Child Psychopathology Midterm

What four features distinguish child/adolescent disorders from adult disorders?

1) Adults, not the child, usually raise the concern and make the referral.

2) Many concerns involve a failure to show expected developmental progress.

3) Many concerning behaviours aren't entirely atypical, since most kids show some of them.

4) Interventions aim to promote further development, not just restore a prior level of functioning

What are the four research goals in child psychopathology?

Defining psychopathology, identifying causes/correlates, predicting long-term outcomes, and developing and evaluating treatment/prevention.

How were children viewed before the 18th century?

Their mental health was rarely discussed. Children were seen as inherently uncivilized, and the Church attributed odd behavior to possession by evil forces. About two-thirds died before age 5. Cruelty and neglect were treated as parental rights.

What was "moral insanity"?

A 19th-century term (Pritchard, 1837) for children with normal cognitive ability who were disturbed, implying a defect of character or personality.

What replaced the "moral insanity" view?

The organic disease model, which supported more humane treatment.

What happened to attitudes in the early 20th century?

A return to the custodial model, with fear, segregation, institutionalization, and eugenics aimed at people with intellectual disability.

Phenomenological

20th-century philosophical and research approach that studies conscious, first-person experiences as they are lived and perceived, rather than explaining them through abstract theories or outside assumptions.

Name and define Bronfenbrenner's five systems (Ecological Systems Theory)

Microsystem: settings the child directly interacts with (home, school).

Mesosystem: connections between microsystems (family-school).

Exosystem: structures that indirectly affect the child (local politics, funding, media, economy).

Macrosystem: overarching societal and cultural structures.

Chronosystem: timing, the time course of events and the child's developmental stage.

Define psychological disorder (three features).

A pattern of behavioural, cognitive, emotional, or physical symptoms associated with:

1) distress

2) disability (impairment in important areas of functioning)

3) increased risk of further harm (death, pain, disability, loss of freedom). It excludes reactions that are expected and culturally appropriate (e.g., grief).

Define competence and developmental tasks.

Competence is the ability to successfully adapt using internal and external resources, and it varies across cultures. Developmental tasks are broad domains of expected achievement at each age, such as conduct, academics, peers, and self-identity.

Give examples of developmental tasks in infancy-preschool

Attachment, language, differetiation self, self-control/compliance

Give examples of developmental tasks in Middle childhood

School adjustment, academic achievement, peer relationships, rule-governed conduct

Give examples of developmental tasks in adolescence

Transition to secondary school, academics, extracurriculars, close friendships, cohesive self-identity

What is a developmental pathway?

The sequence and timing of behaviours and their relationships over time. it treats development as an active, dynamic process.

Multifinality

Similar beginnings lead to different outcomes (e.g., early maltreatment → eating, mood, or conduct disorder, or normal adjustment).

Equifinality

Different beginnings lead to a similar outcome (e.g., genetic, family, and environmental pathways → conduct disorder).

Risk factor

A risk factor precedes a negative outcome and increases its likelihood

Protective factor

A personal or situational variable that reduces the chance of developing a disorder.

Define resilience

Resilience is the process and outcome of effectively adapting to challenging experiences.

What is the "protective triad"?

Strengths of the individual (good intellect, easygoing temperament, self-efficacy, talents, faith), the family (close bond with a caring parent, authoritative parenting, extended support), and the school/community (supportive adults, effective schools, social organizations). Not all three are necessary.

How do resilience-supporting environments differ by gender?

Males: an identified male role model, structure and rules, some encouragement of emotional expression.

Females: independence and risk-taking combined with support from an identified female caregiver.

Distinguish how stressors affect onset vs. course.

Stressors like poverty, abuse, or lack of safety can be nonspecific triggers for onset in vulnerable children, and they also affect the course by attenuating or worsening existing difficulties.

Sex differences in disorders?

Males have higher rates of reading disorders, ASD, ADHD, childhood-onset schizophrenia, and early-onset persistent conduct problems. Females have higher rates of depression (peaking in adolescence), eating disorders, and most anxiety disorders. Differences are negligible before age 3 and grow with age

Developmental trajectories of internalizing vs. externalizing problems?

Externalizing (aggression, delinquency) starts higher in boys and declines until rates nearly converge by 18.

Internalizing (anxiety, depression, somatic, withdrawn) starts similar, then females outpace males over time.

What are ACEs?

Adverse childhood experiences

Why is adolescence a high-risk period?

Substance use, risky sexual behavior, violence, injuries, and mental health problems peak. Mortality rates more than triple from late childhood to early adulthood, mainly due to risk-taking.

What is behavioural inhibition?

A tendency to approach new or challenging situation with greater apprehension and fear than other children

What does the cognitive model say about emotions and behaviour?

People’s emotions and behaviours are driven by how they perceive or interpret a situation, not by the situation itself. Thoughts, feelings, and behaviour are interrelated.

