Child Psychopathology, Eighth Edition
By Eric J. Mash, David A. Wolfe and Katherine T. Nguyen Williams
Contents:
Preface xx
Acknowledgments xxvi
Reviewers xxvii
Part 1
Understanding Child Psychopathology
1 Introduction to Psychopathology
in Children and Adolescents . . . . . . . . . 1
Georgina: Counting for Safety . . . . . . . . . . . . . 3
1.1 Historical Views and Breakthroughs . . . . . . . 4
The Emergence of Social Conscience 5
A Closer Look: Box 1.1 Victor of Aveyron 6
Early Biological Attributions 6
A Closer Look: Box 1.2 Masturbatory Insanity . . . 7
Early Psychological Attributions 8
A Closer Look: Box 1.3 Little Albert, Big Fears,
and Sex in Advertising 10
Evolving Forms of Treatment . . . . . . . . . . . 11
Progressive Legislation 11
A Closer Look: Box 1.4 UN Convention
on the Rights of Persons with Disabilities
(2007) 12
1.2 What Is Psychopathology in Children
and Adolescents? . . . . . . . . . . . . . . . . . . 13
Sandy Hook Mass School Shooting:
Early Troubles . . . . . . . . . . . . . . . . . . . . 13
Defining Psychological Disorders . . . . . . . . . 14
Competence . . . . . . . . . . . . . . . . . . . . 15
Developmental Pathways . . . . . . . . . . . . . 16
1.3 Risk and Resilience . . . . . . . . . . . . . . . . . . 18
Raoul and Jesse: Why the Differences? . . . . . . . 18
A Closer Look: Box 1.5 Overcoming
the Odds . . . . . . . . . . . . . . . . . . . . 19
1.4 The Significance of Mental Health
Concerns among Children
and Adolescents 20
The Changing Picture of Children’s
Mental Health 21
1.5 What Affects Rates and Expression
of Psychopathology? A Look at Some
Key Factors 22
Poverty and Socioeconomic Disadvantage 23
Sex and Gender Differences . . . . . . . . . . . . 24
Race and Ethnicity 25
Cultural Issues 26
Child Maltreatment and Non-Accidental
Trauma . . . . . . . . . . . . . . . . . . . . 27
Risk Issues Concerning Adolescents . . . . . . . . 27
Lifespan Implications . . . . . . . . . . . . . . . 27
A Closer Look: Box 1.6 Classic and Current
Reports on Mental Health Issues
Pertaining to Children and Youths . . . . . . 28
Looking Ahead . . . . . . . . . . . . . . . . . . . . . . 30
Study Resources . . . . . . . . . . . . . . . . . . . . . 31
2 Theories and Causes . . . . . . . . . . . . . 32
2.1 What Is Causing Jorge’s Mental
Health Concerns? 33
Jorge: Not Keeping Up . . . . . . . . . . . . . . . . . 35
2.2 Theoretical Foundations . . . . . . . . . . . . . .36
Developmental Psychopathology Perspective . . . 37
An Integrative Approach . . . . . . . . . . . . . 41
2.3 Developmental Considerations . . . . . . . . . . 42
Organization of Development . . . . . . . . . . . 42
2.4 Biological Perspectives . . . . . . . . . . . . . . .43
Neural Plasticity and the Role
of Experience . . . . . . . . . . . . . . . . . 44
Genetic Contributions . . . . . . . . . . . . . . . 45
A Closer Look: Box 2.1 Gene–Environment
Interactions in Child Psychopathology . . . . 47
Neurobiological Contributions . . . . . . . . . . 48
A Closer Look: Box 2.2 The HPA Axis and
Stress Regulation . . . . . . . . . . . . . . . 51
2.5 Psychological Perspectives . . . . . . . . . . . . . 53
Emotional Influences . . . . . . . . . . . . . . . 53
Behavioral and Cognitive Influences 56
Applied Behavior Analysis (ABA) . . . . . . . . . 56
2.6 Family, Social, and Cultural
Perspectives . . . . . . . . . . . . . . . . . . . . . 58
Infant–Caregiver Attachment . . . . . . . . . . . 58
The Family and Peer Context . . . . . . . . . . . 60
A Closer Look: Box 2.3 The “Core Story”
of Development . . . . . . . . . . . . . . . . 61
Looking Ahead . . . . . . . . . . . . . . . . . . . . . . 62
Study Resources . . . . . . . . . . . . . . . . . . . . . 63
