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3
Principles and Practices
ofDevelopmental Psychopathology
Chapter Outline
The Framework of Developmental
Psychopathology 35
Developmental Pathways, Stability, and Change 36
Competence and Incompetence 38
The Case of Zane
The Case of Jasmine
Risk and Resilience 40
Risk and Risk Factors
Types of Risk Factors
Numbers and Timing of Risk Factors
Learning Objectives
1. Summarize the construct of developmental pathways.
2. Describe new cases that illustrate the concepts of
multifinality and equifinality.
3. Explain the factors and processes that contribute to
consistency/inconsistency and stability/instability across
development.
4. Explain the factors and processes that contribute to
competence or incompetence across development.
5. Explain how individual, family, and sociocultural risk
factors contribute to the increased vulnerability to disorders
in children and adolescents.
6. Explain how the numbers and timing of risk factors
contribute to overall risk.
Resilience and Protective Factors
Types of Protective Factors
Patterns and Pathways of Protective Factors
Research Strategies in Developmental
Psychopathology 46
Cross-Sectional and Longitudinal Approaches
Complex Hypotheses and Complex Models
Research in Real-World Settings with Practical Applications
Box 3.1 Risk and Resilience: The Pediatric Innovation
Initiative: Research, Policy, and Practice
7. Discuss the multisystemic approach to resilience.
8. Explain how individual, family, and sociocultural protective
factors contribute to resilience in children and adolescents.
9. Describe several important research findings related to the
multisystemic approach to resilience over time.
10. Describe how longitudinal research, cross-sectional research,
and complex models contribute to a better understanding of
risk and resilience.
11. Explain the importance of research that prioritizes
real-world settings and practical applications.
12. Analyze a case study for examples of risk and resilience
over time.
34
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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 Framework of Developmental Psychopathology 35
As we examine the principles and practices of developmental
psychopathology, keep in mind the definitions provided
in Chapter 1’s introduction: Psychopathology refers to
intense, frequent, and/or persistent maladaptive patterns
of emotion, cognition, and behavior; and developmental
psychopathology extends this description to emphasize
that these maladaptive patterns occur in the context of
typical development and result in the current and potential
impairment of infants, children, and adolescents. Here,
we will use these definitions as our cornerstones and
build on them to explore related concepts of distress and
dysfunction.
This chapter has three sections. The first section is
primarily focused on development, with descriptions
of developmental pathways and child competence
and incompetence. The second section reviews the
key constructs of risk and resilience. Examples from a
variety of empirical and clinical studies make explicit
the connections between theoretical constructs and reallife children. The third section provides an overview of
research strategies in developmental psychopathology.
The Framework of Developmental Psychopathology
Developmental psychopathology is a research-based,
conceptual approach that provides a framework for
understanding how specific disorders develop, what
happens over time to children who develop disorders, and
what we can do to help these children. From a theoretical
perspective, as emphasized in Chapter 2, developmental
psychopathology is not associated with a single model of
development and disorder. Developmental psychopathology
is a synthesis of multiple theoretical and research
approaches (refer to Figure 3.1). From a clinical perspective,
developmental psychopathologists assume that a variety
of assessment, prevention, and intervention techniques
will prove useful. The contributions of other disciplines
are explicitly acknowledged. Numerous researchers and
clinicians in psychiatry, social work, education, and public
policy provide important hypotheses, data, and interpretive
insight and mental health care. Many individuals have
contributed to the growth of the field; their seminal reviews
Figure 3.1 A framework for developmental psychopathology
Genetic
Biological
Individual
Factors
Extended
family
Family and
Other Social
Support
Marital
Parent/
Child
Society and
Environment
Government Financial Community
Psychological
Peers
Siblings
Psychological Functioning
(Responses and Patterns)
Cognitions Emotions
Physical and
health
environment
Physiological/
biological
responses
Period of life span
Social
Social competence
Adjustment
Maladjustment
Internalizing
problems
Externalizing
problems
Source: Cummings, E. M. (1999). Some considerations on integrating psychology and health from a life-span perspective.
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36 Chapter 3 Principles and Practices ofDevelopmental Psychopathology
Equifinality:
Multifinality: Similar starting points lead to different outcomes.
have focused the organization and content of this chapter
(Achenbach, 1982, 1990; Cicchetti, 1984, 1990a, 1990b;
Garmezy & Rutter, 1983; Rutter, 2013; Sameroff, 2000;
Sroufe, 1997, 2009, 2013).
