Deficits in Emotional Regulation in ADHD
|
|
- Melina Morgan
- 5 years ago
- Views:
Transcription
1 Deficits in Emotional Regulation in ADHD Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital
2 Disclosures My spouse/partner and I have the following relevant financial relationship with a commercial interest to disclose: Research support: DOD, AACAP, Alcobra, Forest Research Institute, Ironshore, Lundbeck, Magceutics Inc., Merck, PamLab, Pfizer, Shire Pharmaceuticals Inc., SPRITES, Sunovion, Vaya Pharma/Enzymotec, and NIH. Honoraria for tuition-funded CME courses: MGH Psychiatry Academy Royalties paid to the Department of Psychiatry at MGH, for a copyrighted ADHD rating scale used for ADHD diagnoses: Ingenix, Prophase, Shire, Bracket Global, Sunovion, and Theravance US Patent Application (Provisional Number #61/233,686) through MGH corporate licensing, on a method to prevent stimulant abuse.
3 Amgydala-Prefrontal Circuitry Amygdala: Red Ventromedial prefrontal cortex: Blue Dorsomedial prefrontal cortex: Green (Kim 2011 Behavioral Brain Research)
4 Bipolar Disorder and Broader Definitions of Mood Disturbance Lewinsohn 1995 USA BPD 1 Lewinsohn 1995 USA Subsyndromal BPD 5.7 Costello 1996 USA 0 BPD Brotman 2006 USA Severe Mood Dysregulation 4 Stringaris 2009 UK 0.1 BPD Stringaris 2009 UK Mood Lability Percent with Disorder
5 Are All Forms of Irritability the Same? Heterogeneity of Irritability
6 Increasing Severity Heterogeneity of Irritability in Children ADHD ODD MDD MANIA Months Mick et al, 2007
7 Heterogeneity of Irritability Labile mood/hot temper: ODD Severe irritability: MDD Explosive/violent irritability: BPD Mick et al. Biological Psychiatry. 2005; 58:
8 Juvenile Mania The type of irritability observed in manic children is very severe, persistent, and often violent. The outbursts often include threatening or attacking behavior towards others, including family members, other children, adults, and teachers. Biederman et al. J Am Acad Child Adolesc Psychiatry. 1996; 35(8):
9 Irritability of ODD vs. Furiosity of Mania The irritable ODD child is hypersensitive to provoking stimuli from authority figures and may or may not be able to self-regulate The furious bipolar child is hypersensitive and experiences extremes of emotion that are impossible to self-regulate
10 Deficits in Emotional Regulation vs. Mood Disorders Deficits in emotional regulation are phenomenologically distinct from mood disorders, which are characterized by the experience of strong emotions, not their self-regulation Unlike deficits in emotional regulation, mood disorders require the presence of non-mood criteria including somatic and behavioral impairments Mood disorders show dysregulted mood throughout each episode, not only in response to provoking stimuli
11 Deficits in Emotional Regulation vs. Mood Disorders In contrast to mood disorders, subjects with deficits in emotional regulation do not have distinct episodes of DESR Unlike mood episodes, deficits in emotional regulation subsides relatively rapidly and does not form a distinct protracted episode of the type that would qualify for a mood disorder Thus, subjects with deficits in emotional regulation have normal moods but can become easily frustrated or angry with unexpected emotional challenges
12 Deficits in Emotional Regulation vs. Mood Disorders: Important Caveat Deficits in emotional regulation and Mood Disorders are not mutually exclusive and can co-exist
13 The MGH Study of Deficient Emotional Self Regulation in Pediatric ADHD
14 DESR in Pediatric ADHD Study Study Population 242 Youth with ADHD 224 Controls without ADHD
15 85 75 Mean 65 * CBCL Clinical Scales (Biederman et al., JAACAP, 1995) * * * * * * Bipolar ADHD Control p<0.01 Bipolar vs. ADHD Delinquent Behavior Aggressive Behavior Withdrawn Somatic Complaints Anxious Depressed Social Problems Thought Problems Attention Problems Significantly elevated in children of BPD parents (Wals et al., JAACAP, 2001)
16 CBCL Mood Dysregulation Profiles CBCL-DESR was operationalized using an aggregate score 180 and <210 in the Anxious/Depressed, Attention, and Aggression scales (AAA profile) of the CBCL CBCL-Severe Dysregulation (BP) profile was defined as 210 on the CBCL-AAA scale
17 Rates of DESR in ADHD and Control Youth (Spencer et al., Postgrad Med 2012) Controls p<.05 ADHD
18 ADHD Symptoms ADHD ADHD+DESR % No significant differences (all p>0.05)
19 Percent of subjects with ADHD-Associated Severe Impairment p< ADHD ADHD+DESR (Spencer et al., Postgrad Med 2012)
20 ADHD predicts DESR Independent of Lifetime History of Comorbidity (Spencer et al., Postgrad Med 2012) Regression model included individual comorbid disorders and ADHD as DESR predictors RED= association with DESR ADHD remained associated with DESR when covaried with each comorbidity Oppositional Defiant Disorder Conduct Disorder Multiple Anxiety Disorders Bipolar Disorder Major Depression Substance Use Disorders
21 Main Findings of Pediatric ADHD Study 44% of ADHD children had a + CBCL- DESR profile vs. 2% of controls (p<0.001) The CBCL-DESR profile was associated with elevated rates of anxiety disorders, CD and ODD but not major depression or bipolar disorder
22 Biederman et al. J Dev Behav Pediatr 2012;33(3):236-43
23 CBCL scores vs Glutamate levels Wozniak et al 2012 Solid lines represent the linear fits to the low score group data (blue) and high score group data (green). Dashed lines represent 95% confidence intervals.
