Midterm 1 Flashcards
1
Q
What is Unique about Understanding and
Treating Psychopathology in Youth?
A
- Some disorders are only diagnosed with childhood onset
Ex: Autism, ADHD - Indicators of a significant emotional or behavioral problem may be different
Ex: children may not have the same cognitive capacity of adults to express their depressive feelings - Presentation over time might change
Ex: A child that’s depressed may just present a lot of irritability - Developmental differences may lead to differences in efficacy in treatment
Ex: Cognitive therapy & Medication - Who advocates for youth? -> Decision-makers in course of care and treatment for a child is not usually the child
2
Q
Why is cognitive therapy not always effective for children?
A
Children may not respond well with therapies that are purely based on cognitive functions that focus on sharing cognitive experiences (sharing thoughts and feelings) since they may struggle to understand and vocalize their thoughts and feelings
3
Q
What are the indicators of abnormal behaviour?
A
- Norm Violation
- Statistical Rarity
- Personal Discomfort
- Maladaptive Behaviour
- Deviation from an Ideal
4
Q
Describe the “norm violation” indicator of abnormal behaviour
A
- Norm violation indicates abnormality when one deviates from the “norm”
- Norms are culturally bound -> dependent on what our reference group is and to whom we are comparing people
- Dependent on reference groups and sub-groups within that reference group (ex: reference group = women in Canada and sub-group = women in Canada who attended university)
5
Q
Describe the “statistical rarity” indicator of abnormal behaviour
A
- Represent base rates or how frequent/likely we are to see a certain behaviour or diagnosis
- Statistical rarity looks at the tails of a distribution (2% or 0.1%)
Ex: someone with an IQ of 145 is abnormal because you’re unlikely to have it (0.1% in distribution)
Ex: Sheldon’s high IQ (from the Big Bang Theory) is a statistical rarity
Ex: Eating insects in Canada or North America is a statistical rarity
6
Q
Are DSM disorders a statistical rarity?
A
- DSM disorders in general are not that rare
- Lifetime prevalence of meeting criteria for any disorder by age 75 is = ~ 12 - 47.4% (almost 1 in 2 people)
- However, abnormal levels of impairment (significant impairment) or higher levels of anxiety would be deemed more statistically rare
7
Q
TRUE or FALSE: Prevalence rates are always consistent
A
FALSE
* Prevalence rates may not be consistent across different samples and sources in part due to:
- Different sampling procedures
- Different sample sizes and variability
- Different populations (who is your reference group?)
- Changes in population over time (ex: mental health base rates change over time)
8
Q
Describe the “deviation from an ideal” indicator of abnormal behaviour
A
- Ideal self VS actual self
- Parents often have very high expectations for their children (they have an ideal of how their child should be -> if their child doesn’t meet expectations, this would be a deviation from an ideal with which the parents would consider their child as abnormal) -> example of deviation from an ideal as imposed on someone
9
Q
How is abnormal behaviour defined?
A
Defined as a pattern of symptoms associated with:
- distress
- disability
- increased risk for further suffering or harm
- Distress and disability can be lumped together as impairment
10
Q
With regards to abnormal behaviour, what can “disability” and “risk” be defined by?
A
Adaptational failure (of failure to meet benchmarks) with typical behaviour as a benchmark
11
Q
Describe the “personal discomfort” indicator of abnormal behaviour
A
- People have different thresholds of personal discomfort
- Someone may feel constantly burdened and bothered by their disorder, others may see the benefits in it
- Abnormality is determined by going above that threshold and leading to lots of personal discomfort
12
Q
Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 0-2?
A
- Eating
- Sleeping
- Attachment
13
Q
Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 2-5?
A
- Language
- Toileting
- Self-care skills
- Self-control
- Peer relationships
14
Q
Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 6-11?
A
- Academic skills and rules
- Rule-governed games
- Simple responsibilities
15
Q
Concerning developmental benchmarks, what are the normal achievements for a child between the ages of 12-20?
A
- Romantic relations
- Personal identity
- Separation from family (may be more culturally-embedded)
- Increased responsibilities
16
Q
Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 0-2?
A
- Stubbornness
- Temper
- Toileting difficulties
17
Q
Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 2-5?
A
- Arguing
- Demanding attention
- Disobedience
- Fears
- Overactivity
- Resisting bedtime
18
Q
Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 6-11?
A
- Arguing
- Inability to concentrate
- Self-consciousness
- Showing off
19
Q
Concerning developmental benchmarks, what are common behaviour problems for a child between the ages of 12-20?
A
- Arguing
- Bragging
20
Q
Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 0-2?
A
- Intellectual disability
- Feeding disorders
- Autism spectrum disorder
21
Q
Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 2-5?
A
- Speech and Language disorders
- Problems stemming from child abuse and neglect
- Some anxiety disorders (ex: phobias)
22
Q
Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 6-11?
A
- ADHD
- Learning disorders
- School refusal behaviour
- Conduct problems
23
Q
Concerning developmental benchmarks, what are clinical disorders common for a child between the ages of 12-20?
A
- Anorexia
- Bulimia
- Delinquency
- Suicide attempts
- Drug and alcohol abuse (substance abuse)
- Schizophrenia
- Depression
24
Q
What is the Denver Dev Screening Test (DDST) and what does it evaluate?
A
A screening test that can be used to assess if developmental benchmarks are being met at the appropriate age according to a percentile range indicating abnormal development through statistical rarity
25
How could failure to meet developmental benchmarks be an indicator of the onset of pathology?
- If a child fails to meet the normal achievements for their age range, that could be a predictor of the development of the clinical disorders related to that age range
- Ex: Failing to meet eating and sleeping achievements can be early indicators of intellectual disability or autism spectrum disorder
26
What's the developmental psychopathology framework?
