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24 Chapter 2 Models of Child Development, Psychopathology, and Treatment
Psychodynamic Models
Historical and Current
Conceptualizations
Psychodynamic models have a rich past and a relevant
future. They include the classic psychoanalytic explanations
set forth by Sigmund Freud, the socially oriented
explanations of Erik Erikson and Harry Stack Sullivan, the
work of object-relations theorists such as Margaret Mahler
and Donald Winnicott, and the contemporary perspectives
provided by Robert Emde, Daniel Stern, and others.
Psychodynamic models have historically focused on several
themes, including (1) the impact of unconscious processes on
typical and atypical personality development; (2) conflicts
among processes and structures of the mind (e.g., id, ego,
and superego); (3) stages of development, with different
ages associated with distinctive emotional, intellectual, and
social challenges; and (4) the lasting impact of more (or less)
successful resolutions of stage-related challenges on later
outcomes. Indeed, these themes were well appreciated by
the novelist and astute observer of human nature, William
Faulkner, who wrote (in 1950’s Requiem for a Nun), “The
past is never dead. It’s not even past.”
Psychodynamic theorists and clinicians usually
emphasized a fixation–regression model of psychopathology,
which suggested that individuals who failed to work through
developmental issues become “stuck” in the past. Disorders
themselves were rooted in traumas or conflicts experienced
during early childhood. Psychoanalytic interventions
for children, such as those developed by Anna Freud and
Melanie Klein, made special use of play (using toys and
games) and art to bring repressed traumas and unconscious
conflicts into therapeutic awareness.
Setting aside some of the more scientifically dubious
claims of early psychodynamic models, we are still left
with much to appreciate. Contemporary psychodynamic
approaches continue to emphasize (1) unconscious
cognitive, affective, and motivational processes; (2) mental
representations of self, other, and relationships; (3) the
meaningfulness of individual (i.e., subjective) experiences;
and (4) a developmental perspective focused on the origins
of typical and atypical personality in early childhood and
the constantly changing psychological challenges faced by
children as they age (Emde, 1992; Fonagy & Target, 2008;
Westen, 1998).
These emphases are evident in some of today’s most
significant psychodynamically informed research, such
as work on parent–child attachment and attachment’s
enduring effects on personality and interpersonal
functioning. Mentalizing, for example, “the capacity
to understand others and oneself in terms of internal
mental states,” is a construct that is receiving considerable
theoretical and research attention (Luyten et al., 2020,
p. 297). Mentalizing’s components and consequences will be
detailed in discussions of attachment and social interactions
in later chapters, but here, we want to emphasize its roots
in psychodynamic models of relationships, adaptation, and
maladaptation.
With respect to treatments, today’s psychodynamic
assessments and treatments continue to rely on play to
make connections with troubled children, to identify the
specific pathology, and to effect change. Psychodynamic
interventions for children and adolescents also emphasize the
important goal of emotion regulation and the therapeutic
role of parents and family members.
Thinking about Max
From a psychodynamic perspective, we are concerned
that the management of early developmental challenges
may have compromised Max’s current adjustment. For
example, do his inattentive and distractible activity and
lack of school success reflect unconscious conflicts about
autonomy that he failed to resolve in a healthy manner
during his preschool years? Or has a somewhat older
Max encountered a more troubling set of issues related
to competence and achievement? Should we consider the
possibility of an underlying identification with his recently
unemployed father? And are there connections between
problems with family relationships and problems with peer
relationships?
With these types of dynamic issues to explore,
it will take some time to formulate a clear, clinical
understanding of Max and a focused intervention plan.
Treatment strategies may include exploring such dynamic
issues through art, games, and imaginative play and
formulating less specific, more open-ended treatment
goals. A treatment plan is likely to include family sessions
with Max’s parents.
Thinking about Aisha
From a psychodynamic perspective, we wonder whether
the physical and emotional changes associated with early
adolescence have stirred up conflicts about intimacy and
sexuality in Aisha. Within a more general attachment
framework, she may be struggling with a basic sense of
insecurity. Early and ongoing experiences with her father’s
inconsistent availability may contribute to her wariness
in relationships and increasingly negative expectations
about her ability to manage demanding school and social
challenges. In addition, Aisha’s mother’s insistence on
close supervision of her friendships and restrictions on
school activities may be making it difficult to express ageappropriate individuality or independence.
Given her age, Aisha’s assessment and treatment
are more likely to include psychosocial therapy with
an emphasis on dynamic strategies of interpretation
and clarification. Treatment goals will be focused on
intellectual and emotional insight, based on the premise
that insight will lead to improved functioning in Aisha’s
everyday life.
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Behavioral and Cognitive Models 25
Behavioral and Cognitive Models
Historical and Current
Conceptualizations
In contrast to the inward orientation of the physiological
and psychodynamic models, the behavioral models have an
outward orientation, focusing on the individual’s observable
behavior within specific environments. According to behavioral
models, environmental variables have powerful effects on the
development of personality and psychopathology, and these
effects have been described by major theorists such as B. F.
Skinner, Walter Mischel, and Albert Bandura.
Behavioral models of development and disorder are based
on the core concepts of learning theories and share a strong
empirical foundation with them. These theories propose that
both typical and atypical behaviors are gradually acquired
via processes of learning, including classical conditioning,
operant conditioning, and observational learning. The
construct of reinforcement (i.e., the idea that positive and
negative consequences lead to changes in behavior) is a
critical component of all these learning processes.
