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Ch 19: Risk and resilience in development (Case 2: (Alcohol) addiction…
Ch 19: Risk and resilience in development
Intro. Developmental pathology
Why does someone develop pathologies and another person in same situation does not? (Rutter)
Gene x environment
Stability
Developmental trajectories
Programs of research to promote opportunitites to investigate factors that play a role on future development (externalisign and internalising)
Continuity normal-abnormal behaviour
Risk, protective, vulnerability factors
Attention for development of problems and for positive development and resilience
Interventions from this perspective
Crucial because: being there in time and best check of the causality of a concept
Risk, resilience, vulnerability
Risk factors: threaten basic needs of child
Present before development of problems
(Objective) threats of basic needs of child (catastrophe, lack of safety...)
Present with high chances of later problems (Romanian orphanages)
Risk factors can be present at different times and interact (Bronfenbrenner's)
Microsystem
Individual + settings (family, peers, school)
Mesosystem
Relations, interaction between microsystem and exosystem
Ex: interaction problem between microsystem and macrosystem because parents don't understand the culture
Exosystem
Neighbours, media, wider family
Macrosystem
Culture
Chronosystem (Y-axis)
Time, giving bigger picture that always has to be taken in mind
Examples
Parenting
Poor parenting, abuse...etc depdens on different factors at different levels
Stress
Frequent stress; bad, some; ok. Long-lasting one causes stress to no longer go back to normal level (allostasis)
General / specific
Specific
Specific outcomes
General
Effects on global outcomes
Cumul;ative factors: Adding up all factors, seeing the amount of factors you have to predict, the more the worse and suprisingly efficient
Equifinality / Multifinality
E: multiple risk-factors can lead to outcome M: same risk-factor can have multiple effects
Protective - vulnerability factors: moderate the effects of risk factors
Protective factors increase chance of adaptive development
Vulnerability factors decrease chance of adaptive development
Protective factors increase the probability or resilience, vulnerability decrease them, different situations:
Individual (easy/difficult temperament)
Family (positive/negative parenting)
External support (peers, school) positive/negative)
Levels
Child
Genetics, prenatal development)
Temperament; combination of thoughts and emotions, can be easy or difficult
Family
Warmth, support and attachment style
External support system
Friendships, school/teacher, neighborhood
Internalising / externalising
Debated whether this would cause an effect on adult life, externalising much more common in men
Internalising
Risk factors
Inhibited temperament (shy)
Withdrawn (wants to, doesn't dare to)
Cognitive - attentional characteristics
Exaggeratin possible negative outcomes
Protective factor
High effortful control: 'I have some difficulties, but I can handle this problem'
Environmental characteristics
Exposure to strong negative events
Family
Protective factors (positively challenging father)
Easier to see in behaviour
Externalising
Risk-factors
Disinhibited temperament
Weak self-control
Bad environment
Development
Strong age effect (universal)
Influential model regarding continuity: the fact that at the beginning of childhood one has a lot of antisocial behaviour can cause more pathologies later in adult life
Protective factors
Positive challenge, goal...
Interplay risk - vulnerability factors
'Dark side of the moon', your life is normal but after going through the glass (event) you are going to have more or less resilience depending on the height of adaptation
Transgenerational transmission problems
Increase on chance of developing problems when parents already have one
Because of genetics, prenatal influences...etc
The fact that for example ytou are alcoholic usually comes with a cumulative factor. Ex: smoking from parents, cannabis, drugs, out of school, bad friends...etc
Theoretical models of vulenrability
both risk environment and risk-gene, causing increases in risk of later anti-social behaviour
But the fact that you have a gene realted to violence, doesn't mean that you are goin gto be violent, only if maltreated you will
Plasticity genes: being more sensible to the evnironment
Protective factors in interaction-models
(Rutter) determining factors taht empirically cause a change in development, in the presence of adversity-risk-factors (genes that are activated, they will push the environment and environemnt will push back) that wouldn't affect development under normal circumstances
Main effect
Homogenous group: Study focsuing on a group of children type, you can study the impact of something but you don't know if it will play a role in another group
Rutter: not a good design to determine general protective factors
Because could have the same impact under normal circumstances, so it is not a proof of protective factor and you need to show interactions for that
Defining resiliance: If one has a higher resilience inside his homogenous group, but is still underneath the general average, is he resilient or not?
Meidator effect: the result could tell what changes inside the group, but wouldn't be able to tell resilience. Would help to make decision to intervene or not on that person, but it won't tell you the risk factor directly
Case 1: Dunedin study
NZ, thousand children studied through their lives to see if any childhood facts could influence future development
Now in their 40s, many findings
Continuities in developmental psychopathology
Sometimes homotypic (same problem redevelopped again) or heterotypic (different problems after previous ones)
GxE
Heavily debated for criminal offences, if a gene could cause a type of behaviour
So, is psychopathology a general factor? Don't know yet
Measurements were done realy well (self-reports, observations...) and otucomes were strong as well (psychiatric interviews, police reports...)
Results: The ones who were more healthy in the beginning would have more self-control and as adults, the ones who had more self-control would have more wealth
Case 2: (Alcohol) addiction
Genetic factors (twins and adoption studies)
General factors realted to personality
Substance-specific behaviours
Environemntal factors
Social learning; lack of authority
Sub-optimal parenting
Deviant peer-groups; early subtance consumption triggering genetic mechanisms
Different trajectories of behaviour
Externalising
Addicted before 23, high genetic contribution
Early addiction and behavioural problems
Internalising
Addiction comes later, moderate age contribution (30 percent)
Escalation after negative evnt in adult life
Age of onset, importnat moderator
Early; better for future development
During adolescence cognitve control not yet fully matured, more difficult to moderate or quit because mix with other factors
Horseman
Rider being the reflection
Horse being the impulses
Interventions & Developmental Psychopathology
Model of ''abanico''
Health promotion
Posters and programs are not that effective, better making increase in price and age minimum
Universal prevention
Selective prevention
for risk-group
Indicative prevention
for beginning problems
Treatment
Developing new ways to make a change, implicit processes in addiction that helps through added therapy
Process orientated: targetting hypothetical mechanisms
General goal
Positively influence trajectories
Risk-focused
Reducing expsure to risk-factors
Asset-focused
sti;ulating protective factors
Universal interventions
Example 1: School-based
Background
Hardly effective in school...etc parents that give strict rules correlate with no drinking, but alternative explanations are still possible
Intervention
Useless, but looks as if something is happening
Example 2: Self-control
Self-control is really useful, can it be trained in school?
Intervention Good Behaviour Game (GBG): Teacher only reinforces positive behaviour and ignores negative behaviour, positive results even years after
Example indicated interventions
Early intervention for at-risk infants
Background
Maltreated develop stress-responses, can it be prevented in time?
Intervention
Intense coaching to parents, long-term effects
Personality-based intervention for early adolescents
Background
Different personality backgrounds predict later susbtance use problems
Intervention
Selecting high-behaviour adolescents and sign them to an intensive coach session where they realise the pros and cons of behaving in such a way
Sensation seekers
They want to risk (alcohol + drugs), so provide other activities such as climbing...etc, positive for at least a year
Case 3: James Fallon
Studied his family, realised he had a different brain from the family and was present with all the risk factors of becoming a psychopath