Kuhn, among others, has shown us that science is not entirely objective. To study phenomena, scientists all take a perspective from which they view it. If a perspective is shared by researchers, this is called a paradigm. It is a kind of cognitive frame of reference that includes assumptions and concepts. The advantage of such a (subjective) perspective is that it provides guidelines for the way in which a problem is approached, investigated and interpreted. A disadvantage is that researchers can limit themselves by assuming this perspective and are confined within the boundaries of it. They can limit themselves in the type of research questions or in the interpretation of research results. Despite these disadvantages, it is still smart to take a perspective.
Theories and models
A theory is a formal, integrated set of principles that explains a phenomenon (or multiple phenomena). Scientific theories are supported by evidence. In addition, they offer formal assumptions that can be tested, which can lead to an increase in knowledge. A model provides a description of what is being studied. Models that show that many factors lead to psychopathology are especially interesting for psychology. Interactional models assume that several variables together lead to an outcome. An example of this is the vulnerability stress model. This model is based on multiple vulnerability factors and stress factors that together cause psychopathology. Vulnerability (diathesis) is often regarded as a biological factor and stress as an environmental factor. The biological vulnerability of a child to anxiety (meaning you’re more likely to get anxiety than others), for example, can lead to psychological problems in interaction with the stress of a divorce.
Transactional models are used to investigate both normal and abnormal behaviour. These models assume that the development is the result of continuous, reciprocal transactions between the individual and the environment. The individual is seen as an active being formed by past experiences. The environmental context includes variables that are close to (proximal) or far (distal) away from the person.
Transactional models fall under the system models. System models assume different levels of functioning. The development is the result of interactions between the different levels. Changes at one level affect the other levels. An example of this is the biopsychosocial model, which integrates brain functioning, genes and behaviour with aspects of the social environment. Another example is the ecological model, which states that the individual and the environment influence each other.
The developmental psychopathology perspective integrates research into normal developmental processes with research into psychological disorders in young people. Central to developmental psychopathology is the origin and development of disturbed behaviour, and individual adaptation and competence. Developmental psychopathology is a framework for understanding disturbed behaviour in relation to normal development. It does not provide specific theoretical explanations but integrates different theories and approaches.
Development
The concept of development is hard to define. There is, however, some consensus among theoreticians about the essence of development:
The medical model
Many attempts have been made to explain the aetiology of abnormal development in a relatively simple way. An example of this is the medical model , which states that disorders are the result of biological factors in the person themselves. However, we now know that psychological or behavioural disorders never arise from just one single cause.
To study causal relationships, not only must the contributing factors be identified, but it must also be studied how causal factors work together and what the underlying processes are. A distinction must be made between direct and indirect causes. There is a direct effect if X immediately leads to Y (X → Y). With an indirect effect , X exerts a different influence on some other variable that leads to Y (X -> …… -> Y). An example is the connection between alcohol abuse by parents and performance problems of children. There is an indirect effect in this case, because alcohol abuse leads to marital problems and parental difficulties. This in turn leads to performance problems in the child.
A mediator is a variable that causes an effect (Y) indirectly. Identifying mediators is crucial in understanding causal processes. In the example above, marital problems and parental difficulties are mediators.
The identification of moderators is also important in understanding causal processes. A moderator influences the direction (or strength) of the relationship between an independent variable (predictor) and a dependent variable (criterion). For example, culture can play a moderating role. Beating up your children has different effects on them in different cultures.
A distinction must also be made between necessary, sufficient and contributing causes. A necessary cause must be present for a disorder to manifest itself. A sufficient cause can (without the presence of other factors) be responsible for the occurrence of a disorder. In Down's syndrome, genetic abnormalities are both necessary and sufficient. In schizophrenia, on the other hand, brain abnormalities are necessary, but not sufficient, because there must also be specific environmental factors. Contributing (contributing) causes make a contribution, for which, to cause an actual problem, as specific limit or amount has to be present.
Adjustment
Developmental psychopathology assumes that abnormal behaviour develops gradually. The development is characterized as continuous adaptations or maladaptation to changing circumstances. The five developmental pathways in adolescence are:
Equifinality and multifinality
The term equifinality occurs when several factors can lead to the same outcome. Kind of like an ‘all roads lead to Rome’, kind of thing. Children with different experiences can develop the same problems. Multi-finality means that one factor can lead to multiple outcomes. Children with the same experiences can develop different problems. An example of this is that child abuse can lead to various psychological problems, from aggressive disorders to social withdrawals.
Risk and vulnerability
Risk factors are variables that increase the risk of psychological disorders. Risk factors can exist at biological, cognitive, psychosocial and other levels. Examples of risk factors are below-average intelligence, poverty, etc.