According to Thomas, summarizing Skinner’s
behaviorism, “As a child grows up, two things develop:
(a) the variety of behavior options (potential ways of acting)
that the child acquires and (b) the child’s preferences
among those options. As children interact with
their environments, they learn to prefer rewarding
over nonrewarding actions” (Thomas, 2001, p. 14).
Psychopathology, within the behavioral framework, is
understood as t he result of learning gone awr y: the acquisition
and reinforcement of maladaptive or undesirable behaviors,
the lack of opportunity to learn adaptive or appropriate
behaviors, unavailable or inadequate reinforcement of those
adaptive or appropriate behaviors, or some combination
of these. Over many decades, behavioral treatments have
focused on unlearning, relearning, and new learning.
Current behavior models are increasingly shaped by
advances in related fields of psychology, with more focus on
the role of the individual-in-context (Araiba, 2020).
With cognitive models, the focus is on the
components and processes of the mind. Jean Piaget’s
and Lev Vygotsky’s landmark studies on the stages and
processes of cognitive development and later informationprocessing and interactionist models are exemplars of the
cognitive perspective. Contemporary cognitive models
emphasize evolutionary theory, the social context of
early cognition, both qualitative and quantitative change
across development, and connections to education and
academic skills (e.g., reading, mathematics, and scientific
reasoning) (Gopnik & Wellman, 2012; Newcombe, 2011;
Siegler, 2016). Developmental cognitive neuroscience
is an integrative field that reflects this more holistic
approach to understanding children’s cognitive abilities
(Bjorklund, 2018).
With respect to cognitive variables and psychopathology,
“it is becoming increasingly clear that single cognitive
deficit models of developmental disorders, like dyslexia,
attention deficit/hyperactivity disorder (ADHD), language
impairment, or autism, do not work” (Pennington, 2009,
p. 76). Instead, an understanding of combinations of
cognitive delays and dysfunction is required. This more
complex, and accurate, explanation of disorders depends
on understanding the multiple influences of cognitive
components, processes, and contexts across development.
Effective cognitive-based interventions involve increasing
complexity as well.
Thinking about Max
Within the behavioral and cognitive frameworks, Max’s
difficulties may be understood as a reflection of maladaptive
learning, various cognitive dysfunction or difficulties, or
both. For example, his inappropriate classroom behaviors
may result in increased displays of adult concern and adult
contact. Although negative in tone, these episodes may be
positively reinforcing because of the adult attention and
proximity that they generate. These interactions may be
especially salient given his father’s loss of employment and
the change in his family’s focus from children’s activities to
adult worries. Additional focus on Max’s on-task behaviors,
such as reading quietly in his seat and completing his
math problems within the allotted time, and rewards for
homework may be required. Both school performance and
peer problems may also be influenced by Max’s impulsive
decision making and maladaptive thinking patterns. A
cognitive-behavioral emphasis on more extensive analysis
of situational cues and more deliberate examination of the
likely consequences of problem behaviors will be a key part
of Max’s treatment plan. Another treatment goal may target
overly negative attitudes and expectations.
Thinking about Aisha
As with Max, Aisha’s problems can be viewed from a
cognitive-behavioral perspective as the result of maladaptive
learning and cognitive dysfunction. Her social difficulties
are conceptualized as rooted in her misinterpretations of
the intentions and actions of others. This misreading of
neutral social cues as signifying rejection has had a negative
effect on Aisha’s self-esteem and on her belief in her ability
to influence her environment positively. These cognitive
errors, in turn, have led to avoidant behaviors. These
avoidant behaviors, which—in the short term—minimize
the distress that Aisha feels, are then reinforced and lead to
further isolation.
The interventions designed to address these behavioral
and cognitive difficulties include identifying the cognitive
errors that Aisha is making and teaching her new ways to
interpret and think about social situations. In addition, it is
necessary to devise a schedule of positive reinforcements and
rewards for increasing more adaptive and healthy behaviors.
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
26 Chapter 2 Models of Child Development, Psychopathology, and Treatment
Humanistic and Positive Psychology Models
Historical and Current
Conceptualizations
Humanistic models also have made valuable contributions
to our understanding of development, psychopathology,
and treatment. These models, including those of Carl
Rogers and Abraham Maslow, emphasize personally
meaningful experiences, innate motivations for healthy
growth, and the child’s purposeful creation of self. Within
the humanistic framework, psychopathology is usually
linked to interference with or suppression of the child’s
natural tendencies to develop an integrated (or whole) sense
of self, with valued abilities and talents. Parents, teachers,
social conventions, and children themselves can hinder
healthy development. Intervention, then, involves the
discovery or rediscovery of internal resources and provision
of external support for self-organization, self-direction, and
self-righting capacities. Among the most influential family
therapists within the humanistic framework was Virginia
Satir (Satir et al., 1991).
At times criticized as overly optimistic about the
potential for happiness, creativity, and actualization, the
humanistic models are thematically related to more recent
discussions of well-being (Keyes & Martin, 2017) and
positive psychology (Luthar et al., 2014). There is an
increasing emphasis on the positive subjective experiences,
positive individual traits, and positive institutions that
promote individual, family, social, and community
well-being (Seligman & Csikszentmihalyi, 2000).
