Depression in children: Behavioral
manifestations and intervention
David A. Songco, M.A., Psy.D.
New Insights, LLC
Milwauk...
Depression
Introduction
• Prevalence of depression increases with age.
• Mood disorders among preschool-age children
are extremely ra...
Depression: What is it?
• Major Depressive Episode (2 Week
Period)
• Depressed Mood most of the day, nearly every day, as ...
Depression in ChildrenDepression in Children
How is it Different?How is it Different?
Signs and Symptoms
• Depression in children typically manifests
itself differently than in adults
• The core features of M...
Depression in Children
• Children and adolescents with depression often
display:
• Irritability
• Withdrawal from family a...
Recognizing depression
• Persistent themes in play and fantasy will
often reflect mood
• School phobia and excessive cling...
Examples
Distinguishing between depression and
other BX Disorders
• In depression, behavioral disturbances will subside when the
mo...
Behavioral disorders
Conduct Disorder, Oppositional Defiant Disorder
and Attention Deficit/Hyperactivity Disorder can
occu...
Depression and Abuse
• Most young children with major depressive
disorder have histories of abuse or neglect.
• As profess...
Suicide and DepressionSuicide and Depression
Suicide
• Suicide is the 3rd leading cause of death among adolescents in the US.
• Reports indicate that half of suicidal ...
A point to remember
It is always OKAY to Ask about it!It is always OKAY to Ask about it!
Aggression
Working with aggression
• The nature of the population we work with is
very prone to acts of aggression.
• It is important...
De-Escalation Model
• Physical Presentation
• Content of Speech
• Listening Tools
• Clarification
• Negotiation
• Positive...
Communication as
De-Escalation
De-Escalation
• Undivided Attention
• Be Nonjudgemental
• Focus on Feelings
• Allow for Sil...
Program Development
Model
• Social-Cognitive Information processing
(SCIP) perspective of Aggression
• Decision Making Mod...
SCIP
• See Handout
• Right Column: Methods that can be used
to train the social-cognitive information-
processing componen...
SCIP Application• Cognitive Mediation Training
• Trained to evaluate consequences of their
behavior
• 8 Steps
• Is there a...
Services from New Insights,
LLC
• Psychological AssessmentPsychological Assessment
• Psychological Testing (Coming Soon)Ps...
Contact Us
• Dr. David Songco
• dsongco@newinsightsllc.com
• 414 - 604 - 6413
References
• American Psychological Association. Diagnostic and Statistical Manual of
Mental Disorders, 4th Ed. (2000).
• ...
Depression In Children: Behavioral Manifestations and Intervention
Depression In Children: Behavioral Manifestations and Intervention
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Depression In Children: Behavioral Manifestations and Intervention

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Presentation delivered to the West Side Health Authority. This presentation was attended by program developers, teachers, principals, and directors of local community organizations.

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  • What do you think it is?
  • the rate of Major Depressive Disorder in preschoolers is estimated to be about 0.3 % in the community.
    Slightly higher rates of depression in boys than girls in school aged children
    in adolescence, the prevalence of depression differs greatly in regards to biological sex.
    The reported rates of major depression range from 1 percent to about 6 percent in community samples of adolescents. However, in older adolescence, prevalence rates jump to between 14 and 25 percent.
  • Details: When was the last time it happened, what happened, did it leave a mark etc.
  • Point 2: What does this mean for us
    A completed suicide is rare in children younger than 12.
  • take all threats seriously
  • Program Components addressing the script search and retrieval step (Step 2) of the SCIP model would help children by providing them with direct exposure to and instruction on a variety of prosocial skills
  • Eg: An adolescent wanted to watch a television show but another child was already watching TV, though half asleep. Come up with and evaluate three ways to deal with the situation. Then apply it to another personally relevant situation.
  • Depression In Children: Behavioral Manifestations and Intervention

