COMMON CHILD AND ADOLESCENT MENTAL DISORDERS

Forms of disorders - Externalizing disorders like ADHD, oppositional deviant behavior, conduct disorder. Internalizing disorders like separation anxiety, depression, social phobia

Stages in developmental process and disorders that might arise
Infancy (first 4-5years);  ADHD, autistic disorder, mental retardation
Childhood (5-10years);  depression, anxiety disorder, conduct disorder
Puberty (10-13years);  OCD, conduct disorder, eating disorder
Adolescence (13-20years);   social phobias, OCD, bipolar, suicide

ATTENTION DEFICIT AND HYPERACTIVITY DISORDER
ADHD is defined by symptoms of inattention, hyperactivity and impulsivity.
ADHD frequently occurs together with learning disabilities, depression, anxiety, conduct disorder, or oppositional deviant disorder.

Prevalence of ADHD
ADHD is the most frequently diagnosed behavioral disorder of childhood.
 It is common in the school age population
It is usually hard to diagnose for ADHD before  a child is 4 or 5 years because some normal behaviors during this developmental period seem t o the DSM-IV-TR criteria

DSM-IV-TR ADHD DIAGNOSIS
Either the criteria for (1) inattention, or (2) hyperactivity- impulsivity must be met, if the criteria for both are met, the diagnosis would be for ADHD combined disorder

1.   Inattention. At least six of the following symptoms must occur and have persisted for 6 months or more to a degree that is both maladaptive and not consistent with the developmental level

DSM-IV-TR ADHD DIAGNOSIS
Fails to pay close attention to details, or make careless mistakes in school or at work assignment or other activities
Has difficulty keeping attention on task or play activities
Does not seem to listen when directly spoken to
Does not follow through on instructions, and fails to finish tasks
Has difficulty in organizing activities and tasks
f.  Avoids or is reluctant to engage in tasks that require substantial mental effort
Loses things necessary for tasks or activities
Easily distracted by other stimuli
Is forgetful in daily activities

2.   Hyperactivity- impulsivity. At least six of the following hyperactivity or impulsivity symptoms must occur often and must have persisted for 6 months or more to a degree that is both maladaptive and not consistent with the developmental level:
a. Fidgets with hands and feet or squirms in seat
b. Leaves seat in situations where staying in seat is expected
c. Runs about or moves excessively in inappropriate situations or, if an adult has strong feeling of restlessness
e. Finds it hard to play or do leisure activities quietly

Is “on the go” or appears “motor driven”

f. Talks excessively
Impulsivity symptoms
g. Blurts out answers before questions are completed
h. Has difficulty awaiting his or her turn
Interrupts or intrudes on others (e.g., by butting into ongoing conversation or games)
In addition to meeting the criteria for inattention or hyperactivity- impulsivity in (1) or(2) above:
Some of the same symptoms must have been present before the age of 7
Some impairment from these symptoms is present I two or more settings, for example, at school or work and at home
The impairment that the symptoms produce must be marked enough to be of clinical significance
The symptoms cannot be part if another disorder, for example, a psychotic disorder, mood disorder, personality disorder, autism, or mental retardation

Some of the same symptoms must have been present before the age of 7
Some impairment from these symptoms is present I two or more settings, for example, at school or work and at home
The impairment that the symptoms produce must be marked enough to be of clinical significance
The symptoms cannot be part if another disorder, for example, a psychotic disorder, mood disorder, personality disorder, autism, or mental retardation

Consequences of ADHD
It has negative impact in both
Academic skill, this is so because it makes it difficult for the child to pick up information and concepts
Social skill, it is compounded by distraction

Possible causes of ADHD
Genetic inheritance
Environmental factors
Functions in several bran regions, and
Level of neurotransmitter activity

Treatment
Stimulants, the use of stimulant drugs that affect the central nervous system such as methylphenidate (Ritalin).
Behavioral training, the use of reinforcement by parents and/or teachers.

Oppositional Defiant Disorder (ODD)
Children and adolescents are likely to behave in negativistic, defiant, disobedient, and hostile ways towards authority figures.
 if such behavior is severe enough to interfere with the child’s functioning and relations with others, the child may be diagnosed of ODD

ODD
DSM-IV-TR also requires that these behaviors not only occur more frequently, but they also occur frequently than is  typical for children of a comparable age and level of development.
When ODD occurs in the later preschool years, from ages 4 to 5 ½, it may be an indicator of high risk for later problems

DSM-IV-TR criteria for diagnosis

Causes of ODD
ODD seems to be more common in families in which at least one parent has a history of ODD, conduct disorder, ADHD, anti social personality disorder, substance related disorder or mood disorder.
Negative parenting practices. For example, harshness, strictness.

Treatment of ODD
Parenting training programs can reduce ODD and also improve parenting skills

CONDUCT DISORDER
Conduct disorder is serious in their consequences because of the violation of important societal norms and disregard of the rights of others.
The persistent behaviors  typical of conduct disorder includes aggressive actions that cause or threaten harm to people or animals, non-aggressive conduct that causes property damage.
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