24 The MGH Study of Deficient Emotional Self Regulation in Adult ADHD
25 DESR in Adults with ADHD Study Study Population 206 Adults with ADHD 123 Controls
26 Deficient Emotional Self Regulation (DESR) Methods in Adults with ADHD Barkley s Current Behavior Scale SCID / KSADS modules for Axis I disorders Quality of Life, Enjoyment, Satisfaction Scale- Short Form Social Adjustment Scale - Self Report Functional outcomes questionnaire
27 Deficient Emotional Self Regulation Inventory Items 1. Quick to get angry or become upset 2. Easily Frustrated 3. Over-react emotionally 4. Easily excited by activities going on around me 5. Lose my temper 6. Argue with others 7. Am touchy or easily annoyed by others 8. Am angry or resentful Severity: None (0), Sometimes (1) Often (2), Very Often (3) Items from Barkley s Current Behavior Scale
28 Rate of subjects endorsing DESR symptoms as Often or Very Often Not ADHD ADHD Item43 Item 1 Item 2 Item44 Item45 Item 3 Item50 Item 4 Item92 Item 5 Item93 Item 6 Item 7 Item 8 Item97 Item98 Item Item43 1 Item44 Item 2 Item45 Item 3 Item50 Item 4 Item 5 Item92 Item93 Item 6 Item97 Item 7 Item 8 Item Internal Consistency of Items (Cronbach s alpha: 0.90)
29 DESR in ADHD and Control Adults (Surman et al., American J Psychiatry, 2011) p< Controls ADHD
30 ADHD predicts DESR Independent of Lifetime and Current Comorbidity (Surman et al., American J Psychiatry, 2011) Regression model included individual comorbid disorders and ADHD as DESR predictors RED= association with DESR ADHD remained associated with DESR when covaried with each comorbidity Disruptive Behavior Disorders Major Depression Anxiety Disorders Alcohol Abuse Substance Dependence Bipolar Disorder Substance Abuse Alcohol Dependence
31 Quality of Life Enjoyment / Satisfaction in ADHD+DESR Probands ADHD/NOS n = 206; Control n =123
32 Social Adjustment Scale in ADHD+DESR Probands Correlation Functioning Domain Coefficient Z p 1. Work < Social/Leisure < Extended Famil y < Primary Relationship < Parenting Family Unit < Total SAS ScaleScore < ADHD/NOS n = 206; Control n =123
33 Rates of Divorce by Proband Diagnosis (Surman et al., American J Psychiatry, 2011) ADHD+DESR P=.001 vs. controls & ADHD ADHD Control
34 Percent of Subjects who Ever Had an Auto Accident (Surman et al., American J Psychiatry, 2011) ADHD+DESR p<.001 vs. controls p=.01 vs. ADHD ADHD p<.001 vs. controls Control
35 Intellectual Functioning and DESR (Surman et al., American J Psychiatry, 2011) ADHD+DESR ADHD Full Scale IQ WRAT Arithmetic All p s >.10 WRAT Reading
36 Rates of Executive Function Disorder in ADHD Adults With and Without DESR (Surman et al., American J Psychiatry, 2011) ADHD 33 All p s >.10 ADHD+DESR
37 Summary of DESR Findings in Adults with ADHD A Large Community Sample of Adults with and without ADHD reveals: DESR questionnaire validity Acceptable internal consistency Correlated with functional impairment A sizeable majority of ADHD Adults had DESR Comorbidity did not account for DESR in ADHD adults
38 Surman et al. Am J Psychiatry 2011
39 Percent (%) Emotional Dysregulation in ASD a***b*** Controls ADHD ASD 60 a*** 50 a**b*** 40 a*** a*** a* 10 0 Emotional Dysregulation Deficient Emotional Self-Regulation 0 Severe Emotional Dysregulation
40 Amgydala-Prefrontal Circuitry Amygdala: Red Ventromedial prefrontal cortex: Blue Dorsomedial prefrontal cortex: Green (Kim 2011 Behavioral Brain Research)
41 Resting state functional connectivity of amgydala correlation with reappraisal failure (or success) Reappraisal score: Self Report Ratings on Negative - Reappraisal
42 Tromp et al Arch Gen Psychiatry 2012;69(9):
43 What DESR is Not
44 Disruptive Mood Dysregulation Disorder (DMDD)
45 Heterogeneity of Irritability Severe recurrent temper outbursts grossly out of proportion to the situation or provocation The temper outbursts occur >3 times per week The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day There has never been a distinct period lasting > 1 day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met
46 Heterogeneity of Irritability A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both : 1. The child rarely seeks comfort when distressed 2. The child rarely responds to comfort when distressed A persistent social and emotional disturbance characterized by >2 of: 1. Minimal social and emotional responsiveness to other 2. Limited positive affect 3. Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers
47 Percent of Subjects HIGH EPA OMEGA-3 FATTY ACIDS AND INSOSITOL IN PEDIATRIC BPD STUDY: ANTIMANIC RESPONSE OR=1.33 OR=3.75 OR=3.75 OR=21.67 OR=5.83 OR= OR=3.33 a* OR=1.07 OR= OR=6.82 OR=6.82 OR= % YMRS Improvement % YMRS Improvement YMRS<12 at Endpoint Inositol (n=7) Omega-3 FA (n=7) Omega-3 FA + Inositol (n=10) CGI Mania Improvement 2 Wozniak et al, JCP in press
48 Summary Deficits in emotional regulation are frequently associated with ADHD and ASD in both children and adults Deficits in emotional regulation increase the risk for mood disorders and associated conditions Deficits in emotional regulation are associated with functional impairment in both pediatric and adult patients with ADHD and ASD Deficits in emotional regulation are independent of psychiatric comorbidity
