Main Topics Notes
1. Introduction When is behavior abnormal? (in less dramatic cases ; within ind. or reaction to env.?
- atypical harmful: disturbances, dysfunction mental processes, distress, disability
de ning abnormal - devel. norms: dev. delay; dev. regression/ deterioration (bed-wetting for yrs ;
at pical frequency, intensity, duration (persisting ; inappropriate to situation; abrupt
changes; several problem behaviors; qualitatively di erent (lack eye-contact
- cultural norms ( rates and expression of disorder; norms, treatments, views
ethnicity: common values, language, traits of national origin/ geographic area/ race
- gender norms: expectations; situational norms ( places, context, conduct
- others' judgement: depends on parents, teachers'... changing views over time!
!!! harm/ interference norm!
prevalence - - preschoolers, children and adol. in USA
- most young adults have experienced some type of mental problem
- secular trends: across time, mixed results; some evidence of increase, for girls
- o en unrecognized, - inadequate treatment; accumulates, in uences lifespan
developmental level - speci c age of onset for disorders, (emerging abilities and demands
- if disorder occurs especially earlier than typical onset, likely to be more severe
gender prevalence - boys: most disorders, neurodevelopmental, early onset
- girls: anxiety, fear, depression and eating dis., later in life
- expression, timing of onset for each dis., severity, causes…
! methodological issues… reporting, preferences, referral biases ( disruptive, studied
more, described based on boys , biological sex di erences (X, Y in responses, risks
historical in uences Psy.pathol. focused on adults s child has needs (nourish innocent/ blank slate
- s: explanations for adult psy.pathol.: demonology (possessed, evil themselves ,
somatogenesis (from bodily dysfunction; inheritance, as early degeneration - today!
- end of s: some disturbances and causes of children's dis.: aggression, psychosis,
hyperact., masturbatory insanity, mental retardation
- s: psychoanalytic theory (psychogenesis, from defense mechanisms, anxiety,
Freud, psychiatry to study childhood disorders ; behaviorism social learning theory
(Watson's classical c., Thorndike's Law of E ect, Skinner's operant c., Bandura's
observational learning ; mental hygiene child guidance mov. ( understanding,
treatment, prevention, juvenile institutions, interdisciplinary ; scienti c studies
current study practice - multiple causation, normal goes w/ abnormal, science, prevention, treatment
- interdisciplinary e orts to working w/ children; parents are crucial, can be
cotherapists, coclients; children have attitudes, consciousness, techniques are
developmentally sensitive, ethical and legal requirements (con dentiality, reporting
2. The Developmental understanding: w/ perspectives, paradigms (also limits ; guided by theories, models:
Psychopathology - interactional: factors, eg. vulnerability-stress model ( vulnerability stress
Perspective - transactional: development comes from transaction ind.-env., systems models
overview understanding disordered behavior in relation to normal development
- development change (qualitative/quantitative over lifespan (not always , from
ongoing transaction ind w/ bio, psycho and sociocultural factors (also changing
searching for etiology - medical model: disorders are discrete, from single bio cause
- also search for interaction of factors and underlying mechanisms
- direct e ect (more straight in uence X Y vs indirect (X mediator a, b, c… Y
- moderator: in uences direction/ strength of relation predictor (X criterion (Y
- necessary cause vs su cient vs contributing
pathways of development - gradual, progressive (mal adaptation to changing circumstances; redirection
(continuity or change , probabilistic (not deterministic ; to target intervention!
- dev. pathways: adaptation level at any given time doesn't predict later functioning
- development is transactional and probabilistic: equi nality ( factors same
outcome and multi nality (factor outcomes
risks - precede chance psy.p.; tend to cluster; intensity/ duration/ timing impacts
, di erently; early worse FACTORS AND PROCESSES!
- ind's tendency to respond maladaptively (genetic, learning… , social injustice,
neighborhood, low IQ, birth complications, abuse, SE, nonnormative stressful event,
di cult temperament
- transactional: stressors (major/minor/ chronic events mediators (bio/psycho/social
processes ps p moderators child/env charac. ( -way in uences
vulnerability ind factors that act as risk factors; opposite of resilience
resilience good outcome in signi cantly adverse experiences; competence in
developmental tasks (cultural age-expectations ; can change over time,
risk protection
continuity of disorder - protective factors: personal family attributes, and out of the family support
- varies for disorders (autism vs eating d. , subgroups within disorder
- heterotypic cont. (expression changes vs homotypic (stable expression over time
normal --- abnormal - env. (poor parental care.. , brain develop., genetic, view of social env., negat. events
- attachment: Freud, Bowlby (parenting, secure base regulation, coping ; secure,
insecure avoidant (ignore caregiver or resistant (can't seek careg. , disorganized (mov,
expression incomplete, slow ; to later relationships; risk or protective!
- temperament: bio based, modestly stable behavioral style eas , slow to warm, di cult
(sensitivity to context, for better or worse ; malleable, goodness-of- t (w/ parents,
envir. ; dimensions: self-regulation, negative reactivity, inhibition; risk or protective!
- emotion regulation: bio basis, env. in uence, family modeling; communication,
empathy; critical to psych. maladjustment, emotion knowledge, reactivity
- social cognitive processing: how interpret; emotion knowledge, (hostile biases...
