Developmental Psychopathology
Fundamentals of developmental psychopathology
Fundamental principles of developmental psychopathology
1. What is developmental psychopathology?
2. How does it emerge?
3. How do we explain it?
4. How do we diagnose is?
5. How do we treat it?
What is developmental psychopathology?
Psychopathology: intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition, behavior
Developmental psychopathology: emphasizes that these maladaptive patterns occur
in the context of typical development and result in the current and potential impairment
of infants, children and adolescents.
In other words, the problems arise as the child grows up, it gives temporal
understanding.
Psychopathology in the context of typical development
1. Dynamic appreciation of children’s strengths and weaknesses as they experience
salient, age-related challenges. So, the child experiences specific age-related
challenges as it grows up and we have to consider its strengths and weaknesses
as it faces these challenges.
Now if we see, for example, at the different life stages here from infancy all the way to
adulthood, we see that the person progressively acquires the capacities that allow it to
become self-governed and independent, but embedded and contributing to the society
that it lives in.
So, starting from infancy when the individual has the task of forming an effective
attachment bond with its caregivers over to adulthood where it needs to be self-
governed and liberated, guiding and living its life on its own.
2. Individual, familial, ethnic, cultural, societal beliefs about desirable vs.
undesirable outcomes (= definitions of normality). We have to understand that
, there are specific beliefs about what is desirable and undesirable, these are not
so set in stone.
How do we assume if something is pathological or not?
Defining typical/normal vs. atypical/abnormal
- Statistical deviance: how differently the person feels/thinks/acts compared to
others.
o Issues: where is the cutoff?
Which side of the spectrum is concerning? Are you supposed to be
focusing on the extremely high or the extremely low.
- Sociocultural norms: how the person is expected to think/feel/act
o Issues: group values are not universal truths. For example, gender norms
are not the same across cultures and across countries. And depending on
how much you may exhibit specific kinds of behaviors, you may be
considered to be pathological or not.
- Mental health definitions: what experts consider as mental health/illness
o Issues: experts’ subjectivity and values steer the definition, they all have
their own biases.
Absence of psychopathology vs. flourishing?
How does it emerge?
Disorders in the context of development
1. Delay or dysfunction
A delay is pretty self-explanatory, in the sense that people, children, do not
develop a skill that they should have already developed. For example, they fail, or
they are delayed in their language acquisition
Dysfunction is not necessarily not having those skills or those capacities but not
putting them to use. So, for example, extremely aggressive behavior by an
adolescent. It’s not that they don’t know how to behave well, it’s that they don’t
want to do it. So this severe sort of dysfunction can be considered as
developmental psychopathology.
2. Typical vs. atypical development as a process:
Adjustment & maladjustment are points along a lifelong map. A child’s
psychopathology at one moment is just a snapshot, just a click of what happens
to that kid at that very moment. But that doesn’t mean this can change.
So, how do kids develop psychopathology?
There are two fundamental pathways, the multi-finality principle and the equifinality.
Multi-finality: similar starting points lead to different outcomes
It means that the same cause or the same underlying mechanism is leading to many
different outcomes. For example, child maltreatment has been associated with a very
,big range of psychological problems. But it could also very well lead to typical
adjustment for some kids. So, we’re never entirely sure what kind of experiences may
lead to what outcomes.
Equifinality: different starting points lead to similar outcomes
The other way is quite opposite, it means that many different starting points, for
example, genes, personality, temperament, family characteristics, experiences within
the neighborhood, experiences with the peers, they may differ from kid to kid, but they
may lead to the same problem. So, think for example of a very aggressive disposition
that may lead to conduct disorder, but also if a kid grows up in a rough neighborhood
where conduct problems or conduct these kinds of antisocial behaviors are used as
means to actually gain status among the peer group and therefore are highly endorsed
as a means of fitting in with a group.
Continuity & stability
Thinking of psychopathology is a snap, so we can understand that not everybody has the
same trajectories. Just to see there’s an example of different trajectories, there are
people who continuously do well over time and those that continuously do bad. But
there are some that depending on their life situations may go from adaptive to
maladaptive outcomes. Things are not always stable, and they may change. There are
three kinds of development, three profiles of development based on continuity and
stability.
Continuity has to do with the average levels across the population of a phenomenon.
For example, how does internalizing symptomatology change over time for all
adolescents?
Stability is about rank ordering. If I am the most anxious person when I am 12, am I still
the most anxious person in the same group when I am 16?
For some cases there is continuity and stability. Overall levels don’t change; overall
ranking doesn’t change.
