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Chapter 14

Abnormal Psychology CHAPTER 14 NOTES - I got a 4.0 in the course

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University of Miami
PSY 240

Chapter 14: Developmental Disorders Common Developmental Disorders: • Those disorders that are revealed in a clinically significant way during a child’s developing years and are of concern to families and educators • As clinicians have grown to appreciate the far reaching effects of childhood problems and the importance of early intervention in treating most disorders, they have become more interested in understanding the diversity of severe problems experienced in early life Attention Deficit/Hyperactivity Disorder: • The primary characteristics of such people include a pattern of inattention, such as not paying attention to school, or of hyperactivity and impulsivity • These deficits can significantly disrupt academic efforts, as well as social relationships • Tasks are often unfinished and they often seem not to be listening when someone else is speaking • Display motor hyperactivity • Acting apparently without thinking is a common complaint made about people with ADHD • Three symptoms for diagnosis: inattention, hyperactivity, and impulsivity • Academic performance tends to suffer Statistics: • Estimated to occur in 3-7% of school age children in the US • 5.2% of the child populations across all regions of the world • Children were more likely to receive the label ofADHD in the US than anywhere else • Some have argues thatADHD in children is simply a cultural construct, meaning that the behavior of these children is typical from a developmental perspective and it is Westerns societies intolerance that causes labelingADHD as a disorder • Boys are 3 times more likely to be diagnosed than girls. Boys tend to be more aggressive, which will more likely result in parents taking them to see attention by mental health professionals. Girls withADHD, on the other hand, tend to display more behaviors referred to as “internalizing” specifically, anxiety and depression • Are identified as different from their peers around age 3 or 4, their parents describe them as active, mischievous, slow to toilet rain, and oppositional • Estimated that about half of the children withADHD have ongoing difficulties through adulthood • During adolescence, the impulsivity manifests itself in different areas; greater risk for pregnancy and contracting STDs and driving difficulties • Up to 80% of children withADHD are diagnosed with one or more other disorders as well • Almost 90% of adults withADHD are likely to have at least one other disorder, including disruptive behavior, depression, anxiety, and substance use disorders • This overlap can complicate diagnosis in these children Causes: • Researchers have known for some time thatADHD is more common in families in which one person ahs the disorder • Most attention to date focuses on genes associated with the neurochemical dopamine, although norepinephrine, serotonin, and GABAare also implicated in the cause • The dopamine D4 receptor gene, the dopamine transporter gene (DAT1) , and the dopamine D5 receptor gene are all strongly associated to the cause • DAT1 is of particular interest because Ritalin inhibits this gene and increases the amount of dopamine available • Researchers are looking for endophenotypes, those basic deficits (such as specific attentional problems) characteristic ofADHD • Specific areas of current interest forADHD are the brain’s attention system, working memory functions, inattentiveness, and impulsivity • Researchers found that children with a specific mutation involving the dopamine system were more likely to exhibit the symptoms ofADHD if their mothers smoked during pregnancy • Other research is now pointing to additional environmental factors, such as low socioeconomic status and parental marital instability and discord • The overall volume of the brain in those with this disorder is slightly smaller than in children without • The theory that food additives are responsible for the symptoms ofADHD has been highly controversial • Avariety of other pregnancy complications may play a role in increasing the chance • Psychological and social dimensions ofADHD may further influence the disorder itself. Negative responses by parents, teachers, and peers to the affected child’s impulsivity and hyperactivity may contribute to feelings of low self-esteem, especially in children who are also depressed Treatment: • Typically the goal of biological treatments is to reduce the children’s impulsivity and hyperactivity and to improve their attentional skills. Psychosocial treatments generally focus on broader issues such as improving academic performance, decreasing disruptive behavior, and improving social skills • The first types of medication used for children were stimulants • Though it seems paradoxical, on the same low doses, children and adults with and withoutADHD react in the same way. It appears that stimulant medications reinforce the brain’s ability to focus attention during problem solving tasks • The concerns over the use of stimulant medications now include their potential for abuse • Anewer drug—atomexetine (Strattera) also appears effective for some children with ADHD, but it is a selective norepinephrine reuptake inhibitor and therefore does not produce the same “highs” when used in larger doses • Some portion of children withADHD do not respond to meds, and most children who do respond show improvement inability to focus their attention but do not show gains in the important areas of academics and social skills • Behavioral programs set such goals as increasing the amount of time the child remains seated, the number of math papers completed, etc. Reinforcement programs reward the child for improvements, and , at times, punish misbehavior with loss of rewards • Social skills training for these children which includes teaching them how to interact appropriately with their peers, also seems to be an important treatment components Learning Disorders: • Are