Study Notes on Child Psychopathology: Theories and Causes

Child Psychopathology: Theories and Causes

Chapter 2: Theories and Causes

Agenda

  • Chapter 2 + 4 lecture

  • Guest Lecture: Dr. Elizabeth Roberts

  • Topics Covered:

    • Adverse Childhood Experiences (ACEs)

    • Attachment Theory

    • Emotion Regulation

Reminders

  • Case Presentations:

    • The case must involve a fictional child or adolescent.

    • Review grading rubric as it will guide your presentation.

    • The video depicting the “character” must not exceed 5 minutes. This can be a combination of clips; the character must be integrated throughout the presentation to discuss intervention methods.

    • All slides need to be cited, and references must be included at the end.

    • Encouragement to collaborate and form groups.

  • Mid-term Quiz:

    • Focus on the biological perspective (no specifics about brain structures, neurotransmitters, or drugs).

    • 40 questions; attending class and engaging with material is crucial, along with reading the chapters.

The Case of Jorge

Overview

  • Profile of Jorge:

    • 14 years old, male

    • Academic difficulties since grade 4 (performance is below average)

    • Experiences concentration problems

    • Reports feeling targeted by teachers who “yell” at him

    • Perceives that teachers think he is "dumb"

    • Spanish speaker attending an English-medium school

    • Potential learning disorders in question

    • Parents exhibit anger and frustration towards him

    • Jorge displays signs of anxiety and low self-esteem

    • Discussion on the consideration of potential medications (reference: Wolfe & Mash, 2018).

Analysis of Jorge's Problems
Influences to Consider (1 of 2)

  • Problems in children must be viewed through multiple levels of influence, including:

    • Individual Factors: Internal traits and behaviors of the child.

    • Family Dynamics: Interactions among family members and their impact on the child.

    • Community Context: The child's social surroundings, including peers and education system.

    • Cultural Background: The child’s cultural identities and how they affect experiences.

Influences to Consider (2 of 2)

  • Possible causes of Jorge's behavior could encompass:

    • Biological Influences: Genetic predispositions, neurobiological factors.

    • Emotional Influences: Issues in emotional regulation, potential mood disorders.

    • Behavioral and Cognitive Influences: Learning disabilities, cognitive processing issues.

    • Familial, Cultural, and Ethnic Influences: Family structure and attitudes towards education and learning (reference: Wolfe & Mash, 2018).

Determining Areas for Intervention

  • Influential factors surrounding Jorge’s case include:

    • Parent frustration

    • Cultural discrepancies impacting education

    • Biological influences on psychological well-being

    • Jorge's low self-esteem

    • Poor academic performance

    • Increased criticism from school staff

    • Symptoms of anxiety and worry (reference: Wolfe & Mash, 2018).

Theoretical Foundations of Child Psychopathology

  • Understanding child psychopathology necessitates:

    • Grasping developmental processes involved.

    • Recognizing events that influence a child's emotional and psychological trajectory.

    • Studying various factors that contribute to biological, psychological, and environmental processes that result in clinical outcomes over time (reference: Wolfe & Mash, 2018).

Integrative Approach

  • Acknowledgement that:

    • No singular theoretical orientation fully explains the complexity of behaviors or disorders.

    • Models incorporating multiple causes are often constrained by inherent disciplinary boundaries.

    • A multi-theoretical perspective is deemed the most effective for studying childhood psychopathology.

Perspectives on Child Psychopathology

Biological Perspectives

  • Neurobiological Perspective:

    • The brain as a central causal element in psychological disorders.

    • Neuroplasticity: Brains adapt structurally based on experiences, showcasing a use-dependent anatomical differentiation. Early caregiving, prenatal environments, childhood illnesses, and nutrition play crucial roles in healthy brain development.

  • Genetic Factors: Genes influence tendencies but don't dictate behaviors directly. The interactions between genetics and environment substantially affect psychopathological outcomes.

  • Brain Structure and Function: Specific brain regions are linked with designated functions. The limbic system, basal ganglia, cerebral cortex, and frontal lobes each contribute to behavior regulation.

Psychological Perspectives

  • Behavioral, cognitive, and emotional processes help children understand their experiences and surroundings. This perspective emphasizes cognitive-behavioral processes in therapy.

Behavioral Assessment

  • Behaviors are often analyzed through their antecedents (previous events), behaviors (actions displayed), and consequences (results of actions). This ABC model aids in understanding behavior patterns (reference: Wolfe & Mash, 2018).

Family, Social, and Cultural Perspectives

  • Addressing social contexts: Proximal (close) and distal (distant) events influence child behaviors.

  • Bronfenbrenner’s Ecological Model: positions the child at the center of nested and interconnected structures representing their environment (reference: Wolfe & Mash, 2018).

Infant-Caregiver Attachment
Definition and Importance

  • Attachment: The formation and maintenance of emotional bonds with caregivers. Initiated between 6-12 months, attachment styles influence future relationships and emotional regulation.

  • An internal working model arises from initial attachments, shaping future relational behaviors (reference: Wolfe & Mash, 2018).

Patterns of Attachment

  • Four main attachment styles identified:

    • Secure: Infants feel safe to explore and seek caregiving when distressed.

    • Insecure - Anxious Avoidant: Children display limited interaction and emotional expression; they ignore caregivers and are wary of interaction.

    • Insecure - Anxious Resistant: Children oscillate between seeking and resisting contact with their caregiver, reflecting conflicting emotions.

