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Historical Views of Child Psychopathology


Historical Views of Child Psychopathology. The Emergence of Social Conscience Historically children often ignored or subjected to harsh treatment John Locke (17thC) Jean-Marc Itard (19thC) – treat children with kindness. Historical Views (cont.).

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Historical Views of Child Psychopathology

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Historical Views of Child Psychopathology

  • The Emergence of Social Conscience

    • Historically children often ignored or subjected to harsh treatment

    • John Locke (17thC)

    • Jean-Marc Itard (19thC) – treat children with kindness


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Historical Views (cont.)

  • Early Psychological Attributions (for adults, mostly)

    • emerged in early 1900’s

    • psychoanalytic theory

    • behaviorism laid foundation for studying conditioning and elimination of children’s fears


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Historical Views of Child Psychopathology

  • Child psychopathology generally ignored

    • Insanity

    • DSM

      • 1980 version of DSM included a child section


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Reasons why ignored

  • Psychoanalytic theory

  • Behavior theory


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Historical Views (cont.)

  • Evolving Forms of Treatment based in historical context

    • institutionalized

    • foster families and group homes

    • behavior therapy


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Evidence for change in perspective on children’s problems

  • Child-focused journals

  • Divisions of APA

  • Child abuse laws enacted

  • IDEA


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Change in perspective (cont.)

  • Surgeon General’s report (2001)

    • 1 in 10 has severe mental or behavior problem

    • Only 2 of 10 with problems get help


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Surgeon General’s goals

  • Promote public awareness

  • Develop scientifically proven treatments

  • Improve assessment methods

  • Eliminate ethnic/SES disparities in services


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Surgeon General’s goals

  • Train frontline providers

  • Monitor access to mental health services

  • Improve infrastructure of services

  • Increase access to mental health services


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Reasons why child psychopathology is now receiving more attention

  • Problems are common

  • Lifelong consequences

  • Predict adult disorders

  • Few children receive necessary help

  • Develop early intervention programs

  • Legal mandates


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Defining Psychological Disorders

  • Determining what is normal and abnormal is an arbitrary process

  • Traditionally defined as a pattern of behavioral, cognitive, or physical symptoms, that is associated with one or more of:

    • distress

    • disability

    • increased risk for further suffering or harm


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Defining Psychological Disorders (cont.)

  • Many childhood problems best depicted in terms of relationships

  • Labels describe behavior, not the child

  • Problems may be the result of children’s attempts to adapt to abnormal or unusual circumstances

  • Need to consider age/developmental level


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Developmental Pathways

  • Refers to the sequence and timing of behaviors, and the relationship between them over time

  • Two types of developmental pathways:

    • multifinality: similar early experiences lead to different outcomes

    • equifinality: different early experiences lead to a similar outcome


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Developmental Pathways (cont.)

Figure 1.1 (a) Multifinality: Similar early experiences lead to different outcomes; (b) Equifinality: Different factors lead to a similar outcome


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Developmental Pathways (cont.)

  • With abnormal child psychology, must keep in mind:

    • there are many contributors to disordered outcomes in each child

    • contributors vary among children who have the disorder

    • children express features of their disturbances in different ways

    • pathways leading to particular disorders are numerous and interactive


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Issues unique to child psychopathology

  • Referral process

  • Greist et al.: why do parents bring their children in to clinics?

    • Predicted mother’s ratings of their children

    • Home observation for objective ratings

    • Got ratings of mom’s mood/depression


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Referral process cont.

  • Webster-stratton (1988)

    • Questions of interest

    • Method

    • Results

    • implications


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Temperament & reciprocal relationships

  • Innate biological factors which influence behavior

    • “easy” temperament

    • “difficult” temperament

      • Easiness to soothe

      • Activity

      • Sociability

  • Parent-child relationships are reciprocal


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Reciprocal relationships

  • Pelham et al. (1997)

    • Questions of interest

    • Method

    • Results

    • implications


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What Affects Rates and Expression of Mental Disorders?

  • Poverty and Socioeconomic Disadvantage

    • about 1 in 6 children in North America live in poverty

    • poverty is associated with greater rates of learning impairments and academic problems, conduct problems, chronic illness, hyperactivity, and emotional disorders


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Rates and Expression (cont.)

  • Sex Differences

    • sex differences appear negligible in children under age 3, but increase with age

    • boys > girls in early/middle childhood; girls > during adolescence


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Figure 1.3

Figure 1.3 Normal developmental trajectories of Externalizing problems (top graph) an Internalizing problems (bottom graph) from the Child Behavior Checklist. Ages are shown on the x axis. The y axis represents the raw scores (higher score means more problems). Source: Bongers, Koot, van der Ende, & Verhulst, 2003.


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Rates and Expression (cont.)

  • Ethnicity

    • minority children over-represented

    • once other effects (SES, gender, age, referral status) are controlled for, very few differences emerge in relation to race or ethnicity

    • minority children face multiple disadvantages


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Rates and Expression (cont.)

  • Ethnicity (cont.)

    • Research has often ignored cultural factors


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Rates and Expression (cont.)

  • Culture

    • contributes to development and expression of disorders

    • some underlying processes are similar across diverse cultures