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Western University
Psychology 2320A/B
Jeff St.Pierre

2042B Study Notes – Exam 1 CHAPTER 1 What is Abnormal in Children and Adolescents? Competence  Competence is the ability to successfully adapt in the environment  This varies across culture and ethnicity, so it is important that the traditions, beliefs, languages, and value systems be taken into account  The study of abnormal child psychology takes into account the degree of maladaptive behaviour as well as the extent to which they achieve normal development milestones  Developmental tasks (broad domains of competence such as conduct and academic achievement) tell how children typically progress within each domain as they grow  Conduct indicates how well a person follows the rules of a particular society Developmental Pathways  In addition to distinguishing between normal and abnormal adaptation, we must consider the temporal relationship between emerging concerns in early childhood and the likelihood that they will lead to problems later on  Developmental pathway is the sequence and timing of particular behaviours and possible relationships between behaviours over time  Maltreatment can significantly alter the child’s initial course of development, resulting in diverse and often unpredictable outcomes, such as eating, mood, or conduct disorders  Multifinality is various outcomes may stem from similar beginnings  Equifinality is that similar outcomes stem from different early experiences and developmental pathways  Diversity in how children acquire psychological strengths and weaknesses is a hallmark of abnormal child psychology SECTION SUMMARY  Defining a psychological disorder involves agreement on particular patterns of behavioural, cognitive, and physical symptoms shown by an individual  Terms used to describe abnormal behaviour are meant to define behaviour, not to be used as labels to describe individuals  Defining abnormal behaviour requires judgment concerning the degree to which a person’s behaviour is maladaptive or harmful as well as dysfunctional or impaired  Diversity in how children acquire psychological strengths and weaknesses is a hallmark of abnormal child psychology. The main contributors to abnormal behaviour may vary within and between individuals with similar disorders  The study of psychological disorders involves attempts to describe the presenting problems and abilities, to understand contributing causes, and to treat or prevent them  Developmental pathways help to describe the course and nature of normal and abnormal development; Multifinality means that various outcomes may stem from similar beginnings, whereas Equifinality means that similar outcomes stem from different early experiences Risk and Resilience  A risk factor is a variable that precedes a negative outcome of interest and increases the chance that the outcome will occur  Protective factor is a personal or situational variable that reduces the chances for a child to develop a disorder  Children who survive risky environments by using their strong self-confidence, coping skills, and abilities to avoid risk situations are considered resilient  Resilient children are also most likely to show sustained competence while under stress, or to rebound to a previously healthy level of competence following traumatic or stressful experiences SECTION SUMMARY  Children’s normal development may be put in jeopardy because of risk factors, which can include acute, stressful situations and chronic adversity  Some children may seem to be more resilient in the face of risk factors. Resiliency is related to strong self- confidence, coping skills, and the ability to avoid risk situations, as well as the ability to fight off or recover from misfortune  Children’s resilience is connected to a protective triad of resources and health-promoting events that include individual opportunities, close family ties, and opportunities for individual and family support from community resources The Significance of Mental Health Problems among Children and Youths  About one child in eight has a mental health problems that significantly impairs functioning, which extends to toddlers and infants  Despite the magnitude of children’s mental health needs today, the youngest one-fourth of the population (under age 18) have very few treatment options, and those whose options that are available are underfunded The Changing Picture of Children’s Mental Health  Fewer than 10% of children with mental health problems receive proper services to address impairments related to personal, family, or situational factors  Those disproportionately afflicted with mental health problems are:  Children from disadvantaged families and neighborhoods  Children from abusive or neglectful families  Children receiving inadequate child care  Children born with very low birth weight due to maternal smoking, diet, or abuse of alcohol and drugs What Affects Rates and Expression of Mental Disorders?  