3 Research . . . . . . . . . . . . . . . . . . . . . 64
3.1 A Scientific Approach . . . . . . . . . . . . . . . .65
When Science Is Ignored 67
3.2 The Research Process . . . . . . . . . . . . . . . . 68
Common Research Questions and Topics . . . . . 69
Whitney: Always Sad . . . . . . . . . . . . . . . . . . 69
Tito: Constantly Fighting . . . . . . . . . . . . . . . . 69
A Closer Look: Box 3.1 Cross-Cultural
Epidemiological Research: Parenting,
Culture, and the Development of
Externalizing Behaviors from Age 7 to 14
in Nine Countries . . . . . . . . . . . . . . . 72
3.3 Methods of Studying Behavior . . . . . . . . . .75
Standardization, Reliability, and Validity . . . . . 75
Measurement Methods . . . . . . . . . . . . . . 76
Reporting Methods . . . . . . . . . . . . . . . . 76
Psychophysiological Methods . . . . . . . . . . . 77
Neuroimaging Methods . . . . . . . . . . . . . . 78
Observation Methods . . . . . . . . . . . . . . . 79
3.4 Research Strategies . . . . . . . . . . . . . . . . . 80
Identifying the Sample 81
General Research Strategies . . . . . . . . . . . . 82
Research Designs . . . . . . . . . . . . . . . . . 84
A Closer Look: Box 3.2 Longitudinal Research:
Does Child Maltreatment Lead to More
Peer Rejection over Time? 88
Qualitative Research 88
A Closer Look: Box 3.3 Qualitative Research:
Siblings Talk about Their Autistic
Brothers . . . . . . . . . . . . . . . . . . . . .89
3.5 Ethical and Pragmatic Issues . . . . . . . . . . . . 91
Informed Consent and Assent . . . . . . . . . . . 91
Voluntary Participation . . . . . . . . . . . . . . 92
Confidentiality and Anonymity . . . . . . . . . . 92
Nonharmful Procedures . . . . . . . . . . . . . . 92
Other Ethical and Pragmatic Concerns . . . . . . 92
Study Resources . . . . . . . . . . . . . . . . . . . . . 93
4 Assessment, Diagnosis,
and Treatment . . . . . . . . . . . . . . . . . 94
4.1 Clinical Issues . . . . . . . . . . . . . . . . . . . . .95
The Decision-Making Process . . . . . . . . . . . 95
Felicia: Multiple Mental Health Concerns . . . . . 96
Developmental Considerations . . . . . . . . . . 97
Purposes of Assessment . . . . . . . . . . . . . .100
4.2 Assessing Disorders . . . . . . . . . . . . . . . . 103
Clinical Interviews 104
Felicia: History . . . . . . . . . . . . . . . . . . . . . .106
Behavioral Assessment 107
Psychological Testing . . . . . . . . . . . . . . .110
A Closer Look: Box 4.1 Observing Behavior:
Seeing the Whole Picture . . . . . . . . . . 111
A Closer Look: Box 4.2 WISC-V Primary
Indexes and Subtest Items Similar to
Those Included in WISC-V . . . . . . . . . 114
4.3 Classification and Diagnosis . . . . . . . . . . . 118
Categories and Dimensions . . . . . . . . . . . .119
The Diagnostic and Statistical Manual
of Mental Disorders (DSM-5-TR) 120
4.4 Treatment and Prevention . . . . . . . . . . . . 126
Intervention . . . . . . . . . . . . . . . . . . . . 127
Cultural Considerations . . . . . . . . . . . . . . 129
Treatment Goals 129
Ethical and Legal Considerations . . . . . . . . .130
General Approaches to Treatment . . . . . . . . . 131
A Closer Look: Box 4.3 Model Comprehensive
Mental Health Program: A Culturally
Competent School-Based Mental Health
Program 136
Treatment Effectiveness . . . . . . . . . . . . . . 136
Felicia: Multiple Solutions . . . . . . . . . . . . . . . 137
4.5 New Directions . . . . . . . . . . . . . . . . . . . 140
Study Resources . . . . . . . . . . . . . . . . . . . . .141
Part 2
Neurodevelopmental Disorders
5 Intellectual Developmental
Disorder (Intellectual Disability) . . . . 142
5.1 Intelligence and Intellectual
Developmental Disorder
(Intellectual Disability) ……
The Eugenics Scare . . . . . . . . . . . . . . . .
