Developmental Psychopathology

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Developmental Psychopathology

Developmental psychopathology is an approach or field of study designed to better understand the complexities of human development. Its primary goal is to chart the diverse pathways individuals take in the development of psychological difficulties (e.g., aggression, depression, substance use) and normal or optimal psychological health (e.g., self-esteem, scholastic success, moral development). Several key questions guide developmental psychopathology. First, how are individuals similar to and different from each other in the healthy and maladaptive paths they take as they grow older? Second, what accounts for why individuals experience differences in psychological functioning over time? For example, what characteristics within (e.g., genes, personality, perceptions of relationships) and outside (e.g., family relationships, neighborhoods) the individual are responsible for similarities and differences in psychological development over time? Third, what consequences do people's histories of experiences, coping, and adjustment have on their subsequent mental health? Because developmental psychopathology, as an approach, is concerned with answering a broad set of questions, it can be usefully applied to a number of specialty areas in psychology, biology, and sociology.

Risk and Resilience

Understanding why some children develop disorders or maladaptation whereas other children develop normally necessitates considering a host of factors that may undermine or foster healthy adjustment. The search for these factors is guided, in part, by the notion that interdependency exists among parts in any system, that is, the principle of holism. Thus, in any system or unit of study, parts must be examined in the fabric of the larger context of the system. For example, the way parents interact with children is a key factor that affects children's development.

However, the impact of parenting practices on children is affected by other characteristics in the larger ecological context, including child or parent characteristics (e.g., temperament, personality), the quality of family relationships, and parameters in the community (e.g., neighborhood, schools, peer relations) and culture. Consequently, the effects and meaning of parenting practices must be examined in the context of the larger setting or ecology. For example, the effects of various parenting practices on children vary across different ethnic groups. Thus, although strict parental discipline styles increase children's risk for psychological difficulties (e.g., anxiety, depression, submissiveness, poor self-confidence) among white families, the same discipline styles pose little or no risk for children in Asian or African U.S. families (Chao 1994; Deater-Deckard et al. 1996; Steinberg, Dornbusch, and Brown 1992). A possible explanation for these findings is that the same parenting practices take on different meanings in families with different cultural backgrounds. For example, strict control may be interpreted as a sign of involved, caring, and effective parenting within certain ethnic and cultural groups (Chao 1994; Baumrind 1997).

Thus, child development is best understood as embedded in a variety of social and ecological contexts, including community, cultural, and ethnic contexts of child development (Bronfenbrenner 1979). By extension, both normal and abnormal development are regarded as a cumulative result of multiple influences originating in the child, family, and larger community or cultural setting.

The Complexity of Risk Processes

By definition, risk factors increase the likelihood of experiencing psychological difficulties. Family risk factors include child maltreatment, parental rejection, lax supervision, inconsistent or harsh discipline practices, parental conflict, unsupportive family relations, and parental mental illness and substance use. However, exposure to even the most harmful risk factors does not doom all or even most children to a life of psychological problems. Also, children exposed to the same risk factor may have a range of healthy and maladaptive psychological outcomes. For example, although parental depression is one of the most robust risk factors, children of depressed parents exhibit a wide range of adaptive and maladaptive outcomes (e.g., depression, anxiety, aggression, academic problems) (Cummings and Davies 1994). Moreover, exposure to parental mental illness does not affect children in a psychological vacuum. Instead, parental psychopathology (e.g., depression, alcoholism) often co-occurs with other risk factors: familial (e.g., parenting impairments, marital discord, poor parent-child relations); sociocultural (e.g., poverty, community isolation); and biological (e.g., transmission of risk through the operation of genes, birth complications, temperament). These risk factors may contribute to the caustic effects of growing up in depressive or alcoholic families. Consequently, to better understand the development of psychological problems, developmental psychopathologists advocate moving beyond simply identifying individual risk factors that increase the likelihood of disorder to answer more complex questions of: When, how, and why do only some children exposed to risk develop problems?

