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Intro to Child Psychopathology

• Some disorders are unique to childhood onset and require continuity for diagnosis (e.g., autism, ADHD).
• Indicators of emotional/behavioral issues differ in children compared to adults.
• Distress can manifest differently in children.
• Presentation of disorders shifts as individuals develop socially and cognitively.
• Developmental variations influence treatment effectiveness; cognitive therapy and medication may vary in efficacy.
• Family involvement is vital in treating children, unlike adult-focused approaches.
• Youth may resist treatment advocated by parents or guardians.

Defining Abnormality

• Norm violation relies on the reference group, varying across cultures and regions.
• Statistical rarity denotes a behavior or trait's infrequency in the general population.
• Personal discomfort and maladaptive behavior are key indicators of abnormality.
• Deviation from an idealized level of advanced skill or development can be problematic.
• Overly ambitious expectations for children can create issues.
• Adaptational failure shows as a pattern of symptoms including distress, disability, and heightened risk, indicating a deviation from typical development.

Developmental Benchmarks

• Developmental benchmarks serve as guidelines for assessing progress.
• Failure to achieve milestones can indicate future diagnoses.
• Benchmarks include motor skills, social behavior, and academic knowledge.

Scope of the Problem: Prevalence

• The Ontario Child Health Study reports an 18% prevalence of mental health issues in children (4-11 years) and 22% in adolescents (12-17 years).
• The Great Smokey Mountains Study indicates a cumulative prevalence of any DSM diagnosis by age 21 at 61.1%.
• The Dunedin Birth Cohort Study reports a 35% disorder rate by age 15, escalating to 59% by age 18.

Scope of the Problem: Impact

• Failing to address issues early results in more significant, harder to treat, problems later on.
• Approximately 20% of children with severe disorders encounter lifelong hardships.
• Child psychopathology can present costly, lifelong consequences.

Scope of the Problem: Inadequate Services

• High demand is not met by service availability.
• Symptoms often overlooked.
• Access is limited by stigma and barriers, medical doctors are first point of contact.

Epidemiology and Risk Factors

• Mental health can vary because of biological and social risk factors.
• Boys are more likely to have ADHD or conduct problems; girls face higher depression rates.
• Timing differentiates effects: boys usually show issues in childhood, while girls in adolescence.
• LGBTQ+ youth and racial/ethnic minorities face increased risk due to discrimination and socioeconomic disparities.
• Cultural context shapes symptoms, with social anxiety varying across collectivist cultures (e.g., Taijin kyofusho in Japan).

Models of Etiology: Diathesis-Stress Model

• This model explains disorders via underlying vulnerabilities triggered by stress.
• Each person requires a different level of stress to reach the diagnosable state; there is not a single level.
• It acknowledges the complex nature of behavior and emotions through nature and nurture interactions.
• Almost no disorders are caused by just genes or just stress – dual contribution.

Developmental Pathways

• Developmental pathways are the sequence and timing of particular behaviors as well as the relationships between behaviors over time.
• Multifinality: Similar beginnings lead to diverging outcomes.
• Equifinality: Dissimilar beginnings result in similar outcomes.

Developmental Psychopathology: A Perspective

• Abnormal development has multiple determinants and requires past and present symptom considerations.
• Holistic understanding acknowledges interdependence of children and their environments.
• Development involves continuities with incremental changes and discontinuties of stages.

Organization and Sensitive Periods

• Early adaptation patterns evolve, impacting later development.
• Sensitive periods highlight heightened vulnerability to stressors.

Integrative Approach and Biological Perspectives

• Intergrative: There is not a single theoretical orientation which explains behaviors.
• Neurobiological Factors: Brain as an origin of behavioral patterns which develops from all purpose to its specific needs, and the brain changes with experience during this process of change.

Genetic Contributions, Gene-Environment Interaction and GxE Types

• Genetic influences combine and react with experience depending on the individual.
• Different correlations affect your genes and environment depending on your personal life.
• Passive - your genes are directly related, not influenced by your attitude.
• Evocative - relates to how the people around you react to who you are as a result of your genes.
• Active - what you do as a person in reference to your predispositions.

Neurobiological and Psychological

• Active increase as you get older related to maturity controlling your environment, passive decreases and evocative stays the same as it relates to how others influence you.
• The traits that have been expressed through psychological disorders - transmitters, and other factors - are Serotonin, GABA, Norephinphrine, and Dopamine.

Psychological and Biological

• Multifinality & Equifinality are all that are considered.
• Emotional expression effects everything from childhood experiences, activity, how we regulate to those relationships.

Assessing Abnormal Child Behavior

• Appraisals are subject to shapes based on previous experiences and biases, must watch our biases to ensure proper testing.
  • Structured
  • Unstructured
  • Clinical Judgement

Statistical Measurements and Ethics as it Relates to Care

• Validity is important to measurements is whether one is testing and reporting it correctly and reliable, as ethical means to approach care for subjects.

  • Reliability Internal Consistency

• Test-retest reliability

• How do you test over over time.

Test Measurements and Design as Related to Behavior

• It is important to isolate the specific traits, behavior models, and variables that need to be tested for the most accurate data.
  • Randomized Tests
  • Longitudinal Tests
  • Statistical significance

What Causes Disorder and Where Should you Look To

• Multifinality vs equifinality.
• Nosology - what the symptoms are as influenced by environment (what has worked, what has failed in the past, etc.)
• Where has this been seen before, where did it work (culture, family, etc)

ADHD: Neurodivergence

• It can present in different ways that can sometimes be misdiagnosed.
• The symptoms usually have to have been seen before children are 12 years old.
• There is high comorbidity and is mainly associated with those of lower socioeconomic standards and has both high and low presentation standards.

Deviant Behavior: ODD and CD

• There are different kinds of disorder - age, community, etc - the main factor is their effect on mental control and family.
• ODD and CD cannot exist as a subtype of one or the other.
• The spectrum focuses on aggression, violating societal and familial expectations.

The Core of ODD/CD

• Both disorders focus on negative emotions with regards to both the individual and those that exist around them.
• ODD and CD's expression can stem from a gene or learned factors that must be addressed from the root to treat them all

Etiology and Externalities: Cognition vs Community

• External conditions such as low income and community disruption as well as bad parenting, reinforce bad behavior and thinking patterns.
• Treatment requires identifying the root cases and building new healthy patterns.

Treatments & Etiology: Cognitive Behavior

• Cognitive behavior must then be retrained away from any negativity as well as to not respond to angry and aggressive behaviors
• Multisystemic therapy aims to fix the whole families patterns to help create success as well.

Externalities: Substance and Anxiety

• Substance abuse, disorders, and family life are all intertwined, the core fix it comes down the breaking thought and behavior.
• Therapy can help identify harmful mental and behavioral patterns as well as to manage negative externalities and influences.
• Anxiety can influence a situation for someone, as well as can be an expression of fear, the core goal is to manage how the person interprets and addresses both.

What To Do For Anxiety and Comorbidity

• Treatment can range along the path from medication, CBT and SSRI's as well as family and community fixes for mental health.
• Exposure and response prevention - exposing their concerns and removing them and those are good responses to help with long term success.