Clinical Psychology: Mental health challenges (ESSBP1080)
Institution
Erasmus Universiteit Rotterdam (EUR)
This is a summary (in English) for the course 1.6 Clinical Psychology: Normal or Abnormal? in the Erasmus University Rotterdam. I made the summary by reading and doing my own notes on the literature. After each tutorial I added missing information or removed irrelevant details. By using my notes I ...
Clinical Psychology: Mental health challenges (ESSBP1080)
All documents for this subject (13)
1
review
By: venlaoksanen00 • 1 year ago
Seller
Follow
ilinaaasparuhova
Reviews received
Content preview
Problem 1
ADHD & Autism
ADHD – persistent pattern of inattention and/or hyperactivity (impulsivity)
o lack of attention
o making careless mistakes
o difficulty maintaining attention
o dislike for tasks that require sustained self-application and mental effort
o prevalence: 5% in children, 2.5% in adults
Hyperactivity – higher level of activity, may manifest as excessive fidgetiness; talk
excessively
Impulsivity – impatience, difficulty in appropriately delaying responses, interrupting
others constantly
Diagnosis
o ensure that hyperactivity/inattention is significantly
greater than normal
o impairment is present before 12 years of age and is
found in 2/> contexts
o attention deficit hyperactivity disorder ->
predominantly inattentive presentation
o attention deficit hyperactivity disorder ->
predominantly hyperactive/impulsive presentation
o if both are present -> combined presentation
o associated with violation of social norms and basic
rights of others
o easily recognised at the beginning of schooling
o in adolescence: symptoms become less obvious
o ADHD – more common in boys (reason: unknown)
Consequences:
o temper outbursts
o frustration
o changeable moods
o poor self-esteem
o adulthood: less success and safety at work; poorer
interpersonal academic outcomes
Causes
Þ Biological factors:
o genetic factors
• chromosome 16 – most consistent linkage evidence
• abnormalities in neurotransmitter systems –
dopamine, norepinephrine, and serotonin systems
o genes-environment interaction
• inherited vulnerability to ADHD
• becomes manifested only when certain environmental influences are found:
maternal prenatal smoking, pre- or perinatal complications and maternal
drinking during pregnancy
o neuroscience (ADHD sufferers)
• smaller brains
• smaller brain volume
, • global reduction in grey matter– frontal, parietal, temporal, and occipital
lobes are affected
• decreased volume includes the frontal cortex, basal ganglia, and cerebellum
• deficits in executive functioning (planning, problem-solving), difficulty
inhibiting responses -> controlled by the frontal lobe -> poor performance on
tests of attention, and tasks that require behaviour to be inhibited
• abnormalities in the cerebellum -> choosing, initiating, and carrying out
complex motor and cognitive responses
o prenatal factors
• maternal smoking – prenatal exposure to nicotine caused abnormalities in
the dopaminergic neurotransmitter system, resulting in difficulties inhibiting
behaviour
• drinking during pregnancy
• general complications associated with childbirth
o environmental factors
• biochemical imbalances caused by food additives, lead poisoning, etc.
o heritability – 76%
Þ Psychological factors
o parent-child interactions
• children with ADHD – more likely to be brought up by parents who also have
the disorder => may worsen any symptoms caused by the genetic component
alone -> impatient with the child
• inconsistent, ineffective parenting
o Theory of mind (TOM) deficits
• react inappropriately to family and peers
• ADHD -> poor performance on TOM tasks
• deficits related to planning and inhibition of behaviour -> give rise to
behavioural problems
Treatment
o psychostimulants – increase CNS activity (e.g.: Adderall), produce immediate
and noticeable effects in children
• psychostimulants improve attention and decrease hyperactivity
• less effects on attention and learning
• psychostimulants – do not lead to long-term improvements in behaviour,
learning, and other areas
• side effects: decreased appetite, increased heart rate, and sleeping
difficulties.
