Developmental Psychopathology. Группа авторов
G. M., First, M. B., Kogan, C. S., Hyman, S. E., Gureje, O., Gaebel, W., & Saxena, S. (2019). Innovations and changes in the ICD‐11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry, 18(1), 3–19.
20 Regier, D. A., Kuhl, E. A., & Kupfer, D. J. (2013). The DSM‐5: Classification and criteria changes. World Psychiatry, 12(2), 92–98.
21 Rutter, M. (2011). Research review: Child psychiatric diagnosis and classification: Concepts, findings, challenges and potential. Journal of Child Psychology and Psychiatry, 52(6), 647–660. doi: 10.1111/j.1469‐7610.2011.02367.x.
22 Wittchen, H. U., & Beesdo‐Baum, K. (2018). “Throwing out the baby with the bathwater”? Conceptual and methodological limitations of the HiTOP approach. World Psychiatry, 17(3), 296–298. doi: 10.1002/wps.20560.
23 Wittchen, H. U., Beesdo‐Baum, K., Gloster, A. T., Hofler, M., Klotsche, J., Lieb, R., & Kessler, R. C. (2009). The structure of mental disorders re‐examined: Is it developmentally stable and robust against additions? International Journal of Methods in Psychiatric Research, 18(4), 189–203. doi: 10.1002/mpr.298.
24 World Health Organization (2019). World Health Assembly Update. Retrieved from: https://www.who.int/news‐room/detail/25‐05‐2019‐world‐health‐assembly‐update.
Chapter 2 Developmental Psychopathology
Rebecca Lipschutz and Johanna Bick
Chapter Overview
The developmental psychopathology approach helps us to understand why some individuals develop mental disorders and other individuals follow a different path. Developmental psychopathology is the study of the origins and course of individual patterns of behavior (Sroufe & Rutter, 1984). This approach to studying mental disorders in childhood and adolescence stresses the importance of developmental processes or how one changes and adapts throughout childhood. It takes into account individual factors about the child (temperament, biological risk) and their context (family, neighborhood, community) as influences on child development. In addition to understanding risk for psychopathology, the developmental psychopathology approach also seeks to understand resiliency. This approach links different fields or disciplines of science together to study normal development and psychopathology (mental disorders).
In summary, an overarching objective of the developmental psychopathology framework is to better understand why some individuals develop psychopathology whereas others do not. This can be broken down into several more questions:
1 How does psychopathology look the same or different across different phases of child development?
2 Are there underlying traits or biological factors that help explain individual risk?
3 What role does the environment (parents, neighborhood, culture) play in increasing or decreasing risk for an individual?
4 How can we understand the interplay of timing (i.e., stage of development), nature (i.e., genetic susceptibility), and nurture (i.e., environmental influence) to explain risk and resiliency?
5 Can answers to the above questions help prevent or ameliorate psychopathology at different phases of life?
The History of the Developmental Psychopathology Approach
The field of developmental psychopathology emerged from a synthesis of theories across several disciplines, including embryology, genetics, the neurosciences, psychoanalysis, and clinical, developmental, and experimental psychology (Cicchetti, 1990). Influential theorists across these disciplines came to a mutual conclusion: learning about what it means to “function normally” was reliant on understanding the non‐normal or pathological. Likewise, a complete understanding of abnormal depends on accurate understanding of normal behavior, development, and functioning (Cicchetti, 2006). Implicit in this thinking was that psychopathology and normal behavior were opposite ends of a continuum, and that behavior described as “psychopathological” was merely an exaggerated case of the normal. Building from this logic, the field of developmental psychopathology pushed a new way of studying abnormal behavior by examining the entire continuum of behavior, rather than focusing on the extreme, atypical cases (Cicchetti, 2006).
Some of the early applications of the developmental psychopathology model took place in the 1970s. One group of researchers followed children at high and low risk for developing schizophrenia over time (Wall et al., 1984). This prospective, longitudinal study allowed for a comparison of typical and atypical developmental trajectories. A goal of this work was to understand better the developmental origins of a serious mental illness that is typically not diagnosed until late adolescence or early adulthood.
Over the past four decades, the field of developmental psychopathology has grown substantially. It is now considered an integrative framework that links different scientific disciplines, theories, and research strategies to understand better how individuals adapt and develop risk for psychopathology. Importantly, the developmental psychopathology approach is not a specific theory in its own right. It is better considered as a guide or framework for how to best understand psychopathology, in terms of its roots, development, and persistence or remittance over the lifespan.
By bringing together ideas from separate disciplines and fields, studying developmental change, and comparing normal to abnormal, this approach offers a promising framework for furthering knowledge on etiology, developmental change, course, and pathways to resilience. In summary, this reflects the overall mission of developmental psychopathology, which is to “prevent or ameliorate behavioral problems and disorders and promote positive development” (Masten, 2006).
The Definitional Principles of Developmental Psychopathology
There are several core principles of developmental psychopathology that comprise an overarching framework.
1 Interplay between normal development and pathological functioning
2 Studying developmental continuities and discontinuities of traits, behaviors, emotions, and disorders
3 Evaluating evidence across multiple levels of analyses to include the biological, individual, family, social, and cultural levels
4 Incorporating distinct perspectives: clinical, developmental psychology, child/adolescent psychiatry, genetics, neurology, public health, philosophy of science into a multidisciplinary effort
5 Examining both risk and protective factors to delineate pathways of risk and resilience
6 Involving reciprocal, transactional models of influence in the field’s causal models
Interplay Between Normal Development and “Abnormal” or Pathological Functioning
The common, unifying principle of developmental psychopathology is the integration of understanding “normal” and “abnormal” behavior, traits, and processes. Developmental psychopathology models highlight that all phenomena occur along a continuum of normal developmental processes and pathways. Psychopathology is judged in relation to what is “normal” in a given time and society for a person of a specific gender or age (Masten, 2006). Developmental psychopathologists look at developmental processes and how they function by looking at the extremes, which may indicate psychopathology. The level of psychopathology an individual exhibits may change over time and at one point in the lifespan it may be classified as a mental disorder whereas at another point it would not be. It is also common for individuals to move between pathological and nonpathological forms of functioning (Cicchetti, 1993). Therefore, manifestations of psychopathology may be non‐linear or transient.
Let us consider examples of psychopathology