There are five important aspects with regard to risk factors:
Vulnerability refers to the tendency of children to react maladaptively to living conditions. Vulnerability can be congenital (for example due to genetic factors) or acquired (for example due to learned thought patterns). Although it is often persistent, vulnerability can be adjusted.
Risk factors can be incorporated into a transactional model that contains both individual factors and environmental factors. For example, stressors can lead to psychopathology through mediators. In addition, the relationship between stressors and mediators can be moderated by characteristics of the child or environment. Finally, this model recognizes the reciprocal influences between the components. This reflects the dynamic development processes.
Resilience
Of resilience occurs when there is a psychological positive result, while there is (or was) a negative or traumatic experience. Resilience refers to individual differences in the response to risks and in the ability to overcome negative circumstances. Resilience is often defined as the absence of psychopathology, or few symptoms, while this would not be expected under the circumstances. It can also be defined in terms of terms of competence related to development tasks. In this case, resilience exists when an individual is able to complete developmental tasks despite adverse circumstances.
Resilience can exist on three levels: personal factors, family factors and factors outside the family. These factors can be considered as protective factors : factors that resist the effect of risk factors. Examples of youth resilience are problem-solving skills, skills in self-regulation, a positive self-image, performance motivation, self-efficacy and control, coping strategies, a close and safe relationship with family members, supportive relationship with adults within society, friends or romantic relationships, and spirituality. Some of these factors are characteristics of the individual, such as problem-solving skills. In this sense, resilience can be seen as the opposite of vulnerability. The more resilience, the more stress is needed for the development of disorders.
Some problems of young people remain stable, while others are only temporary. There are two types of continuity. With heterotypic continuity , the manifestation of some disorders changes over time. Depression manifests itself differently in childhood than in adolescence. With homotypic continuity, disorders are expressed by means of stable symptoms.
Factors that can sustain problems are:
Attachment is a special social-emotional bond, for example between a child and his / her parents, that develops gradually and manifests itself after seven to nine months after birth. According to Bowlby, behaviours that are conductive to attachment, such as crying, smiling and eye contact of babies, are biologically determined to ensure that a child is cared for by an adult. These behaviours are components of an attachment system that protects against threat or anxiety and is conducive to exploring new situations. Bowlby considered the bond between a child and the parents as something fundamental to further development. He stated that attachment experiences of the child provide expectations or internal models about the availability and responsiveness of parents. This influences the ability of a child to regulate emotions and to deal with stress. In addition, it influences self-confidence.
During the time the child is an infant, the attachment is studied with Ainsworth's procedure, also known as The Strange-Strange Situation. In it, the mother, the child and a stranger sit in a room. The mother leaves the room several times and returns after a while. To see the type of attachment, you look at the way babies react differently to being left with a stranger and to the reunion with their mother. A distinction can be made between different bonding styles:
In late childhood and adolescence, the attachment system includes relationships with peers and romantic relationships. Some claim that early attachment experiences or troubles affect later relationships. The concepts of secure and insecure bonding are still relevant today. However, there is no consensus on the categories that are a good representation of the later attachment.
Bonding styles are related to behavioural patterns. For example, a secure attachment is related to adaptive behaviour, such as competence and positive interactions with peers. Insecure attachment, in particular disorganized attachment, on the other hand, is related to maladaptive behaviour, such as aggression and fear. However, the strength of the relationship between attachment style and later behaviour is moderate and is not found in every study. Moreover, the attachment style can change from safe to unsafe, or vice versa.
Temperament refers to a biological predisposition. Chess and Thomas have discovered that there are reasonably stable individual differences in temperament in babies. They defined temperament in terms of nine dimensions of behavioural styles (including mood, response to stimuli, adaptation to change and regulation of body functions). They also identified three basic temperament styles: (1) easy, (2) difficult to initiate (slow-to-warm) and (3) difficult. A difficult temperament style is characterized by intense reactivity and a negative mood and is related to social and psychological problems.
Chess and Thomas state that the temperament of parents influences the reactions of the child, which influences the reactions of parents, and so on. It is a vicious cirlcle. According to them, temperament is malleable, and the final result depends on goodness-of-fit : how well the behavioural tendencies of the child match the characteristics of the parents. A good match can lead to a good adjustment.
Temperament is considered as individual differences in behavioural style, which develop into the child’s personality in interaction with the environment. With developments in research, changes have taken place in the dimensions or categories of temperament. According to Sanson, three dimensions of temperament are recognized worldwide, although the name may vary per study:
The outcome can vary due to interactions between the different dimensions.
