Child Development and Disorders

Childhood Disorders and Their Interacting Factors

• Childhood disorders are likely to emerge from a complex interaction between emerging neurodevelopmental vulnerabilities and aspects of the child's prenatal and postnatal environment.
• Developmental aspects of childhood disorders reflect the child's maturation psychologically and socially as they grow up.

Genetic Factors

• Children with psychiatric problems often have parents who suffer from a psychiatric disorder, with environmental factors accounting for a substantial part of this association.
• Genetic factors contribute significantly to some psychiatric disorders, especially ASD, hyperactivity, and anxiety disorders, with a heritability of around 40%.
• Genetic studies have produced relevant findings, especially in sections on autism and hyperactivity.

Temperament and Individual Differences

• Certain temperamental factors detected before the age of 2 years predispose to later psychiatric disorder.
• Early temperamental differences are determined both genetically and by environmental factors.
• Association between temperamental styles and subsequent childhood psychopathology has been confirmed, with examples including:
  • Behavioural inhibition predicting later anxiety disorders
  • Low positive affect linked to the development of depression
  • Difficulties with self-control and high levels of irritability predicting disruptive behaviour problems, including conduct disorder

Brain Disorders

• Brain disorders, such as traumatic injury, epilepsy, infections, tumours, neurodegenerative, or other conditions, are significant risk factors for psychological problems in childhood.
• Physical disease of any kind can predispose to psychological problems in childhood, but brain disorders are the most important risk factors.
• The relationship between brain disorder and psychological problems was first noted in the original Isle of Wight study, with about 7% of physically healthy children aged 10-11 years classified as having psychiatric problems, compared to about 12% of physically ill children and 34% of children with brain disorders.

Brain Injury and Epilepsy

• Brain injury in childhood is a common cause of neurological damage, with consequences including intellectual impairment and behaviour disorder.
• The form of the consequent disorder is not very specific, partly because the effects of head injury are seldom localized to one area of the brain.
• Epilepsy is a strong predictor of psychiatric disorder in childhood, with the causal relationship potentially being of four kinds:
  • The brain lesion causing the epilepsy may also cause the psychiatric disorder
  • The psychological and social consequences of recurrent seizures may cause the disorder
  • The effects of epilepsy on school performance may cause the disorder
  • The drugs used to treat epilepsy may cause the disorder through their side effects

Environmental Factors

• Life events can predispose to or provoke a disorder, or protect against it, with the concept of life events being useful in child psychiatry as well as adult psychiatry.
• Life events can be classified by their severity, social characteristics, or general significance, and their psychological impact is influenced by factors such as temperament, cognitive style, and previous life experience.
• Family influences, including prolonged separation from or loss of parents, poor relationships, and overt conflict between parents, can have a profound effect on psychological development in infancy and childhood.

Maternal Deprivation and Attachment

• Bowlby's work on maternal deprivation led to concern about the effects of prolonged separation from the mother on psychological development.
• Attachment is a crucial stage of early psychological development, with adaptive attachments characterized by an appropriate balance between security and exploration.
• Internal models of themselves, others, and relationships with others are formed during infancy and persist into adult life, influencing self-concept and relationships.
• Secure attachments are associated with caregiving that is sensitive and responsive to the child's needs, while insecure attachments are associated with caregiving that is rejecting, intrusive, unpredictable, or lacking.