- Broad approach to disorders of youth -> thinking about a lots of factors (ex: developmental processes and tasks) that may lead to disorders in youth
- Stresses importance of developmental processes and
tasks
- To understand maladaptive behavior, one must view it in relation to what is considered normative within whatever our particular reference group is
27
How can we describe the prevalence for child psychopathology?
- The prevalence is broad
- Numerous studies from different places and using different samples come to different prevalence rates
- However, often the fact that someone meets criteria for a disorder is considered more of a norm than abnormal
28
What are lifespan implications of child psychopathology?
- Impact on someone's life course outcome is most severe when problems go untreated for extended periods of time
* About 20% of children with the most chronic and serious disorders face life-long difficulties and on average have worse life course outcomes
* Lifelong consequences associated with child psychopathology are costly (for individuals and to healthcare systems)
29
What are common problems with mental health services?
* Inadequate services (shortage of healthcare and mental healthcare workers in Quebec, often our systems aren't set up to help individuals effectively)
* 1st point of contact often medical doctor (may not have the mental health knowledge to help out individuals)
* Racial/ethnic disparities in mental health service access
- Lower levels of utilization due to unique barriers (barriers related to geography and finances)
- Are your practitioners sensitive to cultural differences or nuances?
- Is the treatment that you're getting tailored or adapted to your ethnic or cultural background?
30
What are gender differences in psychopathology?
- Social and Biological differences
- Certain criteria aren't well suited for particular genders (ex: women with ADHD often go undiagnosed)
- Differences in timing
(Males show higher rates of disorders in childhood (ex: ADHD, early conduct problems) VS Females show higher rates of disorders in adolescence (ex: depression, eating disorder))
- Differences in form
(disorders may look different in the different genders -> men tend to show higher levels of externalizing behaviours VS women tend to show higher levels of internalizing behaviours)
31
What are SES differences in psychopathology?
* Poverty and socioeconomic (SES) disadvantage
- Yearly snapshots may underestimate the # of youth who live in poverty
* The ways we assess poverty may underestimate the percentage of children that experience poverty
- Poverty linked with higher rates of MANY disorders
32
What are racial/ethnic differences in psychopathology?
- Disparities NOT all attributable to SES
differences
* More noticeable in treatment settings
- Differential treatment: certain racial groups (ex: black children) may be more likely to be diagnosed with conduct disorders
* Black youth more likely to be diagnosed with disruptive behavior
disorders & psychosis & less likely to be diagnosed with mood and substance use disorders (ex: school 2 prison pipeline)
- Shows bias in diagnostic practices (how do mental health practitioners and clinicians interpret behaviours? -> over-diagnosis of certain groups of people -> implicit bias in diagnostic practices)
- Racism = large driver of health disparities
- These groups show lots of resilience and positive outcomes
33
What's a large stressor that could lead to the onset of disorders in LGBTQ people?
- Victimization
- They're more likely to be victimized by their peers and family members
- The vast majority of them experience verbal abuse (81%)
- Almost half (38%) threatened with physical attacks
- Higher rates of mental health problems stemming from this discrimination and maltreatment
- However, lots of resilience in these populations
34
What are cultural differences in psychopathology?
- Meaning of behaviors varies
- Ex: Social anxiety (fear of evaluation by others) VS Taijin kyofusho (incapacitating fear of offending or harming others through one’s social awkwardness) -> Taijin has to do with cultural norms in Japan around group harmony, not sticking out from the group
- Expression of symptoms varies
- Racial/ethnic minority group members often reports physical symptoms when there is underlying mental health problem (ex: "I have a tummy ache)
35
What are models of etiology & maintenance of disorder used in child psychopathology?
◼Diathesis-stress model
◼Developmental pathways (multifinality and equifinality)
36
Describe the General Diathesis-Stress Model
* Diathesis:
underlying vulnerability or tendency toward disorder (could be * biological, contextual, or experience-based)
- Vulnerability can be changed throughout your lifespan (ex: due to the loss of a loved one)
- Diathesis is subject to change but its more stable because it has a biological component
* Stress:
situation or challenge that calls on resources (typically thought of as external, negative events)
* The underlying vulnerability interacts with stressors and could lead to the onset of some type of disorder
* Different people have different levels of vulnerability (determines where you start in the race)
* The stressors keep pushing us toward the onset of a disorder
- People that have more vulnerability have a higher likelihood of developing a disorder
* Applied to many disorders
37
What's the difference between Diathesis Stress Model and Differential Susceptibility
* Differential susceptibility: some children are more susceptible to the effects of their environments, both good and bad
- There may be vulnerability factors but there are also protective factors (these may reduce vulnerability and risk)
* Diathesis-stress: some children are more susceptible to the negative effects of a problematic environment
38
What are the strengths of the Diathesis-Stress Model?
* Organizes thinking about nature AND nurture behavior & that emotions are complicated
- Almost no disorders is caused by “just” genes or “just” stress
- Brain structure and function changes (neural plasticity) in response to environment
- Genes change in response to environment (behavioral epigenetics)
- This model isn't prescriptive (not if x then y) -> interaction makes disorder more probable
(diathesis ≠ disorder & stress ≠ disorder)
- Can have multiple interacting diatheses & stressors
39
What are developmental pathways?
- The sequence and timing of particular behaviors as well as the relationships between behaviors over time
- What kind of path do you get on and is that leading to an adaptive or maladaptive outcome?
40
What are the 2 common types of developmental pathways?
- Multifinality
- Equifinality
- They refer to the end points
41
What's multifinality?
* Multi -> multiple outcomes
* A same stressor may lead to a wide variety of outcomes
- Ex: Early childhood maltreatment is a common stressor that can lead to a variety of disorders (conduct disorder, mood disorder, eating disorder, normal adjustment (aka resilience))
42
What's equifinality?
- Different stressors might lead to a similar outcome
- Ex: experiences of SA, car accident and gun violence can all lead to PTSD
43
What's the scientific approach and why is crucial when assessing child psychopathology?
