3 - Early contributors to developmental risk

Summary

The emerging field of developmental psychopathology has begun to impact on a number of the traditional problem areas in child psychiatry by illuminating new possibilities for understanding the etiology, future course, and treatment of many childhood problems. Such new possibilities are contained in the dynamic models of development that are implicit in the new discipline. A redefinition of psychopathology in developmental terms was provided by Sroufe and Rutter (1984, p. 18), who saw the discipline as “the study of the origins and course of individual patterns of behavioral adaptation.”

Rutter and Garmezy (1983) described the differences between developmental psychopathology and other disciplines. They argued that developmental psychologists assume an essential continuity in functioning such that severe symptoms (e.g., depression) are placed on the same dimension as normal behaviors (e.g., sadness or unhappiness). On the other hand, clinical psychiatrists use an implicit assumption of discontinuity such that disordered behavior is interpreted as different in kind from normal behavior. In contrast to both approaches, developmental psychopathologists make no prior assumptions about either continuity or discontinuity. They are concerned centrally with both the connections and lack of connections between normality and disorder.

The need for a new orientation to the etiology of psychopathology arises not solely out of academic interests but rather because of the failure of more customary models to explain how mental and behavioral disorders arise and are maintained. Within the health sciences, the traditional model of disorder is based on the presumption that there are identifiable somatic entities that underlie definable disease syndromes. The current dominant view of mental disorder within psychiatry is still strongly biomedical and disease-oriented, with little role allowed for social and psychological etiological factors (Engel, 1977).