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Chapter 12

PSYC18H3 Chapter Notes - Chapter 12: Family Therapy, Brain Damage, Physical Abuse

Course Code
G Cupchik

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Chapter 12 – Emotions and Mental Health in Childhood
Emotions and disorders
- Disorders of emotional life in childhood/adolescence are states when they are no longer able
to cope
- Concerned with extremes of emotions: intense and long-lasting states of anxiety, depression
or of anger
- The Case of Peter (child acting out at school as well as at home)
- Classifying childhood disorders
oMental health workers have developed classification systems for clusters of
disordered behaviour
oMain system is that of psychiatric diagnosis, usually by means of an interview
oDiagnoses are descriptions of patterns of behaviour
oFor children reaching these criteria, family and school relationships have often
become extremely strained and the child’s symptoms may have made normal life
oMain scheme used to diagnose psychiatric problems of adults and children in North
America: Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text
Revision(DSM-IV-TR) or International Classification of Diseases, Tenth Revision,
Clinical Modification (ICD-10-CM) Both based on a medical model and focus on
individuals rather than their contexts
oThere is a continuum, (NOT: Having a disorder or not having one). Method of
assessment typically involves checklists of symptoms or behaviour patterns and
sometimes questionnaires
oIn middle childhood, two kinds of emotional disorder become important: externalizing
disorders defined by anger, hostility, aggression, stealing, and lying. Internalizing
disorders include anxiety and depression with tendencies to withdraw.
- How are emotions involved in children’s disorders
oTwo principal emotion-based externalizing disorders of childhood are called
oppositional defiant disorder and conduct disorder
Oppositional defiant disorder (DSM-IV-TR): Over a 6 month period, a child
frequently displays four or more of the following behaviours that lead to an
impairment of social or school life(Loses temper, argues with adults, defies or
refuses adult requests or rules, deliberately does things that will annoy other
people, blames others for own mistakes, is touchy or easily annoyed by others,
is angry and resentful, is spiteful or vindictive)
Criteria for conduct disorder are similar but more seriously antisocial behaviour
such as truanting before age 13, stealing, fire-setting, sexual assault, physical
fights, physical cruelty to people or animals, and use of weapons

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Chapter 12 – Emotions and Mental Health in Childhood
oTwo main types of internalizing disorders: anxiety and depression.
Anxiety disorders are fears that are abnormal in intensity, duration and how
they are elicited (excessive or unrealistic anxiety or worry, with marked tension
for at least six months across a range of areas: future events, incompetence,
self-consciousness, and concerns about previous performance). There is also
separation anxiety with main attachment figures.
Depressive episodes: child feels either very low in mood or has no interest in
anything for at least 2 weeks. Must also have 4 other symptoms (weight
changes, sleep disturbance, fatigue, feelings of worthlessness, inability
concentrate and recurrent thoughts of death or suicide)
- What is disordered? Hypotheses about relationship between emotion and disorder
oPredominance of one emotion system
Tomkins (1962): one emotion becomes prominent (e.g. little girl being
separated from her parents when taken into hospital. Event elicits great fear
and sadness. Subsequent events that have any similarity to the initial eliciting
circumstances then trigger the same emotions, magnifying and amplifying
them. Sees a man with white coat = doctor = Gets scared again)
Dodge and Coie (1987): aggressive and non-aggressive children read vignettes
about one child bumping into another or one child refusing to let another child
play. Are they being deliberately mean? Aggressive children were more likely
to say that the perpetrator was being intentionally hostile. Depressed children
are more likely to make attributions for negative events that are stable (it will
always be like this), internal (it is my fault) and global (all situations will be like
In terms of temperament, boys are more likely than girls: think aggression
enhances self-esteem
In externalizing disorders: children found value gaining control over another
child (social goal of assertion) more than cooperation (social goal of affiliation)
and to value aggressive solutions more positively than their non-aggressive
oInappropriate emotional responses
Children with a disorder react to events with deviant emotional responses
(laughing when someone is distressed, crying when nothing happened, being
angry when someone is friendly) Emotional responses are unsettling and
people find it hard to make sense of them.
Emotions are not properly regulated and inappropriate to the social context

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Chapter 12 – Emotions and Mental Health in Childhood
Rothbart, Ellis and Posner (2004) think of regulation of emotions as a
dimension of temperament, based on effort to direct attention
Eisenberg (2005) relate dysregulation to lack of effortful control so children
with externalizing disorders (not internalizing) are impulsive and low in effortful
regulation of their emotions.
Prevalence of disorders in childhood
- Psychiatric epidemiology: study of how many people show a particular disorder in the
population, statistically relating disorder to factors in people’s lives
- Prevalence is proportion of a population suffering from some disorder over a particular time
- Incidence is the number of new onsets of a particular disorder in a given time
- First major study in children’s psychiatric epidemiology was by Rutter, Tizard and Whitmore
(1970): Isle of Wight
- Epidemiological methods were a breakthrough in understanding origins of disorder and have
helped plan services for children. Psychological instruments assessing presence of disorder
have been developed for use with parents, teachers and children.
- Diagnoses differ according to whether informant is a parent, a teacher or a child. Children
are more closely in touch with fear and anxieties than parents so they report more of them.
Parents are more in touch with externalizing behaviours than children and report more of
them. Reliability of children as respondents increases with age, suggesting a problem
because young children are cognitively immature.
- Externalizing disorders
oYounger children show more externalizing behaviours such as aggressive behaviour,
screaming, cruelty to animals than internalizing behaviours such as sadness, anxiety
and withdrawal
oOppositional defiant disorder is most common in early childhood but conduct disorder
becomes more common later
oBongers (2004): aggression, property violations, and opposition gradually decrease
from age 4 to 8 whereas status violations increase with age
oBoys show more externalizing disorders of all kinds than girls throughout childhood
- Anxiety disorders
oPrevalence of anxiety generally increases with age during childhood
oThe forms that anxiety disorders take change with age: Separation anxiety disorder is
more common in early childhood but overanxious disorder affecting many aspects of
life is more common in adolescence
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