Chapter 16: DEVELOPMENTAL PSYCHOPATHOLOGY

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Chapter 16Development Psychopathology
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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)

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Developmental Aspects

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

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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

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Infancy - Autism

• Begins in infancy more boys
• Several autistic spectrum disorders
• Impaired social interaction, communication
• Repetitive, stereotyped behaviors
• 80 retarded savant syndrome can occur
• Severe cognitive impairment
• Biologically based
• Concordance MZ60, DZ less (0-6)

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Childhood

• Externalizing problems
• Undercontrolled disorders
• Acting out
• Aggressive, out of control
• Internalizing problems
• Overcontrolled disorders
• Inner distress, shyness
• More girls

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Attention-Deficit Hyperactivity Disorder

• DSM-IV Criteria some combination of
• Inattention
• Impulsivity
• Hyperactivity
• More boys 3-5 (and rising) of US kids
• Comorbidity common
• Overactive behavior wanes with age
• Attentional, adjustment problems remain
• Most well adjusted in adulthood

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ADHD-Causes and Treatment

• Neurological low Dopamine, other NTs
• Differential processing
• Underactivity in motor area
• Hypometabolism of prefrontal cortex
• Genetic predisposition Environmental stress
• 70 helped by stimulants
• Overprescription a problem
• Most successful if combined with behavioral
  treatment

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Depression

• Infancy
• Somatic symptoms
• Depressive-like states
• Related to poor attachment
• At risk if mother depressed
• Failure to thrive syndrome may occur
• Childhood
• Somatic symptoms
• Psychotherapy, medication effective
• Nature/Nurture question
• Adolescence
• Often related to childhood symptoms

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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

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Adolescence

• Storm and stress
• Heightened vulnerability to psychological
  disorders
• Alcohol and drugs are problems
• Eating disorders
• Anorexia nervosa more girls
• Bulemia nervosa binge-purge
• Some genetic predisposition stress also
• Psychological treatment usually successful

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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)

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Depression and Dementia

• Many undiagnosed and untreated
• Elderly can benefit, should NOT be excluded from
  treatment
• Sometimes dementia symptoms appear as depression
• Dementia progressive deterioration
• Not normal aging
• Alzheimers Disease
• Leading cause of dementia
• Progressive and irreversible

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Causes of Cognitive Impairment

• Genetic e.g., Alzheimers
• 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