Chapter 16 Development Psychopathology

1. Chapter 16Development Psychopathology

2. Chapter 16: Developmental Psychopathology • Abnormality • Statistical deviance • Maladaptiveness • Interferes with personal and social life • Poses danger to self or others • Personal distress • DSM-IV diagnostic criteria (APA)

3. Developmental Aspects • Development, not disease • A pattern of maladaption, not defects • Social and Age Norms • Developmental issues • Nature/Nurture • Risk factors • Prediction

4. The Diathesis-Stress Model • Interaction of genes and environment • Example: Depression • Genetic vulnerability • Environmental trigger(s) • Not specific stressors for specific disorders • “Bad things have bad effects for some people some of the time”

5. Autism • Begins in infancy: more boys • Several autistic spectrum disorders • Impaired social interaction, communication • Repetitive, stereotyped behaviors • 80% retarded: savant syndrome common • Severe cognitive impairment • Biologically based • Concordance: MZ=60%, DZ= 0%

6. Depression • Infancy • Somatic symptoms • Depressive-like states • Related to poor attachment • “At risk” if mother depressed • “Failure to thrive” syndrome may occur

7. Childhood • Externalizing problems • “Undercontrolled” disorders • Acting out • Aggressive, out of control • Internalizing problems • “Overcontrolled” disorders • Inner distress, shyness • More girls

8. Figure 16.3

9. Attention-Deficit Hyperactivity Disorder • DSM-IV Criteria: some combination of • Inattention • Impulsivity • Hyperactivity • More boys; 3-5% of US kids • Comorbidity common • Overactive behavior wanes with age • Attentional, adjustment problems remain • Most well adjusted in adulthood

10. ADHD-Causes and Treatment • Neurological: low Dopamine, other NT’s • Differential processing • Underactivity in motor area • Genetic predisposition; Environmental stress • 70% helped by stimulants • Overprescription a problem • Most successful if combined with behavioral treatment

11. Depression • Childhood • Somatic symptoms • Psychotherapy, medication effective • Nature/Nurture question • Adolescence • Often related to childhood symptoms

12. Adolescence • Storm and stress • Only about 20% • Heightened vulnerability to psych disorders • Alcohol and drugs are problems • Eating disorders • Anorexia nervosa; more girls (3/1) • Bulemia nervosa; binge-purge • Some genetic predisposition; stress also • Psychological treatment usually successful

13. Adolescent Depression and Suicide • 35% depressed; 7% diagnosable • Cognitive symptoms • Behavioral acting out • Genetic link • Environmental triggers • Suicide 3rd leading cause of death • Males commit 3/1; girls attempt 3/1

15. Adulthood • Rates of disorder decrease after age 18 • Depression • Elderly less vulnerable to major depression • Concern with elderly • Depression often related to health • 15% have some symptoms • 1-3% diagnosable • Difficult to diagnose • More women (2/1)

16. Depression and Dementia • Many undiagnosed and untreated • Elderly can benefit, should NOT be excluded from treatment • Dementia: progressive deterioration • Not normal aging • Alzheimer’s Disease • Leading cause of dementia • Progressive and irreversible

17. Causes of Cognitive Impairment • Genetic: e.g., Alzheimer’s • Vascular dementia - multi-infarct • Minor strokes: deficits accumulate • Related to lifestyle: diet and exercise • Reversible dementia, about 20% • Delerium: reversible, often drug related • Depression: treatable • Critical to distinguish for proper treatment

18. Figure 16.6

19. Figure 16.5