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Abnormal Child Psychology International Edition 5th Edition By Eric J. Mash – Test Bank

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2            Theories and Causes

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Chapter Summary:

There are many factors and processes, which may influence child and family disturbances (e.g., biological, psychological, familial, cultural).  The study of the etiology of childhood disorders is a consideration of how different variables interact to produce a particular outcome. An integrative approach allows for many different theories and models to contribute insights into human behavior. The developmental psychopathology perspective provides a general framework of studying childhood disorders and emphasizes the role of developmental processes, and the influence of multiple, interrelated events in guiding both abnormal and normal development.  Importantly, the developmental psychopathology perspective stresses that an understanding of normal development is necessary in order to appropriately understand abnormal development.  Biological perspectives examine how children’s brain development is influenced by genetics, neuroanatomy, and maturation rates. Brain development and environmental experiences interact as a child’s brain structure develops, with development continuing throughout a person’s lifetime. Neural plasticity, genetics, brain structures, the endocrine system, and neurotransmitters all play significant roles in brain function. Psychological perspectives examine emotional, behavioral and cognitive influences on abnormal behavior. Emotional reactivity and regulation, as well as temperament and personality, play a role in the emotional development of the child. Behavioral and cognitive perspectives emphasize children’s learning and interpretation of their environment. Three major approaches that follow behavioral or cognitive-behavioral models include Applied Behavior Analysis (ABA), classical conditioning, and social learning and cognition theories. Family and cultural perspectives view the child’s social and environmental situations as influential factors. Knowledge about a child’s attachment level and family relationships is essential in understanding behavior. A health promotion view recognizes that many causes interact together within a child’s environment, and this perspective is emphasized within the context of understanding abnormal child psychology.

 

Chapter Outline:

I.                   Theoretical Foundations

• The study of abnormal child behavior requires an understanding of developmental processes and of individual and situational events that can influence the course and direction of a particular child

• • Theories allow us to predict behavior based on samples of knowledge

• The study of the etiology of childhood disorders considers how biological,

psychological, and environmental processes interact to produce outcomes over time

1. Underlying Assumptions
2. Abnormal development is multiply determined – we must look beyond current symptoms and consider developmental pathways and interacting events that, over time, contribute to the development and expression of a particular disorder
3. The child and the environment are interdependent and interact dynamically – the child and the environment are both active contributors to adaptive and maladaptive behavior (called the “transactional” or “relational” view)
4. Abnormal development involves continuities and discontinuities, with both quantitative and qualitative changes in patterns of behavior over time
5. An Integrative Approach
6. Abnormal child behavior is best studied from a multi-theoretical perspective

II.                Developmental Considerations

• Adaptational failure is the failure to master or progress in accomplishing developmental milestones

1. Organization of Development
2. Implies an active, dynamic process of continual change and transformation
3. Sensitive periods are windows of time during which environmental influences on development are enhanced
4. The attempt to understand influences on abnormal child development is made easier by considering the fact that development proceeds in an organized, hierarchical way

B.                 Developmental Psychopathology Perspective

1. Developmental psychopathology is an approach to describing and studying disorders of childhood and adolescence in a way that stresses the importance of developmental processes and tasks
2. The developmental psychopathology perspective is viewed as a macroparadigm
3. To understand maladaptive behavior, one must view it in relation to what is considered normative

III.             Biological Perspectives

• A neurobiological perspective considers brain and nervous system functions as underlying causes of psychological disorders

1. Neural Plasticity and the Role of Experience
2. The brain shows neural plasticity (i.e., malleability; use-dependent anatomical differentiation) throughout the course of development
3. Experience plays a role in brain development, with transaction occurring between ongoing brain development and environmental experiences; these experiences may include early care-giving
4. Maturation of the brain is an organized, hierarchical process with brain structures changing and growing through the life span
5. As the brain is shaped by early experiences, consequences of traumatic experience may be difficult to change
6. Genetic Contributions
7. Any trait a child has results from an interaction of environmental and genetic factors
8. Very few specific genetic causes have been isolated or identified as the underlying cause of child psychopathology
9. Genes produce tendencies to respond to the environment in certain ways, but do not determine behavior
10. Behavioral genetics investigates possible connections between genetic predispositions and observed behavior through familial aggregation studies and twin and adoption studies
11. Molecular genetics offer more direct support for genetic influences on child psychopathology
12. Molecular genetics methods directly assess the association between variations in DNA sequences and variations in a particular trait or traits
13. Conclusions from behavioral geneticists are that genetic contributions to psychological disorders come from many genes that each make relatively small contributions
14. Neurobiological Contributions
15. Brain Structure and Function – Different areas of the brain regulate different functions and behaviors, with the limbic system, basal ganglia, cerebral cortex, and frontal lobes of particular interest to researchers of psychopathology
16. The endocrine system regulates certain processes in the body through the production of hormones; it is closely related to the immune system, and therefore is especially implicated in health- and stress-related disorders
17. The hypothalamus and pituitary and adrenal glands make up the regulatory system known as the hypothalamic-pituitary-adrenal (HPA) axis, which has been implicated in several disorders, especially anxiety and mood disorders
18. Neurotransmitters are like biochemical currents of the brain that make connections between different parts of the brain; changes in neurotransmitter activity may make people more or less likely to exhibit certain behaviors. Neurotransmitters most commonly implicated in psychopathology include serotonin, benzodiazepine-GABA, norepinephrine, and dopamine.

IV.             Psychological Perspectives

1. Emotional Influences
2. Emotions are critical to healthy adaptation in that they serve as internal monitoring and guidance systems that are designed to appraise events as being beneficial or dangerous, as well as provide motivation for action
3. Children may have difficulties in emotion reactivity or emotion regulation:
4. Emotion reactivity – individual differences in threshold and intensity of emotional experience, which provides clues to an individual’s level of distress and sensitivity to the environment
5. Emotion regulation – involves enhancing, maintaining, or inhibiting emotional arousal, often for a particular purpose of goal
6. Temperament shapes the child’s approach to the environment and vice versa. Three primary dimensions of temperament have relevance to the risk of abnormal development: positive affect and approach, fearful or inhibited, and negative affect or irritability
7. Behavioral and Cognitive Influences
8. Applied Behavior Analysis (ABA) explains behavior as a function of its antecedents and consequences (reinforcement and punishment)
9. Classical conditioning explains the acquisition of deviant behavior on the basis of paired associations between previously neutral stimuli and unconditioned stimuli
10. Social learning considers the influence of cognitive mediators on behavior, as well as the role of affect and the importance of contextual variables in the etiology and maintenance of behaviors
11. Social cognition relates to how children think about themselves and others, resulting in the formation of mental representations of themselves and others

V.                Family, Social, and Cultural Perspectives

·         Ecological models describe the child’s environment as a series of nested and interconnected structures

1. Infant-Caregiver Attachment
2. Attachment theory emphasizes the evolving infant-care-giver relationship, which helps the infant regulate behavior and emotions, especially under conditions of threat or stress
3. Children develop internal working models of relationships based on early relationships with caregivers. Four patterns of attachment styles, which are believed to reflect different types of internal working models, have been identified: secure, anxious-avoidant, anxious-resistant, and disorganized
4. The Family and Peer Context
5. Increasingly, the study of individual factors and the study of the child’s context, including family and peer relationships, are being seen as mutually compatible and beneficial to both theory and intervention
6. Family system theorists study children’s behavior in relation to other family members

 

Learning Objectives:

 

1. To outline three main underlying assumptions of abnormal child psychology

 

1. To explain why an integrative approach to child psychology is important

 

1. To define neural plasticity and explain how nature and nurture work together to influence brain functioning

 

1. To identify some of the structures of the brain and the functions that they perform

 

1. To name some of the major neurotransmitters and describe their functions and roles in psychopathology

 

1. To consider how emotions can influence abnormal behavior

 

1. To describe the dimensions of temperament that may lead to abnormal development

 

1. To compare and contrast some of the major behavioral and cognitive theories of abnormal child psychology

 

1. To describe how attachment and family systems influence children’s development

 

10. To explain the health promotion view of child development

Key Terms and Concepts:

 

adaptational failure

attachment

behavioral genetics

brain circuits

continuity

cortisol

developmental cascades

developmental psychopathology

discontinuity

emotion reactivity

emotion regulation

epigenetic

epinephrine

etiology

family systems

frontal lobes

gene-environment interactions (GXE)

health promotion

hypothalamic-pituitary-adrenal (HPA) axis

interdependent

molecular genetics

neural plasticity

nonshared environment

organization of development

sensitive periods

shared environment

social cognition

social learning

temperament

transaction

 

 

Test Items:

 

1. A child’s problems must be considered in relation to the influence of the:
2. individual
3. family
4. community/culture
5. all of the above

ANS: D           REF: p.29-30  DIF: Easy                    COG: Factual

 

2. Victor is fearful of approaching new situations and often appears inhibited. Victor’s mother reported that she struggles with similar difficulties. This is an example of:
3. emotional influences
4. biological influences
5. cognitive influences
6. behavioral influences

ANS: B           REF: p. 29       DIF: Moderate            COG: Factual

 

3. Etiology refers to the ___________ of childhood disorders.
4. causation
5. treatments
6. correlates
7. prevention

ANS: A           REF: p.31        DIF: Easy                    COG: Factual

 

4. Which of the following is NOT an underlying assumption regarding abnormal child behavior?
5. Abnormal development is multiply determined.
6. The child and the environment are interdependent.
7. Abnormal development involves continuities and discontinuities.
8. All of these are underlying assumptions.

