1
Introduction to Normal and
Abnormal Behavior in
Children and Adolescents
Eric J. Mash
A. Wolfe
©David
Cengage Learning
2016
© Cengage Learning 2016
Introduction
• Research studies in abnormal child
psychology seek to:
– Define normal and abnormal behavior for
children of different ages, sexes, and ethnic
and cultural backgrounds
– Identify the cases and correlates of abnormal
behavior
– Make predictions about long-term outcomes
– Develop and evaluate methods for treatment
and/or prevention
© Cengage Learning 2016
Features That Distinguish Child and
Adolescent Disorders
• When adults seek services for children, it
is not often clear who has what “problem”
• Many child and adolescent problems
– Involve a failure to show expected
developmental progress
– Are not entirely abnormal
• Interventions are often intended to
promote further development
© Cengage Learning 2016
Historical Views and Breakthroughs
• Ancient Greek/Roman view
– The disabled were a burden - scorned,
abandoned, or put to death
• Before the 18th century
– Children were subjected to harsh treatment
and largely ignored
• By end of 18th century
– Interest in abnormal child behavior surfaced
© Cengage Learning 2016
The Emergence of Social Conscience –
Locke and Itard
• John Locke (17th century)
– Believed children should be raised with
thought and care, not indifference and harsh
treatment
• Jean-Marc Itard (19th century)
– Focused on the care, treatment, and training
of “mental defectives”
© Cengage Learning 2016
The Emergence of Social Conscience –
Hollingworth and Rush
• Leta Hollingworth
– Distinguished individuals with mental
retardation (“imbeciles”) from those with
psychiatric disorders (“lunatics”)
• Benjamin Rush
– Claimed that children were incapable of adultlike insanity
• Children with normal cognitive abilities but
disturbing behavior suffer from “moral insanity”
© Cengage Learning 2016
Early Biological Attributes
• Late 19th century: mental illnesses were
viewed as biological problems
– This was thwarted by the prevailing bias that
the individual was at fault for deviant or
abnormal behavior
• Clifford Beers’ efforts led to detection and
intervention
© Cengage Learning 2016
Early Biological Attributes – Eugenics and
Sterilization
• Early 20th century: society reverted to a
belief that disorders could not be
influenced by treatment or learning
– There was a return to custodial care and
punishment of behaviors
• Mental disorders viewed as “diseases” led
to fear of contamination
– Eugenics (sterilization) and segregation
(institutionalization) were implemented
© Cengage Learning 2016
Early Psychological Attributes –
Psychoanalytic Theory
• Linked mental disorders to childhood
experiences and surroundings
– Focused on the interaction of developmental
and situational processes
• Purported that mental disorders can be
helped with proper environment or therapy
• Retains a role as a model for abnormal
child psychology
© Cengage Learning 2016
Early Psychological Attributes –
Behaviorism
• Laid the foundation for evidence-based
treatments
• Key studies
– Pavlov’s research on classical conditioning
– Watson’s studies on the elimination of
children’s fears and the theory of emotions
• Famous study: Little Albert
© Cengage Learning 2016
Evolving Forms of Treatment –
Psychodynamic Approaches
• 1930 to 1950: psychodynamic approaches
prevailed
– Most children with intellectual or mental
disorders were institutionalized
• Late 1940s: Spitz’ studies pointed out the
harmful impact of institutional life
• 1945 to1965: institutionalization decreased
– Placement in foster care and group homes
increased
© Cengage Learning 2016
Evolving Forms of Treatment – Behavioral
Approaches
• 1950s and early 1960s: behavior therapy
emerged as a systematic approach to
treatment of child and family disorders
• Behavior therapy is a prominent form of
therapy
© Cengage Learning 2016
Progressive Legislation – IDEA
• IDEA (Individuals with Disabilities
Education Act) requires:
– Free and appropriate public education for
children with special needs in the least
restrictive environment
– Each child must be assessed with culturally
appropriate tests
– An individualized education program (IEP) for
each child
© Cengage Learning 2016
Progressive Legislation – The UN
• United Nations General Assembly (2007)
adopted a new convention to protect the
rights of persons with disabilities
– The convention supports the attitude of
considering persons with disabilities as
individuals with human rights
© Cengage Learning 2016
What Is Abnormal Behavior in Children and
Adolescents?
