Developmental Psychopathology Framework Research Articles

Association of comorbid anxiety with social functioning in school-age children with and without attention-deficit/hyperactivity disorder (ADHD)

Although attention-deficit/hyperactivity disorder (ADHD) is frequently comorbid with disruptive behavior disorders, less is known about ADHD and comorbid anxiety. To improve understanding about the association of anxiety and social functioning, we studied 223 6 to 9year-old ethnically diverse boys and girls (M=7.4years) with and without ADHD. According to parents, children with ADHD and anxiety (n=46) and ADHD only (n=71) were consistently less socially competent than comparison children (i.e., no anxiety and ADHD: n=80) and children with anxiety only (n=26), who did not differ from one another. A similar pattern emerged for teacher ratings where youth with ADHD only and ADHD with anxiety exhibited the most social problems, but they did not differ from each other. These data suggest that comorbid anxiety does not exacerbate social dysfunction among 6 to 9year-old children with ADHD. We consider findings within a developmental psychopathology framework to further understand social development in children with ADHD and anxiety.

The integration of emotional availability into a developmental psychopathology framework: Reflections on the Special Section and future directions

We appreciate both the opportunity to co-edit this Special Section of Development and Psychopathology and the thoughtful commentaries provided by Marjorie Beeghly, Marc Bornstein, Robert Emde, and David Oppenheim. Their commentaries review historical perspectives, provide new insights, and suggest future horizons for the study of emotional availability (EA) within a developmental psychopathology framework. Along with the collection of empirical studies in this Special Section, they begin to chart a course for further growth and integration of EA into the field of developmental psychopathology. Taking stock of the research on EA, we realize that there is now a sufficient corpus to suggest that research focusing on this construct, as operationalized by the EA Scales (Biringen, Robinson, & Emde, 1998) is entering a more mature phase of inquiry. In the last 14 years, research on EA, including several special journal issues on the topic (see Biringen & Easterbrooks, 2008; Easterbrooks & Biringen, 2000, 2005, 2009), has explored the methodological concerns, reliability, and validity of the EA Scales and application across different samples and ages. This “critical mass” of knowledge (more than 100 peer-reviewed publications) supports the current focus on asking incisive questions for the field of developmental psychopathology (Cicchetti & Toth, 1995, 2009).

A developmental psychopathology perspective on emotional availability research: Current trends and challenges

Studies using the Emotional Availability Scales have burgeoned in the past decade. The collection of papers included in this Special Section represents the latest innovations in research with this paradigm. Consistent with a developmental psychopathology perspective, these papers evaluate emotional availability in a variety of typical, at-risk, international, and intergenerational samples of children and caregivers, with many utilizing longitudinal designs or employing measures from multiple levels of analysis. One study begins to translate findings from this body of research into a promising intervention program. Although further growth and refinement in research with this paradigm is needed, the results to date begin to place the construct of emotional availability into a complex, dynamic biopsychosocial context, and promise to inspire a new generation of studies. In this commentary, some of the key contributions and challenges of this collection of studies are highlighted using a developmental psychopathology framework.

The quality of the mother–child relationship in high-risk dyads: Application of the Emotional Availability Scales in an intergenerational, longitudinal study

The present research examined how family psychosocial risk may be associated with emotional availability (EA) across age and time in two longitudinal, intergenerational studies with high-risk, disadvantaged mother-child dyads. Study 1 examined dyads during preschool and middle childhood. Study 2 examined a different sample of dyads, tested intensively at five time points (6, 12, and 18 months; preschool; and school age). Across studies, maternal childhood histories of aggression and social withdrawal predicted negative EA (higher levels of maternal hostility) during mother-child interactions at preschool age. In Study 1, mothers with higher levels of social withdrawal during childhood had preschoolers who were less appropriately responsive to and involving of their mothers during interactions. In Study 2, higher levels of observed appropriate maternal structuring predicted child responsiveness while observed maternal sensitivity (and structuring) predicted observed child involvement. More maternal social support and better home environment combined with lower stress predicted better mother-child relationship quality. Findings contribute to the burgeoning literature on EA by focusing on a high-risk community sample across time and generations. Results are interpreted in light of the developmental psychopathology framework, and have implications for a broader understanding of how EA is related to parental history and personal characteristics, as well as ongoing family and environmental context.

