scholarly journals Comorbidities and continuities as ontogenic processes: Toward a developmental spectrum model of externalizing psychopathology

2013 ◽  
Vol 25 (4pt2) ◽  
pp. 1505-1528 ◽  
Author(s):  
Theodore P. Beauchaine ◽  
Tiffany McNulty
Keyword(s):  
Risk Factors ◽  
Externalizing Behavior ◽  
Mental Health Problems ◽  
Peer Group ◽  
Externalizing Disorders ◽  
Levels Of Analysis ◽  
Quarter Century ◽  
Individual Level ◽  
Contextual Risk ◽  
Trait Impulsivity

AbstractResearch on child and adolescent mental health problems has burgeoned since the inaugural issue of Development and Psychopathology was published in 1989. In the quarter century since, static models of psychopathology have been abandoned in favor of transactional models, following the agenda set by editor Dante Cicchetti and other proponents of the discipline. The transactional approach, which has been applied to autism, depression, self-injury, and delinquency, (a) specifies vulnerabilities and risk factors across multiple levels of analysis spanning genes to cultures, (b) identifies multifinal and equifinal pathways to psychopathology, and (c) transcends traditional disciplinary boundaries. However, as noted by Rutter and Sroufe (2000), specific mechanisms of continuity, discontinuity, and comorbidity of psychopathology must be identified if we wish to understand etiology fully. In this article, we present a model of early-onset externalizing behavior in which comorbidities and continuities are viewed as ontogenic processes: products of complex longitudinal transactions between interdependent individual-level vulnerabilities (e.g., genetic, epigenetic, allostatic) and equally interdependent contextual risk factors (e.g., coercive parenting, deviant peer group affiliations, neighborhood criminality). Through interactions across levels of analysis, some individuals traverse along the externalizing spectrum, beginning with heritable trait impulsivity in preschool and ending in antisociality in adulthood. In describing our model, we note that (a) the approach outlined in the DSM to subtyping externalizing disorders continues to obscure developmental pathways to antisociality, (b) molecular genetics studies will likely not identify meaningful subtypes of externalizing disorder, and (c) ontogenic trait approaches to psychopathology are much more likely to advance the discipline in upcoming years.

scholarly journals Instantiating the multiple levels of analysis perspective in a program of study on externalizing behavior

2012 ◽  
Vol 24 (3) ◽  
pp. 1003-1018 ◽  
Author(s):  
Theodore P. Beauchaine ◽  
Lisa M. Gatzke-Kopp
Keyword(s):  
Middle Childhood ◽  
Externalizing Behavior ◽  
Developmental Psychopathology ◽  
Personality Development ◽  
Developmental Model ◽  
Self Report ◽  
Levels Of Analysis ◽  
Quarter Century ◽  
Trait Impulsivity ◽  
Multiple Levels

AbstractDuring the last quarter century, developmental psychopathology has become increasingly inclusive and now spans disciplines ranging from psychiatric genetics to primary prevention. As a result, developmental psychopathologists have extended traditional diathesis–stress and transactional models to include causal processes at and across all relevant levels of analysis. Such research is embodied in what is known as the multiple levels of analysis perspective. We describe how multiple levels of analysis research has informed our current thinking about antisocial and borderline personality development among trait impulsive and therefore vulnerable individuals. Our approach extends the multiple levels of analysis perspective beyond simple Biology × Environment interactions by evaluating impulsivity across physiological systems (genetic, autonomic, hormonal, neural), psychological constructs (social, affective, motivational), developmental epochs (preschool, middle childhood, adolescence, adulthood), sexes (male, female), and methods of inquiry (self-report, informant report, treatment outcome, cardiovascular, electrophysiological, neuroimaging). By conducting our research using any and all available methods across these levels of analysis, we have arrived at a developmental model of trait impulsivity that we believe confers a greater understanding of this highly heritable trait and captures at least some heterogeneity in key behavioral outcomes, including delinquency and suicide.

The Oxford Handbook of Emotion Dysregulation

2018 ◽  
Keyword(s):  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Social Dynamics ◽  
Peer Group ◽  
Collaborative Work ◽  
Treatment Strategies ◽  
Externalizing Disorders ◽  
Levels Of Analysis ◽  
Affective States ◽  
Unified Protocol

Emotion dysregulation—which is often defined as the inability to modulate strong affective states including impulsivity, anger, fear, sadness, and anxiety—is observed in nearly all psychiatric disorders. These include internalizing disorders such as panic disorder and major depression, externalizing disorders such as conduct disorder and antisocial personality disorder, and various other disorders including schizophrenia, autism, and borderline personality disorder. Among many affected individuals, precursors to emotion dysregulation appear early in development, and often predate the emergence of diagnosable psychopathology. Collaborative work by Drs. Crowell and Beauchaine, and work by many others, suggests that emotion dysregulation arises from both familial (coercion, invalidation, abuse, neglect) and extrafamilial (deviant peer group affiliations, social reinforcement) mechanisms. These studies point toward strategies for prevention and intervention. The Oxford Handbook of Emotion Dysregulation brings together experts whose work cuts across levels of analysis, including neurobiological, cognitive, and social, in studying emotion dysregulation. Contributing authors describe how early environmental risk exposures shape emotion dysregulation, how emotion dysregulation manifests in various forms of mental illness, and how emotion dysregulation is most effectively assessed and treated. This is the first text to assemble a highly accomplished group of authors to address conceptual issues in emotion dysregulation research; define the emotion dysregulation construct at levels of cognition, behavior, and social dynamics; describe cutting-edge assessment techniques at neural, psychophysiological, and behavioral levels of analysis; and present contemporary treatment strategies. Conceptualizing emotion dysregulation as a core vulnerability to psychopathology is consistent with modern transdiagnostic approaches to diagnosis and treatment, including the Research Domain Criteria and the Unified Protocol, respectively.

