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Part II ISQ Club - Child Psychiatry

57 posts in this topic

Part II ISQs will be posted regularly. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

1. Genes are as important as relationships are determining adjustment in children.

2. Children of parents with personality disorder are more likely to have mental disorder than children of parents with schizophrenia.

3. A baby experiences visual cliff regardless of mother's facial expression.

4. Theory of mind develops around the age of 4 years.

5. If a child of six can read 6 words or less this predicts he/ she is more likely to develop mod/severe learning disability.

6. If a child of 6 has not developed clear right/left dominance he/ she is more likely to develop mod/severe learning disability.

7. Concrete operational thinking is protective against depression in children.

8. Clonidine and methylphenidate together are more effective than either alone in treatment of ADHD with associated tics.

9. Impulsivity is not associated with Prader-Willi syndrome.

10. Impulsivity is characteristic of Prader Willi syndrome.

11. Prader Willi is associated with self mutilation.

12. Lesch-Nyhan is a sex linked disorder.

13. Fragile X is associated with repeats on the short arm of the X chromosome.

14. Gaze avoidance is characteristic of Fragile X.

15. Lack of empathy is characteristic of Asperger's syndrome.

16. Angelman’s syndrome causes EEG changes by the age of 1 year.

17. Screening for galactosaemia can decrease the amount of mental retardation.

18. A 15 month old baby who refuses to open their arms to their primary caregiver when she comes back is a sign of insecure attachment.

19. The heritability of conduct disorder is in the range 0.1 - 0.2.

20. Partner abuse is more common in family with teenage children.

21. Partner abuse is more common in family with teenage children than a family with young children.

22. In divorce, adjustment difficulties are seen in children before the event even if lack of parental conflict.

23. When mother remarries, girls are more likely to be distressed than boys.

24. Deliberate self harm in an adolescent girl usually occurs immediately after an episode of parental criticism.

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13.fragile x is associated with repeats on the short arm of the X chromosome

FALSE - long arm

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11. Prader Willi is associated with self-mutilation

FALSE

(Lesch-Nyhan assoc. with self-mutilation)

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18. 15/12 baby refusing to open arms to caregiver on reunion is a sign of insecure attachment

TRUE

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14 Gaze avoidance is characteristic of Fragile X

FALSE

In Goodman & Scott it's 'common in' and 'associated with' Fragile X, but not characteristic of it

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17 Screening for galactosaemia can decrease amount of mental retardation

TRUE (Goodman & Scott)

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9.Impulsivity is not associated with Prader-Willi syndrome - false

10.Impulsivity is characteristic of Prader Willi syndrome - false.

11.Prader Willi is associated with self mutilation - ?

'Although described as pleasant, good-tempered, and cheerful, subjects with Prader– Willi syndrome can manifest severe behavioural problems associated with hyperphagia and self-injurious behaviour particularly in the form of incessant spot picking and temper tantrums. A behavioural syndrome consisting of motor slowness, skin picking, sleepiness, ritualistic behaviour, impulsive talk, and stubbornness has been described.'

-(oxford tp, 8.5 Specific conditions leading to mental retardation)

12.Lesch-Nyhan is a sex linked disorder - true,

X-linked recessive condition,long arm of chromosome Xq26-27.

http://www.ninds.nih.gov

13.Fragile X is associated with repeats on the short arm of the X chromosome - false.

The fragile X mental retardation 1 (FMR-1) gene. The genetic abnormality is caused by abnormal trinucleotide CGG repeat at a fragile site on the X chromosome (Xq27.3). In cases of phenotypically manifested fragile X syndrome, CGG repeats range from 230 to over 1000.(normal CGG repeats 54-200)

14. Gaze avoidance is characteristic of Fragile X - false, (can occur in autism)

still there is a controversy about these phenotypes and not yet established by evidence-

oxford tp

16. Angelman’s syndrome causes EEG changes by the age of 1 year - true.

Angelman syndrome can be diagnosed in the first year (6-12 months) if the diagnosis is given due consideration. An abnormal EEG may be the first sign for diagnostic evaluation [boyd et al., 1988]. Abnormal EEG, characteristic pattern with large amplitude slow-spike waves (usually 2-3/s), facilitated by eye closurehttp://www.angelman.org/diagnostic_criteria.htm

4. Theory of mind develops around the age of 4 years - true, ox t p

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8. Clonidine and methylphenidate together are more effective than either alone in treatment of ADHD with associated tics - true

Methylphenidate and clonidine (particularly in combination) are effective for ADHD in children with comorbid tics

Treatment of ADHD in children with tics: a randomized controlled trial.

