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

2.2.3. 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

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.

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.

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)

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

• 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

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.

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,

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.

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).

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).

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).

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).

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).

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.

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.

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.

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)

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.

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.

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.

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

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).

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 )

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).

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.

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.

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.

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)

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.

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.

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.

• 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.

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.

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)

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.