ANS: D           REF: p.31-33              DIF: Moderate            COG: Factual

 

5. Isabella is three years old and she frequently demands attention, overreacts, and refuses bedtime. These behaviors are considered:
6. common due to her age
7. diagnosable as clinical disorders
8. signs of an overly sensitive child
9. early warning signs of future difficulties

ANS: A           REF: p.34        DIF: Moderate            COG: Applied

 

6. The dynamic interaction of child and environment is referred to as:
7. mutuality
8. etiology
9. transaction
10. continuity

ANS: C           REF: p.32        DIF: Easy                    COG: Factual

 

7. The single theoretical orientation which can explain various behaviors or disorders in childhood is the ________ perspective.

1. biological
2. psychological
3. family
4. none of these

ANS: D           REF: p.34        DIF: Moderate            COG: Factual

 

8. The failure to master or progress in accomplishing developmental milestones is referred to as:

1. adaptational failure
2. developmental disintegration
3. discontinuity
4. dysregulation

ANS: A           REF: p.35        DIF: Easy                    COG: Factual

 

9. Most often, adaptational failure is due to:

1. a single cause
2. poor relationships
3. an ongoing interaction between individual development and environmental conditions
4. poor environmental opportunities

ANS: C           REF: p.35        DIF: Easy                    COG: Factual

 

10. An organizational view of development implies a(n) _____________ process.
11. static
12. unchanging
13. dynamic
14. fixed

ANS: C           REF: p.35                    DIF: Moderate            COG: Factual

 

11. Windows of time during which environmental influences on development are enhanced are called:

1. sensitive periods
2. critical periods
3. crucial periods
4. necessary periods

ANS: A           REF: p.35        DIF: Easy                    COG: Factual

 

12. Because development is ____________, sensitive periods play a meaningful role in any discussion of normal and abnormal behavior.
13. disorganized
14. organized
15. hierarchical
16. organized and hierarchical

ANS: B           REF: p.35        DIF: Easy                    COG: Factual

 

13. Children’s development occurs in a(n) ____________ manner.
14. disorganized
15. organized
16. hierarchical
17. organized and hierarchical

ANS: D           REF: p.36        DIF: Easy                    COG: Factual

 

14. The developmental psychopathology approach to studying childhood disorders emphasizes the importance of:
15. developmental disruptions
16. developmental processes and tasks
17. developmental regressions
18. developmental obstacles

ANS: B           REF: p.36        DIF: Easy                    COG: Factual

 

15. A central tenet of developmental psychopathology is that to understand maladaptive behavior it is necessary to consider:

1. one’s genetic predisposition
2. how problematic behaviors develop over time
3. the child’s familial history for maladjustment
4. what is normative for a given period of development

ANS: D           REF: p.36        DIF: Moderate            COG: Factual

 

16. Children’s early caretaking experiences play an important role in designing parts of the brain that involve:
17. planning and complex processes
18. problem solving skills
19. emotion, personality, and behavior
20. fine motor skills

ANS: C           REF: p.37        DIF: Moderate            COG: Factual

 

17. Brain maturity occurs in a(n) _____________ fashion.
18. disorganized
19. organized
20. hierarchical
21. organized and hierarchical

ANS: D           REF: p.38        DIF: Easy                    COG: Factual

 

18. Which of the following statements about neural development is false?
19. Most developing axons reach their destination even before a baby is born.
20. Synapses both proliferate and disappear in early childhood.
21. The connections in the brain are relatively pre-determined and the environment cannot change their course.
22. Primitive areas of the brain develop first.

ANS: C           REF: p.38        DIF: Moderate            COG: Factual

 

19. Which of the following statements about neural development is true?
20. Major restructuring of the brain in relation to puberty occurs between 6 and 9 years of age.
21. The brain stops changing after 3 years of age.
22. Primitive areas of the brain mature last.
23. Brain regions which govern basic sensorimotor skills undergo the most dramatic changes within the first 3 years of life.

ANS: D           REF: p.38        DIF: Moderate            COG: Factual

 

20. Which of the following statements about genetics is false?
21. Genes determine behavior.
22. Genes are composed of DNA.
23. Genes produce proteins.
24. The expression of genes is influenced by the environment.

ANS: A           REF: p.38-39  DIF:    Moderate         COG: Factual

 

21. The problem with family aggregation studies is that they:
22. are difficult to carry out
23. do not control for environmental variables
24. only tell us about the influence of the environment
25. only tell us about chromosomal abnormalities

ANS: B           REF: p.40        DIF: Easy                    COG: Factual

 

22. Behavioral geneticists have concluded that:
23. many psychological disorders can be accounted for by an individual gene
24. much of our development and behaviors are influenced by a small number of genes
25. genetic contributions to psychological disorders come from many genes, which each make a small contribution
26. behavior is largely influenced by the environment

ANS: C           REF: p.40-41  DIF: Easy                    COG: Factual

 

23. The part of the brain that regulates our emotional experiences, expressions, and impulses is the:
24. hypothalamus
25. hindbrain
26. basal ganglia
27. limbic system

ANS: D           REF: p.41        DIF: Easy        COG: Factual

 

24. Epinephrine is also known as:
25. dopamine
26. serotonin
27. cortisol
28. adrenaline

ANS: D           REF: p.43        DIF: Easy                    COG: Factual

 

25. The part of the brain that is implicated in disorders affecting motor behavior is the:
26. hypothalamus
27. hindbrain
28. basal ganglia
29. limbic system

ANS: C           REF: p.41-42  DIF: Easy                    COG: Factual

 

26. The _________ gives us the distinct qualities that make us human and allows us to think about the future, to be playful, and to be creative.
27. cerebral cortex
28. limbic system
29. basil ganglia
30. hippocampus

ANS: A           REF: p.42        DIF: Easy                    COG: Factual

 

27. The _________ lobes contain the functions underlying much of our thinking and reasoning abilities.
28. temporal
29. frontal
30. parietal
31. occipital

ANS: B           REF: p.42        DIF: Easy                    COG: Factual

 

28. The ___________ gland produces epinephrine in response to stress.
29. hypothalamus
30. thyroid
31. adrenal
32. pituitary

ANS: C           REF: p.43        DIF: Easy                    COG: Factual

 

29. The glands located on top of the kidneys are important because they produce hormones that:
30. orchestrate the body’s regulatory functions
31. control the entire HPA axis
32. energize us and get our bodies ready for possible threats in the environment
33. all of the above

ANS: C           REF: p.43        DIF: Easy        COG: Factual

 

30. The ___________ gland plays a role in energy metabolism and growth, and is implicated in certain eating disorders.
31. hypothalamus
32. thyroid
33. adrenal
34. pituitary

ANS: B           REF: p.43        DIF: Easy                    COG: Factual

 

31. The ___________ gland oversees the body’s regulatory functions by producing several hormones, including estrogen and progesterone.
32. pineal
33. pituitary
34. thyroid
35. adrenal

ANS: B           REF: p.43        DIF: Easy                    COG: Factual

 

32. ____________ has been implicated in several psychological disorders, especially those connected to a person’s response to stress and ability to regulate emotions.
33. The HPA axis
34. BZ-GABA
35. Norepinephrine
36. Dopamine

ANS: A           REF: p.43        DIF: Moderate            COG: Factual

 

33. _____________ is an inhibitory neurotransmitter that reduces overall arousal and levels of anger, hostility, and aggression.
34. Serotonin
35. Benzodiazepine-GABA
36. Norepinephrine
37. Dopamine

ANS: B           REF: p.44 (Table 2.1)             DIF: Moderate            COG: Factual

 

34. ____________ acts like a “switch” in the brain, turning on various circuits associated with certain types of behavior.
35. Serotonin
36. Benzodiazepine-GABA
37. Norepinephrine
38. Dopamine

