There is considerable evidence that the development of joint attention and pretend play skills are impaired in children with autism. Some accounts of autistic psychopathology give a crucial role to early impairments in joint attention and suggest that these lead to impoverished development of the representational abilities that underlie the later emerging impairments in pretend play and theory of mind. Other accounts of impairments in joint attention and pretend play see them merely as symptoms of a more basic underlying cognitive deficit, in attention or executive function. This review examines the evidence for the possible relationships that may exist between joint attention and pretend play and the later development of a theory of mind. It also suggests directions for future work to clarify the relationship between the two skills and to identify the nature of the underlying primary deficit in autism.

The interdisciplinary science of developmental psychopathology has evolved from its historical roots in a variety of fields including: sociology; epidemiology; embryology; the neurosciences and psychobiology; psychoanalysis; clinical, developmental, and experimental psychology; and psychiatry (Cicchetti, 1990) into an increasingly mature integrative framework within which the contributions of these heretofore largely separate disciplines could be fully realized within the broader context of understanding individual development and functioning, both normal and abnormal (see chapters in Cicchetti & Cohen, 1995a, 1995b; see also Cicchetti & Toth, in press). In one of the early statements concerning the goals of this field, Cicchetti (1990) asserted that: “Developmental psychopathology ... should bridge fields of study, span the life cycle, and aid in the discovery of important new truths about the processes underlying adaptation and maladaptation, as well as the best means of preventing or ameliorating psychopathology. Moreover, this discipline should contribute greatly to reducing the dualisms that exist between the clinical study of and research into childhood and adult disorders, between the behavioral and biological sciences, between developmental psychology and psychopathology, and between basic and applied science” (p. 20).

Maternal cocaine use during pregnancy can affect the infant directly through toxic effects or indirectly through cocaine's influence on maternal psychological status. We followed 160 cocaine exposed and 56 nonexposed infants and their mothers identified at birth through interview and/or urine screen. Although cocaine exposure defined the groups, infant exposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% African American and poor. All mothers completed the Brief Symptom Inventory (BSI) and infants were given the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected age of 17 ± 8 months. Both MDIs (94 ± 17 vs. 103 ± 16) and PDIs (101 ± 16 vs. 108 ± 12) were lower for cocaine exposed infants. Psychological distress was greater in cocaine using mothers. Hierarchical multiple regression was used to assess the relative effects of gestational age, maternal psychological distress, and cocaine and polydrug exposure on infant outcomes. Both psychological distress and cocaine and alcohol exposure predicted lower MDIs after controlling for prematurity. Neither psychological distress nor alcohol exposure predicted motor outcome, while cocaine had a significant effect. Tobacco and marijuana exposure were unrelated to outcome. These findings provide further support for direct effects of cocaine and alcohol on infant development, as well as highlight the need for studies to document maternal psychological factors, which may increase child risk for poorer outcomes.

The concepts of self-organization, state changes, and energy flow are central to dynamic systems theory. In this work I suggest that to apply these general principles to the study of normal and abnormal development, these constructs must be specifically defined in reference to current knowledge of brain development. Toward that end, I present an overview of the properties of self-organizing developmental systems, and then propose a model of attachment dynamics as synchronized energy exchanges that cocreate nonlinear changes of state, discuss the roles of bioamines and energy-generating brain mitochondria in state regulation, and describe the energy-dependent imprinting of synaptic connectivity and neural circuitry in the infant brain. In this application of nonlinear concepts to developmental models of both resistance against and vulnerability to mental disorders, particular emphasis is placed upon the experience-dependent maturation of a system in the orbital prefrontal cortex that regulates psychobiological state and organismic energy balance. This frontolimbic system is expanded in the nonlinear right hemisphere that generates stress-regulating coping strategies, and it serves as the hierarchical apex of the limbic and autonomic nervous systems. Early forming microstructural alterations and energetic limitations of this regulatory system are suggested to be associated with a predisposition to psychiatric disorders.

Previous research has documented differences in the pattern of EEG activation between 3-month-old infants of depressed mothers and infants of nondepressed mothers. In the present study, EEG was recorded in even younger 1-month-old infants of depressed and nondepressed mothers. The infants of depressed mothers exhibited greater relative right frontal EEG asymmetry (due to reduced left frontal activation), and this pattern at 1 month was significantly related to 3-month EEG asymmetry. Right frontal EEG asymmetry was also related to more frequent negative facial expressions (sad and pre-cry faces) during the Brazelton exam. Finally, the infants of depressed mothers showed more indeterminate sleep, were less active, and cried less than infants of nondepressed mothers.

