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Developmental Psychopathology: A Review and Integration
by
Gabriella Kortsch
From its earliest conception and origins several decades ago, to the definition it was given in 1984 as the “study of the origins and course of individual patterns of behavioral maladaptation” (Rutter and Sroufe, 2000, p. 265), developmental psychopathology has appeared to emerge rapidly as a rising star within the academic arena of lifespan developmental psychology. Its proponents appreciated that ideas that attempt to tie the entirety of human development, growth and process into relatively rigid and narrow confines, that “see development as a single universal progression that varied only in its timing” (Rutter & Sroufe, 2000, p. 267), and that frequently give a very cold shoulder indeed to offers to blur boundary lines between disciplines, could not and would not suffice to further the understanding of both normal development and disorder. Developmental psychopathology however, presents – or attempts to present– a worldview that is as broad in concept, as it is open to new ideas and research from other disciplines. This worldview directs the inquiry of a discipline that looks to person-environment interactions within wide-flung parameters of probabilistic processes, where no specific outcome ever has to happen (Tubman, unpublished).
Precisely by not confining itself within strict parameters, precisely by opening its doors to a multitude of disciplines (Cicchetti & Sroufe (2000), indicate that contributions have emerged from all sectors of social and biological sciences), from which it hopes to separate the wheat from the chaff in its quest to find answers, and precisely because it does not pretend to have all – or even most - of the answers, it offers a strong basis for optimism that it will indeed achieve its purpose: that of identifying the myriad causal pathways that ultimately lead to pathological outcomes, as well as those other pathways, that indicate that while a number of individuals may have had similar initial experiences or risk factors, they do not necessarily lead to the same result.
These two pathway concepts: equifinality and multifinality lie at the heart of developmental psychopathology and offer a showcase window into its inner mechanisms as it searches for “interindividual differences in intraindividual change processes” (Tubman, unpublished). In other words, it seeks to ascertain – by making use of an interdisciplinary approach – why specific situations bring about normative outcomes for some individuals and pathological outcomes for others, and why other sequelae, similar for a large group of individuals, have nevertheless come about through multiple and highly distinct paths.
The study of the dynamic processes that are subjacent to these varied outcomes and varied starting points, form part of the concepts of equifinality and multifinality that make up the methodological essenceof developmental psychopathology. Moreover, in order to comprehend the abnormal, not only must those samples that are at-risk be examined, but also the normal must be understood (Cummings, Davies, & Campbell, 2001).
This pursuit to understand disorders in all their aspects, manifestations and variations, must necessarily commence with the study of their origin. Further, if the emergence of a specific disorder is not uniform over all samples (equifinality), minute examination should be undertaken of this phenomenon as well. It further behooves the researcher in developmental psychopathology to consider the time course that developmental processes take, since their normative course offers guidelines for the study of their deviant course. The study and understanding of “transformation of patterns of adaptation and maladaptation over time” (Cicchetti & Sroufe, 2000, p. 259) is a fundamental aspect of this research.
Multiple risk and protective factors and their interplay (Chicchetti & Sroufe, 2000) form another one of the key issues involved in this field of study. Nevertheless, what at first glance may seem obvious, is not so, given once again, the key concepts of equifinality and multifinality. What are considered to have been risk factors in one individual’s life that eventually evolved into a full-scale disorder, had no such effect in another individual’s life, since the dynamic process underlying the second individual’s life played itself out differently, and the risk factors did not lead to the same outcome. Likewise, despite protective factors in another instance, which would normally be of considerable help in ensuring that the individual does not have a disorder outcome, do not always protect. Further, “[i]ndividual risk factors seldom are powerful, and when they are it is likely that it is because they are surrogates for multiple influences” (Cicchetti & Sroufe, 2000, p. 256).
Resilience studies, another core factor of developmental psychopathology, offer much insight into reasons that explain some of the differences in developmental outcome, although this research is still very much in its infancy. Clearly, similar pernicious circumstances in childhood do not result in similar outcomes in all instances, since some children demonstrate “strong self-striving toward resilience” (Cicchetti & Sroufe, 2000, p. 257). Why this occurs, and what exactly is different in children who show resilience (Masten & Curtis, 2000), resulting in a positive outcome despite marked trauma, poverty, or abuse, is central to this line of research.
Whether adaptive or maladaptive behaviors are manifested as continuous or discontinuous along a developmental continuum of normality and pathology (Cicchetti & Rogosch, 1999; Rutter & Sroufe, 2000), is also material for much of the research. Further, is continuity heterotypic: “continuity of developmental process may be represented by very different behavioral manifestations” (Cicchetti and Rogosch, 1999, p. 442), or homotypic: “involving the same behavioral presentation of an underlying developmental process at subsequent age periods” (Cicchetti and Rogosch, 1999, p. 442)?
Cicchetti and Rogosch (1999) also insist on the importance of “reducing the dualisms that exist between the clinical study of and research into childhood and adult disorders” (p. 433) in the field of developmental psychopathology. Preventive measures and interventions could thus be more readily developed since both sides of the forum would be using the same groundwork as a basis for such work.
