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__________________________________________________________ 1. Introduction to Normal and

Abnormal Behavior in Children and Adolescents

__________________________________________________________ Chapter Summary:

During the 17th and 18th centuries, many children were subjected to harsh treatment or parental indifference. Concern for the plight and welfare of children with mental and behavioral disturbances rose with increasing advances in general medicine, physiology, and neurology. In addition, the growing influence of the philosophies of Locke and others led to the view that children needed moral guidance and support. These changing views resulted in an increased concern for moral education, compulsory education, and improved health practices. The late 19th century was marked by more compassionate attitudes towards children and adults with mental disorders, and detection and intervention methods flourished. However, during the early part of the 20th century, this educational and humane model returned to a custodial model, and attitudes became pessimistic and hostile towards persons with mental disorders. Psychoanalytic and behavioral theories helped shape emerging psychological and environmental influences in the beginning of the 20th century. Freud linked childhood experiences to mental disorders, causing a shift in the view of children as insignificant beings to that of human beings in distress. Watson scientifically investigated behavior, based on the learning theory of classical conditioning. In the late 1940s the institutionalization of children with intellectual or mental disorders was criticized, and from 1945 to 1965, the institutionalization of children decreased dramatically as children were placed in foster homes and group homes. Behavior therapy emerged in the 1950s and 1960s as treatment for child and family disorders. Defining the term psychological disorder is a difficult task, but it has been broadly defined as a pattern of symptoms associated with features of distress and/or disability, and/or increased risk of further suffering or harm. Recent longitudinal studies have found that by their 21st birthday, 3 out of 5 young adults meet criteria for a well-specified psychiatric disorder. In addition, a significant number of children do not grow out of their childhood difficulties. Childhood poverty is a daily reality for about 1 in 5 children in the United States and 1 in 7 in Canada. Poverty and socioeconomic disadvantage, sex differences, race, ethnicity, culture, child maltreatment and non-accidental trauma, other special issues concerning adolescents and sexual minority youths, and lifespan implications are all factors that influence the changing rates and expression of mental disorders. Chapter Outline:

Historical Views and Breakthroughs Historically, children were often ignored or subjected to harsh treatment because of the belief that they would die, were possessed, or were the property of their parents

1

A.

The Emergence of Social Conscience

In the 17th century, John Locke, an English philosopher and physician, advanced the belief that children should be raised with thought and care, rather than indifference and harsh treatment. He saw the importance of treating children with kindness and understanding and providing them with opportunities for education 2. Jean-Marc Itard undertook one of the first documented efforts to work with a special needs child around the turn of the 19th century, an undertaking that launched a new era of a helping orientation towards children 3. Although not entirely clear, the distinction was made in the latter half of the 19th century between individuals with mental retardation (“imbeciles”) and individuals with psychiatric disorders (“lunatics”) 4. Children with normal cognitive abilities but disturbing behavior were said to be suffering from “moral insanity” 5. Advances in medicine, physiology, and neurology led to a replacement of the moral insanity view by the organic disease model, and the growing influence of philosophies of Locke and others fostered the belief that children needed moral guidance and support Early Biological Attributions 1. Early attempts at biological explanations for abnormal behavior were very biased in favor of locating the cause of the problem within the individual 2. The view of mental disorders as being “diseases” meant that they were progressive and irreversible, and resistant to treatment or learning 3. The early educational and humane model for assisting persons with mental disorders returned to a custodial model during the early part of the 20th century, meaning that attitudes towards those with mental disabilities were once again hostile and negative. Many communities chose to prevent the transmission of these mental “diseases” through sterilization and institutionalization. Early Psychological Attributions 1. Psychological influences did not emerge until the early 1900s, corresponding with the formulation of a taxonomy of illnesses (diagnostic categorization system) 2. Psychoanalytic theory linked mental disorders to childhood experiences; for the first time the course of mental disorders was not viewed as inevitable 3. Behaviorism laid the foundation for studying conditioning and elimination of children’s fears Evolving Forms of Treatment 1. Up until the late 1940s, most children with intellectual or mental disorders were institutionalized 2. Research in the mid 1940s by Rene Spitz revealed the very harmful impact of institutional life on children’s physical and emotional development; within the following 20-year period there was a rapid decline in institutionalization and an increase in foster family and group home placements 1.

B.

C.

D.

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3. E.

A.

B.

C.

