-ly or +ly reinforced) -internalizing problems -ADHD-related symptoms -casued by soc,neurobio(dopamine and endorphins high use), med. related,comm. issues,family,vulnerability, stigma
ID: Causes and Risks -prenatal:genetic disorders(single G,multiG,chromosome abnormalities),CNS issues,exposure(maternal infection, teratogen, malnutrition-M) -perinatal:low birth weight,prematurity,delivery complixns -postnatal:infs,toxins,deprivation,disease,M, accs/trauma
ID: Down Syndrome -Trisomy 21 (single determinimsm -rates inc. w/ maternal age (exponentially after 30/31) -better receptive languag than expressive lang. -diff. in hippocampal fning -perceive global but not local features (details)
ID: Fragile X Syndrome (FXS) (pinched chromosome) -phys:large forehead,prominent jaw,low protruding ears,macroorchidism (large testes),heart murmur,Crossed eyes,FX handshake (body turned away when shaking hands) -cog: hypervigilance&hypersensitivity -ASDlike B& ADHD CMD(boys)&dep(girls) -girl:less sev
ID: William's Synrome -deletion on Ch7 -1/7500 live births -mild to moderate ID -phys:elf appearance, low nasal bridge, star-shaped patterns in irises -cog: local over global, dampened amgydala act., <prob, solving -beh: freindly,musical prowess, normal to good lang
ID: Prader-Willi Syndrome -Paternal imprinting of Ch15(7G) -1/12000-15000 -Phys:Short,incomplete sexual development,hypotonia, involuntary urge to eat constantly-no fullness feeling,other obsessions&compulsions,hypothalamic abnormalities -Cog:LD,att. difficulties,good VS skills
ID: Angelman Syndrome -maternal imprinting of Ch15 -phys: Large jaw, open mouthed expression, movements, stiff walk, Seizures -cog: Lang: expressive difficulties, Attn difficulties -B: Hyperact., wants personal interaction,Frequent laughter,happy disposition, <3 H2O
ID: Phenylketonuria (PKU) -autosomal recessive -missing enzyme that breaks down phenylalanine (can build up to toxic levels) -1/10000 environmental and food change can prevent issues
ID: Fetal Alcohol Syndrome -due to extensive prenatal exposure to alc. (but this characteristic is not required for diagnosis) -must have growth deficiency, FAS facial features, and CNS damage -problems in: intellectual functioning, CNS, behvior, growth, phys. face abnormalities
ID: Individuals w/ Disabilities Education Improvement Act -disabled can receive free, appropriate public education and get needs met -protect rights of kids and parents -provide funding (federal act) -assess and ensure the effectiveness of these educational efforts -includes LD, ID, dev. delay and more
ID Treatment: Educational Opportunities -individualized educ. plan (IEP): basically considers everything that is needed 2 get child from now to B -Least restrictive env: mainstreaming (may be more normal)/inclsuion(various levels of ability) -More restrictive option for more attn *Pros&Cons
ID Treatment: Behavioral Modification -ABCs (antecedents, beh, conseq) -think about what fuels/maintains beh. -Reinforce other behavior or lack of challenging -Punish bad behavior with either positive practice (do good thing repeatedly) or negative punishment
ID Treatments: Medication -challenge and decrease behaviors with atypical antipsychotics (block dopamine and serotonin receptors-->antagonists) -may make kids sluggish and less responsive
ID Treatments: For Parents -parents at risk for depression--> care for them
ID: FAS Facial Features and Brain Features -smooth philtrum, thin vermillion (upper lip), short palpebral fissures (inner to outer corner of eye) -FAS brain is more blobby and more smooth; often smaller -underdeveloped frontal cortex
ID: DSM-5 Required Criteria -intellectual deficits->confirmed by clinical assessment & individualized, intelligence testing -deficits in adaptive fning--> limit fning in 1/+ daily life activities in multiple environments -onset of these deficits during the developmental period
ID: DS Physical Feaures -Small skull -large protruding tongue, -small mouth -almond shaped eyes -sloping eyebrows -flat nasal bridge
ID: William's Syndromr Physical Problmes cardiovascular problems, kidney problems, deficient depth perception, hyperacusis (unusual sensitivity to loud noises)
Created by: ymazil