Week 10: Childhood Mental Health

Question 1

Define Infant Mental Health

Answer 1

The developing capacity from birth to 3 yrs to:
■experience, express and regulate emotions (emotional competence)
■form close interpersonal relationships
■explore the environment and learn (within cultural context of expectations)

Question 2

Define emotion regulation

Answer 2

The process of maintaining an individualʼs emotional arousal within their capacity to cope + inhibiting expression of an emotional response (both + and - emotions)

Question 3

Define extrinsic processes in emotion regulation

Answer 3

Parental ʻholdingʼ - infants are initially highly dependent on caregivers to regulate their emotions

Question 4

Define intrinsic processes in emotion regulation

Answer 4

Developments in brain and nervous system + thinking and language

Question 5

What are mental health difficulties centred around?

Answer 5

Deficits or unusual patterns of emotional expressiveness, understanding and / or regulation
(awareness of normal milestones of emotional competence in order to be able to recognise disturbances)

Question 6

What 9 dimensions of temperament (personality) in 0-5yr old infants were suggested by Thomas and Chess (1977)?

Answer 6

1.Activity level
2.Rhythmicity (regularity of activities e.g., sleep)
3.Approach/withdrawal reactions to novelty
4.Adaptability to new situations
5.Intensity of reactions
6.Threshold (how intense stimulation needs to be before infant reacts)
7.Mood
8.Distractability
9.Attention span/persistence

Question 7

Classify the typology of temperament for infants proposed by Thomas and Chess (1986)

Answer 7

Easy:cheerful, rhythmic, adaptable (40%)

Difficult:low on rhythmicity, easily upset by novelty, cries often (10%)

Slow to warm:adjusts slowly to new experiences, negative mood, inactive (50%)

Question 8

What contextual roles drive the social/emotional development of 0-5-year-old infants?

Answer 8

-Relationship between primary caregiver and infant greatest impact on infant social/emotional development + mental health
-Multiple secondary contexts e.g., impact of other parent + grandparents both directly on infant, and through support to the primary caregiver

Question 9

Explain Bowlby’s attachment theory

Answer 9

Focuses on the development of affectional ties between the infant and the caregiver essential to develop over a critical period and modifies the outcome of an infant’s internal working model

Question 10

Define attachment and how it’s achieved

Answer 10

A special relationship between infant and primary caregiver
promoting survival (protected from danger)
-Attachment behaviours e.g., crying, increases proximity to caregiver. Effectiveness of infantʼs signals depends on the caregiver’s ability to understand/react appropriately to them

Question 11

Define internal working model

Answer 11

A mental representation of experiences with primary caregiver. It influences all of the childʼs subsequent relationships. Ideally the relationship is a source of affection/nurturance where through it, the child learns to modulate affect (emotions).

Question 12

What does a secure attachment consist of?

Answer 12

■Develops when the caregiver responds sensitively to the babyʼs signals, providing a safe base for them to explore his/her environment
■Enables development of positive beliefs about oneself and others
■Foundation for all future relationships
■Helps development of self-regulation
■Protects against future adversity

Question 13

What does an insecure attachment consist of?

Answer 13

■Develops when a primary caregiver is insufficiently responsive/attuned to an infantʼs signals
■Leads to negative beliefs about oneself and others
■Hinders the development of self-regulation
■Leads to difficulty making reciprocal relationships
■Increases risk of mental health difficulties in later life

Question 14

What is the most common reason for referral to CAMHS in UK?

Answer 14

■Childhood disruptive behaviour difficulties e.g., persistent oppositional/aggressive behaviour, are the most common reasons for referrals(Kazdin, 1995). (30% - 50% of all referrals)
■These disorders are particularly concerning because of the high
degree of impairment and poor developmental trajectory.

Question 15

What’s the broad distinction between clusters of symptoms used in diagnosis?

Answer 15

–Overcontrolled or ʻinternalising’ or emotional problemsʼ
–Undercontolled or ʻexternalising or behavioural problemsʼ.

