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1、PowerPoint Lecture Notes Presentation Disorders of Childhood 兒童期疾患,Abnormal Psychology, Tenth Edition by Ann M. Kring, Gerald C. Davison, John M. Neale, & Sheri L. Johnson,Copyright 2005 John Wiley & Sons, NY,2,Classification and Diagnosis of Childhood Disorders 兒童期疾患的分類和診斷,Developmental psychopatho
2、logy 發展的心理病理學 Studies disorders of childhood within the context of normal child development 在正常兒童發展的背景脈絡下研究兒童期的疾患 Externalizing disorders 外化性疾患 Characterized by outward behaviors 以外化性的行為為其特性 Noncompliance, aggressiveness, overactivity, impulsiveness 不服從,攻擊,過動,衝動 More common in boys 在男孩較普遍 Internaliz
3、ing disorders 內化性疾患 Characterized by inward behaviors 以向化的行為為其特性 Depression, anxiety, social withdrawal 憂鬱,焦慮,社會退縮 More common in girls 在女孩較普遍,Copyright 2005 John Wiley & Sons, NY,3,Table 14.1 Chapters Where Disorders are Discussed That Occur in Both Children and Adults 在兒童和成人身上皆會發生的疾患章節,Copyright 2
4、005 John Wiley & Sons, NY,4,Attention Deficit/Hyperactivity Disorder 注意力不足/過動疾患,Excessive levels of activity 過多的活動 Fidgeting, squirming, running around when inappropriate, incessant talking 不安,扭動,不恰當的走動,不停的說話 Distractability and difficulty concentrating 分心和有困難集中 Makes careless mistakes, cant follow
5、instructions, forgetful 粗心犯錯,不能聽從指令,健忘 Must be severe and persistent 必須嚴重且持續 Present for at least 6 months and cause impairments in functioning 持續至少六個月並產生功能的受損,Copyright 2005 John Wiley & Sons, NY,5,Attention Deficit/Hyperactivity Disorder 注意力不足/過動疾患,Three subcategories in DSM-IV-TR 在DSM-IV-TR中可分為三個
6、亞型： Predominantly inattentive type 主要為不注意型 Predominantly hyperactive-impulsive type 主要為過動-易衝動型 Combined type 複合型 Differential diagnosis 鑑別診斷 ADHD or Conduct Disorder? 注意力不足過動疾患或品性疾患？ ADHD注意力不足過動疾患 More off-task behavior, cognitive & achievement deficits 較多無法達成工作的行為,認知和成就上缺陷 Conduct Disorder 品行疾患 Mor
7、e aggressive, act out in most settings, antisocial parents, family hostility 較多攻擊性, 常出現動作外化行為,反社會性父母,家人敵意,Copyright 2005 John Wiley & Sons, NY,6,Attention Deficit/Hyperactivity Disorder 注意力不足/過動疾患,ADHD often comorbid with anxiety and depression 通常和焦慮和憂鬱共病 Prevalence estimates 2 to 7% 盛行率估計約2到7 Sympt
8、oms persist beyond childhood 症狀在兒童期之後仍持續 Most still meet criteria in adolescence 大部分在青少年期仍符合準則,Copyright 2005 John Wiley & Sons, NY,7,Etiology of ADHD 注意力不足過動疾患的病因學,Genetic factors 遺傳因素 Twin studies 雙生子研究 Heritability estimates as high as 70 to 80% 遺傳率估計有百分之70到80高 Two dopamine genes implicated 二個多巴胺
9、基因受到影響 Neurobiological factors 神經生物因素 Underresponsive frontal lobes 額葉反應性低 Reduced cerebral blood flow 大腦血流量減少 Smaller frontal lobes, caudate nucleus, globus pallidus 額葉,尾核和蒼白球較小,Copyright 2005 John Wiley & Sons, NY,8,Etiology of ADHD 注意力不足過動疾患的病因學,Perinatal and prenatal factors 出生前後和產前因素 Low birth
10、weight 出生體重低 Maternal tobacco and alcohol use 母親吸菸和酒精使用 Environmental toxins 環境毒素 Food additives and sugar not related to ADHD 食品添加物和糖與注意力不足過動疾患沒有相關 Nicotine from maternal smoking 來自母親吸煙所產生尼古丁 May damage dopaminergic system in fetus 可能損害胎兒多巴胺內生性系統,Copyright 2005 John Wiley & Sons, NY,9,Etiology of A
11、DHD 注意力不足過動疾患的病因學,Psychological Factors 心理因素 Ineffective parenting, negative interactions 無效能的親職教育,負向互動 Probably interact with genetic and neurobiological factors 可能和遺傳和神經生物因素產生交互影響 Likely to exacerbate or maintain ADHD behaviors but not cause them 很可能惡化或維持ADHD的行為問題但不會造成此疾患,Copyright 2005 John Wiley
12、 & Sons, NY,10,Treatment of ADHD 注意力不足過動疾患的治療,Stimulant medications 興奮劑藥物治療 Reduce disruptive behavior 降低破壞性行為 Improve attention and concentration 改善注意力和專心 Ritalin 利他能 Adderall Concerta Strattera Side effects 副作用 Loss of appetite 失去食慾 Sleep problems 睡眠問題,Copyright 2005 John Wiley & Sons, NY,11,Treat
13、ment of ADHD 注意力不足過動疾患的治療,Psychological treatment 心理治療 Operant conditioning 操作制約 Parent training 父母親訓練 Classroom management and teacher training 課堂管理和老師的訓練 Classroom structure 課堂結構 Brief assignments 簡短的作業 Immediate feedback 立即回饋 Task-focused style 聚焦於作業的方式 Breaks for exercise 中間休息以作運動,Copyright 2005
14、 John Wiley & Sons, NY,12,Conduct Disorder (CD) 品行疾患,Pattern of engaging in behaviors that violate social norms, the rights of others, and are often illegal.從事違反社會規範,侵害他人權利和經常犯法的行為模式 Aggression 攻擊 Cruelty towards other people or animals 虐待他人或動物 Lying 說謊 Stealing 偷竊 Vandalism 暴力行為 Often accompanied b
15、y lack of remorse and callousness 通常伴隨缺乏憐憫和無情,Copyright 2005 John Wiley & Sons, NY,13,Oppositional Defiant Disorder (ODD) 對立性反抗疾患,ODD behaviors do not meet criteria for CD but child displays pattern of defiant behavior 對立性反抗疾患的行為並不符合品行疾患的準則 但兒童呈現反抗的行為模式 Argumentative 愛爭論的 Loses temper 脾氣不佳 Lack of c
16、ompliance 缺乏服從性 Deliberately aggravates other 故意激怒他人 Hostile, vindictive, spiteful, or touchy 充滿敵意,懷恨,惡意或暴躁的 Blame others for their problems 將自己的行為問題責怪他人 Most often diagnosed in boys but may be as prevalent in girls 通常診斷於男孩但女孩也可能很普遍,Copyright 2005 John Wiley & Sons, NY,14,Conduct Disorder (CD) 品行疾患,Many times first identified by legal authorities 通常會先被法庭發現其問題行為 Juvenile delinquents 青少年罪犯 Substance abuse common普遍有物質濫用
