DSM criteria/prevalence Disorders EBD

Anxiety Disorders Specific Phobias

Answer: • Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation. • Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which take the form of a situationally bound or pre disposed panic attack. • The person recognizes that the fear is excessive and unreasonable. • The phobic situation is avoided or is endured with intense anxiety or distress.  3-4% in community samples  More prevalent in girls than in boys  Specific phobia begin in early to middle childhood. Improvement is expected over time, but there is a reason think in terms of continuity over time.

Anxiety Disorders Social Phobia

Answer: • A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual gears that he or she will act in a way that will be humiliating or embarrassing. • Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack. • The person recognizes that the fear is excessive or unreasonable • The feared social or performance situations are avoided or else are endured with intense anxiety or distress  1-2% in children, 3-4% in adolescents  Prevalence increases with age  Age ½-3 >stranger anxiety and separation anxiety are common.  Age 4-5 > abilities to see oneself as a social object/feel embarrassment.  Age 8 > concern about people’s possible negative evaluation.

Anxiety Disorders Separation Anxiety

Answer: Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following: 1. Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated, 2. Persistent and excessive worry about losing or harm major attachment figures 3. Persistent and excessive worry that an untoward event will lead to separation 4. Persistent refusal to go to school or elsewhere because of fear or separation 5. Persistent and excessive fear to be alone 6. Persistent refusal to go to sleep alone 7. Repeated nightmares involving separation 8. Repeated complaints of physical symptoms separation occurs/anticipated  3-12% of young people (community samples)  Prevalence is higher in children than in adolescents  Sometimes more among girls than boys, sometimes no sex differences

Anxiety Disorders Generalized Anxiety Disorder

Answer: • Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities • The person finds it difficult to control the worry • The anxiety and worry are associated with three (or more) of the following six symptoms: 1. Restlessness or feeling keyed up or on edge, 2. Being easily fatigued, 3. Difficulty concentrating or mind going blank, 4. Irritability, 5. Muscle tension, 6. Sleep disturbance • The distress the youth with generalized anxiety feels is not limited to a specific type of situation • The anxiety cause clinically significant distress or impairment in social, occupational or other important areas of functioning.  2-14% among youth of all ages  Sometimes reported to be more common in girls, also reports of no sex differences in prevalence  The median age of onset is estimated to be about 10 years of age.

Anxiety Disorders Panic Disorder

Answer: Panic disorder involves recurrent unexpected panic attacks. To receive a DSM diagnosis of panic disorder at least one of these attacks has been followed by a months or more of one of the following: 1. Persistent concern about having other attacks 2. Worry about the implications of the attack (going crazy, having a heart attack) 3. A significant change in behavior related to attacks  Occur in adolescents and, to a lesser degree, in prepubertal children.  Occur equally in boys and girls; however panic disorders is typically reported more frequently in girls

Anxiety Disorders Panic Disorder

Answer: Discrete period of intense fear or discomfort, in which 4 (or more) of the following symptoms developed abruptly and reached a peak within ten minutes 1. Palpitations, pounding heart or accelerated heart rate 2. Sweating 3. Trembling or shaking 4. Sensations of shortness of breath or smothering 5. Feeling of choking 6. Chest pain or discomfort 7. Nausea or abdominal distress 8. Feeling dizzy, unsteady light headed or faint 9. Derealisation or depersonalization 10. Fear of losing control or going crazy 11. Fear of dying 12. Paresthesias 13. Chills or hot flushes  Occur in adolescents and, to a lesser degree, in prepubertal children.  Occur equally in boys and girls

Anxiety Disorders Obsessive-Compulsive Disorder

Answer: • Obsessions are unwanted, repetitive, intrusive thoughts that are not simply excessive real life concerns. • Compulsions involve repetitive, stereotyped behaviors that the youth feels compelled to perform and that are meant to reduce anxiety or to prevent a dreaded event. 1. Recurrent persistent thoughts, impulses or images that are experienced at some time during the disturbance, as intrusive and inappropriate and cause marked anxiety or distress 2. The thoughts, impulses or images are not simply excessive worries about real life problems. 3. The person attempts to ignore or suppress such thought, impulses or images or to neutralize them with some other thought or action. 4. The person recognizes that the obsessional thoughts, impulses or images are a product of his or her own mind  1% in nonreferred adolescents  Most estimates suggests that at younger ages, boys outnumber girls, but that by adolescence, the genders are equally represented

Anxiety Disorders Posttraumatic Stress Disorder (PTSD)

Answer: The current DSM criteria for PTSD require exposure to a serious traumatic event to which the child or adolescent shows an intense fearful reaction. The young person must also experience the PTSD triad of symptoms – re-experiencing, avoidance, and arousal – for more than 1 months. In addition, the disturbance must cause significant interference in important areas of the youth’s functioning. The individual has persistent symptoms of increased arousal (not present before the trauma). Acute: if duration of symptoms is less than three months Chronic: if duration of symptoms is three months or more  Some victims of violent crime may be at particular risk. For example, infants and younger children are at greater risk for maltreatment and homeless adolescents are at increased risk for victimization  One quarter of children and adolescents had experienced a serious traumatic event by the age of 16, 1/3 of them PTSD  Higher incidence of PTSD among girls

Mood Disorders Depression Dysthymic Disorder

Answer: It is essentially a disorder in which many of the symptoms of a major depressive episode are present less severe from but are more chronic – that is, they persist for a longer period of time. Depressed mood most of the day for more days than not, for at least 2 years, and the presence of two or more of the following symptoms. 1. Depressed or irritable mood 2. Poo appetite of overeating 3. Sleep disturbance 4. Low energy or fatigue 5. Loss of self-esteem 6. Concentration or decision-making problems 7. Feelings of hopelessness The symptoms must cause clinically significant distress or impairment.  Prevalence rates between 0.5 and 1.5% for children and between 1.5 and 8.0% among adolescents

Mood Disorders Depression Adjustment Disorder with Depressed Mood

Answer: This disorder is described by the presence of one or more major depressive episodes. Depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day. 1. Depressed or irritable mood 2. Loss of interest of pleasure 3. Change in weight or appetite 4. Sleep problems 5. Motor agitation or retardation 6. Fatigue or loss of energy 7. Feelings of worthlessness or guilt 8. Difficulty thinking, concentrating, or making decisions 9. Thoughts of death or suicidal thoughts/behavior  Major depressive disorder is the most frequently diagnosed mood disorder among children and adolescents  Children ranging between 0.4 and 2,5% and adolescents between 0.4 and 8.3%