49
Differentiating MDD vs. Bipolar Depression In Youth
Differentiating MDD vs. Bipolar Depression In Youth Mai Uchida, M.D. Staff Physician Clinical and Research Programs in Pediatric Psychopharmacology Massachusetts General Hospital Disclosures Neither I
More informationIs ADHD Always a Childhood Onset Disorder? Towards Understanding Adult Onset ADHD
Is ADHD Always a Childhood Onset Disorder? Towards Understanding Adult Onset ADHD Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric
More informationDifferentiating Unipolar vs Bipolar Depression in Children
Differentiating Unipolar vs Bipolar Depression in Children Mai Uchida, M.D. Director, Center for Early Identification and Prevention of Pediatric Depression Massachusetts General Hospital Assistant Professor
More informationPediatric Bipolar Disorder and ASD
Pediatric Bipolar Disorder and ASD Janet Wozniak, MD Associate Professor of Psychiatry Massachusetts General Hospital Disclosures My spouse/partner and I have the following relevant financial relationship
More informationDisruptive Mood Dysregulation Disorder
Walden University ScholarWorks School of Counseling Publications College of Social and Behavioral Sciences 2015 Disruptive Mood Dysregulation Disorder Brandy L. Gilea Walden University Rachel M. O Neill
More information5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development
By Pamela Pepper PMH, CNS, BC DSM-5 Growth and Development The idea that diagnosis is based on subjective criteria and that those criteria should fall neatly into a set of categories is not sustainable,
More informationIs ADHD Always a Childhood Onset Disorder? Towards Understanding Adult Onset ADHD
Is ADHD Always a Childhood Onset Disorder? Towards Understanding Adult Onset ADHD Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric
More informationDiagnosis & Assessment in Pediatric Psychopharmacology
Diagnosis & Assessment in Pediatric Psychopharmacology Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult
More informationMood swings in young people
Mood swings in young people Bipolar I & II Disorders are uncommon before puberty; Mood Dysregulation (MD) is very common before puberty Are they the same problem? What are the beginnings of bipolar? What
More informationRANZCP 2010 AUCKLAND, NEW ZEALAND
RANZCP 2010 AUCKLAND, NEW ZEALAND Dr Veronica Stanganelli et al. RANZCP 2010 1 INTRODUCTION Bipolar disorder within young people has been debated for years. It is still controversial in DSM V (1), whether
More informationChronic irritability in youth that may be misdiagnosed as bipolar disorder. Ellen Leibenluft, M.D.
Chronic irritability in youth that may be misdiagnosed as bipolar disorder Ellen Leibenluft, M.D. Chief, Section on Bipolar Spectrum Disorders Emotion and Development Branch National Institute of Mental
More informationSevere Mood Dysregulation in Children and Adolescents Research Findings Support Diagnostic Validity of Pediatric Bipolar Disorder
Severe Mood Dysregulation in Children and Adolescents Research Findings Support Diagnostic Validity of Pediatric Bipolar Disorder Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric
More informationPediatric Bipolar Disorder and ADHD
Pediatric Bipolar Disorder and ADHD Janet Wozniak, M.D. Director, Pediatric Bipolar Disorder Research Program Associate Professor Psychiatry Massachusetts General Hospital Harvard Medical School Disclosures
More informationEmotional lability in adults with ADHD: a core feature
Emotional lability in adults with ADHD: a core feature Philip Asherson MRCPsych, PhD Professor of Clinical and Molecular Psychiatry & Honorary Consultant Psychiatrist, MRC Social Genetic Developmental
More informationPediatric Bipolar Disorder: Advances in Diagnosis and Research
Pediatric Bipolar Disorder: Advances in Diagnosis and Research Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric Bipolar Disorder Research Program Harvard Medical School Massachusetts
More informationATTENTION DEFICIT HYPERACTIVITY DISORDER COMORBIDITIES 23/02/2011. Oppositional Defiant Disorder
ATTENTION DEFICIT HYPERACTIVITY DISORDER COMORBIDITIES The comorbidity of ADHD with other disorders is between 60% and 80% The most commonly comorbid disorder that occur alongside ADHD are: Oppositional
More informationThe shift in nosology from the Diagnostic PROCEEDINGS FROM CHILDHOOD TO ADOLESCENCE: DIAGNOSIS AND COMORBIDITY ISSUES * Thomas J. Spencer, MD ABSTRACT
FROM CHILDHOOD TO ADOLESCENCE: DIAGNOSIS AND COMORBIDITY ISSUES * Thomas J. Spencer, MD ABSTRACT Attention-deficit/hyperactivity disorder (ADHD) tends to manifest differently in adolescents than in children,
More informationJ. Indian Assoc. Child Adolesc. Ment. Health 2012; 8(1):1-5. Editorial
1 J. Indian Assoc. Child Adolesc. Ment. Health 2012; 8(1):1-5 Editorial Controversies in Paediatric Bipolar Disorder Vivek Agarwal 1, Sivakumar T 2 1.Editor JIACAM & Associate Professor, Department of