New pressures and social changes may place children at increasing risk for the development of disorders at younger ages  Higher rates of fetal survival have contributed to a greater number of children with behaviour and learning difficulties who require specialized who require specialized services at a younger age Poverty and Socioeconomic Disadvantage  Childhood poverty is a daily reality for about 1 in 5 children in the U.S. and is especially pronounced among Native American/First Nations and African American children  These impairments may be due to the pronounced effect on pre-frontal cortex development stemming from the social inequalities of chronic poverty Sex Differences  Boys and girls express their problems in difference ways  Hyperactivity, autism, childhood disruptive behaviour disorders, and learning and communication disorders are more common in boys than girls; anxiety disorders, adolescent depression, and eating disorders are more common in girls than boys  Boys show higher rates of early onset disorders that involve some form of neurodevelopmental impairment, and girls show more emotional disorder, with a peak age of onset in adolescence  Resilience in boys is associated with households in which there is a male role model ; structure; rules; and some encouragement of emotional expressiveness  Girls who display resilience come from households that combine risk taking and independence with support from a female caregiver Race and Ethnicity  Cultural anthropologists today believe that race is a socially constructed concept, not a biological one  This helps explain why very few emotional and behavioural disorders of childhood occur at different rates for different racial groups  Even though rates of problems are similar, significant barriers remain in access to, and quality and outcomes of, care for minority children  Misunderstanding and misinterpreting behaviours have led to tragic consequences, including inappropriately placing minorities in the criminal and juvenile justice systems  Poverty and exclusion from society’s benefits, this is referred to as marginalization Culture  The values, beliefs, and practices that characterize a particular ethnocultural group contribute to the development and expression of children’s disorders, and affect how people and institutions react to a child’s problem  Children express their problems somewhat differently across cultures  Because of cultural influences, it is important that research on abnormal child behaviour not be generalized from one culture to another unless there is support for doing so  Social and cultural beliefs and values are likely to influence the meaning given to these behaviour, the ways in which they are responded to their forms of expression, and their outcomes Child Maltreatment and Non-Accidental Trauma  Each year nearly 1 million verified cases of child abuse and neglect occur in the U.S. and more than 80,000 in Canada  Phone surveys of children and youths between 10 and 16 years of age estimate that more than one third of children in that age bracket experience physical and or sexual assault during these ages  In a telephone survey of more than 4,000 youths between 12 and 17 years of age, 16% of boys and 19% of girls met the criteria for either post-traumatic stress disorder, major depressive episode, or substance abuse dependence in relation to acts of violence Special Issues Concerning Adolescents and Sexual Minority Youths  Mortality rates more than triple between late childhood and early adulthood, primarily as the result of risk-taking behaviours  Growing up in a society that is predominately heterosexual – and largely biased against other sexual identities – makes adolescence a particularly difficult time for lesbian, gay, bisexual, or transgendered (LGBT)  They are more likely to be victimized by their peers as well as by family members, and report more bullying, teasing, harassment, and physical assault than other students  LGBT youths have higher rates of mental health problems, including depression and suicidal behaviour, substance abuse, and risky sexual behaviour, compared to their heterosexual counterparts Lifespan Implications  The impact of children’s mental health problems is most severe when the problems continue untreated for months or years  Lifelong consequences are exceedingly costly SECTION SUMMARY  A clear understanding of both normal and abnormal child development and behaviour is needed to decide which problems are likely to continue and which might be outgrown  About one children in eight has a mental health problem that significantly impairs functioning  A significant proportion of children do not grow out of their childhood difficulties, although the ways in which these difficulties are expressed are likely to change in both form and severity over time  Mental health problems are unevenly distributed. Children who experience more social and economic disadvantage or inequality and children exposed to more violent, inadequate, or toxic environments are disproportionately afflicted with mental health problems  A child’s biological sex, ethnic background, and cultural surroundings are all important contributors to the manner in which his or her behavioural and emotional problems are expressed to and recognized by others  Many childhood problems can have lifelong consequences for the child and for society CHAPTER 2  Contextual events in the family or school environment exert considerable influence over an individual’s course of development Theoretical Foundations  Most clinical and research activity begins with a theoretical formulation for guidance and information  A theory permits us to make educated guesses and predictions about behaviour based on samples of knowledge, moving us forward to explore possible explanations  