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Psychiatry Epidemiology
JHSPH09
327
Other
Graduate
12/16/2009

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Cards

Term
Three Generations of Psych Epi
Definition
Generation 1 = Facility Record / Specific Diagnoses
Generation 2 = Early Surveys
Generate 3 = Diagnostic Surveys
Term
Important Generation 1 Studies
Definition
Jarvis Commission (lunacy and paupers in MA)
Eastern Baltimore (Lemkau)
Chicago (Faris and Dunham)
New Haven (Hollingshead & Redlich)
Term
Important Generation 2 Studies
Definition
Midtown Manhattan (Srole)
Stirling County (Leighton)
Term
Important Generation 3 Studies
Definition
ECA
NCS
NCS-R
Term
What are symptoms and Complaints?
Definition
What individuals say about their disease
Term
What are signs and behaviors?
Definition
What we observe about their disease?
Term
What is a syndrome?
Definition
It is the co-ocurrence of signs and symptoms or complaints and behaviors
Term
What is reliability?
Definition
The consistency of a measurement
Term
What is validity?
Definition
Measuring what is supposed to be measured
Term
What are the three type of prevalences
Definition
Point
Period
Lifetime
Term
What is point prevalence?
Definition
The proportion who have a disorder at a specific point in time
Term
What is period prevalence?
Definition
The proportion would have a disorder during a defined period (3, 6, 12 months)
Term
What is lifetime prevalence?
Definition
The proportion would have or who have ever had a disorder
Term
What are the four perspectives?
Definition
Disease
Dimensional
Behavior
Life-Story
Term
Three parts to the disease perspective?
Definition
Clinical Entity --> Pathological Condition --> Etiology
Term
Three parts of dimensional perspective
Definition
Potential --> Provocation --> Response
Term
Three parts of behavioral perspective
Driven Behaviors
Definition
Physiological Drive --> Choice --> Conditioned Learning (works in a circle)
Term
Three parts of behavioral perspective
Socially Learned Behaviors
Definition
Antecedents --> Responses --> Consequences
Term
Three parts of the life course perspective
Definition
Setting --> Sequence --> Outcome
Term
What is an attack rate?
Definition
The rate at which cases form, during a specified period, among individuals who did not have the disorder at baseline
Term
What is first lifetime incidence?
Definition
The rate at which cases form during a specified period among individuals who never had the disorder at baseline
Term
Describe the onset and the presentation of a disorder...
Definition
A disease does not progress linearly over time, they vary and expand over the life course (remember the stingray!)
Term
Precursors, complaints and behaviors measure disorder (imperfectly or certainly)
Definition
Imperfectly
Term
Prodromal, sign or symptom measure disorder (imperfectly or certainly)
Definition
Certainly
Term
What is one common measurement problem in surveying?
Definition
Insight (e.g. dementia, autism, bipolar, schizophrenia)
Term
Rates, proportions (SURVEY METHOD)
Definition
Numerator (ever ill)
Denominator (alive at survey)
Term
Rates, proportions (REGISTER method)
Definition
Numerator = # of admissions
Denominator = Census count
Term
Interviewers for Structured Diagnostic Interviews tend to be...
Definition
1) Middle-aged
2) Female
3) Less than college educated
4) Articulate
5) Greater than 50% attrition
Term
Structured survey (DIS) vs. Clinical Exam (SCAN) agreement issues?
Definition
Yes, for depression kappa at 0.32, high specificity, low sensitivity

Yes, panic disorder kappa = 0.40, sensitivity = 28%, specificity = 99%
Term
What are the 6 main symptoms for PTSD?
Definition
1) Exposure to a traumatic event
2) Re-experiencing the traumatic event
3) Avoidance of related stimuli or numbing
4) Hyperarousal
5) Significant distress or impariment
6) Symptoms lasting at least a month
Term
What are the three clusters of symptoms for PTSD?
Definition
Reexperiencing, avoidance/numbing, hyperarousal
Term
What is the prevalence of PTSD lifetime?
Definition
7% (Kessler, 2005)
Term
Is PTSD more common in men or women?
Definition
Women - 9.7%, Men - 3.6% (Kessler, 2005)
Term
What are some neurological consequences of PTSD?
Definition
1) Dysregulation of HPA and neurotransmitters
2) Disturbances in perception, learning, memory
3) Exaggerated release of cortisol in response to stressor (Nemeroff, 2006)
Term
What is the age peak for trauma exposure?
Definition
16-20 (Breslau et al., 2004)
Term
What type of trauma is most common for PTSD?
Definition
Assaultive Violence
Term
What percentage of PTSD cases remit within 6 months?
Definition
50% (Breslau et al., 1998)
Term
How are martial status and immigrants at risk for PTSD?
Definition
Immigrants/refugees higher rate, no longer married (Marshall, 2005)
Term
How do comorbidities affect PTSD?
Definition
They all have the potential to increase the prevalence (substance abuse, MDD, GAD)
Term
Panic Disorder is defined how in the DSM-IV?
Definition
1) Recurrent unexpected Panic Attacks
2) One month or more of the following?
a) Concern about additional attacks
b) Worry about consequences
c) Change in behavior related to attacks
Term
What is the prevalence of Panic Attacks?
Definition
4.7% (Kessler, 2006)
Term
Are panic attacks more common in women or men?
Definition
Women (2:1) over men
Term
The prevalence of Generalized Anxiety Disorder?
Definition
6% (Kessler, 2006)
Term
Is GAD more common in women or men?
Definition
Women 7% to Men 4%
Term
What are the major symptoms of GAD?
Definition
1) Excessive anxiety and worry, occurring more days than not for at least 6 months

