CHAPTER 16 DEVELOPMENTAL PSYCHOPATHOLOGY

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CHAPTER 16DEVELOPMENTAL PSYCHOPATHOLOGY
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Abnormality

• Maladaptiveness
• Interferes with personal and social life
• Poses danger to self or others
• Personal distress
• DSM-IV diagnostic criteria (APA)
• Statistical deviance

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Developmental Aspects

• Development, not disease
• A pattern of maladaption, not defects
• Social and Age Norms
• Poor person-environment fit
• Developmental Issues
• Nature/Nurture
• Risk factors
• Prediction

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The Diathesis-Stress Model

• Interaction of genes and environment
• Example Depression
• Genetic vulnerability
• Environmental trigger(s)
• Not specific stressors for specific disorders
• Bad things have bad effects for some people some
  of the time

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Autism

• Begins in infancy, more boys
• Several autistic spectrum disorders
• Impaired social interaction, communication
• Repetitive, stereotyped behaviors
• 80 retarded savant syndrome common
• Severe cognitive impairment
• Biologically based
• Concordance MZ60, DZ 0

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Depression

• Infancy
• Somatic symptoms
• Depressive-like states
• Related to poor attachment
• At risk if mother depressed
• Failure to thrive syndrome may occur

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Childhood

• Externalizing Problems
• Undercontrolled disorders
• Acting out
• Aggressive, out of control
• Internalizing Problems
• Overcontrolled disorders
• Inner distress, shyness
• More girls

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• Relationships between behavior at age 3 and
  psychological disorders at age 21. Part A shows
  that children with uncontrolled, externalizing
  behavioral styles are more likely than other
  children to show antisocial behavior and repeated
  criminal behavior at age 21. Part B shows that
  inhibited, internalizing children are at high
  risk of depression, but not anxiety disorders, at
  21.

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Attention-Deficit Hyperactivity Disorder

• DSM-IV Criteria, some combination of the
  following
• Inattention, Impulsivity, Hyperactivity
• More boys 3-5 of US kids
• Comorbidity common
• Overactive behavior wanes with age
• Attentional, adjustment problems remain
• Most well-adjusted in adulthood

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ADHD-Causes and Treatment

• Neurological Low Dopamine, other NTs
• Differential processing
• Underactivity in motor area
• Genetic predisposition Environmental stress
• 70 helped by stimulants (like Ritalin)
• Overprescription a problem
• Most successful if combined with behavioral
  treatment

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Depression

• Childhood
• Somatic symptoms school, social also
• Psychotherapy, medication effective
• Nature/Nurture question
• Adolescence
• Often related to childhood symptoms

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Adolescence

• Storm and Stress?
• Only about 20
• Heightened vulnerability to psych disorders
• Alcohol and drug problems
• Eating Disorders
• Anorexia nervosa more girls (3/1)
• Bulimia nervosa binge-purge
• Some genetic predisposition stress also
• Psychological treatment usually successful

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Adolescent Depression and Suicide

• 35 depressed 7 diagnosable
• Cognitive symptoms
• Behavioral acting out
• Genetic link
• Environmental triggers
• Suicide Third leading cause of death
• Males commit 3/1 girls attempt 3/1

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Adulthood

• Rates of disorder decrease after age 18
• Depression
• Concern with elderly
• Elderly less vulnerable to major depression
• Depression often related to health
• 15 have some symptoms
• 1-3 diagnosable
• Difficult to diagnose from other conditions
• More women (2/1)

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Depression and Dementia

• Many undiagnosed and untreated
• Elderly can benefit, should NOT be excluded from
  treatment
• Dementia Progressive Deterioration
• Not normal aging (Senescence)
• Alzheimers Disease
• Leading cause of dementia
• Progressive and irreversible

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Causes of Cognitive Impairment

• Genetic e.g., Alzheimers Disease
• Vascular dementia -multi-infarct
• Minor strokes Deficits accumulate
• Related to lifestyle Diet and exercise
• Reversible dementia, about 20
• Delirium Reversible, often drug related
• Depression Treatable
• Critical to distinguish for proper treatment

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• Alzheimers disease emerges gradually over the
  adult years brain cells are damaged long before
  noticeable cognitive impairment results in old
  age. Changes in brain functioning are
  significantly different from those associated
  with normal aging.