Introduction to Childhood Mental

IllnessThe Beginning

Introduction to Childhood Mental Illness This course examines:

◦ Clinical Paradigms: Descriptions, Etiology, Treatment of Categorical Disorders

◦ Developmental Theory: What goes on when a child is growing up? How does this effect them later in life?

What is Psychopathology?

The study of Nature, Development and treatment of psychological disorders

Through the scientific method

Mainstream stigma is the single most formidable obstacle in the progress of this

study.

What is Disorder? A clinically significant syndrome or pattern of behaviour

associated with distress or disability or with significantly increased risk of suffering, death, pain, disability or loss of freedom *American Psychiatric Association, Diagnostic and Statistical Manual IV Text Revision (DSM-IV-TR)

Not a culturally sanctioned response to a particular event

Must be considered a manifestation of behavioural, psychological or biological dysfunction

What is dysfunction?When an internal mechanism is unable to perform its natural

function

The Social Norm Must contain evidence from neurology,

biology or medicine OR Must show a clear link between Theory and Practice

Emphasis on distress and harmful dysfunction

However, our scientific psychology is mostly based on studies of middle-class first world people

The Social Norm

Shamans show and describe behaviours western medicine would diagnose as severe psychopathology, but it is culturally sanctioned.

-> Different developmental process-> Different social norms-> Different psychology

History of Psychopathology Demonology, exorcism The Dark Ages: Witch Hunts, Lunacy Trials

“Lunacy”: Paracelsus (1493-1541)

Abnormal behaviour attributed to a misalignment of the moon and stars

Hippocrates (460? – 377? BC) – Mental health and brain functioning dependant on a balance among blood, black bile, yellow bile and phlegm.

Early Asylums

Past Treatments Benjamin Rush (1745 – 1813) – “Father of Modern

Psychiatry” treated patients by drawing huge amounts of blood or scaring them by convincing them they were about to die

Patients were shackled with iron collars on the walls, not allowed lie down at night and presumed to be animals.

Electro-convulsive shock therapy Prefrontal lobotomy

Psychoanalytic Theory Behaviourism

Modern Treatment in Psychopathology Clinical Psychology – emphasis on research, statistics, neuroscience and

empirical study- Techniques of assessment- Diagnosis of mental disorders- Psychotherapy

Counseling Psychology

Psychiatry - - Diagnosis

- Pharmacotherapy

Psychoanalysis Social work Field work (psychopathologists)

Treatment in Children Developmental Psychopathology

studies disorders of childhood in the context of normal life-span development, enabling identification of behaviours that are considered appropriate at one stage but disturbed at another

Some disorders are unique to children Some disorders start in childhood and

continue to adulthood

There is an ongoing increase in the diagnosis and medical treatment of childhood psychopathology

1. More research is neededBipolar disorders are more common in children than originally thought, but diagnosis classification in the DSM-IV applies mostly to adults

2. Psychological treatment should be used alongside medical-Depressed children on antidepressants are more likely to become suicidal. -Suicide is most likely to occur in the first 4 weeks of treatment-Medication takes 3-4 weeks to begin to act, Cognitive Behavioural Therapy acts much more quickly.

Paradigms in Psychopathology

A Paradigm is a set of basic assumptions, a general perspective, that defines how to conceptualise and study a subject, how to gather and interpret relevant data

Useful to organise our thinking

Genetics Neuroscience Psychodyamics Cognitive Behaviourism Diathesis-Stress

Nature Vs Nurture

Stress

Relationships

Culture

Genetic coding

Genetic regultation and expression

Leads to Neurobiology and behaviour

Genetics

Almost all behaviour is heritable to some degree

Genes do not operate independently from the environment

- Gene-environment InteractionEnvironment can alter gene expression- Genes may predispose us to seek out

certain environments that then increase our risk for developing a particular disorder

Psychopathology is polygenic (not caused by one gene but rather the interaction of many)

Neuroscience

Depression, anxiety, dementia and other psychopathologies all show associations with neurological dysfunction

Neuron: The neural cell, stimulated through a change in electrical potential to cause a nerve impulse which releases a chemical

Neurotransmitter: The chemical release to allow communication between neural synapses, usually generating an excitatory or an inhibitory signal

Neuroscience

Examples of Neurotransmitters: - Dopamine- Serotonin- Norepinephrine –

stimulatory/arousal- Gamma-aminobutyric acid (GABA)

Too much or too little of a neurotransmitter can result in error in metabolic pathways which can cause alterations in the usual process of the neurons

Medical treatment

Antidepressant medications may help to balance sensitivity of neurons to neurotransmitters

e.g. Failure to reuptake excess neurotransmitters may cause excessive excitation

=Anxiety

Neuroscience

Do the drugs work? Do they work as well as other psychological

methods?

Certain phenomena emerge only at certain levels of analysis and will be missed by investigators who focus only at the molecular level.

Psychopathology is probably impossible to explain in terms of neurobiology.

Psychodynamics

Childhood experiences help shape adult personality

There are unconscious influences on behaviour The causes and purposes of human behaviour

are not always obvious

Freud: Psychopathology results from unconscious conflict- Anecdotal evidence, not the scientific method

Benefits of gameplay, maintenance of negative schema internal cognitive processes