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LSHD Micro Teaching.ppt

  1. Dilla University Institute of Education and Behavioral Science Department of Psychology Life Span and Human Development  Developmental Psychopathology  By: Galchu D. (MA in Counseling fellow) February, 2023 Dilla University, Ethiopia
  2. 2.2.3. Developmental Psychopathology • It is about how development influences psychopathology and how psychopathology influences development. • What Makes Development Abnormal? • Clinical psychologists, psychiatrists, and other mental health professionals struggle to define the line between normal and abnormal behavior and diagnose psychological disorders, often using three broad criteria to do so: • Statistical deviance • Maladaptiveness • Personal distress
  3. Statistical Deviance • Does the person’s behavior fall outside the normal range of behavior? By this criterion, a mild case of the “blahs” or “blues” would not be diagnosed as clinical depression because it is so statistically common, but a more enduring, severe, and persistent case might be.
  4. Maladaptiveness • Does the person’s behavior interfere with adaptation or pose a danger to self or others? • Psychological disorders disrupt functioning and create problems for the individual, other people, or both. Personal distress • Does the behavior cause personal anguish or discomfort? • Many psychological disorders involve personal suffering and are of concern for that reason alone. Although these guidelines provide a start at defining abnormal behavior, they are vague. • We must identify specific forms of statistical deviation, failures of adaptation, and personal distress.
  5. The individual must experience at least five of the following symptoms, • 1. Depressed mood (or irritable mood in children and adolescents) nearly every day • 2. Greatly decreased interest or pleasure in usual activities • 3. Significant weight loss or weight gain (or in children, failure to make expected weight gains)
  6. Cont’d… 4. Insomnia or sleeping too much 5. Psychomotor agitation or sluggishness/slowing of behavior 6. Fatigue and loss of energy 7. Feelings of worthlessness or extreme guilt 8. Decreased ability to concentrate or indecisiveness 9. Recurring thoughts of death, suicidal ideas, or a suicide attempt
  7. • Alan Sroufe (1997) argues that psychopathology is better seen as development rather than as disease; • it is a pattern of adaptation that unfolds over time. • From this perspective, a researcher cannot understand psychological disorder without understanding not only the person’s characteristics, developmental status, and history of adaptation but also the interactions over time between person and environment that either support or undermine healthy development
  8. The Infant • Because infant development is strongly channeled by biological maturation, few infants develop severe psychological problems. • Yet psychopathology exists in infancy, and its effects can be tragic.
  9. Autism • Autism is a serious disorder that begins in infancy and is characterized by abnormal social development, impaired language and communication, and repetitive behavior. • first identified and described by Leo Kanner in 1943,
  10. Cont’d… • Three defining features of autism highlighted in DSM-IV-TR (American Psychiatric Association, 2000; also see Bowler, 2007; Frith, 2003): A) Abnormal social development • Autistic children have difficulty forming normal social relationships, responding appropriately to social cues, and sharing social experiences with other people.
  11. Cont’d… • They also have great difficulty reading other people’s minds and emotions, responding with empathy when others are distressed and demonstrating self-awareness and self-conscious emotions such as embarrassment and guilt. B) Impaired language and communicative skills • Some autistic children are mute; others acquire language skills with some degree of success but still cannot communicate—that is, carry on a true conversation (Tager-Flusberg, 2000).
  12. C) Repetitive, stereotyped behavior and restricted interests • Autistic children seek sameness and repetition. • They engage in stereotyped behaviors such as rocking, flapping their hands in front of their faces, or spinning toys; • if they are more intellectually able, they may carry out elaborate rituals such as a particular sequence of getting-dressed activities. • They also become obsessed with particular objects and interests and can become highly distressed when their physical environment is altered (as when a chair in the living room is moved a few feet).
  13. Suspected Causes • Early theorists suggested that rigid and cold parenting by “refrigerator moms” caused autism, but this harmful myth has long been put to rest (Achenbach, 1982). • The source of genes that contribute to autism, sometimes have mild forms of some autistic spectrum traits themselves. • Bad parenting is not responsible for autism; rather, autism has a biological basis. • Genes contribute strongly to autism (Veenstra- Vanderweele & Cook, 2003).
  14. Developmental Outcomes and Treatment • The long-term outcome in the past has usually been poor, especially if autism is accompanied by mental retardation. • Most individuals with autism improve in functioning, but they are autistic for life, showing limited social skills even as adults, although about a third are employed in their 20s (Howlin et al., 2004).
