UU KLOP – samenvatting deeltentamen 1
Chapter 1: Introduction
Developmental psychopathology -> gaining a better understanding of
children’s disorders when thinking about disorders within the context of
typical development.
One of the first steps leading to accurate and useful conceptualizations of
psychopathology is to recognize the many connections between typical
and atypical development.
A dynamic appreciation of children’s strengths and weaknesses is required
as they experience salient, age-related challenges. A dynamic model takes
into account the complexities of individual, familial, ethic, cultural and
societal beliefs about desirable and undesirable outcomes for children and
adolescents.
Descriptions of normality and psychopathology focus on:
1. Statistical deviance -> the infrequency of certain emotions,
cognitions and/or behaviors
A child who displays too much of any age-expected behavior or too little of
any age-expected behavior might have a disorder.
2. Sociocultural norms -> belief and expectations – in a given time or
place or of a group of people – about what kinds of emotions,
cognitions, and/or behaviors are problematic, undesirable, or
unacceptable
Children who fail to conform to age-related, gender-specific, or culture-
relevant expectations might be viewed as challenging, struggling, or
disordered. There may be within-group or across-generation
disagreements about sociability, emotion regulation and/or gender
identity.
3. Mental health definitions -> theoretical or clinically based notions of
distress and dysfunction.
A child’s psychological well-being is the key consideration. Children who
have a negative quality of life, who function poorly, or who exhibit certain
kinds of symptoms might have a disorder. Mental health as a continuum
and the identification of specific mental disorders are both ways to
understand how well children are doing.
Psychopathology -> intense, frequent, and/or persistent maladaptive
patterns of emotion, cognition and behavior.
Developmental psychopathology -> extends description to emphasize that
these maladaptive patterns occur in the context of typical development
and result in the current and potential impairment of infants, children and
adolescents.
Developmental epidemiology: frequencies and patterns of disorders in
infants, children and adolescents.
Prevalence refers to the proportion of a population with a disorder
(i.e. all current cases of the disorder)
, Incidence refers to the rate at which new cases arise (i.e. all new
cases in a given time period).
Random sampling of a general population is one option for estimating
prevalence (e.g. using surveys, phone questionnaires, and/or detailed
psychopathology screening instruments). Sampling in schools, using
teachers’ assessments, or in children’s primary care clinics are other
options for data gathering.
Hypotheses about higher frequencies of disorders -> increased help-
seeking by children, parents, and others; more screening and better
recognition of disorders, and changes related to individual vulnerability,
family life and widespread sociocultural change and challenge.
Chapter 3: Principles and Practices of Developmental
Psychopathology
Developmental psychopathology is a research-based, conceptual approach
that provides a framework for understanding how specific disorders
develop, what happens over time to children who develop disorders, and
what we can do to help these children. Developmental psychopathology is
a synthesis of multiple theoretical and research approaches.
Developmental psychopathologists assume that a variety of assessment,
prevention, and intervention techniques will prove useful.
Disorders are understood as delay (e.g. the child acquires language more
slowly than other children) or dysfunction (e.g. children behave in a way
that does not achieve a positive outcome). Understanding children’s
disorders as delay or dysfunction highlights the difficulties of a particular
child at a particular point in time.
Adaption (or maladaptation) is an ongoing activity. We can think about
disorders as series of problems over time, with small problems leading to
larger problems, or one problem leading to many more problems.
Children’s psychopathology, then, does not emerge suddenly or out of the
blue; rather, it unfolds over time.
Developmental pathways (or trajectories) illustrate the principle that
adjustment and maladjustment are points or places along a lifelong map.
With a developmental pathways’ perspective, we need to account for the
ways in which adaptation (or maladaptation) at an earlier point in time
connects to adaptation (or maladaptation) at a later point in life.
Equifinality and multifinality refer to similarities and differences in
individual pathways to a distorted outcome.
Equifinality -> sets of differing circumstances that lead to the same
diagnosis. With equifinality, different beginnings result in similar
outcomes.
Multifinality -> sets of similar beginnings that lead to different
outcomes. With multifinality, similar beginnings result in different
outcomes
,Two important points to remember when thinking about developmental
pathways are that (1) change is possible at many points, and (2) change is
constrained or enabled by previous adaptations. With a collection of
unique factors for any given child – the timing of diagnosis, the specific
disorder, the kind of intervention, and specific familial and environmental
variables – we expect differences in the types of change or rates of
change.
