Chapter 12: Psychopathology of Emotions in Childhood Flashcards
Week 4: Clinical Practice
psychopathology of childhood and adolescence
most psychopathology of childhood and adolescence involves impairments in emotional functioning. disorders in childhood are distinct from those in adulthood
psychopathology
refers to disorders that affect children’s mental health and behavior. these disorders are assessed and classified using two broad approaches
categorical diagnosis
the most common classification system in North America is the DSM-5, while in other parts of the world, the International Classification of Diseases (ICD) is used
key assumptions of categorical diagnosis
- disorders are distinct and separate from normal functioning
- each disorder has a specific cause and corresponding treatment
- the course of illness is similar across children with the same disorder
comorbidity
disorders can be present simultaneously, making it difficult to distinguish one disorder from another
heterogeneity
there is considerable variability within disorders, meaning that the same diagnosis may look very different across children. for example, autism might manifest in diverse ways in different children
subclinical symptoms
categorical systems may overlook less severe, subclinical emotional issues, which might not be classified as disorders but still cause distress
practical use of categorical systems
despite the challenges, categorical systems are valuable for clinicians to communicate diagnoses to parents and for policymakers to allocate resources based on prevalence data
dimensional diagnosis
instead of viewing disorders as discrete categories, the dimensional approaches consider symptoms as varying along a continuum
psychometric assessments
this approach involves gathering data from clinicians, teachers, parents, and children through checklists and questionnaires. these tools provide a continuous range of symptom scores, helping to identify patterns of behavior that might overlap with those categorized by traditional diagnostic systems
benefits of the dimensional approach
- research suggests that using dimensional measures improves the reliability of diagnoses by 15% and validity by 37%.
- the DSM-5 has been modified to incorporate findings that emphasize the dimensional nature of psychopathology, recognizing that disorders exist on a spectrum rather than as distinct, separate entities
categories of childhood psychopathologies
often in two categories
- internalizing
- externalizing
externalizing
involves hostility and disruptive behavior, such as oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD)
internalizing
characterized by depressed mood and anxiety, encompassing disorders related to fears
predominance of one emotion system (biases)
this theory suggests that one emotion or a family of emotions becomes dominant, leading to an imbalance among emotions
inappropriate emotional responses (inappropriate emotions)
children with disorders may exhibit atypical emotional responses to events
poor emotion regulation (difficulty regulating emotions)
this theory emphasizes the challenges children with psychopathology face in managing their emotions to meet situational demands
emotional adaptation to negative environments (adaptations to negative environments)
this hypothesis suggests that psychological patterns in children viewed as disordered may reflect strategic adaptations to negative environments
epidemiology
focuses on understanding the frequency and patterns of disorders in a population. epidemiologists study prevalence and incidence
prevalence
the proportion of a population affected by a disorder over a specific time period
incidence
number of new onsets of a particular disorder in a given time
comorbidity in individuals
where individuals with a diagnosis often have multiple additional diagnoses
heterogeneity in individuals
where different symptom clusters can lead to the same diagnosis, suggesting diverse subtypes with distinct etiologies, courses, and treatment responses
p factor
accounts for a significant portion of the variance in psychopathology and is associated with emotion dysregulation and negative affectivity
risk factors and psychopathology
relationship between risk factors and outcomes is characterized by nondeterministic and nonspecific, meaning the presence of a risk factor increases the probability of a disorder but does not guarantee it
multilevel influences
involves recognizing indirect effects between different aspects of a child’s environment
maladaptive personal context
where the child and the environment mutually influence each other
diathesis-stress perspective
suggests that a child’s dispositional vulnerabilities combine with negative environments to create difficulties
differential susceptibility
proposes that some children are more influenced by both positive and negative environments due to neurophysiological differences, showing greater reactivity to various contexts
quantitative genetics
estimate heritability for disorders by comparing frequencies between monozygotic and dizygotic twins
gene-environment interactions
genes are not deterministic; their effects on behavior are influenced by environmental experiences, leading to gene-environment interactions
epigenetics
reveals that adversities can alter gene function without changing the DNA sequence. this impacts the production of neurochemicals crucial for emotion-related processes
depression in adolescence
linked to increased inflammatory biomarkers (CRP, IL-6) associated with the immune response
proximal influences on emotional development
proximal influences, like attachment and parenting, directly influence a child’s emotional growth. risk factors do not guarantee psychopathology but raise the likelihood
parental hostility
this is closely linked to disorders, creating a “negative coercion cycle” where child aggression and parental harshness reinforce each other. studies confirm that controlling parents lead to anxiety, self-doubt, and internalizing problems in children
differential parenting
when parents treat siblings unequally, children subjected to more negativity are more likely to develop behavioral issues, regardless of genetics
child maltreatment
experiences of abuse and neglect disrupt development, affect emotional regulation and social skills, which worsen over time
marital conflict
exposure to ongoing parental conflict increases stress-related internalizing and externalizing problems in children. this may also disrupt physiological systems, leading to increased vulnerability to mental health issues
attachment security
secure attachment reduces the risk of emotional disorders. disorganized attachment carries the highest risk for both externalizing and internalizing issues
institutionalization studies (BEIP)
studies on children raised in Romanian orphanages reveal that a lack of attachment stunts emotional and cognitive growth. early placement in foster care can improve outcomes, especially if done before age two
childhood bullying
has severe, long-lasting impacts leading to increased use of mental health services and poorer quality of life
distal risk factors
are more indirect than those that bear a direct effect on children
neighborhoods
also play a role, supportive communities reduce parenting stress and improve child outcomes
homotypic continuity
stability of the same disorder over time
heterotypical continuity
transition from one type of disorder to another over time
self-perpetuating cycles
certain behaviors can reinforce themselves through negative social responses
transdiagnostic vulnerability (p factor)
emotional dysregulation may underlie both types of continuity, influencing different disorders across time. this vulnerability is often shaped by stable factors such as genetics, neurobiology, and family/peer influence
focal treatments
targeting specific symptoms of a disorder, often overlooking comorbidities
evidence-based psychotherapies (EBPs)
have been developed for children and adolescents, demonstrating efficacy in treating various disorders
parent management training (PMT)
effective for externalizing problems and addressing maladaptive parent-child interactions. for externalizing issues
cognitive behavior therapy (CBT)
focuses on cognitive distortion, emotion regulation, and social problem-solving, improving psychological adjustment. for cognitive and emotional regulation
multisystemic treatment (MST)
addresses multiple needs of children and families, considering ecological systems theory that posits disorders are influenced by various environmental factors. for multi-environmental challenges
transdiagnostic models
may be particularly effective as first-line interventions for treatment-naive children and adolescents
