● Principles & perspective

- Children & adolescents

- Developmental pschopathology
perspective
- Reciprocal transaction btw ind & env
- Evidence-based
- Individual is unique  case vignettes
- Existing diagnostic systems (categoric vs
dimensional)
First, a few notes about the
Definition
Definition: who is normal
●

anyway?
- Why & how psychopathology develops?

- Classify people into MH categories or

continuum?
Mental health
- Mental health = absence of disorder?

- Capacities that underlie mental health

- Emotion regulation
- Cognitive processes
- Relational functioning
- Behavior regulation
- Motivation
- Stability sense of self
- Capacity to tolerate crises
DSM definition of mental disorder

- Persistent, maladaptive bhvrs ass with

- Current distress
- Impairment in functioning
- Risk of suffering death, pain, loss of freedom
 6

● DSM = categorical model

- Axis I: All psychological diagnostic categories except ID and
personality disorder (e.g., anxiety dis)
- Axis II: Personality dis and intellectual dis
- Axis III:Brain injuries and other medical/physical disorders which
may aggravate existing diseases or present symptoms similar to other
disorders.
- Axis IV: Psychosocial factors contributing to the disorder
- Axis V: Global Assessment of Functioning

10/28/2020
Dilemmas of the categorical
model

- Common/shared etiology (emotional

instability  mood, anxiety and most
pers dis)
- High rates of comorbidity (diagnostic co-
occurence-boundaries are arbitrary.)
- Lack of treatment specificity is the rule
rather than exception!
Definition of maladjustment
maladjustment/abnormality

Deviant Distress Dysfunction Danger

Wakefield’s (2010)
harmful
dysfunction:
● Vignette 1
- Imagine a family with a chronically depressed mother,
attempting suicide several times, hospitalized for long
periods of life

- Father is an abusive alcoholic

- 3 children
- The oldest daughter (12 yrs) taking care of the

family
- The 10-year-old, academic problems, no friends

- The 8-year-old boy, anger bursts, bullying other

children
- How would you explain the differences they
exhibit?
● Vignette 2
- Imagine a family, high-educated parents, no violence or
abuse, good resources at home

- Father announces Divorce. After the separation

- 12-year-old daughter-low academic performance,

problems with friends

- 10 year-old daughter is doing well in almost all

areas of functioning

- How would you understand each child in terms of

psychopathology?
 ●

Bio and Env Background of

Psychopathology

Nihal Yeniad, Boğaziçi University

 Biological pathways to
psychopathology

Early-
- Prenatal (during pregnancy)
- Perinatal (At about the time of birth)
- Postnatal (During later development)
 ● Problems in prenatal development
Teratogens might enter the mother’s
bloodstream
• smaller-than-typical brains.
• heart defects
• hearing losses,
• their faces are distinctive,
• a somewhat flattened nose
• an unusually long space between nose
and mouth
• smaller heads,
• mild intellectual disability
● Teratogens??
- Poor diet
- Maternal diseases (rubella-kızamıkçık)
- Exposure to lead (kurşun)
- Drugs
The timing of teratogen exposure –
weeks 3 to 15 !!!
- Risks of Novel Coronavirus Disease
(COVID-19) in Pregnancy????

- Do a quick research and write-down your

responses in chat-box...
Perinatal influences
(gestatitonal age)
- Preterm (<37 weeks) delivery
- extremely preterm (less than 28 weeks)
- very preterm (28 to 32 weeks)
- moderate to late preterm (32 to 37 weeks).

Preterm birth complications

are the leading cause of
death among children under
5 years of age, responsible
for approximately 1 million
deaths in 2015 (1). (WHO)
Low birth weight (LBW)
- LBW  developmental problems, acad
difficulties
• The optimal weight: 3000 to 5000 grams
• LBW: <2500 gram, Very LBW: < 1500 gram

- Infants of smoking mothers grow more slowly

in the womb and are on average lighter at birth
than infants of nonsmoking mothers (Gowen, 2011; Mohsin,
Wong, Bauman, & Bai, 2003).
Overall, it is estimated that 15% to 20%
of all births worldwide are low birth
weight, representing more than 20
million births a year.
LBW &infant mortality

https://www.who.int/bulletin/volumes/95/8/16-180273/en/
- Preterm delivery and low birthweight are
risk factors for infant and childhood
morbidity (illness) and mortality (death).
- Can Preterm Infants Catch Up with Full-
Term Infants?
- Can Preterm Infants Catch Up with Full-
Term Infants? It depends.

.
- chromosomes strings of genetic material
in the nuclei of cells

- deoxyribonucleic acid (DNA) chemical

material that makes up chromosomes
and genes
Each cell in the human body has 23 pairs of
chromosomes in its nucleus.

Twenty-two pairs of chromosomes, called autosomes, contain most of the

genetic information for the new individual. The twenty-third pair, the sex
chromosomes, determines the sex.
Problems in prenatal development

Chromosomal disorders

1. Trisomies (3 copies of a particular chromosome)

2. Sex chromosome anomalies (incorrect sex

chromosome)
● Problems in prenatal development I
• Autosomal disorders, caused by the genes located on the
autosomes (e.g., PKU)

• Sex-linked disorders, caused by the gene on X chromosome (e.g.,

red-green color blindness, hemophilia, fragile X syndrome)

Facial
characteristics of
people with
Fragile X
syndrome
Problems in prenatal development II

2. Chromosomal disorders,
a. Trisomies (when an
individual has 3 copies of
a particular autosome :
Down syndrome= trisomy
21)

b. Sex-chromosome
abnormalities (e.g., XO
pattern = Turner’s
syndrome)