Nigg has suggested two approaches to temperament and psychopathology. The first perspective regards problem behaviour as an extreme form of normal temperament. The second perspective regards temperament as a risk or protective factor, depending on the specific tendencies and circumstances.
Emotional reactivity and regulation are elements of temperament. Three elements of emotion are recognized worldwide: (1) feelings such as sadness, happiness and anger, (2) nervous system reactions , such as a faster heartbeat and sweating, and (3) behavioural expressions, such as laughter, frowning and fleeing. Emotions can be considered as short or more general moods that vary in intensity and can be experienced as positive or negative.
Children express their emotions at a young age. Babies show basic emotions such as joy, sadness and fear. Between the age of 1 and 1.5, children learn 'social referencing', (using the expression of others to determine their own reaction - for example, when deciding to approach or avoid an object). Children of two years of age can already name and discuss basic emotions and can exercise some level of control over their emotion expression. Children learn to make connections between emotion and cognition between the ages of 2 and 5. Subsequently, further progress is made in understanding and regulating emotions.
Emotions have a biological basis, which interacts with environmental influences and which is formed by socialization and the cultural context. Proper care, open discussion of emotions and modelling of emotional behaviour all influence the formation of emotions. Emotions have different functions. They play a role in communication, empathy, cognition and behaviour. Emotions also play a role in psychological problems, such as depression.
Understanding emotions is important for the competence and adaptation of children. Emotional knowledge consists of (1) recognizing the emotional expressions of others and (2) knowing which emotions are experienced in specific circumstances. Emotion regulation also plays an important role in adaptation. Emotion regulation includes the ability to initiate, retain and modulate feelings, biological responses and expression of emotions. Education plays an important role in the development of emotion regulation. Children with little knowledge about emotions and poor emotion regulation have (later) more social and behavioural problems.
Social cognitive processing
Social-cognitive processing is about how people think about the social world. It focuses on the way in which individuals understand and interpret social situations and how behaviour is subsequently influenced. Although the emphasis in social information processing is on cognition, emotion also plays an important role. Cognition and emotion interact in different ways. A poor understanding of emotions causes social cues to be misinterpreted. From interpretation occurs when, among other things, consideration is given to the causes of events and the intentions of people. The wrong interpretation of behaviour sometimes plays a role in psychopathology. Aggressive children, for example, often mistakenly interpret other people's behaviour as hostile. The processing of the social context influences a lot of human functioning. For example, children's perception of how their parents interact with them is related to parents' influence on their children.
When is behaviour abnormal? - Chapter 1You can use many varying terms to describe abnormal behaviour. Consider, for example, ‘mental disorder’, ‘psychological disorder’, ‘psychopathology’ of ‘developmental disorder’. This is thus why guidelines have been developed to help identify abnormality. What does abnormal behaviour actually mean?
Abnormal behaviour occurs when the actions of a significant person deviate from the normal standard of behaviour. According to this definition, a child with a far above average IQ is thus also considered abnormal. So, abnormal doesn’t immediately mean ‘bad’. Psychopathology research involves abnormal behaviours that are harmful to the individual. The APA (American Psychiatric Association) defines a disorder as a ‘clinically significant pattern in an individual’ (psychological and behavioural). This pattern causes frustration, disruptions, an increased risk of harm or danger to one’s wellbeing. Psychopathology interferes with the adaptation to the environment and impedes the individual from completing developmental tasks. A disorder can be seen as an internal problem or as a person's response to circumstances. The final explanation tend to be more obvious to recognise.
Age can be considered as an index for the level of development and is important in assessing behaviour. Assessments of behaviour depend on developmental norms , which say something about the growth of motor skills, language, cognition and socio-emotional behaviour. These standards serve as a benchmark when looking at the (abnormal) development of a child. There are different ways to regard behaviour as deviating from the norms:
There is culture when groups of people are organized in specific ways, live in a specific environment and share specific beliefs, norms, values and customs. Cultural norms influence the expectations, assessments and ideas regarding the behaviour of young people. What is very normal in one culture can be very strange in another culture. As a result, disorders can be culturally specific.
Ethnicity is about shared values,
.....read more What does developmental psychopathology include? - Chapter 2Kuhn, among others, has shown us that science is not entirely objective. To study phenomena, scientists all take a perspective from which they view it. If a perspective is shared by researchers, this is called a paradigm. It is a kind of cognitive frame of reference that includes assumptions and concepts. The advantage of such a (subjective) perspective is that it provides guidelines for the way in which a problem is approached, investigated and interpreted. A disadvantage is that researchers can limit themselves by assuming this perspective and are confined within the boundaries of it. They can limit themselves in the type of research questions or in the interpretation of research results. Despite these disadvantages, it is still smart to take a perspective.