The study of the causes of childhood disorders is known as etiology – it considers how biological, psychological, and environmental processes interact to produce the outcomes that are observed over time  Biological determinants has focuses on possible causes such as structural brain damage or dysfunction, neurotransmitter imbalances, and genetic influences  Psychological and environmental models emphasize the role of environmental toxins, early experiences, learning opportunities, disciplinary practices, family systems, and sociocultural contexts Underlying Assumptions Abnormal Development is Multiply Determined  Multiply determined simply means that we have to look beyond the child’s current symptoms and consider developmental pathways and interacting events that, over time, contribute to the expression of a particular disorder  Take into account multiple influences, including developmental profile and abilities, home and school environment, and the ongoing, dynamic interactions among these factors Child and Environment are Interdependent  The child and environment are interdependent – how they influence each other  Children also influence their own environment  The concept of interdependence appreciated how nature and nurture work together and are interconnected  Children elicit different reactions from the same environment; different environments, such as home or school, elicit different reactions from the same child  Dynamic interactions of a child and environment is called transaction  Both contribute to the expression of a disorder, and one cannot be separated from the other Abnormal Development Involves Continuities and Discontinuities  Some forms of abnormal child development may be continuous or discontinuous across childhood, adolescence, and adulthood, in either a consistent or transformed manner  Continuity implies that developmental changes are gradual and quantitative (expressed as amounts that can be measures numerically, such as changes in weight and height) and that future behaviour patterns can be predicted from earlier patterns  Discontinuity implies that developmental changes are abrupt and qualitative (expressed as qualities that cannot be measured numerically, such as changed in mood or expression) and that future behaviour is poorly predicted by earlier patterns  Continuity refers to patterns of behaviour, rather than specific symptoms that remain over time. It is well supported for early onset and persistent conduct disorders, which have a significant likelihood of later evolving into serious antisocial acts  Other behaviours like eating disorders seem to follow a more discontinuous pattern; they occur more suddenly and without much prior warning  Sometimes discontinuity can refer to an unexpected or atypical outcome, such as a child who shows normal development until about 18 months of age and then displays loss of language and reduced social engagement (characteristics of autism)  Positive factors such as individual competence or social intervention, as well as negative factors such as poverty or discrimination, can influence the continuity or discontinuity of development Not in the textbook  Piaget’s Children (carefully watched his own children to develop his ideas about adaptation)  Organization:  Arranging information into structures he called schemes (arrangement of information in our head of how we understand the world)  Adaptation:  In adjusting to our environment we can: assimilate (fit into scheme) or accommodate (alter scheme – i.e. what you thought you knew, you need to change definition. i.e. every table had to have four legs, and then you see one with five or six)  Piaget’s Stages of Cognitive Development  Sensorimotor stage  Everything you pick up as a baby you want to taste, smell, bang it. Use all senses to can to figure out what world means  Preoperational  Start to have symbolic representation; even though they can’t see you during peekaboo they know you’re there)  Concrete operational  Take two glasses of water in same glass of same amount pour one into small short and one into large skinny – just because shape changed doesn’t mean amount did  Formal operational stage  We begin to think abstractly – beyond the concrete (think about the future) SECTION SUMMARY  A theory allows us to make educated guesses and predictions about behaviour that are based on existing knowledge, and it allows us to explore these possible explanations empirically  A central theme of this text is the importance of considering multiple, interactive causes for abnormal behaviour, in conjunction with the major developmental changes that typically occur  Three underlying assumptions about abnormal development are stressed: it is multiply determined, the child and the environment are interdependent, and abnormal development involves continuities and discontinuities of behaviour patterns over time  The complexity of abnormal child behaviour requires consideration of the full range of biological, psychological, and sociocultural factors that influence children’s development Developmental Considerations  Psychological disorders are an indication of Adaptational failure in one or more areas of development  Adaptational failure is the failure to master or progress in accomplishing developmental milestones Organization of Development  Change and reorganization are fundamental aspects of biological and behavioural