1. Disorders of Childhood and Adolescence

2. Externalizing Disorders  Disorders with behaviors that are disruptive and often aggressive  Attention-deficit Disorder, with or without Hyperactivity (ADD/ ADHD)  Tic disorders (Tourette’s)  Oppositional defiant disorder (ODD)  Conduct disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005

3. Internalizing Disorders  Related to worries and disturbing thoughts rather than to overt behaviors  Separation Anxiety Disorder  Social phobia  Generalized anxiety disorder  Obsessive-compulsive disorder  Depression  Eating Disorders Abnormal Psychology, 11/e by Sarason & Sarason © 2005

4. Frequency of Disorders in Children and Adolescents, aged 9-17 Type of DisorderPercent Affected Anxiety Disorders13.0 Mood Disorders6.2 Disruptive Disorders10.3 Abnormal Psychology, 11/e by Sarason & Sarason © 2005

5. Attention Deficit Disorder (ADD/ ADHD)  Either criteria for inattention or hyperactivity- impulsivity must be met.  Attention Deficit Behaviors may include  Does not seem to listen or follow through on instructions  Difficulty in organizing activities and tasks  Easily distracted by other stimuli  Forgetful in daily activities  Hyperactive Behaviors may include  Fidgets, runs about excessively  Hard to play quietly  Talks excessively  Gluts out answers  Can’t wait turn Abnormal Psychology, 11/e by Sarason & Sarason © 2005

6. Issues in ADHD  How common?  7 out of 100 children  4 boys to 1 girl  Consequences?  Deficiencies in academic and social skills  Poor school achievement  Negative self-view  Problematic interactions with parents and teachers Abnormal Psychology, 11/e by Sarason & Sarason © 2005

7. Rates of ADHD Abnormal Psychology, 11/e by Sarason & Sarason © 2005

8. Risk Factors for ADHD  Genetic inheritance  Brain functioning  Neurotransmitter activity  Environmental factors Abnormal Psychology, 11/e by Sarason & Sarason © 2005

9. Treatment of ADHD  Stimulant medication (e.g. Ritalin)  Antidepressant medication  Behavioral intervention  Classroom intervention  Parent training  Combination of medications and behavioral intervention is most efficacious Abnormal Psychology, 11/e by Sarason & Sarason © 2005

10. Tic Disorders  Tics  Involuntary, sudden, recurrent, stereotyped motor movements or vocalizations  Tourette’s Syndrome  Large motor ticks (shoulders, trunk, arms, legs) combined with uttering obscenities (coprolalia)  Genetic basis likely  Both often occur together with ADHD  Treatment for Tourette’s Syndrome  Antidepressant medication  Relaxation therapy Abnormal Psychology, 11/e by Sarason & Sarason © 2005

11. Oppositional Defiant Disorder  Pattern of negativistic, defiant, hostile behavior lasting more than six months and not typical for age or developmental level  Cause impairment in social, academic functioning  Examples:  Loses temper  Argues with adults  Refuses to comply with requests  Deliberately annoys others  Angry and resentful  Spiteful and vindictive Abnormal Psychology, 11/e by Sarason & Sarason © 2005

12. Oppositional Defiant Disorder  Risk factors  Genetic  Family relationships  Poor or inconsistent parenting Abnormal Psychology, 11/e by Sarason & Sarason © 2005

13. Rates of Oppositional Defiant Disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005

14. Conduct Disorder  More serious than ODD  Aggressive behavior that violates social norms and rights of others  Examples  Threatens or causes harm to people and animals  Property damage, theft, deceitfulness  Serious violations of rules  Behaviors would constitute antisocial personality disorder if child were over 18 years Abnormal Psychology, 11/e by Sarason & Sarason © 2005

15. Conduct Disorder  Risk Factors  Negative family environment  Lack of social and academic skills  ADHD and ODD often associated with later development of conduct disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005

16. Treatment of Conduct Disorder  Prevention  Develop social, emotional, and cognitive skills  Cognitive-behavioral interventions  Cognitive review of situation before reacting, thinking aloud  Time out; behavioral shaping  Positive encounters with clinicians and other adults to develop pro-social behaviors  Interventions must involve parents Abnormal Psychology, 11/e by Sarason & Sarason © 2005

17. Separation Anxiety Disorder  Defined by excessive anxiety or panic when absent from major attachment figures, lasting for more than four weeks, and impairing functioning  Often develops after some stress (loss of parent, relative, or pet or serious family illness, parental separation or divorce)  Usually from caring families  Sometimes the result of failure to achieve secure attachment bond in early childhood  Diminishes after the age of 10 years Abnormal Psychology, 11/e by Sarason & Sarason © 2005

18. Separation Anxiety Disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005

19. Other Anxiety Disorders Commonly Seen in Children  Social phobia  Shun contact with unfamiliar people, especially if under pressure to perform.  Generalized anxiety disorder  In situations associated with pressure to perform, seek out peers to establish dependent relationships; overly eager to please peers.  Obsessive-compulsive disorder  Persistent intrusion of intense, unwanted thoughts with compulsions to perform ritualistic, repetitive behaviors; mostly concerned with dirt and contamination, performing washing rituals.  These disorders often persist into adulthood; may also develop into agoraphobia or depression Abnormal Psychology, 11/e by Sarason & Sarason © 2005

20. Treatment of Anxiety Disorders  Antidepressant or anti-anxiety medication  Family treatment  Cognitive-behavioral interventions, as used for adults Abnormal Psychology, 11/e by Sarason & Sarason © 2005

21. Symptoms of Childhood Depression  Birth to 2 years  Whining, withdrawal, delays in physical, cognitive, language development  Nightmares, night terrors, clinginess  3 to 5 years  Sadness, weight loss, tiredness, thoughts of suicide, anger, apathy, irritability  6 to 12 years  Similar to adults with verbalization of thoughts and feelings; sometimes delinquent behavior; somatic problems; irritability and anger; poor school performance  13 to 18 years  Similar to adults; possible volatile moods, rage, low self- esteem, sexual acting out, substance abuse, suicidal thoughts and behavior. Abnormal Psychology, 11/e by Sarason & Sarason © 2005

22. Rates of Depression in Childhood Abnormal Psychology, 11/e by Sarason & Sarason © 2005

23. Other Types of Child and Adolescent Therapies  Play therapy  Talk and play techniques; puppetry  Family therapy  Family systems approach  Effectiveness  Unclear how effective in clinical settings, though research settings indicate some positive effects. Abnormal Psychology, 11/e by Sarason & Sarason © 2005