Psychopathology: A Simple Twist of Fate or a Meaningful Distortion of Normal Development? Toward an Etiologically Based Alternative for the DSM Approach

In this comment, I focus on a central issue that spans the entirety of Sidney Blatt's research career, namely his contributions to the development of a theoretically consistent and clinically relevant classification system of psychopathology. First, I discuss empirical evidence concerning the key assumptions underlying the currently dominant classification system of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Second, I compare these assumptions with assumptions underlying Blatt's categorization of psychopathology based on his distinction between two developmental lines, that is, self-definition and relatedness, together with a discussion of recent research on these two developmental lines in the context of the development of a more etiologically based classification system of depression and other disorders. Finally, I argue that research concerning Blatt's model of normal and pathological development—aside from direct contributions—may also inform empirically derived criteria for the development of a theoretically consistent and clinically useful way of classifying psychopathology.     

Developmental psychopathology. Current research, issues, and directions

Developmental psychopathology refers to the study of clinical dysfunction in the context of maturational and developmental processes. Although the field encompasses the entire life span, the present focus is on childhood. Special characteristics make the study of childhood dysfunction somewhat unique, including the emergence, evolution, and attenuation of seemingly problematic behaviors over the course of development; the manner in which children are referred for clinical evaluation; and complexities in identifying the appropriate foci for clinical intervention. Notwithstanding these obstacles, recent work has advanced considerably in diagnosis, assessment, and treatment of childhood disorders. The present article highlights recent advances in these areas and promising extensions in current research. Many advances have relied heavily on the extension of paradigms developed in research with adults. Additional research is needed that draws on and integrates conceptual and empirical work from developmental psychology.     

Still looking for Poppa

In 1992, V. Phares published an article titled "Where's Poppa?: The Relative Lack of Attention to the Role of Fathers in Child and Adolescent Psychopathology". Since that time, there have been modest gains in the research literature on clinical child issues, but there remains a wide gap between the inclusion of mothers and fathers in clinical child and family research. To provide an update of this issue for the field of developmental psychopathology, the authors of this comment conducted an updated review and analysis of the research on fathers and developmental psychopathology. These current data were compared with the data from the Phares and Compas (1992) study. It was found that there continues to be a dearth of research on fathers and developmental psychopathology.     

Attachment Theory,Psychoanalysis, Personality Development,and Psychopathology

Blatt and Levy place attachment theory and research in a broad theoretical matrix by considering the relationship of attachment patterns to personality development and to different types of psychopathology in adults. Thus Blatt and Levy construct conceptual bridges between the two configurations of personality development and psychopathology that Blatt and colleagues have developed over the past quarter century (e.g., Behrends and Blatt, 1985; Blatt, 1974, 1995; Blatt and Behrends, 1987; Blatt and Blass, 1990, 1996; Blatt and Shichman, 1983) and attachment theory and research. Blatt and Levy identify a polarity that is central to attachment theory and research, the polarity of attachment and separation, and they note that this polarity has also been central in much of classic psychoanalytic theory (e.g., Freud, 1930; Loewald, 1962). This polarity is expressed in attachment theory and research in the differences between avoidant and anxious-preoccupied insecure attachment patterns as well in the distinction between two types of disorganized attachment, helpless-withdrawn and negative intrusive, identified by Lyons-Ruth (1999, 2001).

