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Child Psychopathology

Child Psychopathology. Sleep Disorders Elimination Problems Reading: Chapter 12. Normal course of sleep. How many hours per day do you sleep on average? How many hours per day did sleep when 15 yrs.? What happens when you do not have enough sleep?

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Child Psychopathology

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  1. Child Psychopathology Sleep Disorders Elimination Problems Reading: Chapter 12

  2. Normal course of sleep • How many hours per day do you sleep on average? • How many hours per day did sleep when 15 yrs.? • What happens when you do not have enough sleep? • Sleep deprivation impairs pre-frontal cortex, decreases concentration, loss of inhibition of emotions and basic drives • How many hours do newborns sleep? The elderly? • Developmentally, sleep becomes more organized and nocturnal • Problems arise in toddlerhood (nighttime awakening), preschoolers (getting to sleep), elementary-school-age (bedtime rituals)

  3. Sleep Disorders: Dyssomnias • Protodyssomnia • problems initiating and maintaining sleep • Hypersomnia • excessive sleepiness • Narcolepsy • bouts of REM sleep during wakefulness • inherited, neurological disorder • Breathing related sleep disorder • Sleep apnea: loss/ disruption of breathing

  4. Nightmares Occur during REM Common (up to 50% of children) Can recall if awakened Movement and vocals inhibited No ANS arousal Anytime Night Terrors Non-REM sleep Uncommon Cannot remember Ambulatory, vocal Cannot be awakened ANS arousal Early in evening Sleep Disorders: Parasomnias

  5. Sleep Disorders Incidence and treatment of nightmares, night terrors, and somnambulism (sleep walking) Table 12.2 of text

  6. Normal bedwetting behavior

  7. Enuresis: Diagnostic criteria • Involuntary discharge of urine during the day or night • At least twice a week for three consecutive months • Significant distress or impairment • At least age 5 years or MA of 5 • Not accounted for by medical condition or physiological effects of a substance (diuretic) • Specify nocturnal or diurnal, primary or secondary

  8. Treatment for enuresis • Behavioral approaches • Bell & pad (Classical Conditioning) • Overcorrection (Operant, punishment) • Sticker charts (Reinforcement) • Drugs: Imipramine • Family-based interventions • Bathroom before bed, awakening • Dietary manipulations • restrict fluids, caffeine (e.g., COKE)

  9. Bowel movements and encopresis

  10. Encopresis: Diagnostic criteria • Passage of feces into inappropriate places • once per month for 3 months • child at least 4 years-old or MA of 4 • not accounted for by medical condition or physiological effects of a substance • Specify: With or without constipation and overflow incontinence

  11. Treatment for encopresis • Behavioral approaches • Reinforcement for appropriate tioleting • Regular scheduling of tioleting • Drugs, laxatives, enemas, mineral oil (goal: empty large intestine) • Family-based interventions • Guilt, shame associated with tioleting, pressure to produce • Dietary manipulations: Fibre, non-binders, increase natural motility

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