In the 1950s and 1960s behavior therapy emerged as a systematic approach to treatment of child and family disorders Progressive Legislation 1. In countries such as the U.S. and Canada, many laws have been enacted in the past few decades to protect the rights of children with special needs a. Individuals with Disabilities Act (IDEA): the US mandates that free and appropriate education be provided for K-12 children with special needs in the least restrictive environment b. Each child must be assessed with culturally appropriate tests c. Individualized Educational Plan (IEP): each child must have an IEP tailored to his or her needs, and must be re-assessed 2. In 2007, the United Nations General Assembly adopted a new convention and treaty to enact laws and other measures to improve disability rights, and abolish legislation, customs, and practices that discriminate against persons with disabilities 1. What is Abnormal Behavior in Children and Adolescents? Defining Psychological Disorders 1. Determining the boundaries between what is normal and abnormal is an arbitrary process 2. Psychological disorders have traditionally been defined as patterns of behavioral, cognitive, emotional, or physical symptoms, which are associated with distress and/or disability and/or increased risk for further suffering or harm 3. Due to children’s dependency on others, many childhood problems are better depicted in terms of relationships, rather than problems contained within the individual 4. Labels describe behavior, not people; children have many other nonproblematic attributes that should not be overshadowed by global descriptives 5. Problems may be the result of children’s attempts to adapt to abnormal or unusual circumstances Competence 1. The study of abnormal child psychology considers not only the degree of maladaptive behavior, but also children’s competence (the ability to successfully adapt in the environment) 2. Successful adaption varies across culture and ethnicity a. Traditions, beliefs, languages, and value systems need to be considered when defining a child’s competence b. Some children and families face greater obstacles in adapting to their environment (e.g. minorities who cope with racism, prejudice, discrimination, oppression, and segregation) 3. Knowledge of developmental tasks provides a backdrop for determining if there are impairments in developmental progress Developmental Pathways

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1.

A.

B.

A.

Refers to the sequence and timing of particular behaviors, as well as the possible relationships between behaviors over time 2. Two examples of developmental pathways: a. Multifinality – similar early experiences lead to different outcomes b. Equifinality – different early experiences lead to a similar outcome 3. With respect to abnormal child psychology, the following must be kept in mind: a. There are many contributors to disordered outcomes in each child b. Contributors vary among children who have the disorder c. Children express features of their disturbances in different ways d. Pathways leading to particular disorders are numerous and interactive 2. Risk and Resilience Risk Factors 1. Risk factors are variables that precede negative outcomes of interest, and which increase the probability that the outcomes will occur 2. Typically involves acute, stressful situations, as well as chronic adversity 3. Known risk factors include community violence, parental divorce, chronic poverty, care-giving deficits, parental mental illness, death of a parent, community disasters, homelessness, family breakup, and perinatal stress, especially in absence of compensatory resources Protective Factors 1. Protective factors are personal or situational variables that reduce the chances for a child to develop a disorder 2. Resiliency toward a stressful environment and ability to achieve positive outcomes despite significant risk for psychopathology 3. Associated with strong self-confidence, coping skills, ability to avoid risk situations, and ability to fight off or recover from misfortune 4. Resilience is not a universal, fixed attribute - it varies according to the type of stress, its context, and similar factors 5. The concept of resilience suggests that there is no certain pathway leading to a particular outcome; there are protective factors (which reduce the chances of developing a disorder) and vulnerability factors (which increase the chances of developing a disorder) which must be considered as well 3. The Significance of Mental Health Problems Among Children and Youths Mental Health Issues in Children and Adolescents 1. About 1 in 8 children have a mental health problem that significantly impairs functioning and many others have emerging problems that place them at-risk for the later development of a psychological disorder 2. The majority of children needing mental health services do not receive them due to limited treatment dollars, poor understanding of mental disorders and limited access to intervention 3. By the year 2020, behavioral health disorders will surpass all physical diseases as a major cause of disability throughout the world

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B.

A.

B.

C.