2) The person finds it difficult to control the worry

3) The anxiety and worry are associated with 3 or more of the following:
- Restlessness
- Being easily fatigued
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep disturbance
Term
What are the three symptoms of agoraphobia?
Definition
1) Anxiety about being in places or situations from which escape might be difficult

2) The situations are avoided or are endured with marked distress

3) The anxiety or phobic avoidance is not better accounted for by another mental disorder
Term
What are the five symptoms of Social Phobia?
Definition
1) A fear of social or performance situations
2) Exposure invariably provokes anxiety
3) The fear is recognized as unreasonable
4) The feared situation are avoided
5) The avoidance, anxious anticipation, or distress interferes with the person's normal routine
Term
What are the four major risk factors for all anxiety disorders?
Definition
1) Being female
2) Low SES
3) Marriage is protective
4) Depression is risk and consequence
Term
What are the nine symptoms of depression and how many do you need for DSM?
Definition
1) Depressed mood 2) Loss of all interest and pleasure 3) Appetite and weight disturbance 4) Sleep disturbance 5) Agitation or slowing 6) Fatigue 7) Abnormal, inappropriate guilt 8) Poor concentration 9) Thoughts of death or suicide

 

For two weeks,

Remember it this way:

Seriously, (Suicide)

Sam (Sleep)

Can (Concentration)

Get (Guilt)

All (Agitation)

Frisky (Food - weight/appetite)

For (Fatigue)

A (Anhedonia)

Decade (Depressed Mood)

Term
What is the prevalence of depression?
Definition
17% (Kessler)
Term
Is depression more common in men or women?
Definition
Women 20% to men 13%
Term
Where does depression fall in the DALY according to the WHO?
Definition
3rd leading cause of DALY (2003)
Term
How do incidence rates differ between men and women in regards to depression?
Definition
Higher in women than men (occurs 5 years earlier)
Term
What is the prodromal period?
Definition
Time from the onset of the problem until the onset of the disorder
Term
What depression symptoms have long prodomal periods?
Definition
1) Dysphoria
2) Suicidal ideation
Term
What is depression a strong predictor of according to the ECA?
Definition
1) MI/CHD
2) Stroke
3) Dementia
4) Osteoporsis
5) Diabetes
Term
Why do women have a higher prevalence of depression?
Definition
Because they have a higher incidence, and P = I*D. NOTE: Chronicity does not differ by gender!
Term
How does stress interact with neuroticism?
Definition
It increases the risk of depression, more in women than men (Kendler, 2004)
Term
What is the relationship between social support and depression?
Definition

Lower social support leads to more depression, more risky in women than men (Kendler, 2005)

 

This was a Twin Study

Term
What is a phenotype?
Definition
A measurable characteristic or trait, that is determined by the genotype
Term
What is an endophenotype?
Definition
Related clinical characteristics that are the marker of an underlying susceptibility to the disorder; more reliably and validly measured; genetically less complex
Term
What are the three types of studies for genetics?
Definition
Family
Adoption
Twin
Term
What is the rationale behind a family study?
Definition
Trait resemblances should increase with increasing genetic relatedness and should aggregate in families
Term
What is the rationale behind adoption studies?
Definition
Adoption creates genetically related individuals who do not share environment - similarities thus are genetic contribution

Adoption creates individuals who are not genetically related but who share environments - similarities thus are environmental contribution
Term
What is the rationale behind a twin study?
Definition
Given equal environments, any difference in trait must be due to genes
Term
What is heritability?
Definition
A measure of how genetic factors contribute to a trait; proportion of phenotypic variance that can be accounted for by genetic differences (h2 = Vg/Vp)
Term
What type of genetic studies are used to determine transmission?
Definition
Segregation studies
Term
What types of genetic transmissions are there?
Definition
Mendelian
- Dominant (Huntington's)
- Recessive (PKU)
- X-linked recessive (hemophilia)
Polygenic
Term
What is segregation analysis?
Definition
Different models of transmission of trait are studied across generations to determine which is most consistent with observed data
Term
What are limitations of segregation analysis?
Definition
It assumes random mating, is susceptible to ascertainment bias
Term
What two studies are used to identify candidate genes?
Definition
1) Linkage studies
2) Association studies
Term
Linkage studies are based on what type of models?
Definition
Allele sharing, in individual families
Term
Association studies are based off of what type of studies?
Definition
Family based or population basd, looking at marker alleles with a trait across individuals
Term
What is linkage disequilibrium?
Definition
Linkage disequilibrium is the condition in which the haplotype frequencies in a population deviate from the values they would have if the genes at each locus were combined at random.
Term
What is phenotypic uncertainty, that is how is it a problem with genetic studies?
Definition
There are no gold standards for defining valid psychiatric diagnoses
Term
What is oligogenic inheritance?
Definition
Multiple genes may be involved in producing the phenotype

(think oh, lovely i's (eyes)!)