Question 16

Are rates of CMH problems increasing in the 21st century for children/toddlers? (Bor et al 2014)

Answer 16

NO studies show either an improvement on mental health symptoms or no change

Question 17

Are rates of CMH problems increasing in the 21st century for Adolescents in externalising problems? (Bor et al 2014)

Answer 17

–NO, No studies reported an increasing burden of behaviour problems in boys

-only two studies reported an increase in girls.

Question 18

Are rates of CMH problems increasing in the 21st century for Adolescents in internalising problems? (Bor et al 2014)

Answer 18

–Found evidence of increased symptom burden especially girls.
– 5/8 studies reported an increase in internalizing symptoms in
adolescent girls
–In boys, 3 studies report an increase, 2 report a decrease, and 4 report mixed findings or no change.

Question 19

Why might rates of mental health change?

Answer 19

■Improving/worse income
■Increased rates of single parenting, family conflict, parental mental health problems and the emergence of parenting styles that place a lower value on child obedience
■Increasing exposure to screen time, internet and social media (American Academy of Pediatrics, 2009)
■Increasing pressure within contemporary school settings

Question 20

Women are more likely to experience depression/anxiety than men (Zahn-Waxler et al., 2008): Why is there an increase in internalising problems in girls?

Answer 20

-Built-up worries=increased pressure e.g., school performance,weight,appearance
-Earlier sexualization exposure associated with poor self-esteem and depressed mood? (e.g., APA, 2010)
-Are girls more socio-emotionally attentive/introspective than boys, with negative cognitive style and rumination interacting to
predispose girls to depression?
-Current generation of girls may be experiencing puberty earlier,
increasing risk for earlier depression? (Euling et al., 2008;
Crockett et al., 2013)

Question 21

True or false: Friends, family (siblings), schools and community have a crucial role to play in promoting resilience even where there are adverse circumstances, such as poverty and severe family difficulties (Masten, 2014)

Answer 21

True

Question 22

What risk factors are there for mental health?

Answer 22

–Family factors:violence, abuse, neglect,discordant family relationships,being a young person looked after outside the family.
–Psychosocial factors: poverty, economic crises, deprivation.
–Individual factors: low intelligence, brain damage, chronic physical illness.
–Rejection by parents or peers.
–Being a member of a deviant peer group.

Question 23

What protective factors are there for mental health?

Answer 23

–Supportive relationships with adults.
–Access to good educational facilities.
–A sense of competence.
–Participation in activities, sports and outside interests.
–Being a member of a non-deviant peer group.
–Small family size.
–Personal attributes e.g., good health, even temperament, positive self-esteem, intelligence or good social skills.
–Material resources, such as adequate family income.
–Religious affiliation.

Question 24

Define instrumental aggression

Answer 24

To achieve some external aim with an incidental consequence (hurt is incidental—for example, a child pushes or hits another in order to get a toy that the other child has.

Question 25

Define hostile aggression

Answer 25

When a child deliberately attacks another in order to hurt them.

Question 26

Define reactive aggression (focus is on the precursors of the aggression)

Answer 26

In response to some provocation (whether real or perceived)

Question 27

Define proactive aggression (focus is on the precursors of the aggression)

Answer 27

Dominant behaviour employed to achieve a specific goal (similar to instrumental aggression without the presumption that any hurt is incidental)

Question 28

What did Crick and Dodge (1996) show in the distinction between proactive and reactive aggression?

Answer 28

■reactively aggressive children tended to show a hostile attribution bias, very readily assuming aggressive intent in a peer.
■proactively aggressive children differed in the stage of evaluation of consequences—they evaluated aggressive acts more positively, in terms of their outcomes.

Question 29

What are the types and typologies of Aggressive Behaviour-based on the type or context of actions

Answer 29

■Individual VS group aggression
■Direct physical aggression
■Direct verbal aggression
■Indirect aggression:tells bad or false stories, becomes friends
with another as revenge. This is not aimed directly at someone but via a third party e.g., spreading nasty rumours about someone

Question 30

What has research found on the sex differences in direct and indirect aggression?