- An organized way of investigating claims, without relying on common sense and casual observations, that requires that a claim be based on theories backed up by data from well-designed studies that test alternative explanations and that observations be checked and repeated before conclusions are drawn
- Parents and professionals who work with children tend to interpret and relate information according to their own belief systems and experiences
44
Explain the reasons why people are skeptical about research in abnormal child psychology
1. Experts on childhood problems frequently disagree
2. Research in mainstream media is often oversimplified, and the way that findings are presented can make them more or less believable
3. Research findings in abnormal child psych often conflict with one another
4. Research has led to different recommendations regarding how children with problems should be helped
5. Even when scientific evidence is clear and produces a consensus, many parents and professionals may dismiss the findings because they have encountered an exception (usually from personal experience)
45
What's a real-life example of scientific methods and evidence being ignored or dismissed concerning abnormal child psychology?
- Facilitated communication (FC)
- Procedure used to teach children with autism and other impairments how to communicate
- Controlled studies have consistently found that the child’s communication is being controlled by the facilitator
- Example of pseudoscience
46
Describe the research process
1. Develop a hypothesis (research question) based on observation, theory, and previous findings, and decide on general research approach
2. Identify sample to be studied, select measurement methods, and develop research design and procedures
3. Gather and analyze data and interpret results in relation to theory and previous findings
- Findings and interpretations from the study can then be used to generate future research questions and stimulate further research
47
What's epidemiological research?
The study of the incidence, prevalence, and cooccurrence of childhood disorders and competencies in clinic-referred and community samples
48
What are incidence rates?
- The rate at which new cases of a disorder appear over a specified period of time
- Ex: the number of youths who develop a depressive disorder during the school year
- Estimates of incidence and prevalence can be obtained over a short period, such as 6 months, or a much longer period
49
What are prevalence rates?
- The number of cases of a disorder, whether new or previously existing, that are observed during a specified period of time
- Ex: the number of teens with conduct disorder in the general population during 2012 and 2013
50
What's the difference between lifetime prevalence estimates of mental disorders obtained prospectively and those obtained retrospectively?
Those obtained prospectively (studying the same sample of children over time and assessing them at periodic intervals) are double those found in retrospective studies (asking people to remember what occurred at an earlier time), which are subject to recall failure
51
Why is a case definition in abnormal child psychology complex?
- Children don't refer themselves for treatment -> equating illness with seeking treatment can be misleading
- The factors that lead to referral sometimes have more to do with the child’s parents, teachers, or doctor than with the child’s behavior
- Children who are not referred to clinics for treatment should also have their problems studied
52
What are some explanations for why prevalence rates vary so widely in abnormal child psychology?
- Prospective vs retrospective studies
- Clinical cases vs community cases
- Whether cases are defined in terms of patterns of symptoms, impairment in functioning, or both
- Demographic and situational factors (ex: SES, parents’ marital status, age, gender, cultural background)
- Cultural variations in what constitutes abnormal behavior, how to identify such behavior, and what to do about it
53
What are the 3 variables of interest in abnormal child psychology?
- Correlates
- Risk or protective factors
- Causes of other variables
54
What are correlates (or correlated variables)?
Variables that are associated at a particular point in time with no clear proof that one precedes the other
55
What's a risk factor?
- Variable that precedes an outcome of interest and increases the chances of a negative outcome
- Doesn't necessarily mean that it'll occur -> its occurrence depends on other factors
- Sometimes the effects of exposure to a risk factor during infancy or early childhood may not be visible until adolescence or adulthood (delayed or sleeper effects)
56
What's a protective factor?
A positive variable that precedes an outcome of interest and decreases the chances that a negative outcome will occur
57
What's the key difference between moderating and mediating variables?
Moderators have an independent effect on the existing relationship between 2 variables, whereas mediators account for some or all of the apparent relationship between 2 variables
58
What are moderator variables?
- A factor that influences the direction or strength of a relationship between variables
- The association between 2 variables depends on/differs as a function of moderating variables, such as the child’s age, sex, SES, or cultural background
- Ex: sex of the child moderates relationship between abuse and internalizing problems
59
What are mediator variables?
- The process, mechanism, or means through which a variable produces a specific outcome
- Mediators describe what happens at the psychological or neurobiological level to explain how one variable results from another
- Ex: type of discipline used by mothers on days they're feeling distressed mediates the relationship between maternal distress and child behavior problems
60
What are randomized controlled trials (RCTs)?
- Design used to evaluate treatment outcomes in which children with a particular problem are randomly assigned to various treatment and control conditions
- Numerous studies evaluate treatment outcomes using RCTs
- Findings from controlled research studies indicate that children who receive treatment are generally better off than children who don't
61
What's treatment efficacy?
- Degree to which a treatment can produce changes under well-controlled conditions that depart from those typically used in clinical practice
- In efficacy research, careful control is exercised over the selection of cases, therapists, and delivery and monitoring of treatment
62
What's treatment effectiveness?
- Degree to which a treatment can be shown to work in actual clinical practice, as opposed to under controlled laboratory conditions
- In research on effectiveness, treatment is evaluated in clinical settings, clients are usually referred rather than selected, and therapists provide services without many of the rigorous controls used in research
63
Fill in the blank: The benefits of treatment for children with problems have generally been found to be lower in ______ than in _______
- The benefits of treatment for children with problems have generally been found to be lower in clinical practice settings (effectiveness trials) than in controlled research settings (efficacy trials)
- A high priority for intervention research is on developing and testing interventions in settings where clinical services for youths are typically provided and finding ways to strengthen the bridge between research, public policy, and clinical practice
64
What's standardization?