 

... as eye color is an example

Term
What is incomplete penetrance?
Definition
A disease susceptibility allele at one particular gene may not always produce the phenotype
Term
What is genetic heterogeneity?
Definition
Different genes independently produce the same phenotype
Term
What is allelic heterogeneity?
Definition
Different alleles of the same gene may produce the same phenotype
Term
What is epistasis?
Definition
Genes interact with each other to produce a phenotype
Term
What are the three symptom categories for autism?
Definition
1) Social Interaction (2+ needed)
2) Communication (1+ needed)
3) Stereotyped behaviors (1+ needed)
Term
What are the 5 categories of pervasive developmental disorders?
Definition
1) Autistic Disorder
2) Asperger's Syndrome
3) PDD-NOS
4) Rett's Syndrome
5) Childhood Disintegrative Disorder
Term
What two measurements are used to determine a PDD dx?
Definition
ADI-R (interview) and the ADOS (observation interview)
Term
What were some important studies that measured childhood disorder prevalences?
Definition
1) MECA (Shaffer - 1996)
2) Great Smokey Mountain Study (Costello - 1996)
Term
What are the diagnostic criteria of ADHD?
Definition
1) Inattention
2) Hyperactivity-impulsivity
3) Onset before age 7, in two settings
Term
What are the associated (outcomes) of childhood ADHD?
Definition
1) Low academic performance
2) Negative peer and teacher relations
3) Negative family relations
4) Injuries/Accidents
Term
What is the prevalence of ADHD, which subtypes are more common?
Definition
3-7%, Inattentive>Combined>Hyperactive
Term
What is the gender difference is ADHD?
Definition

Boys 2-9X higher than girls

(Gaub, 1997)

Term
What are some theories for ADHD?
Definition
1) Motivational deficits
2) Short-term memory deficits
3) Deficits in self-regulation and inhibition
Term
What are some biological reasons for ADHD?
Definition
1) Frontal lobe damage
2) Dopamine/Norephinephrine deficiency
3) Genetics (family historysies)
Term
What is the prevalence of childhood and adolescent MDDs?
Definition
Children = 0.4-2.5%
Adolescent = 0.4-8.8%
Term
What disorders are comorbid with MDD in children?
Definition
anxiety, substance abuse, disruptive behavior
Term
What are some notable causes of MDD in children?
Definition
1) Norepinephrine and serotonin depletion
2) Dysregulation of neuroendocrine system
Term
What are three thinking style deficits that could result in childhood MDDs?
Definition
1) Learned helplessness
2) Hopelessness theory
3) Self control model
Term
Dementia is a syndrome of memory loss plus at least of one?
Definition
1) Agnosia
2) Apraxia
3) Aphasia
4) Disturbance in EF
Term
What are the full diagnostic criteria of dementia?
Definition
1) Memory loss plus either i) agnosia, ii) apraxia, iii) aphasia, iv) disturbance in EF

2) Impairment in occupational/social functioning, decline in functioning

3) Definitive dx made at death with beta-amyloid plaques and neurofibrillary tangles
Term
What are the two types of dementia?
Definition
1) Cortical
2) Subcortical
Term
What is more common cortical or subcortical dementia?
Definition
Cortical
Term
Alzheimer's represents what type of dementia?
Definition
Cortical
Term
Parkinson's dementia is what type of dementia?
Definition
Subcortical
Term
What is the key difference between cortical and subcortical dementia
Definition
The regions of the brain, subcortical is more internal in brain and has an earlier onset
Term
What is the symptomatic course of dementia?
Definition
1) Gradual onset with continual cognitive decline
2) Personality changes: irritability and depression
3) Cortical atrophy
4) MMSE deterioration over 5 years
Term
Where does the mild cognitive impairment fit into the dementia picture?
Definition
It fits inbetween normal functioning and dementia
Term
What are the five nosological categories of MCI (Mild Cognitive Impairment)
Definition
1) Age associated memory impairment
2) MCIa
3) Age associated cognitive decline
4) Cognitive Impairment not dementia
5) Dementia
Term
What is the expected prevalence of AD?
Definition
6.5% of 65+ (Jorm - 1987)
Term
What are risk factors for AD?
Definition
1) Age
2) Gender - women maybe worse
3) CVD
4) Genetics E4/E4
Term
How much of an increase is there for having the E4/E4 genotype for AD?
Definition

15X vs. E3/E3

3X with 1 E4

Term
What are protective factors for AD?
Definition
1) Diet
2) Physical Activity
3) Higher Education
4) Higher Occupational attainment
5) Social engagement in late-life
6) Larger cognitive reserve
Term
What are the diagnostic criteria for schizophrenia?
Definition
1) Delusions
2) Hallucinations
3) Disorganized speech
4) Disorganized behavior
5) Negative symptoms
6) Poor functioning

Last 6 months or longer
Term
What are the DSM-IV criteria for bipolar mania?
Definition
1) Episode of elevated mood (lasting at least one week)

2) Three or more
- Grandiosity
- Decreased need for sleep
- Talkative
- Flight of ideas
- Distractible
- Increase in goal-directed acts
- Spending sprees, promiscuity
Term

Big finding of the US-UK study was?

Researcher/Year was?

