You 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, beliefs and customs in an area. Race , on the other hand, is based on physical characteristics. Shared customs and values may also exist based on race. Within a heterogeneous society, ethnic or racial groups can express psychopathology in a different way and have different ideas about this than in the dominant cultural group.
Something that can also influence behaviour and psychological wellbeing is sex norms. We are more worried about a shy boy than a shy girl. In behavioural assessments, situational norms are also taken into account: expectations in specific settings or social situations. It is normal to run on the soccer field, but not in the library.
Generally, when children are sent for clinical evaluation, it’s because of the account of others. This reference has just as much to do with the characteristics of the person who refers the child (for example the parents or a teacher) as with the child itself. There is often disagreement about whether the child has a problem. This may be due to differences in the extent to which adults are exposed to different child behaviours, but also due to differences in attitudes, sensitivity, tolerance and the ability to cope with the behaviour ( coping ).
Assessments of abnormality change over time. Masturbation used to be seen as a sign of insanity, whereas nowadays that is no longer the case. Many factors contribute to changes in behavioural assessments, such as an increase in knowledge and changes in cultural beliefs.
Determining a disorder depends on, among other things, the definition of a disorder, the criteria for identifying a disorder, the method used to identify a disorder and the population being examined. Some people are concerned that social changes have led to an increased risk of youth disorders. However, there is no consensus regarding this upcoming ‘trend’ among young people. While some studies show that the prevalence of disorders is increasing, other studies have concluded that there is a decrease. Moreover, it is difficult to draw conclusions about such supposed increases. Perhaps it is possible that there are more kids with trouble focussing, simply because we are able to save more babies that have been born prematurely and these kids have an increased chance of concentration problems. It has been discovered that this increase in percentages was not due to doctor’s being quicker with diagnosing mental health problems or to higher percentages of parents with divorce. For example, the mother's emotional problems could contribute to behavioural problems or emotional problems.
Often mental health problems are not recognized. This is a serious problem because early disorders can interfere with subsequent developmental processes. This leads to an accumulation of problems – and this is what developmental psychopathology looks at.
There is a connection between specific problems and the age at which they usually arise. For example, speech problems are noticed when a child starts talking. Other disorders develop gradually and sometimes the starting point differs per gender. The following is an overview of the age categories in which specific disorders are often encountered or identified for the first time.
It is useful to determine at what age a disorder occurs in a child. If it is known at what age a specific disorder usually develops, this may give indications for its aetiology. For example, if a disorder develops at a young age, this indicates a genetic and / or prenatal aetiology, while a later starting point indicates environmental influences. In addition, this information provides starting points for assessing the severity or outcome of the disorder: the sooner a disorder develops, the more serious the problems are. Finally, parents, teachers and other adults are more aware of the signs of specific problems if they know at what age these problems usually arise. This can lead to the prevention or early treatment of the problems.
Many disorders are more common in men than in women. The prevalence of the following disorders is higher for men:
The following disorders are more common in women:
Men are more sensitive to neurological developmental disorders that arise early, while women are more sensitive to emotional problems in adolescence. Problems are also expressed differently by men and women. For example, men engage in physical aggression faster, while women exhibit more relational aggression, such as spreading gossip. The severity causes and consequences of some disorders also differ per gender.
It is possible that found sex differences (in terms of disorders) are the result of methodological causes. In the past, for example, the main focus of studies were men. Misleading research results may also be due to the willingness (or unwillingness) of men and women to talk about their problems. There can also be a referral bias, which means that on certain behaviour (such as shyness, one gender is quicker to have it be defined as ‘problematic behaviour’). In clinical samples, bias can also arise when more boys are involved in a study of a certain disorder, because they are being treated more, this leads to a description of how boys deal with a disorder. This may look different for girls, which may make them fall outside the definition of said disorder.
Nevertheless, despite these methodical problems, there are real differences between men and women. There are differences in biological predisposition, brain function and gender hormones between men and women. Men and women can also react biologically differently to stress. There are also sex differences in exposure to risky and protective experiences that are associated with psychopathology.
In the course of the 17th century, people recognized that children need attention, care and love. In the 18th century, children were considered either sinful or innocent. Others considered the child to be an "unwritten sheet," filled with experiences. In the 19th century, adolescence was seen as a phase with many challenges. In this century, adult mental disorders were attributed to two causes: (1) demonology: the adult is possessed by the devil or by evil spirits; and (2) somatogenesis: mental problems are caused by the malfunctioning of the body. In the late 19th century, the dominant assumption was that disorders occur early in childhood and are inherited from their parents. There is currently much interest in this way of thinking in science.