Within the developmental psychopathology framework,
disorders are frequently understood as either delay (e.g., the
child acquires language more slowly than other children) or
dysfunction (e.g., children behave in a way that results in their
own or others’ distress or in a way that does not achieve a
positive outcome). Understanding children’s disorders as delay
or dysfunction highlights the difficulties of a particular child at
a particular point in time, providing us with one way of thinking
about the connection between typical and atypical development.
Another way of thinking about the connection between
typical and atypical development is to examine the notion of
process. Adaptation (or maladaptation) is an ongoing activity.
With this in mind, we can think about disorders as series of
problems over time, with small problems leading to larger
problems, or one problem leading to many more problems,
and so on. Children’s psychopathology, then, does not
emerge suddenly or out of the blue; rather, it unfolds over
time. To illustrate this point, we can think metaphorically
of developmental psychopathologists making difficult
choices between taking photographs or videos of troubled
children. Single photographs can be compelling in their
detail but are time bound. Videos provide a more dynamic
perspective, but wide-angle views may miss some important
details. We have to be creative in our use of both the camera
lens and film as we try to capture the essence of children’s
psychopathology.
Developmental Pathways, Stability, and Change
The concept of developmental pathways (or trajectories)
illustrates the principle that adjustment and maladjustment
are points or places along a lifelong map. There are diverse
positive developmental pathways: many different ways for
children to grow up safe, happy, and capable. Less happy,
less adept children also follow multiple developmental
pathways, but these are distinct, different roads. With a
developmental pathways perspective, we need to account for
the ways in which adaptation (or maladaptation) at an earlier
point in time connects to adaptation (or maladaptation) at
a later point in time.
Equifinality and multifinality refer to similarities and
differences in individual pathways to a disordered outcome
(Sroufe, 2013; refer to Figure 3.2). Equifinality is best
understood as sets of differing circumstances that lead to the
same diagnosis. For example, one child may fall behind in
school and experience repeated academic failures. Another
may be part of a family that is disengaged and hostile. Still
another may have a genetic vulnerability to mood disorders.
Figure 3.2 Equifinality and multifinality
Different starting points lead to similar outcomes.
Equifinality describes the process by which all three of these
children go on to develop major depression in adolescence.
With equifinality, different beginnings result in similar
outcomes.
Multifinality is best understood as sets of similar beginnings
that lead to different outcomes. Here, three children
all begin with the same set of circumstances, perhaps
involving maternal psychopathology and severe economic
disadvantage. One child may struggle and manage to just
get by. Another may surpass all expectations. And the last
may fail in school, in relationships, and in the job market.
With multifinality, similar beginnings result in different
outcomes. For both equifinality and multifinality, we
are concerned with the kinds of individual, familial, and
social variables that influence children’s developmental
pathways both toward and away from disorder.
So far, our discussion of developmental pathways has
emphasized stability, the ways in which adaptation or
maladaptation continues over time and place. We refer
to Figure 3.2 and note the straight lines or direct paths
of development and the apparent inevitability of certain
outcomes. But developmental pathways also encompass
change and transformation. Figure 3.3 provides additional
examples of zigzag or nonlinear developmental paths.
Two of the most important things to remember when
thinking about developmental pathways are that (1) change
is possible at many points, and (2) change is constrained
or enabled by previous adaptations (Sroufe, 2013). For
example, the transition to middle school is often associated
with a larger group of peers from which a child may
choose new friends. Whether children are able to develop
Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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.
Path 1
3
Figure 3.3 Zigzag and nonlinear pathways
Good
Adaptation
Poor
Early adolescence Late adolescence
Developmental Pathways, Stability, and Change 37
Path 5
Path
Path 4
Path 2
Stable
Path 1
Adaptation
Stable
Path 2
Maladaptation
Reversal of
Path 3
Maladaptation
Decline
Path 4
Adaptation
Temporal
Path 5
Maladaptation
Source: Compas (1995). Adolescent Development: Pathways and Processes of Risk and Resilience.
new friendships depends on their self-image, social skills,
and earlier successful (or unsuccessful) experiences in
elementary school. With a collection of unique factors
for any given child—the timing of diagnosis, the specific
disorder, the kind of intervention, and specific familial
and environmental variables—we expect differences in the
types of change or rates of change.
We can also explore the timing of change: the
“transitions and turning points” of developmental
pathways (Rutter, 1996). Both internal, intrinsic factors
(such as the acquisition of language or the onset of puberty)
and external factors (such as a move to a new home or a
divorce) are associated with potential gains or reversals.
These transitions or turning points are tied to the shutting
down or opening up of opportunities. For example, the
decision by an academically struggling adolescent to drop
out of school may result in the shutting down of a number
of employment options or the closing off of certain
aspects of a positive self-image, such as high intelligence
or academic achievement. A move to a new neighborhood
Few behavior problems: Good self-worth.