What is acculturation, and which approach is most adaptive?

Acculturation is the process of adapting to a receiving culture. Biculturalism, adapting to both heritage and receiving cultures, appears to be the most adaptive approach.

What family/community risk factors are linked to child mental health problems?

Low SES, ethnic minority status, marital discord, family legal problems, lack of social support, and unresponsive caregiving. Children also need a safe community, good schools, health and nutrition, peers, and extended family and community connections.

What is a theory used for, and what is case conceptualization?

A theory is a language of science that lets us organize knowledge, make educated predictions, and guide our search for causes (like a treasure map). It is the basis of case conceptualization, which guides effective intervention.

Etiology

The study of the causes of childhood disorders, specifically how biological, psychological, and environmental processes interact to produce outcomes over time.

Epigenetics

The study of how behaviour and environment can cause changes that affect the way genes work. It’s best described as how environmental influences “get under the skin,” and it is a potential pathway for intergenerational transmission of trauma effects

What are the three underlying assumptions about child development?

1) Child psychopathology is multiply determined.
2) Child and environment are interdependent (transactional).
3) Development involves continuities and discontinuities.

Multiply determined

A single-cause explanation (e.g.m Jorge lack motivation”) is overly simplistic. A disorder usually stems from many causes, and similar risk factors can lead to different outcomes (ties to multifinality/equifinality)

Define continuity and discontinuity

Continuity: Gradual, quantitative chnage where future behaviour can be predicted from earlier patterns

Discontinuity: abrupt, qualitative change where earlier patterns poorly predict later ones.

What are developmental cascades?

The process by which earlier interactions and experiences spread across other systems and alter later development, like a chain reaction. this can be positive or negative (e.g., curiosity → academic performance.

Typical concerns and clinical disorders by age

0-2: attachment, eating, sleeping → intellectual disability, feeding disorders, ASD.

2-5: language, toileting, self-control → speech/language disorders, effects of abuse/neglect, phobias.
6-11: academic skills, rules → ADHD, learning disorders, school avoidance, conduct problems.
12-20: intimate relationships, identity → anorexia, bulimia, delinquency, suicide attempts, substance abuse, schizophrenia, depression.

What does an integrative approach say about competing theories?

No single theory explains every behaviour or disorder. Major theories have become compatible, each supplying a piece of the puzzle, and theories are tools whose limits you need to know.

Define adaptive failure

Failure to master or progress in accomplishing developmental milestones. It’s the common ground across child disorders, and it rarely has a single cause.

What is the organization of development?

Early patterns of adaptation evolve with structure over time and transform into higher-order fucntions (e.g., early speech sounds → language). Development is hierarchical: current abilities build on prior ones.

Define sensitive periods

Windows of time when environmental influences on development, good or bad, are enhanced. They are not the only opportunities, since change can occur at other times (e.g., orphanage-adopted children are also affected by later environments)

What is neural plasticity?

The brain’s malleability. Its anatomical differentiation is use-dependent: nature provides the basic processes and nurture provides the experiences that select the most adaptive connections. It continues throughout development.

Timeline of brain maturation?

Primitive sensory/motor areas mature first and are restructured in the first 3 years. The prefrontal cortex and cerebellum are not rewired until about 5-7 years. Major restructuring occurs at ages 9-11 (puberty), and the brain prunes again through adolescence. Frontal lobes continue to mature into the 20s.

How does experience shape the brain?

Prenatal environment, diet, illness, stimulation, and caregiving all count as experience. Healthy caregiving builds coping and learning capacity, while abuse and neglect can prime the brain for lifelong difficulty with stress and relationships. Earlier disruptions tend to cause more severe organic problems.

Define gene-environment interaction (G×E)

Interplay of nature and nurture, including timing.

Dopamine

A “switch” for brain circuits, linked to exploratory and pleasure-seeking activity → schizophrenia, mood disorders, ADHD

Norepinephrine

Emergency and alarm responses → general regulation, not ties to a specific disorder

Serotonin

Regulates eating, sleeping, and anger, and inhibits exploration → eating and sleep disorders, OCD, schizophrenia, mood disorders.

Why do emotions matter for development?

They appraise events as beneficial or dangerous, motivate action, guide attention and approach/avoidance, and are a child’s primary early form of communication. Children read caregivers’ emotional cues to understand situations.

Emotion reactivity vs. emotion regulation?

Reactivity: individual differences in the threshold and intensity of emotional experience.

Regulation: enhancing, maintaining, or inhibiting emotional arousal, usually toward a goal.

Regulation concerns vs. dysregulation?

Regulation concerns: weak or absent control structures (e.g., trouble concentrating).

Dysregulation: control structures operate atypically (e.g., fear with no environmental reason).