ANS: D           REF: p.44 (Table 2.1)             DIF: Easy                    COG: Factual

 

35. The neurotransmitter implicated in regulatory problems, such as eating and sleep disorders is:
36. Norepinephrine
37. Serotonin
38. Benzodiazepine-GABA
39. Dopamine

ANS: B           REF: p.44 (Table 2.1)             DIF: Easy        COG: Factual

 

36. Emotions serve what purpose?
37. to serve as internal monitoring systems which appraise events as beneficial or dangerous
38. to provide motivation for action
39. both a and b
40. none of the above

ANS: C           REF: p.45        DIF: Moderate            COG: Factual

 

37. The neurotransmitter, which is not directly involved in specific disorders but is more generally involved in emotional and behavioral regulation is:
38. Serotonin
39. Benzodiazepine-GABA
40. Dopamine
41. none of the above

ANS: D           REF: p.44 (Table 2.1)             DIF: Moderate            COG: Factual

 

38. James often appears to be in a bad mood and he is easily frustrated when given challenging tasks. His temperament would be considered:
39. angry and intense
40. negative affect or irritability
41. fearful or inhibited
42. positive affect and approach

ANS: B           REF: p.46        DIF: Moderate            COG: Applied

 

39. ___________ serve(s) as a filter for organizing large amounts of new information and avoiding potential harm.
40. Cognitions
41. Emotions
42. The HPA axis
43. Benzodiazepine-GABA

ANS: B           REF: p.45        DIF: Easy                    COG: Factual

 

40. A child who cannot control his temper has problems in emotion __________.
41. sensitivity
42. reactivity
43. regulation
44. deregulation

ANS: C           REF: p.45        DIF: Easy                    COG: Factual

 

41. _______ relates to how children think about themselves and others, resulting in mental representations of themselves, relationships, and their social world
42. Social cognition
43. Observational learning
44. Cognitive mediation
45. Cognitive development

ANS: A           REF: p.49        DIF: Moderate            COG: Factual

 

42. Individual differences in emotion __________ account for differing responses to a stressful environment.
43. affectivity
44. sensitivity
45. reactivity
46. regulation

ANS: C           REF: p.45        DIF: Easy                    COG: Factual

 

43. _________ problems refer to weak or absent control structures, whereas _________ problems mean that existing control structures operative in a maladaptive way.
44. Regulation, dysregulation
45. Dysregulation, regulation
46. Reactivity, regulation
47. Regulation, reactivity

ANS: A           REF: p.45        DIF: Moderate            COG: Factual

44. Temperament:
45. refers to the child’s organized style of behavior that appears very early in development
46. shapes the child’s approach to the environment and vice versa
47. is considered one of the building blocks of personality
48. all of these

ANS: D           REF: p.46        DIF: Easy                    COG: Factual

 

45. ________________ describes the “slow-to-warm-up child”, who is cautious in approaching novel or challenging situations.
46. Positive affect and approach
47. Fearful or inhibited
48. Negative affect or irritability
49. Adaptive with negative mood

ANS: B           REF: p.46        DIF: Easy        COG: Factual

 

46. ABA involves the examination of:
47. behavior
48. antecedents
49. consequences
50. all of the above

ANS: D           REF: p.48        DIF: Easy        COG: Factual

 

47. __________ explain the acquisition of problem behavior on the basis of paired associations between previously neutral stimuli (e.g., homework), and unconditioned stimuli (e.g., parental anger).
48. Operant models
49. Classical conditioning models
50. Social learning models
51. Social cognition models

ANS: B           REF: p.48        DIF: Moderate            COG: Factual

 

48. ___________ theorists emphasize attributional biases, modeling, and cognitions in their explanation of abnormal behavior.
49. Behavior
50. Psychodynamic
51. Social learning
52. Biological

ANS: C           REF: p.48        DIF: Easy                    COG: Factual

 

49. __________ models portray the child’s environment as a series of nested and interconnected structures.
50. Environmental
51. Ecological
52. Societal
53. Macroparadigm

ANS: B           REF: p.50        DIF: Easy                    COG: Factual

50. Brofenbrenner’s (1977) model does not include a consideration of:
51. the child in isolation
52. the child’s family members
53. the society in which the child lives
54. the model includes a consideration of all of these

ANS: D           REF: p.50        DIF: Easy                    COG: Factual

 

51. Attachment theory considers crying (in an infant) to be a behavior that:
52. serves to keep predators away
53. stimulates the immune system
54. irritates others
55. enhances relationships with the caregiver

ANS: D           REF: p.51        DIF: Easy                    COG: Factual

 

52. Today’s research and thinking accepts the notion that many childhood disorders:
53. cannot be overcome
54. are treatable with the use of medications
55. receive too much media attention
56. share many clinical features and causes

ANS: D           REF: p.52        DIF: Moderate            COG: Factual

 

53. The process of attachment typically begins between _________ of age.
54. 0-2 months
55. 6-12 months
56. 12-18 months
57. 18-24 months

ANS: B           REF: p.51        DIF: Easy        COG: Factual

 

54. Infants that explore the environment with little affective interaction with the caregiver are likely to have a(n) ____________ attachment pattern.
55. secure
56. anxious-avoidant
57. anxious-resistant
58. disorganized

ANS: B           REF: p.52 (Table 2.2)             DIF: Easy        COG: Factual

 

 

55. Infants that are wary of new situations and strangers and who often cannot be comforted by the caregiver are likely to have a(n) ____________ attachment pattern.
56. secure
57. anxious-avoidant
58. anxious-resistant
59. disorganized

ANS: C           REF: p.52 (Table 2.2)             DIF: Easy        COG: Factual

 

56. The attachment pattern that has been linked to conduct problems and aggressive behavior is:
57. secure
58. anxious-avoidant
59. anxious-resistant
60. disorganized

ANS: B           REF: p.52 (Table2.2)              DIF: Moderate            COG: Factual

 

57. The attachment pattern that has been linked to phobias and anxiety problems is:
58. secure
59. anxious-avoidant
60. anxious-resistant
61. disorganized

ANS: C           REF: p.52 (Table 2.2)             DIF: Moderate            COG: Factual

 

58. This term describes a child’s model of relationships involving what the child expects from others and how the child relates to others.
59. internal working model
60. external working model
61. internal attachment model
62. external attachment model

ANS: A           REF: p.51        DIF: Moderate            COG: Factual

 

59. ___________ theorists argue that a child’s behavior can only be understood in terms of relationships with others.
60. Cognitive
61. Behavioral
62. Family systems
63. Genetic

ANS: C           REF: p.51        DIF: Easy        COG: Factual

 

60. The __________ view of child development recognizes the importance of balancing the abilities of individuals with the challenges and risks of their environments.
61. health promotion
62. family systems
63. attachment
64. psychopathological

ANS: A           REF: p.53        DIF: Easy                    COG: Factual

 

Short Answer/Essay Questions:

 

1. Discuss the three major underlying assumptions regarding abnormal child behavior.
2. Distinguish between continuous and discontinuous patterns of behavior development.
3. What is meant by using an integrative approach to understanding factors that influence a child’s behavior?
4. Describe how sensitive periods can impact children’s development. Can developmental change occur outside of these periods?
5. How can a baby with a difficult temperament influence and be influenced by the environment?
6. Discuss how children learn from their emotions and the emotional expression of others.
7. How permanent are early neuronal connections?
8. Discuss the major functions of four major neurotransmitters in the brain and their implicated role in psychopathology.
9. Discuss the importance of attachment and how it affects a child’s internal working model of relationships.
10. Distinguish between emotion reactivity and emotion regulation.
11. Briefly describe the three primary dimensions of temperament.
12. Provide everyday examples of positive and negative reinforcement, extinction, and punishment.
13. Explain why an integrative approach is important in abnormal psychology.
14. Discuss the main principles of a developmental psychopathology perspective.
15. Why do family systems theorists stress the importance of looking at the whole family as opposed to one individual’s difficulties?