Married Women’s Justification of Intimate Partner Violence in Bangladesh: Examining Community Norm and Individual-Level Risk Factors

2015 ◽  
Vol 30 (6) ◽  
pp. 984-1003 ◽  
Author(s):  
Syeda S. Jesmin
Keyword(s):  
Risk Factors ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Mental Health Problems ◽  
National Sample ◽  
Intimate Partner ◽  
Wife Beating ◽  
Individual Level ◽  
Community Influence ◽  
Community Influences

One-third of the women worldwide experience intimate partner violence (IPV) that increases their vulnerability to both short- and long-term physical, sexual, reproductive, and mental health problems. Surprisingly, IPV is justified by many women globally. Although the IPV literature to date is mostly focused on risk factors associated with actual occurrences, little is known on attitudinal acceptance of such violence. Also, despite the growing scholarship of community influence and health link, IPV research has relatively overlooked the effects of norms at the community level. Using a representative national sample of 13,611 married women in Bangladesh, this study examined the association of community attitudes and women’s individual attitudes toward wife beating. The results revealed that women living in communities with permissive attitudes toward wife beating were more likely to justify husbands’ beating (OR = 4.5). Women married at a younger age, who had less than primary-level education, lived in households categorized as poor or middle class, and did not consume media appeared to be at higher risk for justifying wife beating. This research adds to a growing research body on community influences on health by examining IPV attitudes and community norms link.

Treating the Child and Adolescent in the Family and Social Context

2016 ◽  
Author(s):  
John E. Lochman ◽  
Nicole Powell ◽  
Caroline Boxmeyer ◽  
Meghan L. Sallee ◽  
Casey Dillon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conduct Problems ◽  
Mental Health Problems ◽  
School Contexts ◽  
Contextual Risk ◽  
Symptoms Of Depression ◽  
Effective Interventions ◽  
The Family ◽  
Contextual Risk Factors

Conduct problems and depression are two commonly occurring mental health problems affecting youth. For both conduct problems and depression, risk factors in the family, peer, and school contexts can contribute to the development and maintenance of these disorders in young people. Addressing contextual risk factors can lead to improvements in conduct problems and symptoms of depression. This chapter provides an overview of contextual risk factors for conduct problems and depression, and it reviews several effective interventions for treating each disorder. Outcome results are summarized for these interventions, as well as some of the major activities and objectives. The role of family, peer, and school contexts in the treatment of conduct problems and depression is highlighted.

Association between Criminological Risk Factors and Mental Health Problems among Urban Jail Inmates

2013 ◽  
Author(s):  
Ernie Gonzalez ◽  
Jorge G. Varela ◽  
Erika J. Canales ◽  
Alexandra Tellez ◽  
Amy B. Percosky
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Health Problems ◽  
Health Problems ◽  
Jail Inmates

Neurobiological Mechanisms of Psychopathology and Treatment Action

2018 ◽  
Author(s):  
Theodore P. Beauchaine ◽  
Aimee R. Zisner ◽  
Elizabeth P. Hayden
Keyword(s):  
Emotion Regulation ◽  
Executive Function ◽  
Treatment Response ◽  
Trait Anxiety ◽  
Environmental Influence ◽  
Externalizing Disorders ◽  
Psychosocial Treatment ◽  
Childhood And Adolescence ◽  
Trait Impulsivity ◽  
Heterotypic Continuity

In recent years, it has become increasingly clear that common forms of psychopathology derive from complex interactions among neurobiological vulnerabilities and environmental adversities. These interactions can alter neurobehavioral development to yield progressively intractable forms of psychopathology across childhood and adolescence. This chapter focuses on neurobiological mechanisms of trait impulsivity, trait anxiety, stress reactivity, and emotion regulation/executive function. How these traits confer vulnerability to externalizing disorders, internalizing disorders, heterotypic comorbidity, and heterotypic continuity is described. Next, neurobiological mechanisms of treatment response are considered. Trait impulsivity and trait anxiety are highly heritable and derive initially from subcortical structures that mature early in life. In contrast, emotion regulation and executive function, which modulate trait impulsivity and trait anxiety, are more sensitive to environmental influence and derive from cortical structures that mature into young adulthood. Neurobiological mechanisms of psychosocial treatment response are represented largely in the cortex and its neuromodulatory connections with the subcortex.

