Historical Views of Child Psychopathology

1. Historical Views of Child Psychopathology • The Emergence of Social Conscience • Historically children often ignored or subjected to harsh treatment • John Locke (17thC) • Jean-Marc Itard (19thC) – treat children with kindness

2. Historical Views (cont.) • Early Psychological Attributions (for adults, mostly) • emerged in early 1900’s • psychoanalytic theory • behaviorism laid foundation for studying conditioning and elimination of children’s fears

3. Historical Views of Child Psychopathology • Child psychopathology generally ignored • Insanity • DSM • 1980 version of DSM included a child section

4. Reasons why ignored • Psychoanalytic theory • Behavior theory

5. Historical Views (cont.) • Evolving Forms of Treatment based in historical context • institutionalized • foster families and group homes • behavior therapy

6. Evidence for change in perspective on children’s problems • Child-focused journals • Divisions of APA • Child abuse laws enacted • IDEA

7. Change in perspective (cont.) • Surgeon General’s report (2001) • 1 in 10 has severe mental or behavior problem • Only 2 of 10 with problems get help

8. Surgeon General’s goals • Promote public awareness • Develop scientifically proven treatments • Improve assessment methods • Eliminate ethnic/SES disparities in services

9. Surgeon General’s goals • Train frontline providers • Monitor access to mental health services • Improve infrastructure of services • Increase access to mental health services

10. Reasons why child psychopathology is now receiving more attention • Problems are common • Lifelong consequences • Predict adult disorders • Few children receive necessary help • Develop early intervention programs • Legal mandates

11. Defining Psychological Disorders • Determining what is normal and abnormal is an arbitrary process • Traditionally defined as a pattern of behavioral, cognitive, or physical symptoms, that is associated with one or more of: • distress • disability • increased risk for further suffering or harm

12. Defining Psychological Disorders (cont.) • Many childhood problems best depicted in terms of relationships • Labels describe behavior, not the child • Problems may be the result of children’s attempts to adapt to abnormal or unusual circumstances • Need to consider age/developmental level

13. Developmental Pathways • Refers to the sequence and timing of behaviors, and the relationship between them over time • Two types of developmental pathways: • multifinality: similar early experiences lead to different outcomes • equifinality: different early experiences lead to a similar outcome

14. Developmental Pathways (cont.) Figure 1.1 (a) Multifinality: Similar early experiences lead to different outcomes; (b) Equifinality: Different factors lead to a similar outcome

15. Developmental Pathways (cont.) • With abnormal child psychology, must keep in mind: • there are many contributors to disordered outcomes in each child • contributors vary among children who have the disorder • children express features of their disturbances in different ways • pathways leading to particular disorders are numerous and interactive

16. Issues unique to child psychopathology • Referral process • Greist et al.: why do parents bring their children in to clinics? • Predicted mother’s ratings of their children • Home observation for objective ratings • Got ratings of mom’s mood/depression

17. Referral process cont. • Webster-stratton (1988) • Questions of interest • Method • Results • implications

18. Temperament & reciprocal relationships • Innate biological factors which influence behavior • “easy” temperament • “difficult” temperament • Easiness to soothe • Activity • Sociability • Parent-child relationships are reciprocal

19. Reciprocal relationships • Pelham et al. (1997) • Questions of interest • Method • Results • implications

20. What Affects Rates and Expression of Mental Disorders? • Poverty and Socioeconomic Disadvantage • about 1 in 6 children in North America live in poverty • poverty is associated with greater rates of learning impairments and academic problems, conduct problems, chronic illness, hyperactivity, and emotional disorders

21. Rates and Expression (cont.) • Sex Differences • sex differences appear negligible in children under age 3, but increase with age • boys > girls in early/middle childhood; girls > during adolescence

22. Figure 1.3 Figure 1.3 Normal developmental trajectories of Externalizing problems (top graph) an Internalizing problems (bottom graph) from the Child Behavior Checklist. Ages are shown on the x axis. The y axis represents the raw scores (higher score means more problems). Source: Bongers, Koot, van der Ende, & Verhulst, 2003.

23. Rates and Expression (cont.) • Ethnicity • minority children over-represented • once other effects (SES, gender, age, referral status) are controlled for, very few differences emerge in relation to race or ethnicity • minority children face multiple disadvantages

24. Rates and Expression (cont.) • Ethnicity (cont.) • Research has often ignored cultural factors

25. Rates and Expression (cont.) • Culture • contributes to development and expression of disorders • some underlying processes are similar across diverse cultures