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Anxiety disorder in childhood Origins of ear
Health of baby- crying Infant needs to learn how to regulate emotion Facialexpressions High heartrate
Uses shadow casting Looks like expanding dot B4 9m reflexive blinking 8-9m anticipatory reaction- heart rate increased
Gibson & Walk
Depth perception Visual cliff Babies arenÂ’t afraid until can crawl 5ms heart rate slows- attention 9m heart rate acceleration
end 1st year of life wariness to strangers
Reingold and Eckeman
Predicatbility Control How mother reacts
noisy bear if unpredictable cried if could push button ok
Ross & Goldman
Intrusive strangers vs people who wait -better to wait
Look in mirror Red dot on nose
One way window- Platform self regulation experiment Ramp
Cognitive appraisal of situation Look to motherÂ’s emotion 2-3yrs kids talk about emotion scared or afraid Fears expand when lang development and imagination And understanding of future Fears change as get older
Silverman 95
273 kids semistructured interview what is it they worry about health school physical harm performance lowest worry appearance
temperament personality
behavioral inhibiton
Diff scared types of things: Inhiibited Average Disinhibited (rel to boulby attachment)
Longtitudinal High activity and positive mood At four months
High heartrate as foetus and activity in womb
Blue eyed narrow faces and diff temp on forehead Individ diffs may b undergenetic control
Bio environmental development
Neuroendocrine reponse Pituary adrenal gland 6months- finetuned damping down of cortisol response to stress over time hemispheric specialisation frontal lobe activation for +ive and –ive emotion Neuroendicrine development Reactivity to events decreases= sharp increase in cortosol
Cortosol level measured at 2ms old Decreases by 4 and 6ms Individual difs Cortosol correlated btw 2m and 4m =0 2-6m correl a little 4 sig correl w response at 6m individual diffs level out over development
Fox and davidson
electrodes on head +ive emotion = L activation -ive emotion = R frontal activation High levels of cortosol in baby saliva High levels of frontal asymmetry
Early fearfulness and inhibition
Kids w parents w panic dis- have probs Kids w fearfulness shy in preschool Early fearfulness in babies: high risk for anxiety dis
Biederman –
kids w anxious parents Inhibitied kids high risk for social anxiety 16% less likely to be diagnosed w disruptive behavior dis not inhib- opposite trend
If risk for panc dis / dep – high risk for SAD Parent may panic therefore fx kid Parental panic disorder associated with panic attack and agoraphobia. Parental psychopathology
General characteristics
Oversensitivity Unreaslistic fears Shyness/ intimdated Pervasive inadequacy Sleep disturbances Fear of school Dependency
Ethnic diffs
North America African american vs hispanic or european
Ordinance of national statistics survey
Only asked mothers May be underestimates in UK 5-15yrs Twice incidence in girls 0-15yrs than 5-10yrs Anxiety disorder –different most common is seperation anxiety
SLCDS 11 yr olds
London community sample Child and mother say symptoms Girls greater than boys No sig diffs btw girls and boys
Diagnostic criteria
Excessive anxiety after sep from home or primary caregiver Not baby
Excessive distress Persistent worry Reluctance to be alone Refusal to go to sleep Nightmares Physical symptoms Worry about loosing or harm
199 kids 8-13yrs
high comorbid diag than kids w GAD/ social phobia and exteranlizing probs
Longtitudinal study Clinical/ subclinical separation anxiety Assessed at 3& 6 Yrs Clin diff from non clin Diag not stable over time SAD high comorbid diag Parents of SAD high dep and OCD and phobias
Great smoky mountains study
Anxious school refusal vs truancy 13 more likely to be depressed SAD 8.7 more likely to have diagnoses of this Truency- odd –2.2 x as likely and cd-7.4 x as likely
Hay & Pawlby 2003
Adversities of child Mother been murdered some had but ?is it a sign of empthay look at other info in sample kids high prosocial and internalizing low externalizing- t think of childÂ’s inner world high prosocial kids may be anxious and visa versa
genetic transmission
comorbidity 4 emotional problem
parental depression
fx attatchment
Hay 2003
SLCDS study
