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Samenvatting Ontwikkelings- en gedragsstoornissen: psychologische diagnostiek

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Dit is een samenvatting van alle lessen en slides van het vak Ontwikkelings- en gedragsstoornissen: psychologische diagnostiek. Dit vak wordt gegeven door Roeljan Wiersema. Dit examen is een openboek examen dus een samenvatting van alle info van de slides aangevuld met eigen notities kan handig zij...

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  • May 5, 2021
  • 129
  • 2020/2021
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Ontwikelings- en gedrag stoornissen




1

,INHOUDSOPGAVE

1. INLEIDEND ................................................................................................................................................................................ 7
1.1. Ontwikkelingsstoornissen ........................................................................................................................................... 7
1.1.1. DSM-III-R (1987) .........................................................................................................................................................................7
1.1.2. DSM-IV (1994) * DSM-IV-TR (2000) ...........................................................................................................................................7
1.1.3. ICD-10 (1992) .............................................................................................................................................................................7
1.1.4. DSM- 5 (MEI 2013, NL 2014) ......................................................................................................................................................7
1.1.5. (Neurobiologische) Ontwikkelingsstoornissen ...........................................................................................................................9
1.2. Gedragsstoornissen ................................................................................................................................................... 10
1.2.1. DSM-III-R (1987) en DSM-IV(-TR; 1994, 2000): ........................................................................................................................10
1.2.2. DSM-5: .....................................................................................................................................................................................10
1.2.3. ICD-10 (1992): Behavioral & emotional disorders with onset usually occurring in childhood and adolescence .....................10
1.2.4. Wat zijn gedragsstoornissen ....................................................................................................................................................10
1.3. Ontwikkelings- en gedragsstoornissen in dit opleidingsonderdeel ........................................................................... 11
1.4. Diagnose: verschillende vormen................................................................................................................................ 12
1.4.1. Beschrijvende of onderkennende diagnose .............................................................................................................................12
1.4.2. Etiologische of verklarendediagnose .......................................................................................................................................12
1.4.3. Assesment, indicerende of handelings-gerichte diagnose ........................................................................................................12
1.5. Instrumenten ............................................................................................................................................................. 12
1.5.1. Screenings instrumenten .........................................................................................................................................................13
1.5.2. diagnostische instrumenten / diagnose ...................................................................................................................................16
1.5.3. Assessment instrumenten .......................................................................................................................................................17
1.6. Verschillende vormen diagnostiek ............................................................................................................................ 18
1.6.1. Focus onderkennende diagnostiek ..........................................................................................................................................18
1.6.2. Rekening houden met ..............................................................................................................................................................19
1.7. Diagnostiek moet op verschillende niveaus gebeuren .............................................................................................. 19
1.7.1. Genetische of chromosomale stoornis ~ gedragsmatig fenotype ..............................................................................................21
1.8. Intelligentie ............................................................................................................................................................... 22
1.8.1. Ontwikkelings en intelligentietesting .......................................................................................................................................22
Belangrijkste ontwikkelings- en intelligentie-testen in Nederlandse taalgebied (BFP, 2015) ..................................................................22
1.8.2. Invloeden op prestatie op intelligentietest ..............................................................................................................................23
1.8.3. Mentale retardatie DSM-IV-TR, Verstandelijke beperking DSM-5 ...........................................................................................23
1.8.4. hoogbegaafdheid .....................................................................................................................................................................23

AUTISMESPECTRUM STOORNISSEN .......................................................................................................................................... 25

1. AUTISMESPECTRUMSTOORNIS ( ASS) .......................................................................................................................................... 26
1.1. DSM-criteria .............................................................................................................................................................. 26
dsm-5 specifiers .......................................................................................................................................................................29
DSM IV(-TR) (1994, 2000).........................................................................................................................................................29
In vlaanderen ...........................................................................................................................................................................29
DSM-5 (2013): VAN MEER NAAR 1 EN VAN 1 NAAR MEER ......................................................................................................29
1.2. Comorbiditeit ............................................................................................................................................................ 30
1.3. Prevalentie ................................................................................................................................................................ 30
Autismespectrumstoornissen een epidemie? ..........................................................................................................................31
Meisjes/vrouwen met ass ........................................................................................................................................................31
1.4. Geschiedenis.............................................................................................................................................................. 31
Leo Kanner (1894-1981) ...........................................................................................................................................................31
Hans Asperger (1906-1980) .....................................................................................................................................................32
1.5. DSM IV TR .................................................................................................................................................................. 33
DSM-5: geen onderscheid meer tussen autistische stoornis en Asperger ...............................................................................33
1.6. LORA WING ............................................................................................................................................................... 34
sociale subtypen (1979) ...........................................................................................................................................................34
1.7. THEODORE HELLER.................................................................................................................................................... 34
ACHTERGROND ........................................................................................................................................................................34
DSM IV TR: Desintegratiestoornis van de kindertijd ................................................................................................................34
1.8. Andreas Rett .............................................................................................................................................................. 35
DSM-IV tr: hET SYNDroom van rett ..........................................................................................................................................35



