Developmental psychopathology

I will get a 10.0

Atypical/abnormal

Deviates from what is considered standard or average (positively or negatively)

Psychopathology

study of atypical behaviours that are harmful and interfere with the normal functioning of the individual

Disorders

Syndromes ( intrinsic or extrinsic (reaction to environment)) that cause significant disturbances in behaviour, cognition or emotions, reflecting a dysfunction in mental processes and leading to distress or disability in key areas of life

Developmental norms

Typical growth rates, growth sequences and forms of physical skills, language, cognition, emotion and social behaviour, used to evaluate behaviour

The prevalence of a condition depends on (4)

1. Definition and criteria established for identifying a disorder 

2. Measurement used 

3. Source of the information (child themselves, parent, teacher, etc)

4. Characteristics of the population under study 

Types of Classification of abnormal behaviour

1. Categories: discrete; either the individual has or does not have the disorder

2. Dimensions: continuous; individuals may have high/moderate/low levels of a disorder

Clinical approach of classification

Diagnosis is classified when there are clusters of persistent symptoms that cause significant distress or impair major life areas

• Clinical consensus

• Problems are categorical

• Focus on quantitative differences 

• Eg. DSM

Empirical approach of classification

Identifying interrelated patterns of behaviour and symptoms using research and statistical methods to understand psychopathology

• Research-driven (based on empirical methods) 

• Problems are dimensional

• Focus on qualitative differences

• Eg. Achenbach (CBCL)

Research-based approach to classification

Understanding mental disorders through underlying biological, psychological, and behavioural processes rather than traditional diagnoses

• Research-driven

• Dimensional: symptoms exist on a spectrum rather than being simply present/absent

• Focuses on underlying mechanisms (e.g., fear, reward, cognition)

• Uses multiple levels of analysis, such as genes, brain circuits, behaviour, and self-report

Referral bias

Boys who are more likely to exhibit a disruptive behaviour are more likely to be referred to a professional than girls who exhibit the same behaviour

Law of effect (Thorndike)

Behaviour is shaped by its consequence 

Thomas Kuhn

Believed science is not completely objective but is influenced by the perspective (view, approach, and cognitive disposition) of the researcher 

Paradigm

Assumptions, concepts, and ways of evaluating the assumptions and concepts shared by researchers

Interaction models

Assume that variables are interrelated to produce an outcome (eg., vulnerability-stress model, which conceptualizes multiple causes of psychopathology as the cooperation of a vulnerability factor and stress factor)

Transactional models

• Emphasize the reciprocal relationship between different influences

• Assumes that the individual is an active agent and whose history has shaped his functioning

System models

Models that involve multiple levels of functioning (systems) that interact over time

Bio-psycho-social model

Idea that mental health and behaviour are influenced by a combination of biological, psychological, and social factors

Medical model

• Views disorders as discrete entities resulting from specific and limited biological causes within the individual, and it ignores context 

  • Has been challenged as there is no single cause for abnormal behavior

Mediator factors

Factor or variable that explains or brings an outcome (DV) indirectly

Moderator

A third variable that affects the direction or strength of the relationship between an independent and dependent variable

Necessary cause

Must be present for the disorder to occur

Sufficient caus

A cause that can lead to a disorder by itself 

Contributing causes

Causes that are neither sufficient nor necessary, but can accumulate and multiply their effects until the threshold of disorder is reached and a problem arises

Pathways of adaptation and maladaptation drawing

Stable adaptation (Path 1)

Youths who follow this path have little exposure to negative circumstances, have positive self-esteem and show few problems

Stable maladaptation (Path 2)

Characterised by chronic setbacks in the environment and insufficient resources to alleviate them

Reversal of maladaptation (Path 3)

maladaptation turns into a positive outcome because of life changes that create new opportunities

Decline of adaptation (Path 4)

Indicates initial adaptation that, due to environmental or biological shifts, ends in decline

Temporal maladaptation (Path 5)

Can reflect transient experimental risk taking

Equifinality

different factors can lead to the same outcome

Multifinality

A similar start state, risk factor, or early experience can lead to many different, divergent outcomes

Risks/ risk factors

Variables that precede and increase the likelihood of mental disorders

Direct cause/effects

 X leads directly to the result

Indirect cause/effects

X influences other variables that in turn lead to the outcome

Distal influence

Factor that is further removed from the person’s direct experience and affects them indirectly

