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STUDY GUIDE TO
PSYCH IATRY
for residents, fellows, and practicing psychiatrists reviewing for Board examinations or
Maintenance of Certifcation. Even for child and adolescent psychiatrists not reviewing for
certifcation, the book is a great refresher and self-assessment resource. The questions are
short and case based. The study guide contains up-to-date and evidence-based information
Consuelo Cagande, M.D., DFAPA, DFAACAP, Chief, Division of Community Care and A Companion to Dulcan’s Textbook of Child and
Wellness and Senior Associate Fellowship Program Director/Advisor, Department of Child
and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia Adolescent Psychiatry, Third Edition
STUDY GUIDE TO
S tudy Guide to Child and Adolescent Psychiatry is a question-and-answer companion
that allows you to evaluate your mastery of the subject matter as you progress through
Dulcan’s Textbook of Child and Adolescent Psychiatry, Third Edition. The Study Guide is made
up of approximately 295 questions divided into 49 individual quizzes of 5–8 questions each
that correspond to chapters in the textbook. Questions are followed by an answer guide
that references relevant text (including page numbers) in the textbook to allow quick access
to needed information. Each answer is accompanied by a brief discussion that not only
addresses the correct response but also explains why other responses are not correct.
The Study Guide’s companion, Dulcan’s Textbook of Child and Adolescent Psychiatry, Third
Edition, provides practitioners the depth and breadth of knowledge covering topics including
neurodevelopmental and other psychiatric disorders and disorders affecting somatic function;
multiple approaches to psychosocial treatments; the principles of pediatric psychopharmacology
and use of the medications; and special topics, including cultural and religious considerations,
youth suicide, legal and ethical issues, and gender and sexual diversity.
Tapan Parikh, M.D., M.P.H., is Assistant Mina K. Dulcan, M.D., is Professor of Psy-
Professor of Psychiatry and Behavioral Sci- chiatry and Behavioral Sciences and Pedi-
ences at Northwestern University Feinberg atrics at Northwestern University Feinberg
School of Medicine, in Chicago, Illinois, School of Medicine, in Chicago, Illinois,
and Medical Director of Acute Care Ser- and a member of the Pritzker Department
vices at the Pritzker Department of Psychia- of Psychiatry and Behavioral Health at Ann
try and Behavioral Health, Ann & Robert H. & Robert H. Lurie Children’s Hospital of Parikh
Lurie Children’s Hospital of Chicago. Chicago.
Dulcan
EDITED BY
Cover design: Susan Westrate • Cover images: Tammy J. Cordova;
Shutterstock.com: © Monkey Business Images, © wavebreakmedia, Tapan Parikh, M.D., M.P.H.
© pixelheadphoto digitalskillet, © Garry Killian, © Mary Morgan,
© CandyRetriever, © Cincinart, © iunewind, © VisualArtStudio Mina K. Dulcan, M.D.
STUDY GUIDE TO
Edited by
Tapan Parikh, M.D., M.P.H.
Mina K. Dulcan, M.D.
Note: The authors have worked to ensure that all information in this book is accurate at
the time of publication and consistent with general psychiatric and medical standards,
and that information concerning drug dosages, schedules, and routes of administration
is accurate at the time of publication and consistent with standards set by the U.S. Food
and Drug Administration and the general medical community. As medical research and
practice continue to advance, however, therapeutic standards may change. Moreover,
specific situations may require a specific therapeutic response not included in this book.
For these reasons and because human and mechanical errors sometimes occur, we rec-
ommend that readers follow the advice of physicians directly involved in their care or
the care of a member of their family.
Books published by American Psychiatric Association Publishing represent the find-
ings, conclusions, and views of the individual authors and do not necessarily represent
the policies and opinions of American Psychiatric Association Publishing or the Ameri-
can Psychiatric Association.
If you wish to buy 50 or more copies of the same title, please go to www.appi.org/
specialdiscounts for more information.
Copyright © 2023 American Psychiatric Association Publishing
ALL RIGHTS RESERVED
First Edition
Manufactured in the United States of America on acid-free paper
27 26 25 24 23 5 4 3 2 1
American Psychiatric Association Publishing
800 Maine Avenue SW
Suite 900
Washington, DC 20024-2812
www.appi.org
Library of Congress Cataloging-in-Publication Data
A CIP record is available from the Library of Congress.