Emotion Dysregulation and Externalizing Spectrum Disorders

2019 ◽  
pp. 236-247
Author(s):  
Tiffany M. Shader ◽  
Theodore P. Beauchaine
Keyword(s):  
Emotion Dysregulation ◽  
Externalizing Disorders ◽  
Developmental Model ◽  
Peer Influences ◽  
Neighborhood Violence ◽  
Number Of Children ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant ◽  
Trait Impulsivity ◽  
And Function

As described in the literature for many years, a sizable number of children with hyperactive-impulsive and combined subtypes/presentations of attention-deficit/hyperactivity disorder (ADHD)—especially males—progress to more serious externalizing syndromes across development. Such outcomes include oppositional defiant disorder, conduct problems, delinquency, substance use disorders, and in some cases antisocial personality disorder, incarceration, and recidivism. This chapter summarizes a developmental model that emphasizes different contributions of trait impulsivity, a highly heritable, subcortically mediated vulnerability, versus emotion dysregulation, a highly socialized, cortically mediated vulnerability, to externalizing progression. According to this perspective, trait impulsivity confers vulnerability to all externalizing disorders, but this vulnerability is unlikely to progress beyond ADHD in protective environments. In contrast, for children who are reared under conditions of adversity—including poverty, family violence, deviant peer influences, and neighborhood violence/criminality—neurodevelopment of prefrontal cortex structure and function is compromised, resulting in failures to achieve age-expected gains in emotion regulation and other forms of executive control. For these children, subcortical vulnerabilities to trait impulsivity are amplified by deficient cortical modulation, which facilitates progression along the externalizing spectrum.

Loneliness, social isolation and cardiovascular risk

2019 ◽  
Vol 14 (10) ◽  
pp. 1-8 ◽  
Author(s):  
Jackson Alun ◽  
Barbara Murphy
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Social Isolation ◽  
Mental Health Problems ◽  
Cognitive Disorders ◽  
Premature Death ◽  
Physical And Mental Health ◽  
Cardiac Events ◽  
Patients At Risk ◽  
Traditional Risk Factors

Loneliness and social isolation are increasingly being acknowledged as risk factors for both physical and mental health problems. Recent statistics demonstrate that loneliness and isolation are on the rise internationally, to the point of being classed as an epidemic. In this paper, the authors outline some of the recent research linking loneliness and isolation to significant chronic diseases such as cardiovascular disease and type II diabetes; mental health disorders such as anxiety and depression; cognitive disorders and dementia. Isolation has also been shown to compromise recovery after acute cardiac events, being associated with increased hospital readmission and premature death. Indeed, isolation has now been identified as a risk factor equivalent in effect to traditional risk factors such as smoking, hypertension and obesity. While distinguishing between objective and subjective indicators of isolation, the authors highlight the complexity of this phenomenon, both in terms of definition and measurement, as well as the interplay between subjective and objective indicators. Important clinical implications for health professionals working with cardiac patients are also proposed, in terms of screening for isolation, and possible interventions to support patients at risk of isolation. The aim of the current article is to emphasise the importance of acknowledging loneliness and isolation as key risk factors requiring urgent attention, both in research and in clinical practice.

scholarly journals Hierarchical disentanglement of contextual from compositional risk factors of diarrhoea among under-five children in low- and middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi
Keyword(s):  
Risk Factors ◽  
National Level ◽  
Cross Sectional ◽  
Middle Income ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.

Elder Abuse and Neglect in China: Prevalence, Co-occurrence, and Intergenerational Risk Factors

2021 ◽  
pp. 088626052098550
Author(s):  
Mengtong Chen ◽  
Ko Ling Chan
Keyword(s):  
Risk Factors ◽  
Childhood Abuse ◽  
Low Socioeconomic Status ◽  
Rural Areas ◽  
Elder Abuse ◽  
Elderly Parents ◽  
Contextual Risk ◽  
Elder Abuse And Neglect ◽  
The Past ◽  
Abuse And Neglect

The prevalence and patterns of elder abuse and neglect in China have been understudied. The objectives of this study were to examine the chronicity and prevalence of different patterns of elder abuse, and the influence of individual and contextual risk factors. We used data from a sample of 7,466 adults randomly recruited from six regions in China. The participants responded to a questionnaire about their demographic characteristics, childhood abuse experiences, and instances of abuse and neglect against their elderly parents. Logistic regression analysis was performed to examine the association of elder abuse and neglect with individual and contextual factors. The results showed that one in 10 participants reported that their elderly parents had experienced abuse or neglect in the past year. The elder victims were reported to have suffered different types of abuse and neglect on multiple occasions, ranging from 3.6 to 11.82 times on average. More than 5% of participants reported that their elderly parents had suffered two or more types of abuse and neglect in the past year, accounting for 40% of the elderly victims. The co-occurrence of elder abuse within elderly couples was also high. Reports of abuse and neglect of elderly parents were related to low socioeconomic status, living in rural areas, and the experience of childhood abuse of the participants. This study supports the model of intergenerational transmission of violence in the Chinese population. The high prevalence, chronicity, and co-occurrence of elder abuse and neglect underline the importance of screening for risk factors, and have implications for preventive practice and policy.

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