The broaden-and-build theory of positive emotions, for
instance, explores the ways in which positive experiences
lay the groundwork for the development of health and
resilience across the lifespan (Fredrickson, 2001). An
especially meaningful contribution of the theory is that
“everyday positive emotions, as fleeting as they may be,
can initiate a cascade of psychological processes that
carry enduring impact on people’s subsequent emotional
well-being. That is, beyond making people feel good in
the present moment, positive emotions also increase the
odds … that people will feel good in the future (Fredrickson
& Joiner, 2018, p. 195).
Another example of positive psychology is provided
by theory and research on positive youth development.
Positive youth development (PYD) focuses on fostering
healthy development in adolescents and emphasizes
youth strengths, the plasticity of development, and
resilience (Lerner et al., 2011). An illustration of PYD
is provided by Onyeka et al. (2021) who describe a
mentoring intervention for youth of color living in
high-stress communities. The researchers examine the
ways in which specific youth characteristics—internal
strengths of competence, confidence, and character
and external strengths of caring, connection, and
contribution—predict increases in mental health and
decreases in problematic behaviors.
A final positive psychology example highlights the
role of nature in contributing to children’s well-being.
Children who perceive themselves as more connected to
nature are more involved in pro-ecology and sustainable
behaviors. These behaviors influence levels of happiness
(Barrera-Hernandez et al., 2020). Although this textbook
is about psychopathology and disorder, thinking about
happiness, hope, creativity, and growth provides an
essential balance when considering children’s distress and
dysfunction.
Thinking about Max
Max has experienced an abrupt shift in educational
atmosphere, from activity-centered learning to a teacherorganized approach with much less time for highly enjoyed
art and music. As the classroom expectations for academic
achievement become more prominent, Max has struggled
to find his place in the classroom setting. It is hard for him
to relate what he is expected to learn with what he sees as
his abilities and talents. From a humanistic and positive
psychology perspective, Max’s problems with peers may
reflect his dissatisfaction with himself and his feelings of
incompetence.
Humanistic and positive psychology interventions
will focus on increasing Max’s chances for pleasure and
mastery in school and build on his specific strengths to
make meaningful progress in treatment. In addition,
therapeutic work may include numerous opportunities
(talk-based, play-based, art-based, etc.) for the creation
(and re-creation) of a valued sense of self. With a strong
belief in the self-righting tendencies of children, we
expect that Max will be able to use these resources and
experience more rewarding personal, academic, and social
outcomes.
Thinking about Aisha
Aisha, too, is facing a new school setting and increasing
pressure from her mother, her peers, and society for her to
identify special interests and specific goals for her future.
Unlike Max, Aisha does not think that she has any unique
gifts that provide personal satisfaction or that make
contributions to others. In fact, over time, Aisha has come
to regard herself as unintelligent, unartistic, unathletic, and
unattractive. These feelings have led to sadness, irritability,
and withdrawal.
Within the humanistic and positive psychology
framework, psychotherapeutic challenges that require Aisha
to take charge of planning, decision making, and her own
happiness wil l be balanced by clear expressions of support and
encouragement that she actually is capable, competent, and
uniquely qualified for this responsibility. The expectation is
that individual positive experiences will lead to a cascade of
positive emotions and enhanced well-being.
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Family Models 27
Family Models
Historical and Current
Conceptualizations
Leo Tolstoy proposed in Anna Karenina that “happy families
are all alike, but every unhappy family is unhappy in its own
way,” and he showed much insight into the myriad ways that
misery and dysfunction may be experienced and expressed
by marriage partners, parents and children, and siblings.
However, Tolstoy’s assertion about the uniformity of happy
families is inaccurate, for there are also myriad ways in which
joy and commitment may be experienced and expressed.
Different families have different beliefs about what children
are like and how to raise them. Different families have
different dreams for themselves and their children as well as
different fears, and these different beliefs, dreams, and fears
have meaningful effects on the functioning and adjustment
of both happy and unhappy families.
In many individually focused models of disorder, we
examine “identified patients” and their unique collection
of psychologically healthy and unhealthy characteristics
(including physiological vulnerabilities, psychodynamic
demons, and maladaptive thinking patterns). In contrast,
family models propose that the best way to understand the
personality and psychopathology of particular children is to
understand the dynamics of their particular families. In fact,
almost from the beginning of our concern with childhood
disorders, we have understood that many of these disorders
may reflect, at least in part, family psychopathology.
At times, we have correctly recognized the connections
between, for example, child and parent anxieties. At other
times, with heartbreaking consequences, we have wrongly
linked specific child disorders such as autism with alleged
parental shortcomings (e.g., Bettelheim, 1967).
Families have a special impact on typical and atypical
development because they are the first setting for children’s
experiences; the influence of families, and parents in
particular, is clear and powerful. Parents are challenged to
meet a variety of children’s needs, including nurturing and
socializing, promoting education, and providing financial
support, and they can succeed or fail at any or all of these
tasks (Emery & Kitzmann, 1995).
Many parent characteristics have been the focus of
theoretical and empirical attention. Examining the
influences of parent age, personality, and mental health
or mental illness experiences on children’s adaptation
and maladaptation are examples of this kind of research.
