Developmental Psychopathology – TEXTBOOK
DISORDERS OF CHILDHOOD – R.H. PARRITZ & M.F. TROY (3rd edition)
Index
Chapter 1 Introduction Page 2
Chapter 2 Models of child development Page 5
Chapter 3 Principles and practices of developmental psychopathology Page 10
Chapter 4 Classification, assessment and diagnosis, and intervention Page 15
Chapter 5 Disorders of early childhood Page 19
Chapter 9 Attention deficit/ hyperactivity disorder Page 23
Chapter 11 Anxiety disorders, obsessive compulsive disorder, and somatic Page 27
symptom disorders
Chapter 7 Autism spectrum disorder Page 33
Chapter 12 Depressive disorders, bipolar disorders, and suicidality Page 38
Chapter 13 Eating disorders Page 45
Chapter 14 Substance-related disorders and transition to adult disorders Page 49
Chapter 8 Maltreatment and trauma- and stressor-related disorders Page 54
Chapter 10 Oppositional defiant disorder and conduct disorder Page 59
Chapter 6 Intellectual developmental disorder and learning disorders Page 65
1
,Chapter 1: Introduction
Developmental psychopathology = an approach which suggests that we gain a better understanding
of children’s disorders when we think about those disorders within the context of typical
development.
➔ Placing descriptions of disorders against the background of usual development (comparing)
➔ Acknowledge the everyday problems and difficult phases that characterize typical child
development
➔ Making clear the connections and disconnections between adaptation and maladaptation
➔ Both children and their disorders develop and change over time
Defining disorders of infancy, childhood and adolescence
One of the first steps leading to accurate and useful conceptualizations of psychopathology is to
recognize the many connections between typical and atypical development. Models to the field of
child development may help to provide some context for decision making. Models of typical
development should emphasize a dynamic appreciation of children’s strengths and weaknesses and
take into account the complexities beliefs about desirable and undesirable outcomes for children and
adolescents (e.g. individual, familial, ethnic, cultural, and societal beliefs).
➢ The major salient, age-related issues of development:
Infancy Formation of an effective attachment
Toddler period Guided self-regulation
Preschool period Self-regulation
School years Competence
Adolescence Individuation
Transition to adulthood Emancipation
What is normal?
Common descriptions of normality and psychopathology often focus on:
(1) Statistical deviance: the infrequency of certain emotions, cognitions, and/or behaviours;
(2) Sociocultural norms: the beliefs and expectations of certain groups about what kinds of
emotions, cognitions, and/or behaviours are undesirable or unacceptable; and
(3) Mental health perspectives: theoretical or clinically based notions of distress and
dysfunction.
The statistical deviance perspective focusses on the concept of children who display too much or too
little of any age-expected behaviour might have a disorder. Note: some types of extreme
characteristics are to be accepted or even prized, e.g. high intelligence.
From a sociocultural norm perspective, children who fail to conform to age-related, gender-specific,
or culture-relevant expectations might be viewed as disordered. Norms in particular social/ cultural
settings will vary, but certain patterns are considered evidence of psychopathology.
The mental health perspective focusses a child’s psychological well-being as the key consideration.
According to this perspective, children who have a negative quality of life, who function poorly, or
who exhibit certain kinds of symptoms might have a disorder.
2
,The role of values in conceptualizations of psychopathology is very important. A key value judgment
involves distinctions between adaptation and maladaptation and standards of adaptation.
Types of adaption:
➢ Poor adaption = adaption that is not moving in a positive developmental direction
➢ Adequate adaptation = adaption that is considered okay, acceptable, or good enough; even
with traumatic life events, the development is moving in a positive direction but there are
still challenges and problems with managing past traumas
➢ Optimal adaptation = adaption that is excellent, superior, or “the best of what is possible.”
despite of traumatic life events
➔ Note: neither adequate nor optimal adaptation guarantees smooth sailing throughout
development. Challenges are inevitable, and struggles themselves are not evidence of
disorder, but are viewed as forces of growth.
➢ The irreducible needs of children, according to Brazelton and Greenspan (2000)
- The need for …
o ongoing nurturing relationships
o physical protection, safety, and regulation
o experiences tailored to individual differences
o developmentally appropriate experiences
o limit setting, structure, and expectations
o stable, supportive communities and cultural continuity
➔ Prevention and intervention strategies are often based on these needs
Definitions in psychopathology and developmental psychopathology
Psychopathology refers to intense, frequent, and/or persistent maladaptive patterns of emotion,
cognition, and behaviour. Developmental psychopathology extends this description to emphasize
that these maladaptive patterns occur in the context of typical development and result in the current
and potential impairment of infants, children, and adolescents.
