Explicating the “Developmental” in Preschool Psychopathology

Abstract

In this chapter on preschool psychopathology, we discuss common emotional and behavioral syndromes during the preschool developmental period, including attentional, oppositional, conduct, anxiety, and mood problems. Current knowledge based on the current classification system will be summarized briefly, including rates of disorders, patterns of comorbidity, and evidence of reliability and validity (e.g., stability of disorders, associations with impairment, observed behavior, and family history). The remainder and main focus of the chapter is devoted to applying a developmental psychopathology approach to examine preschool psychopathology within a dimensional, developmental domain framework. Recent measurement advances in the dimensional operationalization of behavior in preschool‐age children are discussed. We then characterize four broad developmental domains: emotion regulation, self‐control, social engagement, and internalization of rules and standards, and discuss their expression in early childhood as a framework for advancing knowledge of the spectrum of normal to abnormal behavior. Within each domain, we describe essential developmental capacities, normative variation in behavior, and clinically concerning deviation within each domain. In addition, we highlight the central features of each domain using an exemplary syndrome and highlight how the cross‐cutting domains are relevant to other common syndromes as well. We also delineate steps for translating dimensional, developmentally sensitive measurement from research to clinical application. To conclude, we offer suggestions for future directions for research geared toward advancing multilevel, developmentally oriented conceptualization of psychopathology.

Clinical Implications of a Dimensional Approach: The Normal:Abnormal Spectrum of Early Irritability

“…We have previously suggested the following heuristic: 11 Level 1: Well-regulated emotions and behavior (annual assessments); Level 2: Watch (longitudinally) and wait: clinically at risk. This level would be targeted to children with mildly elevated scores (e.g., .5–1 SD from the mean) to assess whether patterns escalate, remain stable, or diminish over the course of a year.…”

“…This is of particular importance in early childhood, when the capacity for self-control improves dramatically across relatively short time intervals. 11,12 Dimensional, longitudinal approaches also hold promise for elucidating the substantial heterogeneity in outcome amongst young children exhibiting early high irritability (i.e. which early irritable children will go on to develop clinical problems and which will not).…”

Preschool psychiatric disorders: homotypic and heterotypic continuity through middle childhood and early adolescence

“…The decline in rates of DBD suggests that clinically-significant disruptive behavior problems decrease with age, or that it is difficult to distinguish normative, developmentally-limited oppositional behavior from psychopathology in preschoolers (Wakschlag et al , 2012; Bufferd et al , 2016). …”

Mapping the Frequency and Severity of Depressive Behaviors in Preschool-Aged Children

“…In addition, earlier onsets may contribute to long-term impairment and chronicity [10]. However, mood difficulties can be developmentally normative in young children [11, 12]. Therefore, it is critical to clarify the range of normative mood experiences to non-normative pathological mood problems in early childhood [11–15].…”

“…However, mood difficulties can be developmentally normative in young children [11, 12]. Therefore, it is critical to clarify the range of normative mood experiences to non-normative pathological mood problems in early childhood [11–15]. In a sample of 3–5-year-old children, the present study examined the spectrum of the frequency of behaviors relevant to depression.…”