Mothers’ age, for instance, is associated with increased risk
for several neurodevelopmental disorders, while fathers’
age is associated with increased risk for autism spectrum
disorders. Younger parental age is linked with various
patterns of problematic behaviors in children (Merikangas
et al., 2017). Parental mental illness is associated with
worse outcomes for children. Depression in mothers, for
example, is a global challenge for children’s mental health
(Fatori et al., 2020). In contrast to studies focused on
parent characteristics that increase the risk for problematic
outcomes and consistent with the previously described
positive psychology framework, new studies explore the
ways in which positive parental mental health such as the
repeated experience of positive emotions (e.g., joy, empathy)
or mothers’ social connections contribute to children’s good
outcomes (Phua et al., 2020).
Many family characteristics have also received a lot of
attention. These family variables include family type (e.g.,
two-parent, single-parent, and blended families); family
activities, rituals, and narratives; family warmth versus
conflict; and parenting practices. Examples of family
studies with connections to developmental psychopathology
include research focused on identifying the risks and
challenges experienced by single mothers to support
individual and family well-being (e.g., Taylor & Conger,
2017); research focused on father–child relationships that
reflect contemporary family life (e.g., Cabrera et al., 2018);
and research focused on the ways in which parenting beliefs
influence parenting practices and children’s adaptations
(e.g., Bornstein et al., 2018).
Kate_sept2004/E+/Getty ImagesiStock.com/kate_sept2004
Children and adolescents may live in two-parent, one-parent,
or multigenerational families.
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28 Chapter 2 Models of Child Development, Psychopathology, and Treatment
When we think about these kinds of family influences on
development and disorder, we need to consider intersections
of individual and family processes. For example, we might
explore how subsystems of the larger family system interact
with one another to influence child outcomes. The most
frequently researched subsystem is the parent–child
relationship. One example of parent–child interaction that
has been studied for decades is parental control (Baumrind,
1971; Grolnick & Pomerantz, 2009). Current research
shifts from a primarily unidirectional approach (parent →
child) to a more interactional emphasis (with parent and
child each influencing the other). These studies of parental
control—authoritative, authoritarian, permissive, and
rejecting/neglecting patterns—provide convincing evidence
of connections to adaptive and maladaptive outcomes.
In addition, researchers examine the components of
authoritative parenting, warmth + control, to explore their
influence at different ages (e.g., during childhood versus
adolescence) (Morris et al., 2021).
The family factors that have been discussed so far are
examples of shared environment, the aspects of family
life and function that are shared by all children in the
family. Shared environmental variables are variables that
are often contrasted with genetic variables; that is, what
is not explained by genes, or nature, is usually thought to
be explained by shared environment, or nurture. Indeed,
shared environments are an important contributor to
mental health outcomes (Burt, 2014). We also need to
explore the nonshared environment, the aspects of
family life and function that are specific and distinct for
each child. Nonshared environmental variables are those
that contribute to differences in sibling experiences and
outcomes. Siblings are distinctive, for example, in terms
of gender, age, and personality and may receive different
types of parenting, more or less affection, and greater or
fewer family resources (Jenkins & Bisceglia, 2011; Liben,
2016). Sibling relationships themselves may be the source of
nonshared experiences. Siblings’ differing views of support,
conflict, and respective value within a family may lead to
one sibling’s positive well-being and another sibling’s painful
struggle. Another example of a distinctive sibling experience
is illustrated by how siblings respond to a sibling who is
diagnosed with a disorder. With this challenging family
situation, some siblings display unexpected resilience, while
others have a much more difficult time.
Any research on parents and families should pay
attention to cultural and global contexts. We need to better
understand the similarities and differences in cultural
beliefs, cultural practices, and cultural settings that are
related to children’s development and disorder. One
example of this type of theoretical and research emphasis
is an examination of the pathways through which African
American families anticipate and respond to challenges and
stressors to achieve positive individual and family outcomes
(Murry, 2019). Murry’s results highlight the impact of
parental beliefs (e.g., optimism and control) on positive
parenting practices, positive child outcomes, and positive
parent–child relationships.
Another example of this research is a longitudinal
investigation of problem behaviors from age 7 to age 14
in nine countries (China, Colombia, Italy, Jordan, Kenya,
the Philippines, Sweden, Thailand, and the United States).
In Italy and the US, children and their parents were
intentionally recruited for participation from different
regions and racial/ethnic groups. Beliefs about aggression,
caregiving, and childrearing were identified and linked
to better and worse outcomes for youth. Cross-cultural
similarities were observed as well as significant variability
within cultures (Lansford et al., 2018). In another report
from the same longitudinal study, youth perceptions of
parent coldness, hostility, neglect, and rejection predicted
specific types of distress and dysfunction across cultures
(Rothenberg et al., 2021).
Beyond Family Relationships:
The Role of Peers
Just as relationships within families are associated
with better and worse health and well-being outcomes,
relationship networks outside families are also related to
immediate and long-term consequences. For example, many
children derive great pleasure from close relationships with
extended family members, neighbors, and peers. In addition
to happiness, these relationships serve as rich settings for
socioemotional learning. Friendships provide opportunities
for companionship, acceptance, and intimacy. An absence
of friendships because of rejection, conflict, or withdrawal is
associated w ith maladjustment. It is importa nt to underst and,
however, that the benefits and costs of relationships are not
always similarly experienced. For example, it appears that
peer relationships differentially shape the emotional and
behavioral development of boys and girls (Liben, 2016).
