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Brock University
Child and Youth Studies
John Mc Namara

Child and Youth Studies CHYS 1F90
 Dr. J. McNamara Fall/Winter 2010 Who are we talking about? 10% of the population of children and youth Defining “Abnormal” Development • Abnormal ­ Not average What does it mean to have a disorder? • “Dis ease” – dis order • Sense of how much away from the normal “Abnormal” Development  Development that is not within “normal” ranges ­ What is typical behavior ­ e.g. five year old having an imaginary friend is normal/typical but a 19 year old having an imaginary  friend is not normal  Norms are decided upon by development – Example – childhood fantasizing  What is normal development?  When does fantasizing become “not the norm”?  Abnormal development is what characterizes disorder Children and Youth Affected by Mood and Anxiety Disorders Depression (major depressive disorder) “Fighting the dragon” General Characteristics in Children and Youth General Characteristics in Children and Youth • Poor performance in school • Withdrawal from friends and activities • Sadness and hopelessness • Anger and rage Prevalence Prevalence  1% of pre-school children  2-3% of elementary school children  6-20
% of adolescents • Society used to think depression only happened to adults What causes Depression  Related to chemical imbalance in the central nervous system – Associated with decreased levels of neurotransmitters such as serotonin  However, it is not simply a lack of serotonin  The exact cause remains elusive Two influences 1. Biology (genetics) – depression runs in families (a certain gene for depression) 2. Environment – traumatic situation OR BOTH Why do some children cope well with adverse environmental conditions while others do not? • Notion of a psychological toolkit – we all have it • Helps get out of depression  Children have a Psychological Toolkit – Genetics – Personality – Parents – Friends – Etc. The negative outcomes of depression • Suicide • Attempted suicide • Social withdrawal • Poor school achievement • Substance abuse • Family isolation • Etc. The positive outcomes of preventing or treating depression • Coping skills • Healthy relationships • Social acceptance Depression - Treatment  Medicinal – Anti-depressants  Prozac, Paxil, Zoloft etc.  Selective Serotonin Reuptake Inhibitor (SSRI) • When one neurotransmission is disabled between two neurons and serotonin helps prevent this – Benefits unclear for children and youth  Behavioural – Social support systems  Prevention – Warning signs – Offer your support Child and Adolescent Bipolar Disorder • Manic depression • Not tied to environment • Genetic biologically based Characteristics  Defined by marked changes in mood and energy  Extreme highs (mania) and lows (depression) within a 24 hour period Causes  Strong causal links to genetics – Concordance rates:  Monozygotic twins – 55%  Dizygotic twins – 5%  Bipolar is associated with fluctuation in neurotransmitters which affect the hypothalamus (central role in emotion regulation) Bipolar treatment • Cannot just treat depression because than you would be supporting the mania or vice versa  Medicinal – Mood stabilizers  Lithium, Depakote  Serious side effects – Confusion, lack of coordination, frequent urination, dehydration, thyroid problems  Behavioural – Psychotherapy – Counselling – Behavioural supports When treatment works…..  Cortisol levels (stress hormone)  Each point is a day  This person is cycling every 24 hours  The right reflects lithium treatment • Lithium stabilizes behaviour Anxiety becomes disorder when it affects your functioning • Big class of disorders Types of Anxiety Disorders  Posttraumatic Stress Disorder  Separation Anxiety Disorder  Obsessive – Compulsive Disorder  Panic Posttraumatic Stress Disorder (PTSD) • First diagnosed when people came home from Vietnam war • They were bombarded with thoughts and their experiences during the war • They didn’t go out • Not just a military disease now • Kids are also affected by it • E.g. 9/11 – even people who didn’t experience it were affected because they saw it very well on TV Why does PTSD occur?  May develop after an individual experiences a traumatic event such as; – sexual or physical assault – witnessing a death – natural disaster – terrorist attack Symptoms of PTSD  Reexperiencing the event, which can take the form of intrusive thoughts and recollections, or recurrent dreams  Hypersensitivity, including: inability to sleep, anxious feelings, overactive startle response, hypervigilance, irritability and outbursts of anger Children and PTSD  Young children who have suffered a trauma may: – have dreams of the event which turn into general nightmares – relive the event through play – exhibit physical symptoms, such as headaches and stomachaches; kids will get physically sick Associated Symptoms Associated Symptoms  Children and youth with PTSD are at risk for: • Comorbit disorders (comorbidity) – Depression – Anxiety Panic Disorders • Anxiety related disorder Diagnosing Panic Disorders  the abrupt onset of fear/discomfort peaking in 10
 minutes with four or more of the following symptoms: – pounding heart or rapid heart rate before coming to base line – tremor – sensations of smothering or shortness of breath – feeling of choking – chest pain or discomfort – nausea or abdominal distress – dizziness, lightheadedness or faint – fear of losing control or going crazy – fear of dying – hot flashes • Body cannot sustain these things for more than 10
 minutes Causes • Your susceptibility is based on your toolkit  Genetics – There may be a genetic predisposition to panic disorders – Higher concordance rates for monozygotic twins  Environment – Stressful life events can trigger panic disorders.  Susceptibility – 'life stressor' act like a thermostat; that is, when stresses lower your resistance, the underlying physical predisposition kicks in and triggers an attack
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