Defining and Measuring Children’s Intelligence
and Adaptive Behavior . . . . . . . . . . . .145
A Closer Look: Box 5.1 The Infamous
Kallikaks . . . . . . . . . . . . . . . . . . . . 145
A Closer Look: Box 5.2 Early-Twentieth-Century
Intellectual Developmental Disorder . . . . . .146
The Controversial IQ . . . . . . . . . . . . . . .146
5.2 Features of Intellectual
Developmental Disorder ……. 149
Matthew: Gaining at His Own Pace . . . . . . . . .150
Vanessa: Gaining at Home . . . . . . . . . . . . . .151
Clinical Description . . . . . . . . . . . . . . . . 151
Severity Levels 153
Prevalence . . . . . . . . . . . . . . . . . . . . . 157
5.3 Developmental Course
and Adult Outcomes 159
Carlos: With His Brother’s Help . . . . . . . . . . . 160
Motivation 160
Changes in Abilities . . . . . . . . . . . . . . . . 161
Language and Social Behavior 161
Emotional and Behavioral Challenges . . . . . . . 162
Janella: Disturbed or Disturbing? . . . . . . . . . .162
Other Physical and Health Disabilities 163
5.4 Causes . . . . . . . . . . . . . . . . . . . . . . . . 164
Inheritance and the Role
of the Environment . . . . . . . . . . . . . . 166
Genetic and Constitutional Factors . . . . . . . .167
Neurobiological Influences . . . . . . . . . . . .170
Social and Psychological Dimensions . . . . . . .171
5.5 Prevention, Education,
and Treatment 172
Prenatal Education and Screening . . . . . . . . . 173
Psychosocial Treatments 174
A Closer Look: Box 5.3 Practical Recommendations
for Enhancing Children’s Lives through Early
Intervention . . . . . . . . . . . . . . . . . . 175
Study Resources . . . . . . . . . . . . . . . . . . . . .179
6 Autism Spectrum Disorder and
Childhood-Onset Schizophrenia . . . . 180
6.1 Autism Spectrum Disorder (ASD) . . . . . . . . 181
Description and History . . . . . . . . . . . . . . 182
6.2 DSM-5-TR: Defining Features of ASD . . . . . 184
Autism across the Spectrum . . . . . . . . . . . . 187
Anjelica: ASD with Intellectual Disability . . . . . 187
Denzel: ASD without Intellectual
Disability . . . . . . . . . . . . . . . . . . . . . . . . 188
6.3 Core Behaviors of ASD . . . . . . . . . . . . . . 190
Social Interaction and Communication
Differences . . . . . . . . . . . . . . . . . .190
A Closer Look: Box 6.1 Attachment in Autistic
Children . . . . . . . . . . . . . . . . . . . . 192
A Closer Look: Box 6.2 Early Communication
in ASD . . . . . . . . . . . . . . . . . . . . . 193
Repetitive Behaviors and Interests . . . . . . . . . 195
6.4 Associated Characteristics of ASD . . . . . . . 197
Intellectual Differences and Strengths . . . . . . . 197
Cognitive and Motivational Differences . . . . . . 198
A Closer Look: Box 6.3 The Sally–Anne
Test: What It Means to Have a
Theory of Mind . . . . . . . . . . . . . . . . 199
Medical Conditions and
Physical Characteristics . . . . . . . . . . . . 201
Accompanying Disorders and Symptoms . . . . .202
6.5 Prevalence and Course of ASD . . . . . . . . . 203
Age at Onset 205
Anne-Marie: First Birthday . . . . . . . . . . . . . . 205
Course and Outcomes . . . . . . . . . . . . . . . 206
6.6 Causes of ASD . . . . . . . . . . . . . . . . . . . . 207
Problems in Early Development . . . . . . . . . . 207
Genetic Influences . . . . . . . . . . . . . . . . . 208
Neurodivergence 209
Adaptation 211
6.7 Support and Services for ASD . . . . . . . . . . 212
Overview . . . . . . . . . . . . . . . . . . . . .213
Early Intervention . . . . . . . . . . . . . . . . . 215
Medications . . . . . . . . . . . . . . . . . . . . 217
6.8 Childhood-Onset Schizophrenia (COS) . . . . .218
Hong: Depressed, Disorderly, Doomed . . . . . . 219
6.9 DSM-5-TR: Defining Features
of Schizophrenia . . . . . . . . . . . . . . . . . 219
A Closer Look: Box 6.4 Psychotic Symptoms
in Children with Schizophrenia . . . . . . . . 221
6.10 Prevalence . . . . . . . . . . . . . . . . . . . . . 222
6.11 Causes and Treatment of COS . . . . . . . . . 222
Causes 223
Treatment . . . . . . . . . . . . . . . . . . . . . 224
Study Resources . . . . . . . . . . . . . . . . . . . . .225
7 Communication and
Learning Disorders . . . . . . . . . . . . . . 226
