1. Chapter 3 The Developmental Psychopathology Perspective Bilge Yağmurlu

2. Perspective and Theory
View, approach, cognitive set
Paradigm
Perspective shared by investigators
Assumptions and concepts
Theories of psychopathology
Macro and Micro

3. Perspective and Theory
Theory: a formal, integrated set of principles or propositions that explains phenomena.
Models are descriptions of the phenomenon under study. Models help to organize the researcher’s thinking, surrounding a particular topic under investigation.

4. Models Interactional variables interrelate to produce an outcome
Vulnerability (diathesis) stress model: multiple causes work together
Vulnerability x stress

5. Interactional Model
Child
Environment
Development
(-ATT) x (+E)  +O

6. Models
"diathesis" can refer specifically to a genetic predisposition toward an abnormal or diseased condition, but has been more broadly defined as a vulnerability arising out of early child development.

7. Models Transactional/Systems model
Nature and nurture are both fully involved in providing a source of any behavioral development
They cannot function in isolation

8. Transactional Model (C t1 x E t1)  C t2 x E t2
All features are made up of all features that are transformed by their interaction
(C t1 x E t1)  C t2 x E t2
Where C t1 =  (C tn-1 x E tn-1)
E t1 =  (E tn-1 x C tn-1)

9. Models Transactional/Systems model Negative child reactivity
Stressful and dysfunctional parenting

10. Models
Transactional/Systems
Bio-ecological model

11. Bio-ecological model
Nested, interacting ecosystems

12. Bronfenbrenner’s model of bioecological systems
A1 MICROSYSTEM
A2 MICROSYSTEM
B MESOSYTEM
C EXOSYSTEM
D MACROSYSTEM C B A2 A1

13. Microsystem: stands as child’s venue for learning about the world.
Child is at the center and moves away and toward

14. Mesosystem: relations between 2 or more settings in which the child actively participates.
The number and quality of connections betwen settings have important implications for child’s development.

15. Exosystem: contexts experienced vicariously and yet have impact on child. Does not directly involve the child.
Example: Flexibility in work hours: child realizes stress of parent’s workplace without ever being in these places. D C B A2 A1

16. Exosystem: contexts experienced vicariously and yet have impact on child.
“Risk” and “social address” factors alone don’t determine whether or not a child develops his potential. D C B A2 A1

17. Macrosystem: blueprints for how other components should operate.
dominant ideologies and cultural patterns that organize all other social institution. Influences what, how, when and where we carry out our relations D C B A2 A1 17

18. Macrosystem:
What kind of government departments are provided to support families
How the legal/health system is designed

19. Contributions of the Model:
Inclusive of all systems in which families are enmeshed.
Reflects dynamic nature of relations
Acknowledges that each of the ever-changing and multi-level environments and their interactions are key to development.

20. Two-way interaction
Overriding ideology or cultural pattern of any given society and family
Employer, work hours and family-related policies
Lobbying for political and economic policies that support parent’s roles in their children’s development

21. Developmental Psychopathology
Origins and developmental course of disordered behavior
Adaptation and success
Integration of theories

22. Developmental Psychopathology
Examples of Microparadigms
Psychodynamic
Cognitive
Biomedical
Behavioral
Family
Systems
Sociological
Piagetian IP
Social
Cognition
Psychosexual
Development
- Genetics
- Infectious
- Neurological
- Biochemical
- Neurotransmitters
- Lower Class
Culture Theory
Child’s problems as symptoms of stress
Family causes of anorexia
Reinforcement
Modeling
Figure. Schematic overview of developmental psychopathology in relation to other conceptual levels. From Achenbach (1990).

23. Development Change over the life span
Biopsychosocial interactions with individuals
Quantitative and qualitative change
Common general course of early development
Coherent pattern
Change not always positive

24. Causal Factors Direct cause Indirect
Variable x leads straight to outcome
Indirect
X influences other variables that in turn lead to outcome

25. Causal Factors Mediating factors
Explain the relationship between variables
Specifies how (or the mechanism by which) a given effect occurs

26. Causal Factors Moderating factors
Presence or absence of a factor influences the relationship between variables
Specifies the conditions under which the direction or strength will vary

27. Moderating factors
The effect of a risk factor on a disorder may vary across contexts or populations.
The magnitude of an effect might be changed under different conditions.

28. Moderating factors Example:
The effect of early harsh discipline on the development of conduct disorder is reduced under circumstances of a warm parent-child relationship.