 

Questions and Issues for Discussion:

 

1. Should the distinction between abnormal and normal with regards to psychological functioning be considered absolute or on a continuum?
2. What are some examples of traits that appear to change continuously? What about traits that seem to change discontinuously?  Which model better describes most of development?
3. Pick a television show or movie in which there are mental health concerns with regard to a child. Discuss the child’s problems in the context of various paradigms and how each paradigm may contribute to an understanding of the cause of these problems.
4. The text outlines a variety of approaches to understanding psychological disorders. Which of these approaches seems to be the most valuable to explaining child psychopathology?  Which is the least useful?  Students are likely to have different opinions, which may spark some interesting discussion.
5. Have students research some of the historical perspectives of child psychopathology and present their findings to the class.
6. What is your opinion on Bronfenbrenner’s ecological model? Is there anything missing from the model that you would include or anything you might remove?  How might you improve on the way the model is depicted (as shown in your textbook).
7. Have students discuss their opinions on the nature/nurture debate concerning child psychopathology.
8. How do you think family and social influences change over the course of development? Do you think your parents or your peers were more influential on your own development during your child years? During your teen years?
9. Discuss how normal functioning can be informative of abnormal functioning and vice versa.
10. From a family systems perspective, consider what impact it would make on a child who has a different temperament then the rest of the family with whom the child lives with.

 

Website Suggestions:

 

http://ornl.gov/sci/techresources/Human_Genome/home.shtml The Human Genome Project website, with basic information about this 15-year project to understand more about our genetic composition.  Easily understood by undergraduates, this website provides FAQs, terms, a search engine, and terrific links to related material.

 

http://www.med.harvard.edu/AANLIB/home.html   The Whole Brain Atlas from Harvard University, with neuroimages of the normal and abnormal brain.

 

http://faculty.washington.edu/chudler/neurok.html   Neuroscience for Kids, a fantastic site for those who are interested in learning about the brain and nervous system.  This site is intended for kids, but would certainly be invaluable to those who are not biology or neuroscience majors!

 

Video Suggestions:

 

Children of Poverty (1987).  Films for the Humanities and Sciences.  (26 minutes; $149 purchase price)

Profiles America’s children of poverty and shows the toll on children and mothers of problems finding food and shelter.

 

Secret of the Wild Child (production year unavailable).  PBS Boston (WGBH Boston Video, NOVA).  (60 minutes; $19.95 purchase price)

Tells the story and rehabilitation of “Genie,” a girl who was found at age thirteen and had been imprisoned in her bedroom her entire life.

 

Society’s Problems in Children’s Lives (1995).  Films for the Humanities and Sciences.  (29 minutes; $89.95 purchase price)

Looks at how societal issues such as violence, drugs, and divorce are affecting children’s lives and how they are coping.

 

American Adolescence (1999).  Films for the Humanities and Sciences.  (30 minutes; $89.95 purchase price)

Investigates today’s teens, the many challenges they face, and their hopes and dreams for the future of American society.

 

The Brain (1989).  Films for the Humanities and Sciences.  (23 minutes; $89.95 purchase price)

A look at the world of dreams, the nervous system, and nuclear magnetic resonance and electroencephalography.

 

Classical and Operant Conditioning (1996). Films for the Humanities and Sciences. (56 minutes, $154.95 purchase price)

Explains the nature of behaviorism and its important applications in clinical therapy, education, and child-rearing.

 

Cognitive Development: Representation in Three to Five-Year-Old Children (1997). Films for the Humanities and Sciences. (30 minutes, $154.95 purchase price)

Discusses a theory of mind that stems from a child’s experiential-based understanding of causal relationships. Includes Piaget’s theory.

 

Damage: The Effects of a Troubled Childhood (1997). Films for the Humanities and Sciences. (55 minutes, $174.95 purchase price)

Part of the Series: Myths of Childhood: New Perspectives on Nature and Nurture. Investigates the question: Can the roots of adult phobias and anxieties be found in our childhoods?

 

Do Parents Matter? Judith Harris on the Power of Peers (1999). Films for the Humanities and Sciences. (12 minutes, $69.95 purchase price)

Discusses the controversial theory of child development through adaptation of peer groups.

 

The Development of the Human Brain (1989).  Films for the Humanities and Sciences.  (40 minutes; $149 purchase price, $75 rental price)

An award-winning program that follows the physiological development of the human brain from conception to the age of eight.

 

The Mind vs. the Brain (1995). Films for the Humanities and Sciences. (27 minutes, $89.95 purchase price)

Recent research into the brain has revealed that many mental disorders previously believed to be the product of environment and experience are actually rooted in biology and chemistry.

 

Growing the Mind: How the Brain Develops (2000). Films for the Humanities and Sciences. (50 minutes, $174.95 purchase price)

Charts the changes in the human brain as it develops from infancy to adulthood. Addresses the brain’s extraordinary adaptability and reorganization.

 

__________________________________________________________

 

4      Assessment, Diagnosis, and Treatment

__________________________________________________________

 

Chapter Summary:

 

A plan of assessment leading to diagnostic and treatment decisions needs to be carefully devised in order to organize the numerous influences that may affect a child. Clinical assessment is used to promote and enhance children’s well being by accomplishing effective solutions to the problems they are faced with on a day-to-day basis. Three main purposes of assessment include diagnosis, prognosis, and treatment planning. A clinical interview with the child and parents is commonly used for assessment and can provide information regarding many aspects of the child’s life. Behavioral assessment is also valuable, as it involves directly observing the child’s behavior in a specific setting, rather than making inferences about behavior.  Checklists and rating scales, as well as observations of behavior, are often used to gather information about a child for behavioral analysis. Standardized psychological testing is beneficial because a child’s individual score can be compared to a norm group. Some tests that are commonly used for assessing children include: developmental tests, intelligence tests, projective tests, personality tests, and neuropsychological tests. Although it is recognized that each child is a unique individual, classification is useful for professionals to compare and make decisions regarding children’s mental disorders. The DSM-IV-TR uses a multiaxial classification system for mental disorders and allows researchers and clinicians to use the same criteria and terminology for recognizing mental disorders in children. While diagnostic labels are useful, children who are labeled may experience stigmatization. Intervention for childhood disorders includes prevention, treatment, and maintenance, and involves a range of solutions and strategies. Treatment solutions must have consideration for possible cultural differences in values and practices. Treatment goals and outcomes are focused on areas of child functioning, family functioning, and societal importance. There are several different approaches to treating children with psychological problems; however, the majority of clinicians use an eclectic approach as different treatments can be valuable depending on the type of problem and circumstance. In the past, research therapy for childhood disorders was associated with generally positive outcomes, whereas community-based clinic therapy was demonstrated to be limited in effectiveness. Current discussion in the field of psychology has provided some ideas as to why the research might have reflected these results and suggests that findings from clinic and community studies need more empirical data about therapy in practice to draw any conclusions.

 

         

Chapter Outline:

I.                   Clinical Issues

1. The Decision-Making Process
2. Typically begins with a clinical assessment, which is directed at differentiating, defining, and measuring the child’s behaviors, cognitions, and emotions that are of concern, as well as the environmental circumstances that may be contributing to these problems
3. Assessments are meaningful to the extent that they result in practical and effective interventions
4. Idiographic versus nomothetic case formulations
5. Idiographic case formulation involves a detailed understanding of the child or family as a unique entity
6. Nomothetic case formulation emphasizes more general inferences that apply to broad groups of individuals
7. Developmental Considerations
8. Age, gender, and culture must be considered when making judgments about abnormality, and when selecting assessment and treatment methods
   1. A child’s age has implications for judgments about deviancy and for selecting most appropriate assessment and treatment methods
   2. Important to study both boys and girls as distinct groups in their own right, for example, relational aggression refers to how girls express aggression indirectly through verbal insults, gossip, ostracism, etc; when studied in this manner data better reflects girls difficulties
   3. Cultural information is necessary to establish a relationship with the child and family, motivate the family for change, get valid information, diagnosis accurately, and make recommendations for treatment
      1. Culture-bound syndromes refer to recurrent patterns of maladaptive behaviors and/or troubling experiences associated with different cultures (e.g. concept in Mediterranean and Latino cultures of the “evil eye” as causing symptoms in children)
      2. Awareness of SES and acculturation as impacting scores on measures of psychopathology; cultural customs and values can affect behaviors, perceptions, and reactions to assessment and treatment

• Culturally competent mental health services should include: matching families with clinicians of same ethnicity, customizing treatment to the families values, beliefs, and customs, having an understanding of the cultural context for identifying goals, and to what constitutes optimal functioning of children in that cultural group

2. Normative information must also be considered
3. Need to have a good understanding of normal development of children to make decisions about abnormal development
4. Isolated symptoms are not typically related to children’s overall adjustment
5. Age inappropriateness and patterns of symptoms typically define childhood disorders
6. Purposes of Assessment
7. Description and Diagnosis
8. Clinical description summarizes the child’s unique behaviors, thoughts, and feelings that together make up the features of a given psychological disorder
9. Diagnosis involves analyzing information and drawing conclusions about the nature or cause of the problem, and, in some instances, assigning a formal diagnosis (which is referred to as taxonomic diagnosis)
10. Prognosis and Treatment Planning
11. Prognosis involves generating predictions regarding future behavior under specified conditions
12. Treatment planning involves making use of assessment information to generate a treatment plan and evaluating its effectiveness