This polarity of attachment and separation, or relatedness and self-definition is also fundamental to personality development that occurs in the hierarchical dialectic transaction of two basic developmental lines—interpersonal relatedness and self-definition (Blatt and Blass, 1990, 1996). This polarity is also inherent in the conception of two fundamental configurations of psychopathology—anaclitic psychopathology, the dependent (or infantile) and hysterical personality disorders—that are preoccupied with issues of interpersonal relatedness, and introjective psychopathology, the paranoid, obsessive-compulsive and depressive personality disorders, in which issues of self-definition and self-worth are dominant (Blatt, 1974, 1995; Blatt and Shichman, 1983). Thus, the identification of this fundamental polarity provides the basis for establishing links between attachment patterns, personality development, and adult psychopathology. Blatt and Levy also attempt to integrate psychoanalytic concepts of the representational world (e.g., Sandler and Rosenblatt, 1965)—the development of concepts of self and significant others—with the internal working models (IWMs) of attachment relationships. This integration enabled Blatt and Levy to bring a fuller developmental perspective to the IWMs of attachment theory and to note that, based on differences in the content and structural organization of the IWMs or mental representation of self and significant others, several developmental levels can be identified in both avoidant and anxious preoccupied attachment. These developmental levels within each attachment style also identifies less and more adaptive forms of both types of insecure attachment. Thus, the integration of the psychoanalytic concepts of mental representation with concepts of the IWM of attachment theory and research enables Blatt and Levy to create a fuller developmental perspective in the study of insecure attachment patterns.     

Promoting positive human development and social justice: Integrating theory,research and application in contemporary developmental science

The bold claim that developmental science can contribute to both enhancing positive development among diverse individuals across the life span and promoting social justice in their communities, nations and regions is supported by decades of theoretical, methodological and research contributions. To explain the basis of this claim, I describe the relational developmental systems (RDS) metamodel that frames contemporary developmental science, and I present an example of a programme of research within the adolescent portion of the life span that is associated with this metamodel and is pertinent to promoting positive human development. I then discuss methodological issues associated with using RDS‐based models as frames for research and application. Finally, I explain how the theoretical and methodological ideas associated with RDS thinking may provide the scholarly tools needed by developmental scientists seeking to contribute to human thriving and to advance social justice in the Global South.     

Multiple meanings of a developmental perspective on psychopathology

This review starts with a discussion of what is meant by developmental change. It is concluded that development is an inherently “fuzzy” concept but that it constitutes a useful framework for research into psychopathology. Some of the major changes over the last four decades in the approach taken for the study of development are noted. Ten key developmental issues are discussed: (1) prenatal influences; (2) sensitive period effects; (3) mechanisms mediating long-term effects of experiences; (4) age of onset differences; (5) sex differences; (6) normality and disorder; (7) connections among different psychological domains; (8) psychopathological progressions; (9) resilience; and (10) gene?–?environment interplay. It is concluded that developmental research is a rich field of high potential but it needs to be process-oriented rather than norm-oriented, it needs to focus on interconnections between brain and mind, and it needs to have a major interest in individual differences.     

A developmental psychopathology model of overgeneral autobiographical memory

Overgeneral memory (OGM) is a phenomenon that refers to difficulty retrieving specific autobiographical memories. The tendency to be overgeneral in autobiographical memory recall has been commonly observed among individuals with emotional disorders compared to those without emotional disorders. Despite significant advances in identifying mechanisms that underlie OGM, etiological models are not particularly developmental in nature and, instead, are focused on identifying isolated cognitive presentations of individuals with high OGM. The aim of the current paper is to utilize a developmental psychopathology framework, which emphasizes the interface between typical and atypical development, and risk and protective factors at multiple ecological levels, to propose a comprehensive model of OGM development. Specifically, (1) the progression of current etiological models of OGM is reviewed; (2) developmental theory and research on autobiographical memory that have relevance for OGM are discussed; and (3) an integrative model of OGM that includes processes at psychological, biological, social, and cultural levels is proposed. Directions for future research are formulated and treatment implications derived from this perspective are addressed.     

Self, ego, affects, and drives

I have explored the concepts of self, ego, affects, and drives, with special emphasis on terminological confusions and Freud's use of Selbst and Ich. I have also proposed a modification of the dual instinct theory in the light of the relation between affect and drives. Finally, I have proposed a developmental model on the basis of all the above considerations, and stressed its relevance for the classification of nonorganic psychopathology.     

Experimental psychopathology, clinical science, and practice: An irrelevant or indispensable alliance?