More informationTreatment of Bipolar Disorder in Youth
Treatment of Bipolar Disorder in Youth Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric Bipolar Disorder Research Program Harvard Medical School Massachusetts General Hospital
More informationPaediatric Bipolar Disorder & Transitions to adult services. Adi Sharma on behalf of ABS
Paediatric Bipolar Disorder & Transitions to adult services Adi Sharma on behalf of ABS Talk Paediatric Bipolar Disorder [PBD]: Why bother DMDD Comorbidity and/or Differential Diagnoses: EUPD, ADHD & ASD
More informationIntroduction. PMDC Team
Best Practices for Outpatient Program in Bipolar Disorder: Pediatric Mood Disorders Program at the University of Illinois at Chicago Julie A. Carbray PhD, PMHN-CNS Introduction five fold increase in diagnosis
More informationADHD Across the Lifecycle: Definitions and Overview
ADHD Across the Lifecycle: Definitions and Overview Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD
More informationBipolar Disorder in Youth
Bipolar Disorder in Youth Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric Bipolar Disorder Research Program Harvard Medical School Massachusetts General Hospital Pediatric-Onset
More informationADHD Across the Lifecycle: Definitions and Overview
ADHD Across the Lifecycle: Definitions and Overview Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD
More informationPharmacotherapy of ADHD with Non-Stimulants
Pharmacotherapy of ADHD with Non-Stimulants Timothy E. Wilens, M.D. Chief, Division of Child and Adolescent Psychiatry, (Co)Director of Center for Addiction Medicine, Massachusetts General Hospital Massachusetts
More informationAn empirically based alternative to DSM-5 s disruptive mood dysregulation disorder. for ICD-11
1 In press, World Psychiatry An empirically based alternative to DSM-5 s disruptive mood dysregulation disorder for ICD-11 John E. Lochman 1, Spencer C. Evans 2, Jeffrey D. Burke 3, Michael C. Roberts
More informationGoal: To recognize and differentiate abnormal reactions involving depressed and manic moods
Goal: To recognize and differentiate abnormal reactions involving depressed and manic moods Moods versus emotions DSM-IV mood disorders are now two separate categories in DSM-5 Depressive disorders Bipolar
More informationPharmacotherapy of ADHD with Non- Stimulants
Pharmacotherapy of ADHD with Non- Stimulants Timothy E. Wilens, M.D. Chief, Division of Child and Adolescent Psychiatry, (Co)Director of Center for Addiction Medicine, Massachusetts General Hospital Massachusetts
More informationPediatric Behavior Problems: ODD and DMDD. Stanley Brewer, DO Pediatrics Assistant Professor (Clinical) Psychiatry Adjunct Instructor
Pediatric Behavior Problems: ODD and DMDD Stanley Brewer, DO Pediatrics Assistant Professor (Clinical) Psychiatry Adjunct Instructor Acting out: What to call it Externalizing disorders Oppositional Defiant
More informationTITLE: Practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder.
Brief Summary TITLE: Practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder. SOURCE(S): Practice parameters for the assessment and treatment
More information5 COMMON QUESTIONS WHEN TREATING DEPRESSION
5 COMMON QUESTIONS WHEN TREATING DEPRESSION Do Antidepressants Increase the Possibility of Suicide? Will I Accidentally Induce Mania if I Prescribe an SSRI? Are Depression Medications Safe and Effective
More informationMOOD DISORDERS 101: A primer for recognizing and intervening with children with DMDD JULIE T. STECK, PH.D., HSPP CRG/CHILDREN S RESOURCE GROUP
MOOD DISORDERS 101: A primer for recognizing and intervening with children with DMDD JULIE T. STECK, PH.D., HSPP CRG/CHILDREN S RESOURCE GROUP OBJECTIVES Participants will develop an understanding of Disruptive
More informationWelcome. Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders
Welcome Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders 800-767-4411 rogershospital.org Major Changes in DSM-5 As it Relates
More information4/29/2015. Dr. Carman Gill Wednesday, April 29th
Dr. Carman Gill Wednesday, April 29th 1 Impacted diagnoses Major changes and rationale Special considerations Implications for counselors A sustained condition of prolonged emotional dejection, sadness,
More informationSupplementary Online Content
Supplementary Online Content Sourander A, McGrath PJ, Ristkari T, et al. Internet-assisted parent training intervention for disruptive behavior in 4-year-old children: a randomized clinical trial. JAMA
More informationDisruptive mood dysregulation disorder (DMDD) a
Disruptive mood dysregulation disorder: A better understanding Recognizing key differences in DMDD can help distinguish it from similar pediatric disorders Disruptive mood dysregulation disorder (DMDD)
More informationTypical or Troubled? By Cindy Ruich, Ed.D. Director of Student Services Marana Unified School District Office:(520)
By Cindy Ruich, Ed.D. Director of Student Services Marana Unified School District Office:(520) 682-1046 c.t.ruich@maranausd.org Test Your Mental Health Knowledge 1) Mental Illness is a serious condition.
