CHILD PSYCHOPATHOLOGY PSY 3223, SECTION 12

Instructor: Samantha Connolly

Schedule

Introductions Syllabus review Chapter 1 Lecture

Chapter 1
Introduction to Normal and Abnormal Behavior in Adolescents

The study of child psychopathology

Define

normal and abnormal behavior for children taking into account age, sex, ethnicity, culture Investigate causes Predict long-term outcomes Develop and evaluate methods for treatment and/or prevention

Why study child psychopathology?

1 in 8 children has a mental health problem that significantly impairs functioning Many others are at risk for future disorders Majority of children and youth needing mental health services do not receive them
Poor

understanding of mental disorders, limited access to intervention

Demand for childrens mental health services is expected to double over the next decade http://www.youtube.com/watch?v=l7eKfTw0MOk

The study of child psychopathology

What makes child and adolescent disorders unique?

May

be a difficulty of the child and/or the parents Problem is often a failure to display expected developmental progress Exhibiting problem behaviors during certain developmental periods may not be abnormal
Ex:

Rebellious teenagers

Interventions

often aim to further development, rather than restoring previous degree of functioning

Brief history

Before 18th century:

Children

treated harshly, abuse was acceptable, solely parents property

Massachusetts

Stubborn Child Act of 1654

Severely

disabled children could be kept in cages BUT: John Locke felt otherwise!
Children

should be given attention, care, education

By end of 18th century:

Interest

in abnormal child behavior surfaced Distinction between imbeciles and lunatics

Freud & Psychoanalysis

Unconscious drives to fulfill sexual and aggressive needs Focus on the interaction of developmental and situational processes

Children progress through developmental phases where sexual/aggressive preoccupations must be resolved Some disorders caused by psychological events, particularly during childhood

Children and adults could be helped if provided with proper environment, therapy, or both

Behaviorism, etc.
Set

the stage for the empirical study of how abnormal behavior develops and can be treated through conditioning Pavlovs research on classical conditioning Watsons studies on eliminating childrens fears
Little

Albert http://www.youtube.com/watch?v=HZPXVb0W3Hc

1930s 1950s

Psychodynamic approaches most popular from 1930 -1950

Most

children with intellectual or mental disorders were institutionalized Lobotomies (Rosemary Kennedy)

1950s- 1960s

1945-1965, institutionalization decreases, foster care + group homes increases 1950s -1960s, behavior therapy was popular approach to treatment Behavior therapy has continued to expand in scope, prominent form of therapy

1980s- present

IDEA (Individuals with Disabilities Education Act, 1989):

Free and appropriate public education for children with special needs in the least restrictive environment Individualized education program (IEP)

United Nations General Assembly (2007) adopted a new convention to protect the rights of persons with disabilities

Countries agree to improve disability rights and abolish legislation, customs, and practices that discriminate against persons with disabilities

Child psychopathology today

In the past, use of blanket terms like maladjusted Today, better ability to distinguish among disorders has = increased and earlier recognition of problems Greater awareness of younger children and teens unique mental health issues Greater attention given to evidence-based prevention and treatment programs

What is abnormal behavior?

Not

just atypical but harmful (impairing, causing distress) Developmentally inappropriate Need to consider a variety of variables:
Culture Gender Situation/Context

Parents

and professionals may differ on their views of a child and what is considered inappropriate Society has changing views of abnormality
Masturbatory

insanity

Development and Competence

Take into account the childs competence: the ability to successfully adapt in the environment Ability to achieve normal developmental milestones Knowledge of developmental tasks (ex: conduct and academic achievement) fundamental for determining progress and impairments

Development and Competence

Development and Competence

Development and Competence

Development and Competence

Some evidence that disorders have a particular age of onset

The Role of Gender

Gender differences in disorder prevalence

Caused

by reporting biases or differences in the expression of the disorder? Ex: Aggression

Expressed

more directly by boys Expressed more indirectly by girls

Sex differences appear negligible in children under age 3, but increase with age

The Role of Gender

More common in boys(externalizing problems):

Hyperactivity and autism Acting-out behaviors (aggression and delinquency) Childhood disruptive behavior disorders Learning and communication disorders Early-onset disorders with neurodevelopmental impairment

More common in girls (internalizing problems):

Anxiety, depression, or withdrawn behavior Somatic complaints Eating disorders Emotional disorders with peak age of onset in adolescence

The Role of Gender

The Role of Race

Minority children overrepresented in rates of some disorders in the US:

Substance

abuse, delinquency, teen suicide

However, when controlling for other effects (SES, gender, age), few racial differences emerge
Significant

barriers remain in access & quality of care

Role of poverty and marginalization

The Role of Culture

Values, beliefs, and practices that characterize a particular ethnocultural group:

Contribute

disorders Affect how people/institutions react to childrens problems

to development and expression of childrens

Be careful when generalizing across cultures Social and cultural beliefs and values can influence the meaning given to behaviors, the way in which they are responded to, their forms of expression

The Role of Poverty

About 1 in 5 children in the United States live in poverty Native American and African American children are at greatest risk Associated with impairments in school achievement, as well as less education, low-paying jobs, inadequate health care, single-parent status, limited resources, poor nutrition, greater exposure to violence Poor children suffer more conduct problems, chronic illness, school problems, emotional disorders, and cognitive/learning problems

The Role of Maltreatment and Trauma

Around 1 million verified reports of child abuse and neglect occur in the U.S. every year (10 per 1,000 children)
1/3

of 10- to 16-year-olds experience physical and/or sexual assaults by family members or other people they know 16% of boys and 19% of girls age 12-17 meet criteria for PTSD, MDD, or substance abuse/ dependence due to acts of violence

Developmental Pathways of Disorders

Two types of developmental pathways:

Multifinality:
Various Similar

outcomes may stem from similar beginnings

Equifinality:

outcomes stem from different early experiences and developmental pathways

Developmental Pathways

Developmental Pathways

Risk and Resilience

Risk factors
Acute,

stressful situations, as well as chronic adversity Known risk factors:

Constitutional (e.g., gene abnormalities; birth complications) Family (e.g., poverty; abuse/neglect) Emotional and interpersonal (e.g., difficult temperament; low selfesteem) Intellectual and academic (e.g., below average IQ; learning disability) Ecological (e.g., neighborhood disorganization; crime) Nonnormative life events (e.g., early death of parent)

Risk and Resilience

Mental health problems are more likely in children:

From

disadvantaged families and neighborhoods From abusive or neglectful families Receiving inadequate child care Born with low birth weight because of maternal smoking, diet, or abuse of alcohol/drugs Whose parents have a mental illness or substance abuse problems

Risk and Resilience

Resilience =ability to fight off or recover from misfortune

Associated

w/ strong self-confidence, coping skills, ability to avoid risk Not a universal or fixed attribute; varies across time and situations Protective triad
Strength

of the child Strength of the family Strength of the school/community

Identifying risk and resilience factors

Oprah
http://www.youtube.com/watch?v=Xry51JBMj4w

22:00

Drew Barrymore
http://www.youtube.com/watch?v=XsatK_WYn-s

3:35

Big picture stuff

Impact most severe when problems go untreated Lifelong consequences of child psychopathology are costly (economic impact and human suffering) When provided with the opportunity, children can overcome major difficulties Children cannot advocate on their own behalf! Major prevention and intervention initiatives have begun to be developed

Reminders

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