Chapter 16
16
DEVELOPMENTAL
PSYCHOPATHOLOGY
LEARNING OBJECTIVES
After reading and studying the material in this chapter, the student should be able to understand
the following ideas/concepts:
16.1 WHAT MAKES DEVELOPMENT ABNORMAL?
• Describe three broad criteria of abnormal behavior and the approach taken by DSM-5 in
• Explain and illustrate the diathesis-stress model of psychopathology.
16.2 THE INFANT
• Describe the two defining features and main characteristics, including brain functioning,
16.3 THE CHILD
• Distinguish between externalizing and internalizing problems and discuss nature/nurture
16.4 THE ADOLESCENT
• Evaluate the “storm and stress” view of adolescence and discuss the factors that
contribute to a peaking of risky problem behaviors in adolescence.
16.5 THE ADULT
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CHAPTER OUTLINE
I What Makes Development Abnormal?
A. Criteria for Diagnosing Psychological Disorders
1. Three criteria for diagnosis
a. Statistical deviance – does the person’s behavior fall outside the normal range
of behavior?
2. DSM Diagnostic Criteria
a. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – the fifth
edition of this book (newest version, 2013) used by professionals to diagnosis
psychology disorders
b. Changes in this edition include single category of “autism spectrum disorder”
(rather that subcategories of autism), replace term “mental retardation” with
“intellectual disability,” and disruptive mood dysregulation disorder, and use
d. Not just “a little down” or symptoms due to substance use
e. With bereavement a diagnosis of depression can be utilized if it shows up
immediately following the death of a loved one (whereas in the DSM IV-TR it
had to persist for more than two months)
3. The DSM-5 recognizes a greater need to consider cultural and developmental
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B. Developmental Psychopathology
1. Major theories of human development attempted to understand and treat
psychological disorders
a. Freudian psychoanalytic theory once guided clinical practice
2. New field forged to study abnormal behavior from a developmental perspective
called developmental psychopathology—study course of maladaptive
3. Psychopathology as development, not disease
a. Some developmentalists fault DSM-5 for similar flaws found in earlier
editions of the DSM, for being rooted in a medical and disease model of
psychopathology (i.e., the notion that psychological problems are disease-like
entities a person has or does not have); alternative is that it is the outcome of
some developmental process with some branches leading to more or less
b. Lines between normal and abnormal may be blurred (i.e., different pathways
can lead to same disorder and same risk factors can lead to a variety of
outcomes)
c. March has recently suggested that due to relationship between genes, brain,
and behavior, psychological disorders need to be viewed as lifespan
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5. Developmental issues
a. Concerned with nature-nurture issue (origin) of maladaptive behaviors
i. How do biological, psychological, and social interact?
ii. What are the risk factors?
b. Concerned with continuity-discontinuity (progression) of maladaptive
6. The diathesis-stress model
a. Proposes that psychopathology results from interaction over time of
predisposition or vulnerability to psychological disorder (diathesis) and
environmental pressure (stress)
b. Diathesis-stress description of depression
depressed
c. In one study of individuals with one or two high-risk genes for depression,
10% depressed with no significant negative life event and 33% depressed with
four or more stressful events; in same study, only 17% of individuals with two
low-risk genes became depressed
d. Key is combination of these factors (in Figure 16.2) (e.g., genes both
predispose some to depression and influence the extent to which they
experience stressful life events)
i. Extreme stress and high vulnerability (severe disorder)
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Checking Mastery
1. What are two of the three broad criteria useful in defining when a psychological
disorder is present?
➢ Answer: Psychological disorders are assessed in terms of the broad criteria of
2. Jake says psychological disorders are diseases that some people have and other
people don’t. What might a developmental psychopathologist tell Jake?