• Childhood disorders are accompanied by
various layers of abnormal behavior or
development
• Must also be sensitive to each child’s
stage of development
• Disorders are commonly viewed as
deviancies from normal
– Boundaries between normal and abnormal
functioning are arbitrary
© Cengage Learning 2016
Defining Psychological Disorders
• Patterns of behavioral, cognitive,
emotional, or physical symptoms linked
with one or more of the following:
– Distress
– Disability
– Increased risk for further suffering or harm
• Culture and circumstances matter
• The characteristics describes behaviors,
not causes
© Cengage Learning 2016
Labels Describe Behavior, Not People
• Stigmatization is a challenge
– Separate the child from the disorder
– Problems may be the result of children’s
attempts to adapt to abnormal or unusual
circumstances
• According to DSM-5 guidelines
– The primary purpose of using terms is to help
describe and organize complex features of
behavior patterns
© Cengage Learning 2016
Competence
• The ability to successfully adapt in the
environment
– Successful adaptation is influenced by culture
and ethnicity
• Abnormal child psychology considers:
– The degree of maladaptive behavior
– The extent to which normal developmental
milestones are met
• Knowledge of developmental tasks provides
important background information
© Cengage Learning 2016
Examples of Development Tasks
© Cengage Learning 2016
Developmental Pathways
• The sequence and timing of particular
behaviors as well as the 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
© Cengage Learning 2016
Multifinality and Equifinality
© Cengage Learning 2016
Key Considerations in Developmental
Pathways
• There are many contributors to disordered
outcomes in each child
• Contributors vary among children who
have the same disorder
• Children express features of their
disturbances in different ways
• Pathways leading to particular disorders
are numerous and interactive
© Cengage Learning 2016
Risk Factors and Protective Factors
• Risk factor: a variable that precedes a
negative outcome of interest
– Examples: chronic poverty, care-giving
deficits, parental mental illness, death of a
parent, disasters, and family breakup
• Protective factor: a personal or situational
variables that mitigates a child developing
a disorder
© Cengage Learning 2016
Resilience
• The ability to fight off or recover from
misfortune
– Associated with strong self-confidence,
coping skills, avoiding risk situations
– Connected to a “protective triad” of resources:
• Strength of the child
• Strength of the family
• Strength of the school/community
© Cengage Learning 2016
Characteristics of Those Who Display
Resilience
© Cengage Learning 2016
The Significance of Mental Health Problems
Among Children and Youth
• One in eight children has a mental health
problem (North American studies)
– Many others are at risk for later development
of a psychological disorder
• The majority of children needing mental
health services do not receive them
• The demand for children’s mental health
services is expected to double over the
next decade
© Cengage Learning 2016
The Changing Picture of Children’s Mental
Health
• A better ability to distinguish among
disorders has led to increased and earlier
recognition of problems
• There is a greater awareness of younger
children’s and teens’ unique mental health
issues
• Evidence-based prevention and treatment
programs are more prominent
© Cengage Learning 2016
Prevalence of Mental Health Issues
• Mental health problems are more likely in
children:
– From disadvantaged families
– From abusive or neglectful families
– Receiving inadequate child care
– Born with very low birth weight
– Whose parents have a mental illness or
substance abuse problems
© Cengage Learning 2016
What Affects Rates and Expression of
Mental Disorders?