Low risk exposure.
Chronic adversities; little protection.
Example: Aggressive, antisocial behavior maintained.
Important life change creates new opportunity.
Example: Military carrer affords opportunity.
Environmental or biological shifts bring adversity.
Example: Family divorce contributes to maladaptation.
Can reflect transient experiment risk taking.
Example: Use of illegal drugs.
may open up opportunities, and a child with a difficult
reputation among peers may be able to develop new and
more successful friendships.
As we explore the developmental pathways of individual
children, we also must consider how these children
compare to other children (Bornstein et al., 2017).
Very aggressive children, for instance, may decrease the
frequency of their aggressive behaviors over time but still
maintain their position (as relatively more aggressive)
compared to their peers over time. Figure 3.4 illustrates
three profiles of development that take into account
both individual and peer pathways. In the illustration,
continuity and discontinuity refer to the overall group level
of a characteristic or behavior (e.g., empathy or aggression).
Stability and instability refer to the relative ordering of
individuals compared to peers.
Throughout the textbook, in discussions of how
disorders play out over time, we describe mechanisms
that are hypothesized to underlie stability and change.
It is important to understand that genes, environments,
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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.
38 Chapter 3 Principles and Practices ofDevelopmental Psychopathology
BC
Figure 3.4 Three profiles of development
Note: C1-C5 are individual children measured on a characteristic at two time points.
Continuity and StabilityA
Child 1
Child 2
Child 3
Child 4
Time 1
aggression level
Adapted from Bornstein et al. (2017). Continuity and stability in development.
Child 1
Child 2
Child 3
Child 4
Time 2
aggression level
Discontinuity and Stability
Child 1
Child 2
Child 3
Child 4
Time 1
aggression level
and development itself all contribute to adaptive and
maladaptive pathways. Whether we describe adaptive or
maladaptive pathways, or stable or changing patterns, it is
important to understand that “the course of development
is lawful” (Sroufe & Rutter, 1984). Lawful, or coherent,
development is different from stabil it y. We need to seek out
connections that make developmental sense (Bornstein
et al., 2017; Sroufe, 2013). For example, a child’s
approach to calming herself may look different when
she is eight years old (e.g., talking quietly to herself,
breathing deeply) than it did when she was four years
old (e.g., curling up with a favorite blanket), but her later
efforts are clearly related to her earlier efforts. As another
example, some children who are bullied by older siblings
at home go on to bully children in younger grades in
elementary school. Being mistreated and mistreating
others are not identical forms of behavior, but they are
sometimes connected in terms of emotions, thoughts,
and behaviors related to the self, relationships, and
power. This notion of developmental coherence is the
final component of our understanding of all types of
developmental pathways. Coherence reflects our belief
that beginnings may be logically and meaningfully
linked to outcomes if we carefully evaluate the variables
that lead to stability as well as the variables that lead to
change.
Competence and Incompetence
Up to this point, we may have assumed that children
either do well or do poorly. We may have assumed that
psychological well-being is a characteristic of some children
but not others. In reality, of course, well-being is not an
all-or-nothing phenomenon. Most typically developing
children do better, or are more competent, in some areas
than in others. Competence, within the framework
of developmental psychopathology, reflects effective
Discontinuity and Instability
Child 1
Child 2
Child 3
Child 4
Time 2
aggression level
Child 1
Child 2
Child 3
Child 4
Time 1
aggression level
Child 4
Child 2
Child 1
Child 3
Time 2
aggression level
functioning in important environments (Burt et al., 2016).
Children who are competent display a “track record of
effectiveness in age-salient developmental tasks,” and this
effectiveness is “embedded in developmental, cultural,
and historical context” (Burt et al., 2016, p. 436; refer to
Table 1.1 in Chapter 1). Competence involves multiple
components, including children’s skills and talents,
personality characteristics, accomplishments, and beliefs
about their own effectiveness. The study of competence
overlaps the study of positive development in youth and
takes into account the sociocultural expectations, valued
outcomes, and environmental contexts that influence
children’s adjustment or maladjustment.
The Case of Zane
Zane is in seventh grade. Although his childhood to date
has been relatively happy and uneventful, tensions in
the home have increased in the year since his father was
laid off from his job. Initially supportive of her husband,
Zane’s mother has begun to resent the fact that Zane’s
father has rejected several job opportunities that he felt
were less than what he deserved. Money has become tight,
and the family has had to restrict purchases such as new
school clothes and supplies.