2

, DSM-IV ATTYPISCHE AUTISME (PDD-NOs) ...............................................................................................................................36
DSM-iv autismespectrumstoornis ............................................................................................................................................36
Voorbij het autisme spectrum .................................................................................................................................................36
2. DIAGNOSTIEK AUTISMESPECTRUMSTOORNISSEN (DEEL 2) ................................................................................................. 37
2.1. Minimaal diagnostisch protocol ................................................................................................................................ 37
Overzicht ..................................................................................................................................................................................37
2.2. Diagnostisch protocol ................................................................................................................................................ 37
Psychodiagnostisch onderzoek.................................................................................................................................................39
2.3. Autismespectrumstoornis: differntiaaldiagnose ....................................................................................................... 39
Etiologie = mogelijke oorzaken van ass .....................................................................................................................................40
2.4. Genetica .................................................................................................................................................................... 40
Genetische factor .....................................................................................................................................................................40
Broertjes en zusjes ....................................................................................................................................................................41
Genetische oorzaak ..................................................................................................................................................................41
2.5. ASS: neurobiologie ..................................................................................................................................................... 41
Groei van brein .........................................................................................................................................................................41
Vertraagde en afwijkende ontwikkeling neuronale materie .....................................................................................................42
Connectiviteit ...........................................................................................................................................................................43
Derde vaststelling .....................................................................................................................................................................43
2.6. Conclusie genetica enneurobiologie.......................................................................................................................... 43
Rol genetische factor ................................................................................................................................................................43
Ontwikkeling brein ...................................................................................................................................................................44
2.7. ASS: omgeving (xgen) ................................................................................................................................................ 44
Genetica en omgeving ..............................................................................................................................................................44
2.8. ASS: Etiologie samengevat......................................................................................................................................... 44
Belang van genen .....................................................................................................................................................................44
Invloed omgevingsfactoren ......................................................................................................................................................45
3. NEUROPSYCHOLOGISCHE STUDIES & PSYCHOLOGISCHE VERKLARINGSMODELLEN .................................................................................... 46
3.1. Psychologische theorie .............................................................................................................................................. 47
Psychologische verklaringstheorie tussen genetisch-neurobiologisch en gedrag ......................................................................47
3.2. Zoektochtnaar primair deficit ................................................................................................................................... 47
Universeel – specifiek – stabiel en persistent ..........................................................................................................................47
3.3. Theory of Mind (Verklaringsmodel 1) ......................................................................................................................... 47
Het ontstaan van het concept ...................................................................................................................................................47
Alleen mensen? ........................................................................................................................................................................48
ToM bij demens .......................................................................................................................................................................48
3.4. ToM deficit bij kinderen met autisme (Baron-Cohen et al., 1985) ............................................................................... 49
Enkele cijfers ............................................................................................................................................................................49
Het ‘probleem’ .........................................................................................................................................................................49
Vervolgonderzoek ....................................................................................................................................................................49
Oplossing? ................................................................................................................................................................................50
Nieuw ‘probleem’ .....................................................................................................................................................................50
Reading the mind in the eyes task .............................................................................................................................................51
Conclusie advanced ToMtaken ................................................................................................................................................52
3.5. Mogelijke voorlopers vanToM................................................................................................................................... 52
ASS symptomen voor vier jaar, TOM vanaf 4 jaar? .....................................................................................................................52
Opsomming mogelijke voorlopers ............................................................................................................................................52
ASS en imitatie .........................................................................................................................................................................52
ASS en spiegelneuronen...........................................................................................................................................................53
Joint attention ..........................................................................................................................................................................55
Symbolisch spel ........................................................................................................................................................................56
3.6. Dilemma ToM ............................................................................................................................................................ 57
Centraal dilemma .....................................................................................................................................................................57
3.7. TOM 2.0 hypothese .................................................................................................................................................... 58
Spontaan ToM deficit ...............................................................................................................................................................58
Recente evidentie.....................................................................................................................................................................58
3.8. Conclusie ASS enToM ................................................................................................................................................ 58



