Quiz 1: Tuesday February 10

1
Quiz 1 Tuesday February 10

• 20 m.c. questions
• Emphasis on concrete details, can come from text,
  or interface of text and lectures
• 40 points of short answer
• Emphasis on class lectures and activities,
  including material highlighted from text
• Total 60 points/4 15 of final grade

2
Child Psychopathology

• Negative Affectivity
• Depression in children
• First two presentations
• Reading for today Chapter 8

3
Negative Affectivity

• Definition The tendency to experience aversive
  emotional states best predicted by Trait
  Anxiety and internalizing behavior problems
• Evidence Comorbidity of child anxiety and child
  depression

Dx of Depression
Yes
No
50
10
Yes
Depression scores
Dx of Anxiety
No
25
150
R.75
Anxiety Scores
4
Depression in children

• Mood disorders underdetected because other
  problems may be more obvious, e.g., conduct,
  substance abuse, general malaise of youth
• Debate over whether it even exists, or whether it
  pervasively accounts for other disorders
• How does it differ from adult forms of
  depression? Is the same neuroendocrinology in
  place?
• Importance of family factors

5
Assessment

• Observations
• Report measures CBCL items
• RADS overhead Self report for adolescents
• Cognitive triad Negative thoughts and
  attributions
• Devalue world, self, and future

6
Major depressive disorder in children

• Feelings of sadness, irritability, guilt, shame
• Restlessness, agitation, reduced activity
  speech, withdrawal, aggression
• Feelings of worthlessness and low self esteem
• Self-critical and self-conscious pessimism,
  distorted views of the future, difficulty
  concentrating or remembering, self-blame
• Disruptions in eating or sleeping physical
  complaints diffuse physical symptoms
• Prevalence 2 to 8 of children age 4 to 18
  more common in late adolescence, females gt males

7
Early onset depression is related to other
problems
Youth under stress who experience a loss or who
have attention, learning, or conduct disorders
are at a higher risk for depression. (American
Academy of Child Adolescent Psychiatry
AACAP, 1995) Almost one-third of six- to
twelve-year-old children diagnosed with major
depression will develop bipolar disorder within a
few years. (AACAP, 1995) Four out of every
five runaway youths suffer from depression.
(U.S. Select Committee on Children, Youth
Families) Clinical depression can contribute
to eating disorders. On the other hand, an
eating disorder can lead to a state of clinical
depression. (Stellefson, Medical University
of South Carolina, 1998)
8
Depression and Conduct Disorders

• Jennifer Vickery

9
Depression and Conduct Disorder

• There is a similarity in symptoms
• Drop in school performance, physical symptoms,
  lying, deceitfulness, acting out
• Unexplained irritability, drug use
• Cognitive processing problems in both disorders
• Attributional style attributing positives to
  external factors, negatives to internal factors
• Family Factors and perceived negativity with
  parents
• Distressed verbal affect is common to anger and
  conduct problems
• Development within distressed family is common to
  both
• Siblings behave much like the target child
• Negative impact on family from the clinical
  problem
• Restricted range of emotional expression, esp.
  poor positive affect

10
Causes

• Psychodynamic theory not useful
• Attachment theory parental separation and
  anxious attachment as predisposing factors
• Behavioral theories Lack of positive
  reinforcement or uncontrollable negative events
• Cognitive theories Negative perceptual and
  attributional styles, learned helplessness
• Self-control theory Behavior and long-term
  goals
• Diathesis-stress models biological strata and
  environmental stressors
• Fitting theories together Figure 8.3

11
Peer Relationships and Depression

• Crystal Barr

12
Peers and depression in children

• Peer behavior towards children, as well as
  childrens perceptions of peer behavior is
  important
• Rejected children are prone to depression
• Social status is related to measures of cognitive
  processing unpopular children are more prone to
  focus on more negative words
• Popularity and self perceptions are negative in
  depressed children
• Aggressive children see themselves as better
  accepted than they really are or than depressed
  children
• Deviant peer affiliations predict depression
  indirectly

13
Treatment for depression

• Depression
• Cognitive-Behavior Therapy has shown most
  short-and long-term success
• 70 of children with MDD respond to treatment
• imipramimine (tricyclic) and prozac (SSRI) are
  used, but there has been a failure to show
  advantage of antidepressants over placebo in
  carefully controlled studies
• What is a double-blind study?
• Family therapy, Interpersonal Behavior Therapy

• Bipolar Disorder, marked by manic and depressive
  stages
• Lithium is the first treatment of choice
• High genetic loading of biploar disorder
• No research on psychosocial interventions with
  biploar disorder
• Regarding all depressive disorders, what
  community-based interventions are useful?