In addition, we need to consider normative versus
atypical peer experiences as well as the types of challenges
that children encounter in larger peer groups, smaller
peer groups, and dyads. We need to appreciate the many
developmental advantages provided by friendships as well
as the “dark side” of some friendships, with increases in
maladaptive social behaviors (e.g., exclusion or bullying,
reinforcement of problem drinking) (Choukas-Bradley &
Prinstein, 2014). We must take into account the striking
changes in the nature and frequency of peer interactions
with respect to the near-constant connections enabled
by social media. We also emphasize the immediate and
ongoing negative impacts that months and sometimes years
of remote learning during the COVID-19 pandemic have
had on the development and maintenance of positive peer
relationships (Magson et al., 2021).
It is important to emphasize that the roles and influences
of parents and peers are not experienced in isolation from
one another. Especially in adolescence, parenting beliefs and
practices (which may change over childhood and adolescence),
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
The quality of friendships in childhood is associated with a
variety of developmental outcomes.
and parent–adolescent relationships themselves, interact
with peer influences and adolescent–peer relationships
(Morris et al., 2021). For example, early parental social
support influences developing socioemotional functioning
through childhood and adolescence with a positive impact
on adolescent peer relationships. As another example, both
too little and too much parental control during adolescence
increases the risk of engaging in problematic behaviors with
peers (Morris et al., 2021).
Sociocultural Models 29
skills, strengthen the parents’ alliance, and diffuse sibling
tension. Additional meetings with just the parents also may
address some parenting and marital issues. With respect to
peers, it will be important to identify in-school and afterschool opportunities for Max to improve his friendships.
Thinking about Aisha
Family-focused therapists may closely examine Aisha’s
mother’s family values, beliefs, and practices. Perhaps Aisha
and her mother are close in unhealthy ways, with Aisha’s
mother being overinvolved in her everyday decisions and
Aisha feeling overly responsible for her mother’s welfare and
happiness. Or perhaps Aisha’s mother signals ambivalence
Fuse/Getty Images
or discouragement in response to any signs of Aisha’s interest
in dating, to the extent that it reminds her of her own
romantic unhappiness. As Aisha grows older and begins
to explore dating, previous relationship disappointments
and current struggles may lead to an exacerbation of her
symptoms.
Identifying the family variables that contribute to
Aisha’s difficulties will lead to hypotheses about the kinds
of therapeutic discussions that may be effective; these
therapeutic opportunities will include joint mother–
daughter sessions, as well as separate, individual sessions
for both Aisha and her mother. It is likely that scrutiny
of Aisha’s friendships will reveal challenges that must be
addressed as well.
Thinking about Max
Within the family framework, Max’s difficulties are viewed
as an expression of family distress and disorganization. In
part, his school struggles and sibling conflicts may serve
as a less threatening distraction for his parents than their
marriage and financial concerns. Even if Max is the focus of
treatment efforts, we cannot ignore the context in which his
disorder developed and in which it is maintained.
Other family variables also may contribute to the
maladjustment. It may be that the ideal classroom and
school environments for Max are less hierarchical and more
egalitarian than his close-knit but authoritarian family
environment. In addition, it may be useful to examine
closely Max’s parents’ beliefs about children’s growing-up
years, their expectations about his academic success, and
their dreams for his future. How do these beliefs support or
interfere with his ongoing developmental challenges?
A family-oriented intervention for Max addresses these
many variables and capitalizes on his affectionate family
bonds. In addition to techniques designed to enhance his
sense of self as a valued family member, Max and his parents
are likely to be taught specific cognitive and behavioral
strategies for his use in school and at home (e.g., keeping
records of school assignments, having specific folders for
completed homework, and posting schedules of chores on
the refrigerator). Family sessions will be held, with goals
to foster emotional and problem-solving communication
Sociocultural Models
Historical and Current
Conceptualizations
Many early revisions of classic psychoanalytic theory
attempted to take into account relevant cultural factors.
For instance, Karen Horney argued that Freud’s concept
of “penis envy” was mistaken. Rather than girls envying
the physical fact of maleness, she suggested that they were
envious of the social and cultural rewards associated with
being a boy. Decades later, feminist theorists continue to
make the case that the identification of disorders and
particular interventions are very much influenced by genderbased norms and expectations about desirable personality
outcomes.
Keeping this broad historical perspective in mind, we
often focus on the ways in which social and cultural factors
uniquely disadvantage certain groups in society (e.g.,
girls and women, LGBTQ+ individuals, families from
lower socioeconomic status backgrounds) and increase
vulnerability to disorders in these groups (Barbarin
et al., 2020; Liben, 2016). One of the most frequently
researched variables related to disadvantage and poor
outcomes is poverty. Poverty’s deleterious impact on the
physical and mental health of children and adolescents is
well documented and emphasizes the differing physical
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
30 Chapter 2 Models of Child Development, Psychopathology, and Treatment
Early childhood
Late childhood
Adolescence
Young adulthood
Middle age
Old age
health, mental health, and academic outcomes that are
associated with social disparities.
