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Chapter 16 Development Psychopathology. Chapter 16: DEVELOPMENTAL PSYCHOPATHOLOGY. Abnormality Statistical deviance Maladaptiveness Interferes with personal and social life Poses danger to self or others Personal distress DSM-IV diagnostic criteria (APA). Developmental Aspects.
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Chapter 16: DEVELOPMENTAL PSYCHOPATHOLOGY • Abnormality • Statistical deviance • Maladaptiveness • Interferes with personal and social life • Poses danger to self or others • Personal distress • DSM-IV diagnostic criteria (APA)
Developmental Aspects • Developmental psychopathology – study of origins and course of maladaptive behavior • Disorders and not disease (you have it or you don’t) • A pattern of maladaption, not defects • Social and Age Norms • Developmental issues • Nature/Nurture (origin of maladaptive behaviors) • Risk factors • Prediction
The Diathesis-Stress Model • Diathesis – predisposition or vulnerability (genetic, cognitive, personality) • Stress – environmental pressure • Interaction of genes and environment • Example: Depression • Genetic vulnerability • Environmental trigger(s) • Not specific stressors for specific disorders • “Bad things have bad effects for some people some of the time”
Extreme stress and high vulnerability (severe disorder) • Extreme stress and high resiliency (mild disorder) • Low stress and high vulnerability (mild disorder) • Low stress and high resiliency (no disorder)
Autism • Begins in infancy: more boys • Several autistic spectrum disorders • Impaired social interaction, communication • Repetitive, stereotyped behaviors • 75% have mental retardation: 10% have savant syndrome • Severe cognitive impairment • Biologically based • Concordance: MZ=60%, DZ= 0%
Depression • Infancy • Somatic symptoms • Depressive-like states • Related to poor attachment • “At risk” if mother depressed • “Failure to thrive” syndrome may occur
Childhood • Externalizing problems • “Undercontrolled” disorders • Acting out • Aggressive, out of control • Internalizing problems • “Overcontrolled” disorders • Inner distress, shyness • More girls
Attention-Deficit Hyperactivity Disorder • DSM-IV Criteria: some combination of • Inattention • Impulsivity • Hyperactivity • More boys; 3-5% of US kids • Comorbidity common • Overactive behavior wanes with age • Attentional, adjustment problems remain • Most well adjusted in adulthood
ADHD-Causes and Treatment • Neurological: low Dopamine, other NT’s • Differential processing • Underactivity in motor area • Genetic predisposition; Environmental stress • 70% helped by stimulants • Overprescription a problem • Most successful if combined with behavioral treatment
Depression • Childhood • Somatic symptoms • Psychotherapy, medication effective • Nature/Nurture question • Adolescence • Often related to childhood symptoms
Adolescence • Storm and stress • Only about 20% • Heightened vulnerability to psych disorders • Alcohol and drugs are problems • Eating disorders • Anorexia nervosa; more girls (3/1) • Bulemia nervosa; binge-purge • Some genetic predisposition; stress also • Psychological treatment usually successful
Adolescent Depression and Suicide • 35% depressed; 7% diagnosable • Cognitive symptoms • Behavioral acting out • Genetic link • Environmental triggers • Suicide 3rd leading cause of death • Males commit 3:1 compared to females • Females attempt 3:1 compared to males
Adulthood • Rates of disorder decrease after age 18 • Depression • Elderly less vulnerable to major depression • Concern with elderly • Depression often related to health • 15% have some symptoms • 1-3% diagnosable • Difficult to diagnose • More women (2:1)
Depression and Dementia • Many undiagnosed and untreated • Elderly can benefit, should NOT be excluded from treatment • Dementia: progressive deterioration of neural functioning associated with memory impairment, declines in tested intellectual ability, poor judgment, difficulty thinking abstractly and often personality changes • Alzheimer’s Disease • Leading cause of dementia • Progressive and irreversible
Causes of Alzheimer’s • Senile plaques – masses of dying neural material with toxic protein called beta amyloid • The plaque injures/kills neurons • Neurofibrillary tangles – twisted strands of neural material Early-onset form (prior to age 60)-genetic links Late-onset form (after age 70)-family history not predictive