CAP Interviews/Critical Issues
2 components of a developmental history
What is - in utero exposures, pregnancy complications, labor/delivery complications, early infant temperament, milestones, early childhood neglect/trauma, adoption history?
Two FDA indicated antipsychotics for management of ASD related aggression
What are risperidone and aripiprazole?
Maximum age for onset of symptoms for ADHD diagnosis
Primary differentiating features of depression for children vs adolescents
What is irritability, low frustration tolerance, temper tantrums, somatic complaints, or social withdrawal in children as compared to melancholia and suicide attempts in adolescents?
Duration of symptoms to qualify for social anxiety disorder
What is at least 6 months?
Describe two non-physical interventions to manage a difficult patient in the office
What is - stay calm, do not give in, differential attention, praise appropriate behavior, rewards system, time outs, help practice problem solving, avoid triggers?
2 Diagnostic tools
What is ADOS Autism Diagnostic Observation Schedule? Structured and semi-structured.
What is ADI-R Autism Diagnostic Interview - Revised? Minimum mental age of 24 months
2 rating scales for assessment of severity of ADHD symptoms
What are Conner's, Vanderbilt, ACTeRS?
Most frequent co-morbid diagnosis
What are anxiety disorders?
School refusal is a DSM diagnosis. True or False
What is false?
It is associated with several diagnoses to include GAD, social anxiety, MDD, ODD
Antidepressant Black Box Warning
Issued by the FDA in 2004 about the increased risk, 2% compared to placebo, of suicidal thinking, feeling, and behavior in persons <24 y.o.
In 2007, expanded to include that depression itself is associated with an increased risk of suicide
3 Predictors of Outcome
What are -
Presence of communicative speech by age 5
Overall cognitive ability (IQ)
Evidence that earlier detection and provision of services improves long term prognosis makes early diagnosis is particularly important?
5 Differential Diagnoses of ODD
Adjustment Disorder with disturbance of conduct, Conduct Disorder, ADHD, Anxiety Disorders, Mood Disorders, Substance Use Disorders, Intellectual Disability, ASD, Abuse/Neglect
2 types of therapy treatment with evidence from RCTs
What are CBT and IPT?
2 diagnoses treated by habit reversal training
What is Tourette's, Trichotillomania, skin picking?
Indication with definitions and process to file CPS report
Mandatory reporters of child and adolescent neglect “Failure of responsible caretaking adults to provide adequate physical care and supervision" or abuse “Injury of a child under 18 years to include physical harm, endangerment, inappropriate sexual conduct”
Complete 3200 form within 72 hours either online or faxed with a call within 24 hours to DHS. Include direct information obtained from clinical evaluation.
Early deficits observed in what prior to the age of 18 months
What is Joint attention (shared focus on an object between caregiver and child)?
5 of 15 criterion for CD
Aggression to People and Animals. Often bullies, threatens, intimidates others. Often initiates physical fights. Has used weapon that can cause serious physical harm. Has been physically cruel to people•Has been physically cruel to animals. Has stolen while confronting a victim. Has forced someone into sexual activity
Destruction of Property. Deliberate engagement in fire-setting with intention of causing serious damage. Has deliberately destroyed others’ property
Deceitfulness/Theft. Has broken into someone’s house, building, or car. Often lies to obtain goods or avoid obligations. Has stolen items of nontrivial value without confronting victim
Serious Violation of Rules. Stays out at night despite parental prohibitions (beginning <13 years).vRun away from home at least twice. School truancy (beginning <13 years)
2 characteristics of temper outbursts in DMDD
What are verbal or behavioral, grossly out of proportion in intensity/duration to satiation, inconsistent with developmental level, occur at least three times per week?
2 augmentation strategies for OCD treatment
What is clomipramine, antipsychotics (risperidone/aripiprazole), buspirone, 2nd SSRI, mood stabilizers (lithium, lamotrigine)?
At least 5 suicide risk factors
What is - history of suicidal behavior, male gender, ages 15-19, Native American, history of psychiatric illness (depression, substance use, disruptive disorders, panic attacks), aggression, impulsivity, interpersonal losses, trauma/abuse/bullying, higher SES, parental depression/substance use, poor parent-child relationships, parents or 1st degree relatives with completed suicide?
A: Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history •Deficits in social-emotional reciprocity. •Deficits in nonverbal communicative behaviors used for social interaction •Deficits in developing, maintaining, and understanding relationships
B: Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history.•Stereotyped or repetitive motor movements •Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior •Highly restricted, fixated interests that are abnormal in intensity or focus •Hyper-or hyporeactivityto sensory input or unusual interests in sensory aspects of the environment
3 Neurophysiological or Neuroanatomical changes in ADHD
What are Impairments in working memory, impairments in central executive fxn, Differential response to reward and delay aversion, Difficulty tolerating delayed rewards, Hyporesponsive to reward, Deficits in temporal processing?
What are reduced volumes of brain regions (cerebellar structures, total cerebral volume) or global cortical maturational delay?
Best studied treatment for DMDD
Outcome of Pediatric OCD Treatment Study (POTS)
What is Placebo < Sertraline = CBT < Combo treatment?