Emotional availability: Concept, research, and window on developmental psychopathology

The construct of emotional availability (EA) refers to the capacity of a dyad to share an emotional connection and to enjoy a mutually fulfilling and healthy relationship. The EA Scales were designed to assess multiple components of a relationship from the perspective of both partners. The four caregiver components include sensitivity, structuring, nonintrusiveness, and nonhostility; two scales measure the child's responsiveness to the caregiver and involvement of the caregiver. We describe the EA construct and introduce the papers in this issue, focusing on the contributions of this Special Section to a developmental psychopathology framework.

Parenting Behavior and Conduct Problems in Children with and Without Attention-Deficit/Hyperactivity Disorder (ADHD): Moderation by Callous-Unemotional Traits

There is evidence that negative parenting positively predicts oppositional defiant disorder (ODD) and conduct disorder (CD) and that children’s callous-unemotional (CU) traits may moderate this association. However, it is largely unknown if CU traits show similar interactive effects with positive parenting for ODD/CD. 208 ethnically diverse (56% Caucasian) 6–9 year-old children with and without attention-deficit/hyperactivity disorder (ADHD) were ascertained using multiple methods and informants for ODD, CD, and CU traits. CU traits, corporal punishment, positive parenting, and each of their interactions with CU traits were unrelated to parent- and teacher-rated ODD. Corporal punishment and CU traits were similarly unrelated to parent- and teacher-rated CD. However, positive parenting inversely predicted parent-reported CD symptoms and it was significantly moderated by CU traits. Positive parenting was negatively associated with CD at low to moderate levels of CU traits, but it was unrelated to CD at high levels of CU traits. Children with elevated levels of CU traits exhibited significantly higher levels of CD symptoms that were largely independent of positive parenting behavior. We discuss these findings within a developmental psychopathology framework to provide further perspectives on reciprocal influences between parenting behavior and CU traits in the development of ODD and CD.

An internalizing pathway to alcohol use and disorder.

Research emanating from the field of developmental science indicates that initial risk factors for alcohol use and disorder can be evident in early childhood. One dominant developmental pathway connecting these initial risk factors with subsequent alcohol involvement focuses on the central role of disinhibited or externalizing behaviors. In the current paper, we delineate a second pathway that focuses on internalizing symptomatology. Several studies indicate that internalizing symptoms in early and middle childhood predict alcohol involvement in adolescence and young adulthood. We use a developmental psychopathology framework to describe a risk model that traces the potential developmental markers of this internalizing pathway and to consider the relation between the internalizing pathway and the more widely researched externalizing pathway. We outline the markers of risk in this pathway and conclude with a discussion of the implications of this model for prevention efforts and future research. In this manner, we strive for a translational goal, linking our existing understanding of internalizing processes and alcohol use and disorder with our efforts to develop effective prevention programs.

Developmental psychopathology and the diagnosis of mental health problems among youth.

Recent years have evidenced a tremendous increase in research using a developmental psychopathology framework to examine clinical diagnoses among youth. Despite this increase, a relative dearth of literature systematically examines the development of co-occurring conditions among youth. In this introduction to the Special Issue on comorbidity among youth, we suggest that a developmental psychopathology perspective can provide an important foundation for the diagnosis of mental health problems among youth. As a potential framework for future investigations, we consider several developmental psychopathology principles that can inform assessment and diagnosis among youth psychological disorders. We use these principles as a foundation for considering co-occurring psychological disorders and provide potential explanations for comorbidity that can be addressed in future research that uses a developmental psychopathology perspective.

From child maltreatment to adolescent cannabis abuse and dependence: a developmental cascade model.

