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102 Cards in this Set
- Front
- Back
Definition of abnormal behavior
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Social deviance
Subjective distress disability statistical rarity |
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epidemiology
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study of frequency and distribution of disorders in a population
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prevalence
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proportion of a population with a disorder at a given time
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lifetime prevalence
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proportion of a population with a disorder at any point in their lives
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incidence
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number of new cases in some period (years)
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loss of income and disability adjusted life years
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depression most major cause of disability
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Midtown Manhattan Study
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NYC
1600 people Looked at prevalence rate of symptoms Most show symptoms 18% symptom free, 2.7% totally impaired 20 year follow up 40% same, 60% better or worse more psychological problems in poor |
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NIMH
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19% suffer from a psychological disorder
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National Comorbidity Study
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46% lifetime prevalence
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Center for Disease Control and Prevention Study
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47.8 million ambulatory visits
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religious explanations set forth to account for abnormal behaviors
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800-400 BC
Demonology, exorcism King Saul of Israel- behavior attributed to demons given to care of priests-doctors Purgatives no biological or psychological explanations Greek tragedies |
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Greece- Hippocrates- Somatogenic theory 460-377 BC
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priest, trained in exorcism, father of medicine
stands against religion, believes in natural causes described major disorders we have today: paranoia, depression, epilepsy |
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Dycrasia- Hippocrates- Somatagenic theory
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4 humors (phlegm, black bile, yellow bile, blood)
abnormal behavior caused by an inbalance of humors melancholia= depression |
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witchcraft as an explanation
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decrease in art and medicine
church takes over, get rid of devil Malleus Maleficarum- how to exterminate witches, heresy 2 witnesses chose to let devil in |
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Renaissance
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return of medicine
increase in culture, no inquisition, humane treatment |
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Psychogenic theory
Mesmer's universal magnetic fluid |
Obstruction of universal magnetic fluid getting in way of functioning, influenced by moon, planets, and tides. Need balance to be healthy.
tub with iron filing and iron rods, father of hypnosis |
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psychogenic theory
Charcot |
neurologist, physical reasons
hysteria brought on by neurological dysfunction hypnotizability= symptom of hysteria hysteria= epilepsy= neurological conditions caused by the genitals |
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Breuer
psychogenic theory |
Anna O. with hysteria
talk and feel better (catharsis) past having an effect bring problems to consciousness helps birth of unconscious |
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how social, political, and religious climates throughout history influenced people's conceptualizations of abnormal behavior
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at first, regarded as supernatural, gods and demons. Then with Hippocrates, biological explanation, but church gained influence during dark ages, returned to supernatural causes (witches)
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Bethlehem
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chained with criminal, pay to see them
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La Salpetriere
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brutal care, flooding of Sen= eaten by rats
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Classification becomes possible because of patients in...
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insane asylums
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moral treatment
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Pinel- difficult to manage due to terrible conditions, restore reasoning and give self-control
William Turk's retreat at York- people need esteem and work in order to do well, people were able to leave and get better |
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Psychoanalytic Model (Freud)
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results from unconscious conflicts
id- basic needs ego- deal with reality= symptoms superego- person's conscious Conflict between id and superego creates anxiety= expression of conflict |
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Behavioral Model
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Watson, Skinner
operant and classical conditioning modeling focus on observable |
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cognitive-behavioral model
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Bandura
Beck- cognitive therapy thoughts, attention, distorted thinking thinking has role in problems |
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uses of diagnoses
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science progresses through classification
allows things to be easily identified and described predicts |
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assumptions of the medical model
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aberrant is a symptom-the symptom isn't the problem, there is an underlying problem
time of onset-moment from being well to being sick specific etiology- there is a specific cause of the disease |
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Szasz
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no evidence of brain pathology= no illness?
