CHILD DEVELOPMENT

Major Theories
o Psychoanalytic: stages, importance of early experience
Psychosexual- bio drive and sexual expectations
Psychosocial- cultural context
Discontinuous; One Track; Nature & Nurture
o Behaviorism and Social Learning
Classical Conditioning Operant Conditioning- reward/punishment
Modelling- imitation/observation
Continuous; Many Tracks; Nurture>Nature
o Cognitive Developmental
Ignored importance of sociocultural context
Understanding and reasoning of world occurs at stages
Sensorimotor-PreOp-Concrete Op-Formal Op
Discontinuous; One Track
o Sociocultural
Importance of dialogue btw child and adult
Learning thru socially mediated interxn
Continuous/Discontinuous; Many Tracks; Nature & Nurture
Normal Behaviors
o Rituals:
Toddler-routines
Preschool- less rigid
Elementary
group play (rules and rhymes etc)
solitary (collections)
Jr High: fads, fascinations, focused interests
o Superstitions
o Common, reassuring, socially acceptable and reinforced, decrease over
course of childhood
Abnormal:
o Obsession: persistent thoughts ideascause anxiety or distress
o Compulsive: repetitive behaviorsgoal to reduce anxiety or distress
o Uncommon, distressing, time consuming, socially isolating, increase over
course of childhood-adult

Normal vs OC:
o Age of onset and trajectory: decrease vs increase over time
o Internal experience: reassuring vs distressing
o Social Connection: facilitate vs isolating
o Location: public vs private

CHILD BEHAVIOR PROBLEM DEVELOPMENT

2 Main causes:
o Reciprocal coercive interactions
o Monitoring deficits
Reciprocal Coercive interactions
o Power struggle
o Negative reinforcement of threats/violence
o Escalation over time
Supervision
o Knowledge of child and parental self awareness
o Recognizing patterns of behavior
o Kid becomes transparent and understoodfeels connected to parent
o Development of conscience
o Lack of supervision:
Accidents, fire setting, substance abuse, premature sex etc
Power strugglelack of supervision: learned helplessnessfacilitates
development of maladaptive behavior
Solution
o Behavior programs
Child feels competent
Parent less involved
Fewer verbal interxns

SCHIZOPHRENIA

Clinical Syndrome: Disassociation from reality

o Abnormal mental experiences: halluc, delusions, disorganized thought process
o Loss of mental energy and efficiency: social withdrawal, loss of motivation
o Cognitive impairment w/o gross dementia: exec fxn, attn, verbal memory
o Occurs in clear consciousness
o Chronic course with waxing and waning
o Diagnosis of exclusion cuz symptoms shared by other disorders
Exclude: delirium, dementia, mood disorders
As a Disease:
o Genetic basis
o Risk factors: season, male, birth complications
o Brain Pathology
Neurodegenerative process- volume lossenlarged ventricles
Decreased prefrontal activationdim. Frontal fxn
o Pathology:
Hyperactivity of DA transmission
Glu synaptic disregulation (decreased glu synapses)
o Complex interplay: development, degeneration, dysfunction
Treatment:
o Antipsychotics
o Indvl, group, family psychotherapy
o Social skill/vocational rehab
o Case management

DEMENTIA
Acquired global decline in cognitive fxn, slow onset, progressive
Compared to:
o Delirium: sudden onset, fluctuation levels of consciousness
o Depression: subacute onset, amotivational presentation
Causes
o Alzheimers
o Vascular dementia
o Neurodegenerative disorders
o Metabolic: nutrition, toxic, alcoholic
o Hydrocephalus
Alzheimers:
o Insidious onset, progressive course
o Positive family history
o Loss of cholinergic neurons
Multi-Infarct Dementia
o Patchy distribution of defecits
o Evidence of focal damage
o Evidence of cerebrovascular damage
DELIRIUM
Dx:
o Fluctuation level of conscious, inattention
o Decline in cognition
o Apathy, disorientation, dec memory
o Acute onset
Neuroanatomy: damage/dysfxn to reticular formation
Etiology:
o Infection
o Toxic/Metabolic
o Substance abuse
o Medications
ALZHEIMERS

Symptoms
o Dementia
o Depression- high prevalence
o Psychotic disorders- delusions, halluc, mania
o Aggression
o Apathy
o Sleep disturbance: norm insomnia
o Frontal symptoms: disinhibition, wandering, calling out etc (treat w/ SSRI)
AchE inhibitors

o Cause may be deficit of Ach

o Alters progressionincreases good time
NMDA antagonists: neuroprotective role Glu cause? Possible from excitotocity