Over time, sociocultural models of development and
psychopathology have undergone a paradigm shift in which
cultural considerations have moved from the periphery of
inquiry to the core (Bronfenbrenner, 1989; Rogoff, 2003).
Researchers, theorists, and clinicians are now thinking
about culture in a very different way. We have moved from
macro-level ecological models that identify the everyday
settings—homes, schools, and neighborhoods—in which
children live their lives and culture exerts its influence on
individuals to a cultural microsystems approach in which
cultural practices and pathways and individuals mutually
influence each other (Velez-Agosto et al., 2017).
Glen Elder and his colleagues advocate a cultural
framework that attends to the influence of time and history
on children’s development. In Elder’s model (Modell &
Elder, 2002), there are four key assumptions:
1. Children develop within the social arrangements of a
given moment.
2. These arrangements are changed by events and trends.
3. Developing individuals change history.
4. Cultures make sense of the ways of development.
The construct of birth cohort illustrates Elder’s approach.
A birth cohort includes individuals born in a particular
historical period who share key experiences and events.
Kids growing up during the Great Depression in the United
States belong to a cohort group. Baby boomers are another
cohort. So are Generation X, Generation Y, and millennials
(refer to Figure 2.7).
One sociocultural variable related to cohorts is the pervasive
influence of social media. Children, and especially adolescents,
are increasingly online and connected to one another via
multiple digital platforms. Concerns are often focused on
the ways in which nonstop connectivity influences self and
socioemotional development, interferes with other kinds of
activities (such as in-person interactions, homework, and sleep),
and potentially increases the risk for mental health difficulties
such as anxiety and depression (Morris et al., 2021; Odgers
& Jensen, 2020). Current research continues to examine
the associations between offline and online vulnerabilities,
opportunities to support struggling youth, and ways to bridge
Figure 2.7 Relationship of societal conditions and birth cohorts
U.S. women win voting rights
Popularity of autos grows
Stock market crashes
Alcohol prohibition repealed
Roosevelt offers New Deal
U.S. enters World War II
Wartime economy prospers
GI Bill: Veterans enter college
United Nations formed
McCarthy communist scare
Civil rights demonstrations
Vietnam War
Anti-Vietnam War protests
Feminist movement
Affirmative-action programs
High interest rates
Credit cards: easy credit
High inflation
Low interest rates
Low unemployment
Low inflation
Ku Klux Klan power increases
Probusiness U.S. government
Great Depression
High unemployment rate
Labor unions grow strong
High wartime employment
Wartime family separation
Postwar labor strikes
Postwar baby boom
School racial desegregation
Youths rebel against authority
Illicit-drug-use increase
Sexual freedom
Postmodernism introduced
Rising divorce rate
Increasing teenage pregnancy
Gay-rights movement
AIDS-infection increase
Computer networks
1/3 of U.S. children in
one-parent families
1920
1930
1940
1950
1960
1970
1980
1990
2000
Birth CohortsIndicative Societal Events and Tr ends
One
Two
Three
Four
Five
Source: Thomas, R. M. (2000). Recent theories of human development.
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Sociocultural Models 31
the digital divide that impacts educational and non-educational
experiences (Odgers & Jensen, 2020).
Understanding the ways in which culture influences
adjustment and maladjustment requires the consideration
of both cross-cultural variables (e.g., between resource-rich
and resource-poor countries, or between Western and nonWestern models of development and psychopathology) and
within-culture variables (e.g., among children of different
racial or ethnic backgrounds in a city or country, or
between families of higher-socioeconomic-status and lowersocioeconomic-status environments). Box 2.2 illustrates the
many overlapping impacts of the COVID-19 pandemic
(a birth cohort factor) on children’s development and
disorder, with special attention to the pandemic’s disparate
negative impact on children of color and children from
under-resourced backgrounds.
Three examples of culture-informed investigations
illustrate the compelling influence of society and culture.
In the first example, we focus on how children and their
development are embedded in specific individual, social,
and global contexts. Newland et al. (2019) explored the
associations between children’s well-being and factors such
as gender, home and school environments, family and peer
relationships, neighborhoods, and income inequality in
14 countries (Newland et al., 2019). Over 25,000 10- to
12-year-old children from Algeria, Brazil, Canada, Chile,
England, Israel, Nepal, Romania, Rwanda, Spain, South
Africa, South Korea, Uganda, and the United States
reported on their self-image and life satisfaction. Results
suggested that, across diverse countries, the majority of
variance in well-being was predicted by child factors such as
gender and personality characteristics. Country-level factors
had less impact on well-being.
In the second example, Shonkoff et al. (2021) summarize
the wide-ranging physiological and psychological impacts
of racism and associated toxic stress on young children’s
immediate and future health and well-being. The researchers
emphasize the deleterious effects of systemic racism, everyday
discriminatory experiences, and related early adversity on
brain structure and function, the immune system, risk for
chronic inflammatory conditions, and accelerated aging
processes. Housing and residential segregation, for example,
is associated with increased exposure to hazardous substances
such as lead paint and contaminated water, concentrated
poverty and exposure to violence, and reduced access to
high-quality childcare, better elementary and high school
education, and employment opportunities for caregivers.
Prevention and intervention programs designed to improve
the physical and mental health of at-risk children and their
families will need to be comprehensive, accessible, and
evidence-based.