4. The demand for children’s mental health services is expected to double over the next decade since the number of professionals in this area is not expected to increase at the required rate The Changing Picture of Children’s Mental Health 1. In the past, children with various mental health and educational needs were too often described in global terms, such as “maladjusted” 2. Today, researchers are better able to distinguish among the various disorders, which has given rise to increased and earlier recognition of problems 3. Today, the problems of younger children and teens are also better acknowledged 4. In the past, lack of resources and the low priority given to children’s mental health issues meant that children did not receive appropriate services in a timely manner. Today, this situation is reportedly changing, with greater attention paid to empirically supported prevention and treatment programs. 5. Mental health problems remain unevenly distributed; those from disadvantaged families and neighborhoods, those from abusive/neglectful families, those receiving inadequate care, those born with very low birth weight, and those born to parents with criminal or severe psychiatric histories often have more mental health problems 4. What Affects Rates and Expression of Mental Disorders? A Look at Some Key Factors Poverty and Socioeconomic Disadvantage 1. About 1 in 5 children in the United States and 1 in 7 in Canada live in poverty and it is especially pronounced among Native American/First Nations and African American children 2. Poverty is associated with greater rates of learning impairments and problems in school achievement, conduct problems, violence, chronic illness, hyperactivity, and emotional disorders 3. Poverty has a significant, but indirect, effect on children’s adjustment, likely due to its association with other negative influences like poor parenting and exposure to numerous daily life stressors Sex Differences 1. Sex differences appear negligible in children under the age of 3, but increase with age 2. Boys show higher rates of early onset disorders that involve neurodevelopmental impairment (e.g. autism, ADD, conduct and reading problems) and girls show more emotional disorders with onset in adolescence (e.g. depression and eating disorders) 3. Types of childrearing environments also differ for boys and girls, in terms of predicting their resilience to adversity Race and Ethnicity 1. Minority children in the U.S. are overrepresented in rates of some disorders

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2.

D.

E.

F.

G.

Once the effects of SES, gender, age, and referral status are controlled for, very few differences in the rate of children’s psychological disorders emerge in relation to race or ethnicity 3. Significant barriers remain in access, quality and outcomes of care for minority children; misunderstanding and misinterpreting behaviors of minority groups have led to inappropriately placing minorities in the criminal and juvenile system 3. Minority children face multiple disadvantages, including marginalization and poverty and which can result in a sense of alienation, loss of social cohesion, and rejection of norms in the larger society 4. Despite growing ethnic diversity in North America, ethnic representation in research and ethnic-related issues are given little attention Culture 1. The values, beliefs, and practices that characterize an ethno-cultural group contribute to the development and expression of children’s disorders 2. Some underlying processes may be similar across diverse cultures and less susceptible to cultural influences (e.g., those with strong neurobiological bases) 3. Still, social and cultural beliefs and values likely influence meaning given to behaviors, the ways in which they are responded to, their forms of expression, and their outcomes Child Maltreatment and Non-Accidental Trauma 1. There are over 1 million substantiated reports of maltreatment in the U.S. each year (over 80,000 in Canada); it is estimated that more than one-third of 10- to 16-year-olds experience physical and/or sexual abuse 2. Many reports of “accidental” injuries to children may be the result of unreported neglect/abuse by parents or siblings 3. The adverse effects of maltreatment are particularly devastating with regard to adjustment at school, with peers, and in future relationships Special Issues Concerning Adolescents and Sexual Minority Youths 1. Early- to mid-adolescence is an especially important transitional period for healthy versus problematic adjustment 2. Issues such as substance abuse, sexual behavior, violence, accidental injuries, and mental health problems make adolescence a particularly vulnerable period 3. Sexual minority youth face many challenges that can affect their health and well-being a. Sexual minority youth are often victimized by their peers and family members and can experience verbal and physical abuse b. Given the prejudice that often exists in many parts of society lesbian, gay, and bisexual (LGB) youth have higher rates of mental health problems, including depression and suicidal behavior, substance abuse and risky sexual behavior Lifespan Implications

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1. 2.

Unfortunately, about 20% of children (those with the most chronic and serious disorders) will experience significant difficulties throughout their lives When provided with circumstances and opportunities that promote healthy adaptation and competence, children can often overcome major impediments

Learning Objectives: 1. To outline some of the critical issues in abnormal child psychology 2. To describe important features that distinguish most child and adolescent disorders 3. To identify key historical breakthroughs in abnormal child psychology 4. To consider how children’s mental health problems were addressed in the past and how this view has changed over time 5. To define the term “psychological disorder” and discuss some of the implications of this definition 6. To explain the purpose of defining psychological disorders 7. To consider some of the factors that influence a child’s development and outcomes 8. To discuss the significance of children’s mental health today 9. To identify some of the key factors that affect rates and expression of children’s mental disorders 10. To examine the main goals for studying psychological disorders in childhood Key Terms and Concepts:

competence developmental pathway developmental tasks equifinality externalizing problems internalizing problems multifinality nosologies protective factor psychological disorder resilience risk factor stigma 7

