The environment of child maltreatment: contextual factors and the development of psychopathology

Some professionals have hypothesized that the observed problems in children who have been maltreated may actually be a result of the combination of risk factors surrounding the child, including but not limited to direct results of the abuse itself. This article examines the complexity of hypothesized pathways to poor adjustment after physical and sexual abuse. The literature on the impact of major risk factors associated with maltreatment is reviewed in an attempt to clarify the potential contributions of these contextual variables on the development of psychopathology in physically and sexually abused children. The implications this analysis may yield for prevention, intervention, and research in this field are also discussed.     

Aloneness and borderline psychopathology: the possible relevance of child development issues.

The experience of intense painful aloneness is a common event in the lives of borderline patients, especially those closer to the psychotic spectrum. This experience is defined as an intrinsic aspect of the borderline personality defect and consists of a relative or total inability to remember positive images or fantasies of sustaining people in the patient's present or past life, or being overwhelmed by negative memories and images of these people. The development of borderline aloneness is related to a possible developmental failure, defined by Piaget, Fraiberg, and A.-M. Sandler. These workers describe the child's development of object permanence and evocative memory capacity (Piaget's sensori-motor stage VI). We postulate that a major borderline vulnerability is the tenuous achievement of the capacity for affective object permanence and its regressive loss to recognition memory or earlier when under specific stresses. We relate our hypotheses to possible empathic parental failures during the substages of separation-individuation, especially the rapprochement sub-phase. The treatment implications of our formulations are discussed, with an emphasis on the clarification of the need for the therapist's availability and the use of transitional objects during times of the patient's loss of his affective cognitive capacities. These regressive experiences often emerge as a core transference manifestation during psychoanalytic therapy with borderline patients, and often become the basis of significant therapeutic work.     

The structure of child and adolescent psychopathology: generating new hypotheses

To begin to resolve conflicts among current competing taxonomies of child and adolescent psychopathology, the authors developed an interview covering the symptoms of anxiety, depression, inattention, and disruptive behavior used in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), the International Statistical Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1992), and several implicit taxonomies. This interview will be used in the future to compare the internal and external validity of alternative taxonomies. To provide an informative framework for future hypothesis-testing studies, the authors used principal factor analysis to induce new testable hypotheses regarding the structure of this item pool in a representative sample of 1,358 children and adolescents ranging in age from 4 to 17 years. The resulting hypotheses differed from the DSM-IV, particularly in suggesting that some anxiety symptoms are part of the same syndrome as depression, whereas separation anxiety, fears, and compulsions constitute a separate anxiety dimension.     

The relation of prosocial behavior to the development of aggression and psychopathology

The development of prosocial behavior is traced from middle childhood to adulthood in a 22-year longitudinal study of 800 children first seen at age 8 and is compared to the development of aggression over the same period. Prosocial behavior and aggression seem to represent opposite ends of a single dimension of behavior since they are consistently negatively related to each other and relate in opposite ways to correlated variables both synchronously and over time. Both are stable forms of behavior with good predictability over the time span studied and both are related to the quality of the parent-child relationship. The most important deterrent to the development of antisocial behavior and the encouragement of prosocial behavior is probably a close identification between the child and his/her parents.     

Response to Erich Loewy: commentary

The capacity to suffer, the vulnerability with respect to suffering, confers on all animals with that capacity (not just human beings) a prima facie right not to be caused suffering. Nurturing in order to stave off such suffering is the first act of the community toward the individual, primarily in infancy. Hence for Loewy, autonomy, the gradual growth of self-determination in individuals, is grounded in a broader moral commitment of the community, that of beneficence. This is the critical point in his argument, for it represents a wholesale critique of modern libertarianism. Libertarians, in contrast to Loewy's argument, seem to ground the nature of the community in the prima facie right of autonomy. For Loewy, the community not only has an obligation to refrain from harming individuals (nonmaleficence), but it also has an active duty to ameliorate and prevent, as far as possible, the suffering of its members. Thus, if there is a social contract, it is one of nurturing one another to overcome the vulnerability of suffering, not primarily one of protecting autonomy. This is most significant for clinical ethics as well. Once the primary obligation to ameliorate suffering is no longer necessary, when the individual loses or does not have the primary moral worth prompted by the capacity to suffer, then secondary and symbolic obligations emerge. Loewy is thereby able to suggest a "calculus" of moral worth, wherein our obligations to individuals in a permanent vegetative state or to anencephalics (almost always the individual will have lost the capacity to suffer through some cerebral event) must be weighed against other primary obligations. Although Loewy admits that grounding clinical ethics in the capacity to suffer might be "thin," it nevertheless prompts serious discussion about the nature of the "good" in good clinical ethics decisions.     

