Benjamin B. Lahey – författare

A remarkable and extremely important ongoing positive revolution in how we think about psychological problems is rapidly reaching a tipping point. This book provides a manifesto for this revolution. An increasing number of psychologists and psychiatrists are proposing that we either radically change the next edition of the Diagnostic and Statistical Manual of the Mental Disorders and the International Classification of Diseases or leave them behind entirely. The author argues for a view of psychological problems that is far less stigmatizing and better supported by the data but which will require large changes in thinking. First, there is no clear distinction between "normal" and "abnormal" psychological functioning. Psychological problems do not reflect rare and terrifying "illnesses" of the mind, but are problematic ways of thinking, feeling, and behaving that lie on continuous dimensions from minor to severe. Crucially, psychological problems are ordinary aspects of the human experience. They are ordinary in the sense of being commonplace-the great majority of us will experience distressing and disruptive psychological problems at some time during our lives-and are ordinary in arising through the same natural interplay of genetic and environmental influences as any other aspect of behavior. The dimensions of psychological problems are highly correlated and these correlations provide vital clues as that allow us to see a hierarchy of causes of psychological problems for the first time. These range from factors that influence the likelihood of exhibiting some kind of psychological problem, but not which kind, to highly specific causes.

A remarkable and extremely important ongoing positive revolution in how we think about psychological problems is rapidly reaching a tipping point. This book provides a manifesto for this revolution. An increasing number of psychologists and psychiatrists are proposing that we either radically change the next edition of the Diagnostic and Statistical Manual of the Mental Disorders and the International Classification of Diseases or leave them behind entirely. The author argues for a view of psychological problems that is far less stigmatizing and better supported by the data but which will require large changes in thinking. First, there is no clear distinction between "normal" and "abnormal" psychological functioning. Psychological problems do not reflect rare and terrifying "illnesses" of the mind, but are problematic ways of thinking, feeling, and behaving that lie on continuous dimensions from minor to severe. Crucially, psychological problems are ordinary aspects of the human experience. They are ordinary in the sense of being commonplace-the great majority of us will experience distressing and disruptive psychological problems at some time during our lives-and are ordinary in arising through the same natural interplay of genetic and environmental influences as any other aspect of behavior. The dimensions of psychological problems are highly correlated and these correlations provide vital clues as that allow us to see a hierarchy of causes of psychological problems for the first time. These range from factors that influence the likelihood of exhibiting some kind of psychological problem, but not which kind, to highly specific causes.

A remarkable and extremely important ongoing positive revolution in how we think about psychological problems is rapidly reaching a tipping point. This book provides a manifesto for this revolution. An increasing number of psychologists and psychiatrists are proposing that we either radically change the next edition of the Diagnostic and Statistical Manual of the Mental Disorders and the International Classification of Diseases or leave them behind entirely. The author argues for a view of psychological problems that is far less stigmatizing and better supported by the data but which will require large changes in thinking. First, there is no clear distinction between "normal" and "abnormal" psychological functioning. Psychological problems do not reflect rare and terrifying "illnesses" of the mind, but are problematic ways of thinking, feeling, and behaving that lie on continuous dimensions from minor to severe. Crucially, psychological problems are ordinary aspects of the human experience. They are ordinary in the sense of being commonplace-the great majority of us will experience distressing and disruptive psychological problems at some time during our lives-and are ordinary in arising through the same natural interplay of genetic and environmental influences as any other aspect of behavior. The dimensions of psychological problems are highly correlated and these correlations provide vital clues as that allow us to see a hierarchy of causes of psychological problems for the first time. These range from factors that influence the likelihood of exhibiting some kind of psychological problem, but not which kind, to highly specific causes.

Psychologists have long been interested in the problems of children, but in the last 20 years this interest has increased dramatically. The in­ tensified focus on clinical child psychology reflects an increased belief that many adult problems have their origin in childhood and that early treatment is often more effective than treatment at later ages, but it also seems to reflect an increased feeling that children are inherently important in their own right. As a result of this shift in emphasis, the number of publications on this topic has multiplied to the extent that even full-time specialists have not been able to keep abreast of all new developments. Researchers in the more basic fields of child psychol­ ogy have a variety of annual publications and journals to integrate research in their areas, but there is a marked need for such an integra­ tive publication in the applied segment of child and developmental psychology. Advances in Clinical Child Psychology is a serial publication designed to bring together original summaries of the most important developments each year in the field. Each chapter is written by a key figure in an innovative area of research or practice or by an individual who is particularly well qualified to comment on a topic of major contemporary importance. Each author has followed the stan­ dard format in which his or her area of research was reviewed and the clinical implications of the studies were made explicit.