characterized by performance that is substantially below what would be expected given the person’s age, IQ score, and education • Reading disorder- a significant discrepancy between a person’s reading achievement and what would be expected for someone of the same age • Mathematics disorder- achievement below expected performance in math • Disorder of written expression- achievement below expected performance in writing • Difficulties are sufficient to interfere with the students’academic achievement and to disrupt their daily activities Statistics: • 5-10% although frequency appears to increase in wealthier regions of the country— suggesting that with better access to diagnostic services, more children are identified • 1% of white children and 2.6% of black children were receiving services for problems with learning in 2001 • Difficulties with reading are the most common and occur in some form in 4-10% of the general population • Boys were more likely to have a reading disorder than girls, although more recent research indicated that boys and girls may be equal • Students with learning disorders are more likely to drop out of school, be unemployed, and have suicidal thoughts and attempts • Agroup of disorders loosely identified as verbal or communication disorders seems closely related—stuttering, expressive language disorder, selective mutism, and tic disorder Causes: • It is clear that learning disorders run in families • There are not different genes responsible for reading and math disorders • Various forms of subtle brain impairment have also been thought responsible three areas of the left hemisphere appear to be involved with dyslexia (word recognition)—Broca’s area (articulation and word analysis), an area in the left parieotemporal area (word analysis), and an area in the left occipitotemporal area (recognizing word form) • Adifferent area in the left hemisphere, seems to be critical for the development of a sense of numbers and is implicated in math disorder Treatment: • Primarily require educational intervention • Education efforts can be broadly categorized into 1) specific skills instruction, and 2) strategy instruction including efforts to improve decision making and critical thinking • Direct Instruction program includes several components, amount them are the systematic instruction and teaching for mastery children are constantly assessed and plans are modified based on progress Pervasive Developmental Disorders: • All experience problems with language, socialization, and cognition. • Autism,Asperger’s, Rett’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified Autistic Disorder: • Significant impairment in social interactions and communication and by restricted patterns of behavior, interest, and activities Impairment in Social Interactions: o Do not develop the types of social relationships expected for their age o Research using sophisticated eye tracking technology shows how this social awareness problem evolves as the children grow older Impairment in Communication: o Nearly always have severe problems with communicating, about 1/3 never acquire speech o Some repeat the speech of others, a pattern called echolalia o Some people who can speak are unable or unwilling to carry on conversations with others Restricted Behavior, Interests, andActivities: o Intense preference for the status quo is called maintenance of sameness (upset if even a small change takes place) o Spend countless hours in ritualistic behaviors, making movements as spinning around in circles, waving their hands, or biting their hands Statistics: • 1 in every 500 births • The rise in the rates may be the result of increased awareness on the part of professionals who now distinguish the pervasive developmental disorders from intellectual disability • For people with IQs under 35, autism is more prevalent among females; in the higher IQ range, it is more prevalent among males • Most people with autism develop the associated symptoms before the age of 36 months • 45-60% of people with autism have average or above average IQs • The higher children score on IQ tests, the less likely they are to need extensive support. Children with autism who score poorly are more likely to be severely delayed in acquiring communication skills and to need a great deal of support as they grow older Causes: Psychological and Social Dimensions: • One theory is that autism probably does not have a single cause, instead a number of biological contributions may combine with psychosocial influences • Mothers and fathers of children with autism used to be characterized as perfectionistic, cold, and aloof, with relatively high status, and intelligence • Descriptions such as these have inspired theories holding parents responsible • The lack of the use of first person in people with autism has led theorists to wonder whether autism involves a lack of self-awareness • Suggested that they withdrawal seen among people with autistic disorder reflected a lack of awareness of their own existence Causes: Biological Dimensions: • Few workers in the field of autism believe that psychological or social influences play a major role in the development of this disorder Genetic Influences: o Families that have one child with autism have a 5-10% risk of having another child with the disorder o One area that is receiving attention involves the genes responsible for the brain chemical oxytocin. Because oxytocin is shown to have a role in how we bond with others and in our social memory, researchers are looking for whether genes responsible for this neurochemical are involved with the disorder Neurobiological Influences: o One intriguing theory involves research on the amygdala-emotions and fear. Researchers studying the brains of people with autism after they died note that adults with and without the disorder have amygdalae of about the same size but that those with autism have fewer neurons in this structure o The theory being proposed is that the amygdala in children with autism is enlarged early in life—causing excessive anx
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