II.            Assessing Disorders

1. Clinical assessment relies on a multi-method assessment strategy, which emphasizes obtaining information from different informants, in a variety of settings, using a variety of procedures
2. Clinical Interviews
3. The most universally used assessment procedure; can provide a large amount of information in a brief period of time
4. Often includes a developmental history or family history
5. May incorporate a mental status exam to assess the child’s general mental functioning; involves assessing appearance and behavior, thought processes, mood and affect, intellectual functioning, and sensorium
6. Differ in degree of structure:
7. In unstructured interviews, questions are pursued in an informal and flexible manner; lack of standardization may result in low reliability and selective or biased gathering of information
8. In semi-structured interviews, specific questions are asked to elicit information in a consistent and thorough manner; may be susceptible to a loss of spontaneity between the child and clinician, and a reluctance to volunteer important information that is not directly related to the particular questions
9. Behavioral Assessment
10. Emphasis on observing a child’s behavior directly
11. Often involves observing the antecedents, the behaviors of interest, and the consequences of the behaviors (the “ABCs of assessment”)
12. The more general approach to behavioral assessment is behavior analysis (or functional analysis of behavior), the goal of which is to identify as many factors as possible that could be contributing to a child’s problem behaviors, and to develop hypotheses about which ones are the most important and/or most easily changed
13. Checklists and rating scales
14. Often allow for a child’s behavior to be compared to a normative sample
15. Typically economical to administer and score
16. Lack of agreement between informants is relatively common, which in itself is often informative
17. Behavioral observations and recording
18. Provide ongoing information about behaviors of interest in real-life settings
19. Recordings may be done by parents or others, although it may be difficult to ensure accuracy
20. Sometimes involve setting up role-play simulations in the clinic
21. Children often know when they are being watched and may react differently as a result; also, the informant, the child, the nature of the problem, and the family context may distort findings
22. Psychological Testing
23. Tests are tasks given under standard conditions with the purpose of assessing some aspect of the child’s knowledge, skill, or personality
24. In the past many tests had been “normed” on narrow and limited samples in the population and therefore may not be appropriate to use with individuals from racial, ethnic, or cultural groups other then those with whom the test was normed
25. Currently, tests are standardized on normative groups that are representative of the population so that children can be compared to others without penalizing children from different SES and cultural backgrounds; test items are free from cultural bias as much as possible
26. Clinicians commonly use scales and tests to assess children’s difficulties and are the most commonly used assessment methods with children – test scores should always be interpreted in the context of other assessment information
27. Developmental tests are used to assess infants and young children, and are generally carried out for the purpose of screening, diagnosis, and evaluation of early development
28. Intelligence and Educational Testing
29. A central component in clinical assessments for a wide range of childhood disorders
30. The most popular intelligence scale used today with children is the Wechsler Intelligence Scale for Children (WISC-IV), which is well-standardized, reliable, and valid; provides measures of verbal comprehension, perceptual reasoning, working memory, and processing speed
31. Projective Testing
32. Involves presenting the child with ambiguous stimuli and asking the child to describe what he or she sees; it is believed that the child projects his or her own personality, including unconscious fears, needs, and inner conflicts, on the ambiguous stimuli
33. Although there is controversy surrounding their use, projective tests continue as one of the most frequently used clinical assessment tools
34. Projective techniques, especially figure drawings and play, may be used to help children relax and to make it easier for them to talk about events that they may have difficulty expressing verbally
35. Personality Testing
36. Several dimensions of personality have been identified, including whether a child or adolescent is timid or bold, agreeable or disagreeable, dependable or undependable, tense or relaxed, reflective or unreflective (the “Big 5” factors)
37. May use interviews, projective techniques, behavioral measures, or objective inventories that focus specifically on personality
38. Neuropsychological Testing
39. Attempts to link brain functioning with objective measures of behavior that are known to depend on an intact central nervous system
40. Often involves using a comprehensive battery that assesses a full range of psychological functions, including verbal and nonverbal cognitive functions, perceptual functions, motor functions, and emotional/executive control functions

III.          Classification and Diagnosis

1. Classification refers to a system for representing the major categories or dimensions of child psychopathology, and the boundaries and relations among them; diagnosis refers to the assignment of cases to categories of the classification system
2. There is still no single, agreed-upon, reliable and valid, worldwide classification system for childhood disorders
3. Categories and Dimensions
4. Childhood disorders have been classified using categories and dimensions
5. Categorical classification systems are based primarily on informed professional consensus; “classical/pure” categorical approach assumes that every diagnosis has a clear underlying cause and that each disorder is fundamentally different from every other disorder
6. Dimensional classification approaches assume that a number of independent dimensions or traits of behavior exist and that all children possess these to varying degrees
7. The Diagnostic and Statistical Manual (DSM)
8. The DSM-IV-TR utilizes a multiaxial system consisting of five axes: clinical disorders, personality disorders and mental retardation, general medical conditions, psychosocial and environmental problems, and global assessment of functioning
9. Criticisms of DSM-IV-TR
10. Fails to capture the complex adaptations, transactions, and setting influences that have been identified as crucial to understanding and treating child psychopathology
11. Gives less attention to disorders of infancy and childhood than to those of adulthood
12. Fails to emphasize the situational and contextual factors surrounding and contributing to various disorders
13. Fails to capture the comorbidity known to exist among many childhood disorders
14. Sometimes improperly used, such as when a specific diagnosis is needed in order for a child to qualify for special services
15. Pros and Cons of Diagnostic Labels
16. On the positive side, diagnostic labels help clinicians summarize and order observations, facilitate communication among professionals, aid parents by providing more recognition and understanding of their child’s problem, and facilitate research on the causes, epidemiology, and treatment of specific disorders
17. On the negative side, diagnostic labels may lead to negative perceptions and reactions by others and can influence children’s views of themselves and their behavior

IV.             Treatment

1. Interventions
2. Interventions are problem-solving strategies that involve treatment of current problems, maintenance of treatment effects, and prevention of future problems; by targeting risks and existing problems, the combination of prevention and treatment has enormous potential to reach a diverse range of youths and families across a range of settings
3. Cultural Considerations
4. Growing awareness has arisen of the need to give greater attention to the cultural context of children and families receiving psychological services
5. Parents from different ethnic groups parent their children differently and have different beliefs about child problems, mental health services, how they describe symptoms, when they seek help and what interventions they prefer
6. Cultural compatibility hypothesis states that treatment is likely to be more effective when compatible with the cultural patterns of the child and family
7. Treatment Goals
   1. Treatment goals include outcomes related to the child and family, as well as those of societal importance
8. Ethical and Legal Considerations
9. Both ethically and legally, clinicians who work with children are required to think not only about the impact that their actions will have on the children that they see, but also on the responsibilities, rights, and relationships that connect children and parents
10. General Approaches to Treatment
    1. More than 70% of clinicians identify themselves as eclectic
    2. Psychodynamic approaches view child psychopathology as determined by underlying unconscious and conscious conflicts; treatment focuses on developing an awareness of these conflicts
    3. Behavioral approaches assume that most abnormal child behaviors are learned through operant and classical conditioning; treatment emphasizes re-education using behavioral principles
    4. Cognitive approaches view abnormal child behavior as the result of deficits and distortions in the child’s thinking, including perceptual biases, irrational beliefs, and faulty interpretations; emphasis in treatment is in changing faulty cognitions
    5. Cognitive-behavioral approaches view psychological disturbances as partly the result of faulty thought patterns, and partly the result of faulty learning and environmental experiences; treatment focuses on changing maladaptive cognitions, teaching the child to use cognitive and behavioral coping strategies, and helping the child learn self-regulation
    6. Client-centered approaches view psychopathology as the result of social or environmental circumstances that are imposed on the child and interfere with his or her basic capacity for personal growth and adaptive functioning; the therapeutic setting provides a corrective experience for the child through unconditional positive regard
    7. Family models view psychopathology as determined by variables operating in the family system; treatment often focuses on the family issues underlying problem behaviors
    8. Biological/medical models view psychopathology as resulting from biological impairment or dysfunction and rely primarily on pharmacological and other biological approaches to treatment
    9. Combined treatments make use of two or more interventions, each of which can stand on its own as a treatment strategy
11. Treatment Effectiveness
    1. Best practice guidelines systematically develop statements to assist practitioners and patients with decisions about treatment for specific clinical conditions; intended to offer most clinically- and cost-effective treatments
       1. Evidence based approach derives guidelines from a comprehensive review of current research findings
       2. Expert-consensus approach uses the opinions of experts to fill in the gaps in literature when research is inconclusive or when there is lack of information about multicultural issues
    2. Positive findings regarding effectiveness of treatments with children
       1. therapy leads to significant and meaningful improvements for children
       2. treatments have been shown to be equally effective for internalizing and externalizing disorders
       3. treatment effects tend to be long-lasting
       4. specific problems are more amenable to treatment than nonspecific problems
       5. the more outpatient therapy children receive, the more symptoms improve
    3. On the negative side, community-based clinic therapy for children has been found far less effective than structured research therapy, however it is premature to draw any conclusions from findings from clinic and community studies until more empirical data about therapy in practice are available

