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For this third and final video we're

going to look at theories in developmental
psychopathology.
These theories have more of a focus on
developmental factors in mental health and
well being.
But the, the focus is very similar to
developmental
psychology theories where we are looking
at developmental processes.
To define developmental psychopathology,
it's
an evolving interdisciplinary scientific
field that
seeks to elucidate the interplay among
the biological, psychological, and
social-contextual aspects.
Of normal and abnormal development across
the life course.
Development psychopathology focuses on
normal and abnormal
developments and also adaptive and
maladaptive processes.
As you can see behind me some of the
children are playing on a zip file or
flying forks.
In this apparatus there's one trajectory
that the
child takes from the top down to the end.
However developmental psychopathology
theory shows that in reality there's
a range of developmental trajectories that
children can take.
Compos and colleagues in a
really interesting review of adolescent
development.
Highlighted that there isn't just one
developmental pathway or trajectory.
When you're thinking about mental health
there's often a
variety of pathways that young people can
find themselves on.
They identified five when they were
looking at adolescence and depression.
The first is stable adaption where a young
person showed few problems.
A second pathway with stable maladaption
where a young
person show continual difficulties through
childhood and into adolescence.
There was an adolescent decline where a
young person may not
have been experiencing any difficulties
and then in adolescence difficulties
began.
Adolescent turnaround where a young person
might
have been experiencing problems as a child
and then in adolescence something happens
to lead them on a more adaptive pathway.
And also interestingly there's adolescence
limited maladaption, where a young
person in mid, mid adolescence can begin
to have difficulties psychologically.
That are resolved before the end of
adolescence.
So it's literally a kind of adolescence
blip in mental well being and health.
This model is really interesting because
it highlights that development.
Doesn't just involve one pathway.
There's a range of different pathways that
young people can find themselves on.
And so, other researchers have looked at
the kinds of
factors, that may be involved
in influencing a child's developmental
trajectory.
When we're thinking about the kind of
factors that might lead a young person to
follow a particular trajectory, we can
identify
a range of different risk and protective
factors.
Carr identifies different risk factors, he
said there are predisposing factors and
these can be both psychological and
biological and social and then there is
maintaining factors which are factors that
maintain a difficulty once it's becomes
established, there are protective factors
which
protect a young person from developing
difficulties.
And there are precipitating factors which
can
be life events, which make the difference
between
a young person being able to cope and
their own set of developmental or
psychological difficulty.
When we're thinking about children and
adolescent's mental health.
There isn't a simple recipe of risk
factors and
protective factors, that will lead to a
particular outcome.
Life is more complex than that.
And two developmental phenomena are
particularly
important when we're thinking about
developmental psychopathology.
One is the idea of that equifinality, that
there
can be different process, developmental
process to the same outcome.
So for example, research on Attention
Deficit Hyperactivity Disorder has shown
that you can have different developmental
processes leading to the same disorder.
The other phenomenon is the idea of
multifinality, and that's where you can
have
one risk factor or protective factor, and
it lead to a range of different outcomes.
So for example, secure attachment to a
main caregiver.
Seems to have protective value for a wide
range of mental health outcomes.
Similarly, early puberty seems to be a
risk
factor for a wide range of mental health
outcomes.
Hello, I'm Emily Taylor, and I'm a
clinical
psychologist working in child and
adolescent mental health services.
And I was a lecturer in clinical
psychology at the University of Edinburgh.
Up until the age of ten difficulties
usually present,
and I say usually not always present as
behavioral problems.
And a lot of that has to do with
children's development.
They're not yet able.
In terms of having the cognitive maturity
or the
emotional literacy to be able to
articulate difficulties in
a different way, or necessarily to even
hold a
good sense of those difficulties in their
own minds.
So instead they just feel a bit kind of
off about things and that gets presented
through difficult behavior.
And once you can get past that then
there's quite a range of problems.
So, all those different anxiety disorders
like phobias, fledgling obsessive
compulsive disorders and more generalized
anxiety, particularly separation anxiety
disorders, presenting between the ages of
about five and ten.
You'll also see less commonly, mood
disorders.
So, kind of depressive disorders.
But I would say, that's reasonably rare in
that age group.
And then what we tend to see, are the kind
of the, I suppose, kind of bit
messier, less clear behavioral problems
that are often
attributed to diagnoses, such as ADHD or
Attachment disorder.
That's often reflect a more of a kind of
systemic issue or,
or a problem that, that links to kind of
multiple different causes.
There are plenty of risk and protective
factors.
And I think that's one of the reason's
why using a formulation approach rather
then a diagnosis.
