Child Psychopathology PowerPoint 1

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Blessing the Children

• Mark 1013-16
• And they kept bringing young children to him
  that he might touch them and the disciples were
  reproving them for it. But when Jesus saw it He
  was indignant and pained , and said to them,
  allow the children to come to Me.--- do not for
  bid or hinder them --- for to such belongs the
  kingdom of God. Truly I tell you , whoever does
  not receive and welcome the kingdom of God as a
  little child, positively shall not enter it at
  all. And he took the children up one by one in
  His arms and fervently invoked a blessing,
  placing His hands upon them.
• Jesus touched the children.
• He related to them one to one.
• The Lord blessed the children. He could
  impart a divine blessing for He was God.
• How do we bless and curse the
  children we come in contact with?

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Developmental Psychopathology
Houghton College
Houghton College

• Childhood psychopathology is the study of
  mental illness or disorders in children.
• We will study the etiology, dynamics,
  diagnosis and treatment of psychopathology in
  children.
• Developmental psychopathology is the study of
  the developmental processes that contribute to
  the formation of, or resistance to,
  psychopathology.
• This approach assumes that child psychopathology
  can be understood as normal development gone
  awry.
• (e.g. child having fears, will
  grow out of it)
• This approach alerts us to the fact that some
  problem behavior is normal in the course of life.
  (e.g. my boys fear of a dinosaur exhibit)
• The fruits of this approach affirm Freuds
  analogy that
• The child is father to the man
  What does this mean?
• Our childhood experiences teach
  and form us, as a father does.

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Developmental Framework

• Time
• Chronological time is used by some
  scientists to anchor change. (e.g. Gesell)
• Stages of development are used more often
  to understand developmental changes.
• Stage theories make two assumptions
• 1) Stages represent qualitative changes in
  behavior and mental processing.
• 2) The stages unfold in an unalterable
  sequence.
• Why is, How old is your child?,
  usually followed by, What stage is your child
  in?
• Movement to the next stage and
  transition periods between stages are often times
  of conflict and stress.
• Critical period - a period of time that
  is thought to be crucial for later development
  for it is the optimal time to develop an ability
  or skill
• Sensitive period particular
  developments come to the fore and are most
  vulnerable to disruption and open to
  amelioration.

4
Developmental Context

• The intrapersonal context concerns variables
  within the person, such as personality
  characteristics, thought, feelings, etc.
• The interpersonal context involves interaction
  among individuals. There are two important
  interpersonal contexts of child development the
  family and the peer group.
• The superordinate context has to do with groups
  of individuals taken as a unit (i.e. culture and
  social class).
• The organic context has to do with physiological
  variables (i.e. genetics, brain chemistry, etc.).
• These contexts interact with one another (see
  Bronfenbrenners Ecological Theory).

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Purposes of Psychology

• Describe- get the facts and give an objective
  picture of the data
• 
  
• Explain- get at the reasons or causes for a
  behavior
• Predict-we try to form a hypothesis (testable
  statement that an expected outcome will result
  from specific conditions)
• Control- make behavior happen- start, stop, or
  regulate its rate or strength

Psychology tries to
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Medicine tries to

• Describe-symptoms and the conditions in which
  they came about
• Explain- determine the etiology (genesis of the
  disorder) and the diagnosis
• Predict determine the prognosis (the expected
  outcome of a disorder)
• Control- develop a treatment plan (along with a
  prescription) to control the disorder (cure it,
  stabilize it, control the symptoms)

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Classical Conditioning

• Classical conditioning- The learning process in
  which an originally neutral stimulus becomes
  associated with a particular response that the
  stimulus did not originally produce.
• An unconditioned stimulus (US) elicits an
  unconditioned response (UR) without any previous
  conditioning. This is an unconditioned reflex.
• US ---- UR unconditioned reflex

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Classical Conditioning

• When a conditioned stimulus (CS) which is
  previously neutral, is paired with an
  unconditioned stimulus (US) this constitutes a
  reinforced trial.
• CS ---- US reinforced trial
• With enough reinforced trials the conditioned
  stimulus (CS) is ultimately able to elicit a
  conditioned response (CR) which constitutes a
  conditioned reflex.
• CS ---- CR conditioned reflex

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Phases of Classical Conditioning

• Acquisition- The probability of a CR increases as
  the CS is paired with the US.
• Extinction- The probability of the CR decreases
  as the CS and the US are not paired.
• Spontaneous recovery- after extinction the CS
  spontaneously prompts the CR
• Stimulus generalization- stimuli similar to the
  CS may elicit a CR
• Savings- When the CS and US are paired again, the
  CR returns with strength.

10
Social Learning Theory

• How was it that people, even small children,
  learned without any apparent reinforcement?
• Social learning is proposed (Albert Bandura). It
  is sometimes called imitation, observational, or
  vicarious learning- This is learning that occurs
  by observing the behavior of others as well as
  the environmental outcomes of their behavior.
• The necessary conditions are
• Attention to the behavior
• Retention of the scene
• Motivation to reproduce
• Potential to reproduce the behavior
• Two main factors that produce modeling
• The model is liked and respected by the
  observer
• The observer sees the model reinforced
• e.g., I want to be like Mike., I
  am Tiger Woods.