➢ Answer: Developmental psychopathologists view psychological disorders as
3. What is a diathesis and why is it important?
➢ Answer: A diathesis is a predisposition or vulnerability to a psychological
II The Infant
A. Autism Spectrum Disorder
1. Autism first identified by Leo Kanner in 1943 and characterized by abnormal
social development, impaired language and communication, and repetitive
behavior
2. Two defining features of autism spectrum disorders in DSM-5
a. Abnormal social development
i. Difficulty forming normal social relationships, responding to social cues,
and sharing social experiences with others
security level of parent-child relationship
b. Repetitive, stereotyped behavior and restricted interests
i. Seek sameness and repetition (great distress when environment changed)
3. Autism varies greatly in level of impact (some refer to it as “autisms”)
a. Autism spectrum disorder, ASD – family of conditions within DSM-IV–TR
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b. Asperger syndrome (added in 1991 to the US Government list of disabilities)
is now subsumed under the ASD with several unique characteristics
i. Normal or above-average intellect, good verbal skills, serious deficit in
4. Is there an autism epidemic?
a. Rates have been rising
i. Autism in broadest sense (9 out of 1,000 eight-year-olds in the U.S.) and
more specific sense (1 in 110 eight-year-olds in the U.S.)
ii. Four to five boys affected for every girl
b. Debate over cause of increase
i. One theory involves mercury-based preservative (thimerosal) in vaccines
for measles, mumps, and rubella or the measles virus itself, but evidence
5. Characteristics of autistic individuals
a. Diagnosis does not typically take place until around age two to three years
i. Working on an earlier screening and detection measure as early treatment
may steer development to a more normal pathway
b. Autistic infants given away by lack of normal interest in and response to
social stimuli and delayed language development
i. Fail to orient to human voices
ii. Fail to babble and use first word
Matrices test (nonverbal test involving comparison of geometric patterns)
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6. Suspected causes
a. Early “refrigerator mom” theory (rigid and cold) is now known to be a
harmful myth
b. Parental factors
was 92% in identical twins and 10% in fraternal twins
c. Genetic factors
i. Many genes on different chromosomes have been implicated (most likely
that individual with autism inherits several of these genes)
d. Environmental factors
i. When one identical twin is autistic, the other sometimes is not, indicating
that the environment contributes to autism
v. Maternal bleeding and other birth complications may contribute
e. Neurological-brain factors
i. Neurological abnormalities common, and many autistics have epilepsy
ii. Leading hypothesis is that neurons in frontal lobe and other areas of the
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f. Executive dysfunction hypothesis
i. Deficiency in executive functions—planning and organizing ability based
in prefrontal cortex of brain
male brain)
7. Developmental outcomes and treatment
a. Can improve, but long-tem prognosis usually poor, especially if accompanied
by intellectual disability (autistic for life)
i. Positive outcomes most likely in autistics with IQ over 70 who can
communicate
b. Antipsychotic and antidepressant drugs treat some symptoms but do not cure
iv. Study criticized because it was not a true experiment with random
assignment to control and treatment groups
v. Early behavioral interventions usually do not convert children with autism
into typically functioning children
vi. Can be taught social scripts and how to make eye contact, but training
does not generalize easily to other situations
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B. Depression
1. Still debating whether “true depression” can occur in infancy (i.e., may not be
capable of negative cognitions common among depressed adults like low self-
distressed and those who cannot regulate their own emotions
4. Failure to thrive – neglected, abused, separated from attachment figures, or
otherwise stressed infants that fail to grow normally, lose weight, and become
seriously underweight for their age
Checking Mastery
1. What two major groups of symptoms would you expect to see in a child with
autism spectrum disorder?
➢ Answer: Autism is characterized by abnormal social and communication
2. How does brain development in children with ASD appear to differ from that in
typically developing children?
➢ Answer: In at least some children with ASD, neurons proliferate wildly during
other adolescents’ brains are undergoing a growth spurt.
3. What are two early experiences that could contribute to depressive symptoms in
an infant?