problems in living tied to social context, subjective mental illness takes away responsibility from the individual for their dilemmas |
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Ausubel
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defect not necessary to be an illness
all symptoms involve subjectivity problems in living are a manifestation of a disease |
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Usefulness of the model in the discovery of syphillis
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1st major time they actually found cause of mental disorder
Haslam- delusions of grandeur and dementia. identified the group of people later diagnosed with syphillis Esquirol- inevitability of outcome. identified the typical progression of it Fournier- cricual experiment. asked patients if they were diagnosed with syphillis. ebbing- discovery of cell. injected syphillis into patients to see if they would get it but they already had it Schalinn- found it in specific part of brain |
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early systems in mental illness (Kraeplen)
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contributor to diagnostis classification of mental disorders
manic depression- changes in mood, exaggerated mood, sudden onset, spontaneous recovery, periodic dementia praecox- thought and mood disorder, gradual increase |
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usefulness of diagnosis in present
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communication, etiology, treatment, research
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Axis I
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Clinical Disorders
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Axis II
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Developmental and personality disorders
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Axis III
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Medical conditions, may influence disorders
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Axis IV
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psychosocial and environmental problems
may contribute to problem |
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Axis V
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global functioning scale, takes everything into account, assess function before and after treatment, way to communicate
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advantages of DSM-IV over earlier versions
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descriptive, atheoretical, multiaxal
no theories so everyone can agree on a diagnosis diagnose on observables |
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Critiques of DSM
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classification makes it sound like qualitative differences
illusion of explanation effects of labeling= stigma |
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DSM-5 proposed changes
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additional of dimensional ratings- severity scale
reorganized by cause vs symptoms, etiology, OCD=biological more emphasis on cultural and ethnic considerations a few new diagnoses diagnoses combined |
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primary labeling theory
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we create the disorder by labeling it
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secondary labeling theory
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creates stigma
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Rosenhan experiment
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12 stable people to try and get them admitted to a psych hospital
admit to hearing voices (thud, empty, hollow) each admitted 11/12 schizo 1/12 manic depressive assumptions of disturbed behavior av. 19 days in hospital |
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Scheff
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False negative better than a false positive
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aims of assessment
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diagnosis
aid in intervention and planning understand problems and strengths gather data on causes and correlates of abnormal behavior (research) |
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clinical interview
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leeway in how person responds
how person interprets problem nonverbal info depends on theoretical orientation |
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psychological testing
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a systematic procedure for observing a person's behavior with the aid of a numerical scale or categorical system
standardized test- all get same procedure, get norms to compare |
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Intelligence tests
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IQ- assess current mental ability
memory, attention, problem-solving, reasoning appropriate place in school, can change |
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Minnesota Multiphasic Personality Inventory MMPI
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statements indicative of mental problems
people with disorders and no disorders took test, created scales MMPI-2- increase in validity and acceptability correction scales- lie and infrequency |
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Thematic Apperception Test
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TAT
telling stories to describe pictures |
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Rorschach
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10 inkblots
how you see it, how you perceive blots is how you perceive the world |
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behavioral observations
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functional assessment, before during after
ABC- antecedent, behavior, consequences self-monitoring |
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Psychophysiological assessment
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bodily changes along with physiological conditions
EKG EEG skin conductance heart rate lie detector tests |
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Neurobiological assessment
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CAT- detects differences in tissue density
MRI- magnetic force fMRI- brain structure and function PET- brain structure and function |
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neuropsychological assessment
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pinpoint dysfunctions in brain by looking at how people function
stimulate different parts of the brain |
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neuropsychological assessment
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Halstead-Reitan- TAT, time memory test
Luria Nebraska |
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assumptions of developmental approach
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continuum
past influences present and future continuity depends on development |
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RAD
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markedly disturbed or developmentally inappropriate social relatedness in most contexts
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inhibited type RAD
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persistent failure to initiate or respond in a developmentally appropriate fashion
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uninhibited type RAD
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inability to exhibit appropriate selective attachment. Failure to thrive, baby does not grow properly, low in weight and stature.
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Spitz's 1945 study: what differentiated the Foundling babies from the others?
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less toys, little movement, more personnel, no moms
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Spitz: what happened to the babies whose mothers were removed?
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depressed, recovers rapidly after 3 months, after 3 cannot sit or stand and psychiatric disturbances
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hospitalism
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deterioration of body due to long-term confinement in hospital
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anaclictic depression
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separation after bonding
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mechanisms of growth failure (Gardner)
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secrete when sleeping, but they don't sleep well so not getting it
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mechanism of growth failure: food intake (Widdowson)
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malnourishment, metabolizing food differently as a result of affective climate
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Evans, Reinhardt, Succop on RAD
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unwanted and unplanned
irritable and difficult early management problems later little support from family little support from father profiles |
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3 profiles
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14/40, mother depressed, attained, unsure, loss (of own mother), gained skills in hospital and babies began to thrive
15/40, multi-problematic, low resources, got better at hospital but at home got worse 11/40, mothers angry, distorted relationships, lack of trust |
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Developmental timeline from birth to 3 years
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homeostasis- 2-3 mo. baby needs to get regulated to be alert and learn about the world
attachment- to 12 mo. around 6 or 7 mo. gain sense of object permanence, able to miss, attachment to a specific person, vulnerable to loss differentiation- to 18 mo. baby is trying out his affect on the world, wants to share things with parents Individualization- to 2 years, baby realizes what it wants isn't what everyone else wants Internalization- 2-3, develops moral sense |
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Developmental Crises
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trust vs. mistrust- up to 18 mo.
