PSYC 412 Lecture Notes - Lecture 10: National Comorbidity Survey, Developmental Psychopathology, Generalized Anxiety Disorder
14 May 2018
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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o Includes lots of symptoms like being irritable, lonely, shy, avoidant, withdrawn, etc.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
find more resources at oneclass.com
find more resources at oneclass.com
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
find more resources at oneclass.com
find more resources at oneclass.com