Zane, a rather shy individual, is self-conscious and
generally uncomfortable around his classmates. He had
difficulty making the transition to middle school in sixth
grade, and he felt overwhelmed by the large and bustling
setting. He is a talented student with an especially strong
aptitude in math a nd science. In fact, his science te acher, Mr.
Gordon, invited him to join the middle school math team.
Zane has made a significant contribution there and
was asked by several other team members to join them
in developing and entering a project for a science
competition.
Within these more structured social settings, Zane
has begun to relax and develop some genuine friendships.
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Competence and Incompetence 39
Mr. Gordon has continued to mentor him, and he has
told Zane’s parents that Zane is his hardest-working
student. In fact, he is recommending that Zane switch to
the school’s accelerated academic track for the following
semester. Even with these school achievements, Zane has
become increasingly withdrawn and irritable at home,
where the arguments between his parents have become
more frequent.
The Case of Jasmine
Jasmine is in eighth grade. When she was eight years old,
her parents divorced after several turbulent years, during
which each developed serious chemical dependency
problems. Jasmine was sent to live with her grandmother
for a year. During that time, she struggled with a
number of anxiety symptoms and sleep disturbances and
experienced many problems at school. Her grandmother,
however, was patient and supportive of both her
granddaughter and her daughter while Jasmine’s mother
completed a successful course of treatment, found work,
and rented an apartment close by. After rejoining her
mother, Jasmine gradually came to trust the stability of
her new home and continued to be very involved with her
grandmother.
After several failed attempts to overcome his addictions,
Jasmine’s father recently found a treatment program that
has helped him make real progress. Although his contact
with Jasmine has been limited, he has slowly reentered her
life, with the approval and encouragement of Jasmine’s
mother. In particular, he has taken a strong interest in
Jasmine’s soccer and basketball teams, attending as
many games as possible. Like her father, Jasmine is
an outstanding athlete. She has great natural ability,
works hard at practice, and loves to compete. All her
close friendships have developed from time spent with
teammates. She often says that she is far happier on the
soccer field and basketball court than in the classroom.
In fact, school is an increasing challenge for Jasmine.
Although her pleasant personality and diligence served
her well in elementary school, these qualities have not
been enough to make up for her poor reading skills and
difficulty comprehending the more abstract and complex
content of her middle school courses. She is always behind
in her assignments, and her resistance to spending time on
her homework is the one major area of conflict between
Jasmine and her mother.
Thinking about Zane and Jasmine, it becomes clear that
children’s developmental pathways cannot be described
as altogether good or altogether bad, and children’s
developmental outcomes are not altogether competent or
altogether incompetent. Zane displays academic strengths
but struggles to feel comfortable with his family. Jasmine
is well liked by peers and is a gifted athlete but functions
poorly in the school setting. As an adult, Zane may
eventually derive great satisfaction from a career as an
engineer, but he may always feel some discomfort with
intimate relationships. Jasmine may enjoy her job as a
physical therapy aide, but she may feel more accomplished
when she thinks about her close-knit family and her several
awards for volunteer work in her community. Like Zane and
Jasmine, all children display various domains of competence,
which involve particular skills and achievements, combined
with domains (or areas or types) of incompetence, which
involve lack of skill or lack of achievement. Combinations of
competence and incompetence are as true of children with
disorders as they are of children without disorders. As we
present specific psychopathologies in the following chapters,
it will be essential to remember that children’s disorders
coexist with their talents and successes. We will emphasize
the need to consider children’s strengths during assessment
and diagnosis as well as the need to draw on those strengths
in designing effective treatment plans.
Several models of competencies have been described. An
early and still influential model identified three domains
of competence in younger school-aged children: academic
achievement, behavioral competence, and social competence.
Two additional domains appear in adolescence: romantic
competence and job competence (Burt et al., 2016; Masten &
Coatsworth, 1998). Generally, children who are competent in
one area are somewhat more likely to be competent in other
areas. Still, competence in one area by no means ensures
competence in another. We can all recall a child in elementary
school who was academically gifted but socially awkward,
or a child who enjoyed a wide circle of friends but struggled
with schoolwork. By adolescence, there is less overlap of
domains of competence than there is in childhood, with
social competence no longer related to academic achievement
or behavioral competence. For instance, many adolescents
make increasingly specific decisions about high school
coursework (e.g., enrolling in science or language courses
that are college prerequisites) and extracurricular activities
(e.g., vacations with family or employment opportunities)
that lead to increases or decreases in domain-specific skills.
Competence in any domain does not emerge full blown, and
there are many factors that contribute to the development
and maintenance of competence in children.