ISBN 9781615374915 (paperback), 9781615374922 (ebook)
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
PART I: Questions
CH AP TER 1
Process of Assessment and Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
CH AP TER 2
Assessing Infants and Toddlers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
CH AP TER 3
Assessing the Preschool-Age Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
CH AP TER 4
Assessing the Elementary School–Age Child . . . . . . . . . . . . . . . . . . . . . . . .11
CH AP TER 5
Assessing Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CH AP TER 6
Neurological Examination, Electroencephalography,
Neuroimaging, and Neuropsychological Testing . . . . . . . . . . . . . . . . . . . . .15
CH AP TER 7
Intellectual Disability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
CH AP TER 8
Autism Spectrum Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
CH AP TER 9
Communication Disorders, Specific Learning Disorder,
and Motor Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
CH AP TER 10
Attention-Deficit/Hyperactivity Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
CH AP TER 11
Oppositional Defiant Disorder and Conduct Disorder . . . . . . . . . . . . . . . . .25
CH AP TER 12
Substance Use Disorders and Addictions. . . . . . . . . . . . . . . . . . . . . . . . . . .27
CH AP TER 13
Depressive and Disruptive Mood Dysregulation Disorders . . . . . . . . . . . . .29
CH AP TER 14
Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
CH AP TER 15
Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
CH AP TER 16
Posttraumatic Stress Disorder and Persistent Complex
Bereavement Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
CH AP TER 17
Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
CH AP TER 18
Early-Onset Schizophrenia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
CH AP TER 19
Eating and Feeding Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
CH AP TER 20
Tic Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
CH AP TER 21
Elimination Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
CH AP TER 22
Sleep-Wake Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
CH AP TER 23
Evidence-Based Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
CH AP TER 24
Child Abuse and Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
CH AP TER 25
Cultural and Religious Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
CH AP TER 26
Youth Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
CH AP TER 27
Gender and Sexual Diversity in Childhood and Adolescence . . . . . . . . . . . 63
CH AP TER 28
Aggression and Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
CH AP TER 29
Psychiatric Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
CH AP TER 30
Family Transitions: Challenges and Resilience . . . . . . . . . . . . . . . . . . . . . . .71
CH AP TER 31
Legal and Ethical Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
CH AP TER 32
Telemental Health and e-Mental Health Applications With
Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
CH AP TER 33
Principles of Psychopharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
CH AP TER 34
Medications Used for ADHD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
CH AP TER 35
Antidepressants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
CH AP TER 36
Mood Stabilizers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85
CH AP TER 37
Antipsychotic Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87
CH AP TER 38
Individual Psychotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
CH AP TER 39
Parent Counseling, Psychoeducation, and Parent Support Groups . . . . . .91
CH AP TER 40
Behavioral Parent Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
CH AP TER 41
Family-Based Assessment and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . .95
CH AP TER 42
Interpersonal Psychotherapy for Depressed Adolescents . . . . . . . . . . . . . .97
CH AP TER 43
Cognitive-Behavioral Treatment for Anxiety and Depression . . . . . . . . . . .99
CH AP TER 44
Motivational Interviewing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101
CH AP TER 45
Systems of Care, Wraparound Services, and Home-Based Services . . . .103
CH AP TER 46
Milieu Treatment: Inpatient, Partial Hospitalization, and
Residential Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
CH AP TER 47
School-Based Interventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
CH AP TER 48
Collaborating With Primary Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
CH AP TER 49
Collaborating With Inpatient and Subspecialty Pediatrics . . . . . . . . . . . . . 113
CH AP TER 1
Process of Assessment and Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
CH AP TER 2
Assessing Infants and Toddlers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
CH AP TER 3
Assessing the Preschool-Age Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
CH AP TER 4
Assessing the Elementary School–Age Child . . . . . . . . . . . . . . . . . . . . . . . 133
CH AP TER 5
Assessing Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
CH AP TER 6
Neurological Examination, Electroencephalography, Neuroimaging,
and Neuropsychological Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
CH AP TER 7
Intellectual Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
CH AP TER 8
Autism Spectrum Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
CH AP TER 9
Communication Disorders, Specific Learning Disorder, and
Motor Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
CH AP TER 10
Attention-Deficit/Hyperactivity Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
CH AP TER 11
Oppositional Defiant Disorder and Conduct Disorder . . . . . . . . . . . . . . . .163
CH AP TER 12
Substance Use Disorders and Addictions. . . . . . . . . . . . . . . . . . . . . . . . . .167
CH AP TER 13
Depressive and Disruptive Mood Dysregulation Disorders . . . . . . . . . . . .173
CH AP TER 14
Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179
CH AP TER 15
Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
CH AP TER 16
Posttraumatic Stress Disorder and Persistent Complex
Bereavement Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189
CH AP TER 17
Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .193
CH AP TER 18
Early-Onset Schizophrenia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199
CH AP TER 19
Eating and Feeding Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203
CH AP TER 20
Tic Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
CH AP TER 21
Elimination Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .211
CH AP TER 22
Sleep-Wake Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215
CH AP TER 23
Evidence-Based Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .219
CH AP TER 24
Child Abuse and Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .223
CH AP TER 25
Cultural and Religious Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .227
CH AP TER 26
Youth Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .231
CH AP TER 27
Gender and Sexual Diversity in Childhood and Adolescence . . . . . . . . . . 235
CH AP TER 28
Aggression and Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
CH AP TER 29
Psychiatric Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
CH AP TER 30
Family Transitions: Challenges and Resilience . . . . . . . . . . . . . . . . . . . . . . 251
CH AP TER 31
Legal and Ethical Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
CH AP TER 32
Telemental Health and e-Mental Health Applications With
Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
CH AP TER 33
Principles of Psychopharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
CH AP TER 34
Medications Used for ADHD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
CH AP TER 35
Antidepressants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
CH AP TER 36
Mood Stabilizers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
CH AP TER 37
Antipsychotic Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
CH AP TER 38
Individual Psychotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
CH AP TER 39
Parent Counseling, Psychoeducation, and Parent Support Groups . . . . . 291
CH AP TER 40
Behavioral Parent Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
CH AP TER 41
Family-Based Assessment and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . 299
CH AP TER 42
Interpersonal Psychotherapy for Depressed Adolescents. . . . . . . . . . . . . 303
CH AP TER 43
Cognitive-Behavioral Treatment for Anxiety and Depression . . . . . . . . . .307
CH AP TER 44
Motivational Interviewing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311
CH AP TER 45
Systems of Care, Wraparound Services, and Home-Based Services . . . .315
CH AP TER 46
Milieu Treatment: Inpatient, Partial Hospitalization, and
Residential Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .319
CH AP TER 47
School-Based Interventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323
CH AP TER 48
Collaborating With Primary Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .329
CH AP TER 49
Collaborating With Inpatient and Subspecialty Pediatrics . . . . . . . . . . . . .333
Contributors
Nadina Abdullayeva, M.D.
Child Psychiatrist, Youth Psychiatry, The Royal Ottawa Health Care Group, Ottawa, On-
tario, Canada
xiii
Moshe Bitterman, M.D.
Child and Adolescent Psychiatry Fellow, McGaw Medical Center of Northwestern Uni-
versity, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
xiv | Contributors
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The Project Gutenberg eBook of Marie-Rose au
couvent
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Language: French
MARIE-ROSE
AU COUVENT
PARIS
L I B R A I R I E P LO N
PLON-NOURRIT ET Cie, IMPRIMEURS-ÉDITEURS
8, RUE GARANCIÈRE — 6e
Drichette.
Le Roman d’Arlette.
Histoire d’un honnête garçon.
La Chaumière aux Ravenelles.
Ames vaillantes (Couronné par l’Académie française).
Les Droits de l’enfant (Étude sociale, Couronnée par
l’Académie des Sciences morales et politiques et par
l’Académie de médecine).
Le Rôle des mères dans l’éducation de leurs fils au point
de vue de la morale (brochure).
ALBUMS
PREMIÈRES IMPRESSIONS
I
L’ENTRÉE
Les voilà donc parties toutes deux pour les jardins, Marie-Rose et
la jeune postulante ; celle-ci se dépensant en amabilités, celle-là tout
oreilles, écoutant les explications qui lui sont faites sur la vie et les
hôtes du couvent. De temps à autre, elle réclame un supplément
d’information au sujet des choses et des mots qui la touchent pour
la première fois.
— Qu’est-ce que c’est ?… qu’est-ce que cela veut dire ?…
Sœur d’Ailly répond en termes clairs, précis, et sans concession
trop marquée à la toute petite intelligence de son interlocutrice.
C’est pour l’enfant la première initiation à ce langage qu’elle doit
entendre pendant treize ans, langage sérieux, élevé, si simple
pourtant dans sa noblesse, qu’après un court entraînement, il est
accessible aux esprits les plus jeunes et les moins développés.
I
AU DORTOIR
Une grande pièce oblongue ayant vue, d’un côté sur la mer, de
l’autre sur les terrasses, quinze lits blancs où, sous les rideaux de
basin rayé, quinze petites dormeuses poursuivent leur rêve, sans
souci du jour qui va poindre, ni de la veilleuse qui craque en
achevant de brûler son huile : nous sommes dans le dortoir de
l’Ange Gardien.
La porte s’ouvre doucement, et une religieuse entre à pas de
loup. Elle jette d’abord un coup d’œil d’ensemble, puis visite chaque
« coin ».
Rassurée par le calme qui l’entoure, elle détache le chapelet qui
pend à sa ceinture et commence à prier. Au bout de quelques
minutes, le grand silence est interrompu par les trois premiers
« tints » de l’angélus ; trois « tints » encore, puis trois autres, et la
« volée » annonce qu’il faut se remettre à vivre.
Mère Saint-Boniface prononce comme un appel :
— Jésus !
Quelques voix très endormies répondent :