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Chapter 16

Chapter 16. Developmental Psychopathology. Abnormal Development/Behavior Statistical deviance Uncommon = abnormal & MAY = pathological Maladaptive Interfer w/ functioning, danger to self or others Personal distress Anguish & discomfort. Developmental Psychopathology

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Chapter 16

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  1. Chapter 16 Developmental Psychopathology

  2. Abnormal Development/Behavior • Statistical deviance • Uncommon = abnormal & MAY = pathological • Maladaptive • Interfer w/ functioning, danger to self or others • Personal distress • Anguish & discomfort

  3. Developmental Psychopathology • Focus is on development, not disease • Adaptive course of life • A pattern of maladaptation, not defects • Social and age norms key • Societies, age define ‘normality’ • Normal at 4 years old to fear monsters (but not at 45) • Developmental issues: • Nature/Nurture, risk factors, change & Prediction

  4. The Diathesis-Stress Model • Psychopathology: Interaction of vulnerability (Diathesis) and environment • Genes, biology & stress • Example: Depression • Genetic vulnerability • Environmental trigger(s) • No specific stressors for specific disorders

  5. Figure 16.2

  6. Disorders in infancy: Autism • 3 core symptoms • Impaired social interaction • Inattentive to social/emotional cues • Aversive & disorganized attachments to parents • Deviant communication development • Mute, echolalia (parroting speech), • Some speak but little give-and-take interactions • Repetitive, stereotyped behaviors • Seek sameness, novelty frightening • Rocking, flapping, strong toy/object attachment

  7. Disorders in infancy: Autism • Causes • No theory of mind, symbolic thought • Executive cogntive ablity (integration) • Biology • Epilepsy & Brain stem abnormalities common • Genes key • Outcomes • Lifelong disorder • Early behavioral intervention may help

  8. Disorders in infancy: Depression • Symptoms • Somatic problems (sleep problems, weight loss) • Depressive-like states • Related to poor attachment • At risk if mother depressed • Failure to thrive • Due to abuse, neglect • Fail to grow/develop normally

  9. Disorders in Childhood • Externalizing problems • Undercontrolled disorders • Acting out • Aggressive, out of control • Internalizing problems • Overcontrolled disorders • Inner stress, anxiety • More girls

  10. Disorders in Childhood: Attention-Deficit Hyperactivity Disorder • DSM-IV Criteria • Inattention (easily distracted, never finishes task) • Impulsivity (acts before thinking) • Hyperactivity (perpetual fidgeting, restlessness) • 3%-5% of children diagnosed (boys > girls) • Conduct disorders & learning disabilities common

  11. Attention-Deficit Hyperactivity Disorder • Course • Overactive behavior wanes later in life • Attentional and adjustment problems remain • Most are adjusted in adulthood

  12. ADHD – Causes and Treatment • Causes • Unclear neurological basis • Deficiencies in frontal lobe (planning, inhibit beh) • Underactivity in motor area of brain • Genetic predisposition • Treatment • 70% helped by stimulants (overprescription) • Best if combined with behavioral treatment

  13. Depression • Childhood • Somatic symptoms > cognitive symptoms • Psychotherapy, medication effective • Nature/nurture question • Early adulthood (age 21) adjustment • Related to child symptoms/temperament

  14. Adolescence • Storm and Stress not common • Only about 20% • increased vulnerability for some disorders • Eating disorders common (esp girls) • Anorexia Nervosa • Bulimia Nervosa • American thinness craze (25% 2nd grade girls diet) • Stress, perfection, control • Some genetic predisposition • Successful treatment possible

  15. Adolescent Depression and Suicide • 35% depressed, 7% diagnosable • Cognitive symptoms common • Behavioral acting out • Suicide 3rd leading cause of death (this age) • Females attempt more, males succeed more • Genetic link • Environmental triggers

  16. Adulthood • Rates of disorder decrease after age 18 • Fewer stressors, life strains • Depression • Concern with the elderly (15% report symptoms) • Usually related to health • 1-3% diagnosable • Difficult to diagnose (v. normal aging) • Gender: More women (2/1)

  17. Depression and Dementia • Dementia - progressive deterioration • Not normal aging • Many undiagnosed and untreated • Older adults benefit from treatment • Alzheimer’s Disease • Brain cells die (neurofibrillary tangles) • Leading cause of dementia • Progressive and irreversible

  18. Causes of Cognitive Impairment • Genetic: Some Alzheimer’s • Vascular dementia/Multi-infarct • Minor strokes • Related to lifestyle factors • Other diseases • Reversible dementia: About 20% • Delirium: Reversible • Depression: Treatable

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