Other models of competence are less focused on the
domains in which children display effective behavior
and more focused on characteristics that contribute to
competence in a variety of circumstances. The positive
youth development model (briefly summarized in
Chapter 2’s section on humanistic and positive psychology)
identifies multiple dimensions of healthy adjustment: the
strengths of competence, confidence, character, caring,
connection, and contribution (e.g., Lerner et al., 2011).
Although there are some differences among models, all
of them emphasize distinctive developmental patterns of
effective and ineffective functioning (Burt et al., 2016).
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40 Chapter 3 Principles and Practices ofDevelopmental Psychopathology
Risk and Resilience
We turn now to discussions of some of the multiple
factors and systems that enhance or complicate children’s
development and functioning, focusing first on risk and
resilience (Garmezy & Rutter, 1983; Masten, 2014; Rutter,
2013). The constructs of risk and resilience have been
investigated for decades, with much of the early work
focused on the life outcomes of children of parents with
schizophrenia (Garmezy, 1974; Mednick & Schulsinger,
1968). Key observations regarding this group of children
were that (1) significantly more of them developed
psychopathologies compared to children whose parents were
not diagnosed with schizophrenia, and (2) many of these
children, despite their difficult family circumstances, had
adequate and even excellent outcomes. Why some children
struggle and why others prevail are the questions at the heart
of risk and resilience research.
Risk is defined as increased vulnerability to disorder. Risk
factors are the individual, family, and social characteristics
that are associated with this increased vulnerability.
Resilience is defined as adaptation (or competence) despite
adversity. Protective factors are the individual, family, and
social characteristics that are associated with this positive
adaptation.
Risk and Risk Factors
Risk factors increase vulnerability in two ways: (1)
nonspecific risk, which involves increased vulnerability to
any, or many, kinds of disorders; and (2) specific risk, which
involves increased vulnerability to one particular disorder.
As an example of specific risk, the inactive liver enzyme that
interferes with the metabolism of phenylalanine is associated
with a particular type of intellectual developmental disorder.
As an example of nonspecific risk, poverty is associated with
a variety of negative outcomes. And just to make things
interesting, there are factors that are both somewhat specific
and somewhat nonspecific. For example, children whose
parents are diagnosed with schizophrenia display increased
vulnerability to schizophrenia itself as well as increased
vulnerability to a number of other psychological disorders.
Finally, although it may seem as if a child either has a risk
factor (e.g., poverty) or does not, risks are not usually allor-nothing events (e.g., poverty may be more or less severe;
the consequences of parental unemployment may differ
for under-resourced and well-resourced families). We need
to think about most risk factors as both dimensional and
complex.
In discussing risk and risk factors, we also need to
keep in mind the construct of differential susceptibility
(introduced in Chapter 2). Susceptibility—when a
genetic, epigenetic, or psychological characteristic makes
a child more sensitive to both negative and positive
environmental contexts—is clearly connected to the
construct of risk. In typical discussions of risk and risk
factors, we focus on the ways in which the presence of a
particular characteristic or experience negatively impacts
current or future adaptation or well-being. We often
assume that a particular risk factor (such as inconsistent
parenting or economic disadvantage) is experienced in
similar ways across individuals. Including differential
susceptibility in discussions of risk leads to more nuanced
predictions about the impact of risk factors on more or
less sensitive youth and on their developmental pathways.
Said another way, the child most likely to benefit from
an enriched environment is also the most vulnerable in a
high-risk environment. Consequently, even as we consider
risk factors in detail, it is worth remembering that their
impact on lives over time is moderated by other factors,
including the differential susceptibility of the children
and adolescents who experience those risks.
Types of Risk Factors
The most common distinctions made among types of
risk factors involve individual, family, and sociocultural
risks. Individual risk factors are child focused and include
things like genetics and physiological processes, cognitive
and behavioral predispositions, and temperament and
personality. Being very intense, easily aroused, or difficult
to soothe, for example, makes a child more vulnerable to
distress and dysfunction. As we will learn in upcoming
chapters, both biological sex assigned at birth and
gender make a child more or less vulnerable to certain
disorders. Biological sex and gender are also related to
the timing of disorders. Disorders that are more frequent
in boys tend to be diagnosed early in development (with
neurodevelopmental impairments), while disorders that a re
more frequent in girls tend to be diagnosed in adolescence
(Thapar & Rutter, 2015; refer back to Figure 2.5
in Chapter 2). Keep in mind, however, that a risk factor
for one disorder may be a protective factor for another.
For instance, a child who is easily aroused and fearful is
less likely to develop a conduct disorder but more likely to
develop an anxiety disorder.