Mediating mechanisms. The search for mediators answers the question of "how" and "why" risk conditions lead to maladaptive outcomes. Mediators are the processes or mechanisms that explain or account for why family characteristics increase children's risk for psychopathology. Returning to the example of parental depression, a primary goal of a developmental psychopathologist would be to identify the mechanisms by which parental depression leads to child behavior problems. For example, parental depression is associated with increases in parental conflict and poor parenting practices. The stressfulness of experiencing parental conflict and poor parenting practices, in turn, may directly compromise children's mental health. It is also important to understand the mechanisms that underlie or account for the effects of mediating processes. For example, although the focus on parental conflict and poor parenting practices provide part of the answer to why parental depression is a risk factor, we are still not at the level of specifying the response processes in children that ultimately lead to disorder. For example, the stressfulness of parental conflict and poor parenting practices may negatively affect the way children function and cope in various settings (e.g., family, school) on a day-to-day basis. These daily difficulties in functioning in certain settings may eventually grow into disorders that are stable across time and setting.

Moderating conditions. The search for moderators in models of risk answers questions of "who" is a greatest risk and "when" is the risk greatest. Thus, the assumption is that the likelihood that a risk factor leads to disorder varies across different individuals (i.e., who is at greater risk) and conditions (i.e., when is the risk greatest). Answering the question of who is at greatest risk involves searching for attributes of the person (e.g., gender, temperament, personality) that might amplify or increase the likelihood that they will experience a disorder when exposed to risk. For example, parental discord is especially likely to increase psychological problems for children who have difficult, rather than easy, temperaments (Davies and Windle 2001). Attributes outside the person (i.e., family, school, community, peers) may also intensify the effects of the risk factor. For example, Michael Rutter and colleagues (1976) found that the risk for psychopathology in children exposed to any one of six family risk factors (e.g., family discord, maternal psychiatric disorder, family dis-solution) was comparable to risk for children who experienced no risk factors. However, experiencing two or three risk factors increased the incidence of children's psychiatric problems threefold.

Resilience and the Role of Protective Factors

Even when multiple risk factors are present, many, if not most, children at risk develop along normal, adaptive trajectories. Developmental psychopathologists use the term resilience to refer to children who develop competently and adapt successfully to life's challenges under adverse conditions (Cummings, Davies, and Campbell 2000). Resilience, by definition, cannot occur without some appreciable risk. Thus, a primary challenge is to distinguish between two general groups of competent children: (a) the relatively "normal" children, who experience minimal or no adverse conditions, and (b) the resilient children, who developed relatively normally in the face of considerable risk (Garmezy 1985; Luthar 1993). For example, it cannot be assumed that children of depressed parents who experience healthy development are resilient. Some of these children may, in fact, experience benign contexts of development characterized by parental warmth, consistent discipline, safe and supportive neighborhoods, and high quality schools. Thus, the competence of some of these children may result from the absence of risk rather than the presence of resilience.

Developmental psychopathologists are also sensitive to the notion that resilience is best characterized as consisting of multiple dimensions or features that may change over time. Thus, resilient outcomes are not simply "traits" that individuals have and carry with them across time and setting. These individuals are, by no means, regarded as "invincible" or "invulnerable" to adversity. Rather, resilient children may experience bouts of considerable problems over time or within certain domains of functioning. For example, children may experience normal functioning in one domain of adjustment (e.g., academic achievement) while experiencing difficulties in another domain of functioning (e.g., loneliness, anxiety).

Developmental psychopathologists further emphasize that how resilience is defined may change across contexts and people. For instance, among white, middle-class groups of children, peer ratings of popularity and social competence have been associated with greater academic competence (e.g., better grades) and behavioral competence (e.g., low levels of aggression). In contrast, high-risk inner-city adolescents who were popular among their peers displayed higher levels of conduct (e.g., aggression) and academic problems. In this same group of children, academic competence came at a cost of experiencing lower peer popularity, social isolation, and anxiety problems. Thus, for developmental psychopathologists, identifying who is "resilient" is no simple matter. Resilience is regarded as a complex process that may vary across context (e.g., subculture or culture), domain of functioning (e.g., academic, social, emotional), and the developmental stage of individuals (e.g., children versus adolescents).

