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Lecture

CHYS 2P35 - October 31

6 Pages
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Department
Child and Youth Studies
Course Code
CHYS 2P35
Professor
Ayda Tekok- Kilic

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October 31, 2013
LECTURE 7
(Continuation of last weeks lecture on mood disorders)
Bipolar Disorder (BD)
1- Definition
Recurrent episodes of depression, mania and/or mixed symptom states
BD is difficult to recognize and diagnose in youth
-symptom criteria established for adults
-symptoms can resemble or co-occur with those of other common childhood onset
-symptoms may be instantly mistaken for normal emotions and behaviours of
children and adolescents
2- Manic Symptoms:
Severe change in mood
Overly inflated self-esteem
-grandiosity
-hallucinations
-delusions
Increased energy, decreased need for sleep
Increased talking
Distractibility
Increased goal-directed activity or physical agitation
Disregard of risk
3- Symptoms of mania and depression in children manifest themselves through
a variety of different behaviours (Early vs. late onset)
-irritable
-prone to destructive outbursts rather than elated or euphoric
-BP may be at least as …
Early Onset:
Severe, worst prognosis
Continuous, rapid cycling, irritable mixed symptom state
May co-occur with disruptive behaviour disorders (ADHD, CD)
Late Onset:
Begin suddenly
Often with a classic manic episode
More episodic pattern with relatively stable periods between episodes
Less co-occurring ADHD or CD
This Weeks Lecture: Conduct Disorders
1- Some numbers
Documental in many cultures and countries
Prevalence
Community samples 2-16%
Clinical samples 28-65%
2- Characteristics of Externalizing Disorders
Oppositional Defiant:
Loses temper
Argues with adults
Actively defines or refuses to comply with adult request or rules
Deliberately annoys others
Blames others for own mistakes or misbehavior
Easily annoyed
Angry and resentful
Vindictive
Conduct Disorder:
Aggression toward people and animals
Destructive of the property
Deceitfulness or theft
Serious violations of rules
3- Dimensional Approach
Three dimensions of oppositionality in children (Stringaris & Goodman, 2009)
18.415 (5-16 years)
priori dimensions:
Irritability
Loses temper, angry resentful, touchy or easily annoyed
Headstrong
Argumentative, noncompliant, annoys
Being hurtful
Callous, premeditated, aggressive
Overall Result:
The three dimensions of oppositionality irritable
Headstrong and hurtful, differ in their associations with categorical and
continuous measures of psychopathology
4- Results of Stingaris & Goodman, 2009
General Results:
1. Associations with Categories:
ADHD with headstrong

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Description
October 31, 2013 LECTURE 7 (Continuation of last week’s lecture on mood disorders)  Bipolar Disorder (BD) 1­ Definition • Recurrent episodes of depression, mania and/or mixed symptom states • BD is difficult to recognize and diagnose in youth ­symptom criteria established for adults ­symptoms can resemble or co­occur with those of other common childhood onset ­symptoms may be instantly mistaken for normal emotions and behaviours of  children and adolescents 2­ Manic Symptoms: • Severe change in mood • Overly inflated self­esteem ­grandiosity ­hallucinations ­delusions • Increased energy, decreased need for sleep • Increased talking • Distractibility • Increased goal­directed activity or physical agitation • Disregard of risk 3­ Symptoms of mania and depression in children manifest themselves through  a variety of different behaviours (Early vs. late onset) ­irritable ­prone to destructive outbursts rather than elated or euphoric ­BP may be at least as … Early Onset: • Severe, worst prognosis • Continuous, rapid cycling, irritable mixed symptom state • May co­occur with disruptive behaviour disorders (ADHD, CD) Late Onset: • Begin suddenly • Often with a classic manic episode • More episodic pattern with relatively stable periods between episodes • Less co­occurring ADHD or CD This Weeks Lecture: Conduct Disorders 1­ Some numbers • Documental in many cultures and countries • Prevalence • Community samples 2­16% • Clinical samples 28­65% 2­ Characteristics of Externalizing Disorders Oppositional Defiant: • Loses temper • Argues with adults • Actively defines or refuses to comply with adult request or rules • Deliberately annoys others • Blames others for own mistakes or misbehavior • Easily annoyed • Angry and resentful • Vindictive Conduct Disorder: • Aggression toward people and animals • Destructive of the property • Deceitfulness or theft • Serious violations of rules 3­ Dimensional Approach Three dimensions of oppositionality  in children (Stringaris & Goodman, 2009) 18.415 (5­16 years) priori dimensions:  Irritability Loses temper, angry resentful, touchy or easily annoyed Headstrong Argumentative, noncompliant, annoys Being hurtful Callous, premeditated, aggressive Overall Result: • The three dimensions of oppositionality irritable • Headstrong and hurtful, differ in their associations with categorical and  continuous measures of psychopathology 4­ Results of Stingaris & Goodman, 2009 General Results:  1. Associations with Categories: • ADHD with headstrong • Depression with irritability • Cold, callous emotions with hurtful 2. Associations with Conduct Disorder: • Headstrong ­status violence and non­aggressive offenses • Hurtful ­non­aggressive and aggressive • Irritability ­aggressive offenses and status violations 5­ Age of Onset and Symptom Clusters (CD) Childhood onset (before 10 years): • Family adversely (ex. Parental) • Genetic instability • Lower intellectual functioning • Academic problems (cognitive problems) • Multiple comorbidity • Lower adult outcomes (family, health, socio­emotional) Adolescent onset (after 10 years): • Association with delinquent peers, social status
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