Advanced Abnormal Child Psychology

Michel Hersen, Robert T. Ammerman, Michel Hersen, Robert T. Ammerman

• Publisher: Routledge
• Year: 2000
• Print ISBN: 9780805828665
• eBook ISBN: 9781135680978
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

There was a time when abnormal child psychology was the stepchild of abnormal psychology, with perhaps one or two chapters in an entire advanced textbook devoted to children. Given the explosive amount of new research on child development in general since the 1980s, "stepchild" is obviously no longer a valid characterization. Indeed, in the last 15 years, many new journals devoted to childhood problems have made their appearance on library bookshelves. The first edition of this book was assembled in an effort to integrate the empirical and clinical literatures and show the advanced undergraduate and beginning graduate student the breadth and depth of our existing knowledge about the disorders that manifest themselves early in development. Now, since its publication in 1995, a great deal more work has been done.

This revised and expanded second edition includes much new material from the first edition authors and from several new ones, all respected experts in the field.
Part I offers an overview. It outlines:
*historical developments with documentation of the neglect and abuse that children suffered at the hands of society well into the 20th century;
*developmental psychopathology as a theoretical framework to guide research and clinical efforts;
*psychophysiological determinants of behavior, with special attention focused on childhood autism, and attention deficit and antisocial conduct disorders;
*theoretical, methodological, and practical considerations involved in determining investigatory paths including sampling, design selection, measurement, data analysis, and pragmatics; and
*the reactions of children, families, and society to complex and diverse child health problems.
Part II addresses assessment and treatment issues. It discusses:
*behavioral treatment of childhood disorders and multiple case examples of commonly used techniques;
*new developments in pharmacological treatment and sound guidelines for the consideration of pharmacotherapy; and
*formulations and a review of preventive interventions.
Part III examines specific disorders of childhood and adolescence. It discusses:
*anxiety disorders, affective and mood disorders, mental retardation, autism, specific developmental disorders, conduct disorder, attention-deficit hyperactivity disorder (ADHD), and eating disorders;
*psychological aspects of pediatric disorders--interventions tailored to the needs of the child and family to maximize adaptation and recovery; and
*substance use disorders--ranging from models emphasizing social influences to those focusing on biological vulnerabilities.

Each chapter in Part III has an identical structure--clinical description, causes, course, familial contributions, psychological and genetic influences, current treatments, summary--and includes numerous case illustrations.

PART I
General Issues

When compared to the rest of abnormal psychology, the history of abnormal child psychology is relatively brief. Indeed, the major findings in the field only can be traced to the last three to four decades. And within that time span, the most exciting developments have taken place since the 1970s. Although abnormal child psychology is a relatively new subdiscipline, it already has had numerous influences, including developmental psychology; epidemiology; psychophysiology; genetics; psychopathology; and the data-based approaches to assessment, diagnosis, and treatment. Overall, the influences have been of an empirical nature. In a very short time, the exponential growth of this subdiscipline has made the area complex. Given the extent of such complexity, we believe that the student requires a firm grounding in the basics before she or he can have a full understanding of the nuances of psychopathology and its treatment interventions.

In this part of the text, we provide the reader with an overview of advanced abnormal child psychology, outlining the contributions from a variety of directions. First, in chapter 1, Brad Donohue, Michel Hersen, and Robert T.Ammerman review the historical developments, essentially documenting both the neglect and abuse that children suffered at the hands of society well into the 20th century. The authors describe historical antecedents that led to the discipline of child psychology, consider the status of contemporary psychotherapies, review the short history of child psychopharmacology, and look at the progression of diagnostic and empirical classification.

In chapter 2, Joseph R.Scotti and Tracy L.Morris review the salient issues relating to classification and diagnosis of childhood disorders, including new developments in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Criticisms of the psychiatric diagnostic scheme are considered, and the authors document the improvements in reliability and validity of DSM-III and DSM-III-R. Also discussed are the relations among diagnostic entities and the best methods for evaluating categorization of children at the empirical level.