Theories and models
A theory is a formal, integrated set of principles that explains a phenomenon (or multiple phenomena). Scientific theories are supported by evidence. In addition, they offer formal assumptions that can be tested, which can lead to an increase in knowledge. A model provides a description of what is being studied. Models that show that many factors lead to psychopathology are especially interesting for psychology. Interactional models assume that several variables together lead to an outcome. An example of this is the vulnerability stress model. This model is based on multiple vulnerability factors and stress factors that together cause psychopathology. Vulnerability (diathesis) is often regarded as a biological factor and stress as an environmental factor. The biological vulnerability of a child to anxiety (meaning you’re more likely to get anxiety than others), for example, can lead to psychological problems in interaction with the stress of a divorce.
Transactional models are used to investigate both normal and abnormal behaviour. These models assume that the development is the result of continuous, reciprocal transactions between the individual and the environment. The individual is seen as an active being formed by past experiences. The environmental context includes variables that are close to (proximal) or far (distal) away from the person.
Transactional models fall under the system models. System models assume different levels of functioning. The development is the result of interactions between the different levels. Changes at one level affect the other levels. An example of this is the biopsychosocial model, which integrates brain functioning, genes and behaviour with aspects of the social environment. Another example is the ecological model, which states that the individual and the environment influence each other.
What influence do genes and environment have on behaviour? - Chapter 3The early development of the brain and nervous system is largely determined by biological factors, but the influence that experience has is also fairly large. The nervous system begins to develop shortly after conception, as the neural plate (a group of cells) thickens, folds in and forms the neural tube. The cells start to migrate to fixed locations. The brain contains millions of multifunctional cells, glial cells , and neurons . Neurons carry messages within the nervous system and to and from other body parts. The extensions of these neurons, called nerves, get a layer of myelin, a white substance that promotes the efficiency of communication in the brain. An excess of neurons and connections is produced both before and after birth to ensure the flexibility of the brain. Some parts of the brain develop faster than others. For example, the development of brain parts for vision and hearing is faster than the development of the frontal brain area, which is involved in complex thinking.
There are many developments in the brain during adolescence. In this way the connections between brain areas increase. Also, the amount of grey matter in the frontal brain area decreases, while the white matter shows an increase, which is a reflection of constant myelination. These changes have implications for psychological and behavioural functioning.
The development of the brain depends on the interaction between biological predisposition and experiences (activity-dependent processes). There is pruning occurring both before and after birth, which means unnecessary cells and connections between cells are broken down. This process is probably the cause of the decline in grey matter in adolescence.
Structure
The brain and backbone together form the central nervous system . The peripheral nervous system is formed by the nerves outside the central nervous system, which carry signals to and from the central nervous system. The peripheral nervous system has two subsystems:
What kind of research is involved in this field of psychology? - Chapter 4The general purpose of science is to describe and explain phenomena. Scientific knowledge comes from a systematic formulation of a problem, observation and data collection and interpretation of research results. Theoretical assumptions and concepts are used to choose variables, procedures and research goals. Often hypotheses are tested that are derived from theories. Testing hypotheses is valuable because knowledge is then obtained in a systematic manner. When finished, a study does not prove that a hypothesis is true or false but it does offer evidence in favour or against the hypothesis. If a hypothesis is not supported, this can lead to an adjustment of the underlying theory.
Research participants
Researchers often try to make statements about their entire population of interest. Because it is not possible to examine everyone in a population, a representative sample is used. Representativeness can be achieved through random selection: every person from the population has an equal chance of being selected. Sometimes certain groups of people are systematically excluded from selection. But even though it’s handy, trying to get a true random sample is not always feasible because it is impossible to draw a random sample of, for example, all children with intellectual disabilities. However, there are ways to approach representativeness. The extent to which this is successful influences the interpretation of the research findings.
Research into psychological disorders often uses clinical populations: participants from, for example, hospitals or institutions. Such clinical populations are usually not representative of the entire population because they exclude children who, for example, cannot be treated due to financial circumstances. Clinical populations can also offer an overrepresentation of young people with more severe symptoms or with symptoms that affect the environment. In this case there is a selection bias.
Measurements
A researcher must make an operational definition of the behaviour or concept that is being studied, so that it becomes clear which observable behaviour or concept is involved in the research. For example, aggression can be operationalized as the frequency with which children threaten their peers.
