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Summary developmental disorders
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- Tilburg University (UVT)
Summary of 103 pages for the course Developmental Disorders at UVT (slides and book)
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developmental disorderslecture 1: introduction
Meta-analysis of prevalence (Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015).
Annual Research Review: A meta‐analysis of the worldwide prevalence of mental disorders in children and
adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345-365
I What is normal?
II Developmental disorder
“Psychopathology is behavior that once was, but no longer can be, considered appropriate to the child’s
level of development”
Prevalence
15-20% (APA, 2007) 10% serious, 10% mild
-due to variations across studies and methodological issues, it has been difficult to draw overall conclusions
about historical or so-called secular trends.
-according to the World Health Organization, many of the disorders that carry the heaviest burden of adult
death and disability in the developed areas of the world are related to mental health and are often first
observed in youth
Defining abnormality
• “Ab”-”normal” (away from the average and assumed to be harmful in some ways)
,Age, as an index of developmental level, is always important in judging behavior, but it is especially
important for children and adolescents because they change so rapidly. Judgments about behavior rely on
developmental norms, which describe the typical rates of growth, sequences of growth, and forms of
physical skills, language, cognition, emotion, and social behavior.
• When does a child deviate from the developmental norm? viewed as interfering with adaptation, that is,
with individuals fitting the circumstances of their lives.
• Developmental delay
• Regression or deterioration
• Extremely high or low frequency
• Extremely high or low intensity
• Behavioral difficulty persists over time
• Behavior is inappropriate to the situation
• Abrupt changes in behaviors
• Behavior qualitatively different from normal
• Norms that are significant:
- culture/ethnicity: Rates of disorders have been found to vary and disorders may be expressed in subtly
different ways. Cultural analyses describe the many ways in which cultures shape normal and abnormal
development and also conceptualize, explain, and treat psychopathology. Cultural norms have broad
influence on expectations, judgments, and beliefs about the behavior of youth.
- gender (male: externalizing/more disorders, female: internalizing, eating disorders) Gender norms
significantly influence development; they affect emotions, behaviors, opportunities, and choices. In most
societies, males are expected to be relatively more aggressive, dominant, active, and adventurous, while
females are expected to be more passive, dependent, quiet, sensitive, and emotional. These gender
stereotypes play a role in judgments about normality. We would probably be less inclined to worry about
the hypersensitive, shy girl and the excessively dominant boy than about their opposite-sex counterparts.
- age (autism→ ADHD→ learning problem→ conduct disorder→ drug abuse/eating disorder/schizophrenia)
-situational norms—what is expected in specific settings or social situations.
- lifestyle changes (focus on body size, more drug abuse)
Disorder may be viewed as residing within the individual. Alternatively, it can be regarded as the
individual’s reactions to circum-stances
Developmental psychopathology: “The study of developmental processes that contribute to, or protect
against, psychopathology”
Why is this interesting?
• Etiology and pathophysiology are still unknown
• Therapeutic interventions are only partially effective, are still mainly symptomatic, and often do not bring
complete cure
• A large number and wide diversity of treatments for children currently exist, many of which are
expensive, intrusive, and not supported by scientific data (Mash & Wolfe, 2007)
III. General developmental framework
two explanations of adult mental illness had long been recognized: demonology and somatogenesis.
Demonology is the belief that behavior results from a person’s being possessed or otherwise influenced by
evil spirits or demons. Somatogenesis is the belief that mental disorder can be attributed to bodily
malfunction or imbalance. Kraepelin recognized that particular symptoms tended to group together—to
occur in syndromes—and therefore he thought they might have a common physical cause. He viewed each
disorder as distinct from others in origin, symptoms, course, and outcome.