3. Bio. Environ. Contexts
of Psychopathology
brain and nervous system - develop. is bio guided, but also experience!; glia, neurons (chemical transmission ;
pruning (death some areas develop faster; myelination (white matter in adolescence
- structure: CNS (brain spinal cord , PNS (somatic autonomic (para sympathetic ;
hindbrain (vital function, cerebellum , midbrain (arousal , forebrain ( hemispheres
- neurotransmission: size, shape, chemistry; dendrites cell body axons
NS risk for disorders - can be wired in, but also from in uences:
- prenatal: teratogens (harmful substances : drugs, radiation, virus; amount, timing;
tend to cluster (alcohol tobacco
- perinatal (during: prematurity, lack O , birthweight and postnatal: malnutrition,
illness, chemicals; may recover (plasticity or set cascade (severity, region, timing…
genetic context - chromosomes DNA genes; inheritance or mutation (physical, intellectual and
psycho abnormalities; behavior genetics (mostly regulatory genes, not coding
- genetic code (order of ATGC transcription RNA translation protein
- epigenetics: genotype to phenotype is intricate path!
- single-gene inheritance (Mendel : alleles each parent, dominant/recessive
- person w/ disorder ( index case, proband
- multiple-gene inheritance: w/ QTL (quantitative trait loci ; probability; quantitative
methods assess heritability ( ; environ. in uences in family shared/nonshared;
family, twin, adoption
- molecular methods: how biochemicals coded by genes are involved in b.; linkage
(reveal loci, family disorder--genetic marker association (candidate gene analysis
- gene-env: interaction (GxE, sensitivity to experience due to genotypes, PKU vs
correlation (GE: passive -parents environ-, reactive -evokes reaction in others-, active
-selects environ-
learning cognition - classical (can generalize , operant (reinforce/ punish conditioning, observational
learning ( inhibition/disinhibition depending on model being reinforced/not
- processing and thinking about the world; cogn-behav perspective: maladaptive
cognitions (schemas content distortions ---maladaptive behavior (phobia, anxiety..
socio-cultural context - ecological transactional model (the circle - family, community, societal
family - may be mediator or moderator, risk or protection
- parent roles: for mothers/ fathers, but both crucial; also interaction btw the two
, - parenting styles (relationship is crucial to develop adjustment : warmth/control
(authoritative permissive authoritarian neglectful ; e ectiveness depends on context
- parent psychopathology: a risk factor for child
maltreatment - extreme failure (also from society to provide adequate parenting; cabuse or neglect
that results in serious physical/ harm, sexual abuse or exploitation. ( physical,
( sexual, ( emotional abuse and ( neglect (most common . persistent extreme
- factors:
● Abuser: parents, mostly very young (misinterpreting child, impulsive,
substance abuse, partner violence, likely to have experienced abuse
● Child: youngest ( yrs , w/ disabilities
● Parent child interactional processes
● social cultural in uences: SE, social connectedness
- consequences: lower support for develop.; develop. traumatology model ( PTSD
symptoms in child altered stress-regulating and neurotransmitter systems brain
metabolism adverse brain develop. cognitive, psychosocial outcomes
divorce - of USA family is single-parent; a complex transition, heightens develop. risks
- most children function normal; many predictors, transactional: interaction btw
members (con icts? ; indiv. characteristics (coping, eliciting support ; child's age,
gender, ethnics (AA adapt more to stepdads ; stress; routine stability
peer in uence - grows in in uence: social and cognitive (preventive from disorder ; parental
hostility relates to peer rejection; bidirectional peer di culties---disorder
community societal - school: societal norms, socioemocional growth; peers; teacher---academic outcomes
contexts - SES: persistenc , depth, timing; - safety, stress, - cogn. develop., mediated by family
- neighborhoods: community resources, family relationships, norms/collective e cacy
- culture ethnicit minorit status: acculturation, immigrants: low SES, prejudice…
5. Classi cation, - classi cation taxonomy, delineation of behavioral disorders
Assessment Intervention - diagnosis assigning a category to an individual
- assessment evaluating, for diagnosis intervention ( med, env, social problems
Classi cation Diagnosis - category (discrete vs dimension (degrees
- interrater reliability, test-retest reliability (use of category is stable over time
- validity diagnosis also gives etiology, response to treatment, clinical features
- clinical utility how complete and useful the classi cation system is
DSM approach - clinically derived (based on consensus of clinicians that symptoms go together ,
categorical; chapters w/ similar disorders, criteria, info; over emphasis of problem
within the child? w/ demographic variations; integrating dimensions to the
dichotomous system
- criteria: symptoms are persistent/recurrent/intense/excessive; signif. distress
- comorbidity: co-occurrence ( disorders in ind ; might be development of
disorder/ mixed symptoms… overde ning disorders? (what's normal?
- issue of whether considering xed or relative cuto s basing on sex, age, culture
(reall abnormal for own group? a ects prevalence index getting treatment
- overdiagnosing, lacking clear evidence of validity and decision rules, reifying
disorder, de-emphasizing context and developmental di erences
empirical approach behav. checklists statistics to identify interrelated behaviors (syndrome ;
dimensional; uses normative samples for de ning the normal (speci c to child's sex,
age, culture group
- Achenbach Instruments: Child Behavior Checklist, Teacher Report Form, Youth
Self-Report
- broadband syndromes: internalizing (anxiety-withdrawal and externalizing
(undercontrolled narrowband syndromes
- lower interrater reliability for contexts (rater bias ; strong validity clinical utility
stigmati ation labeling discrimination, prejudice, stereotyping or self-degradation bc of membership
- overgeneralization; expectation and ful lling e ect; but also explains the behavior
Assessment - comprehensive in evaluating variety of problems, aspects of child, contexts and
other individuals; use multiple sources; evidence-based (empirical and theory