- Process by which a set of standards or norms is specified for a measurement procedure so that it can be used consistently across different assessments
- These standards and norms relate to the procedures that must be followed during administration, scoring, and evaluation of findings
- Without standardization, it's nearly impossible to replicate the info obtained using a method of measurement
- Results are likely to be unique to the situation in which they are obtained and will not apply to other situations (ex: the test scores of an 8-year-old boy from a low-SES background should be compared with the scores of other children like him, not with the scores of a 16-year-old girl from an upper-SES background)
65
What's reliability?
- The extent to which the result of an experiment is consistent or repeatable
- 3 types: internal consistency, interrater reliability, test-retest reliability
66
What's internal consistency?
- Type of reliability
- Whether all parts of a method of measurement contribute in a meaningful way to the information obtained
67
What's interrater reliability?
- Type of reliability
- Info must not depend on a single observer or clinician -> various people must agree on what they see (consensus)
68
What's test-retest reliability?
- Tests or interviews repeated within a short time interval should yield similar results on both occasions
- The results need to be stable over time
69
What's validity?
- The extent to which a measure actually assesses the dimension or construct that the researcher sets out to measure
- It's not all or none but rather a matter of degree
- Can be assessed in many ways: face validity, construct validity, convergent validity, discriminant validity, criterion-related validity
70
What's face validity?
- The extent to which the measure appears to assess the construct of interest
- Ex: a questionnaire that asks whether you get nervous before taking an exam would be a face-valid measure of test anxiety, whereas one that asks if you think you're a parrot would not
71
What's construct validity?
- Whether scores on a measure behave as predicted by theory or past research
- Ex: an intelligence test has construct validity if children who obtain high scores on the test also have better grades in school, understanding of concepts, and verbal reasoning than do children who obtain low scores on the test
- 2 components of construct validity: convergent validity and discriminant validity
72
What's convergent validity?
- Type of construct validity
- Reflects the correlation between measures that are expected to be related
- Indication of the extent to which the 2 measures assess similar or related constructs
- Ex: a teen’s report of her depression in a screening interview and her scores on a depression questionnaire
73
What's discriminant validity?
- Degree of correlation between measures that are not expected to be related to one another
- Ex: scores on a measure designed to assess depression and another designed to assess intelligence should not correlate
74
What's criterion-related validity?
- Refers to how well a measure predicts behavior in settings where we would expect it to do so—at the same time (concurrent validity) or in the future (predictive validity)
- Criterion-related validity tells us whether scores on a measure can be used for their intended purpose
- Ex: a child’s high scores on a measure of social anxiety should predict that the child would display anxiety or avoidance in current social situations and will perhaps have difficulties making friends in the future
75
What are the measurement methods used for abnormal child psychology?
- Interviews
- Questionnaires
- Checklists
- Rating scales
- Psychophysiological recordings
- Brain imaging
- Performance measures
- Direct observations of behavior
- A variety of intellectual, academic, and neuropsychological tests are also used
- Because the info we obtain from children and families often varies depending on the method used, researchers frequently rely on several methods to define and assess the constructs of interest
76
What are reporting methods for abnormal child psychology?
- Assess the perceptions, thoughts, behaviors, feelings, and past experiences of the child, parents, and teachers
- Include relatively unstructured clinical interviews, highly structured diagnostic interviews, and questionnaires
77
What's an important question regarding reporting methods?
- Who is reporting on behavior?
- Self-report measure: a child or parent will provide info about their own behavior, feelings, and thoughts
- Informant-report measure: a person who's well acquainted with the child (usually parent or teacher) will provide info about a child’s behaviors, feelings, or thoughts based on their observations of the child
78
What are some of the limitations associated with psychophysiological measures?
- Findings for these measures can be inconsistent between studies -> researchers may have to infer how the child may have processed a particular event or stimulus
- Child’s physiological response can be influenced easily by other factors (ex: child’s reaction to the recording equipment or hunger, fatigue, or boredom)
79
What's the EEG and how is it relevant to abnormal child psychology?
- Electroencephalogram (EEG)
- Electrophysiological measure of brain functioning whereby electrodes are taped to surface of subject’s scalp to record the electrical activity of the brain
- EEG recordings are sensitive to changes in state and emotionality -> useful for studying social and emotional processes
80
What's a naturalistic observation?
- Unstructured observation of a child in their natural environment
- The researcher goes into the child’s home, classroom, or day-care center to observe and record the behaviors of interest of the child and often of parents, teachers, siblings, and peers with whom the child interacts
- The researcher may make a recording of behavior in the natural environment, which can be analyzed at a later time
81
What's a structured observation?
- Observation of a subject, usually occurring in a clinic or laboratory, in which the subject is given specific tasks or instructions to carry out, and researchers look for specific information
- Researchers set up a situation or provide instructions to elicit behaviors of particular interest (ex: the Strange Situation procedure for infant-caregiver attachment styles)
82
What are the advantages of structured observations?
- Cost-effective
- Focus observations on the phenomena of interest
- Especially useful for studying child behaviors that occur infrequently in everyday life
- Researcher has greater control over the situation
- They permit the use of other assessment procedures
83
What's the disadvantage of structure observations?
- Observations in the laboratory or clinic may not provide a representative sample of the behaviors of interest
- Ex: knowing that they are being observed through a one-way mirror may make children and parents not behave in the laboratory as they do in real-life settings
- “Behavior in the presence of an observer"
84
What's internal validity?
- Extent to which an intended manipulation of a variable, rather than extraneous influences, accounts for observed results, changes, or group differences
- Extraneous influences that could explain the results are called threats to internal validity (including maturation, the effects of testing, and subject-selection biases)
85
What's external validity?
- Degree to which findings can be generalized, or extended to people, settings, times, measures, and characteristics other than the ones in the original study
- Threats to external validity include characteristics of participants that apply to some people but not others, the reactivity of subjects to participating, the setting in which the research is carried out, or the time when measurements are made
- Ex: many research studies in abnormal child psych underrepresent cultural minorities and children from low-SES backgrounds
- Ex: children or parents may not behave naturally in an unfamiliar laboratory setting (low external validity)
86
What's comorbidity?
