Chapter 1
Introduction
Chapter Summary:
The authors introduce the developmental psychopathology approach. They also define and discuss
important terms and issues in the field of developmental psychopathology. Some key issues that are
introduced in the chapter include how normality and psychopathology are described and the role of
values in conceptualizing psychopathology. Other issues that are discussed include the rates of disorders
in infancy, childhood and adolescence, allocation of resources, availability and accessibility of care, the
role of the media, and the stigma of mental illness.
Learning Objectives:
1. Introduce the concept of developmental psychopathology.
2. Provide an understanding of how normality and psychopathology are described and the role of
values in making judgments in conceptualizing psychopathology.
3. Provide an understanding about the rates of disorders in infancy, childhood, and adolescence.
4. Provide an understanding about allocation of resources, availability and accessibility of care.
5. Provide an understanding about the role of the media in developmental psychopathology.
6. Provide an understanding about the issue of stigmatization and mental illness.
Chapter Outline:
I. Defining Disorders of Infancy, Childhood, and Adolescence
A. The central premise of developmental psychopathology is that we gain a better
understanding of children’s disorders when we think about those disorders within the
context of normal development.
B. Case study of Emma
C. Importance of knowing different models of childhood and child development
1. Most contemporary theorists, researchers, and clinicians emphasize that a
useful model of normal development requires a dynamic appreciation of
children’s strengths and weaknesses.
II. What is Normal?
A. Common descriptions of normality and psychopathology often focus on:
1. Statistical Deviance – the infrequency of certain emotions, cognitions, and/or
behaviors. Those who display too much or too little of any age-expected
behavior might have a disorder.
2. Sociocultural Norms – the beliefs and expectations of certain groups about
what kinds of emotions, cognitions, and/or behaviors are undesirable or
unacceptable.
© 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
,2 CHAPTER 1
3. Mental Health Definitions – theoretical or clinically based notions of distress
and dysfunction. Children who have a negative quality of life, function poorly, or
exhibit certain kinds of symptoms might have a disorder.
III. The Role of Values
A. The role of values must be taken into account when conceptualizing mental health and
psychopathology. Two such judgments are:
1. Adequate Adaptation – what is considered acceptable
2. Optimal Adaptation – what is considered excellent or superior
3. The cases of Dylan (poor adaptation), Antoine (adequate adaptation), and Jenna
(optimal adaptation)
B. The impact of values on definitions of disorder
1. Judgments must be made with each of the above definitions.
2. In statistical deviance definitions, one must decide whether to examine both
extremes of the continuum or just the “bad” end of the continuum, ignoring the
“good” end.
3. In sociocultural definitions, value judgments are the very basis of different
definitions of disorder (i.e., cultural tolerance of mind-altering substances
influences evaluation of pathological addiction).
4. In mental health definitions, the values of psychologists, psychiatrists, and
clinical social workers are embedded in both scientific and lay community
decision-making.
IV. Definitions of Psychopathology and Developmental Psychopathology
A. Psychopathology refers to intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition, and behavior.
B. Developmental psychopathology extends this description to emphasize that these
maladaptive patterns occur in the context of normal development and result in the
current and potential impairment of infants, children, and adolescents.
V. Rates of Disorders in Infancy, Childhood, and Adolescence
A. Developmental epidemiology is the field that studies frequencies and patterns of
distributions of disorders in infants, children, and adolescents.
B. Prevalence refers to all current cases of the disorder.
C. Incidence refers to new cases in a given time period.
D. It is estimated that 13% of children between 8 and 15 years of age meet criteria for a
mental disorder.
VI. Allocation of Resources, Availability and Accessibility of Care
A. Fewer than half of children who need mental health services receive them.
B. Barriers to care are widespread and include structural barriers, barriers related to
perceptions about mental health difficulties, and barriers related to perceptions about
mental health services.
C. Cost of care is often prohibitive.
D. Funding for prevention is often inadequate.
VII. The Stigma of Mental Illness
A. Stigmatization for parents almost always includes shame, fear, and/or blame.
© 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
,3 INTRODUCTION
B. For children, experiences of secrecy and rejection are commonplace.
C. Adults think that children are overdiagnosed, overmedicated, and poorly parented.
1. Children hold similar beliefs and attitudes to adults.
D. Ignorance and intolerance are critical ongoing issues for those struggling with mental
illness.