29. Moderating Factors Parental harsh discipline
Child externalizing behaviors
Parental harsh discipline
Child externalizing behaviors
Culture: Normativeness of harsh discipline in a culture
Lansford et al. study (2005): moderating influence of culture

30. Warm parent-child relationship
Moderating Factors
Harsh discipline
Conduct disorder
Harsh discipline
Conduct disorder
Warm parent-child relationship

31. Moderating Factors
Divorce/Severe marital conflict
Delinquency
Divorce/Severe marital conflict
Delinquency
Child’s sex
The effect of a risk factor on a disorder may vary across contexts or populations

32. Mediating Factors
Parental harsh discipline
Child externalizing behaviors
Parental harsh discipline
Regulation problems
Child externalizing behaviors
Specifies how (or the mechanism by which) a given effect occurs

33. Mediating Factors
Unresponsive parenting
Child
anxiety disorder
Unresponsive parenting
Anxious/ambivalent attachment
Child
anxiety disorder
Specifies how (or the mechanism by which) a given effect occurs

34. Mediating Factors Parenting x temperament = anxiety disorder
Unresponsive parenting
Child
anxiety disorder
Fearful temperament
Unresponsive parenting
Child
anxiety disorder
Insecure
attachment
Fearful temperament
Parenting x temperament => attachment problems => anxiety disorder

35. Causal Factors Necessary cause - must be present for disorder to occur
Sufficient - can be responsible alone (other factors not required)
Contributing – not necessary or sufficient

36. Causal Factors Necessary cause - must be present for disorder to occur
Example: for schizophrenia genetics (brain dysfunction)
Sufficient - can be responsible alone (other factors not required)
Example: for Down syndrome chromosomal abnormality
Contributing – not necessary or sufficient
Example: Low SES

37. Pathways to Development
Developmental pathways have a transactional and probabilistic nature
Equifinality
a given end state can be reached by many potential means

38. Equifinality Example: Antisocial behavior Neurophysiological
Behavioral Inhibition System (BIS) underactive
Behavioral Activation System (BAS) overactive
OR both systems underactive as child tries to seek sensation
Reduced threshold for fight or flight
Neuropsychological
Frontal lobes
Problems with verbal and executive functions
Family influences
Parent-child interactions
Discipline and monitoring
Temperament
Irritability
Impulsivity
Sensation seeking

39. Equifinality Example: Substance Use Use affected by:
Temperament (poor impulse control)
Emotional regulation
Exposure to trauma
Modeling
Family
Peers
Poor academic performance and low involvement in school activities
SES (poverty): Availability of substances

40. Pathways to Development
Multifinality
one etiologic factor can lead to any of several psychopathologic outcomes, depending on the person and context.

41. Risk and Resilience Risk factors Constitutional Family
Emotional and interpersonal
Intellectual and academic
Ecological
Nonnormative life events

42. Risk and Resilience The more risks, the poorer the outcome
Effects add or multiply
Timing of risk important
Divorce during childhood or adolescence
Some risk is tied to specific outcomes
Multifinality: many risks not
Risk for onset may differ from risk for persistence
Risk can accumulate over time

43. Risk and Resilience Resilience Positive outcome in the face of risk
Trio of protective factors:
Individual
Good IQ
Appealing, sociable
Easy temperament
Self-efficacy and self-confidence
Self-control
Talented
Optimistic

44. Risk and Resilience Resilience, continued Family Extrafamilial
Close to parent or caregiver
Authoritative parenting
Socioeconomic advantages
Connections to support
Extrafamilial
Bonds to positive adult role models
Connections to organizations
Good schooling

45. Risk and Resilience Resilience
Can occur with one protective factor or may require more
Can occur in one domain (emotion) and not another (academic)
Can occur in one setting (friendship) and not another (school)
Can wax and wane over time
Can be linked to neurobiology

46. Continuity and Change Homotypic continuity : Stable symptoms
Heterotypic continuity : Symptoms change with development
An underlying impairment stays the same, but the manifestations do not stay the same.

47. Heterotypic Continuity
Anaclitic depression
Listless, withdrawn, weepy
Preschool
Angry affect, apathy
Elementary
Agitation, somatic complaints
Adolescence
Affective lability, appearance, sensitivity, acting-out

48. Continuity and Change
Heterotypic continuity: Symptoms change with development
Psychopathological progression: One disorder is a risk factor for developing another disorder
E.g., eating disorders such as anorexia nervosa have influence on neurotransmitter levels such as serotonin. Imbalance of serotonin is related to generalized anxiety disorder (GAD) and depression.

49. Continuity and Change
Comorbidity: The presence of one or more disorders (or diseases) in addition to a primary disease or disorder at the same time
Indicates a medical condition existing simultaneously with another condition in a patient

50. Continuity and Change Psychopathological progression Comorbidity
Where comorbidity uses data to state a fact, the other two concepts try to explain the process.

51. Continuity and Change An example from the literature Results:
Continuity from one diagnosis to another (heterotypic) was significant from depression to anxiety and anxiety to depression, from ADHD to oppositional defiant disorder (ODD), and from anxiety and conduct disorder (CD) to substance abuse.

52. Continuity and Change An example from the literature
Background: This paper expands upon recent efforts to advance beyond the examination of concurrent comorbidity between affective and behavioral disorders by testing developmental sequences among disorders.
Participants: Boys were recruited when they were between the ages of 7 and 12, and were reassessed annually until age 18.
Results: Each disorder showed homotypic continuity, but a clear developmental sequence of heterotypic continuity also emerged. ADHD was predicted by no other disorders, and exclusively predicted ODD. CD was predicted only by ODD. However, ODD was also directly predictive of future anxiety and depression, and anxiety predicted future depression as well.