Psychologists have long been interested in the problems of children, but in the last 20 years this interest has increased dramatically. The in­ tensified focus on clinical child psychology reflects an increased belief that many adult problems have their origin in childhood and that early treatment is often more effective than treatment at later ages, but it also seems to reflect an increased feeling that children are inherently important in their own right. As a result of this shift in emphasis, the number of publications on this topic has multiplied to the extent that even full-time specialists have not been able to keep abreast of all new developments. Researchers in the more basic fields of child psychol­ ogy have a variety of annual publications and journals to integrate research in their areas, but there is a marked need for such an integra­ tive publication in the applied segment of child and developmental psychology. Advances in Clinical Child Psychology is a serial publication designed to bring together original summaries of the most important developments each year in the field. Each chapter is written by a key figure in an innovative area of research or practice or by an individual who is particularly well qualified to comment on a topic of major contemporary importance. Each author has followed the stan­ dard format in which his or her area of research was reviewed and the clinical implications of the studies were made explicit.

The second volume of Advances in Clinical Child Psychology continues the high standards set by the contributing authors of Volume 1. The series has been most fortunate in attracting authors who lead the field of applied child and developmental psychology in theory, research, and practice. Their chapters bring together advances from a wide variety of sub fields in essays that can legitimately be called "major statements." Often these integrative chapters prove to be more than the sum of their parts, not only bringing together information on the most current topics in the field but pointing to new directions as well. Donald Meichenbaum summarized current evidence and theory in his chapter on self-control in children. The cognitive and behavioral and convenient strategies he outlines offer the promise of effective treatment methods, but as he points out, much remains to be learned about these methods. Robert Wahler and his associates outline a new model for the study of generalization of child treatment effects. The model views the family as a system that either supports or inhibits generalization. Suggestions for planning treatments within this framework are provided, as well as an outline for extending this analysis to other levels of systems.

Advances in Clinical Child Psychology is a serial publication designed to provide researchers and clinicians with a medium for discussing new and innovative approaches to the problems of children. In this fourth volume, a group of highly distinguished authors have described advanc­ ing knowledge in a number of critical areas of applied child psychology. These include childhood depression, drug abuse, social skills deficits, community-living skills, the genetics of childhood behavior disorders, and affective states in children. In addition, major statements on new approaches to the assessment of dysfunctional family systems and the social skills of children, as well as the increasingly important methodol­ ogy of epidemiology, are included in this volume. These chapters pro­ vide a synopsis of many of the most important advances in the field of clinical child psychology. The quality of a series of this sort is, of course, due to the quality of the contributing authors. We feel very fortunate indeed, therefore, to have been able to entice such a distinguished group of authors to con­ tribute to this volume. We are also most appreciative of the guidance and assistance of the consulting editors who provided us with ideas for chapter topics and authors and who carefully reviewed and edited each chapter. We also express our hearty thanks to Leonard R. Pace of Plenum whose expertise and support has always been generously given. BENJAMIN B. LAHEY ALAN E. KAZDIN ix Contents The Epidemiology of Child Psychopathology 1 William Yule 1. Introduction ............................................ .

Advances in Clinical Child Psychology is a serial publication designed to provide researchers and clinicians with a medium for discussing new and innovative approaches to the problems of children. In this fourth volume, a group of highly distinguished authors have described advanc­ ing knowledge in a number of critical areas of applied child psychology. These include childhood depression, drug abuse, social skills deficits, community-living skills, the genetics of childhood behavior disorders, and affective states in children. In addition, major statements on new approaches to the assessment of dysfunctional family systems and the social skills of children, as well as the increasingly important methodol­ ogy of epidemiology, are included in this volume. These chapters pro­ vide a synopsis of many of the most important advances in the field of clinical child psychology. The quality of a series of this sort is, of course, due to the quality of the contributing authors. We feel very fortunate indeed, therefore, to have been able to entice such a distinguished group of authors to con­ tribute to this volume. We are also most appreciative of the guidance and assistance of the consulting editors who provided us with ideas for chapter topics and authors and who carefully reviewed and edited each chapter. We also express our hearty thanks to Leonard R. Pace of Plenum whose expertise and support has always been generously given. BENJAMIN B. LAHEY ALAN E. KAZDIN ix Contents The Epidemiology of Child Psychopathology 1 William Yule 1. Introduction ............................................ .

