Book disorders of childhood, lectures and articles
CHAPTER 1
Introduction
Developmental psychopathology = emphasized that maladaptive patterns occur in the
context of typical development and result in the current and potential impairment of
infants/children/adolescents.
Salient age relates issues of development
Stage in life Major issue Additional issues
Infancy Formation of an effective Basis state/arousal regulation
attachment Development of reciprocity
Dyadic regulation of emotion
Toddler period Guided self-regulation Increased autonomy/awareness self and
others/standards for behavior
Self-conscious emotions
Preschool period Self-regulation Self-reliance with support
Self-management
Expanding social world
Internalization rules/values
School years Competence Personal efficacy
Self-integration
Competence with peers/school
Adolescence Individuation Autonomy with connectedness
Identity
Peer network competence
Coordinating school, work, social life
Transition to Emancipation Launching a life course
adulthood Financial responsibility
Adult social competence
Coordinating work, training, career, life
Psychopathology in context of typical development
- Dynamic appreciation of children’s strengths and weaknesses as they experience
salient, age-related challenges
- Individual, familial, ethnic, cultural, societal beliefs about desirable vs undesirable
outcomes (= definitions of normality)
Typical/normal vs atypical/abnormal
1. Statistical deviance = how differently the person feels/thinks/acts compared to others
(infrequency)
- Where’s the cutoff?
2. Sociocultural norms = how the person is expected to feel/think/act
- Group values are not universal truths
3. Mental health definitions = what experts consider as mental health/illness
- Experts’ subjectivity/values (psychopathology vs flourishing)
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,This creates values that determine our definitions or judgment of disorders
adequate/optimal adaptation
Essential needs for children
- Ongoing nurturing relationships
- Physical protection, safety and regulation
- Experiences tailored to individual differences
- Developmentally appropriate experiences
- Limit setting, structure and expectations
- Stable, supportive community and cultural continuity
Estimated rate of disorders are based on:
1. Identifying children with clinically significant distress and dysfunction, whether they
are in treatment or not
2. Calculating levels of general categories of disorders and specific subtypes of disorders
3. Tracking changing trends in various rates of disorders
Developmental epidemiology = focus on the frequencies and patterns of disorders in children
and adolescents
Prevalence = the proportion of a population with a disorder (all current cases)
Incidence = rate at which new cases arrive in a certain period
Barriers to care = factors that impede access to mental health services including structural
barriers such as lack of provider availability, inconveniently located services, transportation
difficulties, financial problems, perception (= the inability to recognize disorders, denial and
belief that it will resolve on its own), care system (= a lack of trust, earlier negative
experiences and stigmatization).
Stigmatization = negative attitudes, emotions and behaviors related to psychopathology and
mental illness. This is the result of a lack of respect and a lack of access to care.
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,CHAPTER 2
Models of Child Development, Psychopathology, and Treatment
Dimensional models of psychopathology = emphasize the ways in which typical feelings,
thoughts and behaviors gradually become more serious problems, which ten may intensify
and become clinically diagnosable disorders. No sharp distinctions between
adaptive/maladaptive It is continuous and quantitative.
± More complex, specific and precise information
+ Decisions for medication/hospitalization have very different cut-off points. And due
to differences in predominant features of disorders for specific patients, these can
also very significantly
+ Internally valid to describe specific patient’s psychopathology
+ Less criteria to assess, smaller set of underlying dimensions of functioning
+ Better able to recognize subthreshold conditions
+ Avoiding misleading, unstable, illusory effects
+ Potential to facilitate development of clear demarcations between normal and
abnormal functioning
Categorical models of psychopathology = emphasize direct and qualitative differences in
individual patterns of emotion, cognition and behavior. There is a clear distinction between
what is normal and what is not. It is discontinuous and qualitative.
+ Presents useful clinical information in succinct manner, one diagnosis
+ Decision for education or hospitalization is categorical, thus specific points of
demarcation are needed to guide clinical decisions
- Inaccurate and misleading descriptions
- Thousands of valid categorical distinctions
- Frequent use of ‘not otherwise specified’, inadequate diagnostic coverage
- Conclusion, minor changes to a diagnostic criterion often create substantial changes
in prevalence rates, further complicating scientific theory and public health policy.
Dimensional (continuous, quantitative) Categorical (discontinuous, qualitative)
Gradual transition Distinct patterns
Typical Clinical
Typical Clinical
Psychological models = brain, body, behavior processes (genetic, structural, biological,
chemical), collaboration between child and caregivers in co-construction of the brain,
adaptation of children embedded in specific environments.
Basis tenet: a physiological basis for all psychological processes
Treatment: phycological processes (medication)
Connectome = a diagram of the brain’s neural connections, tools and techniques to map the
anatomical and functional features of brain networks. In contrast to microscopic connections
(between neurons), connectome focus on macroscopic connections (between brain regions).
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, It appears that in disorders you should examine how the different regions of the brain are
connected (instead of the function of individual parts).
Sensitive/critical periods = spans of time when environments have especially powerful and
enduring impacts
Neural plasticity = the brain’s ability to adapt or change to psychological and environmental
challenges, processes related to brain development and (re)organization.
The relationship across development between plasticity
and the amount of effort required for such change
Genotype = genetic material
Phenotype = observable characteristics
Shift from nature vs nurture Gene-by-Environment-by-Time (sensitive periods)
- Genes interact with environment overtime
- Environment influences gene expression and activation (expressions become
biological embedded)
Epigenetics = the study of how environmental factors influence gene expressivity
Behavior genetics = the study of joint effect of genes and environments
Molecular genetics = the study of how differences in the structure of expression or DNS
molecules results in variation
Risk alleles = gene variations that relate to psychopathology
Polygenic models = interplay of multiple genes in disorders
Diathesis-stress model emphasizes the combination of underlying predispositions and
additional factors to the development of psychopathology. Assumes that there are some
people who are more likely to be negatively affected by stressors.
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