➢ Answer: Depressive symptoms in an infant could result from separation from an
III The Child
A. Externalizing and Internalizing Problems
1. Many children experience developmental problems (e.g., temper tantrums) but
smaller portion officially diagnosed with a psychological disorder
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3. Nature and nurture
a. Societal and parental tendency to believe in “parental effect” and blame
parents (especially mom) if children are sad or “bratty”
i. Parents feel guilt because they assume they are at fault
b. Must view developmental disorders from family systems perspective,
4. Continuity and discontinuity
a. Research by Caspi found that externalizing problems at age three (e.g.,
irritable, impulsive, rough) were more likely to be diagnosed with antisocial
personality disorders and records of criminal behavior in young adulthood
b. Same study found that internalizers at age three (e.g., shy, anxious) were more
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B. Attention Deficit Hyperactivity Disorder
1. Inattention, or Impulsivity and Hyperactivity
3. Treatment and Medication
C. Depression
1. Psychoanalytic theorists argued that infants were incapable of experiencing
depression but now know that children as young as age three can meet criteria for
major depressive disorders using adult diagnostic criteria
4. Very young children (two to three years) capable of attempting suicide
a. Jump from high places, stab themselves, run into traffic
b. Those who attempt suicide once are more likely to try again
c. Parents, teachers, and professionals need to appreciate childhood as not
always happy
5. Most children make it through mild episodes of sadness, and carryover of
depression problems from childhood to adolescence not as strong as from
adolescence to adulthood
6. Childhood depression can disrupt intellectual, academic, and social adjustment
7. Multiple types of therapies
a. Cognitive-behavioral therapy – focus on identifying and changing distorted
thinking and maladaptive emotions and behavior
best treatment for seriously depressed children and adolescents
Checking Mastery
1. How would you describe the main difference between an externalizing and an
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internalizing disorder in childhood?
➢ Answer: In internalizing problems like depression, the expression of negative
problems like conduct disorder those negative emotions are expressed (acted out).
2. What two major sets of symptoms characterize ADHD?
3. What is the agreed-upon best way to treat ADHD and in what way is it limited?
➢ Answer: The best way to treat ADHD is a combination of medication and
treatments last beyond childhood.
4. How is major depression in a preschool child similar to and different from major
depression in an adult?
➢ Answer: Although even young children can meet the same DSM-5 criteria for
IV The Adolescent
A. Storm and Stress?
1. Founder of developmental psychology, G. Stanley Hall, viewed adolescence as
emotional time of “storm and stress,” and this depiction has been with us since
1904
2. Most adolescents actually well-adjusted; only about 20% of teens have significant
mental health problems
B. Adolescent Problem Behaviors
1. Risk for behavioral problems in teen years comes in several areas including
overuse of drugs and engaging in delinquent behavior, but they tend not to reach
the level of seriousness that would constitute definition as a psychological
disorder
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consequences
C. Eating Disorders
1. Highly associated with adolescence (specifically, female adolescents); often first
seen in transition from childhood to adolescence or adolescence to adulthood
2. Eating disorders (e.g., anorexia nervosa) have become more common in several
American females than in European- or Asian-American females)
4. Suspected causes
a. Nurture side focuses on cultural factors like social pressures and value to be
thin (especially in Westernized cultures)
i. Media presentations of thinness as ideal women to Fiji; females altered
traditional view of plump body as status symbol to feeling of fatness and
need to control weight
b. Nature side
i. Normal puberty changes involve fat gain and may explain why
adolescence is a prime time for emergence of eating disorders
c. Genes
i. Why do so few adolescent females develop anorexia even though almost
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d. Interaction of genes and environment
i. Genetically predisposed girl living in a weight-conscious culture
ii. Early stress (prenatal and perinatal complications) increases risk of
anorexia
e. Family factors
5. Treatment
a. Effective treatment of anorexia starts with behavior modification to alter
eating (i.e., gain weight) and dealing with medical problems associated with
the disorder; then moving on to psychotherapy designed to help understand
and gain control of the problems, and family therapy to change parent-child
relationships; medications for depression and related psychological problems
c. Individuals with anorexia more difficult to treat; strong resistance in admitting
they have a problem
d. Treatment most effective if begun prior to age 18 (before it is chronic)
e. Prevention might be possible
i. Body Project – dissonance-producing anorexia nervosa intervention
ii. Get adolescent girls who have body image concerns to stop viewing thin
bodies as ideal by having them critique thinness in essays and in role-
as ideal body type, reducing body dissatisfaction, dieting efforts, and