Developmental psychopathology is an integrative approach combining a number of theoretical perspectives and thus tapping the empirically validated contributions of different schools of thought in order to understand the emergence of psychopathology across the life-span (Norcross, 1997). Developmental psychopathology integrates behaviour, cognition, unconscious processes and family processes in order to establish a comprehensive understanding of the development of psychopathology (Cicchetti, 1984; Wenar & Kerig, 2000).
This essay will focus on the contribution of the behaviourist, psychoanalytic, family systems and cognitive models to the understanding of developmental processes (with a focus on attachment, initiative, and control) which are involved in the emergence of psychopathology as discussed in regard to major depression and anorexia nervosa. The models discussed will also be evaluated in terms of their contribution to integrative explanations of psychopathology.
The Behaviourist Model
From a behavioural perspective psychopathology is evident when the behaviour displayed exceeds or occurs at a lower frequency or intensity than is considered age-appropriate (Wenar et al., 2000). Psychopathology is also characterised in terms of learning principles. For instance, the attachment bond between caregiver and child was first understood as a generalised conditional response to the satisfying of the child’s biological needs by the caregiver (Novak & Harlow, 1975). However, it was subsequently demonstrated that psychological needs such as comfort were more important than biological needs in the formation of attachment (Novak et al., 1975). This demonstrates that whilst learning theory is often parsimonious, its reduction of complex behaviour to simple contingencies can sometimes be erroneous.
The behavioural perspective does propose that the abnormal reinforcement and punishment of behaviour related to developmental processes will result in psychopathology (Davison & Neale, 2001). For instance, in the development of anorexia nervosa self-control behaviour (e.g. diet restriction) is frequently positively reinforced by parents and others and reflecting the cultural value placed on thinness (Strober, 2004).
However, this behavioural mechanism whilst explaining the maintenance of restricting behaviour does not explain the cause. A simple behavioural explanation for major depression proposes that a failure in the production of the social behaviour which elicits positive reinforcement from others results in depression through the process of extinction (Cole & Milstead, 1989). Again this explanation fails to identify the cause of this behavioural deficit, but does explain the maintenance of depression by the loss of social support which results from this deficiency.
Behaviourist explanations of psychopathology have been described as oversimplistical and circular (Davison et al., 2001). In particular behaviourist models are most applicable to the explanation of environmental events which maintain current psychopathology but do not provide causative mechanisms or developmental explanations and are therefore of limited use in the understanding of the mechanisms which produce psychopathology.
The Psychoanalytic Model
In the traditional psychoanalytic model psychopathology is typically conceptualised in terms of problems in timing such as the persistence of behaviour beyond a point considered age-appropriate, or a return to behaviours which are no longer considered appropriate (Wenar et al., 2000). Whilst these concepts are broadly useful and have been incorporated into developmental theory, the associated Freudian psychoanalytic model of development is less useful in its traditional form (e.g. it denies the possibility of early childhood depression) and more progressive developments in psychoanalytic theory will be discussed here.
A recent development in the psychoanalytic model is object relations theory which focuses on the development of affectionate attachments throughout life (Biringen, 1994; Masterson, 1977). Disturbed attachment patterns are proposed to result in a failure to form an integrated self early in life which is predictive of a subsequent pathological interpersonal style associated with the development of major depression (Bartholomew & Horowitz, 1991; Hazan & Shaver, 1994). Similarly, in anorexia a lack of coherent sense of self is proposed to result from abnormal caregiving characterised by parental overcontrol and is associated with subsequent psychopathology (Carr, 1999).
Objects relations theory proposes that the child is perceived by the parents as a self-object and expression of need for separation-individuation is seen as a personal betrayal (Diamond, 2004; Masterson, 1977). This need thus becomes associated with abandonment anxiety and results in a failure of the child to develop self-sufficiency. The restriction of appetite contributes to feeling of autonomy and coherence. However, in both major depression and anorexia the processes whereby patterns of caregiving lead to the proposed unintegrated self and to subsequent disorder are not explicated (Hazan et al., 1994).
Recent psychoanalytic perspectives also focus on the abnormal development of initiative (Bateman & Fonagy, 2001). Initiative is described as “surrendered” or “arrested” as a result of cumulative trauma during infancy (Bateman et al., 2001). Subsequently disorders of “Acting Out” are observed whereby the traumatic experiences are unconsciously acted out in an aggressive manner in therapy (Lapkin, 1985; Stein, 1973).
The incorporation of parental neglect into the self-system during attachment results in the subsequent loss of initiative is proposed to result in the coupling of aggression with self-assertion and need-expression (Bateman et al., 2001). In the case of anorexia nervosa the acting out of childhood trauma is proposed to be evident in the self-directed hostility that is characteristic of the disorder (Fonagy & Target, 1997).
This psychoanalytic explanation whilst making developmental sense in indicating the progression of psychopathology from disordered attachment to initiative loss to subsequent psychopathology, again does not sufficiently explain the processes which link the steps in this series and includes vague, poorly designed and unoperationalised terms (e.g. surrendered initiative). As in Freudian psychoanalysis the post-Freudian accounts described rely on invoking a causal nature in regard to unconscious processes to bridge the gaps between concepts and between developmental processes (e.g, initiative development) and the emergence of psychopathology (e.g. hostility-anorexia) (Grunbaum, 2001).
The model also does not sufficiently explicate motives or causes which initiate these unconscious mechanisms (Grunbaum, 2001). The focus of psychoanalytic models are often, as in the above example of “acting out”, therapeutically derived (Fonagy et al., 1997). This method is limited in validity in that it retrospectively infers antecedent processes from clinically presenting phenomena rather than vice-versa (Grunbaum, 2001).
The psychoanalytic model is useful in that it provides developmental accounts of the progression from maladaptive developmental processes to psychopathology. However, the tendency towards retrospective explanation, and the pervasive problem of the unconscious and the resultant reluctance on the part of psychoanalytic theorisers to explain and operationalise dynamic processes limits the usefulness of even the recent formulations of psychoanalytic model in the explanation of psychopathology.