Self-organization can be approached in terms of developmental processes occurring within and between component systems of temperament. Within-system organization involves progressive shaping of cortical representations by subcortical motivational systems. As cortical representations develop, they feed back to provide motivational systems with enhanced detection and guidance capabilities. These reciprocal influences may amplify the underlying motivational functions and promote excessive impulsivity or anxiety. However, these processes also depend upon interactions arising between motivational and attentional systems. We discuss these between-system effects by considering the regulation of approach motivation by reactive attentional processes related to fear and by more voluntary processes related to effortful control. It is suggested that anxious and impulsive psychopathology may reflect limitations in these dual means of control, which can take the form of overregulation as well as underregulation.

Developmental psychopathology stands poised at the close of the 20th century on the horns of a major scientific dilemma. The essence of this dilemma lies in the contrast between its heuristically rich open system concepts on the one hand, and the closed system paradigm it adopted from mainstream psychology for investigating those models on the other. Many of the research methods, assessment strategies, and data analytic models of psychology's paradigm are predicated on closed system assumptions and explanatory models. Thus, they are fundamentally inadequate for studying humans, who are unparalleled among open systems in their wide ranging capacities for equifinal and multifinal functioning. Developmental psychopathology faces two challenges in successfully negotiating the developmentalist's dilemma. The first lies in recognizing how the current paradigm encourages research practices that are antithetical to developmental principles, yet continue to flourish. I argue that the developmentalist's dilemma is sustained by long standing, mutually enabling weaknesses in the paradigm's discovery methods and scientific standards. These interdependent weaknesses function like a distorted lens on the research process by variously sustaining the illusion of theoretical progress, obscuring the need for fundamental reforms, and both constraining and misguiding reform efforts. An understanding of how these influences arise and take their toll provides a foundation and rationale for engaging the second challenge. The essence of this challenge will be finding ways to resolve the developmentalist's dilemma outside the constraints of the existing paradigm by developing indigenous research strategies, methods, and standards with fidelity to the complexity of developmental phenomena.

Two experiments were conducted to evaluate symbolic-deficit and memory-deficit hypotheses to account for the cognitive problems seen in children with autism. Experiment 1 tested imitation, in immediate and deferred conditions, of familiar actions with different sets of objects representing the developmental progression from functional to symbolic play. The results showed that the autism group and both their receptive language and nonverbal IQ-matched controls imitated familiar actions with realistic objects (evidence for functional play) and placeholder objects (evidence for symbolic play) after delays ranging from 24 hr to 3 weeks. Experiment 2 tested familiar three-step event sequences in which a placeholder object was substituted for the second step in half the events. The results showed that the autism group remembered as many of the actions with the placeholder objects as their language-matched controls and as many correctly ordered sequences, a finding that supports a symbolic-delay (rather than deficit) hypothesis. These results were obtained in highly structured test situations and sharply contrast with the impairments seen in children with autism who are observed in naturalistic settings. Two interpretations of these findings are offered. First, structured test settings minimize distractions that typically occur in naturalistic settings that may interfere or disrupt symbolic play in children with autism. Second, the results are consistent with an executive function deficit in that the autistic group demonstrated more knowledge in the test settings than they demonstrate spontaneously in naturalistic ones.

The authors review the constraints of current mental disorder classification systems that rely upon descriptive symptom-based approaches, and weigh the benefits and hazards of these classification and diagnostic strategies. By focusing principally on superficial descriptions of symptoms, current systems fail to address the complex nature of persons' transactions within and adaptations to difficult environments. While attempting to be atheoretical, current systems exclude types of information that may elucidate individuals' functioning across various contexts, often because it is difficult to obtain such data reliably. With current approaches, misdiagnosis is likely, particularly when diagnostic criteria are applied to persons in nonclinical settings. Alternative approaches that take fuller advantage of clinicians' expertise and other forms of clinical data are reviewed, and recommendations are made for the next generation of classification systems. Application of evolutionary theory to psychiatry and psychology, as well as development of a theory and nosology of context in terms of persons' adaptations, are needed to expand our knowledge of normal and abnormal human development and psychopathology.