autonomy vs. shame and doubt- 18mo. to 2 initiative versus guilt= 2 on |
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etiology of RAD
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improper care
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autism
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begins in childhood, deficits in social communication and interaction, restricted and repetitive behaviors
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asperger's disorder
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social relationships poor and stereotyped
rigid behavior language and development intact not in DSM-5 |
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Rett's disorder
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normal 1st year
growth of head decelerates loses hand movement becomes stereotyped and uncoordinated poor speech and relatedness that does not progress removed from DSM-5 mutation in gene- girls |
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childhood disintegrative disorder
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normal 1st 2 years then loss of social play, language, and motor skills
not in DSM-5 no specific genetic etiology |
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prevalence of autism
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1/88, 3-10 fold increase
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theories on the increase in autism
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MMR vaccine and thimerosal. Mercury in vaccines? take out but still increase in autism
diagnostic criteria and measurement tools. DSM-IV more inclusive, broader Increased awareness |
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changes for DSM-5 for autism
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everything combined into autism spectrum
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Kanner's ideas of autism
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11 children
mutism or delayed speech noncommunicative speech- echolalia, reverse pronouns, issues with abstraction lack of relatedness- want to be alone insistence on sameness repetitive and stereotyped play rood rote memory- savant skills not common normal appearance |
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Prognosis for Autism (Kanner)
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11 kids
2 died before adulthood 5 institutionalized 3 in community 1 on farm 2 employed |
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prognosis on autism (Rutter)
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63 children
32 speech at 5 31 no speech at 5 speech early on= better prognosis |
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psychogenic theory of autism
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parents emotionally rigid, lacked warmth (Kanner)
Bettleheim's theory- survivor of concentration camp, children are survivors of their insensitive parents, treatment is to leave homes Singe and Wynne- parents of autistic children were more passive and cynical Koegel et al.- marital relations, biological patterns, stress level, more stress about child |
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genetic theories of autism
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children with autism have more neurons in prefrontal cortex, too much disorganization, not noticing whole
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cognitive theories of autism
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not pulling everything together into a whole
hutt and hutt-modulation of sensory input. normal and autistic kinds in empty room or room with blocks or room with woman and blocks Metz-stimulation through machine, autistic kinds overestimated themselves Kolko=overselectivity, presented with stimulus, ed light or puff of air or white noise. autistic children can only respond to one stimulus at a time |
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ADHD
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individuals who have difficulty attending, controlling their impulses, and organizing behavior
impairs function |
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prevalence of ADHD
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3-7% in U.S. 3x boys
maybe more girls, but quieter due to societal expectations |
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ADHD inattention
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fails to give close attention to details, careless mistakes, difficulty sustaining attention, doesn't listen, fails to complete tasks, disorganized, no sustained mental effort, loses things, distracted, forgetful
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ADHD hyperactive/ impulsive
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fidgets, restless, can't be quiet, driven by motor, talks excessively, blurts out answers, can't wait turn, interrupts
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biological findings
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isn't as much activity in certain parts of brain (attention)
runs in families pre and post natal complications-low birth weight, lead, lack of O2, problematic parenting |
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diagnostic controversies
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overdiagnosed
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treatment for ADHD
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stimulants- Ritalin, focuses attention, double blind study=effective, but not learning just helping behavior
therapy-teaching how to cope, helping parents brain training |
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conduct disorder
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violating basic rights of other or societal norms
stealing, lying, destroying property genetic component, parent aggressiveness, family intervention and multisystematic treatment promising 3X boys, 3-7% children |
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ODD
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loses temper, temper tantrums, argues with adults, defy requests, annoy others
more in boys, disappears when older more tied to environment |
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developmental tasks
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taking on responsibility
own beliefs values physical changes sexuality/relationships vocational issues challenges with peers |
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normative levels of distress
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adolescents-okay
professional-more distressed than they actually are parents-thinks adolescents are negative towards them |
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Erikson's concept of identity
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task that adolescents are doing, called moratorium
problems if unresolved crisis: incapacity for intimacy, diffusion of time perspective, diffusion of industry, choice of negative identity |
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identity statuses and their outcomes in Marcia's study
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interviews about occupation, politics, and religion
achievement- crisis then commitment. little conflict or distress, mature, self-directed, confident, intimacy foreclosure- never had a crisis. low self-esteem, conforming, rigid, dependent, low anxiety, stereotyped diffusion- no commitment. directed, low anxiety, apathy, impulsive moratorium-still struggling in crisis. self-directed, high self-esteem, anxious, ambivalent, intimacy |
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identity disorder
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perception of severe distress with uncertainty about a variety of issues related to identity formation including at least 3 of: long-term goals, career choice, sexual orientation and behavior, religion, moral values, friendship patterns, group loyalties
at least 3 months impairment in function |
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cognitive control
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executive functioning such as planning, reasoning, impulse control
located in prefrontal cortex |
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socioemotional control
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high arousal=lack of control mechanism. sensitive to social and environmental stimuli
located in limbic areas-amygdala |
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hot and cold recognition
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differential development creates differences for adolescents and peers
hot- I hate school lets skip it. lose knowledge, impulses, influence of peers cold- probably should plan for the future. as same rate as adult |