Child Psychopathology Lecture 1: Key Concepts and Frameworks

Today's Objectives

  • Discuss psychological work with children, adolescents, and families

  • Identify differences between working with children/adolescents vs. adults

  • Understand the psychologist's role

  • Explore overarching theoretical and practical considerations

Importance of Childhood Mental Health

  • Origins of Adult Clinical Presentations:

    • 50% of adult mental health issues onset before age 14

    • 75% before age 24

  • Prevalence:

    • 15-20% of children experience psychological disorders.

    • Many more have subclinical issues affecting functionality.

    • Variation in prevalence by age, sex, and specific disorders.

    • Increase in Prevalence over time for some disorders.

Comorbidity:

  • 40% of children with >1 disorder

  • Involves both homotypic and heterotypic comorbidities.

standardized assessment tools:

  • Behavior Assessment System for Children (BASC), 3rd Edition

  • Child Behavior Checklist

  • Strengths and Difficulties Questionnaire

  • Consider transdiagnostic treatment approaches.

Case Discussion: Millie's Situation

  • Millie is 3 ½ years old, displaying regular tantrums and aggressive behavior.

    • Parents are divided on whether she needs psychological assessment.

Clinical Tasks in this scenario:

  • Gather information about presenting concerns, developmental history, and contextual factors.

  • Explore various perspectives on Millie's issues.

  • Determine if the behaviors fit a broader syndrome or if an intervention is warranted.

Referrals

often vary between children and adults:

  • Adult Referrals: Focus on diagnosed issues like panic attacks, stress, or depression.

  • Child/Adolescent Referrals: Often revolve around behavior questions and concerns about ‘normalcy.’

Assessment with Youth

  • Requires input from multiple informants (parents, teachers, the child themselves).

  • Various methods (interviews, observations, standardized tests) over several sessions.

  • Non-linear approach reliant on flexibility and clinical judgment.

Areas of Assessment

  • Key Content Areas to assess:

    • Family context and dynamics

    • Emotional and behavioral functioning

    • Child’s learning and social functioning

    • Physical health, sleep habits, and trauma history.

  • Address discrepancies between informants to aid formulation.

Understanding Contexts of Abnormality

  • Consider development, familial, cultural, and historical contexts to define 'abnormality'.

  • Developmental trajectories may involve delay, deviation, regression, asynchrony, or adaptational failure.

Diagnostic Systems for Childhood Disorders

  • Familiarize with:

    • DC:0-5T (child mental health)

    • ICD-11 (international classification system)

    • DSM-5 (defines mental disorders but lacks developmental specifics)

Challenges in Diagnosis

  • Variability in clarification and diagnosis for children due to:

    • Wide normative ranges for developmental stages.

    • Heterogeneity in presentations.

    • Subjectivity in establishing distress and impairment.

Benefits and Challenges of Diagnostic Labels

  • Benefits: Legitimacy, access to services, shared language for understanding.

  • Challenges: Risk of oversimplification and pathologizing typical behavior.

Practical Application of Diagnosis

  • Discussion of diagnostic considerations with an emphasis on assessment for a range of presentations (including sub-threshold).