Caleb: Smart but Can’t Read . . . . . . . . . . . . . 227
Francine: Shunned and Falling Behind . . . . . . . 227
7.1 Definitions and History . . . . . . . . . . . . . . 228
7.2 Language Development . . . . . . . . . . . . . 231
Phonological Awareness . . . . . . . . . . . . . . 232
7.3 Communication Disorders . . . . . . . . . . . . 233
Jackie: Screaming, Not Talking . . . . . . . . . . . . 233
Language and Speech Sound Disorders . . . . . .234
Childhood-Onset Fluency
Disorder (Stuttering) . . . . . . . . . . . . 238
Sayad: Family Legacy . . . . . . . . . . . . . . . . . . 238
Social (Pragmatic) Communication Disorder . . . 240
7.4 Specific Learning Disorder . . . . . . . . . . . . 242
Caleb: Strong Points Shine . . . . . . . . . . . . . . 242
Tim: Warming with Interest . . . . . . . . . . . . . .243
SLD with Impairment in Reading . . . . . . . . . 246
SLD with Impairment in Written Expression . . .248
Carlos: Slowly Taking Shape . . . . . . . . . . . . . 248
SLD with Impairment in Mathematics 249
A Closer Look: Box 7.1 Factors That Increase
Resilience and Adaptation 252
Francine: Slowly but Surely Improving . . . . . . . 256
The Inclusion Movement . . . . . . . . . . . . 257
A Closer Look: Box 7.2 Steps in Direct
Behavioral Instruction 258
Carlos: Plans . . . . . . . . . . . . . . . . . . . . . . . 260
A Closer Look: Box 7.3 Critical Elements
for a Successful Beginning Reading
Program 261
Study Resources . . . . . . . . . . . . . . . . . . . . .262
8 Attention-Deficit/Hyperactivity
Disorder (ADHD) . . . . . . . . . . . . . . .263
John: Inattentive, Hyperactive, Impulsive . . . . . 264
8.1 Description and History . . . . . . . . . . . . . . 264
Description . . . . . . . . . . . . . . . . . . . .264
History . . . . . . . . . . . . . . . . . . . . . .266
8.2 Core Characteristics . . . . . . . . . . . . . . . . 267
Inattention 269
Lisa: Just Can’t Focus . . . . . . . . . . . . . . . . . .269
Hyperactivity–Impulsivity . . . . . . . . . . . . . 271
Mark: Junior Wild Man . . . . . . . . . . . . . . . . . 271
Presentation Type . . . . . . . . . . . . . . . . .272
Additional DSM Criteria . . . . . . . . . . . . .274
What DSM Criteria Don’t Tell Us . . . . . . . . . 274
8.3 Associated Characteristics . . . . . . . . . . . . 275
Cognitive Deficits . . . . . . . . . . . . . . . . . 275
Speech and Language Impairments . . . . . . . .278
Medical and Physical Concerns . . . . . . . . . .279
Social Concerns . . . . . . . . . . . . . . . . . . 280
Dennis: Nothing Sticks . . . . . . . . . . . . . . . . . 280
8.4 Accompanying Psychological Disorders
and Symptoms . . . . . . . . . . . . . . . . . . 282
Oppositional Defiant Disorder
and Conduct Disorder 283
Shawn: Bad Boy . . . . . . . . . . . . . . . . . . . . . 283
Anxiety Disorders . . . . . . . . . . . . . . . . . 283
- J.: Overactive and Anxious . . . . . . . . . . . . .283
Mood Disorders . . . . . . . . . . . . . . . . . . 284
Developmental Coordination
and Tic Disorders . . . . . . . . . . . . . . . 284
8.5 Prevalence and Course . . . . . . . . . . . . . . 285
Gender 286
Socioeconomic Status and Culture 286
Course and Outcome . . . . . . . . . . . . . . .287
Alan: Off and Running . . . . . . . . . . . . . . . . .288
Alan: Preschool Outcast . . . . . . . . . . . . . . . .288
Alan: I Couldn’t Do Anything Right . . . . . . . . .289
Alan: A Parent’s Viewpoint . . . . . . . . . . . . . . 289
Alan: Adult Challenges . . . . . . . . . . . . . . . . . 289
8.6 Theories and Causes . . . . . . . . . . . . . . . . 291
Genetic Influences . . . . . . . . . . . . . . . . . 291
A Closer Look: Box 8.1 Interrelated Theories
of ADHD 292
Pregnancy, Birth, and Early Development . . . . . 294
Neurobiological Factors . . . . . . . . . . . . . . 294
A Closer Look: Box 8.2 Does the Brain Develop
Abnormally in Children with ADHD, or
Is It Just Delayed? . . . . . . . . . . . . . . . 296
Diet, Allergy, and Lead 297
Family Influences . . . . . . . . . . . . . . . . .297
8.7 Treatment . . . . . . . . . . . . . . . . . . . . . . 299
Mark: Medication and Behavior Therapy . . . . . 299
Lisa: Behavior Therapy and Counseling . . . . . . 299
