Historical Views of Child Psychopathology

1
Historical Views of Child Psychopathology

• The Emergence of Social Conscience
• Historically children often ignored or subjected
  to harsh treatment
• John Locke (17thC)
• Jean-Marc Itard (19thC) treat children with
  kindness

2
Historical Views (cont.)

• Early Psychological Attributions (for adults,
  mostly)
• emerged in early 1900s
• psychoanalytic theory
• behaviorism laid foundation for studying
  conditioning and elimination of childrens fears

3
Historical Views of Child Psychopathology

• Child psychopathology generally ignored
• Insanity
• DSM
• 1980 version of DSM included a child section

4
Reasons why ignored

• Psychoanalytic theory
• Behavior theory

5
Historical Views (cont.)

• Evolving Forms of Treatment based in historical
  context
• institutionalized
• foster families and group homes
• behavior therapy

6
Evidence for change in perspective on childrens
problems

• Child-focused journals
• Divisions of APA
• Child abuse laws enacted
• IDEA

7
Change in perspective (cont.)

• Surgeon Generals report (2001)
• 1 in 10 has severe mental or behavior problem
• Only 2 of 10 with problems get help

8
Surgeon Generals goals

• Promote public awareness
• Develop scientifically proven treatments
• Improve assessment methods
• Eliminate ethnic/SES disparities in services

9
Surgeon Generals goals

• Train frontline providers
• Monitor access to mental health services
• Improve infrastructure of services
• Increase access to mental health services

10
Reasons why child psychopathology is now
receiving more attention

• Problems are common
• Lifelong consequences
• Predict adult disorders
• Few children receive necessary help
• Develop early intervention programs
• Legal mandates

11
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

12
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 childrens attempts
  to adapt to abnormal or unusual circumstances
• Need to consider age/developmental level

13
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

14
Developmental Pathways (cont.)
Figure 1.1 (a) Multifinality Similar early
experiences lead to different outcomes (b)
Equifinality Different factors lead to a similar
outcome
15
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

16
Issues unique to child psychopathology

• Referral process
• Greist et al. why do parents bring their
  children in to clinics?
• Predicted mothers ratings of their children
• Home observation for objective ratings
• Got ratings of moms mood/depression

17
Referral process cont.

• Webster-stratton (1988)
• Questions of interest
• Method
• Results
• implications

18
Temperament reciprocal relationships

• Innate biological factors which influence
  behavior
• easy temperament
• difficult temperament
• Easiness to soothe
• Activity
• Sociability
• Parent-child relationships are reciprocal

19
Reciprocal relationships

• Pelham et al. (1997)
• Questions of interest
• Method
• Results
• implications

20
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

21
Rates and Expression (cont.)

• Sex Differences
• sex differences appear negligible in children
  under age 3, but increase with age
• boys gt girls in early/middle childhood girls gt
  during adolescence

22
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.
23
Rates and Expression (cont.)

• Ethnicity
• minority children over-represented
• 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

24
Rates and Expression (cont.)

• Ethnicity (cont.)
• Research has often ignored cultural factors

25
Rates and Expression (cont.)

• Culture
• contributes to development and expression of
  disorders
• some underlying processes are similar across
  diverse cultures