Evidence from the evolution of human cultural behavior and learning, embryology and genetics of the brain, and the behavior of human infants indicates that the critical and uniquely human motives for cooperative imagination and joint interest in objects and tasks are determined by expression of genes and epigenetic neural systems elaboration long before birth, along with essential peripheral organs of perception and motor expression that will serve in communication by rhythmic facial, vocal, gestural, and body movement signals. These cerebral motives continue to exercise their influence on neural development and behavior throughout life, transforming the behaviors of the developing individual through a succession of phases to which other individuals and cultural institutions are constrained to adapt. We discuss the theory of innate intersubjectivity and relate it to the hypothesis of an Innate Motive Formation that emerges in brain development as regulator of morphogenesis in neural systems, and that continues to function, postnatally, as generator of motives and emotions by which human contacts and relationships are regulated. We suggest that differentiates of the primary motive formation in the embryo brain later serve to generate intelligent exploration of the objective environment, and the emergence of an additional dialogic mechanism that represents the self-subject as a partner for an other-subject, intersubjectively. Intersubjective communication in infancy leads, through systematic age-related transformations of the brain and behavior, to preverbal mimetic negotiation of cooperative awareness and joint task performance. Finally we discuss, in relation to this theory, interpretations of faulty communication and development at different stages of the life cycle that result from maternal postnatal depression, autism, premature birth, and schizophrenia.

The purpose of this study was to examine the relation of maternal interaction styles to the development of a sample of 56 toddlers (19 low risk, 37 high risk) seen at 12 and 24 months of age. At 12 months, videotapes of mother–child interaction were coded for directiveness, sensitivity, and elaborativeness. At 12 and 24 months, cognitive and language measures were collected. A directive maternal style was negatively correlated with sensitivity and elaborativeness, whereas sensitive and elaborative ratings were positively correlated, suggesting a facilitative style. Regression models significantly predicted receptive language and cognitive development at 24 months but not expressive language. Maternal directiveness at 12 months was negatively related to later receptive language skills, whereas elaborativeness at 12 months was positively predictive of later cognitive development. Child status variables and maternal interactional styles contributed about equally to the prediction of later cognitive and language outcomes.

Accelerated longitudinal analyses revealed both similarities and differences between the developmental trajectories of empirically based aggressive versus delinquent syndromes in childhood and adolescence. Syndromes were scored from standardized ratings obtained from parents five times at 2-year intervals for seven birth cohorts of Dutch children initially assessed at ages 4 to 10 years. Scores for both the aggressive and delinquent syndromes declined from ages 4 to 10. After about age 10 years, scores for the aggressive syndrome continued to decline, but scores for the delinquent syndrome increased until about age 17. The aggressive syndrome was significantly more stable than the delinquent syndrome. Long-term predictive correlations between matched subjects from different cohorts were as high as predictive correlations between scores obtained by the same subjects, thus supporting the validity of accelerated longitudinal analyses. The results highlight important developmental distinctions between aggressive versus delinquent conduct problems. Failure to distinguish between aggressive and delinquent conduct problems could generate misleading conclusions about their respective developmental courses and limit the generalizability of results.

The aim of the current investigation was to identify victimized children's responses to peers' aggression that may be associated with reduced versus persistent victimization. To address this aim, 199 5–6-year-old children (96 boys, 103 girls) were interviewed twice during kindergarten (fall and spring) about their own victimization experiences and peers' responses to aggression. Observational ratings of children's victimization experiences were used to examine the validity of the self-reported victimization scores. Relations between response strategies and subsequent victimization status were significant only for boys: “having a friend help” was associated with reduced victimization, whereas “fighting back” was related to stable victimization. Implications for future research on peer victimization and intervention with young victimized children are discussed.

The paper traces the relationship between attachment processes and the development of the capacity to envision mental states in self and others. We suggest that the ability to mentalize, to represent behavior in terms of mental states, or to have “a theory of mind” is a key determinant of self-organization which is acquired in the context of the child's early social relationships. Evidence for an association between the quality of attachment relationship and reflective function in the parent and the child is reviewed and interpreted in the context of current models of theory of mind development. A model of the development of self-organization is proposed which has at its core the caregiver's ability to communicate understanding of the child's intentional stance. The implications of the model for pathological self-development are explored, with specific reference to the consequences of maltreatment.

Construct validity of the newly developed Preschool Assessment of Attachment (PAA) was examined in a sample of depressed and nondepressed mothers and their preschoolers, focusing on attachment related differences in children's general caregiving environments, maternal psychosocial functioning, and child behavior during interactions with mother. Mothers of secure children were more emotionally and verbally responsive to their children than were mothers of insecure children, and secure children were emotionally more positive to their mothers than were insecure children. Mothers of secure children also reported higher levels of social supports than did mothers of insecure children. Finally, dyads with children who lacked unitary, coherent attachment strategies (i.e., anxious depressed, defended/coercive, and insecure other) showed the worst functioning in all domains relative to all other attachment groups. Similar but slightly less robust findings were obtained with socioeconomic variables statistically controlled. These results lend support to the PAA as a valid system for the conceptualization and measurement of quality of attachment among preschoolers. Future research applications with the PAA are discussed.