Answer 30

Björkqvist et al. (1992) found:
–Girls less likely for physical aggression all ages,not much difference in verbal aggression
–Girls were more likely for indirect
aggression

■Crick and Grotpeter (1995) in the used the term ‘relational aggression’ to describe indirect aggression intended to damage another’s self-esteem/social status:
–peer nominations obtained from 8–11-year-old US children for direct (overt) aggression (e.g. starts fights) and relational aggression (e.g. when mad at a person,
ignores them or stops talking to them) also obtaining data on loneliness and depression.

Question 31

What were Crick and Grotpeter (1995) findings in sex differences in aggression?

Answer 31

■Children who did more overt tended to do more of the other (relational) the correlation was r = .54, so moderate in size.
–15.6% of the boys were especially high on overt aggression but only .4% of the girls.
–17.4% of the girls were high on relational aggression but only 2.9% of the boys.
-high in relational aggression=high on depression and loneliness

Question 32

When is physically aggressive behaviour most frequent according to Tremblay (2003)?

Answer 32

2 years of age (the peak) BUT toddlers are usually increasingly ‘socialised’ into realising this is not acceptable behaviour.

Question 33

How does aggression develop from physical as it’s ‘socially shunned?’

Answer 33

■A longitudinal study of 1,183 Canadian children showed that for both sexes, there is a steady decrease in physical aggression and a steady increase in indirect aggression - both trends are more marked for girls (Côté et al., 2007).
-Tremblay and colleagues (2004): rates of indirect aggression increase with age.

Question 34

How/Why can aggression be maladaptive?

Answer 34

Crick and Dodge (1996):
‘-biased/deficient processing= deviant social behaviour (e.g. aggression)’
-‘Social maladjustment related to the formulation of social goals that are likely to be relationship damaging.’
Hetherington and Parke (1993):
-‘Aggressive children may behave in a hostile and inappropriate fashion because they are not skilled at solving interpersonal problems’.

Question 35

Why do some see aggression as normative + potentially leading to social competence?

Answer 35

Hawley et al., 2007:
-aggression is seen throughout animal species (normal behaviour in humans/kids then?)

-considerable evidence that when aggressive behaviour to a degree is used strategically by children, it’s associated more with social competence.

Question 36

define the resource control theory in relation to control, aggression and morality

Answer 36

socially dominant individuals get preferred access to resources in a social group using various strategies to achieve this such as:
1.Coercive strategies (threats and aggression)
2.Prosocial strategies (reciprocity, help and alliances)
Has an evolutionary perspective

Question 37

Define the conventional view in aggression,morality and communication strategies

Answer 37

coercive strategies would be associated with reduced social competence and popularity, compared to prosocial strategies.

Question 38

What did Hawley (2003) propose in relation to aggression,morality and communication?

Answer 38

She argued that some children were ‘bistrategic controllers’—successful at using both coercive and prosocial strategies, depending on the situation + these children would be the most competent and would not be unpopular.
■In her study, she obtained data from 14 classrooms in 6 preschools, with 163 children (mostly 3–5 years) and their teachers participating. The teachers provided the following ratings for each child.

Question 39

What did Hawley (2003) find?

Answer 39

-The strategic use of aggression is compatible with success in gaining
resources, being liked and moral maturity.

-But only for children who can combine the use of prosocial and coercive strategies.

-Children who primarily use coercive strategies are not liked, even though they often get their own way.

Question 40

True or false: Children who show persistent high aggressiveness through the school years are at greatly increased risk for later delinquency antisocial and violent behaviour (Farrington, 1995; Lahey et al., 1999)

Answer 40

True

Question 41

What genetic/environmental effect did Rhee and Waldman (2002) find on aggression and anti-social behaviour?