Test Items:

1. Who may refer a child for treatment?

a. parents b. teachers c. pediatricians d. all of the above ANS: D REF: p.3

DIF: Easy

COG: Factual

2. Many child and adolescent problems involve: a. failure to demonstrate expected developmental progress b. failure to thrive c. failure to meet parental demands d. failure to meet school/educational demands ANS: A REF: p.3 DIF: ModerateCOG: Factual 3. Most problematic behaviors shown by children are: a. qualitatively different from normal behavior b. shown to some degree by most children c. caused by inadequate parenting d. indistinguishable from one another ANS: B REF: p.3 DIF: Easy COG: Factual 4. Interventions for children and adolescents are often intended to: a. restore previous levels of functioning b. eliminate distress c. promote further development d. eliminate distress and promote further development ANS: D REF: p.3 DIF: Easy COG: Factual 5. In the 17th and 18th centuries, children’s disturbing behaviors were attributed to: a. possession by the devil or other evil forces b. poor parenting practices c. chemical imbalances d. low self-esteem ANS: A REF: p.3 DIF: Easy COG: Factual 6. In the 17th and 18th centuries, acts of child maltreatment: a. were illegal b. were very uncommon c. were practiced primarily among lower socioeconomic classes d. were considered to be a parent’s right for educating or disciplining a child ANS: D REF: p.4 DIF: Easy COG: Factual

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7.

John Locke (1632-1704) advanced the belief that children were: a. possessed by the devil b. uncivilized c. emotionally sensitive beings d. young adults ANS: C REF: p.4 DIF: ModerateCOG: Factual 8. The work of Jean-Marc Itard (1775-1838) was notable because: a. in contrast to the societal views of the time, his orientation toward children was one of care and helping b. he was the first documented individual to use behavioral techniques with children c. he was a strong advocate for sending disturbed children to asylums d. he initiated the Massachusetts’ Stubborn Child Act ANS: A REF: p.4 DIF: ModerateCOG: Applied 9. How did Jean-Marc Itard believe he could tame the “wild boy of Aveyron”? a. exorcism b. environmental stimulation c. allow him to behave as he did in the wild d. peer modeling ANS: B REF: p.5 (A Closer Look) DIF: Easy COG: Factual 10. Which method did Jean-Marc Itard use to tame the “wild boy of Aveyron”? a. hot baths b. electric shock c. massages d. all of the above ANS: D REF: p.5 (A Closer Look) DIF: Easy COG: Factual 11. At the end of the 19th century, children with mental retardation were regarded as: a. suffering from "moral insanity" b. imbeciles c. lunatics d. possessed by the devil ANS: B REF: p.4 DIF: Easy COG: Factual 12. At the end of the 19th century, children with normal cognitive abilities but disturbing behavior were thought to be: a. suffering from moral insanity b. imbeciles c. diseased d. possessed by the devil ANS: A REF: p.4 DIF: ModerateCOG: Factual

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13. The first disorder unique to children and adolescents was: a. masturbatory insanity b. mental retardation c. moral insanity d. depression ANS: A REF: p.6 (A Closer Look) DIF: ModerateCOG: Factual 14. During the early part of the 20th century, the biological disease model of mental problems led to: a. increased tolerance for individuals with mental disturbances b. improved treatments c. more controlled research methods d. eugenics and segregation ANS: D REF: p.7 DIF: ModerateCOG: Factual 15. Freud was the first to link mental disorders to: a. neurotransmitter imbalances b. early childhood experiences c. possession by evil spirits d. classical conditioning ANS: B REF: p.7 DIF: Easy

COG: Factual

16. Freud’s theory focused on: a. single causes of behavior b. multiple causes of behavior c. diseases of the mind d. neurological causes of behavior ANS: B REF: p.7 DIF: ModerateCOG: Factual 17. Efforts to classify psychiatric disorders into descriptive categories are called: a. diagnostics b. differential diagnoses c. nosologies d. none of these ANS: C REF: p.8 DIF: ModerateCOG: Factual 18. Who is referred to as the “Father of Behaviorism”? a. Freud b. Albert c. Watson d. Rayner ANS: C REF: p.8 DIF: Easy COG: Factual