In the third example, Barbarin et al. (2020) describe
a social justice framework focused on supporting African
American boys who experience the painful effects of negative
stereotypes, disparate treatment, and resource deprivation.
The investigators reframe theory and research narratives that
focus on the ways in which African American boys struggle
and turn to the Adaptive Calibration (AC) model: “In
contrast to theories that highlight the adverse consequences
of adaptation to stress, AC takes a more positive view
that responses to harsh, threatening, and unpredictable
environments may promote specialized and adaptive
capabilities” (p. 200). They also emphasize the strengths and
talents displayed by African American boys in the context of
Positive Youth Development (PYD, discussed previously in
the section on humanistic and positive psychology models).
Additional studies of the personal, familial, and community
assets that promote positive developmental outcomes, such as
empathy and altruism, attachments to others, an integrated
moral system, and the capacity for happiness, will provide
much-needed data that improve the lives of vulnerable
children.
Thinking about Max
Within a sociocultural framework, the assessment of Max
will include identification of, for example, the impact of his
family’s socioeconomic status (previously solidly middle
class, now less secure), the balance between assimilation
and preservation of Honduran traditions, the embedding
of the family in the Honduran/Latino community, and
the possibility of faith-based resources. The details,
significance, and likely outcome of Max’s situation will
be interpreted in light of a set of particular cultural values
and expectations. A culturally informed intervention will
take into account the concern and availability of Max’s
immediate and extended family and may provide culturally
accessible conceptualizations of disorder and intervention.
Thinking about Aisha
Contributions from a sociocultural perspective also will help
us understand Aisha’s situation. There may be fewer financial
resources for Aisha and her mother, but their participation
in church-related activities may provide additional support.
Perhaps Aisha will become more interested in developing
connections to her religious community, or she will become
more aware of her personal concerns related to gender or
politics. In all instances, we expect this perspective to lead to
a fuller, more nuanced approach to disorder and intervention.
Over the course of this chapter, it has become abundantly
clear that a single model of development, psychopathology,
and treatment, no matter how comprehensive, cannot
provide all the necessary information. Depending on the
particular child, different aspects of various models, taken
together, contribute to better understanding and a greater
number of specific options for support and intervention.
This emphasis on complexity and integration will lead us,
in the next chapter, to the consideration of contemporary
principles and practices of developmental psychopathology.
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32 Chapter 2 Models of Child Development, Psychopathology, and Treatment
Box 2.2 Risk and Resilience
COVID-19: Bio-Psycho-Social Perspectives on a Pandemic
The World Health Organization declared a global pandemic in
March of 2020 as the coronavirus disease 2019 (COVID-19)
began to spread rapidly. Although the immediate concern was
for physical illness, rapidly implemented lockdowns changed
daily life for people across the United States and the world
in ways that were unforeseen and unpredictable. Lockdowns
and restricted activities that were expected to last only weeks
extended into months and years, raising issues of COVID-19’s
impact on both physical and mental health.
It soon became clear that the COVID-19 pandemic amplified
pre-existing and well-documented disparities in health outcomes
rooted in poverty and racism, including the structural legacies of
racism and other cross-generational traumas. These factors are
known to contribute to chronic stress and increased susceptibility
to dysfunction and poor outcomes in physical health,
developmental, and mental health domains. The pandemic in the
United States resulted in disproportionately greater harm to
historically marginalized groups, including substantially higher
rates of infection, hospitalization, and death (Shonkoff &
Williams, 2020). Higher rates of exposure to the virus were
associated with employment in occupations that lacked adequate
protection from infection, in jobs without paid sick leave or
the ability to work from home, and with overcrowded housing.
These risk factors were much more likely to be experienced by
African Americans, Hispanic Americans, and Native Americans.
Individuals also responded differently to COVID-19due to
variability in susceptibility. Variability in susceptibility is
commonly observed for many diseases and is highly influenced
by the environments in which people live. For example, there is
increasing evidence that health-threatening conditions early in
life—including poor nutrition, exposure to pollutants, and
excessive family stress associated with poverty, racism, and
other forms of economic or social disadvantage—can have
disruptive effects on developing immune and metabolic systems
that lead to greater risk for a variety of chronic health
impairments well into the adult years. Differences in
susceptibility help explain the more serious and more deadly
outcomes for individuals from minority and marginalized
backgrounds.
These COVID-19 health disparities issues were not unique
to the United States. The pandemic was a worldwide
phenomenon, as were the resulting health inequities for children
and youth (Kyeremateng et al., 2022). For example, a large
population study of over 2.5 million children in England found
significant associations between race and poorer COVID-19
outcomes, reflecting disparities in testing, infection rates, and
hospitalizations among racial minority children as compared to
the majority population (Saatci et al., 2021).
Among the most disheartening legacies of the pandemic are its
impact on mental health and developmental outcomes among
children and families. Loss of social support networks for children
and parents, loss of structural support for day-to-day life for
children, especially those found in schools, and serious illness and
loss of life of caregivers all contribute to problems associated with
the COVID-19 pandemic. A study in Canada (Gadermann et al.,
2021) documents the ways in which social isolation, school and
childcare closures, and employment instability combined to create
unprecedented challenges for families and a significant increase in
mental health problems, including especially high rates of
depression, anxiety disorders, and general symptoms of
psychological distress. Similar outcomes were reported in studies
conducted in the United States and around the world (e.g., Patrick
et al., 2020; Xiong et al., 2020). Another study was able to compare
the pre-pandemic psychological and behavioral adjustment of
adolescents in nine countries to mental health outcomes during the
pandemic. The researchers found that pre-pandemic internalizing
problems predicted more extensive internalizing problems during
the pandemic. Additionally, poor general psychological adjustment
predicted higher externalizing problems and substance use during
the pandemic (Lansford et al., 2021).