A developmental cascade model tested associations among child maltreatment, internalizing and externalizing psychopathology, social competence, and cannabis abuse and dependence symptoms in a longitudinal cohort (N = 415). Nested structural equation models evaluated continuity and cross-domain influences among broad multi-informant constructs across four developmental periods: age 7 to 9, 10 to 12, 13 to 15, and 15 to 18. Results indicated significant paths from child maltreatment to early externalizing and internalizing problems and social competence, as well as to cannabis abuse and dependence (CAD) symptoms in adolescence. Youth CAD symptoms were primarily related directly to child maltreatment and externalizing problems. Childhood internalizing symptoms contributed to later childhood decreases in social competence, which predicted increases in late adolescent externalizing problems. Using a developmental psychopathology framework, results are discussed in relation to cascade and transactional effects and the interplay between problem behaviors during childhood and development of CAD symptoms during early and late adolescence.

Changes in Externalizing and Internalizing Problems of Adolescents in Foster Care

Using a developmental psychopathology framework, this study aimed to examine changes in externalizing and internalizing problems of adolescents in foster care and to determine whether type of maltreatment, gender, and age influenced trajectories. Authors used 3 waves of data from the National Survey of Child and Adolescent Well‐Being. Growth‐curve analyses of 106 adolescents aged 13–16 in foster care revealed that externalizing and internalizing problems decreased over time. Adolescents, particularly boys, placed in foster care as a result of sexual abuse, physical abuse, or neglect demonstrated faster decreases in externalizing problems and, similarly but to a weaker degree, internalizing problems than did those placed in foster care as a result of other forms of maltreatment.

A Controlled, Longitudinal Study of the Social Functioning of Youth With Sickle Cell Disease

To assess the peer relationships of adolescents with sickle cell disease (SCD) and demographically similar comparison peers who did not have a chronic illness 2 years after an initial evaluation. As a result of ongoing medical challenges associated with SCD and the psychological demands of adolescence, we hypothesized that children with SCD would be viewed by peers as more sensitive and isolated, they would have fewer friends, and they would be less well liked than comparison peers. At follow-up, peer (n = 2067) and teacher (n = 120) reports of social functioning were obtained for 60 children with SCD and 66 comparison peers. Social reputation (What is the child like?) and social acceptance (Is the child liked?) were evaluated cross-sectionally and longitudinally at the 2-year follow-up (ages 10-17). Relative to comparison peers, children with SCD were perceived as less aggressive by peers and teachers. No significant differences were found between groups on measures of friendship or social acceptance. Results of longitudinal analyses indicated that teacher-reported levels of sensitive and isolated behavior increased over time for comparison peers but remained stable for children with SCD. In general, the social functioning of children with SCD remained stable over time and was not suggestive of emergent social dysfunction. Findings are discussed within a developmental psychopathology framework, possible protective effect of SCD for youth from high-risk environments, and implications regarding pain management for these youth.

Trajectories of Peer Victimization: The Role of Multiple Relationships.

This study examined early elementary school children's trajectories of peer victimization with a sample of 218 boys and girls. Peer victimization was assessed (via peer report) in kindergarten, 1(st), 2(nd), and 5(th) grades. Hierarchical linear modeling (HLM) was used to examine multiple types of relationships (mother-child, student-teacher, friendship) as predictors of kindergarten levels of peer victimization and changes in peer victimization across time. Results indicated that the mother-child relationship predicted kindergarten levels of peer victimization, and that the student-teacher relationship did not provide additional information, once the mother-child relationship was accounted for in the analyses. Friendship predicted changes in peer victimization during the elementary school years. Results are discussed in a developmental psychopathology framework with special emphasis on the implication for understanding the etiology of peer victimization.

Relational Climate and Effectiveness of Residential Care: Adolescent Perspectives

In Italy, the evaluation of residential care is particularly important in view of: (1) the process of deinstitutionalization; (2) the power of the public authorities to devolve the running of services, including residential communities, to private partners. The literature has stressed the importance of involving multiple stakeholders in the design and implementation of evaluative research. This article summarizes a research plan for the evaluation of child and adolescent residential communities based on the theoretical framework of developmental psychopathology and Bronfenbrenner's ecological model of human development. A study is presented on the perception that adolescents in care have of the community's relational climate—analyzed by way of everyday routines and communications with adults—and of the effects of the intervention. The results corroborate the hypothesis that the relational climate in a community is a good predictor of the efficacy of residential care.