    1. 1. Depression in children: Behavioral manifestations and intervention David A. Songco, M.A., Psy.D. New Insights, LLC Milwaukee, WI (c) 2014 New Insights, LLC
    2. 2. Depression
    3. 3. Introduction • Prevalence of depression increases with age. • Mood disorders among preschool-age children are extremely rare • Among pre-pubertal school-age children in the community, the prevalence is approximately 1 percent. Similar rates of depression in in terms of gender • The rate of depression in adolescent females is double the rate it is in adolescent males.
    4. 4. Depression: What is it? • Major Depressive Episode (2 Week Period) • Depressed Mood most of the day, nearly every day, as indicated by either subjective report of other observations. • Markedly diminished interest or pleasure in all, or almost all activities • Significant weight loss when not dieting or weight gain, or decrease/increase in appetite nearly every day • Insomnia or hypersomnia nearly every day • Feelings of worthlessness or excessive or inappropriate guilt • Diminished ability to think or concentrate or indecisiveness • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan
    5. 5. Depression in ChildrenDepression in Children How is it Different?How is it Different?
    6. 6. Signs and Symptoms • Depression in children typically manifests itself differently than in adults • The core features of Major Depressive Disorder are highly similar in children, adolescents, and adults, however developmental factors influence its clinical presentation.
    7. 7. Depression in Children • Children and adolescents with depression often display: • Irritability • Withdrawal from family and peers • Deterioration in academic investment • Social isolation
    8. 8. Recognizing depression • Persistent themes in play and fantasy will often reflect mood • School phobia and excessive clinging to parents may also be symptoms • Poor academic performance • Substance abuse • Antisocial behavior • sexual promiscuitY
    9. 9. Examples
    10. 10. Distinguishing between depression and other BX Disorders • In depression, behavioral disturbances will subside when the mood disorder is treated. In conduct disorder and oppositional defiant disorder, the behavioral disturbances are likely more pervasive and embedded in the root of the problem rather than a symptom of it. • In depression, children and adolescents will often be able to recognize feelings of sadness, depressed mood, irritability, etc. when probed. Whereas, when dealing with strictly behavioral issues, these depressive symptoms will likely not be present. • Conduct disorder and Depression are often present in the individual concurrently. It is thought that the likely connection is related to shared risk factors rather than a causal relation.
    11. 11. Behavioral disorders Conduct Disorder, Oppositional Defiant Disorder and Attention Deficit/Hyperactivity Disorder can occur among children who later experience depression.
    12. 12. Depression and Abuse • Most young children with major depressive disorder have histories of abuse or neglect. • As professionals working with children, we are mandated reporters. • Responsibilities • Find as many details as possible • Make the DCFS Phone Call • 1-800- 25-ABUSE
    13. 13. Suicide and DepressionSuicide and Depression
    14. 14. Suicide • Suicide is the 3rd leading cause of death among adolescents in the US. • Reports indicate that half of suicidal individuals express suicidal intentions to a friend or a relative within 24 hours before enacting suicidal behavior. • More than 12,000 children and adolescents are hospitalized in the US each year due to suicidal threats or behavior. • Completed suicide occurs about 5 times more often in adolescent boys than in girls • The rate of suicide attempts is at least 3 times higher among adolescent girls than boys.
    15. 15. A point to remember It is always OKAY to Ask about it!It is always OKAY to Ask about it!
    16. 16. Aggression
    17. 17. Working with aggression • The nature of the population we work with is very prone to acts of aggression. • It is important to recognize the difference horseplay, play fighting, and expressed aggression. • Aggression may be verbal and physical. • It is difficult to work with an individual who is currently in an aggressive state.
    18. 18. De-Escalation Model • Physical Presentation • Content of Speech • Listening Tools • Clarification • Negotiation • Positive Affirmation
    19. 19. Communication as De-Escalation De-Escalation • Undivided Attention • Be Nonjudgemental • Focus on Feelings • Allow for Silence • Clarify Message
    20. 20. Program Development Model • Social-Cognitive Information processing (SCIP) perspective of Aggression • Decision Making Model - 4 steps • Evaluate Environmental Cues • Search memory for a script to guide behavior • Evaluate the generated script • Behave according to the script
    21. 21. SCIP • See Handout • Right Column: Methods that can be used to train the social-cognitive information- processing components of each step • Middle Column: Steps of the SCIP Model • Left Column: Underlying processes contributing to each step.
    22. 22. SCIP Application• Cognitive Mediation Training • Trained to evaluate consequences of their behavior • 8 Steps • Is there a problem • Stop and think • Why is there a conflict • What do I want • Think of Solutions • Look at Consequences • Choose what to do and do it • Evaluate the Results
    23. 23. Services from New Insights, LLC • Psychological AssessmentPsychological Assessment • Psychological Testing (Coming Soon)Psychological Testing (Coming Soon) • Individual TherapyIndividual Therapy • Couples CounselingCouples Counseling • Group TherapyGroup Therapy • Family SessionsFamily Sessions • Workshops and Community PresentationsWorkshops and Community Presentations
    24. 24. Contact Us • Dr. David Songco • dsongco@newinsightsllc.com • 414 - 604 - 6413
    25. 25. References • American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (2000). • Boxer, P & Dubow, E. (2002). A social-cognitive information-processing model for school-based aggression reduction and prevention programs: Issues for research and practice. Applied & Preventative Psychology. 10: 177- 192 • Cowin et al. (2003). De-Escalating aggression and violence in the mental health setting. International Journal of Mental Health Nursing. 12: 64-73. • Sadock, J & Sadock, V (2007). Synopsis of Psychiatry. Philadelphia, PA: Lippincott Williams & Wilkins.

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