- The overlapping of 2 or more disorders at a rate that is greater than would be expected by chance alone
- Research samples from clinical populations will have a disproportionately high rate of comorbidity because referral for treatment is most likely based on the combined symptoms of all disorders
- Failure to consider comorbidity may result in an interpretation of findings about one disorder when these findings are more validly attributed to a second disorder or to a combination of disorders
87
Much of the research conducted on child psychopathology relies on what kind of experimental approaches?
- Nonexperimental, correlational approaches
- Natural experiments, aka quasi-experimental designs or known-group comparisons
- Comparisons are made between conditions or treatments that already exist
- The experiments may involve children with different disorders, parents with different problems, or different family environments
88
What's a cohort?
A group of individuals who are followed over time and who experience the same cultural or historical events during the same time period
89
What are cohort effects?
Influences related to being a member of a specific cohort
90
What are aging effects?
General changes that occur as participants age -> ex: increases in physical prowess, impulse control, or social opportunity
91
What's cross-sectional research?
Method of research whereby different individuals at different ages/stages of development are studied at the same point in time
92
What's longitudinal research?
Method of research whereby the same individuals are studied at different ages/stages of development
93
What's etiology?
- the study of the causes of childhood disorders
* Multiple, interactive causes help in understanding the complexity of disorders
94
Describe the developmental psychopathology perspective
* Abnormal development is multiply determined (beyond current symptoms and need to consider developmental pathways and interacting events)
- Developmental history is crucial to understanding where an individual and their current disorder is coming from
* Children and environments are interdependent (both active contributors to adaptive and maladaptive behavior)
- Abnormal development involves continuities and discontinuities
95
What's the transactional view in child psychopathology?
- Children and environments are interdependent -> both active contributors to adaptive and maladaptive behavior
- Social and structural environments have a big impact on children
- Children also exert an influence on their environment (children may influence how people act around them)
○ Ex: a kid with anger issues may have parents that act different around them
- Gene-environment correlations
96
What's continuous development?
* Gradual and quantitative developmental changes
- Difference in degree
- Ex: how many words does this child know
- They're predictive of future behaviours and patterns
- Development as an additive process that is ongoing
- Patterns of behavior that remain over time
- Ex: early-onset and persistent conduct disorders evolving into serious antisocial acts
97
What's discontinuous development?
- Abrupt and qualitative developmental changes
- Developmental stages
- Differences in kind
- Ex: what kind of competencies there are
- Ex: different stages of development -> no clear bridges showing transition between stages
- Big and abrupt differences between these stages
- Discontinuity implies that future behavior is poorly predicted by earlier patterns
98
What's qualitative research?
- Research for which the purpose is to describe, interpret, and understand the phenomenon of interest in the context in which it is experienced
- Qualitative researchers try to understand the phenomenon from the participant’s perspective
- Qualitative data are typically collected through observations or open-ended interviews and are recorded narratively
- The data are then examined to build general categories and themes
99
What's assent?
Evidence of agreement from a child to participate in a study without having a full understanding of the research that would be needed to give informed consent
100
What's an idiographic case formulation?
Approach to case formulation or assessment that emphasizes the detailed representation of the individual child or family as a unique entity
101
What's a nomothetic formulation?
Approach to case formulation or assessment that emphasizes general principles that apply to all people
102
What are some gender differences in the onset of certain disorders?
- Boys are about 3-4x more likely than girls to display early-onset disorders (ex: autism spectrum disorder (ASD) and ADHD)
- Girls are more likely than boys to display disorders that have their peak onset in adolescence (ex: depression and eating disorders)
103
What are some psychological problems that are more commonly reported among boys?
- ADHD
- Autism Spectrum Disorder
- Childhood conduct disorder
- Intellectual disability
- Language disorder
- Specific learning disorder
- Enuresis
104
What are some psychological problems that are more commonly reported among girls?
- Anxiety disorders
- Adolescent Depression
- Eating disorders
- Sexual abuse
105
What are some psychological problems that are equally reported among girls and boys?
- Adolescent conduct disorder
- Childhood depression
- Feeding disorder
- Physical abuse and neglect
106
Describe the referral biases related to gender
- Boys tend to receive an excess of referrals, whereas girls tend to be overlooked because of their less visible forms of suffering
- Ex: ADHD being underdiagnosed for girls because of differences in how it expresses itself in girls
107
What group of children have a greater risk of being misdiagnosed or underdiagnosed?
- Children who are ethnic minorities
- Ex: a study found that psychiatrically hospitalized African American adolescents were more often diagnosed with organic/psychotic disorders and less often diagnosed with mood/anxiety disorders than Caucasian teens
108
What are cultural syndromes?
- Pattern of co-occurring, relatively invariant symptoms associated with a particular cultural group, community, or context
- These rarely fit neatly into one Western diagnostic category
109
TRUE or FALSE: individual symptoms define childhood disorders
FALSE
- Age inappropriateness, severity, and pattern of symptoms define childhood disorders
110
What are the 3 common purposes of assessment?
- Description and diagnosis
- Prognosis
- Treatment planning
111
Name some of the more common comorbid disorders
- Conduct disorder and ADHD
- ASD and intellectual disability
- Childhood depression and anxiety
112
What's prognosis?
Prediction of the course or outcome of a disorder
113
What's developmental history/family history?
- Info obtained from parents regarding significant developmental milestones and historical events that might have an impact on child’s current difficulties
- Can be done by using a background questionnaire or interview
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List the areas that are covered within a background questionnaire or interview for a child's developmental history
- Birth and related events (ex: pregnancy and birth complications)
- Developmental milestones
- Medical history
- Family characteristics and family history
- Interpersonal skills
- Educational history
- Adolescent’s work history and relationships
- Description of the presenting problem
- Parents’ expectations for assessment and treatment
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What are the “ABCs of assessment”?
