1. CHAPTER 16 DEVELOPMENTAL PSYCHOPATHOLOGY

2. Abnormality Maladaptiveness  Interferes with personal and social life  Poses danger to self or others Personal distress DSM-IV diagnostic criteria (APA) Statistical deviance

3. Developmental Aspects  Development, not disease A pattern of maladaption, not defects  Social and Age Norms Developmental Issues Nature/Nurture & Continuity/Discontinuity Risk factors Prediction

4. The Diathesis-Stress Model  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”

5. Autism  Begins in infancy, more boys  Several autistic spectrum disorders  Impaired social interaction, communication  Repetitive, stereotyped behaviors  80% retarded: savant syndrome common  Severe cognitive impairment  Biologically based  Concordance: MZ=60%, DZ= 0%

6. Depression  Infancy Somatic symptoms Depressive-like states Related to poor attachment “At risk” if mother depressed “Failure to thrive” syndrome may occur

7. Childhood  Externalizing Problems “Undercontrolled” disorders Acting out Aggressive, out of control  Internalizing Problems “Overcontrolled” disorders Inner distress, shyness More girls

8. Relationships between behavior at age 3 and psychological disorders at age 21. Part A shows that children with uncontrolled, externalizing behavioral styles are more likely than other children to show antisocial behavior and repeated criminal behavior at age 21. Part B shows that inhibited, internalizing children are at high risk of depression, but not anxiety disorders, at 21.

9. Attention-Deficit Hyperactivity Disorder  DSM-IV Criteria, some combination of the following: 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

10. ADHD-Causes and Treatment  Neurological: Low Dopamine, other NT’s Differential processing Underactivity in motor area  Genetic predisposition; Environmental stress  70% helped by stimulants (like Ritalin) Overprescription a problem  Most successful if combined with behavioral treatment

11. Depression  Childhood Somatic symptoms; school, social also Psychotherapy, medication effective Nature/Nurture question  Adolescence Often related to childhood symptoms

12. Adolescence  Storm and Stress? Only about 20% Heightened vulnerability to psych disorders  Alcohol and drug problems  Eating Disorders Anorexia nervosa; more girls (3/1) Bulimia nervosa; binge-purge Some genetic predisposition; stress also Psychological treatment usually successful

13. Adolescent Depression and Suicide  35% depressed; 7% diagnosable Cognitive symptoms Behavioral acting out Genetic link Environmental triggers  Suicide: Third leading cause of death Males commit 3/1; girls attempt 3/1

15. Adulthood  Rates of disorder decrease after age 18  Depression Concern with elderly Elderly less vulnerable to major depression  Depression often related to health  15% have some symptoms  1-3% diagnosable  Difficult to diagnose from other conditions More women (2/1)

16. Depression and Dementia  Many undiagnosed and untreated  Elderly can benefit, should NOT be excluded from treatment  Dementia: Progressive Deterioration Not normal aging (Senescence)  Alzheimer’s Disease Leading cause of dementia Progressive and irreversible

17. Causes of Cognitive Impairment  Genetic: e.g., Alzheimer’s Disease  Vascular dementia -multi-infarct Minor strokes: Deficits accumulate Related to lifestyle: Diet and exercise  Reversible dementia, about 20%  Delirium: Reversible, often drug related  Depression: Treatable  Critical to distinguish for proper treatment

18. Alzheimer’s disease emerges gradually over the adult years; brain cells are damaged long before noticeable cognitive impairment results in old age. Changes in brain functioning are significantly different from those associated with normal aging.