Define temperament and its three dimensions

Temperament is an organized style of behaviour appearing early in development (an early building block of personality). Dimensions:

1. Positive affect/approach → the “easy child.”

2. Fearful/inhibited → the “slow-to-warm-up child.”

3. Negative affect/irritability → the “difficult child.”

Personality disorders in youth: key rules?

Rarely diagnosed before late adolescence/early adulthood. Must be an enduring, inflexible, pervasive pattern that deviates from cultural expectations and causes distress or impairment. Under 18, features must be present for at least one year.

Define applied behavior analysis (cognitive approach)

Focuses on observable behavior and rejects the need for cognitive mediation

Define social learning theory (cognitive approach)

Relies much more on cognitive processes.

Behavioural approach

Behavioral approaches focus on controlling variables (current causes) rather than origins.

What are cognitive distortions and attributional bias?

Faulty beliefs and appraisals: reinterpreting events to fit preexisting beliefs. In cognitive models, negative cognitions are posited as the leading cause of negative emotions and behaviours.

Proximal vs. distal environmental events?

Proximal events are close to the child and impinge directly. Distal events are further removed (like a rainstorm vs. the seasons).

Shared vs. nonshared environment?

Shared: factors producing similarities among siblings (marital conflict, poverty, similar parenting).

Nonshared: factors producing differences among siblings (differential parental treatment, peers, school). Nonshared environment accounts for a large portion of the variation.

What is attachment?

Attachment is the process of establishing and maintaining an emotional bond with parents or significant others. It typically begins between 6 and 12 months and gives infants a secure base to explore.

What are “internal working models” and attachment’s function?

The child’s expectations of others and how they relate to them, formed through the first crucial relationship and carried into later ones. Attachment serves a stress-reduction function and helps regulate behavior and emotion.

Family issues that most often influence child disorders?

Parental depression, child abuse, parental substance abuse, marital violence, family instability, poverty, and parental criminality. The common thread is that they disrupt consistent, predictable care and basic necessities.

What distinguishes science from pseudoscience?

Science is testable, variable and replicable. Pseudoscience lacks one or more of these aspects.

What is epidemiological research?

Incidence: new cases over a specified period (e.g., new depression cases during a school year).

Prevalence: all cases, new or existing, during a specified period.

Lifetime prevalence: whether the child has had the disorder at any time in life.

Prospective vs. retrospective prevalence estimates?

Lifetime prevalence from prospective studies (same sample followed over time) is roughly double that from retrospective studies, which suffer from recall failure.

Define correlate

Variables associated at one time with no proof which came first (Whitney’s sadness and lack of friends)

Why do risk/protective factor studies need large samples studied over time?

1) Only a small proportion of at-risk children develop the disorder.
2) The affected functional areas aren’t known in advance.
3) The ages of onset or recurrence aren’t known in advance.

There may also be sleeper (delayed) effects, such as divorce effects surfacing in teen romantic relationships.

Define moderator

Influences the direction or strength of a relationship between two variables (age, sex, SES, culture); the association depends on it

Define mediator

The process or mechanism through which one variable produces an outcome, accounting for some or all of the apparent relationship.

What is an RCT?

A randomized controlled trial: children with a problem are randomly assigned to treatment and control conditions.

Efficacy vs. effectiveness

Efficacy: does the treatment work under well-controlled conditions (selected cases, controlled therapists and delivery)?

Effectiveness: does it work in real clinical practice (referred clients, less control)? Benefits are generally lower in effectiveness trials than in efficacy trials, so a priority is bridging research and practice.

Why are multiple measures needed?

Evaluations reflect different settings and adult perspectives, and are influenced by the child’s age, sex, culture, and the assessor’s expectations. No single measure gives a complete picture.

Define standardization

Norms and procedures for administration, scoring, and evaluation used consistently across assessments (compare a child with similar children)

Define reliability

Consistency or repeatability of results.

• Internal consistency: all parts of the measure contribute meaningfully.

• Interrater reliability: different observers agree.

• Test-retest reliability: results are stable over time.

Define validity

The degree to which a technique measures what it’s designed to measure (a matter of degree).

• Face validity: appears to assess the construct.

• Construct validity: scores behave as theory predicts (includes convergent, correlated with related measures, and discriminant, uncorrelated with unrelated measures, e.g., depression vs. intelligence).

• Criterion-related validity: predicts behaviour, either now (concurrent) or later (predictive).

Internal vs. external validity?

Internal: how much the variable of interest, rather than extraneous influences, accounts for results.

External: how well findings generalize to other people, settings, times, and measures.

Define sample of convenience

Chosen merely because available. Setting and referral source effects are often confounded.

Retrospective design

Identify people with the outcome now and ask about the past. Fast, but prone to recall bias and fails to identify exposed people who didn’t develop the problem (e.g., childhood sexual abuse in eating disorders).