Proximal influence

Factor that is closer to the person’s direct experience and affects them more directly

Vulnerability

Tendency to react inappropriately to life circumstances

Sensitivity period model

proposes that exposure to a risk over a period can have lasting effects

Developmental programming model

Suggests that early environmental phenomena can program certain characteristics of an individual

Resilience

Relatively positive outcome in the face of significantly adverse or traumatic experiences

Promotive/protective factors for resilience

1. Personal characteristics 

2. Family characteristics

3. Support from outside the family

Heterotypic continuity (symptom)

The persistence of a disorder, but symptoms manifest differently over time 

Heterotypic continuity (disorder)

the persistence of a disorder as another disorder (eg. an anxiety disorder transitioning into a mood disorder)

Homotypic continuity

the same condition or symptom persists over time

Fear

Reaction to an immediate threat to promote survival (adaptive & useful)

Anxiety

• Reaction to the anticipation of an event 

  • Can be considered adaptive if in moderation 

Tripartite model

Pattern of 3 types of reactions to a perceived threat:

1. Physiological: physical reactions (eg. increased heart rate)

2. Cognitive: thoughts and interpretations (eg. “Something bad will happen”)

3. Behavioural: actions or responses (eg. avoiding the situation)

Specific phobia

Almost immediate irrational fear or anxiety about a specific object or situation that is actively avoided, persistent for at least 6 months, and causes clinically significant distress or dysfunction 

Social anxiety disorder

Fear or anxiety about one or more situations in which the individual is exposed to possible scrutiny by others, persisting for at least 6 months and causing clinically significant distress or dysfunction

Selective mutism

Failure to speak in specific social situations which interferes with functioning, persisting for at least one month

Separation anxiety disorder

• Developmentally inappropriate and excessive fear or anxiety concerning separation from those whom the individual is attached to, causing significant distress or dysfunction, with at least 3 symptoms 

  • At least 4 weeks in children and adolescents, and 6 months in adults 

Generalized anxiety disorder

Excessive anxiety and worry about multiple events or activities, occurring more days than not for at least 6 months, difficult to control, and causing clinically significant distress or dysfunction

Panic disorder

Recurrent, unexpected panic attacks, followed by at least 1 month of persistent concern about further attacks or their consequences, and/or maladaptive behavioural change

Agoraphobia

Marked fear or anxiety about at least 2 situations, due to concerns that escape or help may be difficult, persisting for at least 6 months and causing clinically significant distress or dysfunction

Biological causes of anxiety & related disorders

• Children of anxiety-disordered mothers are 2x more likely to meet the criteria for an anxiety disorder by 15-years-old 

• Heritable 

• Roles of serotonin and GABA in regulating anxious arousal 

• Roles of limbic system and amygdala in fear processing 

• Role of prefrontal cortex in emotional regulation and coping behaviour

Psychological causes of anxiety & related disorders

• Direct experience 

• Modeling 

• Transmission of information  

• Parent practices/style 

• Peer relationships 

• Negative affectivity: persistent disposition towards negative mood 

• Behavioral inhibition

Social causes of anxiety & related disorders

• Parenting:

  • Direct classical conditioning 

  • Vicarious observational learning 

  • Transmission of verbal threat information 

Anxiety disorders epidemiology

2-13% prevalence, more common in girls

Specific phobia epidemiology

10% in children, more common in girls

Social anxiety epidemeology

1-2% prevalence in children, 3-4% in adolescents

Separation anxiety disorder epidemiology

3-13% prevalence, declines in adolescence

Generalized anxiety disorder epidemiology

2-14% prevalence

Panic disorder epidemiology

16% prevalence in adolescents

Interviews & self-report instruments

Ask individual about their anxiety, feelings, thoughts, and symptoms

Multidimensional anxiety scale for children (MASC)

Questionnaire that measures different types and symptoms of anxiety in children

Direct observations

Observe a person's behaviour in anxiety-provoking situations

Self-monitoring diaries

People record when they feel anxious, what triggers it, and how they react

Physiological recordings

Measuring physical signs of anxiety, such as heart rate, sweating, or breathing rate

Relaxation

Learn techniques to calm the body and reduce anxiety, such as slow breathing and muscle relaxation

Cue-controlled relaxation

Learn to relax by associating relaxation with a specific cue, such as a word

Systematic desensitisation

Gradually face feared situations while practising relaxation

Modelling

Learn to cope with fears by watching someone else do it

Contingency management

Reward behaviours that help reduce avoidance and manage anxiety

Cognitive-behavioural therapy (CBT)