 

Learning Objectives:

 

1. To identify developmental considerations involved in the clinical process
2. To explain the purpose of clinical assessment
3. To consider gender, culture, and diversity issues in assessment, diagnosis and treatment
4. To illustrate what is involved in a clinical interview
5. To discuss the goals and process involved in behavioral assessment
6. To identify some key psychological tests used for assessing children
7. To consider costs and benefits of the classification system of mental disorders
8. To name and describe each of the axes of the DSM-IV-TR and give an example of each one
9. To describe criticisms of the DSM-IV-TR system
10. To describe some of the goals and outcomes of treatment
11. To understand ethical and legal considerations when working with children
12. To discuss major approaches to treating children with mental disorders

Key Terms and Concepts:

 

behavior analysis

behavioral assessment

best treatment guidelines

categorical classification

classification

clinical assessments

clinical description

cultural compatibility hypothesis

culture-bound syndromes

developmental history

developmental tests

diagnosis

dimensional classification

eclectic

family history

functional analysis of behavior

idiographic case formulation

intervention

maintenance

multiaxial system

multimethod assessment approach

neuropsychological assessment

nomothetic formulation

prevention

prognosis

projective tests

screening

semi-structured interviews

target behaviors

test

treatment

treatment planning and evaluation

 

 

 

 

 

Test Items:

 

1. The relationship between assessment and intervention is best viewed as:

1. separate and unrelated
2. related and on-going
3. related but separate
4. related but time-limited

ANS: B           REF: p.83        DIF: Easy        COG: Factual

 

 

 

2. The detailed representation of the individual child or family as a unique entity is referred to as a(n) ___________ case formulation.

1. nomothetic
2. idiographic
3. diagnostic
4. prognostic

ANS: B           REF: p.83        DIF: Easy                    COG: Factual

 

3. A(n) ____________ case formulation emphasizes general inferences that apply to broad groups of individuals.

1. nomothetic
2. idiographic
3. diagnostic
4. prognostic

ANS: A           REF: p.83        DIF: Easy                    COG: factual

 

4. Which of the following typically does NOT have much bearing on a clinician’s approach to assessment, diagnosis, and treatment?

1. age
2. gender
3. culture
4. all of these have bearing

ANS: D           REF: p.83-84  DIF: Easy                    COG: Factual

 

5. A child’s ______ has implications for judgments about deviancy and for selecting appropriate assessment and treatment methods.
   1. peer group
   2. family history
   3. age
   4. academic achievement

ANS: C           REF: p. 84       DIF: Moderate            COG: Factual

 

6. Jessica, age 15, gossips, verbally insults peers, and often ostracizes others. Jessica is displaying:
   1. depressive symptoms
   2. relational aggression
   3. anxiety
   4. ADHD

ANS: B           REF: p.84        DIF: Moderate            COG: Applied

 

 

 

 

 

 

7. All of the following psychological disorders are more common among males than females except:
8. mental retardation
9. autistic disorder
10. conduct disorder
11. adolescent depression

ANS: D           REF: p.84        DIF: Easy        COG: Factual

 

8. Which of the following is equally common among males and females?
9. childhood depression
10. eating disorders
11. enuresis
12. attention deficit hyperactivity disorder

ANS: A           REF: p.84        DIF: Moderate            COG: Factual

 

9. The over-representation of boys with psychological disorders likely reflects:
10. functional deficits in the male brain
11. media influence
12. referral biases
13. different socialization practices for males and females

ANS: C           REF: p.84        DIF: Moderate            COG: Factual

 

10. When working with children and families cultural information is necessary to:
11. establish a relationship with the child and family
12. motivate the family for change
13. get valid information
14. all of the above

ANS: D           REF: p.85        DIF: Easy                    COG: Factual

 

11. What variables can impact scores on measures of psychopathology?
12. SES and acculturation
13. educational level
14. previous attendance in therapy
15. ability to remain focused

ANS: A           REF: p.86        DIF: Moderate            COG: Factual

 

12. Culturally competent mental health services include:
13. matching families with clinicians of the same ethnicity
14. customizing treatment to the family’s values and customs
15. relying on knowledge gained through personal experience with that particular culture
16. both a and b

ANS: D           REF: p.86        DIF: Easy        COG: Factual

 

 

 

 

13. What does it mean if a test is normed on a group that is representative of the population?
14. the majority culture was taken into consideration
15. the test is as free from cultural bias as possible
16. age and ethnicity were considered but not biological sex
17. the test yields higher rates of psychopathology for minorities

ANS: B           REF: p.95-96  DIF: Moderate            COG: Factual

 

14. Research demonstrates that, with respect to aggression, girls:

1. tend not to engage in aggressive acts
2. are more distressed by aggressive acts
3. engage in more relational forms of aggression
4. are more aggressive than boys

ANS: C           REF: p.84        DIF: Easy                    COG: Factual

 

15. Generalizations regarding cultural practices frequently fail to capture ____________ differences that exist within and across ethnic groups.

1. regional
2. generational
3. socioeconomic
4. all of the above

ANS: D           REF: p.85-86  DIF: Moderate            COG: Factual

 

16. Generally, isolated symptoms of behavioral and emotional problems:

1. are highly predictive of children’s overall adjustment
2. show little relation to children’s overall adjustment
3. are moderately related to children’s overall adjustment
4. are completely useless in predicting children’s overall adjustment

ANS: B           REF: p.87        DIF: Easy                    COG: Factual

 

17. A _______________ summarizes the child’s unique behaviors, thoughts, and feelings that together make up the features of a given psychological disorder.

1. nomothetic description
2. symptomatic description
3. diagnostic description
4. clinical description

ANS: D           REF: p.87        DIF: Easy                    COG: Factual

 

18. Which of the following is NOT included in a clinical description?

1. different symptoms and their configuration
2. assessment of various symptoms
3. age of onset and duration of difficulties
4. intensity, frequency, and severity of the problem

ANS: B           REF: p.87        DIF: Moderate            COG: Factual

 

 

19. The formal assignment of a clinical case to a DSM-IV-TR classification category is referred to as a(n):
    1. empirical diagnosis
    2. taxonomic diagnosis
    3. proper diagnosis
    4. psychological diagnosis

ANS: B           REF: p.87        DIF: Moderate            COG: Factual

 

20. Which of the following is not a common pair of comorbid disorders?
    1. enuresis and schizophrenia
    2. conduct disorder and ADHD
    3. autism and mental retardation
    4. depression and anxiety

ANS: A           REF: p.88          DIF: Easy                  COG: Factual

 

21. ___________ means generating predictions concerning future behavior under specified conditions.
    1. Assessment
    2. Diagnosis
    3. Outcome generation
    4. Prognosis

ANS: D           REF: p.88        DIF: Easy                    COG: Factual

 

22. The purpose(s) of assessment is/are:
    1. description and diagnosis
    2. treatment planning and evaluation
    3. prognosis
    4. all of the above

ANS: D           REF: p.87-88    DIF: Easy                  COG: Factual

 

23. The assessment of childhood problems typically makes use of a(n) __________ approach.
    1. multi-method
    2. idiographic
    3. divergent
    4. single theoretical

ANS: A           REF: p.89        DIF: Easy                    COG: Factual

 

24. The most universally used assessment procedure with parents and children is:
    1. personality testing
    2. behavioral observation
    3. the clinical interview
    4. intelligence testing

ANS: C           REF: p.90        DIF: Easy                    COG: Factual

 

 

25. Which of the following would NOT typically be addressed in the developmental/family history component of the initial interview?