In addition to the direct effects of the COVID-19 pandemic
on youth, the higher pandemic-related stress experienced by
parents proved relevant to child mental health outcomes as
well. Calvano and colleagues (2021), for instance, found that
parental stress increased significantly during the pandemic and
more than 50% of parents reported being stressed by social
distancing and the complications that resulted from the closure
of schools and childcare settings (Calvano et al., 2021).
A study linking the stress physiology of mothers and children
during the pandemic found evidence—in increased levels of
cortisol, heightened stress, and anxiety among children—that
parent stress activation was associated with greater internalizing
mental health problems in their children (Perry et al., 2022).
Mothers who reported family job loss, working from home, reading
pandemic-related news, and greater social distancing had greater
concentrations of maternal hair cortisol, a stress-related hormone.
Children whose mothers reported family job loss and greater social
distancing had greater concentrations of child hair cortisol.
Maternal and child hair cortisol were most strongly associated in
the youngest children. Maternal hair cortisol was also associated
with greater anxiety and depression in children. Importantly,
mothers’ stress appears in their own physiology and is linked to
children’s stress physiology and behavior.
Another example of the intersection of social determinants of
health, i ncluding racia l discrimina tion and economic disadva ntage,
and child mental health outcomes during the COVID-19
pandemic was evident in the differential effects of school closures
on academic and social-emotional outcomes. One study, for
example, showed that disruption of in-person schooling negatively
and differentially affected children’s mental health in low-income,
Black, and Hispanic communities across the country (Hawrilenko
et al., 2021). Researchers found that children from lower-income
families and children of Black and Hispanic parents were much
less likely to attend school in person throughout the pandemic
than their peers from higher-income families or those with White
parents. While it was necessary to close schools for all in-person
instruction for much of the pandemic, more flexible and better
supported alternative instruction was evident in communities with
greater resources. Additionally, disparities in resources at home
(e.g., dedicated space for learning and available technology) as well
as the flexibility of parents’ jobs to support working from home,
likely played a role as well.
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Sociocultural Models 33
Key Terms
Dimensional models of psychopathology (14)
Categorical models of psychopathology (15)
Physiological models (15)
Connectome (16)
Sensitive periods (17)
Neural plasticity (17)
Genotype (18)
Phenotype (18)
Behavior genetics (18)
Molecular genetics (18)
Genome-wide association studies (18)
Behavior genetics (18)
Heritability (19)
Gene-by-environment-by-time effects (19)
Gene-by-environment-by-time interactions (19)
Epigenetics (19)
Risk alleles (20)
Polygenic models (20)
Chapter Summary
●
Models of development, psychopathology, and treatment
help direct research efforts, explain typical and atypical
adaptation over time, organize clinical observations, and
design treatment programs.
●
Dimensional models of psychopathology emphasize the
gradual transition from the typical range of feelings,
thoughts, and behaviors to clinically significant problems
and disorders.
●
Categorical models of psychopathology emphasize
differences between distinct patterns of emotion,
cognition, and behavior that reflect typical functioning
and those that define clinical disorders.
●
Physiological models emphasize brain structure and
funct ion, brain grow th and development in environmental
contexts, brain-body-behavior processes, and genes
and environments. Increasingly complex models of
development and disorder examine the influence of
genes by environments by time. Behavior genetics and
epigenetics are the focus of current theory and research.
●
Psychodynamic models emphasize unconscious cognitive
and emotional processes, mental representations of
self, other, and relationships, the meaningfulness of
experiences, and a developmental framework.
Diathesis–stress model (21)
Differential susceptibility (21)
Psychodynamic models (24)
Mentalizing (24)
Behavioral models (25)
Classical conditioning (25)
Operant conditioning (25)
Observational learning (25)
Reinforcement (25)
Cognitive models (25)
Developmental cognitive neuroscience (25)
Humanistic models (26)
Positive psychology (26)
Positive youth development (26)
Family models (27)
Shared environment (28)
Nonshared environment (28)
Sociocultural models (30)
Birth cohort (30)
●
Behavioral models emphasize the individual in
environmental context, the impact of environmental
factors, and processes of learning and reinforcement.
●
Cognitive models emphasize evolutionary theory, the
social context of early cognition, both qualitative and
quantitative change over time, and connections to
academic skills and education.
●
Humanistic models emphasize the potential for growth
and holistic perspectives on the self. Positive psychology
models emphasize the ways in which positive experiences,
positive characteristics, and positive institutions
promote the well-being of individuals, families, and
communities.
●
Family models emphasize development and disorder
within a family context. Parent factors and family
factors are the focus of theory and research. Peer factors
are another important influence on development and
disorder.
●
Sociocultural models emphasize the importance of the
social context, including gender, race, ethnicity, and
socioeconomic status in the development, course, and
treatment of psychopathology.
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.