PSY 381 Lecture 14: Abnormal Psych Chapter 14
4 May 2018
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Abnormal Psych Chapter 14
Developmental Disorders
Childhood disorders
•Neurodevelopmental disorders: disorders based in the CNS that impair cognitive,
affective, learning, social interactions, and memory
1. Intellectual developmental disorders (MR): previously mental retardation; refers
to both cognitive capacity (IQ) and ability to adapt to context; genetic conditions with
associated intellectual deficits
-Trisomy 21 (Down Syndrome)
-Fragile X syndrome: leading cause of ASD; physical manifestations; IQ
dependent on degree of FMRP expression
2. Communication disorders
-Social Communication Disorder: SIMILAR to ASD; A. Persistent difficulties in the social
use of verbal and nonverbal communications (innapropriate greetings, problems
adjusting, following rules of conversation) B. Deficits results in social, academic,
occupational interference
-Childhood-onset fluency disorder (stuttering): problems in fluency
-Expressive language disorders: limited vocabulary or error in verb tense; test
differences in verbal vs. nonverbal
-Selective mutism: failure to speak in specific social circumstances despite ability to
speak in others
-Tic disorders: involuntary motor movements and vocalizations
Pervasive Developmental Disorders
3. Autism spectrum disorder (ASD): problems with language, socialization, cognition;
lifelong (pervasive) impairment;
-Autism: most common of ASDs; 3 categories of symptoms:
1. Problems in social interactions: hallmark feature; minimally responsive or
indifferent to other people; general lack of social awareness (failure to respond to
name, lack of eye contact, inability to respond to social cues, lack of interaction)
2. Problems in communication: delayed speech; approx. 50% never acquire speech;
some speak in “sing-song” voice
3. Restricted behavior, interests, and activities: need for routine; stereotyped and
ritualistic behaviors; repetitive movements for stimulation not purpose (rocking, head
banging)
What causes Autism? Multiply determined, genetics, neurological abnormalities,
myth—perfectionistic parents; lots of research—few answers How is
Autism assessed? no medical test; screening is reliant on behavior; CDC
recommends screening during “well-child” visits (18, 24, 30 months)
The American Academy of Pediatrics: impaired ability to make friends, initiate
conversation, absence of imaginative and social play, repetitive use of language,
restricted patterns of interests, preoccupation with objects or subjects, inflexible
adherence to routines or rituals
How is Autism treated? pervasive; educational/behavioral interventions (structured,
skill-oriented training; counseling for family); no specific medications
Asperger’s Disorder, Rett’s Disorder, Childhood Disintegrative Disorder
4. Attention-Deficit/Hyperactivity Disorder (ADHD): 1. inability to sustain attention, 2.
difficulty sitting still, 3. repeated patterns of impulsive behavior Criteria: 6 or more
symptoms or inattention and hyperactivity; symptoms are maladaptive and
developmentally inappropriate
Stats: prevalence approx. 6%; evident by ages 3-4; sex differences and the DSM
Tx: medications—stimulants such as Ritalin; Paradox; psychosocial treatments—
coping and strategies
5. Specific learning disorders: characterized by performance problems in specific area;
performance is significantly below age norms, cognitive ability, and education; not
an issue of intelligence (reading disorder, mathematics, abnormal psychology,
disorder of written expression, learning disorder NOS)
6. Motor disorders
•Disruptive, Impulse-Control, and Conduct disorders: disorders characterized by
repetitive and persistent patterns of behavior which violate social rules or the basic
rights of others, defy authority, or are characterized but frequent and uncontrolled
emotional outbursts
1. Oppositional defiant disorder
2. Conduct disorder: repetitive and persistent pattern of behavior which violated the
basic rights of others or major age appropriate social norms (bullying); risk factor for
Antisocial PD;
3. Intermittent explosive disorder
4. Other conditions
Feeding and Eating disorders
Pica: eating of nonnutritive substances for at least 1 month; not experimentation; link to
MR and PDD
Rumination disorder: 1 month of regurgitation and chewing; high mortality rate 25%
Elimination disorders
Encopresis: defecating (pooping) in inappropriate places; 1 event a month for 3 months;
4+; Not due to…
Enuresis: urinating in inappropriate places; 2x/wk for 3 months or sig. distress; 5+; not
due to…
Psychotic and Delusional Disorders
Schizophrenia
3 Symptom Clusters
1. “Positive” Symptoms
-“active” or additional experiences vs. absence of experience
1. Delusions
-false beliefs, not based or loosely based in reality
-delusions of grandeur: “I am Queen of Europe” “I came here to save
the world”
-delusions of persecution: “People are planning on assassinating me”
“People are out there to get me”
-bizarre delusions: “My thoughts are being broadcast out load”(thought
broadcasting); “My thoughts are inserted by the aliens”(thought insertion)
-delusions of reference: the song communicates secret messages to me
2. Hallucinations
-sensory perceptions in the absence of stimuli
-can occur in any sensory modality
-visual and auditory most common
-auditory hallucinations: “voices tell me to jump out of the window” “voices
say I am evil”; kill, kill, kill, kill…
-visual hallucinations: “I can see small monsters crawling up my walls” “I
see dead people” “I see penises on your body”
-are schizophrenics hearing “their own” voices?
-Broca’s area is more active than Wernicke’s area during hallucinations—>they are
listening to their own voices
2. Negative Symptoms
-absense or insufficiency of symptoms
1. Avolition: insufficient voluntary movement
2. Alogia:relative absence or minimal speech
3. Anhedonia: loss of pleasure or interest
4. Affective flattening: loss of emotion
3. Disorganized Symptoms
1. Disorganized Speech
-not sure what they are talking about; random thoughts
2. Disorganized Affect
-inappropriée emotional expression
3. Disorganized or inappropriate behavior
-catatonic symptoms, echolalia, echopraxia
Subtypes of Schizophrenia (not specified in DSM V)
1. Paranoid Type
-positive symptoms
-delusions usually of grandiose or persecutory nature
-relatively intact cognitive skills and affect
-little to no disorganized symptoms
2. Disorganized Type
-disorganized symptoms EXCEPT no catatonic features
-flat or inappropriate affect
-self-interest
Document Summary
Childhood disorders: neurodevelopmental disorders: disorders based in the cns that impair cognitive, affective, learning, social interactions, and memory. Intellectual developmental disorders (mr): previously mental retardation; refers to both cognitive capacity (iq) and ability to adapt to context; genetic conditions with associated intellectual deficits. Fragile x syndrome: leading cause of asd; physical manifestations; iq dependent on degree of fmrp expression: communication disorders. Persistent difficulties in the social use of verbal and nonverbal communications (innapropriate greetings, problems adjusting, following rules of conversation) b. Expressive language disorders: limited vocabulary or error in verb tense; test differences in verbal vs. nonverbal. Selective mutism: failure to speak in specific social circumstances despite ability to speak in others. Pervasive developmental disorders: autism spectrum disorder (asd): problems with language, socialization, cognition; lifelong (pervasive) impairment; 50% never acquire speech; some speak in sing-song voice: restricted behavior, interests, and activities: need for routine; stereotyped and ritualistic behaviors; repetitive movements for stimulation not purpose (rocking, head banging)