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19. The development of __________ treatment can be traced back to the rise of behaviorism in the early 1900s. a. psychodynamic b. research-based c. diagnostic d. all of the above ANS: B REF: p.8 DIF: ModerateCOG: Factual 20. In the first half of the 20th century, most children with mental disorders were: a. institutionalized b. treated with behavior therapy c. treated with psychoanalysis d. overlooked ANS: A REF: p.8 DIF: Easy COG: Factual 21. The work of Rene Spitz: a. led to the development of an organic model of mental illness b. was the first documented attempt to help a special child c. led to some of the first empirically supported behavioral techniques for eliminating children’s fears d. raised serious questions about the harmful impact of institutionalization of children’s development ANS: D REF: p.8 DIF: ModerateCOG: Factual 22. During the 1950s and 1960s, ___________ emerged as a systematic approach to the treatment of childhood disorders. a. psychoanalysis b. family therapy c. behavior therapy d. institutionalization ANS: C REF: p.8 DIF: ModerateCOG: Factual 23. The Individuals with Disabilities Education Act (IDEA); U.S. Public Law 101-476 mandates a. free public education for children with special needs b. the use of culturally-appropriate tests for assessing children c. individual education programs (IEPs) for children identified as special needs d. all of the above ANS: D REF: p.10 DIF: Easy COG: Factual 24. What is the purpose of an Individualized Educational Plan (IEP)? a. to test the child using culturally appropriate tests b. to accurately diagnose a child’s specific difficulties c. to tailor the child’s school program to his or her needs d. to discuss the family’s history ANS: C REF: p.10 DIF: ModerateCOG: Factual

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25. The 2007 United Nations Treaty adopted a new convention to do what? a. provide free and appropriate education to children with special needs b. improve disability rights and abolish discrimination c. provide psychotherapy services to children with special needs d. improves test measures to diagnose children with special needs ANS: B REF: p.10 DIF: ModerateCOG: Factual 26. Psychological disorders are defined as patterns of behavioral, cognitive, emotional, or physical symptoms, which are associated with: a. distress b. disability c. increased risk for further suffering or harm d. all of these ANS: D REF: p.11 DIF: Easy COG: Factual 27. In contrast to adults, abnormality in children is often described in terms of: a. relationships b. distress c. disability d. increased risk ANS: A REF: p.11 DIF: ModerateCOG: Factual 28. Which would be an example of a common mistake in terms of labeling a child? a. Ashley is a child with mental retardation b. Karlee is a depressed child c. Amber is a child with autism d. Robyn is a small child ANS: B REF: p.12 DIF: ModerateCOG: Applied 29. Boundaries between abnormal versus normal functioning are: a. scientifically defined b. relatively arbitrary c. well established d. currently agreed upon ANS: B REF: p.12 DIF: ModerateCOG: Factual 30. This is the concept that various outcomes may stem from similar beginnings such as child maltreatment. a. trifinality b. ethnic finality c. equifinality d. multifinality ANS: D REF: p.14 DIF: Easy COG: Factual

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31. Successful adaption to the environment varies across: a. psychological theories b. developmental stages c. sex and gender d. culture and ethnicity ANS: D REF: p.13 DIF: ModerateCOG: Factual 32. The ability to successfully adapt in the environment is referred to as: a. competence b. adjustment c. resilience d. coping ANS: A REF: p.13 DIF: Easy COG: Factual 33. To determine a child’s competencies, it is useful to have some knowledge of: a. social psychological b. animal behavior c. adult dysfunctions d. developmental tasks ANS: D REF: p.13 DIF: Easy COG: Factual 34. Which of the following is NOT a developmental task of middle childhood? a. academic achievement b. getting along with peers c. differentiation of self from environment d. rule-governed conduct ANS: C REF: p.13 (Table 1.1) DIF: ModerateCOG: Factual 35. Which of the following is NOT a developmental task of adolescence? a. academic achievement b. self-control and compliance c. forming a cohesive sense of self-identity d. involvement in extracurricular activities ANS: B REF: p.13 (Table 1.1) DIF: ModerateCOG: Factual 36. Which of the following is NOT a developmental task of infancy? a. attachment to caregiver b. language c. differentiation of self from environment d. forming close friendships within and across gender ANS: D REF: p.13 (Table 1.1) DIF: Easy COG: Factual

