PSYC 412 Lecture Notes - Lecture 10: National Comorbidity Survey, Developmental Psychopathology, Generalized Anxiety Disorder

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PSYC 412: Developmental Psychopathology
Feb 14th, 2018
Lecture 11: Happy Valentines Day <3 (Anxiety Disorders I)
Switching to internalizing disorders
The internalizing spectrum
o Includes lots of symptoms like being irritable, lonely, shy, avoidant, withdrawn, etc.
o A cluster of interrelated problems that include anxiety disorders & mood disorders
(specifically depression)
o Lifetime comorbidity between anxiety & depression is
very high
o Developmental psychopathology framework
Abnormal in context of what is typical in kids at that age
Fear and sadness are both
important emotions
that serve an important
purpose and are necessary at times in your life
At different developmental periods people may experience more/less of them
normatively
Most 1 year olds get extremely distressed when separated from their
moms: this is normal at that age
As kids get older it is typical for them to go through periods where
they are scared of dark, for example, or are concerned that there are
monsters under their bed: typical fears
o
Is this level of fear abnormal given the developmental stage of the child?
Anxiety disorders
o Are associated with significant impairment
Fear is a typical emotion: when it is severe it is extremely impairing
Social impairment
Kids who are very anxious are often left out of peer group
Academic impairment
Anxiety taking tests, going to class, etc.
o Anxiety problems often go
untreated
Despite having very efficacious treatments for anxiety disorders
Of mental health problems in childhood/adolescence in general: most youth
with mental health problems do
not receive treatment
for their problems
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o National Comorbidity Survey Adolescents (Merikangas et al. 2001)
10,123 adolescents 13-18 years old
Nationally representative sample in US
Interviewed about psychiatric diagnoses
Ask them whether they have ever received services for any disorder they met
criteria for
Found that for adolescents meeting criteria for diagnoses of ADHD, 55%
of the non-severe cases reported that they were getting treatment, and
82% of severe
35% of non-severe and 78% severe ODD
26% non-severe conduct disorder and 54% severe conduct disorder
Depression 39% non-severe, 41% severe
Anxiety 14% non-severe, 30% severe
Most adolescents with anxiety disorders do not receive any services
for them
o Service utilization
Girls are more likely to receive services than boys
Older youth more likely than younger
o
Why do we see so many kids with anxiety disorders not getting treatment?
1) some fear and anxiety is normal
Nearly all 1-year-olds become distressed when separated from Mom
Most children have short-lived, specific fear
o About half children from 6-12 have 7+ fears
o Is this getting in the way for the child or for their family in
some way? Is it causing disability, distress or risk?
o Only 5% of children report
excessive fear
in response to given
fear stimulus (e.g. needles, dogs)
o If we start restricting activities because of phobia, or it is
difficult to get child vaccinated because of needles, this is
when it starts to interfere
2) some anxiety is adaptive
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