Extending the spectrum idea: child personality,parenting and psychopathology

The spectrum hypothesis, postulating that differences between referred and non‐referred samples are confined to mean level differences, is elaborated by exploring whether the covariation between child problem behaviour and its predictors—child personality and parenting, rated by mothers—is similar in referred (N = 205) and non‐referred (N = 596) children and whether personality by parenting interactions can be generalized across samples. Results showed significant mean level differences for all the variables. Both personality and parenting explained problem behaviour, with some differences in strength of the effects across samples. Parenting by personality interactions mainly predicted externalizing behaviour, with benevolence and conscientiousness as the most prominent moderators. Results confirmed that moderators of problem behaviour operate similarly in the two samples, thus corroborating the spectrum hypothesis. Copyright © 2006 John Wiley & Sons, Ltd.     

Above and beyond emotional valence: The unique contribution of central and traumatic shame memories to psychopathology vulnerability

This paper explores whether shame memories have a distinct impact on emotional difficulties and psychopathology that goes beyond their negative emotional valence. Study 1 (N=292) investigates the contribution of centrality of shame memory, in comparison to the centrality of fear and sadness memories, to explain the memory's traumatic impact, shame, depression, anxiety, stress, paranoid, and dissociative symptoms. Study 2 (N=192) explores the impact of shame traumatic memory on shame and depression, anxiety, and stress symptoms, in comparison to fear and sadness traumatic memories. Both studies used undergraduate student samples. Results show that shame memories' centrality and traumatic features made an independent contribution to current external and internal shame and distinct psychopathological symptoms, after controlling for the effect of fear and sadness, centrality, and traumatic qualities. Moreover, shame memories' centrality and traumatic features were the best global predictors of external and internal shame and depressive symptoms. Centrality of shame memories was also the only significant predictor of paranoid ideation and dissociation. These results offer novel perspectives on the nature of shame and its relation to psychopathology, emphasising the distinct role of shame memories in human functioning and suffering, which goes above and beyond its negative emotional valence.     

Mapping gray matter development: Implications for typical development and vulnerability to psychopathology

Recent studies with brain magnetic resonance imaging (MRI) have scanned large numbers of children and adolescents repeatedly over time, as their brains develop, tracking volumetric changes in gray and white matter in remarkable detail. Focusing on gray matter changes specifically, here we explain how earlier studies using lobar volumes of specific anatomical regions showed how different lobes of the brain matured at different rates. With the advent of more sophisticated brain mapping methods, it became possible to chart the dynamic trajectory of cortical maturation using detailed 3D and 4D (dynamic) models, showing spreading waves of changes evolving through the cortex. This led to a variety of time-lapse films revealing characteristic deviations from normal development in schizophrenia, bipolar illness, and even in siblings at genetic risk for these disorders. We describe how these methods have helped clarify how cortical development relates to cognitive performance, functional recovery or decline in illness, and ongoing myelination processes. These time-lapse maps have also been used to study effects of genotype and medication on cortical maturation, presenting a powerful framework to study factors that influence the developing brain.     

Stressors and child and adolescent psychopathology: moving from markers to mechanisms of risk

In the first half of this review, the authors critically evaluate existing research on the association between stressors and symptoms of psychopathology in children and adolescents. This analysis reveals (a) problems with conceptualizations of stress, (b) variability in measurement of stressors, and (c) lack of theory-driven research. To address these problems, the authors propose a general conceptual model of the relation between stressors and child and adolescent psychopathology. The authors examine basic tenets of this general model in the second half of this article by testing a specific model in which negative parenting mediates the relation between economic stressors and psychological symptoms in young people. Results generally provide support for the specific model as well as for the broader model.     

Counselling the community: The contribution of counselling psychologists to the development of primary care

The primary care groups (PCGs) newly introduced to the National Health Service require general practitioners and primary care teams to improve the health of their communities by addressing the health needs of their population, promoting the health of that population and working with other organizations to deliver effective and appropriate care. Community-oriented primary care (COPC) is an internationally tested model for primary health care development which is now being employed within the UK. This paper outlines the COPC model, and demonstrates how the skills and knowledge base of counselling psychologists and primary care counselling can contribute to a community-oriented primary care approach.     