High rate of SAD if parent depressed post natally, even if depression worn off quickly
Angold costello and erkmann 99
internalizing probs
Beidel Turner & morris 99
child meets more than one category for externalizing disorder
Barrios & O'dell 98
Tripartite model
a)overt behavioral response
running away
b)physiological reponse (change heart rate)
c) subjective response - feeling upset
Rabian & silverman 2000
Disagreement over categorisation
DSMIV approache
Correlational approach- empiracle
41/2 days old: fearful reaction
McFarlane 54
Longditudinal study
Kids 2-4 yrs
Specific fears 90% time
Laponse & Monk 59
43 % of 6-12 yr olds 7 or more fears
Mothers 41% fewer fears than child reports
Gullone 2000
longditudinal study
normal fears transitory
Miller, Barrett & Hampe 74
Less than 5% mothers = kid w extreme fears
Rutter 70
Isle of white study
7/1000 10-11yrs olds
Ollendick 83
3-11yrs = 9-13 fears
Kirkpatricks 84
15-17 yrs 2-3 fears
Rutter 89
More extreme fears
Bell-Dolan 90
anxiety dis btw 10.7 22.6 %
Gilburg silverman 2000
maybe only girls admit to fear
Bauer 76
Developmental change = change in perception
Ollier King 89
Frequency of fears across age declines
Thurber & Sigman 98
Hersov 60
School refusal
Kessler 88
child agressive projection
fears will be carried out
Kearney & Silver
differentiated school refusal vs truancy
Albano 96
12-13% primary diagnoses of separation anxiety disorder
Last 96
anxiety often get depressed later
King 2000
School refusal
1-2% in general population
5% clinical population
no sex difs
Last & Strauss 90
69% of refusal to do with school refusal
Bernstein 2001
Prognosis best for kids under 10 yrs
Blagg & Yule 94
Important to get child back to school
Elliot 99
Longterm anxiety can escalate
Dolan 2002
emotions are complex psychological and physiological states to a greater or lesser degree index the occurances of value
Morris 98
Amy= lots of blood activity w fear resp
Adolphs 99
Lesion amy = impare cog to fearful faces
Bentin & Carmel 2002
Brain circuits relative to fear give off SCR
Kotsoni 2001
9-8m infants attend to fearful eyes
dehan 2002
electrical brain impluses for fear found in 6m infants
Morris & Dolan 2002
Amy responds to eye contact - esp eye response

Think butterflies with eyes and peacock feathers!
Morris 2002
adults find hard to make eyecontact w strangers
Familiarity inversley proportional to threatening activity in amy when seeing familiar face
fear and anger pathways associated
Mineka & Oluman 2002
monkeys need to learn that are afraid of snake before occurs
social learning
Cahill 99
visual cliff
storage in amy facilitates learning
mother's eyes enought to make circuit
Marks 87
Social learning
King Eleonora Ollendick 97
social learning parents TV,peers
Moracco & Camilleri 83
New brain synapses formed for fear
Muris, Merkelback 2000
Chiuldhood fears asociated w subclinical manifestations 49%
23% full criteria for anxiety dis
Muris Merkelbach 2000
Parent interviews
Fulfilled criteria
evolution of fear
Boulby 73
Theory of attachment
Cannon 29
adaptive functions
Ekman & Fieson 71
basic emotions invariant
Field Woodson
inborn basic emotions
Kalin 91
Fear in monkeys determined by neurochemical systems
Hiatt 79
not consistent fear facial expressions therefore not innate
Caldi Tannenbaum, Sharma 98
fearful responses to stress programmed by maternal care
Donovan & Spence 2000
Multiple risk factors
Kiln 2001
anxiety dis happen in families
Lichenstein & Anhos 2000
gender diffs influences
Girls treated better
Last 91
Interviewed family
kids w anxiety, ADHD none
Parents of kids w anxiety dis were more anxious
Litchenstein & Annas 2000
Twin studies DZ vs MZ high concordance for anxiety dis
Eaves 97
Virginia twin study
Lower heritability than other disorders
King & Ollendick 97
gender factors limited to role
emotional responsivity may be cause
viginia twin study
high anxiety girls vs boys
Lichtenstien and Annas 2000
environment important
Kagan 97
temperamental 51/2 yrs kids are inhibited high fears than uninhibited kids
Kagain 90
inhibited fears - not caused by trauma
uninhibited fears- caused by trauma
Kagan & Biederman 93
Sig difs btw inhib and non inhib- inhib for criteria for dishabited
Ollendick & King 91
Families create environment for kids to be at risk
Natson & Rayner 20
Little albert

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