Definition
That diagnostic differences were mostly due to failure of Americans to exclude affective disorders and instead say everyone was schizophrenic (Kendell - 1971)
Term
What did the International Pilot Study of Schizophrenia tell us? When and who directed it?
Definition
WHO, 1979 - showed that schizohprenia profile types were universal across cultures and was distinct from affective disorders
Term
What is the prevalence and incidence of schizophrenia?
Definition
Prevalence = 5 in 1000
Incidence = 0.2 per 1000/year
Term
What is the key gender difference in schizophrenia?
Definition
Women have 5 year lag in onset, but catch up later in life
Term
How and when does the prodomal period begin in schizophrenia?
Definition
Starts on average around 24, and lasts for roughly 6 years
Term
What is prevalence or chronicity bias?
Definition
Clinicians see people who are chronic who keep coming back
Term
What are the three types of Bipolar Disorder?
Definition
Bipolar I, Bipolar II, Bipolar NOS
Term
What is the mean onset for bipolar disorder, how does it differ by gender?
Definition
Overall = 33, Men = 30, Women = 35
Term
What are risk factors for schizophrenia?
Definition

1) Genes 2) Season of birth 3) Obstetric complications 4) Ethnic status 5) Drug use 6) Infections

 

I     nfections

R             ace

G           enes

                      O         bstetric complications

D      rug Use

S   easonality

Term
What are risk factors for bipolar disorder?
Definition
1) Genes
2) Family loss?
Term
How does random error affect prevalence and incidence estimates?
Definition
Usually overestimation
Term
How are odds ratios and correlation coefficient affected by random errors?
Definition
They are attenuated
Term
Who uncovers more psychopathology, lay-interviewers or psychiatrists?
Definition
Psychiatrists usually uncover more psychopathology than lay interviewers using
structured interviews
Term
Measurement error over a continuum leads to what type of estimates? Give examples of disorders
Definition
Measures of association are probably conservative

Examples = depression, anxiety, and alcohol disorders
Term
Measurement error NOT over a continuum leads to what type of estimates? Give examples of disorders
Definition
Dramatic errors in conclusions.

Examples = psychoses
Term
What are some biological causes/consequences of PTSD?
Definition
- Neurotransmitters (serotonin, norepinephrine)
- Central & autonomic nervous system (HPA axis, amygdala)
Term
What percentage of MDD individuals only have one lifetime episode? unremitting? relapse/remit?
Definition
50% - one episode
15% - unremitting
35% - relapse/remitting
Term
What are some issues of reliability within child psy epi?
Definition
1) Age of onset
2) Between informants
3) Within informants over time
4) Variation in reliability by disorder
5) Children versus parents
6) Characteristics of the Questions
Term
What seasonal affects have been noted for schizophrenia?
Definition
The proportion of people with schizophrenia born during the winter months is about 5-15% higher than at other times of the year (Torrey, 1993)
Term
Brain differences seen in schizophrenics?
Definition
Larger lateral ventricles, smaller hippocampus Steen et al. (2006).
Term
Describe the course of bipolar disorder?
Definition
Mostly stable, not progressive, infrequent psychotic episodes
Term
Describe the course of schizophrenia? What major problems does this cause?
Definition
Extended prodrome and insidious onset. Both the failure to be upwardly mobile and downward mobility are believed to occur because the onset of schizophrenia is insidious and begins during adolescence, when social and occupational skills are learned.
Term
What is the five factor model of personality?
Definition

(O)penness to experience

(C)onscientiousness

(A)greeableness

(E)xtraversion

(N)euroticism

 

Term
What is Neuroticism?
Definition
One’s tendency to experience negative emotions and cope poorly
Term
What is Extroversion?
Definition
One’s quantity and intensity of interpersonal interactions
and positive emotions
Term
What is Openness to Experience?
Definition
One’s appreciation of experience for its own sake
Term
What is agreeableness?
Definition
One’s orientation toward others (altruistic versus antagonistic)
Term
What is Conscientiousness?
Definition
One’s organization, motivation, and persistence in achieving goals
Term
What is the prevalence of personality disorders?
Definition
10% - Hopkins Epidemiology of Personality Disorder Study
Term
What is the most prevalent personality disorder?
Definition
Antisocial personality disorder (by far!)
Term
What are risk factors for Cluster A personality disorders?
Definition
Males; never married
Term
What are risk factors for cluster B personality disorders?
Definition
Males; younger age; lower education
Term
What are risk factors for cluster C personality disorders?
Definition
Never married; higher education
Term
Evolution of DSMs?
Definition

DSM-III (1980)

DSM-III-R (1987)

DSM-IV (1994)

DSM-IV-TR (2000)

Term
Three reasons for an increase in ASD rates?
Definition
1) Changes in diagnostic criteria moving from the DSM-III to the DSM-IV
2) Changes in the interpretation of diagnostic criteria
3) Change in the manner that formal diagnostic criteria are applied
Term
Gender differences in Autism?
Definition
Approximately 4 Males to 1 Female (Autism and Developmental Disabilities Monitoring Network ((ADDMN), 2002)
Term
Birth seasonality affect for Autism?
Definition
Yes, for both twins and single births, with varying trimodal peaks (Lee and colleagues, 2008)
Term
Specific neurotransmitter involved in increased Autism rates?
Definition
It appears that HLA-DR4 may play a role, and has increased odds relative from the general population (Lee and colleagues, 2006)
Term
Racial differences in Autism?
Definition
No, BUT there appears to a later age of first diagnosis in African American (7.9) children when compared to Whites (6.3), could be an access to services issue (Mandell and colleagues, 2002).
Term
What is the key difference between Autistic Disorder and Aspergers Syndrome?
Definition
For children with Aspergers syndrome