More informationManaging ADHD in the Primary Care Setting
Managing ADHD in the Primary Care Setting Andrea E. Spencer, MD Assistant Professor of Psychiatry Boston University School of Medicine Boston Medical Center March 17, 2017 Disclosures Neither I nor my
More informationNOVEL INDICATIONS: Experiences from a Study in MDD with Mixed Features (Mixed Depression)
NOVEL INDICATIONS: Experiences from a Study in MDD with Mixed Features (Mixed Depression) 11 APRIL 2013 Josephine Cucchiaro, PhD Vice President Clinical Operations & Project Management Sunovion Pharmaceuticals
More informationHandout for the Neuroscience Education Institute (NEI) online activity: Juvenile Bipolar Disorder: Further Complicated by Comorbidity
Handout for the Neuroscience Education Institute (NEI) online activity: Juvenile Bipolar Disorder: Further Complicated by Comorbidity Learning Objectives Utilize evidence-based strategies to accurately
More informationNeuropsychology of Attention Deficit Hyperactivity Disorder (ADHD)
Neuropsychology of Attention Deficit Hyperactivity Disorder (ADHD) Ronna Fried, Ed.D. Director of Neuropsychology in the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts
More information9/29/2011 TRENDS IN MENTAL DISORDERS. Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Autism Spectrum Disorders
Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Jason J. Washburn, Ph.D., ABPP Director, Center for Evidence-Based Practice TRENDS IN MENTAL DISORDERS Autism Spectrum
More informationClass Objectives. Depressive Disorders 10/7/2013. Chapter 7. Depressive Disorders. Next Class:
Chapter 7 Class Objectives Depressive Disorders - Major Depressive Disorder - Persistent Depressive Disorder - Disruptive Mood Dysregulation Disorder - Premenstrual Dysphoric Disorder (PMDD) Next Class:
More informationTypical or Troubled? Teen Mental Health
Typical or Troubled? Teen Mental Health Adolescence is a difficult time for many teens, but how does one know the difference between typical teen issues and behavior that might signal a more serious problem?
More informationIrritability in children and adolescents: a challenge for DSM-5
Eur Child Adolesc Psychiatry (2011) 20:61 66 DOI 10.1007/s00787-010-0150-4 REVIEW Irritability in children and adolescents: a challenge for DSM-5 Argyris Stringaris Received: 6 October 2010 / Accepted:
More informationNIH Public Access Author Manuscript J Am Acad Child Adolesc Psychiatry. Author manuscript; available in PMC 2015 April 01.
NIH Public Access Author Manuscript Published in final edited form as: J Am Acad Child Adolesc Psychiatry. 2014 April ; 53(4): 408 416. doi:10.1016/j.jaac.2013.12.026. Disruptive Mood Dysregulation Disorder
More informationTrends in Child & Adolescent Mental Health: What to look for and what to do about it.
Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Jason J. Washburn, Ph.D., ABPP Director, Center for Evidence-Based Practice TRENDS IN MENTAL DISORDERS 1 Autism Spectrum
More informationBIPOLAR DISORDER AND ADHD IN CHILDREN
BIPOLAR DISORDER AND ADHD IN CHILDREN BIPOLAR I DISORDER IS BEING DIAGNOSED WITH INCREASING FREQUENCY (INTENSITY) IN PRE-PUBERTAL CHIDREN WITH THE CAVEAT (WARNING / STIPULATION) THAT CLASSIC MANIC EPISODES
More informationNEW AND REVISED DSM DISORDERS. Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders
NEW AND REVISED DSM DISORDERS Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders Objectives 1. Identify the rationale for the Disruptive Mood Dysregulation Disorder
More informationGoal: To recognize and differentiate abnormal reactions involving depressed and manic moods
Key Dates TH Feb 9 Begin Dimensions-Behavior, Units IIB, 8 through page 147; MW Ch 9 Betty, Elvis TU Feb 14 Unit 8 147-end and Unit 9; MW Ch 8 Jeffrey and Ch 10 Diana TH Feb 16 Unit 10; MW Ch 11 Theodore
More informationDefining Mental Disorders. Judy Bass, MPH, PhD Johns Hopkins University
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationClassification of mood disorders
Classification of mood disorders Congress of Neuropsychiatry and Neuropsychology 2014 Poznań 27 November 2014 Jules Angst Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital,
More information9/17/2013 EVOLUTION OF THE DSM. The Future is Now: DSM-5. The American Psychiatric Association is not. Copyright Statement
The Future is Now: DSM-5 Jason J. Washburn, PhD., ABPP Center for Evidence-Based Practice American Psychiatric Association Copyright Statement DSM and DSM-5 are registered trademarks of the American Psychiatric
More informationPharmacotherapy of Adult ADHD
Pharmacotherapy of Adult ADHD Thomas J. Spencer, MD Massachusetts General Hospital Harvard Medical School Disclosures Dr. Spencer receives research support from Royalties and Licensing fees on copyrighted
More informationThe DSM-5: Juvenile Court Changes from a Mental Health Practitioner s and Defender s Perspective
The DSM-5: Juvenile Court Changes from a Mental Health Practitioner s and Defender s Perspective Presented by: Antoinette Kavanaugh, Ph.D Forensic Clinical Psychologist, IL Mary Ann Scali, JD, MSW National
More informationP s y c h i a t r i c C o m o r b i d i t y w i t h ASD Attention-Deficit/Hyperactivity Disorder
P s y c h i a t r i c C o m o r b i d i t y w i t h ASD Attention-Deficit/Hyperactivity Disorder GAGAN JOSHI, MD Assistant Professor of Psychiatry Director, Autism Spectrum Disorder Program Clinical &
More informationHEADS UP ON MENTAL HEALTH CONCERNS IN CHILDREN WITH DEVELOPMENTAL DISABILITIES. CORNELIO G. BANAAG, JR. M.D. Psychiatrist
HEADS UP ON MENTAL HEALTH CONCERNS IN CHILDREN WITH DEVELOPMENTAL DISABILITIES CORNELIO G. BANAAG, JR. M.D. Psychiatrist MENTAL HEALTH WHO: Health is more than the absence of illness Emotional well being
More informationBroadcastMed Bipolar, Borderline, Both? Diagnostic/Formulation Issues in Mood and Personality Disorders
BroadcastMed Bipolar, Borderline, Both? Diagnostic/Formulation Issues in Mood and Personality Disorders BRIAN PALMER: Hi. My name is Brian Palmer. I'm a psychiatrist here at Mayo Clinic. Today, we'd like
More informationForty-Eighth Annual Teaching Conference Pediatrics for the Practitioner -UT Health Science Center San Antonio School of Medicine June 10-12, 2011
Adelaide Robb, MD Associate Professor Psychiatry and Pediatrics Source Advisory Board Disclosure Speaker s Bureau Bristol Myers Squibb Yes Yes Yes Epocrates Research Contract Royalties Yes Stock Janssen
More informationDSM-5 Depressive Disorders: Diagnostic and Treatment Implications
DSM-5 Depressive Disorders: Diagnostic and Treatment Implications Gary G. Gintner, Ph.D., LPC-S Louisiana State University Baton Rouge, LA gintner@lsu.edu Depressive Disorders Highlights: Chronic depressive
More informationManaging Complex Presentations of ADHD In Adulthood
Managing Complex Presentations of ADHD In Adulthood Craig B.H. Surman, MD Adult ADHD Research Program Massachusetts General Hospital Harvard Medical School www.drsurman.com 1 Disclosures Consultant: Rhodes
More informationInternational Journal of Recent Advances in Multidisciplinary Research Vol. 04, Issue 05, pp , May, 2017 RESEARCH ARTICLE
\ sz www.ijramr.com International Journal of Recent Advances in Multidisciplinary Research Vol. 04, Issue 05, pp.2587-2591, May, 2017 RESEARCH ARTICLE AN INVESTIGATION OF PUBLIC PRIMARY SCHOOL TEACHERS
More informationFAMILY AND ADOLESCENT MENTAL HEALTH: THE PEDIATRICIAN S ROLE
FAMILY AND ADOLESCENT MENTAL HEALTH: THE PEDIATRICIAN S ROLE Mark Cavitt, M.D. Medical Director, Pediatric Psychiatry All Children s Hospital/Johns Hopkins Medicine OBJECTIVES Review the prevalence of
More informationADHD Across the Lifecycle: an Overview
ADHD Across the Lifecycle: an Overview Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts
More informationAutism Spectrum Disorder Across the Lifespan
Autism Spectrum Disorder Across the Lifespan Saturday - Sunday July 11-12, 2015 Boston Marriott Copley Place, Boston, MA Course Directors Joseph Biederman, MD Chief, Clinical and Research Programs in Pediatric
More informationTHE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (PICS-7) SCORING GUIDELINES
THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (PICS-7) SCORING GUIDELINES Copyright, The Hospital for Sick Children, Toronto, Canada 2016. For licensing inquiries,
More informationBipolar disorder in children and young people on the autism spectrum
Exclusively sponsored by: Bipolar disorder in children and young people on the autism spectrum We are members of a multidisciplinary tertiary second opinion referral service for youth (under age 18 years)
More informationPractical Psychopharmacology for More Complex Mental Health Presentations
MINISTRY OF CHILDREN AND YOUTH SERVICES Practical Psychopharmacology for More Complex Mental Health Presentations Part 1: Stimulants Dr. Ajit Ninan & Joel Lamoure 1 Practical Psychopharmacology for More
More informationDepression in Adolescents PREMA MANJUNATH, MD CHILD AND ADOLESCENT PSYCHIATRIST
Depression in Adolescents PREMA MANJUNATH, MD CHILD AND ADOLESCENT PSYCHIATRIST Francis Bacon Children sweeten labors, but they make misfortunes bitter. They increase the cares of life, but they mitigate
More informationThe comparison of behavioral and emotional problems in children with a bipolar parent and children with healthy parents in Zahedan, Iran, 2011
The comparison of behavioral and emotional problems in children with a bipolar parent and children with healthy parents in Zahedan, Iran, 2011 Mahboubeh Firoozkouhi Moghaddam, Nour Mohammad Bakhshani,
More informationMood Disorders and Addictions: A shared biology?