Once people who meet the criteria for exhibiting resilience are identified, the next step is to search for the protective factors that account for their healthy outcomes. Protective factors, which are also called buffers, are moderators that dilute or counteract the negative effects of risk factors. Like risk factors, protective factors can be characteristics of the individual (e.g., personality) or larger ecological setting (e.g., family, school, peers). For example, child intelligence appears to offset the negative effects of interparental conflict on children (Katz and Gottman 1997). Likewise, various family characteristics and relationships (e.g., parental warmth, good sibling relations) appear to act as buffers that help shield children from the risk posed by parental conflict (Cummings and Davies 2002).

The Transactional Nature of Risk and Protective Factors

An assumption of developmental psychopathology is that humans are active agents in influencing their own development. Thus, children are not simply at the mercy of the family that raises them. Rather, the family is part of a transactional, developmental process that not only influences child development, but is also influenced by child development over time. For example, in explaining the development of childhood aggression, the early starter hypothesis stresses that the development of childhood aggression is set in motion by an escalating, reciprocal spiral of negativity and distress in the parent-child relationship rather than in the parent or child alone (Patterson and Yoerger 1997). In this reciprocal process involving an inconsistent parent and difficult child, the parent first responds to child misbehavior with aversive, hostile behavior. In reaction, the child, in turn, maintains or escalates the negative behavior. Sometime during this escalating cycle of negativity, the inconsistent parent eventually displays neutral or positive behavior toward the child as a means of escaping the aversive interaction. However, in the course of surrendering and ending the negative disciplinary bout, the parent inadvertently reinforces or encourages the intensification of child misbehavior. This process may eventually evolve into more persistent behavior problems. Thus, the development of mental health and disorder is an ever-changing product of the mutual, reciprocal influences between the child and his or her family and ecological setting.

Risk and Resilience From a Developmental Perspective

Embedding the "psychopathology" component (i.e., risk and protection) within the "developmental" component in developmental psychopathology requires understanding resilience and maladaptation within broader windows of time instead of a single snapshot at a particular point in the life span. The value of examining risk and resilience from a developmental perspective is supported by three key themes in developmental psychopathology: (a) the dynamic nature of risk and resilience, (b) stage-salient or developmental tasks, and (c) the multiplicity of developmental pathways.

The Dynamic Nature of Risk and Resilience

Developmental psychopathologists stress that the nature of risk and resilience may vary considerably over parts of the life span. First, risk and protective factors differ in terms of their duration and patterning over time. For example, the degree of risk to children of depressed parents depends on their history of exposure to parental depression (e.g., length, frequency), with lengthier and more frequent bouts markedly increasing children's risk for disorder (e.g., Campbell, Cohn, and Meyers 1995). Thus, in understanding why some children develop disorders and others do not, it may be useful to distinguish between transient (e.g.., short-term, temporary conditions) and enduring (e.g., conditions persisting over significant parts of the life span) risk and protective factors (Cicchetti and Toth 1995)

Second, disorders often follow the course of several stages, including onset, maintenance (i.e., continuation of symptoms), remission (i.e., temporary alleviation of symptoms), recurrence (i.e., redevelopment of symptoms) and termination. Each of these stages of maladaptation may be associated with different sets of factors, causes, and consequences. For example, family conflict may play a causal role in the onset of children's conduct problems, but peers and teachers may maintain or further intensify the problems even in the face of marked reductions in family conflict (Fincham, Grych, and Osborne 1994).

Third, individuals may vary in how susceptible they are to risk factors across different parts of the life span. Thus, some models of developmental psychopathology have stressed that children may be most vulnerable to parental depression during the periods of infancy and adolescence (e.g., Cummings and Davies 1994; Gelfand and Teti 1990). However, since age and developmental periods are rather crude markers for the actual processes that increase vulnerability, this information cannot tell us why certain age groups are especially likely to develop disorders in the face of risk. On the one hand, age differences in risk may result from differences in experiences with risk. For example, adolescents of depressed parents may be especially likely to develop disorders because, on average, they have been exposed to depression for a longer period of time than younger children. On the other hand, age differences may also result from the operation of sensitive periods, in which specific risk factors have especially strong influences on individuals within certain periods of the life span (Cicchetti 1993). Thus, the stress of living with a depressed parent may more easily overwhelm adolescents than children because they (a) are more sensitive to family distress; (b) face more developmental challenges (e.g., career decisions, independence from parents, establishment of dating relationships); and (c) must cope with especially an especially large number of stressful events (e.g., establishment of romantic relationships) (Davies and Windle 1997).