Change unhelpful thoughts and behaviours that maintain anxiety

Selective serotonin reuptake inhibitors (SSRIs)

Medications that affect serotonin levels in the brain and can help reduce anxiety symptoms

Obsessive-compulsive disorder (OCD)

Presence of obsessions (intrusive, unwanted thoughts or urges) and/or compulsions (repetitive behaviours or mental acts performed to reduce anxiety or prevent a feared event), which are time-consuming or cause clinically significant distress or dysfunction

OCD epidemiology

• 1-2% prevalence in youth

• More common in prepubertal boys and equalizes out in adolescence

OCD etiology

• 1-2% prevalence in youth

• More common in prepubertal boys and equalizes out in adolescence

Posttraumatic stress disorder (PTSD)

After direct exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, the individual persistently re-experiences the event, avoids trauma-related stimuli, has negative thoughts or feelings, and experiences trauma-related arousal and reactivity (at least 2 times) 

• Symptoms must last more than 1 month and cause serious distress or functional impairment

Trauma-focused CBT

address and change unhelpful thoughts and feelings related to the trauma

Psychoeducation

Learn about PTSD, its symptoms, and how it affects people

Relaxation skills

Learn techniques to calm the body and manage stress

Affective modulation

Learn to recognise and regulate strong emotions

Cognitive coping

Develop healthier ways of thinking about and responding to the trauma

In vivo mastery

Gradually face safe situations that have been avoided because they remind the person of the trauma

Acute stress disorder (ADS)

Symptoms of intrusion, negative mood, dissociation, avoidance, and/or arousal following exposure to a traumatic event, lasting from 3 days to 1 month and causing clinically significant distress or dysfunction

Reactive attachment disorder

Inhibited and withdrawn behaviours towards caregivers due to social neglect

Disinhibited social engagement disorder

Culturally inappropriate familiarity towards unfamiliar adults

Emotion

short-lasting, intense reaction to a specific event or stimulus, usually with a clear cause

Mood

Longer-lasting, less intense emotional state that may not have a clear cause and can influence how you perceive things

Masked depression

Underlying depression is masked by other problems like hyperactivity or delinquency

Major depressive disorder (MDD)

• individual displays 5 (or more) of the following symptoms over 2 weeks 

  • Depressed mood for most of the day 

  • Diminished interest in pleasure 

  • Significant weight change 

  • Insomnia or hypersomnia 

  • Fatigue or loss of energy 

  • Feelings of worthlessness 

  • Diminished ability to think or concentrate 

  • Recurrent thoughts of death

Persistent depressive disorder (dysthymia)

Chronic form of depression, in which at least 2 of the following symptoms persist for at least 2 years (1 year for children) 

• Poor appetite or overeating 

• Insomnia or hypersomnia 

• Low energy or fatigue 

• Low self-esteem 

• Poor concentration or difficulty making decisions 

• Feelings of hopelessness 

 Disruptive mood dysregulation disorder

• Persistent irritability with frequent temper outbursts (at least 3x a week) for at least 1 year, in multiple different settings 

• Diagnosis should be made between ages 6-18

• Onset and symptoms should be apparent before age 10

Depression development

• Infancy/toddlerhood: withdrawal, reduced activity, irritability, and changes in eating or sleeping

• Preschool: irritability, sad facial expressions, crying, loss of interest in play, sleep disruptions, and physical complaints

• School age: sadness or irritability, social withdrawal, low self-esteem, and difficulties at school (more verbal about symptoms) 

• Adolescence: persistent sadness or irritability, loss of interest, hopelessness, social withdrawal, and changes in sleep or appetite

Empirical taxonomy

Identifies syndromes that combine depressive symptoms with anxiety and withdrawal

Biological factors in depression

• Dysregulation of serotonin, norepinephrine and acetylcholine 

• Structural and functional brain abnormalities in the prefrontal cortex and amygdala 

• High negative affectivity and low positive affectivity 

• The 5-HTTLPR gene is associated with an increased rate, only when exposed to stressful life events 

Behavioural models

Emphasize that loss reduces positive social reinforcement

Anaclitic depression

Describes infant withdrawal following prolonged parental separation

Learned helplessness

Believing you cannot control or change a situation because of repeated negative experiences