Chapter 1 – introduction
Developmental psychopathology suggests that we gain a better understanding of children’s
disorders when we think about those disorders within the context of typical development.
Defining disorders of infancy, childhood, and adolescence
One of the first steps leading to accurate and useful conceptualizations of psychopathology is to
recognize the many connections between typical and atypical development -> it is important to
look at peers and experiences. The most contemporary theorists and researchers emphasize
that a useful model of typical development requires a dynamic appreciation of children’s
strengths and weaknesses as they experience salient, age-related challenges.
Age-related issues Major issue Additional issue
of development
Infancy - Formation of an - Basic state and arousal regulation
effective - Development of reciprocity
attachment - Dyadic regulation of emotion
Toddler - Guided self- - Increased autonomy
regulation - Increased awareness of self and
others
- Awareness of standards for
behavior
- Self-conscious emotions
Preschool period - Self-regulation - Self-reliance with support (agency)
- Self-management
- Expanding social world
- Internalization of rules and values
School years - Competence - Personal efficacy
- Self-integration
- Competence with peers
- Competence in school
Adolescence - Individuation - Autonomy with connectedness
- Identity
- Peer network competence
- Coordinating school, work, and
social life
Transition to - Emancipation - Launching a life course
adulthood - Financial responsibility
- Adult social competence
- Coordinating work, training, career,
and life
Common descriptions of normality and psychopathology often focus on (1) statistical deviance
(the infrequency of certain emotions, cognitions, and/or behaviors); (2) sociocultural norms
(the beliefs and expectations of certain groups about what kinds of emotions, cognitions, and/or
behaviors are undesirable or unacceptable); (3) mental health perspectives (theoretical or
clinically based nations of distress and dysfunction). A key value judgement involves distinctions
,between adaptations and maladaptation -> are they adequate or optimal? Neither adequate nor
optimal adaptation guarantees smooth sailing throughout development.
With sociocultural definitions, value judgements are the basis of definitions of disorder.
Definitions of psychopathology and developmental psychopathology
Psychopathology = refers to intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition, and behavior.
Developmental psychopathology = extends this description to emphasize that these
maladaptive patterns occur in the context of typical development and result in the current and
potential impairment of infants, children, and adolescents.
The multipart task of estimating rates of disorder includes:
1. Identifying children with clinically significant distress and dysfunction, whether or not
they are in treatment
2. Calculating levels of general and specific psychopathologies and the impairments
associated with various disorders
3. Tracking changing trends in the identification and diagnosis of specific categories of
disorder
Frequencies and patterns of distributions of disorders in infants, children, and adolescents can
be estimated with varied methodologies and within varied groups. These frequencies and
patterns are the focus of the field of developmental epidemiology. Prevalence (the proportion
of a population with a disorder) and incidence (the rate at which new cases arise) rates are both
measures of the frequency of psychopathology.
Different barriers to care are:
- Structural barriers: include limited policy perspectives, disjointed systems, lack of
provider availability, etc
- Perceptual barriers about mental health difficulties: include the inability to acknowledge
a disorder, denial of problem severity, and beliefs that difficulties will resolve over time or
will improve without formal treatment. -> lack of trust in the system.
- Most mental health insurance policies have strict rules
- Inadequate money for prevention efforts is also a big dilemma -> Tolan & Dodge model
that simultaneously promotes mental health within normal developmental settings,
provides aid for emerging mental health issues for children, target high-risk youth with
prevention, and provides effective treatment for disorders. -> 4-steps:
1. Children and their families should be able to access appropriate and effective
mental health services directly;
2. Child mental health should be a major component of healthy development
promotion and attention in primary care settings such as schools, pediatric care,
community programs, and other systems central to child development;
3. Efforts should emphasize preventive care for high-risk children and families;
4. More attention must be paid to cultural context and cultural competence
The globalization of children’s mental health
To facilitate the success of interventions, mental health professionals must consider how to
implement treatments in countries where the health and welfare systems work differently, as
,well as how to provide treatment to children who are difficult to reach. The development and
implementation of globally useful interventions require recognition of the current disconnect
between where research takes place and where the need is greatest, as well as a commitment
to do better on behalf of the world’s children.