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37. Resiliency in boys would be best associated with households in which there are: a. male role models, structure, encouragement of emotional expressiveness b. female role models, structure, encouragement of emotional expressiveness c. male role models and a combination of risk taking and independence d. female role models and a combination of risk taking and independence ANS: A REF: p.16-17 DIF: ModerateCOG: Factual 38. Multifinality refers to the observation that: a. different disorders may stem from similar causes b. various outcomes may stem from similar beginnings c. the same disorder may have different causes d. developmental pathways may converge at the end ANS: B REF: p.14 DIF: ModerateCOG: Factual 39. Conduct disorder may arise from different developmental pathways, a concept known as: a. equifinality b. multifinality c. developmental diversity d. disordered beginnings ANS: A REF: p.14 DIF: Easy COG: Factual 40. Which is an example of resiliency? a. strong self confidence b. coping skills c. avoidance of risky situations d. all of the above ANS: D REF: p.16 DIF: Easy

COG: Factual

41. What is a risk factor? a. A variable that precedes a negative outcome of interest b. A variable that increases the likelihood that a negative outcome will occur c. Both a and b d. None of the above ANS: C REF: p.15 DIF: Easy COG: Factual 42. Which of the following is true with respect to resilience? a. Resilience tends to be a fixed attribute. b. Resilience may vary over time. c. Resilience may very across situations. d. Resilience may vary over time and across situations. ANS: D REF: p.16 DIF: ModerateCOG: Factual

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43. By the year 2020 the demand for children’s mental health will: a. double b. decrease by 50% c. remain the same as present day d. slightly increase ANS: A REF: p.18 DIF: ModerateCOG: Factual 44. Which is an example of a risk factor increasing a child’s vulnerability to psychopathology? a. chronic poverty b. ability to avoid dangerous situations c. high intelligence d. self-confidence ANS: A REF: p.15 DIF: Easy COG: Factual 45. In the U.S. and Canada, children from ________racial/ethnic backgrounds have the highest rates of poverty. a. African American and Native American b. Native American and Asian American c. Asian American and Mexican American d. African Americans and Mexican American ANS: A REF: p.19 DIF: ModerateCOG: Factual 46. Girls have higher rates of ________then boys. a. reading problems b. autism c. depression d. ADHD ANS: C REF: p.20 DIF: Easy COG: Factual 47. Childhood poverty is a daily reality for about _______________ children in the United States. a. 1 in 4 b. 1 in 5 c. 1 in 7 d. 1 in 8 ANS: B REF: p. 19 DIF: ModerateCOG: Factual 48. Which of the following statements about children’s mental health is false? a. About one child in eight has a mental health problem that impairs their functioning. b. Approximately 75% of children with mental health problems receive proper services. c. Mental health problems of children and adolescents are a significant societal concern. d. About one in ten children meets the criteria for a specific psychological disorder. ANS: B REF: p.19 DIF: ModerateCOG: Factual

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49. Which of the following statements is untrue? a. Childhood psychopathology is a relatively common occurrence. b. Most childhood problems and disorders remit by the end of childhood. c. Children today face greater stressors than they did in the past. d. Young children and adolescents are particularly at risk for psychological problems. ANS: B REF: p.18 DIF: ModerateCOG: Factual 50. Which children are disproportionately afflicted with mental health problems? a. those born with very low birth weight due to maternal smoking b. those born to parents with criminal histories c. those receiving inadequate child care d. all of the above ANS: D REF: p.18 DIF: Easy COG: Factual 51. Children from poor and disadvantaged families demonstrate significantly more_____ than children who are not poor. a. school problems b. hyperactivity c. chronic illness d. all of the above ANS: D REF: p.19 DIF: Easy COG: Factual 52. Which statement is true regarding sexual minority youth? a. They have a higher rate of using mental health services b. They often experience verbal and physical abuse c. They have less academic problems d. They have more peer relationships ANS: B REF: p.22-23 DIF: ModerateCOG: Factual 53. Which statement is true about sex differences and mental health problems in children? a. Anxiety disorders are more common in boys than girls. b. Sex differences in problem behaviors show up by early infancy. c. Boys show greater difficulties than girls starting in early adolescence. d. Boys’ externalizing problems start out higher than girls in the preschool years. ANS: D REF: p.20 DIF: ModerateCOG: Factual 54. Which statement is true about ethnicity and mental health problems in children? a. Minority children in the U.S. are overrepresented in rates of some disorders. b. Even with other factors controlled for (e.g., sex, age), differences emerge in relation to race. c. Minority children and youth do not face any more disadvantages in life than other children. d. Ethnic representation in research studies has received a great deal of attention in studies of child psychopathology. ANS: A REF: p.21 DIF: ModerateCOG: Factual