In other cases, there’s discontinuity and stability, that is overall levels decrease. For
example, we see a decrease in anxiety as people grow older, but not necessarily a
change in who is the most anxious person in the room.
There is also discontinuity and instability, where both the
rank ordering and the minimum levels change.
These are three ways in which people’s symptomatology can
change over time.
, We have to consider some principles of continuity
Types of continuity (that also underlie stability)
- Homotypic continuity
Stable expression of symptoms, the symptoms stay the same, regardless of age.
- Heterotypic continuity
Symptom expression changes with development
- Cumulative continuity
Environment that perpetuates maladaptive style, a person’s symptoms within a
specific environment are being reinforced. And therefore, it leads to more and
more stability of its ranking.
Important take home messages about stability and continuity:
1. Change is possible at many points
2. Change is constrained/enabled by previous adaptions, so knowing past
experiences, we can also understand which kinds of changes may be opened up
or closed down
3. Transitions & turning points shut down/create opportunities
4. Developmental coherence, it may appear in the beginning when we see a child
that problems come out of nowhere, but in reality, there’s a coherence in why a
person develops x kinds of symptoms, not only based on their own temperament,
but also considering their environment, how they’ve grown up, what has
happened to their life.
Risk & resilience factors
There is always a dynamic between things that protect us from psychopathology and
things that make us more vulnerable to it.
What makes us more vulnerable is called a risk factor and what makes us more
protected towards psychopathology is called a resilience factor.
Resilience is defined as positive adaption despite adversity, basically being able to
flourish psychologically, to have good mental health, to thrive in your personal life and in
society, even when you face those risks or challenges.
These factors can be individual, family or social characteristics, ranging for example,
from genes, from temperaments to family characteristics like parenting, warmth, even to
social characteristics like friends with peers, support in the system, but also risk factors,
for example, like extreme poverty.
! A risk factor for one disorder can also be a protective factor for another. So, for
example, if you have high levels of anxiety, you may be unlikely to have psychopathy or
conduct disorder because anxiety itself makes you less prone to engage in extreme acts
of aggression.
! According to strength-based approaches, even
signs of psychopathology may be reinterpreted
as specific strengths. So, if you consider people
growing up in harsh neighborhoods, you can also
think that these people may have developed the
capacities to work in high-stress environments.
The problem is that once you take those kids out
of this context and you put them in a stress-free
Fundamentals of developmental psychopathology
Fundamental principles of developmental psychopathology
1. What is developmental psychopathology?
2. How does it emerge?
3. How do we explain it?
4. How do we diagnose is?
5. How do we treat it?
What is developmental psychopathology?
Psychopathology: intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition, behavior
Developmental psychopathology: emphasizes that these maladaptive patterns occur
in the context of typical development and result in the current and potential impairment
of infants, children and adolescents.
In other words, the problems arise as the child grows up, it gives temporal
understanding.
Psychopathology in the context of typical development
1. Dynamic appreciation of children’s strengths and weaknesses as they experience
salient, age-related challenges. So, the child experiences specific age-related
challenges as it grows up and we have to consider its strengths and weaknesses
as it faces these challenges.
Now if we see, for example, at the different life stages here from infancy all the way to
adulthood, we see that the person progressively acquires the capacities that allow it to
become self-governed and independent, but embedded and contributing to the society
that it lives in.
So, starting from infancy when the individual has the task of forming an effective
attachment bond with its caregivers over to adulthood where it needs to be self-
governed and liberated, guiding and living its life on its own.
2. Individual, familial, ethnic, cultural, societal beliefs about desirable vs.
undesirable outcomes (= definitions of normality). We have to understand that
, there are specific beliefs about what is desirable and undesirable, these are not
so set in stone.
How do we assume if something is pathological or not?
Defining typical/normal vs. atypical/abnormal
- Statistical deviance: how differently the person feels/thinks/acts compared to
others.
o Issues: where is the cutoff?
Which side of the spectrum is concerning? Are you supposed to be
focusing on the extremely high or the extremely low.
- Sociocultural norms: how the person is expected to think/feel/act
o Issues: group values are not universal truths. For example, gender norms
are not the same across cultures and across countries. And depending on
how much you may exhibit specific kinds of behaviors, you may be
considered to be pathological or not.
- Mental health definitions: what experts consider as mental health/illness
o Issues: experts’ subjectivity and values steer the definition, they all have
their own biases.
Absence of psychopathology vs. flourishing?
How does it emerge?