Medication . . . . . . . . . . . . . . . . . . . .301
A Closer Look: Box 8.3 The “Accidental”
Discovery of Math Pills . . . . . . . . . . . . 301
Parent Management Training (PMT) . . . . . . .303
Educational Intervention 304
Alan: Boxed in at School . . . . . . . . . . . . . . . .304
Intensive Interventions 305
Additional Interventions 306
A Comment on Controversial
Treatments . . . . . . . . . . . . . . . . . .307
A Closer Look: Box 8.4 Questions Asked
by Children and Adolescents with ADHD . . . 307
Keeping Things in Perspective . . . . . . . . . . . 308
Mark: Good Support System . . . . . . . . . . . . .308
Study Resources . . . . . . . . . . . . . . . . . . . . .309
Part 3
Behavioral and Emotional Disorders
9 Conduct Problems . . . . . . . . . . . . . 310
9.1 Description of Conduct Problems . . . . . . . 311
Andy: Young Rage . . . . . . . . . . . . . . . . . . . . 312
Marvelle: Defiant . . . . . . . . . . . . . . . . . . . . 312
Nick: Behavioral Concerns . . . . . . . . . . . . . . . 312
Steve: Not without Cause . . . . . . . . . . . . . . .313
A Closer Look: Box 9.1 Beliefs about
Youth Violence: True or False? . . . . . . . . 313
9.2 Context, Costs, and Perspectives . . . . . . . . 314
Context . . . . . . . . . . . . . . . . . . . . . .314
Social and Economic Costs . . . . . . . . . . . .314
Perspectives . . . . . . . . . . . . . . . . . . . .315
9.3 DSM-5-TR: Defining Features . . . . . . . . . . 318
Oppositional Defiant Disorder (ODD) 319
Gordon: Enjoying His Power . . . . . . . . . . . . . 319
Conduct Disorder (CD) . . . . . . . . . . . . . . 320
Greg: Dangerous Distress . . . . . . . . . . . . . . .320
Antisocial Personality Disorder (APD)
and Psychopathic Features . . . . . . . . . .323
Jason: Rule-Breaking Behaviors . . . . . . . . . . .323
A Closer Look: Box 9.2 Bart Simpson:
What’s the Diagnosis? 325
9.4 Associated Characteristics . . . . . . . . . . . . 326
Cognitive and Verbal Deficits . . . . . . . . . . .326
School and Learning Problems 327
Family Problems 327
Peer Problems . . . . . . . . . . . . . . . . . . . 328
A Closer Look: Box 9.3 Bullies and
Their Victims . . . . . . . . . . . . . . . . . 329
Tom and Matthew: Murderous
Meeting of Minds . . . . . . . . . . . . . . . . . 330
Self-Esteem Issues . . . . . . . . . . . . . . . . . 331
Health-Related Problems . . . . . . . . . . . . .331
9.5 Accompanying Disorders
and Symptoms . . . . . . . . . . . . . . . . 332
Attention-Deficit/Hyperactivity Disorder
(ADHD) 332
Depression and Anxiety . . . . . . . . . . . . . . 333
9.6 Prevalence, Gender, and Course . . . . . . . . 334
Prevalence . . . . . . . . . . . . . . . . . . . . . 334
Gender 334
Ann: Runaway . . . . . . . . . . . . . . . . . . . . . . 334
A Closer Look: Box 9.4 Social Aggression
in Girls: “I Hurt Her through the
Grapevine” . . . . . . . . . . . . . . . . . . 336
Developmental Course and Pathways . . . . . . . 336
Marcus: Call of the Wild . . . . . . . . . . . . . . . . 339
Adult Outcomes . . . . . . . . . . . . . . . . . . 340
9.7 Causes . . . . . . . . . . . . . . . . . . . . . . . . . 341
Genetic Influences . . . . . . . . . . . . . . . . . 341
Prenatal Factors and Birth Complications . . . . . 343
Neurobiological Factors . . . . . . . . . . . . . . 343
Social–Cognitive Factors 344
A Closer Look: Box 9.5 Do the Brains of
Children with Early-Onset Conduct
Disorders Differ from Those of Children
with Adolescent-Onset Conduct
Disorders? . . . . . . . . . . . . . . . . . . . 345
Family Factors 345
A Closer Look: Box 9.6 Coercive Parent–Child
Interaction: Four-Step Escape Conditioning
Sequence . . . . . . . . . . . . . . . . . . . 348
Other Family Problems . . . . . . . . . . . . . .348
Jake and Reggie: All Odds Against Them . . . . . 348
Societal Factors . . . . . . . . . . . . . . . . . .349
Cultural Factors . . . . . . . . . . . . . . . . . . 351
9.8 Treatment and Prevention . . . . . . . . . . . . 353
Scott: Salvageable? . . . . . . . . . . . . . . . . . . .353
Parent Management Training (PMT) . . . . . . .354
Problem-Solving Skills Training (PSST) . . . . . .355
