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
Email me (samantha.connolly@temple.edu) presentation preferences by 10 AM this Wednesday 5/22 Order your textbook!