Developmental psychopathology does not look at individuals as separate from their environment. Not only is it interested in studying, as mentioned earlier, person-environment interactions, but it is contextualistic, since it considers individuals to be “embedded in multiple, dynamically interacting social contexts in which there are reciprocal relations among the different levels” (Tubman, unpublished).
The concept of contextualism (partially examined in transactional models, diathesis-stressor models), and also termed ‘developmental systems theory’ (Masten & Curtis, 2000), however, necessarily brings this field of study to consider the need for research that is not only quantitative, but also qualitative and ethnographic in nature (Cicchetti & Aber, 1998), since clearly, in order to adequately measure reciprocal relations among different levels of the social context, quantitative research alone does not suffice. Moreover, context must be more precisely measured, sampled, conceptualized, operationalized, and analyzed by researchers, particularly at the more macro levels (Cicchetti & Aber, 1998).
Prospective longitudinal studies with their clearly enormous advantage of examining continuity and change within individuals over time have formed part of the research since the early days of its inception (Rutter & Sroufe, 2000). Developmental psychopathologists, interested in the entirety of the life span in all its normal and deviant manifestations, as well as in the pathways that bring the individual to those outcomes, require “research designs that address developmental variation over time” (Cicchetti and Rogosch, 1999, p. 443).
Since longitudinal research is time-consuming and costly, offering results only after protracted years of study despite the power and richness of its results, cross-sectional designs are frequently used. Their results are obtained much more quickly than that of longitudinal studies, at a fraction of the financial burden, but results do not offer the capacity to study developmental change within individuals, nor can cohort and period effects be differentiated from developmental effects in these designs (Cicchetti and Rogosch, 1999).
However, follow-up studies that involve assessing a group of individuals for whom prior data is available, at a current time, and follow-back studies, that attempt to obtain earlier data for a currently defined group, may be used to ameliorate the problems of longitudinal studies, offering valuable information. Problems consistent with both approaches involve the fact that individuals and data are not always available at both times being assessed, biases in the record data can not always be made explicit, and it is not always possible to determine life circumstances that may have occurred between the two assessment times (Cicchetti and Rogosch, 1999).
Other designs that are also employed by researcher in the field of developmental psychopathology are accelerated longitudinal designs, high-risk designs, behavior-genetic designs, prevention and intervention designs, and variable-centered and person-centered designs.
Sampling and measurement issues are also of prime importance, since “choices made in samples recruited will affect the extent to which findings from a study are generalizable and to which group they are generalizable” (Cicchetti and Rogosch, 1999, p. 451), and researchers need to “incorporate multiple informants and measurement strategies to attain a comprehensive appraisal of child psychopathology” (Cicchetti and Rogosch, 1999, p. 454).
Finally, while the strengths of this contextualistic worldview that attempts to incorporate biological, psychological, and social processes should be clear, inasmuch as a cogent and all-encompassing manner with which to study the emergence, development and course of disorders is offered, nonetheless, Cicchetti and Sroufe (2000) point out that “the integration of differential gender development into the field of developmental psychopathology remains to be accomplished” (p. 262). Further, researchers are faced with the age, period, cohort problem, which “involves the confidence with which the researcher is able to attribute observed changes to developmental change” (Cicchetti & Rogosch, 1999, p. 443). In other words, a child born in the decade of the 70’s as compared to one born 20 years later, may perform differently due to the influence of different historical, technological, and social environments, even when both individuals stem from the same society. Moreover, as Cicchetti and Aber (1998) clearly point out, the field of developmental psychopathology has far to go “in the area of measurement of context” (p. 139).
Nevertheless, the contextualistic worldview held by developmental psychopathologists further posits that individuals are active creators of their own development, and not simply dependent on an implacable environment (Cummings, Davies & Campbell, 2000). This elevates the individual from a mere pawn to a proactive participant in his or her own life. Coupled with the concepts of resilience, equifinality, and multifinality, developmental psychopathology places man on a level of possible self-reliance not so clearly delineated in the majority of developmental Lebensanschauungen. This bodes well not only for the broad future of the discipline, but also for the individual found under the lens of its keen microscope.
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References
Cichetti, D., & Rogosch, F.A. (1999). Conceputal and methodological issues in developmental psychopathology research. In P.C. Kendall, J.N. Butcher, & G.N. Holmbeck (Eds.), Handbook of research
methods in clinical psychology.(2nd ed., pp. 433-465). New York: Wiley.
Cicchetti, D., & Sroufe, L.A. (2000). Editorial: The past as prologue to the future: The times, they’ve been a-changin’. Development and Psychopathology, 12, 255-264.
Cummings, E.M., Davies, P.T., & Campbell, S.B. (2000). Developmental Psychopathology and Family Process.New York: The Guilford Press.
Masten, A.S., & Curtis, W.J. (2000). Integrating competence and psychopathology: Pathways toward a comprehensive science of adaptation in development. Development and Psychopathology, 12, 529-550.
Rutter, M., & Sroufe, L.A. (2000). Developmental psychopathology: Concepts and challenges. Development and psychopathology, 12, 265-296.
Tubman. (unpublished). CLP 6168 Class 8/28/01
Copyright © Dr Gabriella Kortsch 2005