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Cognitive Developmental Stages

• Jean Piaget- Swiss biologist (1896-1980)
• A human beings primary adaptive capacity and
  advantage over other animals is their ability to
  organize the world.
• Assimilation- refers to fitting new information
  into old schemas (e.g. child sees a different
  kind of dog).
• Accommodation- a new schema is needed or old ones
  need to change so the new information fits
  better (e.g. child constructs the schema cat
  when the dog schema fails.
• e.g. it is easy to assimilate the kindness of
  Jesus into His character profile. However, my
  divine healing schema needed to be revised in
  order to make sense of the fact that some people
  were not healed.

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Cognitive Developmental Stages

• Sensorimotor Stage birth until 2 years of age
• In the beginning, the world is nothing but a
  succession of transient, unconnected sensory and
  motor reactions.
• Two trends that move the child to the next
  stage
• 1) The child develops their first schemas
  (i.e. mental representations that help us relate
  to the world)
• Schemas originate as ways of relating to the
  world.
• For example, the child has four separate ways
  of relating to the world looking, reaching,
  grasping, and sucking. At about 5 or 6 months
  the child begins to coordinate all four into a
  unified exploratory schema.
• You are presently using an analogous schema
  with one addition What are you doing?

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Cognitive Developmental Stages

• 2) Object permanence is developed
• For the child out of sight is out of existence
  (e.g. object hidden by book).
• Separation anxiety (at 8 months) and stranger
  anxiety are accentuated by the childs lack of
  object permanence.
• Erickson says, Separation anxiety is the first
  form of ontological anxiety.
• (e.g. separation, death, separation from God)
• How can we help a child with separation anxiety?

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Freuds Psychosexual Stages

• Pleasure is sought from different erogenous zones
  (pleasure centers) as the child develops. e.g.
  oral stage- pleasure is found in the mouth area
• Fixation- arrested development the child fails
  to move on to the next stage or does so with much
  energy and time given over to the previous stage.
• What is the source of a fixation?
• Excess- too much gratification at this stage and
  the child wants to stay there or go back to it
  when anxious (regression).
• e.g. child breast fed too long
• Deprivation- the child is deprived of
  satisfaction at the stage and keeps seeking it.
• e.g. bulimic patient

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Separation-Individuation (Mahler)

• Normal autism (0-2 months) The child is in an
  autistic shell and cannot differentiate well
  between self and other, external and internal,
  but is thought to distinguish between good and
  bad states. The child is in an objectless period.
• Symbiotic period (2-4 months) The infant
  experiences the self and caretaker as being
  joined. The child is dimly aware of the other,
  but is bound up in symbiotic oneness.
• At about four months old the separation-individuat
  ion phases begin. Separation concerns the childs
  disengagement and differentiation from the
  mother. Individuation involves the development
  of a stable inner representation of the mother, a
  time sense, a capacity for testing reality, and
  an awareness that others have an existence
  discrete from the childs.

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Separation-Individuation Subphases

• 1) Differentiation (4-8 months)-Delay in
  answering the childs needs and mismatched goals
  help the child to recognize that the caregiver is
  a separate person with her own feelings and
  intentions.
• The childs preferential smile indicates both
  recognition of the care giver and the specific
  bond that has been formed.
• 2) Practicing (8-15 months)- The infant can now
  crawl away to explore the world and is
  intoxicated with his or her own abilities and
  sense of omnipotence. There is a new world to
  explore, but the caregiver is still the center of
  that world. The child moves in ever widening
  circles around the parent, but often returns to
  their parental safe base to emotionally
  refuel. Mahler calls this the practicing
  phase, to reflect the infants active
  experimentation with independence versus
  attachment. As the child develops
  representational thought and fears separation,
  and feels less omnipotent, there is a new desire
  to approach the caregiver.

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Separation- Individuation Subphases

• 3) Rapprochement (15-24 months)- The child has
  ambivalence for the caregiver, as the child
  alternates between clinging to the caregiver and
  pushing the caregiver away. Sometimes the child
  in this phase shows strong reactions to
  separation from the caregiver, including protest,
  anger, depressive mood, and inability to play
  alone.
• 4) Object constancy (In this case emotional
  object constancy) (24-36 months)- Central to
  object relations theory is that the childs
  sense of self develops in the context of the
  caregiver. Children who experience warm and
  sensitive care internalize an image of the loving
  parent- the good parent- and therefore
  themselves as lovable (the good me). In
  contrast, children who experience poor parenting
  internalize an image of their caregiver as angry
  and rejecting and come to see themselves as
  unworthy (the bad me). Actually, all children
  have good me and bad me images of themselves.