In chapter 3, Gale A.Richardson and Nancy L.Day familiarize the student with epidemiologic principles. Classic studies in the field are reviewed. Critical issues in child psychiatric epidemiology are addressed, such as comorbidity (i.e., multiple diagnoses), definitions of psychopathology, developmental issues, and use of multiple informants to reach diagnostic conclusions.

In chapter 4, Sally D.Popper, Shelley Ross, and Kay D.Jennings provide an overview of child development and psychopathology. The authors underscore how developmental psychopathology provides a theoretical framework that can guide research and clinical efforts. Throughout this chapter, the importance of defining normal and abnormal behavior from an age perspective, adaptation and maladaptation, and continuity and discontinuity is emphasized.

In chapter 5, Rafael Klorman looks at psychophysiological determinants of behavior, with special attention focused on childhood autism, attention deficit disorder, and antisocial/conduct disorder. Autonomic measures most frequently studied have been heart rate and skin conductance. Researchers have studied autonomic reactivity to classify subjects on a continuum (e.g., sleep-drowsiness to alertness-excitement). Also, studies have examined moment-to-moment reaction of subjects to specific stimuli, looking at the emotional significance of such stimuli. The author brings the reader’s attention to the exciting developments in the field, such as the recent finding that antisocial respondents may display heightened information processing.

In chapter 6, G.Stennis Watson and Alan M.Gross carefully look at the evidence detailing familial factors that contribute to child psychopathology. In so doing, they dispel myths about the field and point out the myriad of anthology, alcohol and drug abuse, divorce, and extrafamilial stressors. Given the age of the child, his or her vulnerability to such stressors will differ. The authors underscore how, in the future, additional studies will be required to disentangle parental factors and child characteristics that produce psychopathology.

In chapter 7, Eric J.Mash and Gloria L.Krahn review the theoretical, methodological, and practical considerations involved in determining the course a researcher will take when investigating a problem in child psychopathology. The research endeavor has been likened to a process that follows a number of stages. Included are considerations of sampling, design selection, measurement, and data analysis, in addition to pragmatic concerns. Research areas most often studied involve the determinants of childhood disorders, risk and protective factors, and treatment and prevention.

Finally, in chapter 8, Kenneth J.Tarnowski and Ronald T.Brown examine psychological aspects of pediatric disorders. The authors address the psychological consequences of pediatric illness and injury, as well as psychological and behavioral contributions to illness. They then review the literature for two types of pediatric disorders: burn injuries and sickle cell disease. In pediatric psychology, assessment is comprehensive, involving both children and their families. Interventions must be tailored to the needs of the child and family to maximize adaptation and recovery.

1
Historical Overview

Brad Donohue
University of Nevada, Las Vegas

Michel Hersen
Pacific University

Robert T.Ammerman
Children’s Hospital and Medical Center

Historically, children have been treated poorly. However, significant events have brought about better treatment for children, including legislation protecting their rights, emergence of child guidance clinics, scientific study of child development, and evaluation of child psychotherapies.

Our introductory chapter (a) examines the history of child abuse and neglect, (b) discusses major historical antecedents that have led to the science of child psychology, (c) briefly examines the etiology and current status of major contemporary psychotherapies, (d) reviews the brief history of child psychopharmacology, and (e) examines the progression of behavioral classification and diagnostic categorizing with children.

HISTORY OF THE TREATMENT OF CHILDREN

In ancient Greece, physical and intellectual strengths were highly esteemed. Philoso phers encouraged proper childhood education and training for attainment of maturity and success in later vocation, which helped to create a Zeitgeist that stressed education, athletics, and skills training for the brightest and most affluent boys in Greece. Older girls and women in that society assumed a domestic role that was limited to taking care of children and home care. However, children with mental or physical handicaps were tormented publicly. Less frequently, children with mental retardation and psychopathology were put to death or abandoned.