Key Terms:
Developmental psychopathology Prevalence
Statistical deviance Incidence
Sociocultural norms Barriers to care
Mental health definitions Stigmatization
Developmental epidemiology
Suggestions for Discussion and Student Activities:
1. What is normal? Collect different examples of cultural differences in what is considered normal
and abnormal. For example, in some cultures (such as Chinese), children are preferred to be
quiet and shy (conform to a group and do what their parents expect them to do), while in other
cultures (such as the U.S.), children are expected to be outgoing and independent. What
implications does this have on development? What then would be considered normal/abnormal
behavior in these different cultures? Come up with other such examples and have your students
do the same. College students are usually amazed by how different parents, religions, and ethnic
and cultural groups view development and what is normal/abnormal.
2. Gather brief case studies on notable people who were unique during childhood – such as Albert
Einstein, who may have been late to speak and read, and Thomas Edison, who set a train car on
fire at age 12. Stories of this sort abound on the internet and are easy to gather. Share the
stories with your class without saying who they are about. Ask the students to debate whether
each case is “normal” or “abnormal,” and by which definition they are making their claim. Once
the class has voted on each case, tell them who the case is about, and then discuss how, if at all,
knowing the identity of the individual affects what they think about their decision.
3. Discuss examples of statistical deviance extremes and if students feel that it is “normal” or
“abnormal.” For example: extremely low IQ vs. extremely high IQ; extremely low sociability
(shyness) vs. extremely high sociability; extremely low fear or anxiety vs. very fearful/anxious.
Have students come up with others and discuss the implications that these raise for family,
education, and community. For example, one extreme of IQ could be a diagnosis of mental
retardation with the other extreme gifted. Will each child who demonstrates these extremes
have problems in education, relationships? How about anxiety and test performance? Research
such as Atkinson and Litwin (1960) demonstrate that those who have too much or too little
anxiety or fear of failure are likely to perform poorly. Are there situations where an extreme is
“good”?
4. Ask your students why they think that over 1/5 of children meet the diagnostic criteria for a
disorder. Is this number higher or lower than your class expected? Why? Have students discuss
© 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
, 4 CHAPTER 1
why this is such a high number and if they think this number has changed in recent years. Some
reasons may be both positive (better diagnostic criteria, less severe stigmatization) and negative
(more children with problems due to environmental reasons (single parenting, prenatal
exposure to teratogens such as smoking and other drugs, environmental pulls).
5. Have students discuss why so many children “fall through the cracks.” Include in your discussion
such items as resources available, where one lives (rural vs. urban), poverty, cultural
perceptions, stigmatization, costs, and time commitment involved of parents or child.
6. Provide students with examples of appropriate and inappropriate ways of describing children
and their mental health problems (e.g., Austin who has autism vs. the autistic child, Austin).
Have students find examples of these in the media. Discuss how important these descriptions
are and their impact that they can have on the child, the parents and families, teachers and
schools, and communities and society as a whole.
7. Have students read Rosenhan’s (1973) article entitled “Being Sane in Insane Places” and discuss
how a label can impact interpretations made by professionals of normal behavior. David
Rosenhan and several of his colleagues had themselves committed to different mental hospitals
without the staff knowing that they had made up the symptom of “hearing voices.” After
arriving at the hospital, they all acted normally and their normal behaviors were misinterpreted
as symptoms of mental illness. This is a great example of how labels can impact perceptions.
8. [Access to a computer lab would be ideal for this class activity, or ask students who have laptops
to bring them to share.] Assign students to work in small groups during class time to research
epidemiological statistics. Each group can be assigned a different group of mental disorders
(e.g., anxiety disorders, mood disorders, etc.) and asked to find out the current prevalence and
incidence rates, and how those rates vary with age.
9. Discuss barriers to care, starting with a large group discussion in which the students review the
barriers presented in the textbook and then brainstorm further possible barriers, while you list
each on the board. Then have the class break into small groups and each choose one barrier
from the list to dig into further. In their small groups, ask them to brainstorm ways to overcome
the barrier they chose, and the needed resources for each of their ideas. Then ask them to
assess the feasibility of overcoming each barrier, and make a suggestion to the class of the best
suggestion for overcoming their chosen barrier, based on their cost-benefit analysis.
Supplementary Reading Material:
Link, B. G., Stuening, E. L., Rehay, M., Phelan, J.C., & Nuttbrook, L. (1997). On Stigma and Its
Consequences: Evidence from a Longitudinal Study of Men with Dual Diagnoses of Mental Illness
and Substance Abuse. Journal of Health and Social Behavior, Vol. 38, 177-190.
Milich, R., McAninch, C. B., & Harris, M. J. (1992). Effects of stigmatizing information on children's peer
relations: Believing is seeing. School Psychology Review, 21, 400-409.
Rosenhan, D. (1973). On being sane in insane places. Sciences, 179, 250-258.