Nowadays, Developmental psychopathology is a systems framework for understanding disordered behavior
in relation to normal development. Rather than imposing specific theoretical explanations, it is a way of
combining various theories or approaches around a core of developmental knowledge, issues, and
questions. Individuals working within a developmental psychopathology framework may be informed by
cognitive, behavioral, psychodynamic, family, genetic, or other theories
CONCEPT OF DEVELOPMENT The concept of development can seem deceptively simple. Most people would
probably offer growth as a synonym, with growth meaning not only bigger but also better. And many would
recognize that development requires time. However, any definition that stops here would fall far short of a
,full description of development. Although many different depictions and explanations have been proposed,
there is some consensus among theorists on the essence of development:
-Development refers to change over the lifespan that results from ongoing transactions of an individual
-qualitative change is more salient
-Early development of the biological, motor, physical, cognitive, emotional, and social systems follows a
general course
-Development proceeds in a coherent pattern, so that for each person, current functioning is connected
both to past and future functioning
-Over the lifespan, developmental change may produce higher modes of functioning and the attainment of
goals, but change is not inevitably positive
Five contexts •Biological •Individual •Family •Social •Cultural
At the heart of interactional models is the assumption that variables interrelate to produce an outcome.
Ecological & Transactional Models (Bronfenbrenner / Sameroff; see also p48)
Transactional models are widely employed in the study of both normal and abnormal development. The
basic assumption is that development is the result of ongoing, reciprocal transactions between the
individual and the environmental context. Transactional models fall into the domain of systems models in
that they incorporate several levels, or systems, of functioning in which development is viewed as occurring
over time as the systems interact or enter into ongoing transactions with each other.
IV. 5 models of child psychopathology
1.Medical
• Psychopathology result from organic disfunction
• Problems are individual
• Classifying psychopathological behaviors→ diagnosis
• ICD-10 and DSM
considers disorders to be discrete entities that results from specific and limited biological causes within the
individual
-direct and indirect effects, moderators
-A necessary cause must be present in order for the disorder to occur. A sufficient cause can, in and of
itself, be responsible for the disorder. Contributing causes can also be operating; these are not necessary or
sufficient.
, Brain development: Biology and experience
The nervous system begins to develop shortly after conception when a group of cells called the neural
plate thickens, folds inward, and forms the neural tube. The rapidly developing cells migrate to fixed
locations. The brain contains millions of multifunctioning cells, the glial cells, and neurons that are
specialized to chemically transmit impulses within the nervous system and to and from other body parts.
These cells continue to become more interconnected and functional, and nerve fibers become sheathed in
myelin, a white substance that increases the efficiency of communication in the brain. Both before and
after birth, an excess of neurons and connections are produced, apparently setting the brain up to ensure
flexibility. Both before and after birth the shaping of the brain involves the mechanism of pruning, whereby
unneeded cells and connections are eliminated. The brain and spinal cord together form the central
nervous system. The nerves outside the central nervous system that transmit messages to and from it
compose the peripheral nervous system, which has two subsystems. One of these, the somatic system,
involves the sensory organs and muscles and is engaged in sensing and voluntary movement. The other, the
autonomic system, helps involuntary regulation of arousal and the emotions. Although neurons vary in size,
shape, and chemistry, they all have three major parts: a multifunctional cell body, dendrites, and an axon.
Communication between neurons occurs across a synapse, the small gap between the cells. When the
impulse reaches the end of the axon, packets of chemicals—the neurotransmitters—are released. They
cross the synaptic gap and are taken up by the receptor sites on the dendrites of the receiving neuron
risks for disordered functioning
prenatal influences. Numerous prenatal influences can put the developing child at risk. Among these are
poor maternal diet and health. Research also shows that maternal stress can alter the fetal biological
system, including the brain, in ways that can affect susceptibility to later psychological problems. At one
time, it was believed that the fetus was protected from most harmful substances, or teratogens, that might
enter the mother’s bloodstream. We now know that a variety of agents can be detrimental. Perhaps
unsurprising, the amount of exposure to a teratogen makes a difference in outcome. So does the timing of
exposure during gestation.
Perinatal and Postnatal Influences. Developmental risks are associated with birth. Excessive medication
given to the mother, unusual delivery, and anoxia (lack of oxygen) can result in neurological problems in
the newborn. Preterm delivery and low birthweight are associated with death and a variety of
developmental problems. When brain damage occurs in youth, a major concern is the degree to which the
resulting problems can be remediated. At issue is the plasticity, or flexibility, of the brain to recover.
genetic influences
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