Validity
A measurement must be valid. Validity refers to the accuracy of the measurement: the extent to which a measurement is an accurate indicator of the behaviour being studied. A distinction can be made between internal validity and external validity. Internal validity refers to the degree to which the statement/hypothesis is correct. Depending
.....read more How can disorders be classified? - Chapter 5The terms classification, assessment and diagnosis are used to describe the process of description and grouping. Classification (or taxonomy) stands for creating large categories or dimensions of behavioural disorders. It is a system for describing phenomena. These systems are mostly for clinical or scientific purposes. A diagnosis is when a category or classification is considered applicable to an individual. Assessment refers to evaluating (young) people to facilitate classification and diagnosis and to make treatment plans.
Classification systems try to systematically describe a phenomenon. For example, biologists have classification systems for organisms, such as cold and warm-blooded animals. There are also systems for classifying psychological problems. These systems describe categories or dimensions of problem behaviour, emotions and / or cognitions.
A category is a discrete grouping, for example anxiety disorders, to which an individual belongs or does not belong. A dimension , on the other hand, is a continuous property that can occur in various sizes. For example, there are different degrees to which a child is anxious.
The categories or dimensions in a classification system must be clearly defined: the criteria must be explicitly named. In addition, a distinction must be made between the different categories. It must also be proven that a category or dimension actually exists, meaning that the characteristics used to describe a category or dimension must regularly occur together.
Classification systems must be reliable and valid. There are two types of reliability:
Validity refers to
.....read more What are the anxiety disorders and what are their characteristics? - Chapter 6There is a difference between anxiety and fear. Anxiety is an emotion that is focused on the future. This emotion is characterized by the feeling that someone has no control over possible negative events. The events also seem to be unpredictable for the person in question. If someone is confronted with potentially dangerous events, there is immediately a lot of attention for the dreaded (or for the emotions that accompany it).
Stress is a response to an existing threat. It is characterized by an alarm response. stress and fear are considered a complex pattern of three types of responses to perceived threat:
Anxiety is a cognitive component of stress and is difficult to control. Worries are thoughts about possible negative consequences that are difficult to control.
It is difficult for clinicians to determine whether the anxiety of a child or adolescent is normal and temporary, or atypical and persistent. Anxiety is part of normal development, as a result of which children develop certain competencies and become more autonomous, for example. For example, children learn how to cope with the dark, while adolescents learn how to cope with dating fears.
Age differences, gender differences and cultural differences
Both the number and the intensity of fears decrease with age. Concern becomes prominent around the age of 7 and becomes more complex and varied as development progresses. Certain fears appear to be more common at certain ages, such as the fear of strangers between 6 and 9 months after birth and social anxiety and fear of failure in adolescence. Changes in the content of fears and worries are probably a reflection of cognitive, social and emotional development.
Anxiety disorders are more common among girls than among boys. This gender difference also becomes larger with older children. It is suggested that the intensity of anxiety in girls is also higher. However, research findings regarding gender differences should be interpreted with
.....read more What are the mood disorders and what are their characteristics? - Chapter 7An important aspect of internalizing disorders are mood problems. Children and adolescents who have an unusually sad or euphoric mood, which are extreme or persistent and interfere with functioning, can be diagnosed with a depressed or manic mood disorder. Nowadays there is increasing attention for mood disorders, for various reasons:
It is difficult to distinguish between different sub-categories of mood disorders, because many people meet the criteria of more than one disorder.
For many years the orthodox psychoanalytic perspective has been dominant. According to this perspective, depression was the result of the functioning of the superego and adult ego. For example, because the superego punishes the ego, a certain type of depression occurs. Because the superego in children is not yet fully developed, depression could not occur in them. That is why this subject received little attention.
A second important perspective contributed to the controversy regarding the existence of childhood depression. The concept of masked depression meant that child depression did exist, but that the sad mood and other characteristics of depression were often not present in children. There might have been an underlying depression, but this was masked by other problems (depressive equivalents), such as hyperactivity or delinquency. The idea of a masked depression was problematic because there were no clear guidelines for deciding whether or not a particular symptom was a sign of depression.
This perspective was nevertheless important, because it was at least recognized that depression could also be a major and common problem in children. Moreover, the central idea of masked depression is still really relevant in the terms that depression can exist in children and that this can be expressed in age-related forms that differ from depression in an adult.