Family risk factors are those associated with the child’s
immediate caretaking environment and include parent
characteristics such as the presence of psychopathology
(e.g., depressive disorders or substance use disorders) or
harsh, punitive styles of parenting; family characteristics
such as neglect, lack of supervision, or chronic conflict
between parents; and family events such as divorce or
unemployment. Maternal psychopathology is often cited
as a nonspecific risk factor. That is, having a mother
with a serious psychological disorder is frequently related
to children developing disorders. The child’s disorder is
sometimes similar to the mother’s disorder, but they are also
often different. Moms who have depression may have kids
with depression, but moms who have depression may also
have kids with anxiety and kids with conduct problems.
And because a risk factor does not necessarily lead to poor
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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.
Risk and Resilience 41
outcomes, moms with depression may also have kids who
are well-adjusted.
Sociocultural risk factors include those associated
with the child’s larger environment, including peers
and schools, neighborhood and socioeconomic status
(SES) background, and racial, ethnic, and cultural
characteristics. With respect to peers and schools,
for example, we pay attention to academic quality
and support, school climate and activities, and peer
relationships such as bullying, rejection, or negative
influence. It is very important to note that not all
children in an elementary school, middle school, or high
school experience the school environment the same way.
Not all children have equal access to the best teachers or
extracurricular activities. Adolescents who need to work
after school may not have time to participate in sports or
in music and drama productions. Other school activities
may be too expensive. In addition, youth of color and
gay, lesbian, transgender, and gender-nonconforming
youth may experience harassment and discrimination
that others in their school do not.
With respect to socioeconomic factors, we are especially
concerned with the ways in which poverty compromises
children’s well-being. Poverty is a complex experience, and
risk is measured in terms of degree, chronicity, and timing.
(Refer back to Chapter 2’s box examining COVID-19’s
disparate impact on families experiencing poverty and
other adversities.) Food insecurity and lack of access to
safe and affordable housing are, of course, significant risk
factors related to poverty and neighborhood disadvantage.
Environmental stressors such as exposure to environmental
toxins and noise, crowding, and chaos are additional
sociocultural risks associated with living in disadvantaged
communities. Children who experience noise and crowding
in homes and classrooms show elevated levels of stress
hormones, sleep less, display slowed academic achievement,
and report more irritability and anxiety (Evans, 2021).
Parents and teachers also report distress and dysfunction
related to noisy, crowded, and chaotic settings (Evans,
2021).
In addition to the pervasive impact of poverty, there
are data that suggest that youth in middle- and upperSES environments are also at increased risk for high levels
of distress and dysfunction (Luthar & Eisenberg, 2017).
Youth in high-achieving settings (e.g., families, schools, and
neighborhoods) experience pressures to excel in academics
and extracurricular activities, and these “unrelenting
pressures to accomplish” are associated with increased rates
of anxiety, depression, and substance use (Luthar et al.,
2020, p. 986).
Adverse experiences related to race, ethnicity, and
culture are well documented. These types of risk factors
include exposure to racism in all forms, from individual
experiences of microaggressions, to unequal rates of
punishment and expulsion in schools for minority and
marginalized youth, to systemic and structural racism, to
vicarious racism (viewing racism directed at others) (Marks
et al., 2020; Shonkoff et al., 2021). Risks are also observed
related to the disproportionate impact of SES disadvantage
on individuals and communities of color, minority groups
(e.g., immigrants), and marginalized groups (Shonkoff
et al., 2021).
Stressful life events are risk factors. Family life
events such as divorce or parental unemployment have
already been noted. Other types of life-event risks
include experiencing natural disasters such as floods
or tornadoes. In addition, far too many children and
adolescents in the world live in war zones, with risks
related to displacement, exposure to violence and trauma,
and parental absence or loss (Masten & Motti-Stefanidi,
2020).
Numbers and Timing of Risk Factors
Many researchers, clinicians, and other youth experts have
concluded that the total number of risk factors that children
and adolescents experience is even more important than
the specific type of risk factors. We know that children
iStock.com/tzahiV
Poverty, lack of access to playgrounds and good schools,
and dangerous neighborhoods are all social risk factors
that may compromise children’s development.
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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.
who are exposed to multiple risks display more distress
and dysfunction and have worse outcomes than children
exposed to single risks (Masten et al., 2021).
