DEVELOPMENTAL
PSYCHOPATHOLOGY
HC 1 FUNDAMENTALS OF DEVELOPMENTAL PSYCHOPATHOLOGY
(CHAPTER 1-4)
Psychopathology intense, frequent, and/or persistent maladaptive patterns of emotions,
cognition, behaviour.
Developmental psychopathology emphasizes 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 problems arise when the child is growing.
Psychopathology in the context of typical development:
1. Dynamic: appreciation of children’s strengths and weaknesses as they experience
salient, age-related challenges.
2. Individual, familial, ethnic, cultural, societal beliefs about desirable vs undesirable
outcomes (= definitions of normality).
Statistical deviance how differently the person feels, thinks, acts compared to others.
- Issues: here is the cutoff? Which side of the spectrum is concerning?
Sociocultutal norms how is the person expected to think, act, feel
- Issues: group values are not universal truths.
Mental health definitions what experts consider as mental health/illness.
- Issues: experts subjectivity and values steer the definition.
Disorders in the context of development
1. Delay of dysfunction
2. Typical vs atypical development as a process; adjustment & maladjustment are points
along a lifelong map.
Multifinality similar starting points lead to different outcomes (child maltreatment).
Equifinality different starting points lead to similar outcomes (conduct disorder).
3 profiles of development:
1. Continuity and stability
2. Discontinuity and stability
3. Discontinuity and instability
Types of continuity:
- Homotypic continuity stable expression of symptoms.
- Heterotypic continuity symptom expression change with development.
- Cumulative continuity environment that perpetuates maladaptive style.
Risk: increased vulnerability to disorder.
Both factors are individual. So one thing can be a risk factor for a person but for another it
can be a resilience factor or they are stress-adapted what helps in different situations.
- Nonspecific vs specific
- Differential impact high risk levels may override resilience factor.
- Timing can dampen or strengthen the factors.
Resilience: positive adaption (or competence) despite adversity.
- Promotive (positive) vs protective (risk)
- Different patterns or pathways of protecting factors.
, 1. Reducing impact of risk
2. Reducing the negative chain of reactions following risk
3. Establishing and maintaining self-esteem and self-efficacy
4. Open up opportunities for growth
- Is dynamic and extends beyond the child/family system level
THEORETICAL MODELS:
“All models are wrong, but some are useful” (George Box)
- Why do we need theories? Organize clinical observation, research & treatment.
- How to approach theories? Diverse perspectives on complex realities (often
overlapping, complementary not exclusive).
Physiological models (principles) Everything that happens to us is own to physiology.
Basic A physiological basis for all psychological processes (brain - body – behaviour
processes)
Treatment focuses on physiological processes.
- A few disorders are innately related to damage or dysfunction.
- Risk alleles gene variations that are connected with psychopathology.
- Polygenic models interplay of multiple genes in disorders.
- The human brain develops over a very lengthy timeline
o Collaboration between child and caregivers in co-construction of the brain.
o Adaptation of children embedded in specific environments.
o Sensitive periods have powerful and enduring impacts
Psychodynamic models a physiological basis for all psychological processes.
Basic Unconscious processes influence development. Conflicts among processes and
structures of the mind. (Ego realism, compromise between superego/id. Superego
morality. Id instinct). Stages of development with specific emotional, cognitive and social
challenges. Lasting impact of resolutions to stage-related developmental challenges.
- Contemporary models emphasize Unconscious, mental representations, importance of
subjective, developmental perspective.
Treatment Play therapy, psychotherapy, psychoanalysis, specific therapies for disorders.
Behavioural and cognitive models We are just machine that have learned thing. There
are different ways of learning.
Basic typical and atypical behaviours are gradually acquired via learning.
Treatment relearning, unlearning and learning new behaviours.
- Classical and operant conditioning and social learning: They focus on observable
behaviour within a specific environment. Environment is a big influencer.
o Classical by association
o Operant reinforcement & punishment from following behaviour.