The idea that depression and expression are expressed differently in children and adults has contributed to the evolution of a developmental psychopathology perspective. Initially, this perspective stated that behaviours that led to the diagnosis
.....read more When is something a behavioural problem and how do they affect people? - Chapter 8While anxiety and depression arise from internalizing problems, behavioural disorders are often the result of externalizing them. The term ‘behavioural problems’ refers to the general group of disruptive and antisocial behavioural problems. The terms behavioural disorder and disruptive behavioural disorder are used to refer to specific diagnostic groups. The term delinquency is mainly used in the legal system and refers to young people who exhibit antisocial behaviour or other behavioural problems. It refers to a minor who is caught performing an index crime (an act that is illegal for both adults and minors, such as theft) or a status crime (an act that is only illegal for minors, such as alcohol consumption).
Classification and description
Disruptive behaviour occurs at different moments in the development. Children of preschool age will beat, kick or bite other children. In the primary school period there is talk of bullying and various forms of aggression, which can definitely also be physical. In adolescence, young people display risky behaviour and / or use illegal drugs. The table below provides an overview of the types of behavioural problems that adults often describe as problematic and the DSM disorders associated with them.
Development period | Problem behaviours | Related DSM disorder |
Early childhood | Disobedience Oppositional behaviour Temper tantrums | Oppositional Defiant Disorder (ODD) |
Middle childhood | Open or covert antisocial behaviour Relational aggression | Oppositional Defiant Disorder (ODD) Conduct disorder (CD) |
Adolescence | Delinquency Drug use Risky sexual behaviour | Conduct disorder (CD) Disruptive Impulse Control |
The DSM category Disruptive Impulse control and Conduct disorders include, among other things, the diagnosis of ODD and CD, as well as, among others, kleptomania and antisocial personality disorder. The latter diagnosis applies to people who show a persistent pattern of aggressive and antisocial behaviour after the age of 18. This pattern must be present from the age of 15. In addition, there must have been a conduct disorder (CD) before the age of 15 .
What characterizes ADHD disorder? - Chapter 9ADHD is defined in many different ways. In the 1950s, the emphasis was on the hyperactivity characteristic of the disorder. Various terms were used at the time, such as hyperkinetic syndrome and hyperactive child syndrome . Over time, attention for hyperactivity and concentration problems decreased. In the DSM-III it was recognized that attention deficit disorder (ADD) could occur with and without hyperactivity. Attention Deficit Hyperactivity Disorder (ADHD) was not included in the revised version of the DSM-III . This disorder is also recognized by dimensional classification systems.
Research suggested that ADHD consists of two components: inattention and hyperactivity-impulsivity. There is a lot of cross-cultural evidence for the validity of these factors. Although both components have unique genetic influences, they are interrelated as a result of shared genetic influences.
DSM classification
The DSM states that the two factors (inattention and hyperactivity-impulsivity) together form three subtypes of ADHD:
The diagnostic criteria state that there must be symptoms of inattention and hyperactivity-impulsivity, respectively. the diagnostic criteria state that some symptoms must be present before the age of 12 and for at least six months. Because all symptoms occur to some extent in normally developing children and may vary with the level of development, the diagnosis is only made if the symptoms are excessive and occur in at least two different settings (for example at home and at school). The symptoms must also interfere with the social and academic functioning of the child.
Inattention
Adults see different signs of inattention in children with ADHD. An apparently special aspect of the disorder is the situational attention of children: the child can concentrate well if he or she is interested or motivated, while it has concentration problems when performing a boring, strenuous or repeated task. Research shows that children and adolescents with ADHD do indeed have more concentration problems than children with learning disabilities or normally developing children. Specific deficits have been identified, including a lack of selective attention: the ability to focus on relevant stimuli and not be distracted by irrelevant stimuli. Children
.....read more What disorders are there with regard to language and learning? - Chapter 10From around 1800 on, there has been attention on language-related problems. During this time, a medical orientation was developed, with specific limitations associated with brain abnormalities. For example, Wernicke discovered brain abnormalities in patients who did not understand language well, but who had no language or cognitive impairment – which you might know because there is a brain area named after him. From 1920 on, there was also a psychological orientation. During this period, more emphasis was placed on gaining insight into the characteristics of people with language and learning difficulties and treating them. In 1963, Krik introduced the term 'learning disabilities'. This is considered a milestone in the emergence of the concept of learning disabilities. For example, teachers were no longer accused of causing such problems.
Definition
According to the 'Individuals with Disabilities Education Act (IDEA)', the definition of a learning disability is as follows: “a learning disability is a disorder in one or more psychological processes involved in the understanding or use of (spoken or written) language. The disorder can affect listening, thinking, speaking, reading, writing, spelling or math. This does exclude children who have learning difficulties due to visual problems, hearing problems, a motor impairment, an intellectual disability, emotional problems or a cultural-economic disadvantage. There are no specific criteria for identifying disabilities. So there are different ways to identify learning disabilities. Differences in definitions have led to different prevalence estimates, incomparable research groups and different criteria for determining whether children are eligible for special education.