Developmental or Stage-Salient Tasks

Developmental psychopathologists commonly view development as a series of biological, psychological, and social challenges that become especially important or salient during a certain period of the life span and remain important throughout the individual's lifetime (Cicchetti 1993). Thus, each developmental period (e.g., infancy, toddlerhood, preschool, school-age, early adolescence) is accompanied by important developmental tasks. For example, during infancy, babies are faced with the challenges of managing biological functions (e.g., eating and sleeping routines, distress and arousal) and forming emotionally meaningful relationships, especially with parents. The transition to toddlerhood is characterized by a new set of challenges, including effectively exploring the social and physical worlds, achieving a sense of mastery and autonomy in the face of new problems and tasks, and acquiring a sense of right and wrong.

Although the quality of family relationships plays an important role in the children's achievement of developmental tasks, the relationship between the family and children's developmental tasks is best viewed as reciprocal or bidirectional. In reflecting the influence of parents on children, infants are more likely to form strong, trusting relationships with caregivers when their caregivers are sensitive and responsive to their signals (e.g., accurately diagnosing the source of infant distress and taking action to help manage the distress; carefully timing and pacing interactions with infants). Conversely, in reflecting children's effects on parents, challenges that arise in each developmental period during childhood create new challenges for parenting. Thus, as children reach the toddler years, their emerging sense of autonomy, individuality, and motivation to explore the world generate a new set of challenges for parents centered on developing effective, consistent methods of supervising and disciplining their toddlers and implementing clear, realistic expectations for the child (Cummings, Davies, and Campbell 2000).

Stage-salient tasks in the earlier developmental periods serve as building blocks or tools for successfully overcoming future developmental challenges. For example, developing trusting emotional relationships with sensitive, responsive primary caregivers is accompanied by relatively favorable thoughts and expectancies about the self and larger social world. The resulting self-confidence and social interest may, in turn, increase children's chances of successfully exploring the world and developing a sense of mastery and autonomy. The opposite also applies: Failing to resolve developmental tasks in healthy ways (e.g., insecure, untrusting relations with parents) reduces children's chances of successfully dealing with developmental tasks later in life. Consequently, the study of adaptation and maladaptation is defined by children's history of success in managing and coping with developmental tasks.

Multiple Developmental Pathways

Resolving earlier developmental tasks does not guarantee that children will successfully overcome later challenges. By extension, children who experience difficulties with earlier developmental challenges are not destined to develop problems in coping with tasks later in life. Change is always possible. Thus, although many children who begin their lives along healthy developmental paths may continue to traverse along healthy paths, some of these children will also evidence discontinuity in their development. In other words, they will experience difficulties in adapting to subsequent developmental challenges despite having the advantage of experiencing healthy development in earlier developmental periods. Similarly, even though many children who suffer from problems early in life will continue to experience difficulties later in life, many of them will be able to "grow out" of their problems by successfully handling later developmental challenges. So, children who begin on the same path may end up in very different places later in life. Still other children who begin life on different developmental paths may end up resembling each other later in life. Development, then, is characterized by many different starts and stops and multiple directions toward competence and disorder.

A key assumption is that change and diversity in developmental paths is, in large part, predictable or understandable when it is evaluated in the larger context of each child's current and past experiences with risk and protective factors. For example, changes in the balance among exposure to risk and protective factors in the family may account in part for why some children develop disorders or difficulties after experiencing earlier histories of adaptive functioning, whereas other children are able to eventually develop normally after experiencing earlier difficulties. Thus, the emergence of later problems may result from increases in exposure to family risk factors (e.g., poor parental supervision, family instability or divorce, high parental conflict, parent depression) and decreases in the accessibility of protective factors (e.g., positive parent-child relationships, supportive family relations). Similarly, children who eventually reclaim healthy trajectories may have been able to benefit from greater access to family resources or protective factors (e.g., development of a positive relationship with a new caregiver), especially relative to their exposure to forms of family risk (e.g., decreases in conflict between primary caregiver and former romantic partner).