1. the child’s birth
2. the age at which the child began walking and self-toileting
3. the mental history of parents and siblings
4. all of these would typically be addressed

ANS: D           REF: p.91        DIF: Easy        COG: Factual

 

26. Unstructured interviews tend to be _______________ than semi-structured interviews.
27. more consistent
28. less reliable and more flexible
29. more reliable and less flexible
30. less biased

ANS: B           REF: p.92        DIF: Moderate            COG: Factual

 

27. What are the most commonly used assessment methods?
28. scales and tests
29. observations
30. gathering of family histories
31. interviews with children

ANS: A           REF: p. 92       DIF: Easy                    COG: Factual

 

28. Semi-structured interviews tend to be _______________ than unstructured interviews.

1. less consistent
2. more spontaneous
3. less reliable
4. more consistent and less spontaneous

ANS: D           REF: p.92        DIF: Moderate            COG: Factual

 

29. Which of the following would generally NOT be assessed by behavioral assessment methods?

1. aggression
2. mood
3. distractibility
4. social skills

ANS: B           REF: p.92        DIF: Moderate            COG: Factual

 

30. The “C” in the “ABCs of behavioral assessment” stands for:
    1. consequences
    2. causes
    3. child
    4. correction

ANS: A           REF: p.93        DIF: Easy                    COG: Factual

 

 

 

31. Gathering information about a child’s behavior for analysis does not involve:
32. observing the child in real-life settings
33. making inferences about the child’s behavior
34. asking parents, teachers, or child about specific situations
35. observing the child in role-playing situations

ANS: B           REF: p.93        DIF: Easy                    COG: Factual

 

32. An advantage of behavior checklists over interviews is that checklists allow a clinician to ______________ while interviews typically do not.

1. establish rapport
2. assess mental status
3. compare results to a normative sample
4. obtain a measure of mood

ANS: C           REF: p.94           DIF: Moderate         COG: Factual

 

33. A leading checklist for assessing behavioral problems in children and adolescents is the:

1. Wechsler Scales for Children
2. Kaufman Assessment Battery for Children
3. Child Behavior Checklist
4. Rorschach

ANS: C           REF: p.94              DIF: Easy  COG: Factual

 

34. A clearly defined group used to compare an individual child’s test score against is called a:
35. reference group
36. comparative group
37. standard group
38. norm group

ANS: D           REF: p.95        DIF: Easy                    COG: Factual

 

35. The most commonly used intelligence scale today is the:
36. Stanford-Binet 5 (SB5)
37. Wechsler Intelligence Scale for Children (WISC-IV)
38. Kaufman Assessment Battery for Children (K-ABC-II)
39. none of the above

ANS: B           REF: p.97        DIF: Easy                    COG: Factual

 

36. The Wechsler Intelligence Scale for Children (WISC-IV) provides a measure of:

1. verbal comprehension and working memory
2. perceptual reasoning and processing speed
3. full scale IQ
4. all of these

ANS: D           REF: p.97        DIF: Easy                    COG: Factual

 

 

 

 

37. The Rorschach is an example of a(n) ____________ test.

1. intelligence
2. achievement
3. projective
4. objective

ANS: C           REF: p.100      DIF: Moderate            COG: Factual

 

38. Projective tests ___________________ with children.

1. should not be used
2. are one of the most commonly used assessment methods
3. are one of the least commonly used assessment methods
4. have not been designed specifically for use

ANS: B           REF: p.100      DIF: Moderate            COG: Factual

 

39. Neuropsychological assessments are primarily used to:

1. identify underlying brain lesions
2. identify genetic abnormalities
3. make inferences about central nervous system dysfunction
4. diagnose mental deficits

ANS: C           REF: p.100-101          DIF: Moderate            COG: Factual

 

40. Functions assessed in neuropsychological functioning do not include:
41. motor functions
42. perceptual functions
43. cognitive functions
44. none of the above

ANS: D           REF: p.101      DIF: Moderate            COG: Factual

 

41. Categorical classification systems are based primarily on:

1. underlying etiologic bases of the disorders classified
2. normative data
3. informed clinical consensus
4. multivariate statistical methods

ANS: C           REF: p.102      DIF: Moderate            COG: Factual

 

42. The ___________ classification approach assumes that all children possess the same traits to varying degrees.
43. trait
44. categorical
45. feature
46. dimensional

ANS: D           REF: p.103      DIF: Moderate            COG: Factual

 

 

 

 

43. Which of the following would NOT be reported on Axis I of the DSM-IV-TR?

1. mental retardation
2. schizophrenia
3. attention deficit hyperactivity disorder
4. autistic disorder

ANS: A           REF: p.105      DIF: Easy                    COG: Factual

 

44. If a child with asthma were suffering from anxiety because of the fear of an impending attack, the asthma would be noted on Axis _____ of the DSM-IV-TR.

1. I
2. II
3. III
4. IV

ANS: C           REF: p.105      DIF: Easy        COG: Applied

 

45. If a child’s best friend had recently died, this factor would be noted on Axis ______ of the DSM-IV-TR.

1. I
2. II
3. III
4. IV

ANS: D           REF: p.105      DIF: Easy                    COG: Applied

 

46. A GAF of _______ reflects significant impairment in social functioning or personal care.

1. -50
2. 10
3. 90
4. 150

ANS: B           REF: p.105      DIF: Easy        COG: Factual

 

47. Interventions are ___________.
    1. unique to the field of psychology
    2. designed to maintain the status quo
    3. problem solving strategies
    4. typically rejected by children and families

ANS: C           REF: p.108      DIF: Easy                    COG: Factual

 

48. Which of the following is NOT a criticism of the DSM-IV-TR?

1. It fails to capture the complexity of influences on child psychopathology.
2. It gives relatively less attention to disorders of infancy and childhood than to those of adulthood.
3. It fails to consider factors such as culture, age, and gender associated with the expression of each disorder.
4. It fails to capture the comorbidity known to exist among many childhood disorders.

ANS: C           REF: p.106      DIF: Moderate            COG: Factual

 

49. Best practice guidelines take into consideration:
50. what the clinician feels is in the best interest of the child and family
51. expert and evidence based approaches
52. what the family feels is in the best interest of the child
53. the family’s history of mental illness

ANS: B           REF: p.117      DIF: Moderate            COG: Factual

 

50. Intervention does not include:
51. maintenance
52. assimilation
53. prevention
54. treatment

ANS: B           REF: p.108      DIF: Easy                    COG: Factual

 

51. ___________ refers to efforts to increase adherence with treatment over time to prevent reoccurrence.
52. Maintenance
53. Prevention
54. Treatment
55. Intervention

ANS: A           REF: p.106      DIF: Easy                    COG: Factual

 

52. Which of the following is a common goal of treatment?

1. improved outcomes relating to child functioning
2. improved outcome relating to family functioning
3. improved outcomes of societal importance
4. all of these are common goals

ANS: D           REF: p.110-112          DIF: D            COG: Easy

 

53. Minimum ethical standards for practice include:
54. selecting treatment goals and procedures that are in the best interest of the child
55. making sure client participation is active and voluntary
56. protecting the confidentiality of the therapeutic relationship
57. all of the above

ANS: D           REF: p.112-113          DIF: Easy        COG: Factual

 

54. More than 70% of practicing clinicians identify their therapeutic approach as ________.

1. behavioral
2. cognitive
3. humanistic
4. eclectic

ANS: D           REF: p.110      DIF: Easy                    COG: Factual

 

 

 

55. _____________ approaches to treatment view child psychopathology as the result of faulty thought patterns and faulty learning and environmental experiences.

1. Behavioral
2. Cognitive
3. Cognitive-behavioral
4. Client-centered

ANS: C           REF: p.113      DIF: Moderate            COG: Factual

 

56. _____________ approaches to treatment view child psychopathology as the result of social or environmental circumstances that are imposed on the child and interfere with his or her capacity for personal growth and adaptive functioning.

1. Psychodynamic
2. Client-centered
3. Cognitive-behavioral
4. Family

ANS: B           REF: p.114      DIF: Easy                    COG: Factual

 

57. Which of the following is NOT true of the meta-analytic findings of research therapy with children?

1. Changes achieved by children receiving treatment are greater than those for children not receiving treatment.
2. Treatment effects are larger for problems that are specifically targeted than they are for nonspecific areas of functioning.
3. Treatments have been shown to be more effective for internalizing that for externalizing disorders.
4. Treatment effects tend to be lasting.

