PSYCHOPATHOLOGIE
PSYCHOPATHOLOGIE:
ADOLESCENTEN
INHOUDSOPGAVE
1. kinderen En hun ontwikkling..................................................................................................5
1.1 Normaal of abnormaal gedrag..........................................................................................5
1.1.1 NIVEAUS.....................................................................................................................5
1.1.2 ERNST.........................................................................................................................6
1.1.3 GEVOLGEN..................................................................................................................6
1.2 Pathogenese = ontstaan...................................................................................................7
1.2.1 SAMENSPEL VAN Factoren:........................................................................................7
1.2.2 GEVOLGEN VAN AL DEZE FACTOREN.........................................................................7
1.3 kinderpsychiatrische aandoeningen.................................................................................9
1.3.1 INVALSHOEKEN..........................................................................................................9
1.3.2 Fasen in het onderzoeksproces.................................................................................9
1.3.3 Indeling kinderpsychiatrische aandoeningen dsm 5 indeling....................................9
2. Het kinderpsychiatrisch onderzoek......................................................................................10
2.1 vERLOOP..........................................................................................................................10
2.2 Van diagnose naar behandelplan....................................................................................13
2.2.1 DIAGNOSE STELLEN..................................................................................................13
2.2.2 WERKHYPOTHESE.....................................................................................................13
2.2.3 oPSTellen Behandelplan:.........................................................................................13
2.2.4 Adviesgeprek............................................................................................................14
3. ADHD.....................................................................................................................................14
3.1 SYMPTOMEN...................................................................................................................14
3.2 SYNDROOMBESCHRIJVING..............................................................................................17
3.2.1 Specifcaae...............................................................................................................17
3.3 Eaologie (= oorzaak ........................................................................................................18
3.3.1 Neuropsychologische modellen...............................................................................18
3.3.2 omgevingsfactoren..................................................................................................19
3.4 Epidemiologie..................................................................................................................19
3.4.1 comorbiditeit............................................................................................................20
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,PSYCHOPATHOLOGIE
3.4.2 Prognose = uitspraak over hoe iets wrs zal verlopen...............................................20
3.5 DIANOSTIEK.....................................................................................................................21
3.6 BEHANDELING.................................................................................................................21
4. aUTISMESPECTRUMSTOORNIS.............................................................................................23
4.1 INLEIDING........................................................................................................................23
4.2 EPIDEMOLGIE..................................................................................................................23
4.3 SYMPTOMEN...................................................................................................................23
4.3.1 Spectrum van auasasche stoornissen volgens WING:............................................23
4.3.2 DSM – 5 criteria voor ASS........................................................................................24
4.3.3 AANTAL SPECIFICATIES.............................................................................................26
4.3.4 ANDERE PERVASIEVE ONTWIKKELINGSSTOORNISSEN DIE VROEGER IN dsm4
stonden.............................................................................................................................26
4.3.5 GEASSOCIEERDE PROBLEMEN.................................................................................27
4.4 ETIOLOGIE.......................................................................................................................27
4.5 DIAGNOSTIEK..................................................................................................................28
4.6 BEHANDELING.................................................................................................................29
4.6.1 PIJLERS VAN DE BEHANDELING................................................................................29
4.6.2 ALGEMENE DOELSTELLINGEN..................................................................................30
5. stemmingsstoornissen..........................................................................................................31
5.1 INLEIDING........................................................................................................................31
5.2 depressie.........................................................................................................................31
5.2.1 Associaae met levensgebeurtenissen......................................................................31
5.2.2 Geslachtsverschillen.................................................................................................32
5.2.3 COMORBIDITEIT.......................................................................................................32
5.2.4 VERLOOP..................................................................................................................32
5.2.5 RISICOFACTOREN VOOR SLECHTE PROGNOSE........................................................32
5.2.6 SYMPTOMEN DEPRESSIEVE STOORNIS....................................................................33
5.2.7 ETIOLOGIE................................................................................................................35
5.2.8 diagnosaek...............................................................................................................35
5.2.9 BEHANDELING..........................................................................................................35
5.3 BIPOLAIRE STOORNIS......................................................................................................37
5.3.1 EPIDEMIOLOGIE.......................................................................................................37
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,PSYCHOPATHOLOGIE
5.3.2 ALGEMENE INDELING STEMMINGSSTOORNISSEN..................................................37
5.3.3 SYMPTOMEN............................................................................................................38
5.3.4 EPIDEIOLOGIE...........................................................................................................39
5.3.5 ETIOLOGIE................................................................................................................39
5.3.6 DIAGNOSTIEK...........................................................................................................39