, o Social learning indirect reinforcement/punishment via observing others
Cognitive models focus on cognitive development, information processing, social context of
early cognition.
Humanistic/positive psychology models
Basic purposeful creation of the self, humans are innately driven to flourish.
Treatment increased emphasis on the child’s positive development and self-actualization
- Psychopathology: Interference with or suppression to develop an integrated sense of self.
How the environment gives us challenges to help us become the best version of
ourselves.
This focus doesn’t focus on the bad things but looks at the healthy development of children.
Family models
Basic psychopathology arises within the family system and reflects systemic problems
Treatment focuses on the family level, with specific C/B strategies
- These models bring a lot of importances with parenting, family warmth, activities,
composition and shared environment between siblings.
Sociocultural models
Basic cross-cultural and within-culture variables influence adjustment/ maladjustment.
General importance of social contexts
Treatment takes cultural variables into account
- Works with BronfenBrenner (micro, meso, exo, macro, chrono).
Classification a system for describing the important categories of disorders.
- Universal.
- It helps understand the causes, course and treatment of specific problems.
- Helps professionals communicate.
- Improves research and theory development.
Diagnosis the method of assigning children to classification categories,
Dimensional (continuous, quantitative)
- Gradual transitions from the typical range of feelings, thoughts and behaviour to clinically
significant problems.
- No strict distinctions.
Categorical (discontinuous, qualitative)
- Distinct patterns of emotions, cognition, and behaviour within the typical range differ from
those that define clinical disorders.
- Strict distinctions.
o The DSM: the diagnostic and statistical manual of mental disorders since 1952
- Categorical approach
- Increasingly included children’s disorders.
- Introduced developmental & continuous perspectives.
o The Achenbach system (ASEBA)
- Dimensional approach.
- Bottom-up process of classifications.
- Classification based on statistical techniques.
- Certain number of symptoms of significant impairment indicates psychopathology.
Assessment systematic collection of relevant information.
- Differentiating everyday problems or transient difficulties from clinically significant
psychopathology.
, - Classifying and caring for those who have been identified as having disorders.
- Assessment includes information about a child’s strengths and accomplishments.
Diagnosis assigning individuals to specific classification categories
- Differential diagnosis.
- Diagnosis efficiency.
Keeping in mind heterogeneity (people with the same diagnosis differ), comorbidity
(frequently co-occurring diagnosis) and transdiagnostic symptoms (symptoms underlying
multiple diagnosis).
Assessment methods: Clinical interview, standardized tests, observations
HC 2 INTELLECTUAL DISABILITIES (CHAPTER 6)
Specialized Journals:
- Journal of Intellectual Disabilities Research.
- Journal of Applied Research in Intellectual Disabilities.
International Association for the Scientific Study of Intellectual and Developmental
Disabilities they organize a big congress every 4 years.
Importance of expertise Intellectual disabilities are multidimensional
- Lack of interchange of knowledge between different clinical fields.
- Lack of Expertise when it comes to behavioural and psychiatry issues.
Need for well-trained psychologists and orthopedagogen!
Three Key Historical Moments in Dutch Disability Care.
- The occupation of Dennendal they give a lot of freedom, and they see them as
real/normal people. The government was concerned and fired the director (Carel Muller).
- The case of Jolanda Venema a photo of her naked and tied up in the newspapers.
She had behaviour problems, and nobody know how to deal with her, so they tied her up.
- Ratification of the UN Convention on Disability they need to give consent for a
treatment or otherwise a legal guardian needs to give consent.
Two models:
1. DSM model
2. AAIDD model
Most important are Intellectual functioning and adaptive functioning.
Other Conditions Included in Disability Care (that are not ID).
- Acquired Brain Injury (ABI).
- Later acquired disabilities.
- Borderline intellectual disabilities.
Different Levels of Intellectual Disabilities:
- Mild intellectual disability
- Moderate intellectual disability
- Severe intellectual disability
- Profound intellectual disability