systems  An organizational viewpoint looks closely at the psychological processes that may explain how these systems influence each other  In the organization of development, early patterns of adaptations, such as infant eye contact and speech sounds, evolve with structure over time and transform into higher-order functions such as speech and language  An organizational view of development implies and active, dynamic process of continual change and transformation  Sensitive periods are windows of time during which environmental influences on development, both good and bad, are enhanced. For example, infants are highly sensitive to emotional cues and proximity to their caregivers, which assists them in developing secure attachments. Toddlers are sensitive to the basic sounds of language, which helps them distinguish sounds and combine them to form words  A child’s current abilities or limitations are influenced by prior accomplishments Developmental Psychopathology Perspective  Developmental psychology emphasized the importance of developmental processes and tasks  This approach uses abnormal development to inform normal development, and vice versa  It also provides a useful framework for organizing the study of abnormal child psychology around milestones and sequences in physical, cognitive, social-emotional, and educational development  To understand maladaptive behaviour adequately, one must view it in relation to what is normative for a given period of development  This perspective emphasized the importance and complexity of biological, familial, and sociocultural factors in predicting and understanding developmental changes  Developmental cascades refer to the process by which a child’s previous interactions and experiences may spread across other systems and alter his or her course of development – like a chain reaction SECTION SUMMARY  Children’s development is organized, which means that early patterns of adaptation evolve over time and transform into higher-order functions in a structured, predictable manner  Developmental psychopathology provides a useful framework for organizing the study of abnormal child psychology around milestones and sequences in psychical, cognitive, social-emotional, and educational development Biological Perspectives  A neurobiological perspective acknowledges and recognizes the need to incorporate environmental influences in accounting for disorders  The examination of biological influences begins with the amazing process of neural growth and differentiation. During pregnancy, the fetal brain develops from a few million all-purpose cells into a complex organ made up of billions of specialized, interconnected neurons  Axonal connections, or synapses, form the brain’s circuits and lay the foundation for further growth and differentiation  By the fifth month of prenatal development, most axons have reached their general destination, although there are far more axons that the target cells can actually accommodate  During early childhood, synapses multiply; then selective pruning reduces the number of connections in a way that gradually shapes and differentiates the important brain functions Neural Plasticity and the Role of Experience  The brain shows neural plasticity (i.e. malleability or use-dependent anatomical differentiation) throughout the course of development  Neural plasticity means the brain’s anatomical differentiation is use-dependent: nature provides the basic processes, whereas nurture provides the experiences needed to select the most adaptive network of connections, based on the use and function of each  Experience plays a critical role in brain development, with transaction occurring between ongoing brain development and environmental experiences  Prenatal environment  Childhood illness and diet  Early caregiving, including maltreatment, inadequate stimulation, and attachment  A transactional model is needed to explain normal and abnormal development  Because the structure of a child’s brain remains surprisingly malleable for months and even years after birth, transaction occurs between ongoing brain development and environmental experiences; neither nature nor nurture is sufficient to explain the complexity of the developing brain  Children’s early caregiving experiences play an especially important role in designing the parts of the brain involved in emotion, personality, and behaviour  Maturation of the brain is an organized, hierarchical process with brain structures restructuring and growing throughout the life span  Primitive areas, which govern basic sensory and motor skills, mature during the first 3 years of life  Perceptual and instinctive centers (the limbic system) are strongly affected by early childhood experiences  Prefrontal cortex and cerebellum are not rewired until a person is 5 to 7 years old  Major restructuring occurs between ages 9 and 11 due to pubertal development and again in adolescence  Process of Myelination = white matter = faster processing  As the brain is shaped by early experiences, consequences of traumatic experience may be difficult to change  Problems or disruptions occurring at a younger age are typically associated with more sever organic disorders and CNS complications  Safeguards such as proper prenatal care, proper nutrition, and avoidance of tobacco or alcohol during pregnancy are important in reducing the risk of complication