Conclusion

In conclusion, the developmental psychopathology perspective views adjustment and development as a dynamic, cumulative result of the reciprocal influences between child, family, and ecological characteristics across time. In studying family relationships, the developmental psychopathology approach highlights: (a) the complex, interdependent relations among different family characteristics and relationships; (b) the role ecological characteristics play in altering or affecting family relations (e.g., culture or subculture, peer relations, school); and (c) the multiple, developmental pathways taken by individuals and families across the life span.

Bibliography

baumrind, d. (1997). "necessary distinctions." psychological inquiry 8:176–182.

bronfenbrenner, u. (1979). the ecology of human development: experiments by nature and design. cambridge, ma: harvard university press.

campbell, s. b.; cohn, j. f.; and meyers, t. (1995). "depression in first-time mothers: mother-infant interaction and depression chronicity." developmental psychology 31:349–357.

chao, r. k. (1994). "beyond parental control and authoritarian parenting style: understanding chinese parenting through the cultural notion of training." child development 65:1,111–1,119.

cicchetti, d. (1993). "fractures in the crystal: developmental psychopathology and the emergence of the self." developmental review 11:271–287.

cicchetti, d., and toth, s. l. (1995). "a developmentalpsychopathology perspective on child abuse and neglect." journal of the american academy of child and adolescent psychiatry 34:541–565.

cummings, e. m., and davies, p. t. (1994). "maternal depression and child development." journal of child psychology and psychiatry 35:73–112.

cummings, e. m., and davies, p. t. (2002). "effects ofmarital conflict on children: recent advances and emerging themes in process-oriented research." journal of child psychology and psychiatry 43:31–63.

cummings, e. m.; davies, p. t.; and campbell, s. b.(2000). developmental psychopathology and family process: theory, research, and clinical implications. new york: guilford.

davies, p. t., and windle, m. (1997). "gender-specificpathways between maternal depressive symptoms, family discord, and adolescent adjustment." developmental psychology 33:657–668.

davies, p. t., and windle, m. (2001). "interparental discord and adolescent adjustment trajectories: the potentiating and protective role of intrapersonal attributes." child development 72:1,163–1,178.

deater-deckard, k.; dodge, k. a.; bates, j. e.; and pettit, g. s. (1996). "physical discipline among african american and european american mothers: links to children's externalizing behaviors." developmental psychology 32:1,065–1,072.

fincham, f. d.; grych, j. h.; and osborne, l. n. (1994)."does marital conflict cause child maladjustment: directions and challenges for longitudinal research." journal of family psychology 8:128–140.

garmezy, n. (1985). "stress-resilient children: the search for protective factors." in recent research in developmental psychopathology, ed. j.e. stevenson. oxford: pergamon.

gelfand, d. m., and teti, d. m. (1990). "the effects of maternal depression on children." clinical psychology review 10:329–353.

katz, l. f., and gottman, j. m. (1997). "buffering children from marital conflict and dissolution." journal of clinical child psychology 26:157–171.

luthar, s. s. (1993). "annotation: methodological and conceptual issues in research on childhood resilience." journal of child psychology and psychiatry 34:441–453.

patterson, g. r., and yoerger, k. (1997). "a developmental model for late-onset delinquency." nebraska symposium on motivation 44:119–177.

rutter, m.; tizard, j.; yule, m.; graham, p.; and whitmore, k. (1976). "research report: isle of wight studies 1964–1974." psychological medicine 6:313–332.

steinberg, l.; dornbusch, s. m.; and brown, b. b. (1992)."ethnic differences in adolescent achievement: an ecological perspective." american psychologist 47:723–739.

patrick t. davies e. mark cummings susan b. campbell

International Encyclopedia of Marriage and Family