Transcript Chapter 16: DEVELOPMENTAL PSYCHOPATHOLOGY

Chapter 16
Developmental Psychopathology
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Chapter 16: DEVELOPMENTAL
PSYCHOPATHOLOGY
Abnormality
– Statistical deviance
– Maladaptiveness
• Interferes with personal and social life
• Poses danger to self or others
– Personal distress
– DSM-5 diagnostic criteria (APA)
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Developmental Aspects
Developmental psychopathology – study of
origins and course of maladaptive behavior
• Disorders and
not disease (you have it or
you don’t)
– A pattern of maladaption, not defects
• Social and Age Norms
• Developmental issues
– Nature/Nurture (origin of maladaptive
behaviors)
– Risk factors
– Prediction
The Diathesis-Stress Model
• Diathesis – predisposition or vulnerability
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(genetic, cognitive, personality)
Stress – environmental pressure
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”
• Extreme stress and high vulnerability (severe
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disorder)
Extreme stress and high resiliency (mild
disorder)
Low stress and high vulnerability (mild
disorder)
Low stress and high resiliency (no disorder)
Autism Spectrum Disorder
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Autism
• Begins in infancy: more boys
• Several autistic spectrum disorders
• Impaired social interaction, communication
• Repetitive, stereotyped behaviors
• 75% have intellectual disabilities: 10% have
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savant syndrome
Severe cognitive impairment
Biologically based
Concordance: MZ=60%, DZ= 0%
Autism Spectrum Disorder
• Asperger syndrome
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Normal or above-average intelligence
Good verbal skills
Clear desire to establish social relationships
Deficient social cognitive and social-communication skills
Autism Spectrum Disorder
• Is there an epidemic?
– 1987: autism affected 4 or 5 of every 10,000 children
– 2006: 1 in 110
– Two years later: 1 in 88
Autism Spectrum Disorder
• Why are rates rising?
– Increased awareness
– Broader definition that includes the entire autistic
spectrum (including more mild cases)
– Increased diagnosis
– Variations in diagnostic practices
Mirror Neurons
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
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– “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-5 Criteria: some combination of
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– Inattention subtype
– Hyperactivity/Impulsivity subtype
– Combined subtype
– More boys; 3-5% of US kids
– Comorbidity common
Overactive behavior wanes with age
Attentional, adjustment problems remain
ADHD-Causes and Treatment
• Neurological: low Dopamine, Serotonin
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– Underactivity in frontal lobes
Genetic predisposition; Environmental stress
70% helped by stimulants
– Overprescription a problem
Most successful if combined with behavioral
treatment
Psychostimulants
• Ritalin
• Concerta
• Focalin
• Adderall
• Strattera
• Cylert
Depression
• Childhood
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– Somatic symptoms
– Psychotherapy, medication effective
– Nature/Nurture question
Adolescence
– Often related to childhood symptoms
Adolescence
• Storm and stress
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– Only about 20%
– Heightened vulnerability to psych disorders
Alcohol and drugs are problems
Eating disorders
– Anorexia nervosa; more girls (10/1)
– Bulemia nervosa; binge-eating
– Binge eating disorder
– Some genetic predisposition; stress also
– Psychological treatment usually successful
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Adolescent Depression and Suicide
• 35% depressed; 7% diagnosable
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– Cognitive symptoms
– Behavioral acting out
– Genetic link
– Environmental triggers
Suicide 3rd leading cause of death
– Males commit 3:1 compared to females
– Females attempt 3:1 compared to males
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
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Many undiagnosed and untreated
Elderly can benefit, should NOT be excluded
from treatment
Dementia: deterioration of neural
Alzheimer’s Disease
– Leading cause of dementia
– Progressive and irreversible
Causes of Alzheimer’s
• Senile plaques – masses of dying neural
material with toxic protein called beta amyloid
• The plaque injures/kills neurons
• Neurofibrillary tangles – twisted strands of
neural material
Early-onset form (prior to age 60)-genetic links
Late-onset form (after age 70)-family history not
predictive
Figure 16.6
Aging and Dementia