1) There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

2) There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
Term
What did the Stirling County study focus on?
Definition
(Leighton, 1963) Better mental health is associated with higher social class
Term
What are three reasons for attrition?
Definition
1) Individual mobility outside the study area or to an unknown residence
2) Death
3) Refusal to participate after some threshold of response burden is reached
Term
What is mortality?
Definition
The rate of death in the population
Term
Two ways of thinking about development toward disease?
Definition
1) An increase in severity or intensity of symptoms
2) An occurrence of new groups of symptoms where none existed
Term
What are key differences between scales and schedules?
Definition
Psychiatric scales are simpler than schedules, and historically they emerged earlier. Diagnostic schedules are more comprehensive and complex in psychiatric coverage than scales. Scales typically have a cut-off scores for diagnosis
Term
What is procedural validity?
Definition
Pertains to criterion validity - comparing the results of a lay-administered schedule with the results of a clinician-administered schedule
Term
Can you receive a diagnosis of alcohol abuse after being diagnosed with alcohol dependence?
Definition
Nope! In addition, dependence and abuse are now defined hierarchically, so that one cannot receive a diagnosis of abuse after meeting criteria for dependence.
Term
What study showed alcoholism runs in families genetically?

What study showed alcoholism could be an etiological problem?
Definition
7X risk in first degree relatives (Merikangas, 1990)

Mirroring of behaviors (Kelley and Fals-Stewart, 2004)
Term
What is ascertaintment bias?
Definition
Type of selection bias where patients gathered do not represent the cases originated in the population
Term
What is an absorbent state?
Definition
Once exposed, always exposed (no need for more assessments)
Term
What are limitations of matching?
Definition
Effect of match var on outcome cannot be assessed, costly, can overmatch, can match on exposure or surrogate
Term
According to the Prentice criteria, what is a surrogate?
Definition
1. Must be correlated to outcome, 2. Must be a full mediator, 3. Must fully capture the effect of tx on an outcome
Term
What is a contamination bias?
Definition
When intervention-type activities find their way to the control group
Term
What is the Hawthorne effect?
Definition
Increase in the outcome under study in participants who are aware of being observed
Term
What are concerns when using prevalent cases?
Definition
1. Survivor cases, 2. Change of exposure due to disease, 3. Reverse causation
Term
3 reasons for apportioning person-time
Definition
1. Risk varies with age, 2. Risk varies over time (secular trend), 3. Risk for disease may vary over expo levels
Term
Name 4 threats to causal inference
Definition
1. Lack of precision, 2. Lack of internal validity, 3. Incorrect asses. of direction of causality, 4. Lack external validity
Term
What is diagnostic bias? Also overlaps strongly with surveillance bias
Definition
Awareness of a possible association between exposure and outcome, where exposed individuals are followed more closely and detection of cases is thus increased
Term
What is the Neyman bias?
Definition
Also called selective survival bias, type of selection bias where the exposure is determinant of or related to prognosis factors
Term
What is the ecological fallacy?
Definition
error of interpretation of statistical data; inferences about the nature of specific individuals are based solely upon aggregate statistics collected for the group to which those individuals belong.
Term
What is Berkson's bias?
Definition
Type of selection bias in hospital based C-C studies. Combination of exposure and disease increases risk of admission to hospital
Term
What are the causal response types?
Definition
1. No effect. Doomed
2. Exp Causal
3. No effect. immune
4. Exp Protective

