Developmental, Conceptual and

Scholarly Issues in Child

Psychopathology

James H. Johnson, PhD, ABPPDepartment of Clinical and Health Psychology

University of Florida

Lifespan Psychopathology

Question !

Why the Focus onChildren and Adolescents?

The Importance of Developmental Processes

• From the beginning of life children are in a constant process of development (motor development, cognitive/language development, behavioral development)

• One cannot make assumptions regarding child psychopathology without understanding development (can’t dress self, wets the bed, doesn’t talk).

• The Child is continually in the process of being challenged by and hopefully mastering developmental tasks.

Examples of Developmental Tasks

Developmental Norms

One can only understand abnormal behavior with reference to normal behaviorGeneral Developmental Milestones• Johnson and Goldman (1990)

Importance of Behavioral Norms• MacFarlane, Allen and Honzik (1954)• Lapouse and Monk (1959).

Normal Versus Abnormal

• Child Psychopathology: Normal development gone awry (Wenar 1982)– Fixation– Regression– Failure to Develop– Exaggerated Behavior– Qualitatively Different Behaviors

The Course of Child Psychopathology: Relationship to

Adult Problems• Changes in Child Psychopathology Over Time

– ADHD – Autism– PDD– Bipolar Disorder

• Implications of changes for diagnostic accuracy

• Childhood Origins of “Adult Psychopathology"– ADHD– Anxiety Disorders– Depressive Disorders– Conduct Disorder– Bipolar Disorder

Role of Developmental and Family Factors in Assessment and

Treatment• Implications of Developmental Factors for

Assessment– Need for Development Norms for Assessment

(e.g. visual motor tasks, Rorschach)– Reliance on Parents and Others as Sources of

Information (Issues of parent child agreement)

• Developmental Factors influencing Treatment– Referral for Treatment– Continuation/Termination– The Nature of Therapy– The Role of the Family Interactions

How do We Make Sense of Child Problem Behavior?

• What is your past experience with children?

• What has been your training with children?

• How has that shaped your views of children?

• What do you see as the major causal factors in the development of childhood difficulties ?

• To what model of child psychopathology do you subscribe?

How do we Make Sense of Deviant Child

Behavior?• Models of Psychopathology and Their

Relevance for Clinical Practice• Assumptions of Models: Clinical Assessment

and Treatment– Biological/Disease Models – Psychodynamic Model – Behavior Model– Family Model

Child Psychopathology and the Scientist-Practitioner

• What is this Scientist-Practitioner Stuff all About?

• But - What if I Don’t Do Research?• Can Somebody Who is “Just a

Clinician” be a Scientist-Practitioner?

Characteristics of The Scientist-Practitioner

Professional• Historically defined as being trained

to do research and clinical work• How successful has that been?• How do we get people to actually

do both– Enhance the training environment– Train in both and model integration

• But What If I’m mainly interested in just clinical work?

Characteristics of the Scientist-Practitioner Clinician

• Conceptual activities of the Scientist-Practitioner

• Hypothesis-generation/Hypothesis testing approach to clinical work.

• Approach to clinical decision making that involves generating and testing hypotheses at the level of the individual clinical case – continuously.

• So easy your mechanic can do it !!!

Other Characteristics of the Scientist Practitioner

• Openness to clinical data• Use of evidence based assessment• Use of evidence based treatments• Evaluates clinical methods used• Uses available research findings to

inform clinical activitiesScientist-Practitioner Approach in

the Clinic –A brief example!

That’s it for This Section!