Can be a more accurate way of
understanding
an individuals presentation and what their
difficulties are,
where they've come from and what we need
to do to fix those difficulties as well.
And so there are obviously individual
factors that an
individual has, so their personality or
temperament or their developmental stage.
And early experiences that they've had, or
prenatal experiences even.
Their biology.
And then there's the, the kind of the
immediate systemic
factors of their family, and how their
family is constructed.
Events that have happened within that
family.
Or changes.
And some of those might me non-normative
changes.
So things like loss or.
And divorce or, or other kind of traumatic
life events that have come along.
ANd then this more normative life events
that can happen within a family that's
might
be quite positive or, or neutral but for
that child have, have been a problem.
And, and then there's the wider system
which is obviously most commonly
is the school and there's lots of school
based factors that can both.
And put a child at risk and protect a
child.
And, and then I suppose there's also the
kind of wider community factors
of how safe a community a child is living
in, and crime levels.
Also political situations as, as well.
And so it, it, you know, I think ap,
approaching it a little like [UNKNOWN]
model I suppose can be a really helpful
way of thinking about a child's individual
situation.
I think the other thing to say is that a
risk
factor for one child can be a protective
factor for another child.
So it's really understanding what the
meaning of that event or,
or factor is for that child and that, and
that child's family.
ADHD is understood as a disorder that
essentially describes children's.
Often quite disorganized behavior and so
on the
one hand there are attention difficulties
and that
can present as difficulties concentrating
in the classroom,
difficulties completing a task, being
distracted into another activity.
Parents might notice it at home because a
child.
And doesn't follow through with something
they've asked them to do, or they have to
ask them five times over to do it and
still it doesn't actually get done.
And, and, and difficulty just following
for
a task that isn't a desirable task, and
often you find that there aren't any
tension
difficulties around playing a computer
game for instance.
But lots of tension difficulties around
doing a piece of homework
and or sitting down at the table for the
whole meal.
And on the other hand, we have the
hyperactivity and, and that's quite
difficult to really measure because
children are,
children should be quite active, as well.
And I suppose it becomes a problem when
easy children who can't settle to sleep at
night.
Are struggling to.
Manage your routine, can't sit still in
the classroom
and often quite fidgety and moving around
a lot.
So that's how we understand the two halves
of the disorder and it should be
presenting across
a range of different setting so it
shouldn't
be just school or home, it should be both.
And it shouldn't be jus in specific
interpersonal interactions, it
should be or people should be able to see
it really.
And obviously very frustrating experience
for parents
is that all children have remarkable
capacity,
to really behave themselves in a clinic
setting, for at least the first hour.
So often parents will sit back, tearing
their
hair out saying it's not normally like
this
but we know that and [LAUGH] as all
children seem to be able to do that.
It is very difficult disorder to diagnose
and, and
I think that creates frustrations for
parents and clinicians alike.
And so, it's certainly the case that
children who present with possible ADHD
certainly having
difficulties of some sort or another, it
will be enough to be flagged up to
a teacher or to a general practitioner
and you know, parents are usually very
concerned
at the point that they're looking for
referral to child and adolescent mental
health services.
So there, there are certainly difficulties
but
it's not always ADHD that is the problem.
Some of the difficulties that we have
about diagnosing
relate to the actual diagnostic criteria
which is quite vague.
It's quite a long list of behaviors that
actually
most children engage in at some time or
another.
And it's quite poorly defined in terms of,
you know, it sort of for much of the time.
Which is, eh, you know, we kind of need
something
a little bit more specific than that to
work with, really.
So it creates a kind of gray area in
diagnosing.
The other problem is that all children,
before
puberty are likely to present mainly with
behavioral problems.
A respect for what the actual problem is
because that reflects what there
repertoire of of abilities is and
their development stage and their brain
development.
So they don't, you know their, the way
that their emotions are constructed
and expressed is, is not as elaborate as
it is for adolescence and adults.
That accountability is such that they
can't
necessarily nor articulate what the
problem is.
and, and they probably feel most
difficulties at
a more physiological level hence we get
this
quite physiological reaction with, you
know, kind of
disorganized behaviors, overactive
behaviors, falling out of routines,
so those all contribute to difficulties
in, in diagnosing.
I hope you've enjoyed this week's class.
We've look at three different things.
In video one we looked at child
development, adolescent development and
how psychologists study it.
In video two we looked at factors
that influence development and how they
interact.
And in this video, we've looked at models
of developmental psychopathology,
and we've also considered some specific
difficulties that children might face.
I've really enjoyed working on this mook
for you, and I hope you've enjoyed it too.
Next week, Emily will tell you all about
resilience.