Neurology. 2002 Feb 26;58(4):527-36.

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2. Children of parents with personality disorder are more likely to have mental disorder than children of parents with schizophrenia. TRUE

('Child Psychiatry', R.Goodman; S. Scott):

....In most cases, however, the adverse effects of parental psychiatric disorder are mediated by the children's exposure to parental hostility and marital discord. These factors increase the risk of emotional and behavioural problems in children in general.

Parents with personality disorder,(whether antisocial or otherwise) are even more likely than parents with affective or psychotic disorder to have children who develop conduct disorders.

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1. True - there is extensive evidence documenting relatively strong associations between psychosocial stresses and adversities of various links and psychiatric disorder in childhood and adolescence. Moreover, at least with some adversities, there are grounds for supposing that the associations represent environmental causative influences, even though many supposedly environmental factors include a genetic component.

I would therefore say that genes and environment are likely to have similar influence on a child's adjustment.

Rutter, 3rd Edition (p.9)

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9. Impulsivity is not associated with Prader-Willi syndrome. -- false

10. Impulsivity is characteristic of Prader Willi syndrome----false not characteristic.

11. Prader Willi is associated with self mutilation.-- usually not but can be seen as skin picking

12. Lesch-Nyhan is a sex linked disorder.-- true

13. Fragile X is associated with repeats on the short arm of the X chromosome.-- false

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2. False - interrelatedness between parent disorder and child functioning may not be a function of a specific psychiatric disorder in the parent, but rather the presence of risk factors that mark troubled families, e.g. genetic and biological influences as well as those provided by negative psychosocial and psychological similarities: family discord, poor parenting, economic distress, poverty, unemployment, welfare status and overcrowding in inadequate housing conditions.

Rutter, 3rd Edition (p.193)

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3. False - see Sorce et al (1985) Maternal Emotional Signalling Theory.

Thanks, Zoran :D

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4. True - it is argued that theory of mind develops between the ages of 4 and 6, though some believe children as young as 2 have theory of mind. This is the ability to recognise that other people have minds of their own.

Baron-Cohen

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5. False - a child of 6 would not be expected to be able to read as many words as this.

Seminars in Child Psychiatry (p.9)

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6. True - right-left dominance generally develops at around 1 year. If this is not clearly present in a six-year old it would imply the presence of marked LD.

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3. A baby experiences visual cliff regardless of mother's facial expression.

FALSE, according to this:

Maternal Emotional Signalling.

Sorce et al., (1985) investigated maternal emotional signalling and its effects on the visual cliff behaviour of one-year-olds.

Infants on shallow side, mothers on deep side. Infant coaxed to within 38cm of the drop off point.

Half the mothers posed happy, half fear.

No infants crossed when mother fearful; 14/19 crossed when mother appeared happy.

Second study with sad, angry and interested mothers

2/18 crossed when mother angry; 11/15 when interested

6/18 when sad. If no drop  off on the cliff 20/24 crossed

Reference: Google

http://www.google.co.uk/search?q=cache:fBMB60kF8rAJ:psychology.unn.ac.uk/marion/webdevptl%2520files%255Clec07%255Clec07.ppt+%22visual+cliff%22+%22facial+expression%22&hl=en

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7. True - concrete operational thinking is protective against depression in children.

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8. True - Methylphenidate and Clonidine (particularly in combination) are effective for ADHD in children with comorbid tics.

Neurology 2002: 58(4); 527-536

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11. Prader Willi is associated with self-mutilation

FALSE

(Lesch-Nyhan assoc. with self-mutilation)

but the seminar series says that there is repeated skin picking in Prader Willi....so i would say true for this question

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5. If a child of six can read 6 words or less this predicts he/ she is more likely to develop mod/severe learning disability.

false.

most children are able to read single short words by the age of 6-7 years

seminars in child and adoloscent psychiatry.

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22. In divorce, adjustment difficulties are seen in children before the event even if lack of parental conflict

true

'some of the effects associated with divorce can be seen before couples separate'(Eliott & Richards).this might be due to the fact that divorce prone couples might have particular child rearing styles.

Richard Gross psychology.

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