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Psyc 422, Section 1, Spring 2013 Introduction to Course Welcome Instructor Syllabus/Course Expectations Extra Credit Options Semester Project Fill out information card: name, student ID#, preferred email, “code” for exams/grades Class Introductions Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Class Introductions With a partner: First name Year in school Major Why you’re taking this class List one thing you’ve done which you think no one else in the class has ever done before. Share with class Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Chapter 1 Introduction to Normal and Abnormal Behavior in Children and Adolescents Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views and Breakthroughs Ancient Greek/Roman view: The disabled were an economic burden and social embarrassment to be scorned, abandoned, put to death. Before 18th century: Children’s mental health problems were ignored and children were subjected to harsh treatment due to beliefs that they would die, were possessed, or were parents’ property. By end of 18th century: Interest in abnormal child behavior surfaced, although strong church influence attributed behavior to their uncivilizied, provocative nature. Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views (cont.) The Emergence of Social Conscience John Locke (17th century) believed children should be raised with thought and care, not indifference and harsh treatment Jean-Marc Itard 1775 - 1838 (19th century) focused on the care, treatment and training of “mental defectives” Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views (cont.) The Emergence of Social Conscience (cont.) Distinction between Psychiatric Disorder and Mental Retardation Leta Hollingworth: Distinction between individuals with mental retardation (“imbeciles”) and those with psychiatric disorders (“lunatics”) Benjamin Rush: Children are incapable of adult-like insanity, so those with normal cognitive abilities but disturbing behavior suffer from “moral insanity” Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views (cont.) Early Biological Attributions Treatment of infectious diseases (late 19th century) strengthened belief that diseases are biological problems Clifford Beers’s efforts led to detection and intervention Intervention was limited to the most visible disorders Belief that development of disorders could not be influenced by treatment or learning caused a return to custodial care and punishment of behaviors The view of mental disorders as “diseases” led to fear of contamination, then eugenics and segregation Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views (cont.) Early Psychological Attributions Psychological influences rooted in early 20th century formulating taxonomy of illnesses Psychoanalytic theory linked mental disorders to childhood experiences and explored their development Behaviorism laid the foundation for empirical study of how abnormal behavior develops and can be treated through conditioning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views (cont.) Evolving Forms of Treatment Until late 1940s, most children with intellectual or mental disorders were institutionalized 1945-1965: The number of children in institutions decreased while the number of children in foster care and group homes increased 1950s and 1960s: Behavior therapy was the systematic approach to treatment of child and family disorders Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Historical Views (cont.) Progressive Legislation IDEA (Individuals with Disabilities Education Act): free and appropriate public education for children with special needs least restrictive environment individualized education program (IEP) for each child United Nations General Assembly (2007): Convention to protect the rights of persons with disabilities Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning What Is Abnormal Behavior in Children and Adolescents? Disorders are commonly viewed as deviancies from normal despite arbitrary boundaries between normal and abnormal functioning Defining Psychological Disorders Traditionally defined as patterns of behavioral, cognitive, emotional, or physical symptoms associated with one or more of the following: distress disability increased risk for further suffering or harm Excludes cultural background Describes behaviors, not causes Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning What Is Abnormal Behavior (cont.) Defining Psychological Disorders (cont.) Labels describe behavior, not people Challenge of stigma: negative attitudes and beliefs that motivate fear, rejection, avoidance, and discrimination Problems may be the result of children’s attempts to adapt to abnormal or unusual circumstances Consistent with DSM-IV-TR, the primary purpose of using terms is to help describe, organize, and express complex features of behavior patterns Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning What Is Abnormal Behavior (cont.) Competence: Must consider the degree of maladaptive behavior and also children’s competence (ability to adapt in the environment and to achieve normal developmental milestones) Knowledge of developmental tasks, such as conduct and academic achievement, is fundamental for determining developmental progress and impairments Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning What Is Abnormal Behavior (cont.) Developmental Pathways The sequence and timing of particular behaviors as well as the possible relationships between behaviors over time Two types of developmental pathways: multifinality: various outcomes may stem from similar beginnings equifinality: similar outcomes stem from different early experiences and developmental pathways Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning What Is Abnormal Behavior (cont.) Developmental Pathways (cont.) With abnormal child psychology, keep in mind: there are many contributors to disordered outcomes in each child contributors vary among children who have the disorder children express features of their disturbances in different ways pathways leading to particular disorders are numerous and interactive, not unidimensional and static Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Risk and Resilience Risk factors: variables that precede a negative outcome and increase the chances that the outcome will occur Protective factors: personal or situational variables that reduce the chances of a child developing a disorder Examples???? Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Risk and Resilience (cont.) Risk factors (cont.) Risk factors typically involve acute, stressful situations, as well as chronic adversity Known risk factors: chronic poverty serious care-giving deficits parental mental illness death of a parent community disasters homelessness family breakup pregnancy and birth complications Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Risk and Resilience (cont.) Resilience is the ability to fight off or recover from misfortune: associated with strong self-confidence, coping skills, ability to avoid risk situations, ability to fight off or recover from misfortune not a universal, categorical, or fixed attribute; it varies across time and situations connected to a “protective triad” of resources and healthpromoting events: strength of the child, strength of the family, and strength of the school/community Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning The Significance of Mental Health Problems Among Children and Youth 1 in 8 children, including infants and toddlers, has a significant mental health problem that significantly impairs functioning; Many others are at risk for later development of a psychological disorder 25% of children who require mental health services receive only 1/9 of the treatment dollars The majority of children and youth needing mental health services do not receive them By 2020, the demand for children’s mental health services is expected to double Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Significance (cont.) The Changing Picture of Children’s Mental Health In the past, children with mental health and educational needs were described in global terms, such as “maladjusted” Better ability to distinguish among disorders has given rise to increased and earlier recognition of problems Today, problems of younger children and teens are better acknowledged Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Significance (cont.) The Changing Picture of Children’s Mental Health (cont.) Mental health problems are more likely seen in children: from disadvantaged families and neighborhoods from abusive/neglectful families receiving inadequate child care born with very low birth weight whose parents are mentally ill or substance abusers Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning What Affects Rates and Expression of Mental Disorders? Poverty and Socioeconomic Disadvantage About 1 in 6 children in the United States and Canada live in poverty (18% nationally, 16% in Idaho) Native American/First Nations and African American children are at greatest risk Poverty is associated with impairments in learning ability and school achievement, as well as less education, low-paying jobs, inadequate health care, single-parent status, limited resources, poor nutrition, and greater exposure to violence Poor children suffer more conduct problems, chronic illness, school problems, emotional disorders, and cognitive/learning problems Poverty has a significant, yet indirect, effect on children’s adjustment, which affects learning and mental health Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Sex Differences Aggression: expressed more directly by boys expressed more indirectly by girls Sex differences appear negligible in children under age 3, but increase with age Examples of problems/difficulties by age/gender??? Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Sex Differences (cont.) Problems seen more in boys (externalizing problems): hyperactivity and autism acting-out behaviors (aggression and delinquency) childhood disruptive behavior disorders learning and communication disorders early-onset disorders with neuro-developmental impairment Problems seen more in girls (internalizing problems): anxiety, depression, withdrawn behavior somatic complaints eating disorders emotional disorders with peak age of onset in adolescence Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Sex Differences (cont.) Resilience: In boys, associated with male role model structure and rules encouragement of emotional expressiveness In girls, associated with households that combine risk taking and independence with support from female caregiver Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Race and Ethnicity Most cultural anthropologists see race as a socially constructed concept, not a biological one Minority children in the U.S. are overrepresented in rates of some disorders: substance abuse delinquency teen suicide When controlling for other effects (SES, gender, age, referral status), few differences emerge in relation to race or ethnicity, although significant barriers to care remain Minority children face multiple disadvantages, including marginalization, poverty, and exclusion from society’s benefits Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Culture Values, beliefs, practices of ethnocultural groups: contribute to development and expression of children’s disorders affect how people/institutions react to children’s problems affect how problems are expressed Important not to generalize research from one culture to another, although some processes and disorders may be similar across diverse cultures Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Child Maltreatment and Non-Accidental Trauma Nearly 1 million verified reports of child abuse and neglect in the U.S. per year Over 600,000 such cases in Canada Estimate: more than 1/3 of 10- to 16-year-olds experience physical and/or sexual assaults by family members or other people they know Such adverse affects of maltreatment lead to significant mental health problems in children and youth 16% of boys and 19% of girls meet criteria for PTSD, major depressive disorder, or substance abuse/ dependence due to acts of violence Financial consequences of abuse and trauma: $94 billion in the U.S. Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Special Issues Concerning Adolescents and Sexual Minority Youths Early- to mid-adolescence is a particularly important transitional period for healthy versus problematic adjustment Substance use, risky sexual behavior, violence, accidental injuries, and mental health problems are a few of the major issues that make adolescence a particularly vulnerable period Mortality rates more than double between early adolescence (ages 10-14) and later adolescence (ages 15-19) due primarily to risk-taking behavior Sexual minority youths face multiple challenges that affect health and well-being, including victimization by peers and family members Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Lifespan Implications Impact is most severe when problems go untreated for extended periods of time About 20% of children with the most chronic and serious disorders will have significant difficulties throughout their lives are least likely to finish school are most likely to have social problems and psychiatric disorders Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning Rates and Expression (cont.) Lifespan Implications (cont.) Lifelong consequences associated with child psychopathology are costly in terms of economic impact and human suffering When provided with circumstances and opportunities that promote healthy adaptation and competence, children can overcome major impediments Recognition of children’s mental health problems has led to major initiatives for prevention and intervention Mash/Wolfe Abnormal Child Psychology, 4th edition © 2009 Cengage Learning