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Disorders of Childhood
Ch 15
Classification Issues
- Distinguishing abnormal childhood behavior requires a
knowledge from developmental psychology of what is
normal for a child at a particular age or stage
- Disorders can be viewed as categories or on a continuum
(dimension)
- Control represents a dimensional variable
- Overcontrolled (internalizing)children show emotional inhibition
- Undercontrolled (externalizing) children show excessive behaviors (extreme aggressiveness)
Ch 15.
Developmental Psychopathology
- Behavior genetics & neurobiological traumas
- Infant / child temperaments and “the problem of the match” with parental temperaments and expectations
- Attachment theory (Bowlby, Ainsworth, Sroufe)
- Secure vs. insecure attachment
- Insecure attachment category may be related to later childhood disorders - “anxious-resistant” category - internalizing disorders - “avoidant”category - externalizing disorders
- How do temperament & attachment interact?
- Evidence is inconclusive, but see Bokhorst et al. (2004)
Disorders of Undercontrolled
Behavior
- Undercontrolled behavior is excessive or inappropriate
for the situation
- DSM-IV recognizes two classes of undercontrolled
behavior:
- Attention-deficit/hyperactivity disorder (ADHD) involves
- An inability to concentrate on task for an appropriate period of time
- Difficulties in controlling motor movements in class and other situation (fidgeting, talking)
Ch 15.
Table 15.2 Prevalence of Symptoms and
Behaviors in Adolescents with and without
ADHD
ADHD: Facts and Statistics
- Prevalence (BD, 3rd. Edition)
- Occurs in 4%-12% of children who are 6 to 12 years of age
- Symptoms are usually present around age 3 or 4
- 68% of children with ADHD have problems as adults
- Gender Differences
- Boys outnumber girls 4 to 1
- Cultural Factors
- Probability of ADHD diagnosis is greatest in the
United States
Psychological Theories of ADHD
- Bettelheim proposed a psychoanalytic view of ADHD in
which hyperactivity results from stress brought on by parental personality (authoritarian, impatient, resentful)
- Learning theory suggests that hyperactivity is
reinforced by the attention it elicits, thereby increasing in frequency and intensity; hyperactivity may represent modeling of older siblings or peers
Ch 15.
Treatment of ADHD
- Stimulant drugs such as methylphenidate (Ritalin) reduce disruptive behavior and improve concentration - Improve compliance and decrease negative behaviors in many children - Medications do not affect learning and academic performance - Beneficial effects are not lasting following drug discontinuation
- Psychological therapy for ADHD involves
- Parent training
- Classroom management programs based on operant-conditioning techniques
- Aim to increase appropriate behaviors and decrease inappropriate behaviors
- Combined Bio-Psycho-Social Treatments
Ch 15.
Figure 15.1 Arrest rates across ages for
homicide, forcible rape, robbery, assault, and
auto theft
Etiology of Conduct Disorder
- Genetic factors may play a greater role in aggressive
behavior, but a lesser role in delinquency-related behaviors
- e.g. stealing, running away
- Psychological factors include
- Deficiencies in moral training and awareness
- Modeling of aggressive behavior (Bandura)
- Cognitive distortions in which ambiguous actions are interpreted as hostile
Ch 15.
Treatment of Conduct Disorder
- Family intervention involves training parents to reward
prosocial behaviors in their children
- Multisystem treatment targets the child, the
community, the school and the family
- Cognitive approaches involve
- Anger control training
- Teaching moral development reasoning
Ch 15.
Learning Disabilities
- Learning disabilities refer to inadequate development
in a specific area of academic, language or motor skills
- The deficit is not due to mental retardation, autism or reduced educational opportunities
- DSM covers 3 areas of learning disabilities
- Learning disorders
- Communication disorders
- Motor skills involve impairment of motor coordination
Ch 15.
Communication Disorder
- Communication disorders include
- Expressive language disorder involves a difficulty in speech expression - Difficulty in finding the correct word for a concept - Use of grammar is below grade level
- Phonological disorder refers to a difficulty in articulating speech sounds, but can comprehend words
- Stuttering involves a problem in verbal fluency in which words are repeated or prolonged
Ch 15.
Mental Retardation
- Mental retardation is defined as
- Subaverage intellectual functioning
- Deficits in adaptive behaviors such as dressing, use of money, use of tools and of public transportation
- Onset prior to age eighteen
- Not due to adult accidents or disease
- Typical onset is in infancy
- American Association of Mental Retardation’s approach
- Focus on remedial supports to facilitate higher functioning
Ch 15.