DCIP - Don't Crap In Public
Term
What is calibration?
Definition
Ability to correctly estimate a disease state or risk of future event
Term
What are the components fo the tripartite model for the nature of anxiety?
Definition
Cognition (of fear)
Behavior (avoidance)
Physiology (symptoms)
Term
Characteristics of 3rd gen studies
Definition
Diagnostic studies
Structured interviews
Term
Characteristics of 1st gen studies
Definition
Facility surveys
Specific diagnosis
Based on medical records
Term
Characteristics of 2nd gen studies
Definition
Household surveys
overall caseness rating
Term
Brown study examined the relationship between what and what?
Definition
The relationship between severe life events and the onset of depression (Brown, 1975) NOTE: WOMEN ONLY!
Term
Minority and disadvantaged children have later age of diagnoses
Definition
Mandell, 2002, 2005
Term
More severity leads to a latter diagnosis
Definition
Hertz-Picciotto & Delwiche, 2009
Term
Intensive behavioral interventions costs 40 - 60 K a year
Definition
Amendah, 2007
Term
Non-medical, educational costs 13K a year
Definition
Kogan, 2008
Term
Parents report frustrations with the initial assessment, including delays in getting final diagnosis
Definition
Brogan & Knussen, 2003
Term
Parents struggle to receive the referrals they need, including family support services and mental health services
Definition
Kogan, 2008
Brookman-Frazee et al., 2012
Term
Parents with children with more complicated presentations of ASDs have reported higher levels of dissatisfaction with school and IEPs
Definition
Zablotsky, Boswell, and Smith, 2012
Term
Parents report frustrations with clinicians lacking knowledge of ASDs
Definition
Rhoades and colleagues, 2007
Term
Half of parents of children with ASDs would transfer their child to another school to receive better services
Definition
Kasari et al., 1999
Term
An individual with an ASD costs 3.2 million in a lifetime
Definition
Ganz, 2007
Term
Parents must give up on career goals and stop working or cut hours
Definition
Cidav et al., 2012
Term
Families with ASDs report lower levels of coherence
Definition
Sivberg, 2002
Term
Families of ASD children report lower marital satisfaction
Definition
Bristol et al., 1988
Term
Families with an ASD, report strained relationships between parent and child
Definition
Doussard-Roosevelt et al., 2003
Term
Parents have high stress levels compared to mothers with children with other disabilities
Definition
Yamada et al., 2007
Term
An improvement in a parent's mental state can reduce the child's risk for physical and mental health problems
Definition
Weissman et al., 2006
Term
An improvement of a parent's mental state can increase service utilization for the child and parent
Definition
Olfson et al., 2003
Term
Improvements in a mother's mental health can lead to more effective parenting strategies
Definition
Webster-Stratton & Hammond, 1988
Term
A child's level of social skills deficit dictates their treatment
Definition
Ingersoll et al., 2001
Term
A child's level of social skills deficit dictates their classroom placement
Definition
Strain & Cordisco, 1994
Term
ADHD and internalizing disorders are the most common among children with ASDs
Definition
Hofvander et al., 2009; Leyfer et al., 2006
Term
Parents of ASDs have to deal with unique and overlapping behavioral challenges
Definition
Jarbrink et al., 2003
Term
As the amount of ASD symptoms increase, greater the parental stress
Definition
Benson, 2006
Term
Parents of children with behavioral problems have higher stress levels
Definition
Davis & Carter, 2008
Term
Parents of Asperger's have the highest levels of parental stress
Definition
Mori, 2009
Term
High stress levels lead to an increased risk for parental depression
Definition
Abbeduto et al., 2004
Term
There is a genetic link between ASDs and mood disorders
Definition
DeLong, 2004
Term
Parents of children with developmental disorders had impairments in health and social relationships
Definition
Mugno et al., 2007
Term
Parents of ASD children had a lower standard of living, poorer mental and physical health, and lower quality close relationships
Definition
Allik et al., 2006
Lee et al., 2009
Term
Hispanics have [depressed] parents who are less likely to have health care access, and/or higher levels of social support.
Definition
Fiscella et al., 2002; Vega et al., 1991
Term
Mothers of older children were less likely to be depressed, how come?
Definition
Depression more likely in newer mothers
(Munk-Olsen et al., 2006)
Term
Parents of children with autism report lower levels of social support, as well as lower quality friendships
Definition
Boyd, 2002
Weiss, 2002
Term
Parents report feelings of isolation, having to put aside personal relationships
Definition
Woodgate et al., 2008
Term
Parents put aside career, and cut hours
Definition
Montes & Halterman, 2008
Term
A self-report clinician diagnosis is considered generally valid
Definition
Sanchez-Villegas et al., 2008
Term
Populations recruiting for clinical hospitals studies can resemble those online
Definition
Joseph & Dohan, 2009
Term
Risk for maternal depression at peak in first few years of child's life
Definition
Dave et al., 2010
Ozonoff et al., 2010
Term
Mental health problems for children decreases with parent mental health problems
Definition
Gunlicks & Weissman, 2008
Term
Pediatricians indicate they do not have the time necessary to effectively screen for child or maternal depression
Definition
Horwitz et al., 2007
Term
Pediatricians indicate they do not believe they are responsible for providing treatment for parents
Definition
Olson et al., 2011
Term
Pediatricians have difficulties in recognizing mothers with depressive symptoms
Definition
Heneghan et al., 2000
Term
Studies with few measures have shown considerable success in screening for depression
Definition
Olson et al., 2005
Term
Coping supports have the potential to reduce a parent's risk for developing depression and other forms of psychopathology
Definition
Coyne, 1991
Term
Families with children with ASDs often have strained siblings and parental relationships
Definition
Rao & Beidel, 2009
Term
Unaffected siblings of children with ASDs report lower quality relationships with affected siblings
Definition
Kaminsky & Dewey, 2001
Term
Families with ASD children report lower levels of coherence, cohesion and adaptability
Definition
Higgins et al., 2005
Pisula & Kossakowska, 2010
Term
Utilizing appropriate coping supports has shown the potential to help mothers of children manage their stress and reduce depressive syptomatology
Definition
Wolfe et al., 1989
Term
Decreasing stress levels of parents can improve well-being of the child
Definition
Bromley et al., 2004
Term
Parents of with higher levels of support have been found to have the lowest levels of stress
Definition
Ekas et al., 2010
Term