Psychopathology research is the scientific foundation for legitimate and credible forms of clinical practice and the ethical delivery of mental health services. Experimental psychopathology is a subfield of psychopathology research; its aims are to elucidate variables and processes that contribute, either in whole or in part, to the etiology, exacerbation, or maintenance of abnormal behavior. To date, experimental psychopathology has been poorly understood with regard to its identity, aims, history, and relevance for clinical practice. In this article, we critically review and address the role of experimental psychopathology in the contemporary field of clinical science and practice. Overall, we suggest that experimental psychopathology can maintain its important contributions to the field, and perhaps more important, adapt to the current health care context to have an even larger impact on directing conceptual and empirical analyses of core psychopathology processes.     

Commentary: Conceptual and Methodological Challenges to the Study of Emotion Regulation and Psychopathology

In this commentary, I argue that although emotion regulation and its role in psychopathology has been the focus of considerable psychological research with both children and adults, fundamental questions remain about how these phenomena are linked. I pose four challenges to the study of emotion regulation and psychopathology that have yet to be fully met, either empirically or conceptually. I note that a multi-level developmental approach that places emotion regulation within the context of both the larger self-regulatory system and the social relationships within which regulation occurs may be useful in understanding the emergence and maintenance of early behavioral patterns that evolve into disorders of psychological functioning.     

The impact of social experience on neurobiological systems: illustration from a constructivist view of child maltreatment

In this article, I highlight the discipline of developmental psychopathology as an integrative framework that builds upon the historical underpinnings of a constructivist perspective. After presenting illustrative developmental psychopathology principles that I consider to be central to a constructivist view, I turn my attention to the role of experience on brain development. This serves as the entree into a discussion of research conducted with maltreated children on brain event-related potentials (ERPs) and the cognitive processing of emotional stimuli, neuroendocrine functioning, and acoustic startle. Each of these components of brain functioning serve to underscore how different neurobiological systems reflect the way in which individuals ascribe meaning to traumatic experiences. Research on child maltreatment, an “experiment of nature,” reveals that maltreated children actively construct their reality at both the biological and psychological levels of analysis, at least in part based on the meaning these children impute to their caregiving experiences.     

Temperament, Development, and Personality

ABSTRACT— Understanding temperament is central to our understanding of development, and temperament constructs are linked to individual differences in both personality and underlying neural function. In this article, I review findings on the structure of temperament, its relation to the Big Five traits of personality, and its links to development and psychopathology. In addition, I discuss the relation of temperament to conscience, empathy, aggression, and the development of behavior problems, and describe the relation between effortful control and neural networks of executive attention. Finally, I present research on training executive attention.     

Experience, Development, and Resilience: The Legacy of Stuart Hauser's Explorations of the Transition from Adolescence into Early Adulthood

The legacy of Stuart Hauser's research into the developmental transformation that takes place from the adolescent living within his or her family to the young adult functioning independently is assessed. Four major themes are identified in this work: the interplay between the intrapsychic and the interpersonal; the need to understand the family in developmental context; the links between development and psychopathology; and the role of resilience in human psychological functioning. Hauser's broad, integrative, and fundamentally optimistic perspective on human nature is discussed as providing a roadmap to guide future research in this area.     

Mechanisms of Gene–Environment Interaction Effects in the Development of Conduct Disorder

ABSTRACT— The gene–environment interaction effect in the development of conduct disorder is one of the most important discoveries of the past decade, but the mechanisms through which this effect operates remain elusive. I propose a model of these processes that focuses on the individual's response to a threatening stimulus in ongoing social interaction. The individual's response coordinates three interrelated systems: neural, autonomic, and information-processing. In each system, adaptive, evolutionarily selected response patterns characterize normal responding, but in psychopathology these patterns have gone awry. Antecedents of individual differences in these response patterns arise from genetic polymorphisms, adverse environmental experiences early in life, and their interaction. Programs of research are proposed to test hypotheses in the model through longitudinal, experimental, and clinical intervention methods. This model can serve as a template for inquiry in other forms of developmental psychopathology.     