Internal, intrinsic factors (such as acquisition of language or the onset of
puberty) and external factors (such as move to a new home or a divorce)
are associated with potential gains or reversals.
As we explore the developmental pathways of individual children, we also
must consider how these children compare to other children:
1. Continuity and discontinuity -> refer to overall group level of a
characteristic or behavior (e.g. empathy or aggression).
2. Stability and instability -> refer to relative ordering of individuals
compared to peers.
Coherence reflects our beliefs that beginnings may be logically and
meaningfully linked to outcomes if we carefully evaluate the variables that
lead to stability as well as the variables that lead to change.
Risk is defined as increased vulnerability to disorder. Risk factors are the
individual, family, and social characteristics that are associated with this
increased vulnerability. Resilience is defined as adaptation (or
competence) despite adversity. Protective factors are the individual,
family, and social characteristics that are associated with this positive
adaptation.
Risk factors increase vulnerability in two ways:
1. Nonspecific risk, which involves increased vulnerability to any, or
many, kinds of disorders
2. Specific risk, which involves increased vulnerability to one particular
disorder.
Risks are usually not all-or-nothing events.
Susceptibility – when a genetic, epigenetic, or psychological characteristic
makes a child more sensitive to both negative and positive environmental
contexts – is clearly connected to the construct of risk. The child most
likely to benefit from an enriched environment is also the most vulnerable
in a high-risk environment.
Individual risk factors -> child focuses and include things like genetics and
physiological processes, cognitive and behavioral predispositions, and
temperament and personality. Biological sex and gender are also related
to the timing of disorders.
Disorders that are more frequent in boys tend to be diagnosed early in
development (with neurodevelopmental impairments), while disorders that
are more frequent in girls tend to be diagnosed in adolescence.
, Family risk factors -> associated with the child’s immediate caretaking
environment and include parent characteristics such as the presence of
psychopathology (e.g. depressive disorders or substance use disorders) or
harsh, punitive styles of parenting; family characteristics such as neglect,
lack of supervision, or chronic conflict between parents; and family events
such as divorce or unemployment.
Sociocultural risk factors -> include those associated with the child’s larger
environment, including peers and schools, neighborhood and
socioeconomic status (SES) background and racial, ethnic and cultural
characteristics. With respect to socioeconomic factors, we are especially
concerned with the ways in which poverty compromises children’s well-
being. Environmental stressors such as exposure to environmental toxins
and noise, crowding, and chaos are additional sociocultural risks
associated with living in disadvantaged communities.
Youth in middle- and upper-SES environments are also at increased risk for
high levels of distress and dysfunction. Youth in high-achieving settings
experience pressures to excel in academic and extracurricular activities,
and these “unrelenting pressures to accomplish” are associated with
increased rates of anxiety, depression and substance use.
The total number of risk factors that children and adolescents experience
is even more important than the specific type of risk factors. Children who
are exposed to multiple risks display more distress and dysfunction and
have worse outcomes than children exposed to single risks.
Research on cumulative risk is often focused on adverse child experiences
(ACEs), extreme adversity, and toxic stress. Examples of ACEs include the
experience of maltreatment, familial violence, parental separation or
divorce, and parental substance abuse. The presence of one risk factor or
ACE is associated with the presence of other risk factors or ACEs.
Differential impact theory, the environment-focused counterpart to
differential susceptibility, is based on the idea that “changes to the
environment cause individuals to change and that these changes depend
on the quality of the psychological, sociocultural, and economic resources
provided by the environment, balanced by the quality and quantity of the
individual’s exposure to risk”.
Child maltreatment involves any of the following: physical abuse, sexual
abuse, psychological abuse, neglect. Child maltreatment is a nonspecific
risk factor, with increased likelihood of immediate, short-term and long-
term developmental outcomes. Maltreatment cannot be traced to a single
source.
Resilience is a special instance of adaptation – it is adaptation in the face
of adversity. Resilient children do well despite their individual, family, or
social circumstances. Three types of resilient children and adolescents:
1. Children and adolescents with many risk factors who have good
outcomes
Chapter 1: Introduction
Developmental psychopathology -> gaining a better understanding of
children’s disorders when thinking about disorders within the context of
typical development.
