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Child Psychopathology

The study of mental illness in children, or children's psychopathology, has evolved since it began in the early 1900s. In the 1990s, children's disorders were included in the DSM-IV, the clinician's guide to diagnosis and treatment of mental illness. Earlier editions of the DSM did not include sections specific to children, indicating the confusion about diagnosing psychopathology in children and adolescents.

Each year, an estimated 20 percent of American children have a diagnosable mental illness. About 5 million children have a mental illness severe enough to interfere with their daily functioning. The most common illnesses are anxiety disorders, behavior disorders, developmental disorders and communication disorders. Eating disorders, mood disorders, as well as tic disorders, are also widespread.

Children with mental illness generally display warning signs. Parents can direct their children to psychiatrists, psychologists or clinical social workers for a full diagnostic interview. Examples of behavior changes to watch for are changes in sleeping or eating habits, antisocial behavior such as stealing or damaging property, and frequent outbursts of rage or temper tantrums. Changes in school performance, abuse of drugs or alcohol, or a significant increase in time spent alone can also indicate the presence of psychopathology. Thoughts of death, loss of interest in formerly pleasurable activities, and inability to cope with daily problems are usually symptoms of a deeper pathology.

The origin of mental illness is debatable. There appears to be a strong genetic link that promotes the development of mental illness. The combination of genetic predisposition and environmental factors may lead to the onset of psychopathology. Psychological traumas, such as abuse or neglect, appear to contribute strongly to the chances of having mental illness.

No brain tests or scans can accurately diagnose the presence of mental illness. A therapist or psychiatrist will thoroughly interview the child, parent and often the child's teacher to obtain a full clinical picture of the child's functioning. The diagnosis will be determined according to the presence of symptoms, the length of time the symptoms last and the extent to which the symptoms interfere with the child's functioning.

A diagnosis is not a definitive label. It serves as a common term that parents, educators and medical professionals can use to determine how best to help the child. The diagnosis describes a set of behaviors and feelings that a child displays during a discrete period of his or her life. Some disorders continue into adulthood, but others are unique to childhood.

Depending on the diagnosis, a child with psychopathology will be treated with psychotropic medications, which are most effective when combined with therapy. Types of useful therapies include individual psychotherapy, art and music therapy, play therapy and family therapy. Often, modifications to the child's home or school environment can significantly improve a child's mood.

There are several types of disorders that are generally diagnosed in infancy, childhood or adolescence. Mental retardation, learning disorders, motor skills disorders and communication disorders are usually noticed early in life. Pervasive developmental disorders, separation anxiety disorder and feeding disorders are also diagnosed in early childhood.

Attention Deficit and Disruptive Behavior Disorders can be diagnosed in adulthood, but are more commonly observed during childhood. ADHD, as it is commonly known, describes the presence of inattention and hyperactivity. Symptoms of inattentiveness include carelessness in work, easy distraction by external stimuli, failing to follow through on instructions and difficulty organizing activities and tasks. Hyperactivity is marked by squirming, fidgeting, excessive talking and difficulty playing quietly.

Conduct disorder and oppositional defiant disorder usually manifest during childhood. The criteria for conduct disorder include a period of 12 months in which the patient has repeatedly violated rules, societal norms or the rights of others. Oppositional defiant disorder's diagnosis requires at least six months of defiant, hostile, negativistic behavior.

Mood disorders can be diagnosed in adults or children. A mood episode refers to any period of time when a person feels abnormally happy or sad. Extreme sadness is called depression, and extreme happiness is construed as mania. Patients can be diagnosed with depression, mania or a combination of the two. Criteria for a major depressive episode include a depressed mood for nearly every day within at least two weeks, decreased pleasure in activities, appetite increase or decrease, change in sleep and loss of energy. Criteria for a manic episode include an exaggerated sense of self, reduced need for sleep, racing thoughts and impulsivity.

Anxiety disorder can also be diagnosed during childhood or adulthood. Anxiety disorders involve specific phobias, generalized anxiety disorder and panic disorder. Obsessive-compulsive disorder and post-traumatic stress disorders are also classified as anxiety disorders.

Selected full-text books and articles on this topic

Child Psychopathology
Eric J. Mash; Russell A. Barkley.
Guilford Press, 2003 (2nd edition)
Child Psychopathology: Diagnostic Criteria and Clinical Assessment
Stephen R. Hooper; George W. Hynd; Richard E. Mattison.
Lawrence Erlbaum Associates, 1992
Advanced Abnormal Child Psychology
Michel Hersen; Robert T. Ammerman.
Lawrence Erlbaum Associates, 2000 (2nd edition)
Librarian’s tip: Chap. 4 "Development and Psychopathology" and Chap. 7 "Research Strategies in Child Psychopathology"
The Development of the Person: The Minnesota Study of Risk and Adaptation from Birth to Adulthood
L. Alan Sroufe; Byron Egeland; Elizabeth A. Carlson; W. Andrew Collins.
Guilford Press, 2005
Parent Management Training: Treatment for Oppositional, Aggressive, and Antisocial Behavior in Children and Adolescents
Alan E. Kazdin.
Oxford University Press, 2005
The Effects of Early Adversity on Neurobehavioral Development
Charles A. Nelson.
Lawrence Erlbaum Associates, 2000
Librarian’s tip: Chap. 8 "Familial and Genetic Factors and Psychopathology"
Internalizing and Externalizing Expressions of Dysfunction
Dante Cicchetti; Sheree L. Toth.
Lawrence Erlbaum Associates, vol.2, 1991
Librarian’s tip: Chap. 2 "Emotional Regulation, Self-Control, and Psychopathology: The Role of Relationships in Early Childhood"
Experimental Analysis of Childhood Psychopathology: A Laboratory Matching Analysis of the Behavior of Children Diagnosed with Attention-Deficit Hyperactivity Disorder
Kollins, Scott H.; Lane, Scott D.; Shapiro, Steven K.
The Psychological Record, Vol. 47, No. 1, Winter 1997
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