Life Course Studies of Psychopathology: Consolidation and Concern

Abstract

The accompanying In Review papers by Dr Ian Colman and Ms Anushka Ataullahjan' and Dr Joseph Murray and Dr David P Farrington2 represent exemplary applications of the life course perspective to psychopathology. Using their papers as points of departure, I briefly sketch the core insights of this approach and the new challenges that this research poses. Historically, life course studies emerged in response to organismic (or ontogenetic) models according to which behaviour reflects inherent features of a person that unfold with maturation and that are largely invariant among people. According to such models, psychopathology typically represents a departure from normative developmental patterns and interferes with adaptive functioning. Symptoms and diagnoses may or may not be explained by environmental causes (real or imagined) but, in any event, relatively little attention is paid to social experience. Three lines of empirical research challenged these models and would subsequently inform, to varying degrees, an interdisciplinary life course model of mental health. The first such tradition is frequently associated with Glen H Elder Jr (see Elder and Shanahan1) and emphasizes the complexities of timing and the mechanisms by which the same social experiences lead to different behavioural patterns among people. The second tradition is influenced by the work of David Barker4 and focuses on associations between early environmental experiences and later indicators of health and disease. The third tradition originates, in significant ways, from Michael Rutter's5 program of research, with its characteristic interest in pathways and the contingencies by which people end up with different health profiles. Only Rutter is concerned with psychopathology, per se; however, all 3 scholars are engaged, with differing emphases, in a central concern of life course studies: the characterization of environments and their relations with behaviours and well-being during many decades of life. Each line of research began within a disciplinary context - Elder (see Elder and Shanahan3) in sociology. Barker4 in epidemiology, and Rutter5 in psychiatry - although all 3 scholars have been consistently interdisciplinary in their ambitions. Indeed, all 3 lines are now converging on an interdisciplinary life course framework that focuses on health and well-being6^10 and that is capably applied to specific psychopathologies in the accompanying papers.1 2 What are the defining characteristics of this interdisciplinary life course framework? Two themes - the dynamic and systematic nature of social settings - are central emphases and resonate with similar ideas in developmental psychopathology and genetics. First, the dynamic theme gives attention to the temporal patterns of change and continuity in context. Many conceptual distinctions have emerged to describe the temporal properties of environments, including the age at which environmental factors are first experienced, their duration, the spacing of recurring spells, pathways (that is, patterns of movement from one role or position in an organization to another), and sequences (that is, the patterning of different statuses over time).3 Similarly, regarding diagnoses and symptoms, age of onset and duration and patterns of recurrence have long been of interest. Trajectories are often used to describe quantitative change over time or groups of people with qualitatively different patterns of change or stability, typically in behaviour, but also, possibly, in social context.12 As research uncovers the complexities of gene expression, it is increasingly apparent that the genome is dynamic as well.13 While developmental psychopathology has traditionally acknowledged the dynamic nature of mental health, the life course perspective emphasizes change and stability in social settings. Second, a systems view positing that context reflects many environmental candidates and how they are organized in relation to one and other. …