Answer 41

-carried out a meta-analysis of 51 twins + 3 adoption studies including measures of antisocial behaviour (ASB). Found:
1.genetic influences accounted for 41% of the variance in ASB
2.shared environment accounted for 16%
3.non-shared environment 43%

Question 42

How can genetic effects directly influence temperament?

Answer 42

–Different parts of the brain—frontal, temporal and parietal cortex, and limbic have effects on temperament (emotional control, behavioural inhibition)
–Caspi et al. (1995) assessed temperament in a sample of 800 children at ages 3-9 years and behaviour problems at 9-15 years.
–Found early ‘lack of control’ (emotional lability, restlessness, short attention span and negativism) correlated with later externalizing problems (e.g., aggressiveness).
– SO ‘temperament is a mediator of the link between genes and behaviour

Question 43

How might genetic effects operate through gene-environment interactions? Caspi and colleagues (2002)

Answer 43

-442 males from birth-26
-severely maltreated in childhood=greater risk of antisocial/criminal behaviour adulthood
-BUT only with MAOA-L genotype (85% of them showed violent behaviour, and 50% had criminal convictions) AS high activity maltreated boys were not

Question 44

What did Hill et al. (2013) find on the effects of social environment e.g. stress during a mother’s pregnancy on the infant?

Answer 44

Compared with infants whose mothers experienced zero life events during pregnancy,
exposure to 4+ Life Events’s was associated with 3.22, proportional increase in the number of NBAS fuss/cry episodes in the MAOA-L group

Question 45

Excluding temperament, what else could be a mediator between genes and aggressive behaviour?

Answer 45

empathy and regard for others’ feelings (influenced by the frontal cortex.)

*Research on children who have ‘callous-unemotional’ traits have some of the highest aggression levels.

Question 46

Define callous-unemotional traits

Answer 46

The lack of guilt/empathy and callous use of others for one’s
own gain (Frick and White, 2008). appears to have high heritability

Question 47

What diagnostic criteria are callous-unemotional traits in?

Answer 47

-adult psychopathy
-disruptive and antisocial behaviour + aggression, from childhood through adolescence
(Frick et al., 2014).
-they’re an important predictor of future antisocial behaviour and particularly poor outcomes (Fontaine et al., 2011; Kahn, Byrd & Pardini,2013)

Question 48

How may parenting environment/developmental pathways influence CU?

Answer 48

PE:Two twin-based studies (Viding et al., 2005, 2008) assessed the level of conduct problems in over 3,000 twin pairs aged 7-9
–conduct problems + high on CU traits=high heritability
–conduct problems + low on CU traits=lower heritability
DP:High-CU decreased brain response to fear and pain in others (Jones et al., 2009; Marsh et al., 2013)

Question 49

How can parenting in childhood affect aggression?

Answer 49

■Insecure and disturbed attachment (Van IJzendoorn, 1997)
■Children who experience
irritable + ineffective discipline at home, poor parental monitoring and a lack of parental warmth=more likely to become aggressive in peer groups/school (Patterson et al. 1989)
–This is because they see aggressive means of solving home
disputes with no clear and
effective guidance given to do otherwise.
–Antisocial behaviour at middle school linked to academic failure and peer rejection
–These young people are also likely to be involved in deviant and
delinquent peer groups.

Question 50

What did Dishion et al. (1995) find on how peer group factors can affect aggression?

Answer 50

-13–14-year-olds highly antisocial boys had more antisocial friends
(more coercive + shorter duration friendships yet still seen as fulfilling)
–Shows aggressive children may not be rejected and just congregates with others of a similar antisocial tendency in ways that they can find rewarding.

Question 51

What predictors of deviant peer group affiliations did Ferguson and Horwood (1999) find in their New Zealand teen study?

Answer 51

1.low family socioeconomic status
2.poor family functioning (parental conflict, low emotional responsiveness, childhood sexual abuse)
3.poor parental functioning (alcoholism, criminality, drugs)
4.earlier child problems at 10 years.

Question 52

Neighbourhood factors: What did Linares et al. (2001) find exposure to community violence in high-crime USA neighbourhoods resulted in?