© 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Introduction
Chapter Summary:
The authors introduce the developmental psychopathology approach. They also define and discuss
important terms and issues in the field of developmental psychopathology. Some key issues that are
introduced in the chapter include how normality and psychopathology are described and the role of
values in conceptualizing psychopathology. Other issues that are discussed include the rates of disorders
in infancy, childhood and adolescence, allocation of resources, availability and accessibility of care, the
role of the media, and the stigma of mental illness.
Learning Objectives:
1. Introduce the concept of developmental psychopathology.
2. Provide an understanding of how normality and psychopathology are described and the role of
values in making judgments in conceptualizing psychopathology.
3. Provide an understanding about the rates of disorders in infancy, childhood, and adolescence.
4. Provide an understanding about allocation of resources, availability and accessibility of care.
5. Provide an understanding about the role of the media in developmental psychopathology.
6. Provide an understanding about the issue of stigmatization and mental illness.
Chapter Outline:
I. Defining Disorders of Infancy, Childhood, and Adolescence
A. The central premise of developmental psychopathology is that we gain a better
understanding of children’s disorders when we think about those disorders within the
context of normal development.
B. Case study of Emma
C. Importance of knowing different models of childhood and child development
1. Most contemporary theorists, researchers, and clinicians emphasize that a
useful model of normal development requires a dynamic appreciation of
children’s strengths and weaknesses.
II. What is Normal?
A. Common descriptions of normality and psychopathology often focus on:
1. Statistical Deviance – the infrequency of certain emotions, cognitions, and/or
behaviors. Those who display too much or too little of any age-expected
behavior might have a disorder.
2. Sociocultural Norms – the beliefs and expectations of certain groups about
what kinds of emotions, cognitions, and/or behaviors are undesirable or
unacceptable.
© 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
,2 CHAPTER 1
3. Mental Health Definitions – theoretical or clinically based notions of distress
and dysfunction. Children who have a negative quality of life, function poorly, or
exhibit certain kinds of symptoms might have a disorder.
III. The Role of Values
A. The role of values must be taken into account when conceptualizing mental health and
psychopathology. Two such judgments are:
1. Adequate Adaptation – what is considered acceptable
2. Optimal Adaptation – what is considered excellent or superior
3. The cases of Dylan (poor adaptation), Antoine (adequate adaptation), and Jenna
(optimal adaptation)
B. The impact of values on definitions of disorder
1. Judgments must be made with each of the above definitions.
2. In statistical deviance definitions, one must decide whether to examine both
extremes of the continuum or just the “bad” end of the continuum, ignoring the
“good” end.
3. In sociocultural definitions, value judgments are the very basis of different
definitions of disorder (i.e., cultural tolerance of mind-altering substances
influences evaluation of pathological addiction).
4. In mental health definitions, the values of psychologists, psychiatrists, and
clinical social workers are embedded in both scientific and lay community
decision-making.
IV. Definitions of Psychopathology and Developmental Psychopathology
A. Psychopathology refers to intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition, and behavior.
B. Developmental psychopathology extends this description to emphasize that these
maladaptive patterns occur in the context of normal development and result in the
current and potential impairment of infants, children, and adolescents.
V. Rates of Disorders in Infancy, Childhood, and Adolescence
A. Developmental epidemiology is the field that studies frequencies and patterns of
distributions of disorders in infants, children, and adolescents.
B. Prevalence refers to all current cases of the disorder.
C. Incidence refers to new cases in a given time period.
D. It is estimated that 13% of children between 8 and 15 years of age meet criteria for a
mental disorder.
VI. Allocation of Resources, Availability and Accessibility of Care
A. Fewer than half of children who need mental health services receive them.
B. Barriers to care are widespread and include structural barriers, barriers related to
perceptions about mental health difficulties, and barriers related to perceptions about
mental health services.
C. Cost of care is often prohibitive.
D. Funding for prevention is often inadequate.
VII. The Stigma of Mental Illness
A. Stigmatization for parents almost always includes shame, fear, and/or blame.
© 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
,3 INTRODUCTION
B. For children, experiences of secrecy and rejection are commonplace.
C. Adults think that children are overdiagnosed, overmedicated, and poorly parented.
1. Children hold similar beliefs and attitudes to adults.
D. Ignorance and intolerance are critical ongoing issues for those struggling with mental
illness.
