chapter 16 development psychopathology

Life-Span Human Development, Fifth Edition, Carol K. Sigelman and Elizabeth A. RiderChapter 16

Chapter 16

Development Psychopathology


Chapter 16: DEVELOPMENTAL PSYCHOPATHOLOGY

• Abnormality

– Statistical deviance

– Maladaptiveness

• Interferes with personal and social life

• Poses danger to self or others

– Personal distress

– DSM-IV diagnostic criteria (APA)


Developmental Aspects

• Development, not disease

– A pattern of maladaption, not defects

• Social and Age Norms

• Developmental issues

– Nature/Nurture

– Risk factors

– Prediction


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”


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: MZ=60%, DZ= 0%


Depression

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


Childhood

• Externalizing problems– “Undercontrolled” disorders– Acting out– Aggressive, out of control

• Internalizing problems– “Overcontrolled” disorders– Inner distress, shyness– More girls


Figure 16.3


Attention-Deficit Hyperactivity Disorder

• DSM-IV Criteria: some combination of– 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


ADHD-Causes and Treatment

• Neurological: low Dopamine, other NT’s– Differential processing– Underactivity in motor area

• Genetic predisposition; Environmental stress

• 70% helped by stimulants– Overprescription a problem

• Most successful if combined with behavioral treatment


Depression

• Childhood– Somatic symptoms– Psychotherapy, medication effective– Nature/Nurture question

• Adolescence– Often related to childhood symptoms


Adolescence

• Storm and stress– Only about 20%– Heightened vulnerability to psych disorders

• Alcohol and drugs are problems

• Eating disorders– Anorexia nervosa; more girls (3/1)– Bulemia nervosa; binge-purge– Some genetic predisposition; stress also– Psychological treatment usually successful


Adolescent Depression and Suicide

• 35% depressed; 7% diagnosable– Cognitive symptoms– Behavioral acting out– Genetic link– Environmental triggers

• Suicide 3rd leading cause of death– Males commit 3/1; girls attempt 3/1


Adulthood

• Rates of disorder decrease after age 18

• Depression– Elderly less vulnerable to major depression– Concern with elderly

• Depression often related to health

• 15% have some symptoms

• 1-3% diagnosable

• Difficult to diagnose– More women (2/1)


Depression and Dementia

• Many undiagnosed and untreated

• Elderly can benefit, should NOT be excluded from treatment

• Dementia: progressive deterioration– Not normal aging

• Alzheimer’s Disease– Leading cause of dementia– Progressive and irreversible


Causes of Cognitive Impairment

• Genetic: e.g., Alzheimer’s

• Vascular dementia - multi-infarct– Minor strokes: deficits accumulate– Related to lifestyle: diet and exercise

• Reversible dementia, about 20%

• Delerium: reversible, often drug related

• Depression: treatable

• Critical to distinguish for proper treatment


Figure 16.6


Figure 16.5

chapter 16 development psychopathology

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