Developmental Psychopathology

PSY 428

2009-2010 SPRING

Introduction to Developmental Psychopathology

What is Developmental Psychopathology?

Seperate discipline?

How developmentalist define the area?

Definitions

“the study of the origins and course of individual patterns of behavioural maladaptation, whatever the age of onset, whatever the causes, whatever the transformations in behavioural manifestation, and however complex the course of the developmental pattern may be” (Scroufe & Rutter, 1984)

Definitions

should take into account “....the emerging behavioural repertoire, cognitive and language functions, social and emotional processes and changes occurring in anotomical structures and physiological processes of the brain” (Institute of Medicine, 1989).

Definitions

The defining features of developmental psychopathology concepts include attention to the understanding of causal processes, appreciation of the role of developmental mechanisms, and consideration of continuities and discontinuities between normality and psychopathology. (Rutter & Sroufe,2000)

Definitions

Developmental psychopathology is the multigenerational, life course study of the biological and social transmission of the modes and forms of vulnerability and resilience (Donald Cohen,1997).

Definitions

Developmental psychopathology, a rapidly emerging scientific dicipline, is characterized by attempts to understand psychopathology from within the framework of normative developmental psychology (Luthar, Burack,Cicchetti & Weisz,1997).

Definitions

investigation of functioning through the assesment of ontogenetic biochemical genetic biological physiological cognitive social-cognitive representational socioemotional environmental cultural ........... influences on behaviour

Definitions

“developmental psychopathology is first and foremost

about the study of development” (Rutter)

Historical roots

publicationsAchenbach 1974/1982Rutter & Garmezy, 1984Child Development, 1984Development & Psychopathology,

1989

Historical roots

This multidisciplinary journal is devoted to the publication of papers

which address the interrelationship of normal and pathological development in adults and children. It is intended to serve and integrate the field of developmental psychopathology which strives to understand patterns of adaptation and maladaptation throughout the lifespan.

Historical roots

Development & Psychopathology, 2000

“Reflecting on the Past and Planning for the Future of Developmental Psychopathology”

Child Development Perspectives, 2009

“The concept of development in developmental psychology” (Sroufe)

Historical roots

more about normal development .....more about abnormal development ...

psychopathology is distortion or exaggeration of the normal condition

led to focus on both normal and abnormal processes

Historical roots

change in developmental psychology researchsocial policyapplied developmentalfocus on context

person-context relationsstudying diversity

…same rules may not apply

Defining characteristics Use of developmental theory and research to inform

issues of psychopathology

Use of insights from at-risk or atypical populations to increase our understanding of normal developmental processes

Integration of developmental, clinical perspectives with other diciplines

Derivation of implications for prevention, intervention, social policy and therapy

How does it differ from other disciplines?Discipline development focus Diagnosis &

treatment

normal abnormal adult child

Developmentalpsychopathology

--

Clinical child psychology

--

Abnormal psychology

--

Developmentalpsychology

-- --

What is psychopathology?

adaptational failure …….deviations or failure to develop age-

appropriate normsexaggeration of normal developmental

process interference in normal developmental

progress

What is psychopathology?maladaptation …

a pause, a regression or a deviation

deviancy ….intensity, frequency, duration,

situational appropriateness, age appropriateness

What is psychopathology?“Psychopathology is not a condition

that some individuals simply have or are born to have; rather, it is the outcome of a developmental process”

(Scroufe, 2009)

CONCEPTUAL ISSUES

developmental psychopathologist concerned with the origins, time course, varying manifestation

with development, precursors, transformations, relation to nondisordered patterns

CONCEPTUAL ISSUES

both normal and abnormal development occur as a qualitative reorganizations (multidirectional and dynamic

interaction)

CONCEPTUAL ISSUES

developmental pathwayssequence and timing of behavioural

continuities and transformationsdiversity in the process and outcome

Multiple contributers Varying contributers, many pathways Heterogeneity of the features

CONCEPTUAL ISSUES

equifinality: different pathways similar expressions of psychopathology

multifinality: similar pathways different forms of dysfunction

CONCEPTUAL ISSUES :Risk factors

genetic predisposition prenatal environmental hazards perinatal stress temperament parental psychopathology parental loss due to death interparental conflict

CONCEPTUAL ISSUES :Risk factors

physical abuse sexual abuse emotional abuse caregiving deficits (negative emotionality,

rejection, hostility) school changes low SES and poverty violence in the community

CONCEPTUAL ISSUES :Risk factors

community disasters out of home placement parental criminality single parenting young maternal age overcrowding

© 2006, Prentice Hall, Wicks-Nelson

Risk and Resilience

The more risks the poorer the outcomeTiming of risk importantSome risk is more predictableSome risk is tied to specific outcomesRisk for onset may differ from risk for

persistenceRisk can accumulate over time

CONCEPTUAL ISSUES :resilience

resilience…successful adaptation despite adversity

CONCEPTUAL ISSUES :protective factors

easy temperament high intelligence self efficacy positive self esteem problem solving skills self regulatory skills talents

