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Summary of Disorders of Childhood

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A comprehensive and clear summary of all chapters from Disorders of Childhood. Includes usefull images (e.g. models).

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  • February 20, 2021
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  • 2020/2021
  • Summary

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Samenvatting Literatuur Developmental
Psychopathology
CH1: Introduction
The term 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.
Typical and atypical when referring to development and patterns of adaptation and maladaptation.

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; and
3. mental health perspectives, theoretical or clinically based notions of distress and
dysfunction.

From a sociocultural norm perspective, children who fail to conform to age-related, gender-specific,
or culture-relevant expectations might be viewed as challenging, struggling, or disordered. Keep in
mind, however, that there is significant potential for disparity among various sociocultural groups
and norms. From a mental health perspective, a child’s psychological well-being is the key
consideration.

Poor adaption –> adequate adaption –> optimal adaption

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 (and most of them are not);
2. calculating levels of general (e.g., anxiety disorders) and specific (e.g., generalized anxiety,
separation anxiety disorder, phobia) psychopathologies and the impairments associated with
various disorders; and
3. tracking changing trends in the identification and diagnosis of specific categories of disorder,
such as autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), and
depression.

Prevalence refers to the proportion of a population with a disorder; incidence refers to the rate at
which new cases arise. Random sampling of a general population is one option for estimating
prevalence.

Holistic approaches are multicomponent approaches that focus on children, their families, and their
communities and systems, and are often embedded in existing health, educational, or social
networks.

Mukolo, Heflinger, and Wallston (2010) identify:
1. several dimensions of stigma, including negative stereotypes, devaluation, and
discrimination;
2. two targets of stigma, the individual and the family; and
3. two contexts of stigma, the general public and the self/individual. Both Mukolo and Heflinger
and Hinshaw urge researchers to continue to investigate the multiple ways that stigma
complicates the experiences of children with mental disorders and their families.

,Key terms: Developmental psychopathology, Statistical deviance, Sociocultural norms,
Developmental epidemiology, Prevalence, Incidence, Barriers to care &Stigmatization.
CH2: Models of Child Development
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.
Categorical models of psychopathology, in contrast, emphasize discrete and qualitative differences in
individual patterns of emotion, cognition, and behavior. Categorical models are sometimes referred
to as discontinuous or qualitative.

Sensitive (or critical) periods in brain development have also been identified, some of which appear
domain or component dependent.

Genetics play a critical role in physiological models. We need to understand the many ways that the
genetic makeup of an individual, or genotype, influences the observable characteristics of an
individual, or phenotype.
Epigenetics is focused on the activity of the gene rather than the presence of the gene.

Polygenic 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.

From a physiological perspective, we emphasize the role of brain structure and function and
consider the likelihood of atypical biochemical processes in the development.

Psychodynamic models (Psychological models that emphasize unconscious cognitive, affective, and
motivational processes; mental representations of self, others, and relationships; the subjectivity of
experience; and a developmental perspective on individual adjustment and maladjustment)have
historically focused on several themes, including:
1. the impact of unconscious processes on typical and atypical personality development;
2. conflicts among processes and structures of the mind (e.g., id, ego, and superego);
3. the stages of development, with different ages associated with distinctive emotional,
intellectual, and social challenges; and
4. the lasting impact of more (or less) successful resolutions of stage-related challenges on later
outcomes.
Although recent psychodynamic models certainly take into account recent advances in neuroscience,
there is still an emphasis on the importance of psychological contexts, such as relationships, when
explaining the development of personality and psychopathology.

In contrast to the inward orientation of the physiological and psychodynamic models, the behavioral
models have an outward orientation, focusing on the individual’s observable behavior within a
specific environment.

According to Thomas, summarizing Skinner’s behaviorism, “As a child grows up, two things develop:
1. the variety of behavior options (potential ways of acting) that the child acquires and
2. the child’s preferences among those options.

Contemporary revisions of Piagetian models focus on the dynamic interaction of tasks, contexts, and
emotional states that influence cognition. The neo-constructivist approach emphasizes evolutionary
contexts, experience–expectant learning, and both qualitative and quantitative change across
development.

,Humanistic models are psychological models that emphasize personally meaningful experiences,
innate motivations for healthy growth, and the child’s purposeful creation of a self.

In many individually focused models of disorder, we examine the “identified patient” and his or her
unique collection of psychologically healthy and unhealthy characteristics. In contrast, family
models propose that the best way to understand the personality and psychopathology of particular
children is to understand the dynamics of their particular families.
- Shared environment = the aspects of family life and function that are shared by all children
in the family.
- Nonshared environment = the aspects of family life and function that are specific and
distinct for each child.

Key assumptions In Elder’s model:
1. Children develop within the social arrangements of a given moment.
2. These arrangements are changed by events and trends.
3. Developing individuals change history.
4. Cultures make sense of the ways of development.

CH3: Principles and Practices of developmental psychopathology
From a theoretical perspective, as emphasized in Chapter 2, developmental psychopathology is not
associated with a single point of view (see Figure). From a clinical perspective, developmental
psychopathologists assume that a variety of assessment, prevention, and intervention techniques
will prove useful.




Disorders are frequently understood as a developmental distortion or a form of unsuccessful
adaptation. Types of adaptational failures have often been viewed as either delay, fixation or
deviance. Another way of thinking about the connection between typical and atypical
development is to examine the notion of process.

, The concept of developmental pathways (or trajectories) illustrates the principle that adjustment
and maladjustment are points or places along a lifelong map.
Development is cumulative (builds upon itself). Second, developmental pathways are probabilistic,
not deterministic. In other words, early difficulties do not directly and always lead to disorder.
Holden (2010) describes several ways in which parents influence children’s pathways.
One way involves initiating trajectories by selecting environments and activities. Another way
involves supporting trajectories by providing attention and encouragement to children. And
another way involves mediating trajectories.
Holden describes children as reacting to parent-initiated pathways, as controlling their own degree
of engagement and effort on a particular pathway, and as initiating their own pathways.




Path 1 Stable Adaptation = Few behaviour problems: Good self-worth. Low risk exposure
Path 2 Stable Maladaptation = Chronic adversities; little protection
Path 3 Reversal of Maladaptation = Important life change creates new opportunity
Path 4 Decline Adaptation = Environmental or biological shifts bring adversity
Path 5 Temporal Maladaptation = Can reflect transient experiment risk taking

Two of the most important things to remember when thinking about developmental pathways:
(1)change is possible at many points; and
(2)change is constrained or enabled by previous adaptations.

Competence reflects effective functioning in important environments. All children display various
domains of competence, which involve particular skills and achievements, combined with domains
(or areas or types) of incompetence, which involve lack of skill or lack of achievement.

The core competencies model is focused on five markers of healthy development:
1. a positive sense of self,
2. self-control,
3. decision-making skills,
4. a moral system of belief, and
5. social connections.

Key observations of risk and resilience (children of parents with schizophrenia):

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