The multipart task of estimating rates of disorders includes:
(1) Identifying children with clinically significant distress and dysfunction;
(2) Calculating levels of general and specific psychopathologies and the impairments associated
with various disorders (e.g. anxiety disorders vs. generalized anxiety or phobia); and
(3) Tracking changing trends in the identification and diagnosis of specific categories of disorder
(e.g. ASD, ADHD, and depression)
Developmental epidemiology is about the frequencies and patterns of distributions of disorders.
• Prevalence = the proportion of a population with a disorder (i.e., all current cases)
• Incidence = the rate at which new cases arise (i.e., all new cases in a given time period).
➢ Recent data from the National Health and Nutrition Examination Study estimate that 13% of
children between 8 and 15 years of age in the United States met the criteria for any disorder.
3
, Difficulties concerning healthcare
(1) Access to care: fewer than half of children and adolescents who need mental health
interventions receive them
(2) Barriers to care:
- Structural barriers: such as limited policy perspectives, long waiting lists, money, etc.
- Barriers related to perceptions about mental health difficulties: the inability to
acknowledge a disorder, denial, beliefs that formal treatment is not needed, etc.
- Barriers related to perceptions about mental health services: lack of trust in the system,
previous negative experiences, stigma related to seeking help, etc.
(3) Stigmatization of individuals with psychopathology; feelings of shame, lack of respect, etc.
- Dimensions of stigma: negative stereotypes, devaluation, and discrimination
- Targets of stigma: the individual and the family
- Contexts of stigma: the general public and the self/individual.
➔ Stigma is often associated with exclusion and many people with disorders ‘self-
stigmatize’ (internalize these negative beliefs and attitudes and exhibit low levels of self-
esteem and self-efficacy.
A four-part model is proposed to address these issues:
1) Direct access to appropriate and effective mental health services;
2) Child mental health should be a major component of healthy development promotion and
attention in primary care settings;
3) Efforts should emphasize preventive care for high-risk children and families;
4) More attention must be paid to cultural context and cultural competence.
Dimensions of abnormal behaviour (4 D’s):
1) Dysfunction
2) Distress
3) Deviance
4) Danger (to self or others)
4
DISORDERS OF CHILDHOOD – R.H. PARRITZ & M.F. TROY (3rd edition)
Index
Chapter 1 Introduction Page 2
Chapter 2 Models of child development Page 5
Chapter 3 Principles and practices of developmental psychopathology Page 10
Chapter 4 Classification, assessment and diagnosis, and intervention Page 15
Chapter 5 Disorders of early childhood Page 19
Chapter 9 Attention deficit/ hyperactivity disorder Page 23
Chapter 11 Anxiety disorders, obsessive compulsive disorder, and somatic Page 27
symptom disorders
Chapter 7 Autism spectrum disorder Page 33
Chapter 12 Depressive disorders, bipolar disorders, and suicidality Page 38
Chapter 13 Eating disorders Page 45
Chapter 14 Substance-related disorders and transition to adult disorders Page 49
Chapter 8 Maltreatment and trauma- and stressor-related disorders Page 54
Chapter 10 Oppositional defiant disorder and conduct disorder Page 59
Chapter 6 Intellectual developmental disorder and learning disorders Page 65
1
,Chapter 1: Introduction
Developmental psychopathology = an approach which suggests that we gain a better understanding
of children’s disorders when we think about those disorders within the context of typical
development.
➔ Placing descriptions of disorders against the background of usual development (comparing)
➔ Acknowledge the everyday problems and difficult phases that characterize typical child
development
➔ Making clear the connections and disconnections between adaptation and maladaptation
➔ Both children and their disorders develop and change over time
Defining disorders of infancy, childhood and adolescence
One of the first steps leading to accurate and useful conceptualizations of psychopathology is to
recognize the many connections between typical and atypical development. Models to the field of
child development may help to provide some context for decision making. Models of typical
development should emphasize a dynamic appreciation of children’s strengths and weaknesses and
take into account the complexities beliefs about desirable and undesirable outcomes for children and
adolescents (e.g. individual, familial, ethnic, cultural, and societal beliefs).
➢ The major salient, age-related issues of development:
Infancy Formation of an effective attachment
Toddler period Guided self-regulation
Preschool period Self-regulation
School years Competence
Adolescence Individuation
Transition to adulthood Emancipation
What is normal?