Key Terms:
Developmental psychopathology Prevalence
Statistical deviance Incidence
Sociocultural norms Barriers to care
Mental health definitions Stigmatization
Developmental epidemiology
Suggestions for Discussion and Student Activities:
1. What is normal? Collect different examples of cultural differences in what is considered normal
and abnormal. For example, in some cultures (such as Chinese), children are preferred to be
quiet and shy (conform to a group and do what their parents expect them to do), while in other
cultures (such as the U.S.), children are expected to be outgoing and independent. What
implications does this have on development? What then would be considered normal/abnormal
behavior in these different cultures? Come up with other such examples and have your students
do the same. College students are usually amazed by how different parents, religions, and ethnic
and cultural groups view development and what is normal/abnormal.
2. Gather brief case studies on notable people who were unique during childhood – such as Albert
Einstein, who may have been late to speak and read, and Thomas Edison, who set a train car on
fire at age 12. Stories of this sort abound on the internet and are easy to gather. Share the
stories with your class without saying who they are about. Ask the students to debate whether
each case is “normal” or “abnormal,” and by which definition they are making their claim. Once
the class has voted on each case, tell them who the case is about, and then discuss how, if at all,
knowing the identity of the individual affects what they think about their decision.
3. Discuss examples of statistical deviance extremes and if students feel that it is “normal” or
“abnormal.” For example: extremely low IQ vs. extremely high IQ; extremely low sociability
(shyness) vs. extremely high sociability; extremely low fear or anxiety vs. very fearful/anxious.
Have students come up with others and discuss the implications that these raise for family,
education, and community. For example, one extreme of IQ could be a diagnosis of mental
retardation with the other extreme gifted. Will each child who demonstrates these extremes
have problems in education, relationships? How about anxiety and test performance? Research
such as Atkinson and Litwin (1960) demonstrate that those who have too much or too little
anxiety or fear of failure are likely to perform poorly. Are there situations where an extreme is
“good”?
4. Ask your students why they think that over 1/5 of children meet the diagnostic criteria for a
disorder. Is this number higher or lower than your class expected? Why? Have students discuss
© 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
, 4 CHAPTER 1
why this is such a high number and if they think this number has changed in recent years. Some
reasons may be both positive (better diagnostic criteria, less severe stigmatization) and negative
(more children with problems due to environmental reasons (single parenting, prenatal
exposure to teratogens such as smoking and other drugs, environmental pulls).
5. Have students discuss why so many children “fall through the cracks.” Include in your discussion
such items as resources available, where one lives (rural vs. urban), poverty, cultural
perceptions, stigmatization, costs, and time commitment involved of parents or child.
6. Provide students with examples of appropriate and inappropriate ways of describing children
and their mental health problems (e.g., Austin who has autism vs. the autistic child, Austin).
Have students find examples of these in the media. Discuss how important these descriptions
are and their impact that they can have on the child, the parents and families, teachers and
schools, and communities and society as a whole.
7. Have students read Rosenhan’s (1973) article entitled “Being Sane in Insane Places” and discuss
how a label can impact interpretations made by professionals of normal behavior. David
Rosenhan and several of his colleagues had themselves committed to different mental hospitals
without the staff knowing that they had made up the symptom of “hearing voices.” After
arriving at the hospital, they all acted normally and their normal behaviors were misinterpreted
as symptoms of mental illness. This is a great example of how labels can impact perceptions.
8. [Access to a computer lab would be ideal for this class activity, or ask students who have laptops
to bring them to share.] Assign students to work in small groups during class time to research
epidemiological statistics. Each group can be assigned a different group of mental disorders
(e.g., anxiety disorders, mood disorders, etc.) and asked to find out the current prevalence and
incidence rates, and how those rates vary with age.
9. Discuss barriers to care, starting with a large group discussion in which the students review the
barriers presented in the textbook and then brainstorm further possible barriers, while you list
each on the board. Then have the class break into small groups and each choose one barrier
from the list to dig into further. In their small groups, ask them to brainstorm ways to overcome
the barrier they chose, and the needed resources for each of their ideas. Then ask them to
assess the feasibility of overcoming each barrier, and make a suggestion to the class of the best
suggestion for overcoming their chosen barrier, based on their cost-benefit analysis.
Supplementary Reading Material:
Link, B. G., Stuening, E. L., Rehay, M., Phelan, J.C., & Nuttbrook, L. (1997). On Stigma and Its
Consequences: Evidence from a Longitudinal Study of Men with Dual Diagnoses of Mental Illness
and Substance Abuse. Journal of Health and Social Behavior, Vol. 38, 177-190.
Milich, R., McAninch, C. B., & Harris, M. J. (1992). Effects of stigmatizing information on children's peer
relations: Believing is seeing. School Psychology Review, 21, 400-409.
Rosenhan, D. (1973). On being sane in insane places. Sciences, 179, 250-258.
© 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