42 Chapter 3 Principles and Practices ofDevelopmental Psychopathology
Research on cumulative risk is often focused on
adverse child experiences (ACEs), extreme adversity,
and toxic stress (Lacey & Missis, 2020; Shonkoff et al.,
2021, discussed in detail in Chapter 8). Examples of
ACEs include the experience of maltreatment, familial
violence, parental separation or divorce, and parental
substance abuse. Estimates of exposure to ACEs suggest
that up to 25% of children and adolescents experience
three or more kinds of adversity (Harvard Center on the
Developing Child, 2017; National Center for Injury
Prevention and Control, Division of Violence Prevention,
2021). As might be expected, the presence of one risk
factor or ACE is associated with the presence of other
risk factors or ACEs (i.e., a high correlation is observed).
Certain combinations of risk factors and adverse child
experiences appear to be especially significant in terms of
predicting poor outcomes (e.g., maltreatment + another
ACE) (Briggs et al., 2021).
In many cases, the environmental risk factors may
be more impactful than individual or family factors.
Differential impact theory, the environment-focused
counterpart to differential susceptibility, is based on the
idea that “changes to the environment cause individuals
to change and that these changes depend on the quality
of the psychological, sociocultural and economic resources
provided by the environment, balanced by the quality
and quantity of the individual’s exposure to risk” (Ungar,
2017, p. 1282). For example, positive beliefs and positive
personality characteristics may be helpful at lower levels
of risk exposure, but their protective effects lessen as
environmental and sociocultural risks increase.
Understanding the role of timing is also important. Risk
factors may have little impact, moderate impact, or profound
impact, depending on the age at which they occur, whether
they occur alone or with other risk factors, and whether
adverse experiences are a one-time event, episodic, or
chronic (Hawes et al., 2021). Taken together, these data on
the types of risk factors, numbers of risk factors, and timing
of risk factors highlight the complexity of the construct of
risk. The following example illustrates this complexity.
Risk: The Example of Child Maltreatment
Because the construct of risk is so central to the field
of developmental psychopathology, we want to take
additional time to consolidate our understanding using
the example of child maltreatment. (More detailed
information about the origins and course of maltreatment
is provided in Chapter 8.) Child maltreatment is a broad
category that involves any of the following (alone or in
combination): physical abuse, sexual abuse, psychological
abuse, and neglect. Child maltreatment is not a diagnosis
that is assigned to a child.
The United States’ Administration for Children and
Families, National Child Abuse and Neglect Data System
(www.childstats.gov/pdf/ac2021/) identified the primary
form of maltreatment in individual cases and reported
that most maltreated children were victims of neglect,
with a parent or primary caregiver failing to provide basic
shelter, nutrition, medical care, and/or supervision. Many
maltreated children were physically abused. Most cases
of maltreatment involved combinations of abuse and
neglect. The Administration for Children and Families
reported that infants and toddlers had the highest rates of
victimization and the highest fatality rates. Socioeconomic
disadvantage and social isolation were frequently correlated
with maltreatment. Children were most often maltreated by
a parent.
Child maltreatment is a nonspecific risk factor, with
increased likelihood of immediate, short-term, and longterm negative developmental outcomes. There is widespread
evidence of physiological impact (e.g., dysregulation of
the stress response), psychological impact (e.g., atypical
socioemotional development, poor school performance,
increased rates of many disorders), and relationship impact
(e.g., disrupted family relationships and peer difficulties).
Advocates for children think about maltreatment in multiple
ways: as its own risk factor, as one of several co-occurring
risk factors, and as a marker of other risk factors. Indeed,
the constellation of multiple negative experiences that are
observed in children who are maltreated is a heartbreaking
example of cumulative risk.
Maltreatment cannot be traced to a single source, such
as parent psychopathology, a parent’s own history of being
maltreated, poverty, or some constellation of difficult
characteristics in a child. Instead, we need to think about
there being many paths to maltreatment. Although child
maltreatment clearly illustrates that risk involves increased
vulnerability to a range of distress and dysfunction, all
experiences of maltreatment do not inevitably lead to
tragic outcomes. The fact that some maltreated children
manage to stay on track developmentally and that some of
them even exceed all expectations leads to our discussion
of resilience.
Resilience and Protective Factors
Remember that resilience is a special instance of
adaptation—it is adaptation in the face of adversity
(Masten, 2014; Rutter, 2012). Children who have all the
advantages of life—good health, supportive parents, safe
neighborhood, and effective social institutions—and thrive
are not “resilient”; they are competent, skillful, blessed,
lucky, or some combination of those. Resilient children do
well despite their individual, family, or social circumstances.
These children “worked well, played well, loved well, and
expected well” (Werner & Smith, 1982). Three types of
resilient children and adolescents have been described:
(1) children and adolescents with many risk factors who have
good outcomes, (2) children and adolescents who continue
to display competence when they are experiencing stress, and
(3) children and adolescents who display good recoveries
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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.