Common descriptions of normality and psychopathology often focus on:
(1) Statistical deviance: the infrequency of certain emotions, cognitions, and/or behaviours;
(2) Sociocultural norms: the beliefs and expectations of certain groups about what kinds of
emotions, cognitions, and/or behaviours are undesirable or unacceptable; and
(3) Mental health perspectives: theoretical or clinically based notions of distress and
dysfunction.
The statistical deviance perspective focusses on the concept of children who display too much or too
little of any age-expected behaviour might have a disorder. Note: some types of extreme
characteristics are to be accepted or even prized, e.g. high intelligence.
From a sociocultural norm perspective, children who fail to conform to age-related, gender-specific,
or culture-relevant expectations might be viewed as disordered. Norms in particular social/ cultural
settings will vary, but certain patterns are considered evidence of psychopathology.
The mental health perspective focusses a child’s psychological well-being as the key consideration.
According to this perspective, children who have a negative quality of life, who function poorly, or
who exhibit certain kinds of symptoms might have a disorder.
2
,The role of values in conceptualizations of psychopathology is very important. A key value judgment
involves distinctions between adaptation and maladaptation and standards of adaptation.
Types of adaption:
➢ Poor adaption = adaption that is not moving in a positive developmental direction
➢ Adequate adaptation = adaption that is considered okay, acceptable, or good enough; even
with traumatic life events, the development is moving in a positive direction but there are
still challenges and problems with managing past traumas
➢ Optimal adaptation = adaption that is excellent, superior, or “the best of what is possible.”
despite of traumatic life events
➔ Note: neither adequate nor optimal adaptation guarantees smooth sailing throughout
development. Challenges are inevitable, and struggles themselves are not evidence of
disorder, but are viewed as forces of growth.
➢ The irreducible needs of children, according to Brazelton and Greenspan (2000)
- The need for …
o ongoing nurturing relationships
o physical protection, safety, and regulation
o experiences tailored to individual differences
o developmentally appropriate experiences
o limit setting, structure, and expectations
o stable, supportive communities and cultural continuity
➔ Prevention and intervention strategies are often based on these needs
Definitions in psychopathology and developmental psychopathology
Psychopathology refers to intense, frequent, and/or persistent maladaptive patterns of emotion,
cognition, and behaviour. Developmental psychopathology extends this description to emphasize
that these maladaptive patterns occur in the context of typical development and result in the current
and potential impairment of infants, children, and adolescents.
The multipart task of estimating rates of disorders includes:
(1) Identifying children with clinically significant distress and dysfunction;
(2) Calculating levels of general and specific psychopathologies and the impairments associated
with various disorders (e.g. anxiety disorders vs. generalized anxiety or phobia); and
(3) Tracking changing trends in the identification and diagnosis of specific categories of disorder
(e.g. ASD, ADHD, and depression)
Developmental epidemiology is about the frequencies and patterns of distributions of disorders.
• Prevalence = the proportion of a population with a disorder (i.e., all current cases)
• Incidence = the rate at which new cases arise (i.e., all new cases in a given time period).
➢ Recent data from the National Health and Nutrition Examination Study estimate that 13% of
children between 8 and 15 years of age in the United States met the criteria for any disorder.
3
, Difficulties concerning healthcare
(1) Access to care: fewer than half of children and adolescents who need mental health
interventions receive them
(2) Barriers to care:
- Structural barriers: such as limited policy perspectives, long waiting lists, money, etc.
- Barriers related to perceptions about mental health difficulties: the inability to
acknowledge a disorder, denial, beliefs that formal treatment is not needed, etc.
- Barriers related to perceptions about mental health services: lack of trust in the system,
previous negative experiences, stigma related to seeking help, etc.
(3) Stigmatization of individuals with psychopathology; feelings of shame, lack of respect, etc.
- Dimensions of stigma: negative stereotypes, devaluation, and discrimination
- Targets of stigma: the individual and the family
- Contexts of stigma: the general public and the self/individual.
➔ Stigma is often associated with exclusion and many people with disorders ‘self-
stigmatize’ (internalize these negative beliefs and attitudes and exhibit low levels of self-
esteem and self-efficacy.
A four-part model is proposed to address these issues:
1) Direct access to appropriate and effective mental health services;
2) Child mental health should be a major component of healthy development promotion and
attention in primary care settings;
3) Efforts should emphasize preventive care for high-risk children and families;
4) More attention must be paid to cultural context and cultural competence.
Dimensions of abnormal behaviour (4 D’s):
1) Dysfunction
2) Distress
3) Deviance
4) Danger (to self or others)
4