Discrepancy between the IQ and performance level
There are two common ways to discover learning disabilities. First of all, we can look at the difference between someone's intellectual capacity (IQ) and specific performance level. It is assumed that if there is a specific disorder, the performance on general assets (IQ) is higher than the performance on tests that relate to the specific disability. Often a difference of two or more standard deviations between the scores on the intelligence test and the specific test is considered significant.
Below average performance
Another way to diagnose a disorder is to see if a child performs at least one academic area lower than the average classmate. A problem with
.....read more When does someone have an intellectual disability? - Chapter 11An intellectual disability (ID, formerly also called mental retardation) is characterized by limitations in both intellectual functioning and adaptive behaviour. This is expressed in conceptual, social and practical skills. ID occurs before the eighteenth year of life. There are three diagnostic criteria:
According to the American Association on Intellectual and Developmental Disabilities (AAIDD) model, the way in which ID is expressed depends on how it works on the five dimensions;
Intellectual limitations are not seen as an absolute trait, because sufficient support can lead to an improvement in functioning.
Initially, the AAIDD made a distinction between four levels of ID: light, moderate, serious and profound. The AAIDD, however, no longer uses this approach because it would not be appropriate for making decisions about the care of individuals with ID. Instead of the ID level, an assessment must be made for each individual of the level of support he or she needs. This approach recognizes that the need for support may be different in different areas of functioning and may change over time. In addition, it emphasizes the perspective in which an ID is seen as dynamically related to the social environment rather than as static quality of the individual.
The DSM approach
The DSM approach to diagnosis has many similarities with the AAIDD approach. A diagnosis requires both intellectual and adaptive limitations, and the disorder must occur during the development phase. The IQ score is usually around 70. The criteria also state that there must be deficits in at least one area of adaptive behaviour.
The DSM in 2013 still classified individuals on the basis of the intelligence level: light (IQ 50-70), moderate (IQ 35-50), severe (IQ 20-40) and profound (IQ <20). About 85% of the cases were only lightly mentally
.....read more What are the most important characteristics of autism and schizophrenia? - Chapter 12In the past, no distinction was made between schizophrenia and pervasive disorders, such as autism. Nowadays we do differentiate between them. Schizophrenia is rare among children, often develops in adolescence and increases in adulthood. Autism and Asperger's syndrome are non-psychotic disorders that arise at a young age.
The DSM-V contains the Pervasive Developmental Disorders (PDD) category. This category includes:
Rett's disorder is now viewed differently and will not be further discussed for this reason. Criticism, such as whether Autistic Disorder and Asperger's syndrome would not be a single disorder, was common. In the DSM-V, the above-mentioned disorders are no longer considered separate. They now coincide in the Autism Spectrum Disorder (ASD). Two domains with primary symptoms can be distinguished in ASD: Firstly, persistent limitations in social communication and interaction, and secondly, restrictive, repetitive behavioural patterns.
What is Autistic disorder (autism)?
Kanner described autism as a disorder characterized by communication problems, atypical cognitive skills and behavioural problems such as obsessiveness, repetitive behaviour and unimaginative play. However, Kanner saw social inability as the biggest problem.
Primary characteristics
Social interaction
Already before the age of 1, autistic children show subtle differences from normally developing babies. They respond less to visual stimuli, respond less when someone calls their name and often don't like to be touched. They do not follow people with their eyes, avoid eye contact, appear to have an ‘empty’ or unseeing eye and respond little to others with emotional expression and positive emotions. Particularly striking is that autistic children exhibit deficits in joint attention, where the child and parent or caregiver focus attention on the same object or situation, thereby sharing an experience. Joint attention is facilitated by certain gestures, such as pointing, and eye contact. Another component of an atypical social interaction is abnormal processing of social stimuli, particularly the face. Children with autism have difficulty recognizing and remembering faces (and associated expressions of emotion). They also process faces in other ways than normal developing children. All in all, delayed or atypical social behaviours seem to occur at a young age in at least five areas of social behaviour: attention to social stimuli, joint attention,
.....read more Which disorders have a strong influence on physical functions? - Chapter 13Paediatric psychology is concerned with the investigation of (psychological) problems leading to disruption of physical function and health.
Problems with toilet training and learning sleeping and eating habits are common. Both the ability of the child to master these skills and the skills of parents to guide the child in this are important for the well-being of the child and parents. Sometimes parents seek help if they are unable to learn certain habits.
