Clinical Child Psych Test 4_2

1. Social Anxiety Disorder
   1. DIAGNOSTIC CRITERIA
      1. A. Fear of social situations where they might be judged, observed, or must perform in front of others
      2. B.Fear that they will be embarrassed and rejected
      3. C. The social situations almost always provoke fear or anxiety
         1. expressed by crying, tantrums, freezing, clinging, shrinking, or failing to socially speak
      4. D. Social situations avoided or endured with intense anxiety
      5. E. Fear or anxiety is out of proportion
      6. F. Fear/ anxiety/ avoidance lasts 6 months or longer, usually
      7. G. Anxiety causes setbacks in functioning
      8. H. Not attributable to any substance
      9. I. Not another mental disorder for sure
      10. J. Fear/ anxiety unrelated if the person has medical conditions
   2. Child can speak but refuses to speak or speaks quietly, caused by fear or embarrassment
   3. Can be limited to performance situations only
      1. Treatment: exposure, knowledge through experience
   4. FEARS

      Annotations:

      • Side note: you are most likely to perform well if you are not thinking about others watching you, it was just automatic
      1. Reading aloud
      2. Performance activities
      3. Eating with others
      4. Etc, but all this stuff happens all the time
   5. SOURCE --> inhibition system
      1. Over-controlling/protective parents
2. Panic Disorder
3. Generalized Anxiety Disorder
   1. "kiddo" that worries about everything
   2. SYMPTOMS
      1. Tension, Apprehensive expectations, negative self-image, need for reassurance, irritability, physical complaints, concentration problems, brooding, fatigue, psychomotor agitation, sleep problems
   3. THINGS THEY WORRY ABOUT THE MOST IN ORDER
      1. Health of others
      2. Family matters
      3. The little things
      4. School
      5. Self health
   4. Reassurance seeking > negative reinforcement rapidly throughout the day
   5. Internalizing Symptoms
      1. Anxious-Misery Symptoms (last a long time)
         1. Major Depressive Disorder
         2. Dysthymic Disorder
         3. GAD
      2. Fear Symptoms (symptoms occur abruptly and then go away and may only occur in certain situations)
         1. Specific Phobia
         2. Social Phobia
         3. Agoraphobia
         4. Panic Disorder
   6. Worrying + Problem Solving = Normal
   7. Worrying + Rumination = GAD
      1. (rumination is usually past oriented)
4. OCD
   1. Compulsion: ex-washing/grooming
      1. Repetitive behaviors/thoughts to prevent anxiety or a dreaded event--won't realistically prevent or neutralize anything
      2. but the compulsion doesn't have to fix the obsession in a sensible way
   2. Obsession: ex-germs
      1. often related to religion or sexual imagery
      2. 1. Persistent thoughts, urges, images that come as intrusive thoughts and cause anxiety
      3. 2. Attempts to ignore the thoughts and to neutralize them with another thought/action
   3. trying to ignore an intrusive thought = a compulsion
   4. DIAGNOSTIC CRITERIA
      1. A The presence of obsessions, compulsions, or both:
      2. B. Time consuming / Impairs functioning
      3. C. Not the result of drugs
      4. D. For sure not another mental disorder
   5. Classifying OCD
      1. With good or fair insight
         1. realizes beliefs are probe not true
      2. With poor insight:
         1. Thinks beliefs are probe true
      3. With absent insight:
         1. Completely convinced of beliefs
      4. Tic-related:
         1. history of tic disorder
   6. Comorbidity with ASD
   7. Disregulation of the cortico-stratial-thalamic circuit
5. More Information
   1. Well-learned tasks are performed better in front of an audience
   2. Poorly learned tasks are performed even more poorly
   3. FEAR Plan
   4. CBT for Parent and Child is the most effective treatment
   5. CBT and Sertraline (meds) do not work as well to relieve anxiety alone as they do together, but anything is better that a placebo

Annotations:

• This should actually be under "Anxiety and OCD"

1. DIAGNOSTIC CRITERIA
   1. Panic attacks reach their peak within 10 mins
   2. 4 plus symptoms occur
      1. Heart irregularities, sweating, trembling, can't breath, chest pain, nausea, dizzy or light-headed, chills/heat flashes, numbness/tingling, feels surreal, fear of losing control or dying
   3. And one of these two happens for the next month or more
      1. Fear of 2+ of these
         1. Public transportation
         2. Open spaces
         3. Enclosed spaces
         4. Standing in line / crowds
         5. Being away from home alone
         6. (THESE ARE SYMPS OF AGORAPHOBIA, which is not the same as PD
         7. How might agoraphobia develop in terms of panic disorder?
            1. Negatively reinforced by avoiding situations in which they might have a panic attack
      2. Must be able to escape or be helped in a situation, in case they have a panic attack
      3. Agoraphobia
      4. Fear is excessive
      5. Persists for 6 months
      6. For sure to another mental disorder
2. You can have a panic attack without having panic disorder
   1. 1/3 of adults // 1/10 of children
3. TYPES OF PANIC ATTACKS
   1. Type A: Calm>PANIC>Calm
      1. (Probs not PD yet)
   2. Type B: Calm>PANIC>Anxious
   3. Type C: Anxious>PANIC>Calm
4. It becomes panic disorder when you start to fear panic attacks happening again