Disorders in the context of development
1. Delay or dysfunction
A delay is pretty self-explanatory, in the sense that people, children, do not
develop a skill that they should have already developed. For example, they fail, or
they are delayed in their language acquisition
Dysfunction is not necessarily not having those skills or those capacities but not
putting them to use. So, for example, extremely aggressive behavior by an
adolescent. It’s not that they don’t know how to behave well, it’s that they don’t
want to do it. So this severe sort of dysfunction can be considered as
developmental psychopathology.
2. Typical vs. atypical development as a process:
Adjustment & maladjustment are points along a lifelong map. A child’s
psychopathology at one moment is just a snapshot, just a click of what happens
to that kid at that very moment. But that doesn’t mean this can change.
So, how do kids develop psychopathology?
There are two fundamental pathways, the multi-finality principle and the equifinality.
Multi-finality: similar starting points lead to different outcomes
It means that the same cause or the same underlying mechanism is leading to many
different outcomes. For example, child maltreatment has been associated with a very
,big range of psychological problems. But it could also very well lead to typical
adjustment for some kids. So, we’re never entirely sure what kind of experiences may
lead to what outcomes.
Equifinality: different starting points lead to similar outcomes
The other way is quite opposite, it means that many different starting points, for
example, genes, personality, temperament, family characteristics, experiences within
the neighborhood, experiences with the peers, they may differ from kid to kid, but they
may lead to the same problem. So, think for example of a very aggressive disposition
that may lead to conduct disorder, but also if a kid grows up in a rough neighborhood
where conduct problems or conduct these kinds of antisocial behaviors are used as
means to actually gain status among the peer group and therefore are highly endorsed
as a means of fitting in with a group.
Continuity & stability
Thinking of psychopathology is a snap, so we can understand that not everybody has the
same trajectories. Just to see there’s an example of different trajectories, there are
people who continuously do well over time and those that continuously do bad. But
there are some that depending on their life situations may go from adaptive to
maladaptive outcomes. Things are not always stable, and they may change. There are
three kinds of development, three profiles of development based on continuity and
stability.
Continuity has to do with the average levels across the population of a phenomenon.
For example, how does internalizing symptomatology change over time for all
adolescents?
Stability is about rank ordering. If I am the most anxious person when I am 12, am I still
the most anxious person in the same group when I am 16?
For some cases there is continuity and stability. Overall levels don’t change; overall
ranking doesn’t change.
In other cases, there’s discontinuity and stability, that is overall levels decrease. For
example, we see a decrease in anxiety as people grow older, but not necessarily a
change in who is the most anxious person in the room.
There is also discontinuity and instability, where both the
rank ordering and the minimum levels change.
These are three ways in which people’s symptomatology can
change over time.
, We have to consider some principles of continuity
Types of continuity (that also underlie stability)
- Homotypic continuity
Stable expression of symptoms, the symptoms stay the same, regardless of age.
- Heterotypic continuity
Symptom expression changes with development
- Cumulative continuity
Environment that perpetuates maladaptive style, a person’s symptoms within a
specific environment are being reinforced. And therefore, it leads to more and
more stability of its ranking.
Important take home messages about stability and continuity:
1. Change is possible at many points
2. Change is constrained/enabled by previous adaptions, so knowing past
experiences, we can also understand which kinds of changes may be opened up
or closed down
3. Transitions & turning points shut down/create opportunities
4. Developmental coherence, it may appear in the beginning when we see a child
that problems come out of nowhere, but in reality, there’s a coherence in why a
person develops x kinds of symptoms, not only based on their own temperament,
but also considering their environment, how they’ve grown up, what has
happened to their life.
Risk & resilience factors
There is always a dynamic between things that protect us from psychopathology and
things that make us more vulnerable to it.
What makes us more vulnerable is called a risk factor and what makes us more
protected towards psychopathology is called a resilience factor.
Resilience is defined as positive adaption despite adversity, basically being able to
flourish psychologically, to have good mental health, to thrive in your personal life and in
society, even when you face those risks or challenges.
These factors can be individual, family or social characteristics, ranging for example,
from genes, from temperaments to family characteristics like parenting, warmth, even to
social characteristics like friends with peers, support in the system, but also risk factors,
for example, like extreme poverty.
! A risk factor for one disorder can also be a protective factor for another. So, for
example, if you have high levels of anxiety, you may be unlikely to have psychopathy or
conduct disorder because anxiety itself makes you less prone to engage in extreme acts
of aggression.
! According to strength-based approaches, even
signs of psychopathology may be reinterpreted
as specific strengths. So, if you consider people
growing up in harsh neighborhoods, you can also
think that these people may have developed the
capacities to work in high-stress environments.
The problem is that once you take those kids out
of this context and you put them in a stress-free