Treatment of children during the Roman Empire was essentially the same. Affluent children were educated in art, poetry, and sports, and poor children were treated harshly. Indeed, decisions as to whether the child should be sold as a slave, abandoned, or murdered depended on his or her value to the family.

The importance of development and formal education for most children was overlooked in Europe during the Middle Ages, even for those with great promise. Games and books for children were absent, and paintings of children during those times depicted them in adult clothing with adult mannerisms. Children were legally sold into slavery, and severe beatings were commonly carried out. Many children were abandoned or forced to work in monasteries to pay debts incurred by their parents. Children in middleto low-income families started to work during their early childhood years, sometimes greater than 13 hours a day. Some girls were forced into marriage contracts during pre-adolescence. The child mortality rate was extremely high due to long hours in poor working conditions, epidemics, malnutrition, childhood disease, and murder (illegitimate and unwanted children usually were murdered).

The Renaissance led to increased sensitivity and humanity toward children. However, changes were slow to develop. Initially, severe physical punishment was widely accepted, and psychopathology was believed to be the result of demonic possession, which resulted in harsh treatment for mentally ill children. However, some important changes did occur during this period. Thomas Phaire’s The Boke of Chyldren was written in 1545, the first publication to address pediatric problems, such as nightmares. Infanticide was determined to be illegal, although abandonment and residential placement in orphanages or church settings was accepted. Although the latter practice appears more merciful than infanticide, it should be mentioned that most children who were raised in orphanages died very young. Mortality rates were generally high, as one of every three children born during this time did not live to adulthood. By the late 1600’s, it became customary for European parents to show affection and play with their children, particularly in affluent populations. However, adults in Colonial America continued to treat children abusively. During colonial expansion of America, children were often imprisoned, punished, or killed if they refused to be transported to America, where they often would be forced to work in harsh conditions or be exploited by male settlers as tobacco “brides.” In 1654, the Stubborn Child Law allowed a parent to have “stubborn” children put to death for noncompliance. However, most children died before they were 4 years old from disease, starvation, malnutrition, and severe beatings.

Conditions for children began to improve in the 1700s. However, high morbidity rates and poor treatment were still common among children, particularly indigent children. Poor children living in cities typically worked excessive hours in factories, and children in rural areas worked on farms. Although many bills were opposed, a bill was submitted that prohibited children from the ages of 9 to 13 to work more than 48 hours a week and also prohibited children aged 13 to 18 from working more than 68 hours per week. As judged by contemporary standards this bill appears harsh. However, it was a substantial improvement at that time. Records were published pertaining to the development of children, which helped to bring about understanding as to the importance of using toys and pictures to stimulate physical and intellectual growth during childhood.

During the early 1800s, Benjamin Rush helped to bring about moral treatment of children with the publication of results from his studies of children (i.e., descriptions of the development of cholera in infants). Other developments in the medical field created an environment conducive to change for the betterment of child welfare in the late 1800s. Hospital-based interventions for children’s medical and psychological conditions were implemented for the first time. Charles Caldwell wrote the first medical degree dissertation on pediatrics, and the first medical textbooks specializing in child psychopathology were published in Europe. Dorothea Dix formally requested the state legislature to increase federal funding to treatment centers that supported moral treatment of children. Her efforts resulted in approximately 30 new mental hospitals that emphasized moral treatment of mentally ill patients. During this time, G. Stanley Hall originated the Illinois Society of Child Study. He studied the motor and emotional development of children by devising the “baby bibliography.” His work consisted of sending questionnaires to parents, teachers, mental health professionals, and children about various areas of child development to obtain normative data. In doing so, he was the first person to examine developmental abilities. He also encouraged others to monitor development of children and to consider the stages of development when assessing children. Hall founded the first scholarly journal devoted to pediatric development, and he wrote a two-volume text entitled Adolescence: Its Psychology and Its Relations to Physiology, Anthropology, Sociology, Sex, Crime, Religion, and Education. In this endeavor, Hall was the first person to describe “adolescence” as a unique stage of development.

