Developmental Psychopathology
Lecture 1 Fundamentals of developmental psychopathology
What is developmental psychopathology? Risk
Increased vulnerability to disorder
Psychopathology: intense, frequent, and/or Risk factors
persistent maladaptive patterns of emotion, individual, family, and social characteristics
cognition, behavior Resilience factors
Developmental psychopathology emphasizes that Resilience
these maladaptive patterns occur in the context of Positive adaptation (or competence) despite adversity
typical development and result in the current and
potential impairment of infants, children, and Risk factors; specific vs. non-specific
adolescents Resilience factors; promotive vs. protective
Patterns & Pathways of Protective Factors
Psychopathology in the Context of Typical 1. Reducing impact of risk
Development; 2. Reducing the negative chain of reactions following
1. Dynamic appreciation of children’s strengths and risk
weaknesses as they experience salient, age-related 3. Establishing and maintaining self-esteem and self-
challenges efficacy
2. Individual, familial, ethnic, cultural, societal 4. Opening up opportunities for growth
beliefs about desirable vs undesirable outcomes (=
definitions of normality) Theoretical models
Defining Typical/Normal vs Atypical/Abnormal; Physiological models
• Statistical Deviance (how differently the person A physiological basis for all psychological processes
feels/thinks/acts compared to others) (brain – body – behavior processes)
• Sociocultural Norms (how the person is Treatment: focuses on physiological processes (e.g.,
expected to think/feel/act) medication)
• Mental Health Definitions (what experts
consider as mental health/illness) Psychodynamic models
1) Unconscious processes influence development
Multifinality: Similar starting points lead to different 2) Conflicts among processes and structures of the
outcomes mind
Equifinality: different starting points lead to similar 3) Stages of development with specific emotional,
outcomes cognitive, and social challenges
4) Lasting impact of resolutions to stage-related
Homotypic continuity: Stable expression of developmental challenges
symptoms Treatments: Play therapy, psychotherapy,
Heterotypic continuity: Symptom expression change psychoanalysis, specific therapies for disorders (e.g.,
with development mentalization-based treatment)
Cumulative continuity: Environment that
perpetuates maladaptive style Behavioral and Cognitive Models
Typical and atypical behaviors are gradually acquired
via learning
Important Take-Home Messages Behaviorism Treatment : relearning, unlearning, and
1. Change is possible at many points learning new behaviors (e.g., via exposure)
2. Change is constrained/enabled by previous Contemporary CB Treatments: increasing complexity
adaptations • Classical conditioning: by association
3. Transitions & turning points shut down/create • Operant conditioning: reinforcement &
opportunities punishment following behavior
4. Developmental coherence • Social learning: indirect
reinforcement/punishment via observing others
,Humanistic/Positive Psychology Models The Achenbach System (ASEBA)
Purposeful creation of the self, humans are innately • Dimensional approach
driven to flourish • Bottom-up process of classification grouping
Treatment: Increased emphasis on the child’s dimensions of problems into higher-order
positive development and self-actualization factors
Positive Psychology / Positive Youth Development: • Classification based on statistical techniques
focus on healthy development (less focus on • Certain number of symptoms/pattern of
pathology and its roots) significant impairment indicates psychopathology
Family Models
Psychopathology arises within the family system
Assessment & Diagnosis
and reflects systemic problems
Treatment: Family level, with specific C/B strategies
Assessment: systematic collection of relevant
information
Sociocultural Models
• Differentiating everyday problems or transient
cross-cultural and within-culture variables
difficulties from clinically significant psychopathology
influence adjustment/maladjustment
• Classifying and caring for those who have been
• General importance of social context (incl.