Prospective design

Identify a sample and follow it over time. Minimizes recall bias and captures those who do and don’t develop the disorder, but has participant attrition and takes a long time.

What is analogue research?

Studying a variable under conditions that only resemble the situation of interest, giving good control but raising external validity concerns.

Describe the A-B-A-B (reversal) design.

 A baseline → B intervention → A return to baseline (intervention removed) → B intervention reintroduced. If behavior changes only during intervention phases, the intervention likely caused it.

What are the limitations of A-B-A-B?

Treatment is introduced in turn across different behaviors, situations, or individuals. Change must occur only when and where treatment is introduced, with untreated targets staying at baseline. No reversal is needed.

Who provides ethical guidelines for research with children?

Institutional review boards (IRBs), federal funding agencies, and organizations like APA, SRCD, and AACAP. Every study undergoes ethical review.

What balance do ethics standards try to strike?

Freedom of scientific inquiry vs. protecting participants’ privacy and welfare, harder with children because they are more vulnerable to harm and less able to evaluate what participation means.

What is informed consent?

Participants are fully informed of the nature of the research, risks, benefits, expected outcomes, and alternatives, without coercion. They must be told they can withdraw anytime and that participation or nonparticipation won’t affect eligibility for other services. It is “the single most protective regulation.”

Define assent

Assent is the child’s agreement to participate without necessarily understanding the full significance, sought at about age 7 or older. Consent is also needed from institutional officials (schools, day cares, medical settings).

Idiographic vs. nomothetic formulation?

 Idiographic: a detailed understanding of the individual child or family as unique.

Nomothetic: broad generalizations that apply to large groups (e.g., children with depression). Nomothetic knowledge helps generate better hypotheses to test idiographically.

Gender patterns in disorders

More common in males: ADHD, childhood conduct disorder, intellectual disability, ASD, language disorder, specific learning disorder, enuresis. More common in females: anxiety disorders, adolescent depression, eating disorders, sexual abuse. Equal: adolescent conduct disorder, childhood depression, feeding disorder, physical abuse and neglect.ccc

Why might boys be over-referred and girls overlooked?

Overactivity and aggression are more visible and bothersome to adults. Girls tend to express concerns in less observable ways (sadness, fear, shame). Diagnostic increases in girls (e.g., ADHD) likely reflect increased recognition, not a true jump in rates.

What is relational aggression?

Indirect aggression through verbal insults, gossip, ostracism, getting even, or third-party retaliation, more characteristic of girls. Its function centers on group acceptance as they enter adolescence. Combined relational and physical aggression is the strongest predictor of later adjustment concerns in girls.

Define culture and cultural syndromes

Culture: learned behaviors and values shared by members and transmitted over time (ethnicity, language, religion, race, gender, SES, age, sexual orientation, geographic origin, group history, life experience).

Cultural syndromes: patterns of co-occurring, relatively invariant symptoms in a particular cultural group (e.g., mal de ojo, the "evil eye"), which rarely fit neatly into one Western diagnostic category.

What defines a childhood disorder (three factors)?

The age-inappropriateness, severity, and pattern of symptoms, rather than any individual symptom. Impairment in functioning is also a key consideration. Symptoms are common behaviors that become disorders when more frequent, more severe, and impairing.

What are the three purposes of assessment?

1) Description and diagnosis

2) Prognosis

3) Treatment planning and evaluation

What does a clinical description include?

How behavior differs from age-mates (same age, sex, SES, culture): intensity/frequency/severity, age at onset and duration, and the full profile/configuration of symptoms, strengths, and weaknesses.

The two meanings of "diagnosis"?

Taxonomic diagnosis: formally assigning a case to a category from a classification system (DSM-5-TR) or empirically derived dimensions.

Problem-solving analysis: the broader process of gathering information to understand the problem, its causes, treatment options, and outcomes.

Define prognosis.

Predictions about future behavior under specified conditions (improve, stay the same, or worsen, with or without treatment). It must reflect developmental understanding, since many concerns (fears, bed-wetting) are common at certain ages.

What is the clinical interview, and how do you tailor it?

• The most universally used assessment procedure with parents and children.

• Use open-ended questions with parents. With children and adolescents, start with close-ended questions and move to open-ended as they get comfortable.

• Address confidentiality beforehand.

• Use games, drawing, and child-friendly settings, involve a parent with younger children, and keep sessions shorter.

• Interviews also let the clinician observe nonverbal cues.

What are the "ABCs" of assessment?

Antecedents (events that precede a behavior), Behavior(s) of interest, Consequences (events that follow). It's used to see what might be reinforcing a behavior.

What is functional analysis (behavior analysis)?

Systematically organizing assessment information into antecedents, behaviors, and consequences to identify as many contributing factors as possible, form hypotheses about the most important or most easily changed ones, and sometimes test them by changing antecedents/consequences. It shows the close link between assessment and intervention.