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Images and Splitting

• The healthy child can integrate the bad mother
  and good mother images into a realistic image
  of mother.
• The healthy child can also integrate the bad me
  and good me images into a realistic view of the
  self.
• The unhealthy child in an attempt to keep from
  being threatened by bad mother images engages
  in splitting. Bad images will be kept separate in
  the mind and the child will then alternate
  between devaluing and admiring his or her mother.
  The child will often split off images of the bad
  me from images of the good me and hence
  alternate between good and bad feelings about the
  their own being.

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Family Systems Model

• In this approach the family is viewed as a
  dynamic system in which each member of the family
  can effect the other.
• Triangulation
• Parent-child coalition- arises when one
  parent forms an alliance with one of the children
  and largely excludes the other parent (e.g.
  daughter takes over for mother who is depressed,
  son and father that make the mother powerless and
  feel alone)
• Child caught in the middle- the child
  attempts to have a coalition with both parents to
  be a peacemaker and/or
• go-between. (e.g. Wayne pulled apart)
• Detouring- Parents spend almost all
  their time and energy on the children and neglect
  their own relationship. The parents often have to
  face their own issues when the child and/or
  children get better.

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Developmental Psychopathology

• Developmental psychopathology is the study of the
  developmental processes that contribute to the
  formation of, or resistance to, psychopathology.
• The Organizational perspective views the human
  organism in a holistic way, as an integrated and
  dynamic system in which all domains of
  development the cognitive, social, emotional,
  and biological are in continual interaction
  with one another. We therefore use all the
  models which might help us gain this holistic
  perspective (see the Developmental Umbrella on
  p.17).

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Developmental Psychopathology

• A key to understanding development in this
  perspective is to attend to the tasks at each
  stage of development termed stage-salient
  issues that must be confronted and mastered.
  Whether these issues are resolved , in adaptive
  or maladaptive ways influences future adaptation.
  (e.g. Eriksons key assumption)
• Another important feature of developmental
  psychopathology is that it pictures a continuum
  between normal and abnormal development. It is
  important to have a clear understanding of
  adaptive development in order to understand how
  development might go awry and why development
  takes one path rather than the other in the case
  of an individual.

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Risk Factors

• Risk factor- any condition or circumstance that
  increases the likelihood that psychopathology
  will develop
• Examples
• organic context- neurological damage
• intrapersonal context- low
  self-efficacy
• interpersonal context- parental
  neglect
• superordinate context- poverty
• There can of course be many risks which have
  a cumulative effect.

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Vulnerability

• Vulnerability - a characteristic that intensifies
  the response to risk, whereas a risk tends to
  determine a disturbance directly
• Examples
• Gender- boys more vulnerable to stress
• Temperament- children who are difficult to
  care for are more often the target of parental
  irritability, criticism, and hostility

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Protective Factors and Resiliency

• Protective factors factors that promote or
  maintain healthy development
• Examples
• intelligence,
• athletic ability
• loving parents
• involvement in church
• Resilient- children who make a good adjustment
  in spite of being at high risk

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Protective Mechanisms

• Protective mechanisms help us understand the
  processes that protect the child.
• 1) Reduction of risk impact
• (e.g. parents forbid child to be with
  gang)
• 2) Reduction of negative chain reactions
• (e.g. a parent stops most of their
  yelling and speaks respectfully, the child is
  less angry and starts behaving a little better,
  the parent stops punishing so often, the child is
  less angry and behaves well, the parent stops
  yelling)

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Protective Mechanisms

• 3) Promote self-esteem and self-efficacy
• (see Building of the Self handout)
• 4) Opening of opportunities
• The resilient child will often take
  advantage of opportunities that reduce the impact
  of risk factors.
• (e.g. A young woman gets close to her
  aunt who knows how to nurture a child in a way
  her mother does not. A young boy from the
  ghetto decides to go as far as he can with his
  education.)
• Determining will of God helps 1) ability
  2) passion 3) open doors 4) peace

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Risks, Vulnerabilities, and Protective
Factors

• It is important to note that no factor inherently
  falls into the risk or vulnerability categories.
  For example, poverty acts as a risk factor for
  many forms of mental disorder and yet may play
  the role of a vulnerability by increasing the
  likelihood that a child will act negatively to a
  stressor (e.g. poor child who is more vulnerable
  to loss of all possessions in a fire)
• Gaining an understanding of the risks,
  vulnerabilities, and protective factors that
  exist for each child is crucial for developing a
  treatment plan.

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Developmental Pathways

• Developmental pathway- How does psychopathology
  emerge over the lifetime of individuals?
• Comorbidity refers to two illnesses occurring
  together (e.g. anxiety and depression,
  hyperactivity and conduct disorder)
• Transformation- the same disorder is manifested
  over time by different symptoms and behaviors
  (e.g. insecurely attached child is dependent on
  mother, teacher, spouse)

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Transactions

• Transactions- a series of dynamic, reciprocal
  interactions between the child and his or her
  family, and social context (see p. 25)
• Child born prematurely gt
• Parental anxiety gt
• Childs difficult conduct gt
• Parental avoidance gt
• Childs language delay