Week 1 : Intro Flashcards
What is special about youth psychopathology
4 things
Some disorders are only diagnosed in youth (ADHD, Autism)
Psychopathology presents differently in different age ranges. eg a 3yo hitting someone is less pathological than a 25yo hitting someone.
Treatments might not work with kids (CBT) or may have different effects (some medicines work less or not at all), there might be issues if not taking the medicine is dangerous (teens!)
There are issues around youth advocacy (who advocates for youth, parents might force kids to get treatment for things they do not want to)
Norm Violation
Norms are culturally dependent
This makes using them to decide if something is abnormal difficult because you could just be seeing something culturally normal and pathologizing it
Examples include indigenous kids starting fires and the timing of a first baby
Statistical Rarity
If things are normnally distributed you could say anyone over 2SDs from the mean is abnormal
Is that always a problem? High IQ might not mean pathology
Also 16.6% of the USA meets depression and 30% for anxiety thresholds at some point. SO these are not statistically rare but are very distressing, he3nce this is not a good way to define things
Personal discomfort
Means it hurts people
Maladaptive behavior
Gets in the way of good things for them
Deviation from an ideal
Anyone who deviates from a perceived exemplar
If people have no XP with kids, they may worry their 1st is not typical and hence abnormal, even if they are not
How do we define abnormal behavior in developmental psychopathology?
(3 things)
It is a pattern of behavior associates with:
(1) Distress
(2) Disability: It gets in the way (such as makes it hard to be at school. socialize etc)
(3) There is an increased risk of further harm
What do we use as a benchmark for developmental psychopathology?
Disability and risk can be defined as adaptational failure:
There is a FAILURE TO REACH developmental milestones
and a LACK OF PROGRESS along adaptive developmental trajectories
(hence we use norms!)
To understand maladaptive behavior we must view it in relation to what is considered normative
Developmental benchmarks
AGE 0-2
AGE 0-2
NORMAL ACHIEVEMENTS: Eating, sleeping, attachment
COMMON BEHAVIORAL PROBLEMS: Stubbornness, temper, toileting difficulties
CLINICAL DIAGNOSES: Mental retardation, feeding disorders, autistic disorder
Developmental benchmarks
AGE 2-5
NORMAL ACHIEVEMENTS: Language development, self care, peer relationships, self control
COMMON BEHAVIORAL PROBLEMS: Arguing, attention seeking, disobedience, overactivity, resisting bedtime
CLINICAL DIAGNOSES: Speech and language disorders,, issues from abuse, anxiety disorders like phobias
Developmental benchmarks
AGE 6-11
NORMAL ACHIEVEMENTS: Academic skills, rules governed games, simple responsibilities
COMMON BEHAVIORAL PROBLEMS: Arguing, inability to concentrate, showing off, self-consciousness
CLINICAL DIAGNOSES: ADHD, learning disorders, school refusal behavior, conduct problems
Developmental benchmarks
AGE 6-20
NORMAL ACHIEVEMENTS: relations with sex, personal identity, separation from family, personal responsibilities
COMMON BEHAVIORAL PROBLEMS: Arguing, bragging
CLINICAL DIAGNOSES: Eating disorders, suicide attempts, drug and drink abuse, schiz, depression
Prevalence
ALL CASES IN A TIME PERIOD (old and new)
Ontario child study shows the 6 month prevalence of DSM diagnosis of depression, anxiety or behavior problems is
4-11: 18%
12-17: 22%
Great Smokey Mountain study showed the cumulative prevalence of a DSM diagnosis by age 21 was 16.5%
Are their adequate services?
No
35-45% of people who meet DSM get ay kind of help
Higher for kids (60%) whose parents ID the problem (so if a child wants help but parent does not think this is anything to worry about, not good.
Effectiveness of many common services is totally unknown (maybe low quality)
Who develops psychopathology? (Epidemiology)
Gender
Gender effects
Males show higher rates of disorders in childhood (ADHD, conduct problems)
Females in adolescence (Depression, anxiety, eating disorders)
Form changes
Men externalize, women internalize
Who develops psychopathology? (Epidemiology)
SES
SES Poverty linked with many conditions
Canadians 9% live in poverty
Between 1996 and 2001, 333% of kids lived in poverty for one year
Who develops psychopathology? (Epidemiology)
Race
Studies do not always show prevalence differences in psychiatric diagnoses across race
But diagnoses do
Could be real differences, could be biases
Lower rates of treatment for non whites, esp for anxiety and mood disorders
Cultural differences in psychopathology
examples
Meaning of behaviors varies (fire starting)
Expression of symptoms varies
Social anxiety - fear of bring evaluated by others is common in the west, in Japan, you can have the fear of hurting others with your social awkwardness (Taiiin kyofusho: same issue, different expression
Diathesis-Stress Model
Diathesis:
Underlying vulnerability
Could be biological, experience based or contextual
Stress:
Situation or challenge that calls on a resource
Typically thought of as external, negative effects
Under stress, diathesis increases the likeliness of disorder
Some are more susceptible to certain stressors
Applies to many things, not just psychopathology
Diathesis doe not equal disorder
Stress does not equal disorder
Interaction makes disorder more probably
There could be multiple interacting diatheses and stressors
Differential Susceptibility vs Diathesis-stress
DIFFERENTIAL SUSCEPTIBILITY is when a child is more susceptible to the effects of their environment, good and bad
Diathesis-Stress: Some children are more susceptible to the NEGATIVE effects of a bad environment
(only focuses on the -ve)
Multifinality
The same course of events leads to different outcomes
Equifinality
Many routes lead to the same outcome