Neighborhood supports have been identified as having a substantial influence on an individual's physical and mental health well-being and level of connectedness
Definition
Feldman & Steptoe, 2004
Term
Medical practitioners can be considered social supports
Definition
Farran & Sparling, 1988
Term
Children of depressed mothers are at an increased risk of developing behavioral health issues and health complications
Definition
Harnish et al., 1995
Olfson et al., 2003
Weissman et al., 1996, 1986
Term
Majority of children with an ASD present with at least one psychiatric comorbidity , especially children with Aspergers
Definition
Rosenberg et al., 2011
Simonoff et al., 2008
Term
Families who are better off financially may be at a reduced risk for negative outcomes
Definition
Gurney et al., 2006
Term
Strong social supports in the neighborhood may play a role in protecting mother's mental health
Definition
Klebanov et al., 1994
Term
Overly stressed mothers are poor responders to interventions
Definition
Osborne et al., 2008
Term
Fathers should not be underestimated in the role they could play in helping the health of the family
Definition
Higgins et al., 2005
Term
Parents of children with disabilities benefit greatly from support groups
Definition
Solomon et al., 2001
Term
Parents of children with the most impaired children are the most likely to use support groups
Definition
Clifford & Minnes, 2012
Term
Parents who make positive meaning of their child's disability may become closer, show resiliency, positive perceptions of their child
Definition
Bayat, 2007
Pakenham et al., 2005
Term
There are 30% of children who are bullied in schools
Definition
Nansel et al., 2001
Term
Children who are bullied show internalizing and externalizing mental health problems
Definition
Bond et al., 2001
Seals & Young, 2003
Term
Children who are bullied show academic problems
Definition
Schwartz et al., 2005
Term
Children who are bullied show impaired school functioning
Definition
Swearer et al., 2010
Term
Children who have disabilities are bullied at an increased rate
Definition
Rose et al., 2011
Term
Children with ASDs are at an increased risk for bullying due to their difficulties in making friends
Definition
Bauminger et al., 2003
Term
Children with ASDs may rely more heavily on parents and school staff to help them combat bullying
Definition
Whitaker et al., 1998
Term
The risk for victimization of children with disabilities varies based on the severity of the disability
Definition
Dawkins, 1996
Term
Children with compromised social skills and poor social cue reading skills appear to be at the greatest risk for bullying (among those with disabilities)
Definition
Kaukiainen et al., 2002
Term
Bullied children may display retaliatory aggressive behaviors
Definition
van Cleave and Davis, 2006
Term
Middle and high school youth who were bullied turn to friends for support, while elementary school aged children turn to parents and teachers
Definition
Waasdorp & Bradshaw, 2011
Term
A child's involvement and attitudes towards bullying are influenced by the school climate
Definition
(Espelage & Swearer, 2009)
Term
A parent's response to bullying is influenced by school factors
Definition
Waasdorp et al., 2011
Term
Parents whose children have been bullied are likely to view the school more negatively and perceive that their own efforts would have little impact on combating bullying
Definition
Sheldon, 2002
Term
Parents who have a positive evaluation of the school climate are more likely to engage in school-related activities
Definition
Sheldon & Epstein, 2002
Term
Parental school involvement benefits include positive academic and social outcomes
Definition
Domina, 2005; Zellman & Waterman, 1998
Term
Parents of children with ASDs may already been meeting actively with guidance counselors and appropriate members of the IEP team
Definition
Zablotsky et al., 2012
Term
Parents who are most actively involvement in IAN are most likely to fill out subsequent surveys
Definition
Kalb et al., 2012
Term
Children who are victims in past month more likely to be bullies too, provocative bullies
Definition
Nansel et al., 2001
Term
Older parents were less likely to be involved in their child's school
Definition
Feurstein, 2000
Term
Lower levels of school involvement at regular education population schools
Definition
Coleman & Hoffer, 1987
Term
Children with Aspergers have highest comorbid rate
Definition
Rosenberg et al., 2011
Term
Bullied more often leads more bullying
Definition
Matsunaga, 2009
Term
Online surveys have the potential to reduce social desirability biases
Definition
Wang et al., 2005
Term
Parents may potentially unreport bullying
Definition
Holt et al., 2009
Term
Many children do not disclose being bullied to adults
Definition
Unnever & Cornell, 2004
Term
Highest functioning ASD children may still show verbal impairements
Definition
Kjelgaard & Tager-Flusberg, 2011
Term
Adoption of school-wide positive behavioral interventions and supports has the potential to subsequently reduce the risk for bullying
Definition
Waasdorp et al., 2012
Term
Teachers need additional training to familiarize themselves with population of children with ASDs
Definition
Barnhill et al., 2011
Scheuermann et al., 2003
Term
There is a shortage of professionals, both educational and medical, who can care for children with ASDs
Definition
Wise et al., 2010
Term
The cost of treating individuals with an ASD has risen in recent years, costs higher than any other developmental childhood condition
Definition
Jarbrink & Knapp, 2001
Term
A shortage in providers can translate to significant delays in receiving interventions
Definition
Rosenberg et al., 2008
Term
Early interventions can lead to gains in functioning, including IQ increases, adaptive behaviors, and ability to maintain gains
Definition
Dawson et al., 2010
Eikeseth et al., 2002
Eldevik et al., 2009
Term
Increased training of professionals could lead to a reduction seen in the litigaiton taken by parents against school districts
Definition
Mandlawitz, 2002
Term
Employment and adults outcomes are poor for ASD individuals
Definition
Taylor & Seltzer, 2010, 2011
Term
Criteria for the disorder is being refined through the DSM-V, new diagnosis may include Social Communication Disorder for high functioning children
Definition
Frazier et al., 2012
McPartland et al., 2012
Term
Aspergers diagnosis has clinical utility
Definition
Ghaziuddin, 2010
Kaland, 2011
Term
Parents who are reliant on Medicaid for their child's insurance may lose such coverage if their child no longer carries their ASD diangosis
Definition
ASAN, 2012
Term
Poor parenting is a risk for child psychopathology, while strong child coping is a protective factor
Definition
Compas et al., 2010
Term
Mothers who perceive social support as more accessible report fewer stress-related somatic problems and depressive symptoms