  15. Cont’d… • Positive outcomes are most likely among those who have IQ scores above 70 and reasonably good communication skills by age 5. • Some autistic children are given drugs to control behavioral problems such as hyperactivity or obsessive–compulsive behavior, drugs that help them benefit from educational programs but do not cure autism (Volkmar, 2001).
  16. Cont’d… • The most effective approach to treating autism is intensive and highly structured behavioral and educational programming, beginning as early as possible, continuing throughout childhood, and involving the family (Koegel, Koegel, & McNerney, 2001; Simpson & Otten, 2005). • The goal is to make the most of the plasticity of the young brain during its sensitive period, so early intervention is key.
  17. The Child • Many children experience developmental problems-fears, recurring stomachaches, temper tantrums, and so on. • A much smaller proportion are officially diagnosed as having one of the psychological disorders that typically begins in infancy, childhood, or adolescence—or as having one of the psychological disorders (such as major depressive disorder) that can occur at any age.
  18. Attention Deficit Hyperactivity Disorder • According to DSM-IV-TR criteria, a child has attention deficit hyperactivity disorder (ADHD) if some combination of the following three symptoms is present (see also Selikowitz, 2004; Weyandt, 2007): • 1. Inattention • The child does not seem to listen, is easily distracted, and does not stick to activities or finish tasks.
  19. Cont’d… • 2. Impulsivity • The child acts before thinking and cannot inhibit urges to blurt something out in class or have a turn in a group activity. • 3. Hyperactivity • The child is restless and is perpetually fidgeting, finger tapping, or chattering. • About 3 to 7% of school-age children, possibly more, are diagnosable as ADHD (American Psychiatric Association, 2000)
  20. Developmental Course • ADHD expresses itself differently at different ages (Pelham et al., 2004; Weyandt, 2007). The condition often reveals itself in infancy. • As infants, children with ADHD are often very active, have difficult temperaments, and show irregular feeding and sleeping patterns (Teeter, 1998). • As preschool children, they are in perpetual motion, quickly moving from one activity to another.
  21. Suspected Causes • Researchers have long agreed that ADHD has a neurological basis, but they have had difficulty pinpointing it until recently. • Low levels of dopamine and related neurotransmitters involved in communication among neurons in the frontal lobes may be at the root of executive function impairments (Selikowitz, 2004; Weyandt, 2007). • Genes predispose some individuals to develop ADHD and probably underlie the physiological problems that give rise to it.
  22. Treatment • Many children with ADHD are given stimulant drugs such as methylphenidate (Ritalin), and most are helped by these drugs. • drugs increase levels of dopamine and other neurotransmitters in the frontal lobes of the brain to normal levels and, by doing so, allow these children to concentrate (Selikowitz, 2004). • Some critics feel that these drugs are prescribed to too many children, including some who do not have ADHD.
  23. Cont’d… • Others are concerned that stimulant drugs have undesirable side effects such as loss of appetite and headaches (see Weyandt, 2007). • Moreover, they do not cure ADHD; they improve functioning only until their effects wear off. • Medication alone was more effective than behavioral treatment alone or routine care in reducing ADHD symptoms
  24. Challenges in treating children and adolescents • Children rarely seek treatment on their own; they are usually referred for treatment by parents who are disturbed by their behavior. This means that therapists must view the child and her parents as the “client.” • Children’s therapeutic outcomes often depend greatly on the cooperation and involvement of their parents • A Point familiar to students of human development—children function at different levels of cognitive and emotional development than adults do, and this must be taken into consideration in both diagnosing and treating their problems • Behavioral therapies proved to be more effective with children than “talk therapies,” but more recent work suggests that children can benefit from cognitive behavioral therapy too, even though it requires more cognitive and linguistic ability that strictly behavioral therapy (Kazdin, 2003).
  25. Ethiopian Societies’ Awareness and Views on Developmental Disorders • The awareness level of the community is very low, and a lot needs to be done. • They don't share their thought with you. They talk about you behind your back and because of that, you will be forced to exclude yourself from them; That is because … we are not living with educated people. • They believe in the curse and they give different explanations. • Due to this and to protect your mind you will exclude yourself. It has a huge impact. It is very difficult. (Caregiver )
  26. Cont’d… • Fearing the prospect of stigma based on previous stigmatising experience also made some parents isolate themselves. • The mother of a nine-year-old boy with ID who stated that her neighbors teased her for having a child who does not speak noted: “If I want to take him [my child] to social places this thing [the negative reaction of her neighbors], this feeling will come to my mind” (Caregiver 2R).