Kraeplin
At the end of the 19th century, treatments and classifications of mental disorders were sought. Kraeplin stated that various symptoms combined together formed syndromes, which probably have a common biological basis. He believed that each disorder has its own cause, its own symptoms, its own development patterns and specific effects. He developed a modern classification system to group deviations in children.
Freud is the founder of the psychoanalytic theory and the associated psychoanalysis treatment method. Freud believed in psychogenesis: that mental problems are the result of psychological factors. He believed that unconscious conflicts and crises from childhood determine behaviour. Freud stated that we all have an ID, an ego and a superego, which are constantly in conflict with each other. Anxiety is a warning signal for the ego (the problem-solving part of the mind) that impulses from the ID, which are unacceptable to the superego, try to penetrate into consciousness. To be protected against the awareness of unacceptable impulses, there are, according to Freud, defence mechanisms that deny or change these impulses.
The psychoanalytic perspective is related to the psychosexual stage theory. This theory assumes there are five phases. In each phase the focus is on a different part of the body: 1) the oral phase, 2) the anal phase, 3) the phallic phase, 4) the latent phase and 5) the genital phase. In the first three phases, there are crises that are crucial for further development. For example, a baby puts pretty much everything in its mouth during the oral phase. During the anal phase the child learns to become toilet trained. During the phallic phase, a boy wants his mother to himself (the Oedipus complex)/ a girl falls in love with her father (the Electra complex). According to Freud, the personality of a person is largely shaped by the way in which the crises in the first three phases are resolved. There has been much criticism of this theory because Freud based this theory on his own patients and the theory was difficult to test. The classical psychoanalytic theory has now been modernized. Less emphasis is placed on sexual forces and more on social influences. Erik Erikson, for example, came up with psychosocial development theory.
Behaviourism is Watson’s best-known theory. It states that most behaviour is explained by learning experiences. Watson strongly believed in classical conditioning; a concept introduced by Pavlov. This concept means that new things are learned by linking a new stimulus to an already known stimulus.
Thorndike came up with the law of effect: behaviour is formed by the associated consequences. If the consequences are positive, the behaviour will increase, while the behaviour with negative consequences will decrease. Skinner introduced operant conditioning. This way of conditioning is about learning behaviour based on the consequences associated with the behaviour. Operant conditioning is therefore based on the law of effect.
The social learning theory of Bandura is based on observational learning. He mainly emphasized social context and cognition. Learning is necessity of survival for everybody. The application of learning principles in the discovery and treatment of behavioural problems is called behaviour modification or behaviour therapy. Approaches that are based primarily on a combination of learning principles and social context (and / or cognition) are called social learning or cognitive behavioural perspectives.
The mental hygiene movement stood for more understanding, better treatment and more prevention of disorders. This movement led to a reformation of the science. There was also the child guidance movement. This movement focused primarily on children, because childhood experiences would affect mental health later in life. At the beginning of the 20th century, children began to become the subject of scientific research. Hall was the first to collect data from children to understand mental disorders, crime and social disorders. Binet and Simon were the first to design an intelligence test for children. They tried to find out which children needed special education. Gesell kept track of the physical, motor and social behaviours of children in his laboratory.
The branch of psychology that deals with abnormal child and adolescent psychology is formed by various historical theories and movements. The objectives are to identify, describe and classify psychological disorders. It is also important to find out the causes of the problems and to prevent and treat disorders differently. Today there are six principles that are important for abnormal child and adolescent psychology:
Central to the current understanding of psychopathology are: (1) interdisciplinary efforts and (2) the role of parents. Interdisciplinary efforts are about the fact that often more than one professional is involved in the treatment of a child's psychopathology. Psychologists, psychiatrists, teachers and social workers often work together. Attempts by a social worker to get therapeutic alliance with the patient can increase the chance of a positive result. Therapeutic alliance means creating a personal bond with the child and collaborating. Parents also have an important role to play. They can provide information about the child that nobody else knows. They can collaborate with psychologists in the implementation of a treatment or can undergo treatment themselves.
The choice of treatment technique must be tailored to the child's developmental level. For example, play therapy is more effective in young children, while cognitive techniques are more effective in adolescence.
Finally, the American Psychological Association has established ethical guidelines, which include the rights to (1) informed consent , (2) co-decision on treatment goals and (3) confidential care. Informed consent requires that the client gives permission for the treatment and fully understands how the treatment will proceed. For children, the parents / guardians must give permission for this.
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