    • Disorganized/Disoriented: Children lack a consistent strategy for attachment, demonstrating incoherent behavior in stressful situations.

Impact of Attachments on Outcomes

  • Insecure attachments are often linked with higher rates of childhood disorders. Strategies from experts like Dr. Elizabeth Roberts may help children with insecure or disorganized attachments regulate emotions effectively (reference: Wolfe & Mash, 2018).

The Role of Family and Peer Context

  • Current research emphasizes:

    • The vital role of the family system in influencing child behaviors.

    • Examining mutual influences within family structures and how they correlate with the child's psychological condition. Integration of individual and contextual factors is crucial in understanding child psychopathology (reference: Wolfe & Mash, 2018).

Assessment, Diagnosis, and Treatment

Purposes of Assessment

  • Description and Diagnosis:

    • Summation of unique behaviors, thoughts, and feelings that characterizes psychological disorders in children.

    • Diagnostic formulation is key to synthesizing and drawing informed conclusions about presenting issues (reference: Wolfe & Mash, 2018).

Purposes of Assessment in Treatment

  • Prognosis and Treatment Planning:

    • Prognosis refers to predictions regarding future behaviors under specified conditions.

    • Utilizing assessment data is imperative in generating effective treatment plans and evaluating their success.

Assessing Disorders

  • Clinical assessments are multimodal, utilizing diverse informants and settings to gain comprehensive insights into specific disorders. There is a continuous interplay between assessment and treatment (reference: Wolfe & Mash, 2018).

Clinical Interviews

  • Often unstructured, leading to potential biases, but aiming to provide significant information on a child’s developmental or family history. Semi-structured interviews enhance reliability through specific questioning (reference: Wolfe & Mash, 2018).

Behavioral Assessment: ABCs

  • Sections of behavior assessment include antecedents (what triggers actions), behaviors (actual actions), and consequences (outcomes from behaviors). Examples of how this applies:

    • Antecedent: Requested to go to school

    • Behavior: Physical complaints leading to school refusal

    • Consequence: Reduction in anxiety through avoidance (reference: Wolfe & Mash, 2018).

Child Behavior Checklist (CBCL)

  • A critical tool providing clinicians with a detailed profile of a child's behavioral issues, widely acknowledged for its utility in clinical assessments (reference: Wolfe & Mash, 2018).

Psychological Testing

  • Tests are standardized evaluations assessing various aspects of children's functioning, including intelligence. Comparisons to a normative group inform findings, although the norm group's demographics can impose limitations (reference: Wolfe & Mash, 2018).

  • Example - Intelligence Testing:

    • Wechsler Intelligence Scale for Children (WISC-IV): Frequently utilized that assesses cognitive functioning, emphasizing fluid reasoning and processing speed.

Ideographic vs. Nomothetic Strategies

  • Ideographic Strategies: Focus on the unique aspects of a child's situation.

  • Nomothetic Strategies: Utilize established knowledge to categorize and understand common patterns in behavior and disorders (reference: Wolfe & Mash, 2018).

Classification Systems

  • Categorical Classification: Based on professional consensus, assumes clear distinctions between disorders.

  • Dimensional Classification: Recognizes multiple dimensions or traits that exist on a continuum among all children (reference: Wolfe & Mash, 2018).

The Diagnostic and Statistical Manual (DSM)

  • Current edition is DSM-5. It provides a framework for understanding and diagnosing psychological disorders.

DSM: Pros and Cons
Pros of Diagnostic Labels:

  • Assist clinicians in organizing observations and fostering communication.

  • Offer recognition and understanding to parents regarding their child’s challenges (reference: Wolfe & Mash, 2018).

Cons of Diagnostic Labels:

  • Questions arise regarding the effectiveness of labels to fulfill intended goals.

  • Possible stigmatization and its negative impacts on children’s self-perception and behavior (reference: Wolfe & Mash, 2018).

Criticisms of DSM

  • Critique for failing to adequately address the complexity of childhood psychopathology and the interrelated nature of different disorders. It has been suggested that there is insufficient attention towards childhood disorders in the DSM framework (reference: Wolfe & Mash, 2018).

Treatment Approaches

  • Interventions: Must be tailored based on the understanding of specific disorders. Treatment decisions should be informed by ongoing assessments, ensuring that interventions remain effective over time (reference: Wolfe & Mash, 2018).

Treatment Goals

  1. Child Functioning:

    • Aim to reduce symptoms and impairment

    • Improve academic competence and social skills

  2. Family Functioning:

    • Goals include reducing dysfunction, enhancing support, and improving relationships

  3. Societal Outcomes:

    • Encourage participation in educational activities, minimize juvenile justice involvement, and support overall health (reference: Wolfe & Mash, 2018).

Types of Treatments

  • Psychodynamic Treatments: Focus on uncovering underlying conflicts influencing psychopathology.

  • Behavioral Treatments: Aim to modify learned behaviors using reinforcement and environmental changes.

  • Cognitive Treatments: Target faulty thought patterns to foster healthier cognitive processing.

  • Combined Treatments: Employ multiple treatment modalities to address psychological disturbances effectively (reference: Wolfe & Mash, 2018).

References

  • Mash, E., & Wolfe, D. (2018). Abnormal Child Psychology, Nelson Education, 7th Edition.

  • Wilmshurst, L. (2014). Essentials of Child and Adolescent Psychopathology, John Wiley & Sons.