One of the first steps leading to accurate and useful conceptualizations of
psychopathology is to recognize the many connections between typical
and atypical development.
A dynamic appreciation of children’s strengths and weaknesses is required
as they experience salient, age-related challenges. A dynamic model takes
into account the complexities of individual, familial, ethic, cultural and
societal beliefs about desirable and undesirable outcomes for children and
adolescents.
Descriptions of normality and psychopathology focus on:
1. Statistical deviance -> the infrequency of certain emotions,
cognitions and/or behaviors
A child who displays too much of any age-expected behavior or too little of
any age-expected behavior might have a disorder.
2. Sociocultural norms -> belief and expectations – in a given time or
place or of a group of people – about what kinds of emotions,
cognitions, and/or behaviors are problematic, undesirable, or
unacceptable
Children who fail to conform to age-related, gender-specific, or culture-
relevant expectations might be viewed as challenging, struggling, or
disordered. There may be within-group or across-generation
disagreements about sociability, emotion regulation and/or gender
identity.
3. Mental health definitions -> theoretical or clinically based notions of
distress and dysfunction.
A child’s psychological well-being is the key consideration. Children who
have a negative quality of life, who function poorly, or who exhibit certain
kinds of symptoms might have a disorder. Mental health as a continuum
and the identification of specific mental disorders are both ways to
understand how well children are doing.
Psychopathology -> intense, frequent, and/or persistent maladaptive
patterns of emotion, cognition and behavior.
Developmental psychopathology -> extends description to emphasize that
these maladaptive patterns occur in the context of typical development
and result in the current and potential impairment of infants, children and
adolescents.
Developmental epidemiology: frequencies and patterns of disorders in
infants, children and adolescents.
Prevalence refers to the proportion of a population with a disorder
(i.e. all current cases of the disorder)
, Incidence refers to the rate at which new cases arise (i.e. all new
cases in a given time period).
Random sampling of a general population is one option for estimating
prevalence (e.g. using surveys, phone questionnaires, and/or detailed
psychopathology screening instruments). Sampling in schools, using
teachers’ assessments, or in children’s primary care clinics are other
options for data gathering.
Hypotheses about higher frequencies of disorders -> increased help-
seeking by children, parents, and others; more screening and better
recognition of disorders, and changes related to individual vulnerability,
family life and widespread sociocultural change and challenge.
Chapter 3: Principles and Practices of Developmental
Psychopathology
Developmental psychopathology is a research-based, conceptual approach
that provides a framework for understanding how specific disorders
develop, what happens over time to children who develop disorders, and
what we can do to help these children. Developmental psychopathology is
a synthesis of multiple theoretical and research approaches.
Developmental psychopathologists assume that a variety of assessment,
prevention, and intervention techniques will prove useful.
Disorders are understood as delay (e.g. the child acquires language more
slowly than other children) or dysfunction (e.g. children behave in a way
that does not achieve a positive outcome). Understanding children’s
disorders as delay or dysfunction highlights the difficulties of a particular
child at a particular point in time.
Adaption (or maladaptation) is an ongoing activity. We can think about
disorders as series of problems over time, with small problems leading to
larger problems, or one problem leading to many more problems.
Children’s psychopathology, then, does not emerge suddenly or out of the
blue; rather, it unfolds over time.
Developmental pathways (or trajectories) illustrate the principle that
adjustment and maladjustment are points or places along a lifelong map.
With a developmental pathways’ perspective, we need to account for the
ways in which adaptation (or maladaptation) at an earlier point in time
connects to adaptation (or maladaptation) at a later point in life.
Equifinality and multifinality refer to similarities and differences in
individual pathways to a distorted outcome.
Equifinality -> sets of differing circumstances that lead to the same
diagnosis. With equifinality, different beginnings result in similar
outcomes.
Multifinality -> sets of similar beginnings that lead to different
outcomes. With multifinality, similar beginnings result in different
outcomes
,Two important points to remember when thinking about developmental
pathways are that (1) change is possible at many points, and (2) change is
constrained or enabled by previous adaptations. With a collection of
unique factors for any given child – the timing of diagnosis, the specific
disorder, the kind of intervention, and specific familial and environmental
variables – we expect differences in the types of change or rates of
change.