EATING DISORDERS

Anorexia: self starvation

o Weight loss <85% ideal body weight
o Fear of fatness
o Body image dissatisfaction
o Restrictive or Binge/Purge
o 0.1-1% of women
Bulimia nervosa
o Binge eating
o Loss of control over eating
o Guilt/shame over binges
o Compensation: purging or non purging
o Fear of fatness, body dissatisfaction
o Not underweight
o 1-3% of women
Dieting Disorder Cycle: Cognitive Disturbance (fear fatness)Behavioral Disorder
Development
o Birth
o Predisposing factors (genetics)
o Development of Behavioral precursor (dieting)
o Precipitating Factors: + feedback for small weight loss
o Onset
o Maintaining factors: starvation, vomiting, becomes easier as you do it
Motivated Behavioral disorder
o Behavior is driven (eating)
o Behavioral expression of appetite modified by social learning
o Dieting becomes a consuming passion to exclusion of other activities
o Behavioral experience reinforces repetition
Dimensions
o Disease: comorbidities, mood and anxiety disorders
o Dimensional: predisposition of certain personalities
o Behavioral: disorder of behavior
o Life story: develops and maintained in context of culture, family, stressors etc

FEEDING

Motivated behavior in a social context

Motivated Behavior
o Drive to a goal
o Stereotyped behaviors satisfy drive
o Satiation temporarycycle
o Modulated by internal/external factors
o Learning
Drive
o Embodied in physiological control mechanisms
o Serves energy homeostasis
o In order to ensure repeat feedingact is rewarding
Increase in obesity: increased food intake, decreased exercise
Signals
o CCK satiety signal
o Leptin decreases food intake
o Ghrelin hunger signal
Hedonic control
o Nucleus accumbens
o Also implicated in opiod reward system

OCD

Disease perspective
o 5 symptom groups:
Contamination/cleaning
Aggressive/sexual/religious
Ordering/symmetry/repeating/counting
Hoarding
Checking/responsibility
o 3 subtypes depending on obsessive or compulsive qualities
o Associated with Tourettes and ADHD
o Pathology:
Increased activity in orbital frontal cortex
Dysfunction or hyperfxn of cortico-striate circuits
o Etiology:
Brain injury/trauma
Genetic
Dimensional perspective
o Obsessive/compulsive personality disorder
May or may not manifest in OCD
Behavior perspective
o Behavioral disorder
o Obsessions are intrusive
o Compulsions are repetitive for anxiety relief
o Causes distress, impairs life fxn
Treatment:
o Cognitive Behavior Therapy
o Medication: SSRIs

AUTISM

Symptoms:
o Impairment in social interaction
o Impairment in communication
o Repetitive and stereotyped patterns of behavior and interests
Pathology
o Elevated neurotrophinspremature growth w/o guidance
o Enlarged head, increased cerebral volume, enlarged amygdale and
hippocampus
Etiology
o Fragile X
o Chromosomal abnormalities
o Congenital rubella
o Genetics
Epidemiology
o 4:1 M:F
o 1:100 with autism
Differs from:
o MR: cuz it has an uneven cognitive profile
o ADHD: cuz much larger degree of social impairment and communication
disorder
o OCD: cuz much larger degree of social impairment, and different
focus/content of repetitive behavior
ADHD
Symptoms
o Inattentiveness
o Hyperactivity
o Impulsivity
o An issue of inhibition
Pathology
o Reduced total cerebral and cerebellar volume
o Abnormal frontal morphology
o Deviation in frontal/striatal circuit
Etiology
o Genetics
Treatment
o Stimulants
o Behavioral therapy
Epidemiology
o 5% of school children
o Often comorbidites- anxiety/mood disorders
o Girls more difficult to dx, often dxd later

SLEEP
o Regulation
o Homeostatice process: balance or amt of sleep:waking in a 24hr period
o Circadian process: timing of sleepiness, reinforced by photoperiod
Super chiasmatic nucleuspineal glandmelatonin
o Sleep architecture
o NREM
Stage 1: slowing EEG; light sleep
Stage 2: sleep spindles and K complex most of night
Stage 3-4: Slow Wave Sleep/Delta Sleep: deep sleep
o REM: decreased muscle tone, although motor areas of brain very active;
towards end of the night
o Sleep Disturbances
o Insomnia
o Excessive sleepiness
o Parasomnia: sleep walking, sleep eating etc.