A = Antecedents -> events that immediately precede a behavior
B = Behavior(s) of interest
C = Consequences -> events that follow a behavior
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What's the organization of development?
- Early patterns of adaptation evolve with structure over time
- Ex: infant eye contact and speech sounds, evolve into higher-order functions -> speech and language
- Sensitive periods
- Development -> process of increasing differentiation and integration
- Current abilities or limitations = influenced by prior accomplishments
- Development can be cumulative -> based on foundation of abilities we have accumulated overtime
- Implies an active, dynamic process of continual change and transformation
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What are sensitive periods?
- Periods during which environmental influences on development (good and bad) are heightened -> providing enhanced opportunities to learn
- Ex: the boy found living with the wolves -> he missed sensitive periods in his development which hindered his ability to learn language
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What's the integrative approach to studying child psychopathology?
* No single theoretical orientation explains various behaviors or disorders
* Abnormal child behavior is best studied from a multi-theoretical perspective
* Knowledge increases through research
- Best thing to do is integrate these multiple perspectives when assessing a person
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What's the neurobiological perspective on child psychopathology?
* Brain = underlying cause of psychological disorders
* Fetal brain develops from all-purpose cells into a complex organ
- We can trace back a psychological problem to a dysfunction in the structure or function of the brain
* Neural plasticity -> the brain’s anatomical differentiation is use-dependent
- Use-dependent -> when we do certain activities, we use certain axons in our brain and these are reinforced and become stronger and if we don't use these axons they prune (use it or lose it)
* Nature and nurture both contribute
* Experience plays a critical role in brain development
- Maturation of the brain
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Describe the process of maturation of the brain
* Areas governing basic sensory and motor skills mature during the first 3 years of life
* Perceptual and instinctive centers are strongly affected by early childhood experiences
* Prefrontal cortex and cerebellum are not rewired until 5 to 7 yrs old
* Major restructuring occurs from ages 9 to 11 due to pubertal development and again in adolescence
- Examples of sensitive periods -> important that these areas of the brain develop in early developmental stages for proper functioning later on
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What's the Gene-environment interaction (GxE)?
- Normal and abnormal child development are the result of complex interchanges between nature and nurture and are affected not only by genetic and environmental influences but also by the timing of when they meet
- The interaction of our genes and our environment overtime
- Similar to Diathesis Model
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What are the different types of Gene-environment interactions (GxE)?
* Passive: simple association between your genes and the environment
* Evocative: you, as a function of who you are, elicit reactions from your environment (people are more likely to give positive attention to a smiling baby) -> how you're invoking reactions from the environment
* Active: you actively control your environment and seek out certain environments due to your genes
- These gene correlations fluctuate in importance throughout your development
- In early years, passive g-e correlation is important because infants and toddlers are in an environment that's mostly controlled by adults -> they don't have the structure to influence their environment
- Later on, as children gain agency, the active g-e correlation becomes more important
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What are some genetic contributions to abnormal child behaviour?
- Expression of genetic influences = malleable & responsive to social environment
- Gene-environment interactions (GxE)
- Behavioral genetics
- Molecular genetics
- Genetic influences are probabilistic, not deterministic
- Most forms of abnormal behavior are polygenic
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What are behavioural genetics?
- Connections between genetic
predisposition & observed behavior
- Ex: how are xyz gene variations associated with your likelihood of starting to smoke
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What are molecular genetics?
- Used to identify specific genes for childhood disorders
- Directly assess the association between variations in DNA sequences and variations in particular traits
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What's projective testing?
- Form of assessment that presents the child with ambiguous stimuli (ex: inkblots or pictures of people) and the child is asked to describe what they see
- The hypothesis is that the child will “project” their personality (unconscious fears, needs, and inner conflicts) onto the ambiguous stimuli of other people and things
- Without being aware, the child discloses their unconscious thoughts and feelings to the clinician
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What are some neurobiological contributions to abnormal child behaviour?
* Neurotransmitters
* Neurotransmitters make biochemical connections
* Neurons more sensitive to a particular neurotransmitter cluster together and form brain circuits
* Neurotransmitters involved in psychopathology -> serotonin, benzodiazepine-GABA, norepinephrine, and dopamine
▪ Psychoactive drugs are used in treatments
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What are the major neurotransmitters involved in psychopathology?
- Benzodiazepine-GABA
- Dopamine
- Norepinephrine
- Serotonin
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What are the functions of Benzodiazepine-GABA?
- Reduces arousal and moderates emotional responses, such as anger, hostility, and aggression
- Linked to feelings of anxiety and discomfort
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What's the role of Benzodiazepine-GABA in psychopathology?
Anxiety Disorder
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What are the functions of Dopamine?
- Can act as a switch that turns on various brain circuits, allowing other neurotransmitters to inhibit or facilitate emotions or behaviour
- Involved in exploration, extroversion, and pleasure
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What's the role of Dopamine in psychopathology?
- Schizophrenia
- Mood disorders
- ADHD
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What are the functions of Norepinephrine?
Facilitates or controls emergency reactions and alarm responses
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What's the role of Norepinephrine in psychopathology?
Not directly involved in specific disorders (acts generally to regulate or modulate behavioral tendencies)
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What are the functions of Serotonin?
- Emotional and behavioral regulation
- Information and motor coordination
- Inhibits children’s tendency to explore their surroundings
- Moderates and regulates several critical behaviours (ex: eating, sleeping, and expressing anger)
- SSRIs - Selective Serotonin Reuptake Inhibitors
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What's the role of Serotonin in psychopathology?
- Regulatory problems -> ex: eating and sleep disorders
- OCD
- Schizophrenia and mood disorders
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What are externalizing behaviors?
Aggressive/rule-breaking behaviors
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What are internalizing behaviors?
Anxious/withdrawn/depressed behaviors
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What are the diagnostic criteria for ADHD?
A. Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
B. Several inattentive or hyperactive-impulsive symptoms were present before age 12 years
C. Several inattentive or hyperactive–impulse symptoms are present in 2 or more settings (ex: at home, school, or work, with friends or relatives)
D. Must be clear evidence that the symptoms interfere with, or reduce the quality of, social academic, or occupational functioning
E. The symptoms don't occur exclusively during the course of schizophrenia or other psychotic disorders and are not better explained by another mental disorder (ex: mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal)
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What are the symptoms that characterize inattention in ADHD?
a) Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities
b) Often has difficulty sustaining attention in tasks or play activities
c) Often does not seem to listen when spoken to directly
d) Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
e) Often has difficulty organizing tasks and activities
f) Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
g) Often loses things necessary for tasks or activities
h) Is often easily distracted by extraneous stimuli
i) Is often forgetful in daily activities
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What are the symptoms that characterize hyperactivity and impulsivity in ADHD?
a) Often fidgets with or taps hands or feet or squirms in seat
b) Often leaves seat in situations when remaining seated is expected
c) Often runs about or climbs in situations where it is inappropriate
* In adolescents or adults, may be limited to feeling restless
d) Often unable to play or engage in leisure activities quietly
e) Often “on the go,” acting as if “driven by a motor” (ex: is unable to be or is uncomfortable being still for extended time)
f) Often talks excessively
g) Often blurts out answers before a question has been completed
h) Often has difficulty waiting their turn
i) Often interrupts or intrudes on others
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How many and how long do symptoms of inattention and hyperactivity-impulsivity have to be present for a child or an adult to meet the criteria for a diagnosis of ADHD?
- 6 (or more) of the symptoms (for each category) have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities
- For older adolescents and adults (age 17 and older), at least 5 symptoms are required
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People with ADHD are likely to have higher or lower levels of dopamine?
Lower levels of dopamine
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What are the psychological perspectives on abnormal child psychopathology?
* These perspectives have value in explaining the development of psychopathology
* Transactions must be considered
* Emotions play a role in establishing an infant's ability to adapt to new surroundings
* Behavioral and cognitive processes assist a young child in making sense of the world
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What are the emotional influences on abnormal child psychopathology?
* Emotions and affective expression are core elements of human psychological experience and are a central feature of infant activity and regulation
* Emotions tell us what to pay attention to and what to ignore (if things make use feel bad, we're less likely to engage with them)
* Emotions help us with our social relationships
* Emotions are crucial to our monitorial processes
* Younger children may not have a good vocab or insight into their emotional experiences (emotional wheel could help them identify emotions)
- Having a wider range of emotions to choose from to describe your own will help you understand yourself better
- Temperament
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What's emotion reactivity?
* Individual differences in the threshold and intensity of emotional experience
- Someone who is rapidly and strongly fluctuating in emotional experience may indicate abnormal behaviour
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What's emotion regulation?
- Enhancing, maintaining, or inhibiting emotional arousal
- AKA coping
- Ex: Emotion regulation at a funeral
- Someone who demonstrates no differences in emotions could indicate abnormal behaviour
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What are emotion reactivity and emotion regulation important signals of?
Normal and abnormal development
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What's temperament?
* Organized style of behaviour that occurs very early in development
* Sort of like a precursor to later personality
- Temperament shapes individual's approach to their environment and vice versa
- Early infant temperament may be linked to psychopathology or risk conditions -> high self-regulation is needed for healthy, normal adjustment
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According to (Rothbart), what are the 3 primary dimensions of temperament?
1. Positive affect and approach/Surgency
2. Fearful or inhibited/Effortful Control: ability to shift attention when necessary and inhibit emotions, high on effortful control = tendency to be very anxious and fearful
3. Negative affect or irritability/Negative affectivity: high on negative affectivity = tendency to be sad, frustrated, low mood, irritable
- You could be high on all 3 dimensions
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What's high self-regulation?
Balance between emotional reactivity and self-control
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What are some behavioural and cognitive influences on abnormal child psychopathology?
- Applied Behavior Analysis (ABA) -> think about learning and development through operant conditioning and think of behaviour as a function of its antecedents and consequences
- Classical conditioning -> pairings between things
- Cognitive theorists -> how thought patterns develop over time
- Social-cognitive theorists -> how children think about themselves and others, changing mental representations of themselves, others and the world, this learning has no obvious reinforcement, latent learning (parents can teach the children behaviours without the children actually engaging in the behaviour themselves -> ex: bobo doll experiment)
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What are the 4 primary operant learning principles?
* Positive reinforcement
- Negative reinforcement
- Punishment
- Extinction
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What does the bobo doll experiment exemplify?
- Example of children learning aggressive/externalizing behavior (social learning)
- Example of latent learning
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What's infant-caregiver attachment?
- Process that occurs early in life of establishing and maintaining an emotional bond with parents or other significant individuals
- An internal working model of relationships comes from a child’s initial crucial relationship
- People can form attachments to multiple figures
- This attachment helps establish this internal-working model for subsequent relationships that are based on how this initial crucial attachment is (the nature of initial attachment)
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What's the Strange Situation Task?
* Most widely used procedure to assess a child's attachment to their parent
* Psychologists are most interest in the "reunion" when the parent comes back after the separation
- In the video example we watched in class, the baby showed signs of secure attachment
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What's the approximate percentage of infants displaying the different types of attachment?
- Secure: ~60% (most)
- Resistant: up to 10%
- Avoidant: up to 15%
- Disorganized-Disoriented: up to 15%
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What are the different types of attachment?
- Secure (kid feels comfortable exploring when parents around, get sad when they leave but are comforted when they come back - slight majority of children show secure attachment)
- Resistant (not warm towards parent when they return)
- Avoidant (indifferent to departure of caregiver, not visibly comforted)
- Disorganized-Disoriented
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What psychopathological outcomes is each attachment type predictive of?