Internal, intrinsic factors (such as acquisition of language or the onset of
puberty) and external factors (such as move to a new home or a divorce)
are associated with potential gains or reversals.
As we explore the developmental pathways of individual children, we also
must consider how these children compare to other children:
1. Continuity and discontinuity -> refer to overall group level of a
characteristic or behavior (e.g. empathy or aggression).
2. Stability and instability -> refer to relative ordering of individuals
compared to peers.
Coherence reflects our beliefs that beginnings may be logically and
meaningfully linked to outcomes if we carefully evaluate the variables that
lead to stability as well as the variables that lead to change.
Risk is defined as increased vulnerability to disorder. Risk factors are the
individual, family, and social characteristics that are associated with this
increased vulnerability. Resilience is defined as adaptation (or
competence) despite adversity. Protective factors are the individual,
family, and social characteristics that are associated with this positive
adaptation.
Risk factors increase vulnerability in two ways:
1. Nonspecific risk, which involves increased vulnerability to any, or
many, kinds of disorders
2. Specific risk, which involves increased vulnerability to one particular
disorder.
Risks are usually not all-or-nothing events.
Susceptibility – when a genetic, epigenetic, or psychological characteristic
makes a child more sensitive to both negative and positive environmental
contexts – is clearly connected to the construct of risk. The child most
likely to benefit from an enriched environment is also the most vulnerable
in a high-risk environment.
Individual risk factors -> child focuses and include things like genetics and
physiological processes, cognitive and behavioral predispositions, and
temperament and personality. Biological sex and gender are also related
to the timing of disorders.
Disorders that are more frequent in boys tend to be diagnosed early in
development (with neurodevelopmental impairments), while disorders that
are more frequent in girls tend to be diagnosed in adolescence.
, Family risk factors -> associated with the child’s immediate caretaking
environment and include parent characteristics such as the presence of
psychopathology (e.g. depressive disorders or substance use disorders) or
harsh, punitive styles of parenting; family characteristics such as neglect,
lack of supervision, or chronic conflict between parents; and family events
such as divorce or unemployment.
Sociocultural risk factors -> include those associated with the child’s larger
environment, including peers and schools, neighborhood and
socioeconomic status (SES) background and racial, ethnic and cultural
characteristics. With respect to socioeconomic factors, we are especially
concerned with the ways in which poverty compromises children’s well-
being. Environmental stressors such as exposure to environmental toxins
and noise, crowding, and chaos are additional sociocultural risks
associated with living in disadvantaged communities.
Youth in middle- and upper-SES environments are also at increased risk for
high levels of distress and dysfunction. Youth in high-achieving settings
experience pressures to excel in academic and extracurricular activities,
and these “unrelenting pressures to accomplish” are associated with
increased rates of anxiety, depression and substance use.
The total number of risk factors that children and adolescents experience
is even more important than the specific type of risk factors. Children who
are exposed to multiple risks display more distress and dysfunction and
have worse outcomes than children exposed to single risks.
Research on cumulative risk is often focused on adverse child experiences
(ACEs), extreme adversity, and toxic stress. Examples of ACEs include the
experience of maltreatment, familial violence, parental separation or
divorce, and parental substance abuse. The presence of one risk factor or
ACE is associated with the presence of other risk factors or ACEs.
Differential impact theory, the environment-focused counterpart to
differential susceptibility, is based on the idea that “changes to the
environment cause individuals to change and that these changes depend
on the quality of the psychological, sociocultural, and economic resources
provided by the environment, balanced by the quality and quantity of the
individual’s exposure to risk”.
Child maltreatment involves any of the following: physical abuse, sexual
abuse, psychological abuse, neglect. Child maltreatment is a nonspecific
risk factor, with increased likelihood of immediate, short-term and long-
term developmental outcomes. Maltreatment cannot be traced to a single
source.
Resilience is a special instance of adaptation – it is adaptation in the face
of adversity. Resilient children do well despite their individual, family, or
social circumstances. Three types of resilient children and adolescents:
1. Children and adolescents with many risk factors who have good
outcomes
