Chapter 16 Developmental Psychopathology

Chapter 16: DEVELOPMENTAL PSYCHOPATHOLOGY Abnormality –Statistical deviance –Maladaptiveness Interferes with personal and social life Poses danger to self or others –Personal distress –DSM-5 diagnostic criteria (APA)

Developmental Aspects Developmental psychopathology – study of origins and course of maladaptive behavior Disorders and not disease (you have it or you don’t) –A–A pattern of maladaption, not defects Social and Age Norms Developmental issues –N–Nature/Nurture (origin of maladaptive behaviors) –R–Risk factors –P–Prediction

The Diathesis-Stress Model Diathesis – predisposition or vulnerability (genetic, cognitive, personality) Stress – environmental pressure Interaction of genes and environment Example: Depression –G–Genetic vulnerability –E–Environmental trigger(s) Not specific stressors for specific disorders “Bad things have bad effects for some people some of the time”

Extreme stress and high vulnerability (severe disorder) Extreme stress and high resiliency (mild disorder) Low stress and high vulnerability (mild disorder) Low stress and high resiliency (no disorder)

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Autism Begins in infancy: more boys Several autistic spectrum disorders Impaired social interaction, communication Repetitive, stereotyped behaviors 75% have intellectual disabilities: 10% have savant syndrome Severe cognitive impairment Biologically based Concordance: MZ=60%, DZ= 0%

Autism Spectrum Disorder Asperger syndrome –Normal or above-average intelligence –Good verbal skills –Clear desire to establish social relationships –Deficient social cognitive and social-communication skills

Autism Spectrum Disorder Is there an epidemic? –1987: autism affected 4 or 5 of every 10,000 children –2006: 1 in 110 –Two years later: 1 in 88

Autism Spectrum Disorder Why are rates rising? –Increased awareness –Broader definition that includes the entire autistic spectrum (including more mild cases) –Increased diagnosis –Variations in diagnostic practices

Mirror Neurons

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

Childhood Externalizing problems –“Undercontrolled” disorders –Acting out –Aggressive, out of control Internalizing problems –“Overcontrolled” disorders –Inner distress, shyness –More girls

Figure 16.3

Attention-Deficit Hyperactivity Disorder DSM-5 Criteria: some combination of –Inattention subtype –Hyperactivity/Impulsivity subtype –Combined subtype –More boys; 3-5% of US kids –Comorbidity common Overactive behavior wanes with age Attentional, adjustment problems remain

ADHD-Causes and Treatment Neurological: low Dopamine, Serotonin –Underactivity in frontal lobes Genetic predisposition; Environmental stress 70% helped by stimulants –Overprescription a problem Most successful if combined with behavioral treatment

Psychostimulants Ritalin Concerta Focalin Adderall Strattera Cylert

Depression Childhood –Somatic symptoms –Psychotherapy, medication effective –Nature/Nurture question Adolescence –Often related to childhood symptoms

Adolescence Storm and stress –Only about 20% –Heightened vulnerability to psych disorders Alcohol and drugs are problems Eating disorders –Anorexia nervosa; more girls (10/1) –Bulemia nervosa; binge-eating –Binge eating disorder –Some genetic predisposition; stress also –Psychological treatment usually successful

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Adolescent Depression and Suicide 35% depressed; 7% diagnosable –Cognitive symptoms –Behavioral acting out –Genetic link –Environmental triggers Suicide 3rd leading cause of death –Males commit 3:1 compared to females –Females attempt 3:1 compared to males

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

Depression and Dementia Many undiagnosed and untreated Elderly can benefit, should NOT be excluded from treatment Dementia: deterioration of neural Alzheimer’s Disease –Leading cause of dementia –Progressive and irreversible

Causes of Alzheimer’s Senile plaques – masses of dying neural material with toxic protein called beta amyloid The plaque injures/kills neurons Neurofibrillary tangles – twisted strands of neural material Early-onset form (prior to age 60)-genetic links Late-onset form (after age 70)-family history not predictive

Figure 16.6

Aging and Dementia