In addition, the child study movement facilitated growth of compulsory education in the United States. An increase in student enrollment during the early 1900s restricted the time that public school teachers were available to assist students with learning disabilities. This led to development of special education programs that were established to accommodate children who were not able to adapt to regular school programs. The poor and ethnic minorities were disproportionately represented in these alternative schools, and issues related to labeling and discrimination were noted for the first time.

During the late 1800s, Alfred Binet developed an objective and standardized way to detect deviance form normal intellectual functioning. In 1916, this test was modified by Lewis Terman and named the Stanford-Binet Scale. The scale was one of the first standardized instruments to compare each child’s performance with standardized norms at different age ranges. Development of this test assisted with identification of learning problems in school. The discriminative ability of the Stanford-Binet test influenced several scientists in the 1920s to begin longitudinal studies, using large numbers of children to produce standard norms on physical, intellectual, emotional, and behavioral characteristics.

Starting in the late 1800s, political organizations that promoted the welfare of children first began to appear. These organizations helped to facilitate federal funding for child mental health treatment centers and helped to establish child protection laws. In 1870, the first child abuse case was processed in court by the American Society for the Prevention of Cruelty to Animals. About this time, the Society for the Prevention of Cruelty to Children was founded. Public responsibility for delinquent children was expedited with correctional institutions in America. In 1909, President Theodore Roosevelt organized the first White House Conference on Children. His political reform movement condemned various cruelties perpetrated by adults toward children. The U.S. government provided funding to initiate the Children’s Bureau in 1912 to protect the rights and welfare of children and to provide aid to dependent children. Volunteer services for children (e.g., Child Welfare League of America) also were formed. Federally funded child development institutes in the United States were initiated after the Iowa Child Welfare Research Station was founded in 1916 to study the cognitive and behavioral development of children. In 1922, Adolph Meyer, a member of the National Committee on Mental Hygiene, formally requested that psychiatrists be placed in the school system to work with teachers to prevent problems that would interfere with school performance and healthy psychological development. After the Wages and Hours Bill was passed in 1938, children under 16 years of age were no longer allowed to work In hazardous occupations.

The first psychology clinic was established in 1896 at the University of Pennsylvania by Lightner Witmer. This was the first clinic to assess, treat, and study primarily childhood difficulties relevant to school performance, such as stuttering, spelling, and learning disabilities. Target populations were individuals with mental retardation, gifted children with speech impediments, and those requiring vocational adjustment. These clinics helped to foster the development of child treatment centers that began to emerge in the first decades of the 20th century, focusing on educational problems, social dysfunction, and behavioral disorders. The National Committee for Mental Hygiene was founded in 1909, which, in part, sponsored research surveys on children’s mental health issues and paved the way for child guidance clinics. In 1909, William Healy established the Juvenile Psychopathic Institute, which primarily focused on the etiology, prevention, and treatment of juvenile delinquents. He also emphasized the social-affective aspects of development and was largely responsible for the beginning of the child guidance movement. The purpose of these clinics was to diagnose and provide psychological treatment recommendations for children who were referred by the juvenile court system. The court system sent most juvenile offenders to state outpatient clinics but also included referrals to child youth organizations such as the YMCA. These organizations were established to provide juveniles with prosocial activities to reduce delinquency rates that had been exacerbated by increased urbanization. By 1932, there were more than 200 clinics in America. The earliest investigative studies of child psychotherapy effectiveness were performed at child guidance clinics during the 1930s and 1940s. Such investigations revealed that about 75% of children evaluated demonstrated significant improvement. However, these investigations were based exclusively on therapists’ judgments of improvement and, of course, they were not controlled comparison conditions. By the early 1930s, many colleges included departments for special education, and some states requi...

Table of contents

• COVER PAGE
• TITLE PAGE
• COPYRIGHT PAGE
• PREFACE
• PART I GENERAL ISSUES
• PART II ASSESSMENT AND TREATMENT
• PART III DESCRIPTION OF THE DISORDERS