Skip to content →

Unit 1: Developmental Psychopathology

I. How do we know things?

  • authority
  • tradition
  • revelation
  • reasoning
  • experience
  • scientific investigation
    • observation and experiment — empiricism

II. differences: Abnormality, Psychopathology, Emotional & Behavioral Problems, Psychiatric Illness, Disturbance

  • All human cultures we know of have extensive vocabularies to identify and discuss individual differences, including emotional/behavioral/cognitive differences
  • What does it mean to say that a child has a “behavior disorder”?

III. Aspects of how abnormality is viewed

  • Standards of difference: on what basis do we judge someone to be abnormal?
    • Relative standards: vary with culture, society, time
      • Distress–pain & suffering [DSM-IV-TM]
      • Functional–impairment & limitation [DSM-IV-TM]
      • Sociological–violating rules (deviance)
      • Mathematical or Statistical–unusual
      • Tolerance–bothers us (the audience)
        • Leo Kanner: “annoyance threshold of the child’s environment”
        • Caretaker concerns (Achenbach, 1982)
          • enduring trait
          • perceived change
          • developmental comparison
    • Absolute standards: universal
      • Idealistic
      • Pathogonomic
  • The nature of the abnormality : how are the exceptional different from the rest of us?
    • categorical–qualitative difference (difference is of kind)
    • dimensional–quantitative difference (difference is of degree)
    • comparison of categorical vs. dimensional systems: Seven Children

8-22-13

Level of analysis: what do we pay attention to?

  • symptom or sign: a behavior, an action, a characteristic
  • syndrome: a pattern of symptoms
  • disorder: a syndrome that persists and has negative consequences
  • disease: a disorder that where we fully understand the mechanisms

IV. Unique features of childhood and adolescence affecting our understanding of psychopathology in youth

  • Source of referral
  • Language
  • Environmental dependence
  • Developmental status
  • Rapidity of change
  • qualitative & quantitate changes with development

V. Classification and diagnosis of exceptional states in childhood and adolescence

  • Purposes of classification
    • advance understanding
    • communicate among professionals
    • make dispositions
    • statistical record keeping
  • Possible negative effects of classification
    • inaccuracy and invalidity
    • stigma & shame
    • negative bias & expectations
  • Relatively common elements/language of classification:
    • sign & symptom, syndrome, disorder, disease
  • DSM-V & ICD-9-CM (ICD-10)
    • American Psychiatric Association (APA)
    • American Psychiatric Association (APA), American Medical Association (AMA), World Health Organization (WHO), United Nations (UN)
      • International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM)
      • International Classification of Diseases, Tenth Edition (ICD-10) scheduled to be adopted in U.S. in fall of 2014
      • ICD-11

8-27-13

IDEA

  • 1975 PL 94-142 (Part B of the federal Education for all Handicapped Children Act)
    • now titled the Individuals with Disabilities Education Act (IDEA)
    • a “free and appropriate public education” for school-aged children with disabilities
    • 1986 PL 99-457 extended the rights and protections of school aged children to preschoolers aged 3-5
    • 1997 reauthorization of IDEA
    • 2004 reauthorization of IDEA

Eligibility under IDEA

  • The student must be identified as having 1 of 12 disability conditions and demonstrate a need for special education and related services
    • mental retardation
    • specific learning disabilities
    • serious emotional disturbance
    • speech or language impairments
    • vision loss
    • hearing loss
    • orthopedic impairments
    • other health impairments
    • deaf-blindness
    • multiple disabilities
    • autism
    • traumatic brain injury

Seven Children

A: Andrew–no problems
B: Bart–mild discipline problems
C: Cindy–slow learner, no behavior problems
D: Drew–behavior problems
E: Edward–learning disability
F: Felicia–mentally retarded
G: Gloria–autistic

DSM-IV-TR Multiaxial Assessment

  • Axis I
    • Clinical Syndromes
    • Other Conditions That May Be a Focus of Clinical Attention
  • Axis II
    • Mental Retardation
    • Personality Disorders
      • personality traits
  • Axis III
    • General Medical Conditions
  • Axis IV
    • Psychosocial & Environmental Problems
  • Axis V
    • Global Assessment of Functioning (GAF) Scale

DSM conceptualization of Mental Disorder:

DSM-IV (1994) and DSM-IV-TR (2000)

“In DSM-IV, each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.” (DSM-IV-TR, 2000, p. xxxi)

  • clinically significant
  • syndrome/pattern
  • occurs in an individual
  • not expectable & culturally sanctioned response to a particular event
  • conflicts between individual and society are not mental disorders, unless the deviance or conflict is a symptom of a dysfunction in the individual
  • classified disorders that people have, not people

DSM 5 (2013)

“A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.” (DSM 5, 2013, p. 20)

  • syndrome
  • clinically significant
  • in an individual’s
  • usually assocaited with significant distress or disability
  • social, occupational, or other important activities
  • expectable or culturally approved response to a common stresor or loss . . . . is not a mental disorder
  • socially deviant behavior/conflicts with society are not a mental disorder, unless
  • caution about legal judgments, eligibility for disability, competency
Skip to toolbar