Advances in Clinical Child Psychology continues to bring to its readers scholarly papers that review and update advances in diverse areas of research with children. The focus on basic and applied work with chil­ dren encompasses several disciplines and professions. This volume, the fifth in the series, continues to expand the range of topics and specialty areas represented by the contributors. In the present volume, contribu­ tions address several different topics related to diagnosis, assessment, and treatment of childhood disorders. Taxonomy, nosology, and assess­ ment of childhood behavioral problems, and social and emotional ad­ justment are discussed. Contributions also address recent advances re­ lated to specific disorders including childhood depression, conduct disorders, and hyperactivity. Factors that impinge on child development and have implications for social adjustment and psychopathology are covered in separate contributions on the effects of divorce and life events as stressors in general. Treatment techniques are also covered in the present volume. A separate contribution on pharmacotherapy de­ tails the latest advances and outstanding issues in that field. Problem­ solving therapy is also covered in a contribution on the cognitive bases of social adjustment in children. As with previous volumes, we would like to express our gratitude to several persons. Foremost are the contributors whose scholarship and expertise contributed fundamentally to this volume, as well as the over­ all series.

With this volume, Advances in Clinical Child Psychology enters its second decade. The goal of the series is to provide clinicians and researchers in the fields of clinical child psychology, child psychiatry, school psychol­ ogy, and related disciplines with an annual compilation of statements that summarize the new data, concepts, and techniques that advance our ability to help troubled children. Looking forward, the series intends to highlight the emerging developments that will guide our field of inquiry and practice; looking back, the eleven volumes in the series provide an interesting chronicle of changes in our understanding. Each year, scholars are chosen whose recent work is on the leading edge of clinical child psychology and its sibling disciplines, who offer potentially important new theoretical viewpoints, or who are well qualified to discuss topics of emerging importance that are not identified with one particular laboratory. Perhaps more than in any previous vol­ ume, the authors of the present volume have achieved fully the goals of the series. Volume 11 is a rich source of exciting ideas, important new information, and cogent analysis. The topics of these chapters, moreover, can be seen to represent the important broad themes in clinical child psychology today. The volume begins with two chapters that describe emerging theoretical perspectives.

The goal of Advances in Clinical Child Psychology is to provide clinicians and researchers in clinical child psychology, child psychiatry, and relat­ ed mental health disciplines with an annual compilation of statements that summarize the new data, concepts, and techniques that advance our ability to help troubled children. Looking forward, the series intends to highlight the emerging developments that will guide our field of inquiry and practice. Looking back, the dozen volumes in this series chronicle the changes in our attempts to understand and solve the psychological problems of children and adolescents. Each year, scholars are chosen whose recent work is on the leading edge of clinical child psychology and related disciplines. They are se­ lected either because their own work offers potentially important new information or theoretical viewpoints or because they are especially well qualified to discuss critical topics in the field that are not identified with one particular research program.

The Advances in Clinical Child Psychology series is directed toward the clinicians and researchers in child psychology to alert them to new developments, data, and concepts which advance the ability of these professionals to help troubled children. This volume represents our at­ tempt to highlight the emerging issues and breakthroughs that are likely to guide our field of inquiry in the near future. Our goal in selecting authors to contribute to this series is to seek out those whose work is innovative, relevant, and likely to influence future work in clinical child psychology and related fields. Each author is chosen either on the basis of potentially important new information or viewpoints in his or her own work, or because the author is especially well-qualified to discuss a topic that is not restricted to one program of research. In this volume, the impact of disciplines other than psychology on clinical child psychology is well-documented. Rubenstein presents a wide-ranging overview of research on the neurological causes, indica­ tors, and reflections of developmental disorders, including a section on the physiological basis of autism. Costello explores how epidemiology is being applied to child psychiatry and offers insights into the growing importance of applying epidemiological methods to clinical practice.

Advances in Clinical Child Psychology is an annual series designed to bring summaries of the latest developments in the field to psychologists, psy­ chiatrists, educators, and other professionals who are concerned with troubled children. This volume, like its predecessors, attempts to high­ light the important emerging issues and breakthroughs that are likely to guide clinical work and research in our field of inquiry in the near future. In selecting authors to contribute to this series, we seek out those whose work is innovative, relevant, and likely to influence future work in clinical child psychology and related fields. Each author is chosen either on the basis of potentially important new information or view­ points in his or her own work, or because the author is especially well qualified to discuss a topic that is not restricted to one program of research. In this volume, a wide range of particularly important topics is addressed. White and Sprague describe an innovative program of re­ search aimed at identifying the underlying deficit in attention-deficit disorder. Schonert-Reichl and Offer summarize and integrate research on gender differences in psychological symptoms among adolescents. Borden and Ollendick offer a cogent proposal concerning the develop· ment and differentiation of subtypes of autism based on social behavior.