CONCEPTUAL ISSUES :protective factors

presence of family positive parenting support from peers, adults, parents SES advantages effective schools role models outside the family

© 2006, Prentice Hall, Wicks-Nelson

CONCEPTUAL ISSUES :Continuity and Change

Homotypic Example=Autism has stable symptoms

Heterotypic Example=ADHD symptoms change with development

CONCEPTUAL ISSUES :continuity-discontinuity

some disorders are childhood specific some chronic some expressed both in childhood and

adulthood

CONCEPTUAL ISSUES :continuity-discontinuity

direct ways developing during childhood and persisting

over time experience altering physical status later

function response patterns not being appropriate

later

CONCEPTUAL ISSUES :continuity-discontinuity

indirect ways early predisposition + environmental

experiences experiences altered self-esteem

difficulties experiences selection of environment

behaviour

Challenges to the study of developmental psychopathology retrospective prediction

base rate error Dream come through = very low

Times we dream

Abused child Not abused child

Abused mother 70% ?

Not abused mother

30% ?

Challenges to the study of developmental psychopathology retrospective prediction

base rate error

Pathology at 6

No pathology at 6

total

Insecure attachment

8 (40%)80%

12 (60%) 20

Secure attachment

220%

36 38

total 10 48

Challenges to the study of developmental psychopathology

retrospective prediction reliability of the information

Challenges to the study of developmental psychopathology

follow-back strategy multiple sources of information control data focus on target population data may be uneven in quality clinical population may be biased

Challenges to the study of developmental psychopathology

follow-up strategy costly drop out rigid design

nature of maladaptive behaviour studying high-risk groups and cause-effect

relationships

Perspective on intervention

When and why disorder occur? How long it persist? Precursors?

timed intervention prevention times of reorganization and change resilience findings equifinality vs multifinality

MODELS OF DEVELOPMENTAL PSYCHOPATHOLOGY

MODELS OF DEVELOPMENTAL PSYCHOPATHOLOGY

Models of development Models of abnormal development

Disorder specific General theories

MODELS OF DEVELOPMENTAL PSYCHOPATHOLOGY

General theories: Psychodynamic

Freud inborn drives id,ego,superego imbalance

 psychosexual stages fixation regression

defense mechanisms

General theories: Psychodynamic

Object relations theory

Parent-infant relations

General theories: Attachment models

early attachment relationship internal working models of self, others and

relationships in general

caregiver insensitivity temperament

insecure attachment

General theories: Behavioural/Social learning models

excessive, inadequate or maladaptive reinforcement histories

principles of learning applies

Vicarious and observational experience

General theories: Cognitive models

distorted or deficient cognitive structures & processes

information processing: faulty information processing

Attention, memory and others Social information processing

General theories: Cognitive models

cognitive behavioural: cognitive distortions:distorted thoughts

Structures Content products

these dysfunctionspsychopathology

Cognitive deficit vs cognitive distortion

Model of aggression

Thinking about social world Take in information Understand Interpret

Crick & Dodge (1994) Encoding social cues -interpret cause and intent of

person Consider desired outcome Select and evaluate a response Enact response

General theories: Genetic and Biological models

Genetics: Mode of inheritance Behavioural genetics

Biological influences: Brain structure and function Neuroendocrinology (hormones) Physiological mechanisms Rate of maturation Temperament

General theories: Affective models

Emotion processing

Emotional regulation

General theories: Family system models

Identified problem

Communication Cohesion and support Control and power Conflict Organization (distance and closeness)

General theories: Ecological system theory

• Family• School:

Teachers, peers

• Culture, society

General theories: Ecological system theory

Peers impact Social behaviors Intimacy Empathy development Morality Cooperation Reciprocity Negotiation skill development Conflict management Sexuality Gender roles

General theories: Ecological system theory

School Teacher support important to self esteem Dropout associated with

Low SES Academic failure Behavioral disorders Lack of family support Motivation Self concept Cognitions about learning

General theories: Ecological system theory

Neighborhoods

More ethnic minorities in poor neighborhoods Affluent neighborhoods associated with school

readiness and achievement Aggressive behavior linked to lower SES Higher rates of sexual activity associated with

lower SES

General theories: Ecological system theory

Culture, Ethnicity/Race, Minority Status Effects of violent media Acculturation-difficult process Prejudice and discrimination

Rear children to be proud of heritage

Lack of health care and mental health services

General theories: Other approaches

Trait or status model: Mt1

Ct1 ---------------------- Ct2

General theories: Other approaches

Environmental model: Time of the event Continuity of the event

General theories: Interactional / transactional models

Both child and environment development Active child active environment

I. Additive model: (- att. ) * (+envi.) + outcome

General theories: Interactional / transactional models

 II. Transformational model:

(- att. ) * (+envi.) (+ att. ) + outcome

(- att. ) * (+envi.) (- envi. ) - outcome

(- att. ) * (+envi.) (+ att. ),(-envi.) outcome

General theories: Interactional / transactional models

Goodness-of-fit model: Mismatch child and environment No transformation

Regression Vulnerable child

Transformational model

General theories: Interactional / transactional models

Transactional model