Definition
Gill & Harris, 1991
Term
Roughly 50% percent of all expenditures on mental health services were either directly funded or administered by the states
Definition
Mark et al., 2007
Term
NAMI reported that the United States received a D in treating individuals with mental illnesses
Definition
Aron et al., 2009
Term
Approximately 1 in 5 children have an emotional or behavioral problem
Definition
Institute of Medicine, 2009
Term
Approximately 20% of children needing mental health services receive them
Definition
Kataoka et al., 2002
Term
Entry into mental health services often begin in a school setting
Definition
Farmer et al., 2003
Term
Caregivers with depression or substance abuse are less likely to seek and obtain mental health care for their children
Definition
Whitson et al., 2010
Term
Less than 1 in 3 children receiving psychotropic medication will also receive psychotherapy
Definition
Mark, 2008
Term
Families must have necessary supports in order to cope with effectively raising their children
Definition
Friesen et al., 1988
Term
The philosophy of family support embodies the perspective that we should be concerned about the impact of childhood disorders on the entire family as well as the impact of family characteristics on the emotions and behavior of the child
Definition
Friesen & Koroloff, 1990
Term
Children with autism have greater health plan-based access and provider based access difficulties than children with mental retardation or controls
Definition
Krauss et al., 2003
Term
Parents in rural settings have negative expectations regarding provision of mental health care for their children, including relationships with providers and access of care
Definition
Starr et al., 2002
Term
A partnership has been developed to prepare school psychologists to coordinate community-based systems of care to promote positive educational and health outcomes for children.
Definition
Power et al., 2003
Term
A deficit-oriented approach to mental health care minimizes the role that ecological factors serve in the development of pathology, and may contribute to the stigma associated with mental health services
Definition
Power, 2003
Term
Deficit oriented models use a reactive approach, often only being implemented in times of crisis
Definition
Fantuzzo et al., 1995
Term
The mental health system's inability to connect with or egnage the most vulnerable groups of children and families may be the provision of incongruent services that lack cultural sensitivity and ecological validity
Definition
Fantuzzo & Mohr, 2000
Term
The majority of children receive mental health services outside the traditional mental health system
Definition
Hoagwood et al., 1994
Term
Approximately 80% of children receive mental health care through the school, mostly guidance counselors and school psychologists
Definition
Burns et al., 1995
Term
Studies comparing concordant rates among peers, teachers, students
Definition
Ladd et al., 2002
Term
Teacher student concordance on bullying is only 20%
Definition
Achenbach et al., 1987
Term
Agreement for oppositional defiant disorders is very low between parent and teacher (8-22%)
Definition
Ronning et al., 2009
Term
Major depressive disorder is unremitting in 15% of cases and recurrent in 35%.
Definition
Eaton et al., 2008
Term
About half of those with a first-onset episode recover and have no further episodes
Definition
Eaton et al., 2008
Term
60% of people who commit suicide had depression or another mood disorder
Definition
Barlow, 2005
Term
1st AD has a 50% remission rate
2nd AD has a 50% remission rate
Definition
Karasu et al., 2000
Term
There is an inverse relationship between sense of belonging and depressive symptoms
Definition
Hagerty et al., 1996
Term
Insecure attachment appears to lead to
depressive symptoms in adulthood through its impact on self-worth contingencies and self-esteem
Definition
Roberts et al., 1996
Term
Parents of ASD children are older
Definition
Croen et al., 2007
Term
Depression reduced with social supports
Definition
Wolf et al., 1989
Term
50–70% of all ASD cases are also diagnosed with an ID
Definition
Fombonne, 2003
Term
Depressed parents are more likely to have children with psychopathology and behavioral disorders?
Definition
Cummings, 1994
Term
Access to care is limited for racial and ethnic minority families, with low parental education, living in non-metropolitan areas, and not following a major treatment approach
Definition
Thomas et al., 2007
Term
A majority of general pediatricians believe that an established diagnosis is important when considering EI referral
Definition
Silverstein et al., 2006
Term
District revenue was associated with higher proportions of children
identified with autistic disorder at baseline and increasing rates of identification when measured longitudinally.
Definition
Palmer et al., 2005
Term
Mental health problems for children can be alleviated or minimized by targeting parental mental health issues as a point of intervention
Definition
Gunlicks & Weissman, 2008
Term
Development of depression from an insecure attachment
Definition
Cole-Detke and Kobak (1996)
Term
Parents may seek a label as way to get children the clinical and educational attention they need - and that this could lead to overdiagnosis
Definition
Evans, 2010
Term
What percentage of depression is genetic?
Definition
37% (Sullivan et al., 2000)
Term
36% of parents reported dissatisfaction with the services their child received in school for ASDs
Definition
Spann et al., 2003
Term
Approximately 82% of pediatricians screen for general developmental delays, only 8% screened for ASD
Definition
Dosreis et al., 2006
Term
3.0 RR for first-degree relatives
of MDD probands vs. the general population
Definition
Maier et al., 1992
Term
There are treatment differences between unipolar and bipolar depression
Definition
Forty et al., 2008
Term
30-50% of depression is genetic
Definition
Sullivan et al., 2000
Term
A cut-off score of 12 is appropriate for ASD only population
Definition
Corsello et al., 2007
Term
Higher reported rates of depression when compared to paper or in-person questionnaires
Definition
Jones et al., 2012
Term
Web-based surveys may present usability and accessibility issues for disadvantaged or novice Internet users
Definition
Boot & Frans, 2010
Term
Depressed parents have insecure attachments with their child
Definition
Cox et al., 1987
Term
1/2 of all mood disorders mothers will be depressed by age 30, 1/4 by 18
Definition
Kessler et al., 2005
Term
Effective medical management may allow a child with an ASD to benefit more optimally from educational interventions
Definition
Myers and Johnson, 2007
Term
Pediatricians appear to be more appropriate than family physicians for treating/screening children with DDs
Definition
Sices et al., 2003
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