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Quiz 1: Tuesday February 10

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.

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Quiz 1: Tuesday February 10

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  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 > 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 children’s 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. 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? Treatment for depression

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