When maladaptation is viewed as development rather than as disease, a transformed understanding results and a fundamentally different research agenda emerges. Within a developmental perspective, maladaptation is viewed as evolving through the successive adaptations of persons in their environments. It is not something a person “has” or an ineluctable expression of an endogenous pathogen. It is the complex result of a myriad of risk and protective factors operating over time. Key research questions within this framework center on discovery of factors that place individuals on pathways probabilistically leading to later disturbances and factors and processes which maintain individuals on, or deflect them from, such pathways once enjoined. There is an interest in recognizing patterns of maladaptation which, while not properly considered disorder themselves, commonly are precursors of disorder and also in conditions of risk that lie outside of the individual, as well as any endogenous influences. Likewise, there is a focus on factors and processes that lead individuals away from disorder that has emerged, which goes beyond interest in management of symptoms. Finally, many topics that currently are capturing attention in the field, such as “comorbidity” and “resilience,” are seen in new ways from within the perspective of development.

Interactive coordination was observed in laboratory play interactions of pairs of 29 clinically depressed and 14 nondepressed mothers and their 13–29-month-old children (M = 18.9 months). Nondepressed mothers and their children displayed more interactive coordination than depressed-mother dyads (p < .001). Depressed mothers were less likely to repair interrupted interactions, and their toddlers were less likely to maintain interactions than nondepressed controls. Toddlers matched their nondepressed but not their depressed mothers' negative behavior rates. Results suggested that early interventions focus on training mothers to attend to, maintain, and repair mother–child interactions to more closely approximate normal levels of interactive coordination.

The concepts of self-regulation and autonomy are examined within an organizational framework. We begin by retracing the historical origins of the organizational viewpoint in early debates within the field of biology between vitalists and reductionists, from which the construct of self-regulation emerged. We then consider human autonomy as an evolved behavioral, developmental, and experiential phenomenon that operates at both neurobiological and psychological levels and requires very specific supports within higher order social organizations. We contrast autonomy or true self-regulation with controlling regulation (a nonautonomous form of intentional behavior) in phenomenological and functional terms, and we relate the forms of regulation to the developmental processes of intrinsic motivation and internalization. Subsequently, we describe how self-regulation versus control may be characterized by distinct neurobiological underpinnings, and we speculate about some of the adaptive advantages that may underlie the evolution of autonomy. Throughout, we argue that disturbances of autonomy, which have both biological and psychological etiologies, are central to many forms of psychopathology and social alienation.

Children's ratings of competence and relationship quality were used to examine the association between idealized or inflated self-perceptions and level of aggression. Participants were 62 aggressive and 53 nonaggressive second and third graders. Ratings of competence were based on the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children; ratings of relationship quality were drawn from the Social Support Appraisals Scale and the Network of Relationships Inventory. External ratings of competence and relationship quality were obtained from mothers, teachers, and peers. Compared to children who were nonaggressive, aggressive children were more likely to rate personal competence and relationship quality in a perfect or idealized manner and to show less differentiation in their ratings of competence and relationship quality. Aggressive children's self-rated competence and relationship quality were also inflated relative to the ratings made by others, whereas the self-ratings of nonaggressive children tended to be underestimates of their functioning. The tendency for aggressive children to idealize and to inflate ratings of competence and relationship quality was associated with higher levels of aggression. For aggressive children, a highly positive self-view is construed—not as a protective factor or measurement error — but as a defensive posture that places the child at added risk and that impedes the progress of psychosocial interventions.

One goal of developmental psychopathology is to understand the origins and course of mental disorders. I argue that pursuit of this goal requires a valid conceptual understanding of disorder and that this understanding can be provided by the “harmful dysfunction” analysis of the concept of disorder. The harmful dysfunction analysis holds that a disorder is a condition that is both harmful according to social values and caused by an internal dysfunction, that is, by a failure of an internal mechanism to perform a function for which it was naturally selected. This analysis explains why many of the distinctive features of developmental psychopathology are appropriate to the study of disorder. It is argued that the harmful dysfunction analysis is a necessary supplement to other proposed criteria for disorder, such as developmental deviation or predictive validity.