“Sinking Into the Ground”: The Development and Consequences of Shame in Adolescence

Although in recent years the developmental antecedents and clinical consequences of shame have received increased theoretical and research attention, little is yet known about shame's development after early childhood or its role in developmental psychopathology. This article reviews the literature on shame and on adolescence and suggests that attention to the role of shame in adolescent development is warranted for several reasons. Social-cognitive, physical, and interpersonal changes associated with adolescence may each be associated with normative increases in shame during adolescence. In addition, several lines of evidence converge to suggest that shame may be implicated in some of the important gender-related shifts in self-esteem and developmental psychopathology that occur over the adolescent years.     

Model building in developmental psychopathology: a pragmatic approach to understanding and intervention

Proposes model building as a pragmatic and integrative approach to developmental psychopathology. The model-building process is iterative within a program of research, cycling through the following phases of research: theory, field observation, construct definition, measurement development, construct analysis, model testing, experimental field trials, and model revision. Research on the development of and interventions for antisocial behavior is discussed as a tool for reflecting on the model-building process. The ecological framework is offered as a science-based heuristic that integrates various levels of analysis and theoretical perspectives.     

Heinz Werner: His Life,Ideas, and Contributions to Developmental Psychology in the First Half of the 20th Century

ABSTRACT

The author provides an overview of Heinz Werner's life and contributions to the field of developmental psychology during the first half of the 20th century. She focuses on his early work in Vienna and Munich as well as his tenure at the Psychological Institute in Hamburg, up through the time when he became a named Professor in Psychology at Clark University. Recognized as one of the founders of developmental psychology, Heinz Werner worked in the areas of perceptual development, comparative psychology, and symbol formation. Versatile in rigorous experimental methodologies, and in observational and phenomenological methodologies, Werner's approach to development stood in contrast to other approaches of development, both past and current. For Werner, development was a heuristic, a way of looking at processes in a variety of domains, including ontogeny, phylogeny, microgenesis, biology, developmental psychopathology, neuropsychology, and comparative psychology. Werner viewed development as proceeding from a state of relative globality and lack of differentiation to a state of increasing differentiation, articulation, and hierarchical integration, but he also stressed that individuals can function at different developmental levels under different times and conditions. Werner's holistic, organismic, comparative, and contextual approach to development transcended interdisciplinary boundaries, allowing him to study the interrelatedness between thought, language, feeling, perception, and culture.     

Novel Insights into Longstanding Theories of Bidirectional Parent–Child Influences: Introduction to the Special Section

Although bidirectional parent and child influences have been incorporated in theoretical models pertaining to the development of internalizing and externalizing behaviors in youth, studies have historically focused on the socializing influence that parents have on their children. This has left several important research questions unanswered about the nature of bidirectional parent-child relations across development, including how these bidirectional effects are related to different types of child and adolescent psychopathology. The goal of this special section is to examine some longstanding issues regarding the nature of bidirectional parent-child effects across time using a diverse array of longitudinal datasets. The results from these studies emphasize the importance of considering bidirectional effects in developmental psychopathology research, particularly the often overlooked influence that children and adolescents have on their parents' behavior and emotional well-being. Following these empirical articles, an expert in the field provides a scholarly commentary designed to outline the progress that has been made in understanding bidirectional parent-child effects across development as well as to propose fruitful areas for future research.     

Standing between two worlds in Harlem: A developmental psychopathology perspective of perinatally acquired human immunodeficiency virus and adolescence

Perinatal HIV infection in the US continues to evolve from a fatal pediatric illness to a chronic medical condition of childhood and adolescence. Although navigating this period is influenced by multi-leveled deprivations commonly experienced by low-income minority families, HIV alters the timing and experience of developmental milestones for many adolescents with perinatal HIV. This selective review of the growing developmental psychopathology literature and the authors' clinical work at a pediatric HIV program in Harlem, NY provide an overview of how developmental psychopathology offers an integrative framework that elucidates how autonomy, peer relationships, and self-concept evolve among 13–21 year old adolescents. This paper highlights the importance of considering influences of both perinatal HIV and the culture of poverty on adolescent development, and of adopting multilevel interventions and research to address how interactions among biologic, environmental, and HIV-related stressors (serostatus disclosure, medical treatment adherence, illness stigma) influence the development of adolescents with perinatal HIV.