• New pressures and social changes may
place children at increased risk for
development of disorder
• Environmental stressors may:
– Act as nonspecific stressors - bring about
poor adaptation or the onset of a disorder
– Affect the extent to which a child’s problems
are attenuated or exacerbated
© Cengage Learning 2016
Poverty
• One in five children in the U.S. and one in
seven in Canada live in poverty
– Native American/First Nations and African
American children are at greatest risk
• Poverty is associated with:
– Impairments in learning ability and school
achievement, less education, low-paying jobs,
inadequate health care, single-parent status,
poor nutrition, and exposure to violence
© Cengage Learning 2016
Socioeconomic Disadvantages Associated
with Poverty
• Poverty’s impact on children
– More conduct problems, chronic illness,
school problems, emotional disorders, and
cognitive/learning problems
• Poverty indirectly impacts children’s
adjustment, which affects learning and
mental health
© Cengage Learning 2016
Sex Differences
• Boys and girls express problems
differently
• Certain disorders are more common in
boys than girls, and vice versa
– Aggression is expressed more directly by
boys; expressed more indirectly by girls
• Sex differences appear negligible in
children under age three
– Disparities increase with age
© Cengage Learning 2016
Externalizing Problems
• Higher in boys than girls in preschool and
early elementary years
– Exhibited as acting-out behaviors, e.g.,
aggression and delinquency
• Rates for boys and girls converge by age
18
© Cengage Learning 2016
Internalizing Problems
• Higher rates in girls
• Associated with:
– Anxiety, depression, or withdrawn behavior
– Somatic complaints
– Eating disorders
– Emotional disorders with peak age of onset in
adolescence
© Cengage Learning 2016
Trajectories of Externalizing and
Internalizing Problems
© Cengage Learning 2016
Sex Differences and Resilience
• Types of childrearing environments that
predict resilience
– For boys:
• A male role model
• Structure and rules
• Encouragement of emotional expressiveness
– For girls:
• Households that combine risk taking and
independence with support from female caregiver
© Cengage Learning 2016
What is Race?
• 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, and teen
suicide
© Cengage Learning 2016
The Effects of Race and Ethnicity
• When controlling for other effects (SES,
gender, age, referral status)
– Few differences emerge in relation to race or
ethnicity
• Barriers remain in access to, and quality
and outcomes of, care for minority children
– Minority children face multiple disadvantages,
including poverty and marginalization
© Cengage Learning 2016
What is Culture?
• Values, beliefs, and practices that
characterize a particular ethnocultural
group
– Contribute to development and expression of
children’s disorders
– Affect how people/institutions react to
children’s problems
– Affect how problems are expressed
© Cengage Learning 2016
Culture and Diversity
• Important not to generalize research from
one culture to another
• Social and cultural beliefs and values
influence:
–The meaning given to behaviors
–The way in which behaviors are responded to
–The forms of expression and their outcomes
© Cengage Learning 2016
Child Maltreatment and Non-Accidental
Trauma: Prevalence
• Nearly one million cases of child abuse
and neglect occur in the U.S. each year
• Estimate: more than one-third of 10- to 16year-olds experience physical and/or
sexual assaults
• Acts of violence contribute to PTSD, major
depressive disorder, or substance
abuse/dependence
© Cengage Learning 2016
Child Maltreatment and Non-Accidental
Trauma: Consequences
• Financial consequences of abuse and
trauma: $124 billion per year in the U.S.
• More attention needs to be given to
developing new ways to prevent and help
those exposed to maltreatment and
trauma
© Cengage Learning 2016
Special Issues Concerning Adolescents and
Sexual Minority Youths
• Early- to mid-adolescence is an important
transitional period for healthy adjustment
• Issues during adolescence
– Substance use, risky sexual behavior,
violence, accidental injuries, and mental
health problems
• Special needs and problems of
adolescents are receiving greater attention
© Cengage Learning 2016
Special Issues: Lesbian, Gay, Bisexual,
and Transgendered (LGBT) Youths
• LGBT youths in middle and high schools
are more likely to be victimized by their
peers and family members
• LGBT youths have higher rates of mental
health problems
© Cengage Learning 2016
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:
• Are least likely to finish school
• Are most likely to have social problems and
psychiatric disorders
• Lifelong consequences associated with
child psychopathology are costly
© Cengage Learning 2016
Lifespan Implications – Solutions
• Children can overcome major obstacles
– When provided with circumstances and
opportunities that promote healthy adaptation
and competence
• Major initiatives for prevention and
intervention have resulted from recognition
of children’s mental health problems
© Cengage Learning 2016
Looking Ahead
• Children cannot advocate on their own
behalf
• Viewing the whole child is the best
strategy in understanding abnormal child
and adolescent psychology
• Efforts to change policies and programs
directed to- ward children and youths are
gaining momentum
© Cengage Learning 2016