Mood Disorders and Addictions: A shared biology? Dr. Paul Stokes Clinical Senior Lecturer, Centre for Affective Disorders, Department of Psychological Medicine Disclosures No relevant disclosures: No paid
More informationDefinitions of primary terms and acronyms of trauma and shame disorders. [Draft ]
Definitions of primary terms and acronyms of trauma and shame disorders. [Draft 7-23-2014] I welcome suggestions. Please email wteague@verizon.net Acronym Definition DSM- ACE Adverse Childhood Experiences
More informationAnxiety Instruments Summary Table: For more information on individual instruments see below.
1 Anxiety Instruments Summary Table: For more information on individual instruments see below. Measure Anxiety Specific Instrument Age Range Assesses total anxiety and different anxiety subtypes Both a
More informationScreening and Assessments for Trauma Adrian James, MS, NCC, LPC-S
Screening and Assessments for Trauma Adrian James, MS, NCC, LPC-S What is a Traumatic Event? An experience that is emotionally painful, distressing, and shocking, which can result in lasting physical and/or
More informationNIH Public Access Author Manuscript J Am Acad Child Adolesc Psychiatry. Author manuscript; available in PMC 2014 December 01.
NIH Public Access Author Manuscript Published in final edited form as: J Am Acad Child Adolesc Psychiatry. 2013 December ; 52(12):. doi:10.1016/j.jaac.2013.09.007. Preschool Irritability: Longitudinal
More informationAnxiety and Depression. What you want to know Leah Hibbeln-Colburn, CMHC Valley Behavioral Health
Anxiety and Depression What you want to know Leah Hibbeln-Colburn, CMHC Valley Behavioral Health Approaching Mental Health Anxiety Definition: a feeling of worry, nervousness, or unease, typically about
More informationADHD and Adverse Health Outcomes in Adults
Thomas J. Spencer, MD This work was supported in part by a research grant from Shire (Dr. Spencer) and by the Pediatric Psychopharmacology Council Fund. Disclosures Dr. Spencer receives research support
More informationPediatrics Grand Rounds 5 March University of Texas Health Science Center at San Antonio I-1
Diagnosis and Treatment of Depression in Children and Adolescents Steven R. Pliszka, M.D. Professor and Vice Chair Chief, Division of Child and Adolescent Psychiatry Department of Psychiatry The Disclosures
More informationHistory of Maltreatment and Psychiatric Impairment in Children in Outpatient Psychiatric Treatment
University of Connecticut DigitalCommons@UConn Honors Scholar Theses Honors Scholar Program Spring 5-10-2009 History of Maltreatment and Psychiatric Impairment in Children in Outpatient Psychiatric Treatment
More informationClinical Considerations for a Strength-Based Intake Assessment
Clinical Considerations for a Strength-Based Intake Assessment Initial Comments/ Assessment Summary 1. Client Demographics - Name: Age: Gender: Race: Note: Domain areas assess the identified child only
More informationEVOLUTION OF THE DSM 8/23/2013. The New DSM-5 : What Administrators Need to Know. American Psychiatric Association Copyright Statement
The New DSM-5 : What Administrators Need to Know Jason J. Washburn, PhD., ABPP Director, Center for Evidence-Based Practice American Psychiatric Association Copyright Statement DSM and DSM-5 are registered
More informationSeasonal Affective Disorder and Other Mental Health Issues. Mental Health Issues and Juvenile Justice. Acronyms
Seasonal Affective Disorder and Other Mental Health Issues Keith Neuber, M.S. I K.A.N. Presentations keith@ikan2.com Mental Health Issues and Juvenile Justice Individual Mental Health Implications for
More informationWI Alliance of Child Psychiatry and Pediatrics CASE STUDY. Mood Disorders. James A. Meyer MD Adolescent Medicine Marshfield Clinic
WI Alliance of Child Psychiatry and Pediatrics CASE STUDY Mood Disorders 12-09-2014 James A. Meyer MD Adolescent Medicine Marshfield Clinic Disclosure Statement I, James Meyer, M.D., do not have any relevant
More informationRunning head: DEPRESSIVE DISORDERS 1
Running head: DEPRESSIVE DISORDERS 1 Depressive Disorders: DSM-5 Name: Institution: DEPRESSIVE DISORDERS 2 Abstract The 2013 update to DSM-5 saw revisions of the psychiatric nomenclature, diagnostic criteria,
More information6/22/2012. Co-morbidity - when two or more conditions occur together. The two conditions may or may not be causally related.