Potty training
The usual order in which children get toilet training is as follows: control of the intestines at night, control of the intestines during the day, control of the bladder during the day and control of the bladder at night. Although there is considerable variation in the age at which children become toilet-trained, they are often toilet-trained between the ages of 1.5 and 3. Parents disagree about when or at what age it is good to start toilet training. This decision often depends on cultural values, attitudes and daily circumstances, such as requirements for childcare and the presence of other siblings.
There are various factors that contribute to good toilet training. First of all, it is important that parents are able to determine when the child is ready for development. In addition, the parents must be able to properly assess when the child needs to go to the toilet. Thirdly, they must prepare well for toilet training, for example by having the child wear clothing that can be easily taken off. Finally, it is effective to positively reinforce the child.
Enuresis refers to a lack of control over the bladder, during the day and / or at night, that cannot be explained by a physical disorder. Often the diagnosis can only be made after the age of 5. The diagnostic criteria also state that there must be a certain frequency of the control deficiency and this frequency varies with the age of the child. It must be done at least twice a week and for three months or there must be a clinically significant disruption of daily functioning.
A distinction is made between urinating in bed and urinating during the day and between primary and secondary enuresis. Enuresis is called primary, if the child has never been toilet trained, and secondary if the
.....read more What is the connection between psychology and (physical) health? - Chapter 14Physical disorders that are influenced by psychological factors have been called psychosomatic disorders in the past . In DSM-II this term had been replaced by psychophysiological disorders and in DSM-III this term had again been changed to psychological factors that influence physical conditions. In the DSM-IV this was transformed into psychological factors that influence medical conditions . Now in the DSM-V there is a new chapter called somatic symptoms and related disorders. This includes the psychological factors category that affect other medical conditions. These adjustments are the result of the discussion about the relationship between body (soma) and mind (psyche). During the 20th century, the interest in the effects of psychological processes on the body has resulted in the development of psychosomatic medicine. It became clear that many physical complaints are influenced by psychological factors. Researchers started with psychogenesis: the identification of the psychological cause of physical disorders. More attention is now being paid to multicausality: the idea that biological, social and psychological factors contribute to health. This perspective is holistic and assumes continuous interactions between influences. Pediatric psychology is the field that focuses on these processes in children and adolescents.
In asthma there is a hypersensitivity of the airways to different stimuli. The airways become chronically inflamed and narrower. This causes breathing problems. Serious attacks (status asthmaticus) can be life threatening. The breathing problems and the danger of serious attacks can lead to anxiety for the patient and his family members.
About 10% of children suffer from asthma. The disorder is extra common in children who are poor, live in an urban area and / or belong to a minority group. A bright spot is that asthma can be temporary.
Research shows that genetic factors influence the risk of asthma. In addition, other factors most likely play a role. People who have asthma may be exposed to factors that influence the chance of an asthmatic attack. These influences are considered as triggers or irritants instead of as direct causes of asthma. Every individual has different triggers and over time triggers can change for the same individual. Repeated respiratory infections can play a role in the development of asthma and viral respiratory infections can lead to an asthmatic attack or worsen its severity. An allergy can also increase the chance of an attack. For example, some children are
.....read more What issues are currently affecting young people? - Chapter 15In recent decades, dramatic changes have taken place in families in the US due to an increased number of divorces, families with one parent and families with stepparents.
Working mothers and childcare
Nowadays, with women having more and more jobs outside of the household, children are more often cared for by others than the mother, such as by relatives or at a day-care centre. The effect of this differs based on the quality of care, the amount of care and certain family characteristics. High quality care is positively related to the cognitive, social and language development of children who go to a day-care centre from an early age. The research findings regarding the effects of the amount of care are inconsistent. In general, the amount of care seems to be negatively related to the child's development. With regard to the interaction between childcare and family characteristics, it appears that children from low-income families benefit from care at a day-care. This means that care by others can serve as a protective factor for children from families with a low socio-economic status. It is also important that a good relationship between parents and child remains.
From the age of 9 to 12, an increasing number of children will start taking care of themselves. The effects of self-care depend on the amount of time self-care, the level of development of the child, family factors, neighbourhood characteristics and social support. Participation in after-school programs often has a positive effect on the social and academic behaviour of children.
Adoption
The number of adoptions has risen sharply in recent decades. Adopted children have relatively more issues with psychological problems. This is especially the case if children have were adopted at an older age or because they have been exposed to negative conditions such as poor prenatal care, drug addiction or care in an orphanage.
A study has made a distinction between two types of peers: peers from the past (peers or brothers or sisters from the institution from which the child was adopted) and current peers (peers in the current situation). The following conclusions can be drawn from this study:
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