5.3.7 BEHANDELING..........................................................................................................39
5.4 DISRUPTIVE MOOD DYSREGULATION DISORDER...........................................................40
5.5 DIAGNOSTIEK STEMMINGSSTOORNISSEN......................................................................40
5.6 OPNAME EN OBSERVATIE BIJ STEMMINGSSTOORNISSEN.............................................41
6. HECHTINGS EN HECHTINGSSTOORNISSEN...........................................................................41
6.1 DEFINTIE HECHTING........................................................................................................41
6.1.1 BOWLBY...................................................................................................................41
6.1.2 AINSWORTH.............................................................................................................42
6.2 ONTWIKKELING VAN GEHECHTHEID...............................................................................42
6.3 EPIDEMIOLOGIE..............................................................................................................44
6.4 SYMPTOMEN...................................................................................................................44
6.4.1 ALGEMEEN...............................................................................................................44
6.4.2 BIJKOMEND..............................................................................................................45
6.4.3 DSM-5.......................................................................................................................45
6.4.4 ZERO TO THREE (is minder belangrijk)....................................................................46
6.4.5 Voorbeeld: overbetrokken relaae...........................................................................47
6.4.6 CHARLEY ZEANAH.....................................................................................................48
6.4.7 NIEUW CLASSIFICATIESYSTEEM...............................................................................48
6.5 ETIOLOGIE.......................................................................................................................49
6.6 DIAGNOSTIEK..................................................................................................................50
6.7 BEHANDELING.................................................................................................................50
7. trauma...................................................................................................................................51
7.1 DEFINTIE..........................................................................................................................51
7.1.1 verschillende types..................................................................................................52
7.1.2 TYPE REACTIES.........................................................................................................52
7.2 SYMPTOMEN...................................................................................................................52
7.2.1 BASISKENMEREN......................................................................................................52
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, PSYCHOPATHOLOGIE
7.2.2 SYMPTOMEN DMS-5................................................................................................53
7.3 BEHANDELING.................................................................................................................55
7.3.1 PREVENTIE................................................................................................................55
7.3.2 PSYCHOTHERAPIE.....................................................................................................56
7.3.3 MEDICATIE...............................................................................................................56
4
PSYCHOPATHOLOGIE:
ADOLESCENTEN
INHOUDSOPGAVE
1. kinderen En hun ontwikkling..................................................................................................5
1.1 Normaal of abnormaal gedrag..........................................................................................5
1.1.1 NIVEAUS.....................................................................................................................5
1.1.2 ERNST.........................................................................................................................6
1.1.3 GEVOLGEN..................................................................................................................6
1.2 Pathogenese = ontstaan...................................................................................................7
1.2.1 SAMENSPEL VAN Factoren:........................................................................................7
1.2.2 GEVOLGEN VAN AL DEZE FACTOREN.........................................................................7
1.3 kinderpsychiatrische aandoeningen.................................................................................9
1.3.1 INVALSHOEKEN..........................................................................................................9
1.3.2 Fasen in het onderzoeksproces.................................................................................9
1.3.3 Indeling kinderpsychiatrische aandoeningen dsm 5 indeling....................................9
2. Het kinderpsychiatrisch onderzoek......................................................................................10
2.1 vERLOOP..........................................................................................................................10
2.2 Van diagnose naar behandelplan....................................................................................13
2.2.1 DIAGNOSE STELLEN..................................................................................................13
2.2.2 WERKHYPOTHESE.....................................................................................................13
2.2.3 oPSTellen Behandelplan:.........................................................................................13
2.2.4 Adviesgeprek............................................................................................................14
3. ADHD.....................................................................................................................................14
3.1 SYMPTOMEN...................................................................................................................14
3.2 SYNDROOMBESCHRIJVING..............................................................................................17
3.2.1 Specifcaae...............................................................................................................17
3.3 Eaologie (= oorzaak ........................................................................................................18
3.3.1 Neuropsychologische modellen...............................................................................18
3.3.2 omgevingsfactoren..................................................................................................19
3.4 Epidemiologie..................................................................................................................19
3.4.1 comorbiditeit............................................................................................................20
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,PSYCHOPATHOLOGIE
3.4.2 Prognose = uitspraak over hoe iets wrs zal verlopen...............................................20
3.5 DIANOSTIEK.....................................................................................................................21
3.6 BEHANDELING.................................................................................................................21
4. aUTISMESPECTRUMSTOORNIS.............................................................................................23