Above and beyond emotional valence: the unique contribution of central and traumatic shame memories to psychopathology vulnerability

This paper explores whether shame memories have a distinct impact on emotional difficulties and psychopathology that goes beyond their negative emotional valence. Study 1 (N=292) investigates the contribution of centrality of shame memory, in comparison to the centrality of fear and sadness memories, to explain the memory's traumatic impact, shame, depression, anxiety, stress, paranoid, and dissociative symptoms. Study 2 (N=192) explores the impact of shame traumatic memory on shame and depression, anxiety, and stress symptoms, in comparison to fear and sadness traumatic memories. Both studies used undergraduate student samples. Results show that shame memories' centrality and traumatic features made an independent contribution to current external and internal shame and distinct psychopathological symptoms, after controlling for the effect of fear and sadness, centrality, and traumatic qualities. Moreover, shame memories' centrality and traumatic features were the best global predictors of external and internal shame and depressive symptoms. Centrality of shame memories was also the only significant predictor of paranoid ideation and dissociation. These results offer novel perspectives on the nature of shame and its relation to psychopathology, emphasising the distinct role of shame memories in human functioning and suffering, which goes above and beyond its negative emotional valence.     

Parenting empathy: Associations with dimensions of parent and child psychopathology

Background. Parenting empathy, the understanding by parents, and the sharing in their child's perspective, represents an important element of competent parenting. The present study tested the hypotheses that maternal empathy might be lower where mothers or their children display symptoms of psychopathology. Method. Mothers (N = 268) of school‐aged children completed questionnaires on child‐directed empathy and egoistic personal distress and their own and their child's symptoms of psychopathology across a number of broadly defined domains. Results. Child conduct problems were associated with decreased child‐directed empathy and increased maternal egoistic distress. Maternal aggressive characteristics and maternal ADHD symptoms were each associated with increased egoistic personal distress. Conclusion. The findings indicate that symptoms of psychopathology in children and adults are associated with deficits in empathy and increased maternal egoistic personal distress. The implications of the findings for responsive parenting and child social behaviour are discussed.     

The child development consultant: an experiment

The effects of a new type of practitioner in elementary schools—the Child Development Consultant—were evaluated in contrast to the effects of persons carrying out typical functions of the elementary school counselor and social worker. This two-year project shows trends but no significant differences favoring one type of worker over the other. Evidence suggests the value of a pupil services practitioner in a school, and indicates that although such practitioners were prepared informally and relatively briefly, their effects are the same as those who engage in full, formal preparation programs.     

Measures of child and adolescent psychopathology in Asia

This article reviews measures of child and adolescent psychopathology used in Asian cultures. Sixteen imported measures from the West are identified and their psychometric equivalence across cultures is reviewed; 2 new measures are briefly introduced. Although initial evidence is generally promising, more studies are needed to support their use in Asia. One recently developed Singapore measure cannot be considered genuinely indigenous. Culture-specific items proposed for imported measures could be grouped into existing diagnostic constructs. There is, as yet, no strong theoretical support for culture-bound diagnostic constructs in Asian cultures.     

The role of fathers in child and adolescent psychopathology: make room for daddy.

This review summarizes research concerning the relation between paternal factors and child and adolescent psychopathology. When compared with mothers, fathers continue to be dramatically underrepresented in developmental research on psychopathology. However, findings from studies of children of clinically referred fathers and nonreferred samples of children and their fathers indicate that there is substantial association between paternal characteristics and child and adolescent psychopathology. Findings from studies of fathers of clinically referred children are stronger for fathers' effects on children's externalizing than internalizing problems. In most cases the degree of risk associated with paternal psychopathology is comparable to that associated with maternal psychopathology. Evidence indicates that the presence of paternal psychopathology is a sufficient but not necessary condition for child or adolescent psychopathology.     

儿童自我延迟满足能力发展的研究

延迟满足是一种心理成熟的表现,专指一种甘愿为更有价值的长远结果而放弃即时满足的抉择取向,以及在等待期中展示的自我控制能力。本文通过论述儿童的自我延迟满足能力的发展的特点以及影响其自我延迟满足能力的发展的因素,探索了如何教育儿童自我延迟满足能力的有效途径,对幼儿健康成长和发展具有一定的指导作用。