A Closer Look: Box 9.7 Cognitive
Problem-Solving Steps . . . . . . . . . . . . 355
Multisystemic Therapy (MST) 356
Preventive Interventions . . . . . . . . . . . . . . 356
Study Resources . . . . . . . . . . . . . . . . . . . . .360
10 Depressive and Bipolar Disorders . . . . 361
Donna: Desperate Despair . . . . . . . . . . . . . . 362
Mick: Up and Down . . . . . . . . . . . . . . . . . . .362
10.1 Overview of Mood Disorders . . . . . . . . . 363
10.2 Depressive Disorders . . . . . . . . . . . . . . 364
History . . . . . . . . . . . . . . . . . . . . . .365
Depression in Young People . . . . . . . . . . . . 365
Depression and Development . . . . . . . . . . .365
Anatomy of Depression . . . . . . . . . . . . . . 366
10.3 Major Depressive Disorder (MDD) . . . . . . . 367
Joey: Feeling Worthless and Hopeless . . . . . . .367
Alison: “I Couldn’t Take It Any More” . . . . . . . . 368
Prevalence . . . . . . . . . . . . . . . . . . . . . 370
Comorbidity 371
Raymond: Depressed and Enraged . . . . . . . . .371
Onset, Course, and Outcome . . . . . . . . . . .371
Gender . . . . . . . . . . . . . . . . . . . . . .372
Ethnicity and Culture . . . . . . . . . . . . . . .374
10.4 Persistent Depressive Disorder
[P-DD] (Dysthymia) . . . . . . . . . . . . . . . . 375
Deborah: A Childhood without Laughter . . . . .375
Prevalence and Comorbidity 376
Onset, Course, and Outcome . . . . . . . . . . .376
10.5 Disruptive Mood Dysregulation
Disorder (DMDD) . . . . . . . . . . . . . . . . .377
10.6 Associated Characteristics
of Depressive Disorders . . . . . . . . . . . . . 378
Intellectual and Academic Functioning 378
Cognitive Biases and Distortions 379
Ellie: Life’s Hardly Worth It . . . . . . . . . . . . . . . 379
Negative Self-Esteem 380
Farah: Never Good Enough . . . . . . . . . . . . . .380
Social and Peer Problems . . . . . . . . . . . . .381
Family Problems 382
Depression and Suicide . . . . . . . . . . . . . .382
Carla: “It Became Too Much” . . . . . . . . . . . . . 382
A Closer Look: Box 10.1 Depressive Disorder
Is Associated with Suicide Thoughts and
Suicide Attempts . . . . . . . . . . . . . . . 383
10.7 Theories of Depression . . . . . . . . . . . . . 385
Psychodynamic . . . . . . . . . . . . . . . . . .385
Attachment . . . . . . . . . . . . . . . . . . . .385
Behavioral . . . . . . . . . . . . . . . . . . . . . 386
Cognitive . . . . . . . . . . . . . . . . . . . . .386
Other Theories 387
10.8 Causes of Depression . . . . . . . . . . . . . . 389
Genetic and Family Risk 390
Neurobiological Influences . . . . . . . . . . . .391
Family Influences . . . . . . . . . . . . . . . . .393
Mrs. D.: Not Up to Parenting . . . . . . . . . . . . . 394
Stressful Life Events . . . . . . . . . . . . . . . . 396
Caroline: How Depression Acts . . . . . . . . . . . 396
Emotion Regulation . . . . . . . . . . . . . . . . 396
10.9 Treatment of Depression . . . . . . . . . . . . 398
Leeta: Feeling Better . . . . . . . . . . . . . . . . . .398
Psychosocial Interventions 399
Medications . . . . . . . . . . . . . . . . . . . . 403
A Closer Look: Box 10.2 Summary of FDA Black
Box Warnings for the Use of Antidepressants
with Children and Adolescents . . . . . . . . 404
Prevention . . . . . . . . . . . . . . . . . . . . . 405
10.10 Bipolar Disorder (BP) . . . . . . . . . . . . . . 406
Ben: Extreme Mood Swings . . . . . . . . . . . . . . 406
Prevalence . . . . . . . . . . . . . . . . . . . . . 409
Comorbidity 410
Onset, Course, and Outcome . . . . . . . . . . .411
Causes 411
Jessi: Runs in the Family . . . . . . . . . . . . . . . .411
Treatment . . . . . . . . . . . . . . . . . . . . . 413
Study Resources . . . . . . . . . . . . . . . . . . . . .415
11 Anxiety and Obsessive–
Compulsive Disorders . . . . . . . . . . . 416
11.1 Description of Anxiety Disorders . . . . . . . 418
Experiencing Anxiety . . . . . . . . . . . . . . .418
Chantelle: The Terror of Being Home Alone . . . . 420
Anxiety versus Fear and Panic 420
Normal Fears, Anxieties, Worries,
and Rituals . . . . . . . . . . . . . . . . . .421
Anxiety Disorders According to DSM-5-TR 423
A Closer Look: Box 11.1 Main Features of