4.1 INLEIDING........................................................................................................................23
4.2 EPIDEMOLGIE..................................................................................................................23
4.3 SYMPTOMEN...................................................................................................................23
4.3.1 Spectrum van auasasche stoornissen volgens WING:............................................23
4.3.2 DSM – 5 criteria voor ASS........................................................................................24
4.3.3 AANTAL SPECIFICATIES.............................................................................................26
4.3.4 ANDERE PERVASIEVE ONTWIKKELINGSSTOORNISSEN DIE VROEGER IN dsm4
stonden.............................................................................................................................26
4.3.5 GEASSOCIEERDE PROBLEMEN.................................................................................27
4.4 ETIOLOGIE.......................................................................................................................27
4.5 DIAGNOSTIEK..................................................................................................................28
4.6 BEHANDELING.................................................................................................................29
4.6.1 PIJLERS VAN DE BEHANDELING................................................................................29
4.6.2 ALGEMENE DOELSTELLINGEN..................................................................................30
5. stemmingsstoornissen..........................................................................................................31
5.1 INLEIDING........................................................................................................................31
5.2 depressie.........................................................................................................................31
5.2.1 Associaae met levensgebeurtenissen......................................................................31
5.2.2 Geslachtsverschillen.................................................................................................32
5.2.3 COMORBIDITEIT.......................................................................................................32
5.2.4 VERLOOP..................................................................................................................32
5.2.5 RISICOFACTOREN VOOR SLECHTE PROGNOSE........................................................32
5.2.6 SYMPTOMEN DEPRESSIEVE STOORNIS....................................................................33
5.2.7 ETIOLOGIE................................................................................................................35
5.2.8 diagnosaek...............................................................................................................35
5.2.9 BEHANDELING..........................................................................................................35
5.3 BIPOLAIRE STOORNIS......................................................................................................37
5.3.1 EPIDEMIOLOGIE.......................................................................................................37
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,PSYCHOPATHOLOGIE
5.3.2 ALGEMENE INDELING STEMMINGSSTOORNISSEN..................................................37
5.3.3 SYMPTOMEN............................................................................................................38
5.3.4 EPIDEIOLOGIE...........................................................................................................39
5.3.5 ETIOLOGIE................................................................................................................39
5.3.6 DIAGNOSTIEK...........................................................................................................39
5.3.7 BEHANDELING..........................................................................................................39
5.4 DISRUPTIVE MOOD DYSREGULATION DISORDER...........................................................40
5.5 DIAGNOSTIEK STEMMINGSSTOORNISSEN......................................................................40
5.6 OPNAME EN OBSERVATIE BIJ STEMMINGSSTOORNISSEN.............................................41
6. HECHTINGS EN HECHTINGSSTOORNISSEN...........................................................................41
6.1 DEFINTIE HECHTING........................................................................................................41
6.1.1 BOWLBY...................................................................................................................41
6.1.2 AINSWORTH.............................................................................................................42
6.2 ONTWIKKELING VAN GEHECHTHEID...............................................................................42
6.3 EPIDEMIOLOGIE..............................................................................................................44
6.4 SYMPTOMEN...................................................................................................................44
6.4.1 ALGEMEEN...............................................................................................................44
6.4.2 BIJKOMEND..............................................................................................................45
6.4.3 DSM-5.......................................................................................................................45
6.4.4 ZERO TO THREE (is minder belangrijk)....................................................................46
6.4.5 Voorbeeld: overbetrokken relaae...........................................................................47
6.4.6 CHARLEY ZEANAH.....................................................................................................48
6.4.7 NIEUW CLASSIFICATIESYSTEEM...............................................................................48
6.5 ETIOLOGIE.......................................................................................................................49
6.6 DIAGNOSTIEK..................................................................................................................50
6.7 BEHANDELING.................................................................................................................50
7. trauma...................................................................................................................................51
7.1 DEFINTIE..........................................................................................................................51
7.1.1 verschillende types..................................................................................................52
7.1.2 TYPE REACTIES.........................................................................................................52
7.2 SYMPTOMEN...................................................................................................................52
7.2.1 BASISKENMEREN......................................................................................................52
3
, PSYCHOPATHOLOGIE
7.2.2 SYMPTOMEN DMS-5................................................................................................53
7.3 BEHANDELING.................................................................................................................55
7.3.1 PREVENTIE................................................................................................................55
7.3.2 PSYCHOTHERAPIE.....................................................................................................56
7.3.3 MEDICATIE...............................................................................................................56
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