  27. Cont’d… • Perceiving mental illness in a traditional explanatory frames such as anger from God (sin) or spiritual possession, contributes to the stigma and discrimination parent’s and primary care giver’s experience. • As a result to this perception parents are also more likely to discriminate against their child. • How parents perceive the problem makes them look for alternative cures.
  28. Cont’d… • Another major concern in Ethiopia is low socio-economic status of the population which cannot afford for appropriate care that needs to be provided for children, • Another main problem in raising children with development disorders is the lack of social support centers (Miraf D. 2016, Aynalem 2014) this lack of support system increases the burden that parents have to take care of everything by themselves.
  29. Developmental Disorders in Ethiopia: Current Prevalence, Treatment & Challenges • Prevalence of developmental disorders • Principal-components analyses identified common syndromes such as aggressive, anxious, delinquent, depressed, hyperactive, uncommunicative, and immature. • additional syndromes, hostile/withdrawn and insecure, were particularly prevalent. • Children whose mothers reported more psychiatric symptoms for themselves tended to score higher on at least one of the pathology subscales.
  30. Cont’d… • On a measure developed for Ethiopian children, the prevalence and risk factors of Developmental Psychopathology were similar to those found in other countries. • Several differences in syndromes indicate the need for culture-specific analyses of psychopathology in children. (Mesfin S.1995)
  31. Treatment of PD in Ethiopia • The traditional concepts and treatment of mental disorders in the Oromo areas in western Ethiopia before the revolution in 1974. • There are three traditional cultural influences operating: traditional Oromo thinking, the Coptic church and the Islamic culture. • One important element in traditional Oromo thinking is that each person is believed to possess an Ayana, which is a special divine agent that can descend upon people, but also means a person's character and personality.
  32. Cont’d… • In the traditional Oromo society, the Kallu is the religious leader who, through an ecstatic ritual technique, can investigate the causes of the disorder and advise what to do. • Mental disorders are generally explained as resulting from disturbances in the relationship between people and divinity. • The second important cultural element in western Ethiopia is the orthodox Coptic church, which usually looks upon mental disorders as possession by evil spirits, which are thus treated by specially gifted priests and monks by praying and giving holy water or eventually exhortation.
  33. Cont’d… • According to Islamic teaching in the area, mental disorders are caused by evil spirits sent by God to punish the unfaithful people. • Some Muslim sheiks treat mental cases with prayers, but herbal remedies are also used. • There is a great intermingling of these different cultural and religious elements and people attend different healers and religious leaders more depending on the reputation of the person than on cultural and religious affiliation.
  34. • Major challenges and impact • Dealing with a child of developmental disorder might bring psychological, social and economic challenges for parents. • Psychological distress have been focused on by different researchers a study done by Estes et al. (2013 )---> examining parental-related stress and psychological distress in mothers of toddler with ASD comparing with those who have TD children and parents of children with ASD showed higher level of stress when compared with the other group.
  35. TD & ASD • ASD (Autism Spectrum Disorder) in toddler  Autism spectrum disorder (ASD) is a developmental disorder.  It affects how children interact and communicate with others.  The disorder is called a spectrum disorder because children can be anywhere on the autism spectrum. • Children with ASD start to show symptoms at an early age. • Healthcare providers don’t know why some children develop ASD. • It may be a combination of genes they are born with and something in their environment that triggers those genes.
  36. TD (Tourette’s Disorder) in children & adolescent • Tourette’s disorder (TD) is part of a cluster of diagnoses called the motor disorders. • TD is a psychiatric disorder that affects between 0.05 – 3% of children and adolescents. • The disorder typically has an onset around age 5 – 7, with symptoms often remitting by early adulthood. • However, earlier ages of onset have been observed. • To be diagnosed with TD, the tics must be present for one year or longer)
  37. Cont’d… • Motor disorders are a group of psychiatric conditions that include: Developmental coordination disorder Stereotypic movement disorder Tic disorders • Motor disorders are a group of psychiatric conditions that affect the ability to produce and control bodily movements. • Motor disorders may involve developmental delays and deficits involving fine and gross motor functions.