and lifelong disabilities Genetic Contributions  Each person’s specific genome (20,000 to 25,000) is established at conception, and genes contain genetic information from each parent (22 pairs, XY=male, XX=female)  Some genetic influences are expressed early in development (shyness, behavioural inhibition), while others show up years later (depressive cognitive style)  Expression of genetic influences is malleable and responsive to social environment  Rarely is one gene the single cause of a disorder The Nature of Genes  A gene is a stretch of DNA, which produces a protein  Proteins produce tendencies to respond to the environment in certain ways  Genes influence how we respond to the environment, and the environment influences our genes (Gene- environment interaction – G X E)  Behavioural genetics investigates possible connections between genetic predisposition and observed behaviour, taking into account environmental and genetic influences  Twins studies can provide a powerful research strategy for examining the role of genetic influences in disorders  Each of us may have genetic vulnerabilities, tendencies, and predispositions, but rarely are the outcomes inevitable Behavioural Genetics  Behavioural genetics: a branch of genetics that investigates possible connections between a genetic predisposition and observed behaviour, taking into account environmental and genetic influences  Family aggregation studies cannot control for environmental variables that may also contribute to a particular outcome  To increase scientific rigor following suggestive familial aggregation studies, researchers may conduct twin studies to control for the contribution of genetic factors Molecular Genetics  Molecular genetics directly assess the association between variations in DNA sequences and variations in a particular trait or traits – variations in genetic sequences are thought to cause the variations in the trait(s)  Used to identify specific genes for a childhood disorder, including autism, ADHD, and learning disabilities  Long-term goal is to determine how genetic mutations alter how genes function in the development of the brain and behaviour of different psychopathologies  Addresses only a small part of genetic risk  Genetic influences are probabilistic, not deterministic  Most forms of abnormal behaviour are polygenic: many susceptibility genes interacting with each other and with environmental influences Neurobiological Contributions Brain Structure and Function  The brain stem  Located at the base of the brain, handles most of the autonomic functions necessary to stay alive  The hindbrain contains the medulla, the pons, and the cerebellum. It provides essential regulation of autonomic activities such as breathing, heartbeat, and digestions, and the cerebellum controls motor coordination  The midbrain coordinates movement with sensory input. It houses the reticular activating system (RAS), which contributes to processes of arousal and tension  The diencephalon contains the thalamus and hypothalamus, which are both essential to the regulation of behaviour and emotion. It functions primarily as a relay between the forebrain and the lower areas of the brain stem  The forebrain  The limbic (or border) system contains a number of structures that are suspected causes of psychopathology, such as the hippocampus, cingulate gyrus, septum, and amygdala. These regulate emotional experiences and expressions and play a significant role in learning and impulse control. It also regulates the basic drives of sex, aggression, hunger, and thirst  The basal ganglia houses the caudate nucleus. This area regulates, organizes, and filters information related to cognition, emotions, mood, and motor function, and it has been implicated in ADHD; disorders affecting motor behaviour, such as tics and tremors; and OCD  The cerebral cortex is the largest part of the forebrain. It allows us to plan, reason, and create. It is divided into the left hemisphere (verbal and other cognitive processes – dominant in right-handed persons) and the right hemisphere (social perception and creativity – dominant in left-handed persons). Researchers believe that each hemisphere plays a different role in certain psychological disorders.  New growth and restructuring during adolescence and early adulthood results in further maturation of lobes in the brain (temporal, parietal, and frontal lobes)  The frontal loves contain the functions underlying most of our thinking and reasoning abilities, including memory  These enable us to make sense of social relationships and customs and to related to the world and the people around us The Endocrine System  This is an important regulatory system that has been linked to anxiety and mood disorders  Endocrine glands produce hormones  Adrenal glands produce epinephrine and cortisol: response to stress  Thyroid gland produces thyroxine: implicated in certain eating disorders  Pituitary gland produces regulatory hormones like estrogen and progesterone: implicated in a variety of disorders  Hypothalamic-pituitary-adrenal (HPA) axis has been implicated in several disorders, especially anxiety and mood disorders as it is a central component of the brains neuroendocrine response to stress  The hypothalamus carries out the commands it receives from the pituitary gland and other hormones. The pituitary gland in turn stimulates the adrenal glands