ANS: C           REF: p.118      DIF: Moderate            COG: Factual

 

58. Which of the following medications would best be used for a child suffering from a severe anxiety disorder?

1. Concerta
2. Elavil
3. Xanax
4. Zyprexa

ANS: C           REF: p.115      DIF: Moderate            COG: Factual

 

59. Which of the following medications would best be used for a child diagnosed with bipolar disorder?

1. Depakote
2. Elavil
3. Ritalin
4. Zyprexa

ANS: A           REF: p.115      DIF: Moderate            COG: Factual

 

 

 

 

60. Which of the following medications would best be used for a child suffering from ADHD?

1. Concerta
2. Elavil
3. Xanax
4. Zyprexa

ANS: A           REF: p.115      DIF: Moderate            COG: Factual

 

 

Short Answer/Essay Questions:

 

1. Distinguish between idiographic and nomothetic case formulations, and indicate when each of these formulations is useful.
2. What is relational aggression? Are males or females more likely to exhibit this behavior? Provide two examples of relational aggression.
3. What are culture-bound syndromes? Why are they important for clinicians to be aware of in relation to understanding symptoms in children? Provide one example of a culture-bound syndrome and the symptoms that the clinician may see exhibited by the child.
4. Describe three ways that a therapist can strive to provide culturally competent mental health services.
5. What considerations must be taken into account when making judgments about abnormality?
6. Under what circumstances would a clinician choose to administer a semi-structured versus an unstructured interview? What are the benefits and/or drawbacks of each?
7. What are some of the areas that are typically covered by developmental and family history questionnaire/interview?
8. Explain the “ABCs of assessment” and give examples of each.
9. What steps have researchers taken to ensure that psychological tests are free from bias?
10. Why is it important to use tests that have been normed on the ethnic/racial/cultural group of the child being tested?
11. Name and describe four psychological tests commonly used when assessing children.
12. Distinguish between categorical and dimensional classification approaches.
13. What information is noted on each of the axes of the DSM-IV-TR?
14. What are the criticisms of the DSM-IV-TR?
15. What are the pros and cons of diagnostic labels?
16. What are best practice guidelines and why were they established?
17. What is the difference between evidence-based approaches and expert-consensus approaches to best practice guidelines?
18. How is the cognitive-behavioral approach different from either the cognitive or behavioral approaches alone?
19. What conclusions have been made regarding the effectiveness of treatments with children?

 

 

Questions and Issues for Discussion:

 

1. One common dilemma faced by child psychologists is determining who the “client” is. Given that children are typically brought to treatment by their parents, how would you handle a child who confides in you some illicit behavior and asks you not to tell his or her parents?
2. Have students imagine that they are parents of a child who requires some sort of psychological intervention. What forms of therapeutic intervention would they prefer that their child receive and what forms would they want their children to avoid?  Why?
3. Given our growing awareness of the importance of cultural values and norms, how can we reconcile the parenting practices of parents from other cultures living in North America (e.g., using shame as discipline or alternative medical practices)?
4. The scientific basis of the DSM has been questioned by a significant number of researchers and clinicians. What are students’ impressions of the DSM?  (To get the discussion going, have students read one or two of the many articles that have been written to criticize the DSM.  Two possible articles, which are both available on InfoTrac, are McHugh, P.R.  (December, 1999).  How psychiatry lost its way.  Commentary, 108 (5), p. 32, and Leo, J. (October 27, 1997).  Doing the disorder rag, S. News and World Report, 123 (16), p. 20.
5. The number of children being prescribed drugs to treat mental health problems is on the rise, despite the fact that controversy exists around whether drugs should be used with children. Have students research some of the issues relating to this issue.  How do they feel about the use of psychopharmacological interventions with children?  (Two possible articles that address, at least in part, some of the relevant issues are Okie, S.  (February 23, 2000).  Behavioral drug use sharply up in toddlers: Research lacking on effects, safety.  Washington Post, p. A1, and Jensen et al. (1999).  Psychoactive medication prescribing practices for U.S. children: Gaps between research and clinical practice.  Journal of the Academy of Child and Adolescent Psychiatry, 38, p. 557).
6. Classification of psychological disorders is a problematic task. Discuss some of the difficulties associated with classification and generate some suggestions as to how these problems may be overcome. (see January, 1995 article “Diagnosis and classification of psychopathology: Challenges to the current system and future directions” in Annual Review of Psychology).
7. Have students imagine administering psychological tests to children in a clinical setting. What are some of the difficulties a clinician might encounter with children at different stages of development or with different psychological disorders?  Discuss some of the factors that should be considered when developing psychological tests for children.
8. How can making cultural generalizations, both aide in providing more insightful and culturally competent therapy, and be limiting in capturing the diversity that exists within and across ethnic groups?
9. Is it ever appropriate to use a test with a child that has not been normed on their particular ethnic, racial or cultural group? What are the implications of testing or not testing the child?
10. Given that many children and families are treated in psychotherapy at community clinics, what might be some reasons that the literature had shown in the past that psychotherapy is less effective in this environment then in research therapy? Discuss the implications and impact this statement might have on families. What are the student’s thoughts on this issue now that current discussion in the field suggests that the jury is still out on this issue?

 

Website Suggestions:

 

http://www.behavenet.com/capsules/disorders/dsm4classification.htm A site specifically dedicated to presenting DSM-IV criteria.

 

http://www.classification-society.org/clsoc/clsoc.php The Classification Society of North America, a nonprofit, interdisciplinary organization whose purpose is to promote the scientific study of classification and clustering.  Not terribly exciting material, but very informative.

 

http://www.apa.org/ethics/code/index.aspx  Full-text Ethical Principles of Psychologists and Code of Conduct.

 

http://psychcentral.com/disorders/childtreatment.htm    Answers frequently asked questions from parents about children’s treatments and provides other information and resources for children’s mental health.

 

http://www.wpspublish.com/ Western Psychological Services (WPS) is a leading publisher of tests, books, software, and therapy tools for professionals in psychology, education, and allied fields.

 

http://www.riverpub.com/products/sb5/index.html This is the Web site for the Stanford-Binet Intelligence Test by Riverside Publishing

 

http://www.mhs.com/ This is the Web site for Multi-Health Systems, Inc. (MHS), publishers of such tests as the Conner’s’ Rating Scales-Revised, the Children’s Depression Inventory, the Positive and Negative Syndrome Scale, the Hare Psychopathy Checklist-Revised 2nd Edition, and the Test of Memory Malingering.

 

http://www.pearsonassessments.com/ This is the Web site for Pearson Assessments. Here you will find such tests as the MMPI-2, the various Wechsler Intelligence Scales, and the Beck Depression Inventory 2.

 

http://www.apa.org/science/programs/testing/index.aspx This is the American Psychological Association’s page devoted to testing.

 

 

Video Suggestions:

 

Autism and Controlled Behavioral Analysis (2001). Films for the Humanities and Sciences. (22 minutes, $89.95 purchase price)

News program shows two children with autism who receive applied behavioral analysis, an intensive and controversial therapy.

Catching Them Early (1998).  Films for the Humanities and Sciences.  (58 minutes; $89.95 purchase price)

Shows the programs at Lincoln Elementary School in Richmond, California, and how the programs target at-risk youth to teach them confidence, cultural identity, conflict resolution, child-care, life skills, and offer support.

 

Depression: Moving On (1993). Films for the Humanities and Sciences. (27 minutes, $129.95 purchase price)

Provides details of clinical depression in seven segments: Defining the Problem, Classifying the Symptoms, Depression in Children, Depression in Adults, Supporting Patients with Depression, Assessment, and Therapy and Treatment.

 

The Special Child: Maximizing Limited Potential (production date unavailable).  Films for the Humanities and Sciences.  (26 minutes; $89.95 purchase price)

Early screening for developmental problems can determine whether the underlying cause is behavioral, neurological, or emotional. Physicians, psychologists, and speech and physical therapists cooperate to measure a child’s potential and helps him or her reach it. Addresses Down’s syndrome, autism, problems of neurological control, speech problems, and ‘crib death’.

 

Treating Tourette’s and Other Mental Illnesses (1991).  Films for the Humanities and Sciences.  (18 minutes; $89.95 purchase price)

A psychiatrist who suffers from Tourette’s syndrome shows how he can live a fairly normal life. Video explains dopamine imbalance and other chemicals that affect the brain, mental disorders and family history, diagnosis and treatment of Tourette’s and other mental illnesses in children.

 

Techniques of Play Therapy: A Clinical Demonstration (1994).  Guilford Publications.  (50 minutes; $95 purchase price)

An introduction to play therapy techniques where the audience observes unrehearsed segments of initial play therapy sessions, follow-up sessions, and scenes from an initial parent interview. Viewers learn how to engage and communicate from ages 4 to 12 at different stages of therapy, use play techniques, and be familiar with play therapy materials.

 

Play Therapy for Severe Psychological Trauma: The Theory and Practice of Play Therapy for Trauma (1998).  Guilford Publications.  (36 minutes; $95 purchase price)

This program discusses the nature of trauma, how it may be manifested clinically, and how to manage its powerful effects on children’s development through play and art.  Includes examples of children’s art, sand play, and other forms of play therapy.