identified as having disorders
gender, race, ethnicity, and socioeconomic
• Assessment includes information about a child’s
status)
strengths and accomplishments
Treatment: Should take cultural variables into
account
Diagnosis: assigning individuals to specific
classification categories
Classification & Diagnosis
• Differential diagnosis
• Diagnostic efficiency
Classification: A system for describing the
important categories/groups/dimensions of
Heterogeneity: people with the same diagnosis differ
disorders
Comorbidity: frequently cooccurring diagnoses
Diagnosis: The method of assigning children to
Transdiagnostic symptoms: symptoms underlying
classification categories
multiple diagnoses
Dimensional (continuous, quantitative)
Assessment methods
Gradual transition from the typical range of
Clinical interviews
feelings, thoughts, and behaviors to clinically
Structures vs. unstructured vs. semi-structured
significant problems
Standardized tests
Problem checklists, self-reports, test batteries
Typical Clinical
Observations
Categorical (discontinuous, qualitative)
Meta-analysis worldwide prevalence in youth: 13,4%
Distinct patterns of emotion, cognition, and behavior
How do we treat it?
within the typical range differ from those that define
clinical disorders
Typical Clinical
DSM-5
• Categorical classification system since 1952
• Atheoretical and descriptive
• Medical model (disorders are categorical, • Psychotherapy
associated with dysfunction, and endogenous) • (Psycho)education for parents and families
• Systemic interventions at schools and within
communities
, Developmental Psychopathology
Lecture 2 Intellectual developmental disorders
The scientific field and clinical practice Different levels of ID;
- Borderline ID IQ 71-85
· Specialized journals (e.g. Journal of Disabilities - Mild ID IQ 51-70
Research - Moderate ID IQ 36-50
· International Association for the Scientific - Severe ID IQ 21-35
Study of Intellectual and Developmental - Profound ID IQ 0-20
Disabilities
Age equivalents/developmental ages; Dutch tool by
Importance of Expertise Dirk Kraijer, compares a person’s functioning to the
− Intellectual disabilities are multidimensional average skills of a child at a certain age
− Lack of interchange of knowledge between Emotional stages; describes functioning in terms of
different clinical fields developmental stages, like functioning at a baby or
− Lack of Expertise when it comes to behavioral toddler level
and psychiatric issues
− Need for well-trained psychologists and Developmental Perspective: slow but normal
orthopedagogen! development vs. Deficit Theory: abnormal
development in specific areas
Three Key Historical Moments in Dutch Disability
Care Causes of intellectual disabilities
• The occupation of Dennendal
(The occupation of Dennendal in 1974 involved a Prenatal Causes; chromosomal abnormalities (e.g.,
police intervention to remove staff from the Down syndrome), exposure to alcohol during
psychiatric facility after prolonged conflict over its pregnancy
experimental, humanistic management style) Perinatal Causes; birth complications such as lack of
• The case of Jolanda Venema oxygen during delivery
(a Dutch girl who was wrongly diagnosed with Postnatal causes; meningitis or metabolic diseases
severe mental disabilities due to trauma, leading to
years of inappropriate treatment and isolation, Zigler: the two-group approach (two types of causes
sparking a public debate about psychiatric care in of an ID)
the Netherlands) - Organic: the cause is organic (genetic, pathological,
• Ratification of the UN Convention on Disability neurological, biological)
(Legal equality for people with intellectual - Cultural-familial: the cause is environmental (= lack
disabilities) of stimulation), most likely being related to low SES
and multigenic, left part of the IQ-distribution
What are Intellectual disabilities?
Development
Two models:
1. DSM model Children with intellectual disabilities are 40% more
2. AAIDD model likely to experience Adverse Childhood Experiences
Intellectual functioning and adaptive functioning (ACEs). These are traumatic events in childhood, like
sexual abuse, domestic violence, or bullying at school
An intellectual disability (ID) is characterized by These ACEs make them more vulnerable to mental
limitations in intellectual functioning and adaptive health problems as adults
behavior
Others in disability care (not ID):
− Acquired Brain Injury (ABI)
− Later acquired disabilities
− Borderline intellectual disabilities