A prospective investigation of the development of borderline personality symptoms.

The antecedents and developmental course of borderline personality disorder symptoms were examined prospectively from infancy to adulthood using longitudinal data from a risk sample (N = 162). Borderline personality disorder symptom counts were derived from the Structured Clinical Interview for DSM Disorders diagnostic interview at age 28 years. Correlational analyses confirmed expected relations between borderline symptoms and contemporary adult disturbance (e.g., self-injurious behavior, dissociative symptoms, drug use, relational violence) as well as maltreatment history. Antecedent correlational and regression analyses revealed significant links between borderline symptoms in adulthood and endogenous (i.e., temperament) and environmental (e.g., attachment disorganization, parental hostility) history in early childhood and disturbance across domains of child functioning (e.g., attention, emotion, behavior, relationship, self-representation) in middle childhood/early adolescence. Process analyses revealed a significant mediating effect of self-representation on the relation between attachment disorganization on borderline symptoms. The findings are discussed within a developmental psychopathology framework in which disturbance in self-processes is constructed through successive transactions between the individual and environment.

Antisocial behavior from a developmental psychopathology perspective

This paper reviews research on chronic patterns of antisocial behavior and places this research into a developmental psychopathology framework. Specifically, research suggests that there are at least three important pathways through which children and adolescents can develop severe antisocial behaviors. One group of youth shows antisocial behavior that begins in adolescence, and two groups show antisocial behavior that begins in childhood but differ on the presence or absence of callous-unemotional traits. In outlining these distinct pathways to antisocial behavior, we have tried to illustrate some key concepts from developmental psychopathology such as equifinality and multifinality, the importance of understanding the interface between normal and abnormal development, and the importance of using multiple levels of analyses to advance causal theories. Finally, we discuss how this development model can be used to enhance existing interventions for antisocial individuals.

A Systematic Review of Parenting in Relation to the Development of Comorbidities and Functional Impairments in Children with Attention-Deficit/Hyperactivity Disorder (ADHD)

This review synthesizes recent research evidence regarding the parenting characteristics associated with families with children with Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is a complex, heterogeneous disorder with a range of genetic and environmental factors that contribute to its behavioral expression and different developmental trajectories. The current review adopts a developmental psychopathology perspective to conceptualize the risk and protective factors that might shape the developmental pathways of the disorder across different domains. Following from Johnston and Mash's review (Johnston and Mash, Clin Child Fam Psychol Rev 4:183-207, 2001), the present review systematically examines empirical studies from 2000-2008 that investigate parenting variables in relation to the development of children with ADHD, with a particular focus on the development of externalizing and internalizing comorbidities, as well as functional impairments in academic and social contexts. The most recent research evidence uses correlational designs to show that ADHD is associated with problematic family functioning, including greater stress within the family, higher rates of parental psychopathology and conflicted parent-child relationships, which appears to be exacerbated in children with comorbid oppositional and conduct problems. However, there is an absence of literature that considers the role that parents play in contributing to children's development in areas such as academic achievement and peer competence, as well as the development of internalizing difficulties. Future research should examine family factors that are associated with resilience in children with ADHD, using longitudinal designs that reflect the dynamic changes associated with a developmental psychopathology framework.

Peer Difficulties in Children with Epilepsy: Association with Seizure, Neuropsychological, Academic, and Behavioral Variables

Purpose/Objective: A developmental psychopathology framework was used to examine variables associated with peer problems in children with epilepsy (CWE). Variables commonly associated with peer difficulties in typically developing children, such as inattentive behavior, anxious behavior, and academic achievement were investigated. Neuropsychological functioning, age at epilepsy onset, and seizure status were also examined. Research Method/Design: Participants were 173 CWE, ages 8–15. Structural equation modeling (SEM) was used to determine which variables predicted peer problems in CWE and to test hypothesized interrelations among variables. Results: The SEM revealed that anxious behavior mediated relations between neuropsychological functioning and peer difficulties and seizure status and peer difficulties. Inattentive behavior mediated the association between neuropsychological functioning and peer difficulties. Neuropsychological functioning mediated the relation between age at epilepsy onset and inattentive behavior, anxious behavior, and academic achievement. Conclusions/Implications: As seen with typically developing children, inattentive and anxious behaviors are related to peer difficulties in CWE. Neuropsychological functioning, age at epilepsy onset, and seizure status are indirectly associated with peer difficulties; therefore, these variables are important to examine in CWE who are experiencing peer problems.