Seven DSM-5-TR Anxiety Disorders . . . . . 423
11.2 Separation Anxiety Disorder . . . . . . . . . . 425
Nadir: “Don’t Leave Me!” . . . . . . . . . . . . . . . . 425
Prevalence and Comorbidity 426
Onset, Course, and Outcome . . . . . . . . . . .426
Eric: Won’t Go to School . . . . . . . . . . . . . . . .427
School Reluctance and Refusal . . . . . . . . . .427
11.3 Specific Phobia . . . . . . . . . . . . . . . . . . 428
Cheyenne: Arachnophobia . . . . . . . . . . . . . .429
Prevalence and Comorbidity 430
Onset, Course, and Outcome . . . . . . . . . . .431
11.4 Social Anxiety Disorder . . . . . . . . . . . . . 431
Prevalence, Comorbidity, and Course . . . . . . .433
11.5 Selective Mutism . . . . . . . . . . . . . . . . . 435
Keisha: Mum’s the Word . . . . . . . . . . . . . . . .435
Prevalence, Comorbidity, and Course . . . . . . .435
11.6 Panic Disorder and Agoraphobia . . . . . . . 436
Eduarda: An Attack Out of Nowhere . . . . . . . . 437
Prevalence and Comorbidity 440
A Closer Look: Box 11.2 Did Darwin Have
a Panic Disorder? . . . . . . . . . . . . . . . 440
Onset, Course, and Outcome . . . . . . . . . . .441
11.7 Generalized Anxiety Disorder . . . . . . . . . 441
Jose: Perpetual Worrywart . . . . . . . . . . . . . . 441
Prevalence and Comorbidity 443
Onset, Course, and Outcome . . . . . . . . . . .444
11.8 Obsessive–Compulsive and Related
Disorders . . . . . . . . . . . . . . . . . . . 444
Obsessive–Compulsive Disorder 444
Ethan: Counting and Cleaning . . . . . . . . . . . .444
A Closer Look: Box 11.3 Main Features
of DSM-5-TR OCD-Related Disorders . . . . 445
Prevalence and Comorbidity 447
Onset, Course, and Outcome . . . . . . . . . . .448
11.9 Associated Characteristics . . . . . . . . . . . 449
Cognitive Disturbances . . . . . . . . . . . . . .449
Physical Symptoms . . . . . . . . . . . . . . . .450
Social and Emotional Deficits . . . . . . . . . . . 450
Anxiety and Depression . . . . . . . . . . . . . . 450
11.10 Gender, Ethnicity, and Culture . . . . . . . . 452
11.11 Theories and Causes . . . . . . . . . . . . . . 454
Early Theories . . . . . . . . . . . . . . . . . . . 454
Temperament . . . . . . . . . . . . . . . . . . .455
Family and Genetic Risk 456
Neurobiological Factors . . . . . . . . . . . . . . 457
Family Factors 458
11.12 Treatment and Prevention . . . . . . . . . . 461
Candy: Afraid to Swallow . . . . . . . . . . . . . . . 461
Overview . . . . . . . . . . . . . . . . . . . . .462
Behavior Therapy . . . . . . . . . . . . . . . . .462
A Closer Look: Box 11.4 Evander Holyfield:
The Best Way to Defeat Fear Is to Face It 463
Cognitive–Behavioral Therapy (CBT) . . . . . . . 464
A Closer Look: Box 11.5 Cognitive–Behavioral
Therapy for Adolescent Social Anxiety
Disorder 466
Family Interventions 467
Medications . . . . . . . . . . . . . . . . . . . . 468
Prevention . . . . . . . . . . . . . . . . . . . . . 468
A Closer Look: Box 11.6 Early Intervention
and Prevention of Anxiety Disorders . . . . . 469
Study Resources . . . . . . . . . . . . . . . . . . . . .471
12 Trauma- and Stressor-Related
Disorders . . . . . . . . . . . . . . . . . . . 472
Mary Ellen: Her Legacy . . . . . . . . . . . . . . . . . 474
12.1 History and Family Context . . . . . . . . . . 475
Healthy Families 476
Continuum of Care . . . . . . . . . . . . . . . .476
12.2 Trauma, Stress, and Maltreatment:
Defining Features . . . . . . . . . . . . . . . . 478
Trauma and Stress 478
A Closer Look: Box 12.1 How Stressed
Out Are Teens Today? 480
Maltreatment . . . . . . . . . . . . . . . . . . .481
Jane and Matt: Used to Neglect . . . . . . . . . . .482
Milton: Abused and Abusive . . . . . . . . . . . . .483
Rosita: No Haven at Home . . . . . . . . . . . . . . . 484
Characteristics of Children
Who Suffer Maltreatment 486
Family Context . . . . . . . . . . . . . . . . . .486
Causes of Maltreatment . . . . . . . . . . . . . . 488
Brenda: Unhappy Childhood,
Unhappy Motherhood . . . . . . . . . . . . . .488
12.3 Trauma- and Stressor-Related Disorders . . . 494
Reactive Attachment Disorder 494
Disinhibited Social Engagement Disorder . . . . . 495