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55. Verified reports of child abuse and neglect number over _______ in the U.S. a. 100,000 b. 200,000 c. 500,000 d. 1,000,000 ANS: D REF: p.22 DIF: Easy COG: Factual 56. Phone surveys suggest that about ________ of 10- to 16-year-olds experience physical and/or sexual abuse. a. 1/10 b. 1/4 c. 1/3 d. 1/2 ANS: C REF: p.21 DIF: ModerateCOG: Factual 57. Phone surveys suggest that about ________ of 12- to 17-year-olds met criteria for either posttraumatic stress disorder, major depressive episode, or substance abuse/dependence. a. 1-5% b. 5-9% c. 16-19% d. 20-35% ANS: C REF: p.22 DIF: ModerateCOG: Factual 58. Which issues make adolescence a particularly vulnerable period? a. risky sexual behavior b. accidental injuries c. substance use d. all of the above ANS: D REF: p.22 DIF: Easy COG: Factual 59. Which is true about children with the most chronic and serious disorders? a. they are more likely to finish school because of all the help they receive b. they face sizable difficulties throughout their lives c. they are less likely to have social problems d. they are less likely to have psychiatric disorders as adults ANS: B REF: p.23 DIF: Easy COG: Factual 60. What might be a lifelong consequence associated with child psychopathology? a. increased demands on health and education systems b. increase in productivity c. less need for repeated interventions d. decreased demands on criminal justice systems ANS: A REF: p.23 DIF: Easy COG: Factual

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Short Answer/Essay Questions: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

How has the societal view of children changed throughout history and who were some of the major historical figures responsible for these changes? What characteristics of a child place him or her at risk for developing a psychological disorder? In regards to legislation pertaining to children with special needs and education, what is IDEA and what does it mandate? What is an IEP and what is its purpose? What is the goal of the Treaty that the United Nations General Assembly adopted in 2007 regarding persons with disabilities? What features distinguish most child and adolescent disorders from adult disorders? In what ways can low income and/or poverty affect children’s development? Define the concept of competence. How may competence be assessed? Distinguish between the concepts of multifinality and equifinality. Distinguish between risk and resilience. What are some of the key factors affecting rates and expression of mental disorders? What are some of the findings regarding sex differences in children’s mental health problems? What child rearing environment predicts the best resiliency for boys, and which predicts the best for girls? Discuss the influence of race and ethnicity in the development of psychological disorders. Discuss the difficulties sexual minority youth experience in society and which mental health disorders they are most at risk for developing.

Questions and Issues for Discussion:

1. 2. 3. 4.

5.

6. 7.

One of the elements of mental disorders is that they are maladaptive. How well does this element "fit" with childhood disorders? What are some instances when problematic behavior may be the result of attempts to adapt to abnormal or unusual circumstances? Should we be “diagnosing” children with psychological disorders? What are some of the advantages and disadvantages of diagnosing children? What are some reasons that children may be under diagnosed? Outline some of the major child factors, parent/teacher factors, and societal factors. Many people have personal beliefs about what influences thinking and behavior. Have students discuss their beliefs about what underlies psychological problems, particularly psychological problems in children. What do they believe is necessary for healthy adjustment? The authors claim that many childhood problems are better depicted in terms of relationships, rather than problems contained within the individual. What are the students’ reactions to this claim? (It may be interesting to re-ask this question near the end of the course to see if students have a change in opinion). What are some of the difficulties in defining psychological disorders? What are some of the advantages of doing so? The ways in which we describe behavior has implications for the child being described. How can we describe behavior in a sensitive and non-stigmatizing manner?

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8. 9.

10.

It is possible for the same event or condition to function as both a protective and a vulnerability factor depending on the context of the situation. Discuss some instances in which one event could act as both a protective and a vulnerability factor. Given that IDEA mandates that children with special needs be placed in the least restrictive environment, should special education classrooms exist at all, or should all students be placed in regular education classrooms with appropriate supports for children who need it? What are the implications of both? Children’s competence and their ability to adapt to the environment always need to be considered when assessing maladaptive behaviors. Discuss how culture, ethnicity, and SES can significantly impact how we define a child’s competency.

