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PSYCH205: Clinical Psychology

Unit 8: Age-related Disorders: Children and the Elderly   Most disorders can arise at any time during a person’s lifetime, though they may be statistically more common at one stage or another. However, certain disorders only develop within specific age ranges, making age diagnostically significant. This unit will take a look at individuals at risk for age-related disorders at both ends of the age spectrum: children and the elderly. You will learn about disorders frequently seen in either childhood or late adulthood and identify their courses of action, etiologies, and treatments.

Unit 8 Time Advisory
Completing this unit should take you approximately 1.5 hours.

☐    Subunit 8.1: 1 hour

☐    Subunit 8.2: 0.5 hours

Unit8 Learning Outcomes
Upon successful completion of this unit, you will be able to:
- describe the current developmental theory of mental health and illness in children;
  - define the symptoms of common mental disorders that manifest in childhood; and
  - explain the assessment and diagnosis of Alzheimer’s Disease and how the disease differs from the normal aging process.

8.1 Disorders of Childhood: Symptoms, Etiology, and Treatment   - Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health” Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health”** (PDF)
 
Instructions: Please click on the above link and read the section entitled “Attention Deficit/Hyperactivity Disorder” and all the subsections under the section entitled “Other Mental Disorders in Children and Adolescents,” with the exception of “Anxiety Disorders,” as you have already read this subsection. If you would like, you can download the PDF version by scrolling down to the bottom of the page, clicking on “Contents,” and then selecting the PDF version of “Chapter 3: Children and Mental Health,” which includes the sections listed above. Please note that the pages in the PDF bar at the top of the document do not match the pages in the table of contents section on the first page. 

 This reading covers Subunits 8.1.1–8.1.5.  

 Reading this text and taking notes should take approximately 1
hour.  
    
 Terms of Use: This material is part of the public domain. 

8.1.1 Attention Deficit/Hyperactivity Disorder   *Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and hyperactivity-impulsivity. These symptoms usually occur together and onset of symptom presentationoccurs frequently and in multiple settings. Prevalence of the disorder is difficult to determine due to differences in diagnostic criteria, but it has been noted that boys are more likely to develop ADHD than girls. Exact etiological causes of ADHD are unknown although there are implications of neurotransmitter deficits, genetics, prenatal complications, as well as environmental exposure to toxins. Treatments for ADHD include pharmacological therapies, such as psychostimulants, and psychosocial therapies, as well as multimodal therapies. However, there are treatment issues such as overprescribing of stimulants and safety concerns of long-term stimulant use.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 142–150 for additional information.*

8.1.2 Autism   *Autism is the most prevalent developmental disorder in children. Etiological causes are rooted in structural brain abnormalities, genetic predisposition, and cognitive deficits in neural circuitry. Treatment for autism focuses on promotion of social and language development, applied behavioral methods, and antipsychotics.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 163–164 for additional information.*

8.1.3 Disruptive Disorder   *Disruptive disorders are a collection of behaviors rather than patterns of mental dysfunction. There are several disorders that are classified as a disruptive disorder, including opposition defiant disorder (ODD) and conduct disorder. The etiology of these disorders is not fully known, although there are implications that the cause may be a combination of various biological and psychosocial components. Psychosocial intervention is effective in treating disruptive disorder but there is no consistent pharmacotherapy.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 164–166 for additional information.*

8.1.4 Substance Use Disorders in Adolescents   *Causality or prediction of substance use disorders in adolescents is not well known, but research indicates a significant co-occurrence of alcohol and other substance use disorders with mental disorders. Research also indicates that multi-systemic family therapies are an effective treatment for substance use disorders.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 166–167 for additional information.*

8.1.5 Eating Disorders   *Eating disorders (e.g., anorexia nervosa, bulimia) typically arise during adolescence, but there are age-of-onset and gender differenceswith these mental disorders. Females are disproportionately affected by eating disorders and age of onset is mid- to late-teens. The etiology of eating disorders is not precisely known, but there are implications that a combination of genetic, neurochemical, psychodevelopmental, and sociocultural factors affect development. Various psychotherapies and pharmacotherapies are used to treat eating disorders.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 167–168 for additional information.*

8.2 Older Adults and Alzheimer’s Disease   - Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): "Chapter 5: Older Adults and Mental Health" Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999):** "Chapter 5: Older Adults and Mental Health" (PDF)
 
Instructions: Read the section titled “Alzheimer’s Disease.” Please note that the pages in the PDF bar at the top of the document do not match the pages in the table of contents section on the first page. 

 This reading also covers the topics outlined in Subunits
8.2.1–8.2.5.  
    
 Reading this text and taking notes should take approximately 30
minutes.  
    
 Terms of Use: Please respect the copyright and terms of use
displayed on the webpage above.

8.2.1 Assessment and Diagnosis   *Assessment and diagnosis of Alzheimer’s is difficult due to the lack of biological markers, subtle onset, and the need to exclude other dementia causes. It is important to differentiate between mild cognitive impairment (i.e., age-related cognitive decline) and the necessary characteristics for Alzheimer’s diagnosis (e.g., memory impairment combined with an additional impairment such as language or executive functioning, and impairments in social and occupational functioning). This disease is associated with a range of cognitive and behavioral symptoms and the course of the disease implicates a gradual decline in function over the course of the illness. The prevalence and incidence rates of Alzheimer’s are significantly high (i.e., “graying of America), and result in a high cost/economic burden for managing the disease.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 356–360 for additional information.*

8.2.2 Etiology   *The etiology of Alzheimer’s is not completely understood, but there are indications that the disease results from a combination of genetic and environmental aspects. More specifically, biological factors, such as chromosomal mutations, plaques, and neuronal/synaptic losses, greatly increase Alzheimer’s development.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 360–361 for additional information.*

8.2.3 Protective Factors   *While there are many suspected causes of Alzheimer’s, there are also many protective factors that may delay disease onset. Factors such as specific allele expression, use of certain medications (i.e., nonsteroidal anti-inflammatory drugs and estrogen), interference of histopathological changes (e.g., therapies to decrease plaque aggregates or neuronal cell death), and understanding the role of acetylcholine (as this neurotransmitter is implicated in Alzheimer’s pathogenesis), may all contribute to delaying the progression or preventing the development of the disease.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 361–362 for additional information.*

8.2.4 Treatment   *Pharmacological and psychosocial therapies are both used to treat Alzheimer’s. Pharmacological therapies include acetylcholine inhibitors and therapeutic medications for behavioral symptoms. Psychosocial therapies include techniques used to preserve cognitive functioning and assist patients and caregivers in managing the disease.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 362–364 for additional information.*

The Saylor Foundation’s “Unit 8 Assessment”   - Assessment: The Saylor Foundation’s “Unit 8 Assessment” Link: The Saylor Foundation’s “Unit 8 Assessment”

 Instructions: Complete this unit assessment. For each question,
pick the best possible answer. The correct answers will be displayed
when you click the "Submit" button.  

 You must be logged into your Saylor Foundation School account in
order to access this quiz.  If you do not yet have an account, you
will be able to create one, free of charge, after clicking the
link.  

 Completing this assessment should take approximately 15 minutes.