Autism Spectrum Disorders and Co-existing Mental Health Issues By Dr. Karen Berkman Objective To present an overview of common psychiatric conditions that occur in persons with autism spectrum disorders
More informationAttention-Deficit/Hyperactivity Disorder Nathan J. Blum, M.D.
ADHD in Preschool Children Preschool ADHD: When Should We Diagnose it & How Should We Treat it? Professor of Pediatrics Diagnosis of ADHD in Preschool Children: Impact of DSM-IV Is Preschool ADHD Associated
More informationCurrent. A bad boy s behavior problems CASES THAT TEST YOUR SKILLS
Two weeks after changing medications, a hyperactive 11-year-old becomes manic and attempts suicide. Is the new regimen or an undiagnosed mental disorder to blame? A. Kenneth Fuller, MD Chief of psychiatry
More informationMore Than Just Moody Blaise Aguirre, MD Child and Adolescent Psychiatrist McLean Hospital Assistant Professor of Psychiatry Harvard Medical School
More Than Just Moody Blaise Aguirre, MD Child and Adolescent Psychiatrist McLean Hospital Assistant Professor of Psychiatry Harvard Medical School Keep in Mind In the U.S., approximately 10-15% of children/adolescents
More informationEffectiveness of Web-Based Multimedia Mental Health Educational Program on Anxiety, Depression, Self Concept and School Adjustment in Adolescents
IJCSNS International Journal of Computer Science and Network Security, VOL.10 No.5, May 2010 59 Effectiveness of Web-Based Multimedia Mental Health Educational Program on Anxiety, Depression, Self Concept
More informationChild Planning: A Treatment Approach for Children with Oppositional Disorder
COURSES ARTICLE - THERAPYTOOLS.US Child Planning: A Treatment Approach for Children with Oppositional Disorder A Treatment Approach for Children with Oppositional Disorder. Duration: 3 hours Learning Objectives:
More informationPost-Traumatic Stress Disorder (PTSD) Among People Living with HIV
Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV Milton L. Wainberg, M.D. Associate Clinical Professor of Psychiatry College of Physicians and Surgeons Columbia University mlw35@columbia.edu
More information#CHAIR2016. September 15 17, 2016 The Biltmore Hotel Miami, FL. Sponsored by
#CHAIR2016 September 15 17, 2016 The Biltmore Hotel Miami, FL Sponsored by Pediatric Bipolar Disorder: Diagnosis and Management Karen Dineen Wagner, MD, PhD University of Texas Medical Branch Galveston,
More informationJason Jent, Ph.D. Assistant Professor of Clinical Pediatrics University of Miami Miller School of Medicine
Screening and Understanding Behavioral Issues in Service Delivery Jason Jent, Ph.D. Assistant Professor of Clinical Pediatrics University of Miami Miller School of Medicine Eugene Hershorin, M.D. Professor
More informationA Closer Look: NH Primary Care Clinician Perspective on Caring for Pediatric Patients with ADHD
A Closer Look: NH Primary Care Clinician Perspective on Caring for Pediatric Patients with ADHD W. Burleson Daviss, MD Dept. of Psychiatry / DHMC Molly O Neil University of New Hampshire Objectives 1)
More informationAdvocating for people with mental health needs and developmental disability GLOSSARY
Advocating for people with mental health needs and developmental disability GLOSSARY Accrued deficits: The delays or lack of development in emotional, social, academic, or behavioral skills that a child
More informationIII. Anxiety Disorders Supplement
K-SADS-PL A. Screen Interview B. Supplements I. Disorders Supplement II. Psychotic Disorders Supplement III. Anxiety Disorders Supplement IV. Disorders Supplement V. Substance Disorders Supplement Advanced
More informationCONDUCT DISORDERS. What to do with your oppositional defiant child. Humberto Nagera MD
What to do with your oppositional defiant child Humberto Nagera MD This Lecture is based on the findings of research conducted at the Inpatient Units for Children and Adolescents of The University of South
More informationChildren's Health Homes: Training on Complex Trauma Determination. Presented by: Meg Baier, LMSW Mandy Habib Psy.D.,
Children's Health Homes: Training on Complex Trauma Determination Presented by: Meg Baier, LMSW Mandy Habib Psy.D., Our Agenda Welcome & Introductions Topics to Cover: What is PTSD? What is Complex Trauma
More informationCHILD AND ADOLESCENT ISSUES BEHAVIORAL HEALTH. SAP K-12 Bridge Training Module for Standard 4 Section 3: Behavioral Health & Observable Behaviors
CHILD AND ADOLESCENT BEHAVIORAL HEALTH ISSUES SAP K-12 Bridge Training Module for Standard 4 Section 3: Behavioral Health & Observable Behaviors MODULE 4: SECTION 34: SECTION 3 4.b. Articulate the school
More informationDeconstructing the DSM-5 By Jason H. King
Deconstructing the DSM-5 By Jason H. King Assessment and diagnosis of disruptive mood dysregulation disorder During the past two decades, the prevalence of pediatric bipolar disorder has dramatically increased.
More information