Social–Emotional Problems in Early Childhood and the Development of Depressive Symptoms in School-Age Children

Research Findings: The present longitudinal study investigated whether a range of social–emotional difficulties in early childhood predict the development of depressive symptoms in middle childhood. Participants were 56 children and their teachers. Teachers' reports of internalizing and externalizing behaviors were obtained during preschool, and children's displays of negative affect were observed through classroom videotapes in preschool. Children's self-reports of depressive symptoms were collected approximately three and a half years later. Teachers' ratings of social problems and atypical behaviors were positively associated with later depressive symptoms. Teachers' ratings of rule breaking and observed negative affect in preschool were stronger predictors of later depressive symptoms in girls than in boys. Findings point to social non-conformity as an important feature in the developmental course of depressive symptoms. Results lend support to a developmental psychopathology framework, showing change over time across types of social–emotional difficulties in gender-specific directions. Practice or Policy: Findings underscore the role that preschool teachers and classroom observation could play in identifying early risk for depressive symptoms. Results suggest the possible utility of early screening programs for at-risk preschool-aged children. Moreover, results could inform school-based intervention or prevention programs targeting internalizing symptoms, an under-recognized area of children's mental health.

Changes in Mental Health in Adolescents with a History of Specific Language Impairment

Little is known about long-term mental health outcomes as individuals with specific language impairment (SLI) approach adulthood.Aims:This longitudinal study examined anxiety (Child Manifest Anxiety Scale; CMAS) and depression (Moods and Feelings Questionnaire; MFQ) during the critical period when adolescents finish compulsory education and then embark upon their chosen course of study or employment.Method:Eighty-nine adolescents with SLI and 90 typically developing (TD) peers were assessed during their final year of compulsory schooling (16 years) and one year later.Results:At 16 years, there is a greater risk of both anxiety and depression in adolescents with SLI compared to their peers. Group scores for adolescents with SLI were significantly higher on both the CMAS (p< .001) and the MFQ (p< .01). However, while this finding is replicated at 17 years for anxiety symptoms (p< .01), there is a significant decrease in depressive symptoms for adolescents with SLI across time such that risk of depression is comparable to TD peers at 17 years. Scores for TD adolescents remain remarkably stable across this period. Poor mental health symptoms were not related to measures of nonverbal IQ, language, literacy or sociability but were associated with higher levels of shyness.Conclusion:Notwithstanding a sustained, elevated risk of anxiety symptoms, there is an encouraging trend for a decrease in depressive symptoms as adolescents with SLI complete compulsory education. The findings are interpreted within a developmental psychopathology framework, focusing on the changing structure of intrapersonal and environmental processes that influence internalizing symptoms during mid-adolescence.

Pathways from infant exposure to marital conflict to parent-toddler role reversal.

We know that exposure to marital conflict places infants at risk, but we know less about processes. One process may be role reversal, when a distressed parent looks to the child to meet unmet needs for comfort, intimacy, or companionship. A parent in marital conflict may be particularly prone to role reversal, which in turn adversely affects child development. The current study examined pathways from infants' exposure to marital conflict at 12 months to role reversal at 24 months. We sampled low-middle socioeconomic status (SES) families with their first child (N = 128). Independent observers assessed marital conflict (in a problem-solving task) and role reversal (in a story-telling task). We found that each parent's conflict behavior predicted the other parent's role reversal. In a direct pathway, mother's conflict behavior towards father led directly to father's role reversal with the child. In an indirect pathway, father's conflict behavior towards mother led to his withdrawal from her, which in turn led to mother's role reversal with the child. Clinical implications are discussed within a developmental psychopathology framework in terms of preventive interventions to offset the deleterious effect of marital conflict and role reversal on child development.