Post-Traumatic Stress Disorder . . . . . . . . . .497
Marcie: Not the Only Victim . . . . . . . . . . . . . . 498
Rosita: Feeling Trapped . . . . . . . . . . . . . . . . 503
Celia: Walled Away . . . . . . . . . . . . . . . . . . . 505
A Closer Look: Box 12.2 What Are the
Long-Term Criminal Consequences of Child
Maltreatment? . . . . . . . . . . . . . . . . 508
12.4 Treatment and Prevention . . . . . . . . . . . 512
Exposure-Based Therapy 512
Special Needs of Maltreated Children . . . . . . . 514
A Closer Look: Box 12.3 Trauma-Focused
Cognitive–Behavioral Therapy (TF-CBT) 514
Milton’s Treatment: Session 1 . . . . . . . . . . . . . 516
Milton’s Treatment: Session 4 . . . . . . . . . . . . . 517
Study Resources . . . . . . . . . . . . . . . . . . . . .520
Part 4
Problems Related to Physical and Mental Health
13 Health-Related and
Substance-Use Disorders . . . . . . . . . 521
Ian: Novel virus . . . . . . . . . . . . . . . . . . . . . . 522
Freddie: Too Worried to Sleep . . . . . . . . . . . . 522
13.1 History . . . . . . . . . . . . . . . . . . . . . . . . 523
13.2 Sleep–Wake Disorders . . . . . . . . . . . . . . 525
The Regulatory Functions of Sleep 525
Maturational Changes 526
Features of Sleep–Wake Disorders 527
Treatment . . . . . . . . . . . . . . . . . . . . . 529
13.3 Elimination Disorders . . . . . . . . . . . . . . 530
Enuresis . . . . . . . . . . . . . . . . . . . . . . 531
Encopresis . . . . . . . . . . . . . . . . . . . . . 534
13.4 Chronic Illness . . . . . . . . . . . . . . . . . . . 536
Typical Variations in Children’s Health . . . . . .538
Diabetes Mellitus . . . . . . . . . . . . . . . . .540
Amanda: Daily Struggle with Diabetes . . . . . . . 540
Childhood Cancer . . . . . . . . . . . . . . . . . 542
Chen: A Determined Boy Fighting Leukemia . . . 542
Development and Course . . . . . . . . . . . . .543
How Children Adapt: A Biopsychosocial Model 545
Intervention . . . . . . . . . . . . . . . . . . . . 547
A Closer Look: Box 13.1 Virtual Support
Groups . . . . . . . . . . . . . . . . . . . . 548
A Closer Look: Box 13.2 A Summer Retreat . . . 549
13.5 Adolescent Substance-Use Disorders . . . . 550
A Closer Look: Box 13.3 Test Your
Knowledge on Substance Use . . . . . . . . . 551
Prevalence and Course 553
Causes 556
Treatment and Prevention . . . . . . . . . . . . . 558
Study Resources . . . . . . . . . . . . . . . . . . . . .560
14 Feeding and Eating Disorders . . . . . . 561
14.1 How Eating Patterns Develop . . . . . . . . . 562
Typical Development . . . . . . . . . . . . . . .563
Developmental Risk Factors 563
Biological Regulators . . . . . . . . . . . . . . .565
14.2 Obesity . . . . . . . . . . . . . . . . . . . . . . . 567
Ellen: Self-Image and Self-Esteem . . . . . . . . . . 568
Prevalence and Development . . . . . . . . . . .569
Causes 570
Treatment . . . . . . . . . . . . . . . . . . . . . 571
A Closer Look: Box 14.1 Junk Food
Corporations in Schools 572
14.3 Feeding and Eating Disorders
First Occurring in Infancy and Early
Childhood . . . . . . . . . . . . . . . . . . . . . 572
Avoidant/Restrictive Food Intake Disorder . . . .572
Pica . . . . . . . . . . . . . . . . . . . . . . . . 574
14.4 Eating Disorders of Adolescence . . . . . . . 576
Anorexia Nervosa . . . . . . . . . . . . . . . . . 577
Sooki: Obsessed with Food and Weight . . . . . .577
Bulimia Nervosa 579
Phillipa: A Well-Kept Secret . . . . . . . . . . . . . .579
Binge Eating Disorder . . . . . . . . . . . . . . . 581
Prevalence and Development . . . . . . . . . . .582
Causes 586
A Closer Look: Box 14.2 Pro-Eating
Disorders Websites . . . . . . . . . . . . . .589
A Closer Look: Box 14.3 Success—At
What Price? . . . . . . . . . . . . . . . . . . 592
Treatment . . . . . . . . . . . . . . . . . . . . . 593
Study Resources . . . . . . . . . . . . . . . . . . . . .596
Epilogue . . . . . . . . . . . . . . . . . . . . . . . . . . . 597
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . 598
References . . . . . . . . . . . . . . . . . . . . . . . . . 609
Name Index . . . . . . . . . . . . . . . . . . . . . . . . . 617
Subject Index . . . . . . . . . . . . . . . . . . . . . . . 623