Influences on problem development
37
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PREDISPOSING FACTORS
PERSONAL PREDISPOSING FACTORS
CONTEXTUAL PREDISPOSING FACTORS
Biological factors
•
Genetic vulnerabilities
•
Pre- and peri-natal complications
•
Early nsults, injuries and illnesses
Parent-child factors in early life
•
Attachment problems
•
Lack of intel ectual stimulation
•
Authoritarian parenting
•
Permissive parenting
•
Neglectful parenting
•
Inconsistent parenting
Psychological factors
•
Low intelligence
•
Difficult or nhibited temperament
•
Personality tra ts (neuroticism,
impulsivity)
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Low self-esteem
•
External locus of control
Exposure to family problems in early life
•
Parental psychological problems
•
Parental alcohol and substance misuse
•
Parental cr minality
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Marital distress or domestic violence
•
Family disorganization
•
Deviant siblings
Stresses in early life
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Bereavements
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Separations
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Child abuse
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Social disadvantage
•
Institutional upbring ng
PERSONAL MAINTAINING FACTORS
PERSONAL PROTECTIVE FACTORS
Biological factors
•
Dysregulation of various physiological systems
Psychological factors
•
Low self-efficacy
•
Dysfunctional attributional style
•
Cognitive distort ons and dysfunctional beliefs
•
Dysfunctional coping strategies
•
Immature defence mechanisms
CONTEXTUAL MAINTAINING FACTORS
Treatment system factors
•
Family denies problems
•
Family is ambiva ent about solving problem
•
Family has not coped with similar problems before
•
Family rejects formulation and treatment plan
•
Lack of co-ordination among involved professionals
•
Cultural and ethnic insensitivity
Family system factors
•
Inadvertent reinforcement of problem behaviour
•
Insecure parent-child attachment
•
Coercive interaction and authoritarian parenting
•
Over-involved interaction and permissive parent ng
•
Disengaged interaction and neglectful parenting
•
Inconsistent parental discipline
•
Confused communication
•
Triangulation
•
Chaotic family organ zation
•
Father absence
•
Marital distress
Parental factors
•
Parents have similar problem
•
Parental psychological problem or criminality
•
Inaccurate expectations about child development
•
Insecure adult attachment style
•
Low parental self-esteem
•
Parental external locus of control
•
Low parental self-efficacy
•
Dysfunctional attributional style
•
Cognitive distort ons and dysfunctional beliefs
•
Dysfunctional coping strategies
•
Immature defence mechanisms
Social network factors
•
Poor social support network
•
High family stress
•
Deviant peer-group membership
•
Unsuitable educational placement
•
Social disadvantage
•
High crime rate
•
Few employment opportunities
•
Media violence
Biological factors
•
Good physical health
PRECIPITATING FACTORS
•
•
•
•
•
•
•
•
•
•
•
•
Acute life stress
Illness or injury
Child abuse
Bully ng
Births and bereavements
Lifecycle transitions
Changing school
Loss of peer friendships
Separation or divorce
Parental unemployment
Moving house
Financial difficulties
Psychological factors
•
High IQ
•
Easy temperament
•
Positive persona ity traits (emot onal stability,
extraversion, consc entiousness, agreeableness)
•
High self-esteem
•
Internal locus of control
•
High self-efficacy
•
Optimistic attributional style
•
Adaptive coping strategies
•
Mature defence mechanisms
CONTEXTUAL PROTECTIVE FACTORS
Treatment system factors
•
Family accepts there is a problem
•
Family is committed to resolving the problem
•
Family has coped with similar prob ems before
•
Family accepts formulation and treatment plan
•
Good co-ordinat on among involved professionals
•
Cultural and ethnic sensitivity
PSYCHOLOGICAL
PROBLEM
Family system factors
•
Reinforcement of adaptive behaviour
•
Secure parent-child attachment
•
Authoritat ve parenting
•
Clear communication
•
Flexible family organization
•
Father involvement
•
High marital satisfaction
Parental factors
•
Good parental adjustment
•
Accurate expectations about child development
•
Parental internal locus of control
•
High parental self-esteem
•
High parental self-efficacy
•
Secure adult attachment style
•
Optimistic attributional style
•
Adapt ve coping strategies
•
Mature defence mechanisms
Social network factors
•
Good social support network
•
Low family stress
•
Positive educational placement
•
Peer support
•
High socioeconomic status
Figure 2.1 Predisposing, precipitating, maintaining and protective factors for child and adolescent
psychological problems
is usually polygenetic. With the exception of some disorders (e.g. Down syndrome), genetic
factors determine the development of specific psychological problems through their influence on broader psychological characteristics such as temperament. Current evidence does
not support the view that most childhood psychological problems are unalterably genetically
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