Risk and Resilience 43
following stress or trauma. Keep in mind that resilience is
observed across a range of positive developmental outcomes,
from generally good functioning or better than expected
functioning (compared with others who experience similar
adversity) to exceptional achievement and well-being.
There is widespread agreement that resilience is not a
trait or characteristic that certain children have and others
do not. Resilience is a dynamic process, a capacity that
develops over time (Masten et al., 2021). Most children and
adolescents will display some combination of strengths and
difficulties in the presence of adversity. Some children display
certain types of resilience but not others (e.g., keeping up
grades while continuing to struggle with peer relationships)
or resilience that builds up over a period of years (e.g.,
keeping up grades, then mending friendships, and then
developing a positive self-image). It is critical to understand
that children’s resilience is embedded in particular contexts.
Children and adolescents interact with their families, their
social and community groups, and within their culture to
achieve individually and culturally relevant resilience (e.g.,
staying in school or caregiving for younger siblings).
Resilience also characterizes other systems that influence
child adaptation and maladaptation such as physiological
systems, family systems, school systems, and community
systems. This broader perspective is reflected in this
definition of resilience: “the capacity of a dynamic system
to adapt successfully through multisystem processes to
challenges that threaten function, survival, or development”
(Masten et al., 2021, p. 524). The implications of a dynamic,
system-focused approach are summarized in Table 3.1. The
emphasis on a system-focused approach also highlights the
ways in which resilience at one level influences resilience at
Table 3.1 A Dynamic, Systems-Oriented
Approach to Resilience
●
Resilience is dynamic, changing over
time as a result of multiple processes and
development.
●
Resilience of a child or family extends beyond
the level of the child or family system to
include the capacity and resources that can be
mobilized in response to challenges.
●
Resilience capacity is distributed across
multiple systems; the resilience of an
individual depends on many systems both
internal and external to the individual.
●
Resilience may be observed in multiple
possible pathways over time.
●
Resilience may cascade across domains of
function, levels, and generations.
●
Interventions to nurture or bolster resilience
can target different processes within levels or
across systems
Source: Masten et al. (2021). Resilience in development and
psychopathology: Multisystem perspectives.
another level (e.g., the interactive effects of resilience in the
home environment and resilience in the school environment)
(Twum-Antwi et al., 2020).
Types of Protective Factors
As with r isk, we examine ind ividual, family, and sociocultu ral
types of protective factors. Before the summary, we need to
distinguish between protective effects and promotive effects.
Promotive effects are the characteristics and experiences that
support positive development and adaptation for children
and adolescents regardless of risk level. Protective effects
support positive development for children and adolescents in
the presence of risk. Although this distinction is important
in research and intervention efforts, here we emphasize
the significant conceptual overlap between promotive and
protective processes and effects.
Many of the most frequently described child and
adolescent protective factors have to do with emotional,
cognitive, and behavioral characteristics. Children and
adolescents who have happy dispositions and who display
conscientious and agreeable behaviors do better. And
research suggests that “youths do not need to exhibit
unusually high levels of these positive traits for them to
attain resilient outcomes in the face of stress and adversity;
rather, modestly positive levels of these traits seem to
suffice” (Shiner & Masten, 2012, p. 526). In other words,
some amount of these positive personality traits is enough to
make a difference in terms of protective effects.
In gene-by-environment-by-time models, genetic variants
(such as the serotonin transporter promoter gene) also
might be counted as individual protective factors. As
noted in the previous discussion of individual risk factors,
not all these factors are necessarily protective in all
circumstances. Genetic variants, as noted in Chapter 2,
may be associated with lower rates of some disorders, such
as fewer episodes of depression, but not with lower rates
of other disorders.
Family factors also serve to protect children and
adolescents in difficult or harmful situations, such as youth
living in impoverished circumstances, those who experience
discrimination or racism, or those experiencing threat or
trauma. Characteristics such as family cohesion and warmth
are helpful. Having supportive, emotionally available, and
determined parents makes it more likely that at-risk children
are able to avoid an ever-increasing string of negative events
than children with less capable parents. Parents who struggle
may do better over time or may seek help for themselves or
their children. Intervention research suggests that a focus
on internal strengths and social support improves the wellbeing and parenting of single mothers and so contributes to
positive child outcomes (Taylor & Conger, 2017).
Having positive relationships with siblings and friends also
makes a difference. Children who report having a best friend
during a negative experience are buffered from some of the
consequences of that experience (Adams et al., 2011). In so
Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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.