Chapter 1 Understanding Abnormal Child Psychology

Historical Views of Child Psychopathology The Emergence of Social Conscience historically, children often ignored or subjected to harsh treatment because of belief that they would die, were possessed, or were simply owned by parents John Locke (17thC) and Jean-Marc Itard (19thC) advanced the belief that children should be treated with kindness and compassion

Historical Views (cont.) Psychiatric Disorder and Mental Retardation in late 19thC, distinction made between individuals with MR (“imbeciles”) and those with psychiatric disorders (“lunatics”) children with normal cognitive abilities but disturbing behavior said to be suffering from “moral insanity” advances in medical science led to replacement of moral insanity view by the organic disease model

Historical Views (cont.) Early Biological Attributions early attempts at biological explanations for abnormal behavior were biased in favor of locating the cause of the problem within the individual the view of mental disorders as “diseases” led to eugenics and segregation

Historical Views (cont.) Early Psychological Attributions psychological influences did not emerge until early 1900’s psychoanalytic theory linked mental disorders to childhood experiences- for the first time the course of mental disorders not viewed as inevitable behaviorism laid foundation for studying conditioning and elimination of children’s fears

Historical Views (cont.) Evolving Forms of Treatment until late 1940’s, most children with intellectual or mental disorders were institutionalized from 1945-1965, number of children in institutions decreased while number of children in foster families and group homes increased in 1950’s and 1960’s, behavior therapy was the systematic approach to treatment

Defining Psychological Disorders Determining what is normal and abnormal is an arbitrary process Traditionally defined as a pattern of behavioral, cognitive, or physical symptoms, that is associated with one or more of: distress disability increased risk for further suffering or harm

Defining Psychological Disorders (cont.) Many childhood problems best depicted in terms of relationships Labels describe behavior, not the child Problems may be the result of children’s attempts to adapt to abnormal or unusual circumstances

Competence Must consider not only the degree of maladaptive behavior, but also children’s competence (the ability to adapt in the environment and achieve normal developmental milestones) Knowledge of developmental tasks is fundamental for determining if there are impairments in developmental progress

Developmental Pathways Refers to the sequence and timing of behaviors, and the relationship between them over time Two types of developmental pathways: multifinality: similar early experiences lead to different outcomes equifinality: different early experiences lead to a similar outcome

Developmental Pathways (cont.) Figure 1.1 (a) Multifinality: Similar early experiences lead to different outcomes; (b) Equifinality: Different factors lead to a similar outcome

Developmental Pathways (cont.) With abnormal child psychology, must keep in mind: there are many contributors to disordered outcomes in each child contributors vary among children who have the disorder children express features of their disturbances in different ways pathways leading to particular disorders are numerous and interactive

Risk and Resilience Risk: risk factors are variables that precede a negative outcome and increase the chances that the outcome will occur typically involves acute, stressful situations, as well as chronic adversity known risk factors include: community violence and disasters, divorce/family break-up, chronic poverty, homelessness, parental inadequacies, parental psychopathology, perinatal stress

Risk and Resilience (cont.) the ability to avoid negative outcomes despite being at risk for psychopathology associated with strong self-confidence, coping skills, ability to avoid risk situations, ability to fight off or recover from misfortune not a fixed attribute connected to a “protective triad” of resources and health-promoting events, involving strengths of the child, the family, and school/community

Risk and Resilience (cont.) Figure 1.2  Characteristics of resilient children and adolescents who display resilience in the face of adversity (Based on Masten & Coatsworth, 1998)

Significance of Children’s Mental Health Problems 1 in 5 children has a significant mental health problem; 10-20% meet criteria for a specific psychological disorder 75% of children who require mental health services do not receive them By 2020, the demand for children’s mental health services is expected to double

Significance (cont.) In the past, children with various mental health and educational needs were described in global terms, such as “maladjusted” Better ability to distinguish among disorders has given rise to increased and earlier recognition of problems Today, problems of younger children and teens are better acknowledged

Significance (cont.) Today there is greater attention paid to empirically supported prevention and treatment programs Mental health problems remain unevenly distributed; those from disadvantaged neighborhoods and families, abusive/neglectful families, those receiving inadequate care, those born with very low birth weight, and those born to parents with criminal or severe psychiatric histories often have more mental problems

What Affects Rates and Expression of Mental Disorders? Poverty and Socioeconomic Disadvantage about 1 in 6 children in North America live in poverty poverty is associated with greater rates of learning impairments and academic problems, conduct problems, chronic illness, hyperactivity, and emotional disorders

Rates and Expression (cont.) Sex Differences sex differences appear negligible in children under age 3, but increase with age boys demonstrate greater difficulties than girls in early/middle childhood; girls’ problems increase during adolescence

Figure 1.3 Figure 1.3 Normal developmental trajectories of Externalizing problems (top graph) an Internalizing problems (bottom graph) from the Child Behavior Checklist. Ages are shown on the x axis. The y axis represents the raw scores (higher score means more problems). Source: Bongers, Koot, van der Ende, & Verhulst, 2003.

Rates and Expression (cont.) Ethnicity minority children in the U.S. are over-represented in rates of some disorders once other effects (SES, gender, age, referral status) are controlled for, very few differences emerge in relation to race or ethnicity minority children face multiple disadvantages, including marginalization and poverty, suggesting that these factors may contribute to the prevalence of behavior problems in some populations

Rates and Expression (cont.) Ethnicity (cont.) In addition, research into child psychopathology has generally been insensitive to possible differences in prevalence, age of onset, developmental course, and risk factors related to ethnicity, and the considerable heterogeneity that exists within specific groups

Rates and Expression (cont.) Culture the values, beliefs, and practices that characterize an ethnocultural group contribute to the development and expression of children’s disorders some underlying processes may be similar across diverse cultures and less susceptible to cultural influences (e.g., those with strong neurobiological bases still, social and cultural beliefs and values likely influence meaning given to behaviors, the ways in which they are responded to, their forms of expression, and their outcomes

Rates and Expression (cont.) Child Maltreatment and Non-Accidental Trauma there are over 1 million verified reports of maltreatment in the U.S. per year estimated that more than 1/3 of 10- to 16-year-olds experience physical and/or sexual abuse adverse affects of maltreatment are particularly devastating with regard to adjustment at school, with peers, and in future relationships

Rates and Expression (cont.) Special Issues Concerning Adolescents early- to mid-adolescence is an especially important transitional period for healthy versus problematic adjustment issues such as substance abuse, sexual behavior, accidental injuries, and mental health problems make adolescence a particularly vulnerable period

Rates and Expression (cont.) Lifespan Implications unfortunately, about 20% of children will have significant difficulties throughout their lives when provided with circumstances and opportunities that promote healthy adaptation and competence, children can overcome major impediments