to produce epinephrine and the stress hormone known and cortisol Neurotransmitters  Neurotransmitters make biochemical connections between different parts of the brain  Neurons more sensitive to a particular neurotransmitter, such as serotonin, cluster together and form brain circuits – paths from one part of the brain to another  Neurotransmitters most commonly implicated in psychopathology include serotonin, benzodiazepine-GABA, norepinephrine, and dopamine  Psychoactive drugs work by either increasing or decreasing the flow of various neurotransmitters  Changes in neurotransmitter activity may make people more likely or less likely to exhibit certain kinds of behaviour in certain situations, but they do not cause the behaviour directly NEUROTRANSMITTER NORMAL FUNCTIONS IMPLICATED ROLE IN PSYCHOPATHOLOGY Benzodiazepine-GABA Reduces arousal and moderates Anxiety disorder emotional responses, such as anger, hostility, and aggression It is linked to feelings of anxiety and discomfort Dopamine May act as a switch that turns on variouSchizophrenia brain circuits, allowing other Mood disorders neurotransmitters to inhibit or facilitaADHD emotions or behaviour Is involved in exploratory, extroverted, and pleasure-seeking activity Norepinephrine Facilitates or controls emergency Not directly involved in specific disorders reactions and alarm responses (regulates or modulates behavioral Plays a role in emotional and behaviouratendencies) regulation Serotonin Plays a role in information and motor Regulatory problems such as eating and coordination sleep disorders Inhibits children’s tendency to explore OCD their surroundings Schizophrenia and mood disorders Moderates and regulates a number of critical behaviours, such as eating, sleeping, and expressing anger SECTION SUMMARY  Brain functions undergo continual changes, described as neural plasticity, as they adapt to environmental demands  Genetic influences depend on the environment. Genetic endowment influences behaviour, emotions, and thoughts; environmental events are necessarily for this influence to be expressed  Gene-environmental interactions (GXE) explain how the environment shapes our genotype thought a process known as epigenetics  Neurobiological contributions to abnormal child behaviour include knowledge of brain structures, the endocrine system, and neurotransmitters, all of which perform their functions in an integrated, harmonious fashion Psychological Perspectives Emotional Influences  Emotional reactions assist us in our flight or fight response – to alert us to danger and to ensure our safety  Emotions give special value to events and make particular actions most likely to occur  Emotions are key to health adaptation, and are at the foundation of early personality development  They serve as important internal monitoring and guidance systems designed to appraise events as either beneficial or dangerous, but also provide motivation for action  Children have a natural tendency to attend to emotional cues from others  Emotions are a primary form of communication for young children, per mitting them to explore their world with increasing independence Emotion Reactivity and Regulation  Emotion reactivity refers to individual differences in the threshold and intensity of emotional experience, which provide clues to an individual’s level of distress and sensitivity to the environment  Emotion regulation involves enhancing, maintaining, or inhibiting emotional arousal, which is usually done for a specific purpose or goal  Problems in regulation: weak or absent control structures  Problems in dysregulation: existing control structures operate maladaptively; may be adaptive in some situations and maladaptive in others  Children’s emotion regulation abilities are important signals of normal and abnormal development  Child-caregiver relationship plays a critical role (authoritative parents) Not in textbook Parenting Styles Barbara Coloroso  Authroitarian (brick wall)  Low warmth, high control  Authoritative (backbone)  High warmth, high control  Permissive (jelly fish)  High warmth, low control  Rejecting/Neglecting  Low warmth, low control Temperament and Early Personality Styles  The development of emotion regulation or dysregulation is thought to derive from both socialization and innate predispositions, or temperament  Temperament refers to the child’s organized style of behaviour that appears early in development (early building block of personality)  There are three primary dimensions of temperament:  Positive affect and approach  The “easy child”  Approachable and adaptive to their environment and possesses the ability to regulate basic functions of eating, sleeping, and elimination relatively smoothly  Fearful or inhibited  The “slow to warm up child”  Cautious in their approach to novel or challenging situations. They are more variable in self-regulation and adaptability, and may show distress or negativity towards some situations  Negative affect or irritability  The “difficult child”  Predominantly negative or intense in mood, not very adaptable, and arrhythmic. Shows distress when faced with novel or challenging situations, and others are prone to general distress or irritability  Temperament may influence later development by affecting a child’s development of self-control  A balance between emotional reac
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