Answer 52

predicted child behaviour problems in 3–5-year-olds + how mothers coped with community violence was also an important mediating factor.

Question 53

Neighbourhood factors: What did Pettit et al. (1999) find?

Answer 53

12–13 years, lack of neighbourhood safety, especially combined with low parental monitoring and unsupervised peer contacts=predicted teacher ratings of externalising behaviour problems.

Question 54

Neighbourhood factors: What predictors did Romano et al. (2005) find after examining multilevel correlates of childhood physical aggression and prosocial behaviour, in a Canadian study of 2,745 11-year-olds?

Answer 54

Individual level predictors:male sex + experience of maternal hostility

Family level predictors:depressed mood of mother and punitive (punishing) parenting style

Neighbourhood level:growing up in a problem/impoverished neighbourhood=significant predictor (even when the other factors were taken into account)

Question 55

Define school bullying

Answer 55

A form of peer aggression characterised by intentionality, perceived power imbalance, and repetition (Olweus, 1997).
–The victim may be outnumbered, or smaller, less physically strong or less psychologically resilient than the person(s) doing the bullying.

Question 56

What did (Monks & Smith, 2006) find using cartoon stick figures to assess understanding of bullying at different ages and in different cultures?

Answer 56

picture of general fight=adults/14-year-olds don’t think of this as bullying, but most 4–6 and 8-year-olds do.

Question 57

State different types of bullying

Answer 57

■Physical bullying - hitting, kicking, punching and taking or damaging someone’s belongings.
■Verbal bullying - teasing, taunting and threats.
■Indirect/relational
– E.g., spreading nasty rumours (done indirectly rather than face to face)
– E.g., systematic social exclusion (‘You can’t play with us’)
– these damage a person’s relations or social network, rather than being a direct physical or verbal attack.
■Identity based bullying -based on the victim being a member of a particular group(often marginalized or disadvantaged) one, rather than on individual characteristics (race, gender, sexuality or disability)
■Cyber-bullying

Question 58

What are some distinctive features of cyberbullying?

Answer 58

1.’no place to hide’/more difficult to escape from
2.It reaches a larger audience
3.Cyber-bullies often have more anonymity
■In contrast to other forms of bullying, prevalence rates of cyberbullying have been found to be greater outside school than inside

Question 59

What are the sex differences in bullying?

Answer 59

■Boys reported as, bullying more than girls
■Boys and girls report being bullied equally
■Girls’ bullying=social exclusion or spreading nasty rumours>physical behaviours used more by boys
■A substantial proportion of self-reported victims say that
they have not told a teacher or someone at home about the
bullying (proportion increases with age + boy victims are less likely to tell anyone)

Question 60

What are some features of bullies?

Answer 60

■Insecure attachment and harsh physical discipline
■Parental maltreatment and abuse (Schwartz, Dodge, Pettit & Bates, 1997)
■Motivated by gaining rewards or displaying power to peers
■May be low on affective empathy (sharing others’ feelings)
■May be low on cognitive empathy (understanding others’ feelings)= ‘cold cognition’ combo
■Perpetrators of both traditional bullying and cyberbullying also show higher scores on moral disengagement which might enable a person bypass the normal kinds of reasoning which would hold us back from hurting someone else.

Question 61

What are some features of victims?

Answer 61

■lack some social skills e.g., coping assertively
■temperamentally timid or shy (Cook et al., 2010)
■report being alone at break time
■feel less well-liked at school
■having few friends, or friends who can’t be trusted/low status, and sociometric rejection (dislike by peers).
■internalizing behaviour (being tearful or anxious) was a risk
factor in victimization

Question 62

What are some consequences of being victimised?

Answer 62

-loneliness and school avoidance.
-lose confidence and self-esteem.
-anxiety and depression, low self-esteem, physical and psychosomatic complaints
-Suicidality
LT effects:
-relationship difficulties later in life
-depression in later life
-educational achievement and earnings