The stigma of mental illness
Mukulo, Heflinger, and Wallston identify (1) several dimensions of stigma, including negative
stereotypes, devaluation, and discrimination; (2) two targets of stigma, the individual and the
family; (3) two contexts of stigma, the general public and the self/individual.
Increasing our tolerance and compassion for the diverse group of those who are diagnosed with
psychopathology and believing in the inherent worth of each struggling infant, child, and
adolescent help stigma’s.
Chapter 2 – Models of child development, psychopathology, and treatment
The role of theory in developmental psychopathology
Models of development, psychopathology and treatment allow us to organize our clinical
observations of children and our research findings into coherent, informative accounts.
- Dimensional and categorical models:
o Dimensional models of psychopathology: emphasize the ways in which typical
feelings, thoughts and behaviors gradually become more serious problems,
which then may intensify and become clinically diagnosable disorders -> no
sharp distinction between adjustment and maladjustment. Also referred to as
quantitative or continuous.
o Categorical models of psychopathology: emphasize discrete en qualitative
differences in individual patterns of emotion, cognition, and behavior. There are
clear distinctions between what is normal and what isn’t. Also referred to as
qualitative or discontinuous.
Physiological models
Physiological models propose that there is a physiological basis for all psychological
processes and events -> body related.
Historical models often focused on the multiple ways in which genes, brain structure and
function, and early critical periods influenced, directed and constrained development.
Research focused on the human connectome: the diagram of the brain’s neural connections. In
contrast to explanations of microscopic connectivity (between neurons), explanations of the
connectome focus on macroscopic connectivity (between brain regions), and include
descriptions of nodes, hubs and modules:
- Nodes are understood in the context of numbers of connections, distances between
them, centrality, and clustering.
- Hubes: are nodes with extensive connections to other nodes.
- Modules: are groups of nodes with strong interconnections.
, We often expect that differences in brain structure, function, and development will be observed
between typically and atypically developing children, but we also must understand that there
are variations within groups of typically developing children.
The brain’s development responds to environmental feedback, resulting in increasingly efficient
processing -> pruning -> experience-dependent.
Neural plasticity illustrates several physiological processes related to brain development,
organization, and reorganization. It involves the development and modification of neural circuits,
with now-conclusive evidence that “both positive and negative experiences can influence the
wiring diagram of the brain”. The primary sensory areas – the brain’s first filters to the outside
world – exhibit striking examples of experience-dependent plasticity early in life.
As important as plasticity is across development, a balance between plasticity and stability is
critical.
Genetics play a critical role in physiological models. Behavior genetics, the study of the joint
effects of genes and environments, provides a framework for understanding many sources of
genetic influence and allows researchers to estimate the heritability of many psychological
characteristics. We have moved beyond the view of nature vs nurture to descriptions of gene-by
environment effects and gene-by-environment interactions. Epigenetics (ex. Synaptic
pruning) is focused on how environmental factors influence gene expressivity -> activity of the
gene rather than the presence. Genetically informed models of psychopathology must account
for the high heritability of many different kinds of disorder. Rather than a correspondence
between particular genetic variants and one disorder, there appear to be a more limited set of
risk alleles that impair general processes across many disorders.
Polygenetic models emphasize the likelihood that many genes have small effects and attempt
to account for the multiple types of genetic variations and processes that result in genetic
burdens that influence the development of both mild and severe forms of disorders.
Physiological models suggest that there are inborn, or acquired vulnerabilities to disorders ->
including abnormalities, structural pathologies, and biochemical disturbances, that may lead to
psychological distress and dysfunction. According to the diathesis-stress model, structural
damage or chemical imbalance does not by itself lead to disorder.
The first step when a child is diagnosed with an biochemical imbalance (low serotonin or ADHD)
is to initiate a trial of medication. However behavioral strategies have a major impact on these
diagnoses.
Psychodynamic models
Psychodynamic models have historically focused on several themes, including (1) the impact
of unconscious processes on typical and atypical personality development; (2) conflicts among
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