o adult ADHD - inattention; impulsivity; overactivity in adults; requires only five
of the six symptoms necessary for the diagnosis in children
o Strattera – nonstimulant medication – treatment of ADHD; prescribed to
adults; less effective than psychostimulants
o Clonidine – can lead to decreases in aggressive behaviour; limited support for
effectiveness
o Antidepressants – justified use only if the psychostimulants fail to work
Article
o Pre-schoolers – parent training is the most appropriate intervention
o School-age children with moderate impairments – group parent training
programmes and classroom behavioural interventions are the most effective
, o School-age children with severe impairments – interventions are more
appropriate when combined with stimulant medication
o Middle school/adolescent children – multimodal interventions. These
interventions usually integrate home and school treatment strategies and often
include an element of social skills training
o Adults – stimulant medication in combination with CBT (Cognitive behavioural
therapy)
Autistic Spectrum Disorder (ASD) – usually
associated with impairment in several areas of
development
o social and emotional disturbances
o intellectual disabilities
o language and communication deficits
o prevalence: 0.05% to 0.2% - increase -> change in
criteria of DSM
Þ impairment of reciprocal social interaction
o in the use of nonverbal behaviours
Þ impairment in communication
o delay in development of spoken language
o inability to sustain a conversation
o echolalia – immediate imitation of words or sounds
that have just been heard
o pronoun reversal – impairment in communication
in which the individual refers to themselves as “he”,
“she”, “you”
Þ impairment in imagination and flexibility of thought
o often display restricted, repetitive, stereotyped
patterns of behaviour and interest
o strong attachment to inanimate objects
Þ intellectual deficits
o intellectual disability, IQ lower than 70 -> in approx. 80% of cases
o perform much better on tests of visuospatial ability than tests of social
understanding or verbal ability
o savant syndrome – extraordinary proficiency in one isolate skill in individuals
with multiple cognitive disabilities
Diagnosis
o deficits in social-emotional reciprocity
o deficits in nonverbal communication (abnormal eye contact)
o deficits in making and maintaining relationships
o symptoms must be present in the early developmental period and must cause
significant impairment in social, occupational, and other areas of functioning
o diagnosing: complicated
• behaviour patterns may change with age
• symptoms may be manifested in varying degrees of intellectual disability
• autistic spectrum disorders are often related to other problems (ADHD,
epilepsy)
Gender
o 80% of those diagnosed are boys
, Causes
Þ Biological causes
o genetic factors
• family history
• appears to co-occur with several genetic disorders
• social impairments, communication impairments, restricted repetitive
behaviours – high levels of heritability
• chromosomal abnormalities – more than 15 genes that could be involved
o biochemical factors
• abnormalities in the brain neurotransmitters that regulate and facilitate
normal adaptive brain functioning
• low levels of neurotransmitters serotonin and dopamine (both essential for
effective cognitive, behavioural, and motor functioning and mood regulation)
o perinatal factors
• risk factors include: maternal infections, maternal bleeding, depressed
maternal immune functioning
• may play a significant role in determining intellectual impairment, but
probably they are not the primary causes of the disorder
o brain abnormalities
• abnormal brain development
• brain abnormalities: limbic system, cerebellum, frontal lobes, basal ganglia
• neurons in the limbic system – smaller, denser; dendrites – shorter, less
developed
• brain abnormalities are both anatomical (structural) and functional
• abnormalities in the cerebellum appear to correspond to deficits in motor
skills (impaired balance, grip)
• overly large brain size – especially the frontal, temporal regions and the
cerebellum (areas associated with language, social, and emotion-based
abilities) – 2-4 years of age begin to become larger, then stop at about 4-5
years
• enlarged ventricles in the brain
• decreased activation of the prefrontal cortex and amygdala -> lack theory of
mind, these areas are responsible for understanding the intentions of others
• these abnormalities may be a result of numerous overgrowth in childhood
and then undergrowth later on in the period when these parts have to be
developed (in frontal cortex and cerebellum)
Þ Cognitive factors
o deficits in executive functioning
• difficulty with problem solving, planning, initiating, organising, monitoring,
and inhibiting complex behaviours
o Theory of mind (TOM) deficits
• fail to develop awareness that the behaviour of others is based on mental
states that include beliefs and intentions
• Sally-Anne false belief task – a way to assess TOM abilities in a range of
clinical populations
• even in adulthood
o The empathising-systematising theory
• theory of social and communication difficulties experiences by individuals
with autistic spectrum disorder
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ilinaaasparuhova. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.59. You're not tied to anything after your purchase.