Website Suggestions: http://www.aboutourkids.org/ Provides perhaps the very best overview of childhood disorders and related matters. Includes warning signs, facts and information, overviews of treatment approaches, research, current news, a special series of article and manuals for parents, teachers, and professionals, and much more. Prepared by the New York University Child Study Center. http://www.aacap.org/ Webpage for the American Academy of Child and Adolescent Psychiatry. Includes facts, links to resources, press releases, publications, research, and more. This site is intended to assist parents and families in understanding mental disorders and problems affecting children and adolescents, but there is also a lot of information that would be of interest to students and professionals, including information about training, job opportunities, and research publications. http://www.apa.org/ Homepage for the American Psychological Association. Provides a variety of psychology-related information geared toward psychologists, the public, and students. http://www.childrensdefense.org/ A non-profit organization whose mission is to “leave no child behind” and provide children with a healthy, fair, safe, and moral start in life. The organization advocates for the needs of poor children, minority children, and children with disabilities. http://www.ffcmh.org/ The Federation of Families for Children’s Mental Illness. A parent-run organization with links to various publications and other relevant websites (including advocacy organizations, federal agencies, information clearinghouses, professional organizations, and research). http://jamesdauntchandler.tripod.com/ Pediatric psychiatric pamphlets compiled from textbooks, journals, and clinical experience by Dr. Jim Chandler of Nova Scotia. Includes interesting case histories. Easy to navigate. http://mentalhealth.samhsa.gov/ An award-winning site provided by the Center for Mental Health Services. Information is intended to suit a wide range of people, including users of

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mental health services and their families, the general public, policy makers, and mental health services providers. http://www.pacer.org/ The mission of the PACER Center is to expand opportunities and enhance the quality of life of children and young adults with disabilities and their families, based on the concept of parents helping parents. The website includes links to other resources and relevant publications. http://psychcentral.com/ Fantastic site with a great deal of information about mental health. Includes articles and essays, book reviews, live chats, discussion forums, and great links to mental health resources. Video Suggestions:

Life’s First Feelings (production year unavailable). PBS Boston (WGBH Boston Video). (60 minutes; $19.95 purchase price) Looks at early emotional development and presents examples of ground breaking clinical work and research by such investigators as Tronick, Izard, Campos, Lewis, Kagan, RadtkeYarrow, Greenspan, in addressing such topics as social referencing, universal emotional expressions, emotion dysregulation, shyness and inhibition, and early intervention. Excellent overview of issues and methods used in studying developmental psychopathology during the early years. Behavior Disorders of Childhood (1992). Alvin H. Perlmutter Inc. in association with Toby Levine Communications, distributed by Magic Lantern Communication (http://www.filmo.com/mlc.htm). (60 minutes; $129 purchase price) “Almost all parents worry whether or not their child's behavior is normal. This program visits families of youngsters with attention deficit hyperactivity disorder, conduct disorder, separation anxiety disorder, and autism. In addition, experts in child development and psychology discuss how to differentiate abnormal behavior from developmental stages.” Child Development (1997). Films for the Humanities and Sciences. (60 minutes; $159 purchase price) “This program examines a range of the major subjects categorized under the rubric of child development, with one- to five-minute segments per subject. Topics covered include: Genetic Counseling and Prenatal Testing, Fetal Alcohol Syndrome, Prepared Childbirth, Reflexes of Newborns, Learning in Infants, Temperament, Physical Abuse of Children, Learning Disabilities, Sexual Abuse of Children, and Teen Suicide.” Kids in Crisis (production year unavailable). International Film Bureau, Inc. (59 minutes; $125 purchase price) Examines escalating incidence of mental illness among teens. Contains candid interviews with kids, parents, etc., and looks at care available at psychiatric hospitals. Family in Crisis (production year unavailable). Films for the Humanities and Sciences. (28 minutes; $89.95 purchase price)

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“This specially adapted Phil Donahue program centers on the plight of poor children growing-up in single-parent households. Senator Daniel Patrick Moynahan (NY) and Dr. Joyce Ladner, Howard University sociologist, examine the problems of children who are growing up without fathers and the cycle of poverty that especially affects minority families.” The Impact of Violence on Children (1995). Films for the Humanities and Sciences. (28 minutes, $89.95 purchase price) A video examining the sources of violence that affect children, including school, home, and the streets. Family Violence: Breaking the Chain (production year unavailable). Films for the Humanities and Sciences. (25 minutes, $149.95 purchase price) Describes the effects of family violence on those who are abused, as well as the abusers themselves. Discusses breaking the pattern of violence in relationships and considers breaking the cycle of inter-generational violence. Raising Non-Violent Children in Violent Times (2000). Films for the Humanities and Sciences. (18 minutes, $89.95 purchase price) Examines the reasons why adolescents become violent and offers parenting strategies that may be used to counteract violent behavior early in a child’s development. Risk factors are discussed by experts in the field, and adolescents describe how violence has affected their lives.

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