- Secure: protective function against disordered outcomes
- Resistant: Phobias, anxiety, psychosomatic symptoms, depression
- Avoidant: Conduct disorders, aggressive behavior, depressive symptoms
- Disorganized-disoriented: No consensus -> generally a wide range of personality disorders
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Describe Bronfenbrenner’s bioecological model
* This model considers different systems of influence
* Microsystem: where the child is located with their biological and psychological characteristics. In this system are parents, siblings and other people in their immediate environment -> these people have a lot of direct contact with the developing child)
* Mesosystem: interaction between agents of microsystem (2 people that have a high influence on the child interact with each other)
* Exosystem: when a parent interacts with another person/institution that doesn't affect the child (ex: parent at work, work has nothing to do with the child but how a parent is treated at work may affect their mood and consequently how the child is treated)
* Macrosystem: cultural elements of society, socio-political aspects, religion
- Chronosystem: passage of time, all of the events that occur in a child's life that has an influence on the systems overtime
* Changes to the chronosystem can affect the other levels of the bioecological model
Parental divorce and COVID are events rooted in time that could affect these levels of the child's system
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What are the strengths and weaknesses of Bronfenbrenner’s bioecological model?
Strengths
* Conceptualizes development as product of biological and environmental forces interacting within a complex system
Weaknesses
* Systems perspectives may never provide a coherent picture of development (“It depends”)
* Human development may be more predictable than bioecological model implies
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Describe Vélez-Agosto et al. (2017) reconceptualization of Bronfenbrenner model
- Reconceptualization of Bronfenbrenner with culture moved from macrosystem to a factor that permeates all levels of the ecological system
- Culture is important at all of these different levels
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Describe oppositional defiant disorder (ODD)
- Age-inappropriate anger/irritability, argumentative/defiant behavior, or vindictiveness
- Characterized by angry/irritable mood, argumentative/defiant behavior, and vindictiveness
- 4 of the behaviors (symptoms) have to be present -> child has to be engaging in behavior more than is normative for their developmental level
- Often ODD behaviours developmentally precede CD
Severity:
- Mild – occurs in only one setting
- Moderate – occurs in 2 settings
- Severe – occurs in 3 or more settings
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What's the assessment of ODD?
- Interviews and Checklists
- Observation -> Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)
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How is the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) used to assess ODD?
- Preschoolers interacting in 3 contexts (with an interactive examiner, with a busy examiner, with their parent
- “Presses” for disruptive behavior (compliance, frustration, rule-breaking)
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What's conduct disorder?
- Repetitive and persistent pattern of violating basic rights of others and/or age-appropriate societal norms or rules
- Characterized by aggression to people and animals, destruction of property, deceitfulness or theft, serious violations of rules
- 3 or more of the behaviors within the past 12 months, with at least one present in the last six months
Specifiers:
- Mild: few if any symptoms in excess of those required to meet diagnostic criteria, symptoms are causing mild impairment and harm to others
- Moderate: number of conduct problems and impact on others is in between mild and severe
- Severe: many conduct problems in excess of those required to make a diagnosis are present, or the behaviors are causing serious harm
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What are callous and unemotional (CU) traits?
- Lack of remorse or guilt
- Callous, lack of empathy
- Unconcerned about performance
- Shallow or deficient affect
- Associated with insensitivity to punishment -> harder to treat
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What's the with ‘limited prosocial emotions’ specifier?
2 of the callous and unemotional (CU) traits have to be persistently present over the last 12 months, and in multiple relationships and settings
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What's the difference between childhood onset and adolescence onset of CD?
Prognosis is poorer for early-onset, but adolescent limited may be associated with significant negative outcomes
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What's the developmental course for Late-onset pathway / ‘adolescent-limited’ for CD?
- Onset in adolescence, frequently with social change
- Peer influences
- 2:1 or 1:1 male to female ratio
- Less extreme antisocial behavior
- Less likely to commit violent offenses
- Less likely to persist
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What's the developmental course for Early-onset/life-course consistent for CD?
- At least one symptom before age 10
- 10:1 male to female ratio
- 50% persist in antisocial behavior into adulthood
- Aggression in childhood
- Less serious nonaggressive antisocial
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What are the 3 effective treatments for CD?
- Problem Solving-Skills Training
- Parent Management Training (PMT)
- Multisystemic Therapy
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What are the 3 critical steps of the Anger coping program?
- Children are taught:
1) To inhibit early angry and aggressive reactions
2) To cognitively re-label stimuli perceived as threatening
3) To solve problems by generating alternative coping responses and choosing adaptive, nonaggressive alternatives
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What are the different types of protective factors?
- Protective
- Protective-stabilizing -> leads to no changes in wellbeing when exposed to risk factors (even high levels)
- Protective-enhancing -> works even better when risk gets higher (high exposure to stress)
- Protective-reactive -> works but its positive effects become less strong as risk increases
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Interaction/Moderation
The association between one IV and the DV varies as a function of the other variable
176
3 types of validity
- Convergent validity: are scores on the measure related to other measures or indicators of the same construct
- Discriminant validity: are scores on the measure different from scores of other constructs
- Face validity: does this appear to measure what it is supposed to measure
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What are behavioural treatments for ADHD?
* Parent management training
* Behavioral classroom management
* Behavioral peer interventions
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Multimodal Treatment of ADHD (MTA)
Treatments
1. Medication management
2. Psychosocial treatment
3. Combination treatment (medication management + psychosocial)
4. Community treatment as usual
Results:
Combination treatment (medication management + psychosocial) significantly lower symptoms than Psychosocial treatment and TAU
- Moderators of the efficacy of combined treatment and medication only
were identified
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What's the coercive cycle?
1. Adult makes request
2. Child reacts with hostility
3. Adult reacts with hostility or withdraws
4. Child doesn't do what was asked
(positive punishment for parent -> less likely to make request again)