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, 3.9. Executieve functies (EF) deficit (Verklaringsmodel 2) ................................................................................................. 59
Evidentie? ................................................................................................................................................................................60
EF en ASSsymptomen ................................................................................................................................................................61
Implicaties voor praktijk ...........................................................................................................................................................61
3.10. Verminderde centrale coherentie (Verklaringsmodel 3) ............................................................................................. 61
Centrale coherentie ............................................................................................................................................................61
Andere cognitieve stijl .........................................................................................................................................................61
Cognitieve stijl: continuüm ..................................................................................................................................................63
Conclusie verklaringsmodellen ...........................................................................................................................................64
Sterktes ASS .........................................................................................................................................................................65
4. DIAGNOSTISCH PROTOCOL ......................................................................................................................................................... 66
4.1. Minimal diagnostisch protocol .................................................................................................................................. 66
4.2. Diagnostisch protocol................................................................................................................................................ 66
medische evaluatie ..................................................................................................................................................................66
Een psychodiagnostisch onderzoek. ........................................................................................................................................67
4.3. Autismespectrumstoornis: differentiaaldiagnose ..................................................................................................... 67

AANDACHTSDEFICIËNTIE- HYPERACTIVITEITSSTOORNIS (ADHD) ............................................................................................. 68

1. AANDACHTSDEFICIËNTIE- / HYPERACTIVITEITSSTOORNIS .................................................................................................................. 69
1.1. DSM 5 over ADHD ..................................................................................................................................................... 69
Omschrijving ADHD ..................................................................................................................................................................69
Relatief t.o.v. anderen in dezelfde context ..............................................................................................................................70
1.3. Bijkomende voorwaarden ADHD ......................................................................................................................................70
Adhd en comorbiditeit .............................................................................................................................................................71
Adhd en negatieve impact .......................................................................................................................................................72
Maar ook positieve impact van ADHD .....................................................................................................................................72
1.2. Een blik op het verleden ............................................................................................................................................ 72
Heinrich hoffmann, 1845 (zappel-phillipp) ..............................................................................................................................73
Sir George Frederic Still (1902) ................................................................................................................................................73
1.3. Prevalentie ................................................................................................................................................................ 74
ADHD EPIDEMie? .....................................................................................................................................................................74
Polanczyk et al., 2015...............................................................................................................................................................75
Adhd een epidemie ..................................................................................................................................................................75
2. DIAGNOSTIEK ADHD ............................................................................................................................................................... 76
2.1. Comorboditeit ........................................................................................................................................................... 76
2.2. Differentiaaldiagnostiek ............................................................................................................................................ 76
2.3. MULTIMODALE ASSESMENT ..................................................................................................................................... 77
Interview ..................................................................................................................................................................................77
vragenlijsten.............................................................................................................................................................................78
2.4. Testonderzoek ........................................................................................................................................................... 79
Intelligentieonderzoek .............................................................................................................................................................79
Neuropsychologisch onderzoek ...............................................................................................................................................79
Vaststellingen neuropsychologisch onderzoek ........................................................................................................................81
Conclusie neuropsychologisch onderzoek ...............................................................................................................................82
Observatie ................................................................................................................................................................................83
3. ETIOLOGIE .............................................................................................................................................................................. 84
3.1. Genetische component.............................................................................................................................................. 84
3.2. Mogelijkse omgevingsfactoren ................................................................................................................................. 84
Pre- en peri-natale complicaties (voor en tijdens zwangerschap) ...........................................................................................84
Post-nataal (na zwangerschap) ................................................................................................................................................85
3.3. Neurologische bevindingen ....................................................................................................................................... 85
In specifieke hersengebieden: .................................................................................................................................................85
Van regio’s naar netwerken .....................................................................................................................................................86
3.4. Neurochemische afwijkingen .................................................................................................................................... 87
3.5. ADHD een hersenziekte? ........................................................................................................................................... 87
3.6. Psychologische verklaringsmodellen ......................................................................................................................... 88
Defict in executief functioneren (a) .........................................................................................................................................88



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