There is remarkable heterogeneity in the symptoms that mental health professionals and researchers use to define disorders, the biosocial processes underlying the development of those disorders, and the environments in which children and their families struggle or thrive. These family environments exist within diverse and changing socio-political, economic, and cultural contexts. Ecological theories of human development emphasize a role for broader contexts as well as more proximal family environments in carrying many of the causal influences that operate in transaction with biologically based factors in contributing to adaptive and maladaptive outcomes. Several papers in this issue of the journal represent thoughtful consideration of these ecological niches, family processes, and the development of psychopathology.
The connection between family adversity and the development of psychopathology can be seen in research investigating difficulties in parenting, parent–child relationships, and the development of aggressive and non-aggressive behavioral problems. Chronic and rare stressors in the lives of families can disrupt relationships between partners and between parents and children, as well as directly influence the functioning of each individual. For some families, there are escalations in hostile reactive parenting and emotional rejection of children over time, particularly when the children already are showing signs of problem behavior such as aggression or delinquency. In their longitudinal study spanning early and middle childhood, Shaw, Lacourse, and Nagin have been examining heterogeneity in trajectories of change in two patterns of behavior – conduct problems (e.g., aggression, noncompliance) and hyperactivity/attention problems – using a growth mixture modeling approach. For each problem behavior, they identified four sub-groups based on patterns of change over 8 years, including those who show chronically high levels of behavior problems as opposed to those who show normative patterns of decline in problems over middle childhood. Specific types of child and family risk factors differentiated the developmental course of chronic conduct problems and to a lesser extent, chronic hyperactivity/attention problems, from normative trajectories. These included higher levels of maternal depressive symptoms, younger maternal age, harsher and more rejecting parenting, and higher levels of child fearlessness. There was substantial overlap in trajectory group membership at lower levels of problem behavior, but less overlap at chronic high levels. Furthermore, none of the measured risk factors differentiated the chronic conduct problem trajectory from the chronic hyperactivity/attention problem trajectory, implicating comparable developmental processes. While providing new insights, this study also raises important new questions regarding the covariation of antisocial, attention, and motor behavioral disorders as they develop over middle childhood.
Another paper in the current issue addresses problems in parenting and children's conduct as well as emotional problems, with a focus on identifying some of the proximal processes involving marital satisfaction and parental alcohol use (Keller, Cummings, and Davies). In some families, the relationship between married or cohabiting partners serves as a chronic source of conflict and distress, which is known to contribute to problems in parenting and children's mental health outcomes. In their study, Keller and colleagues used structural equation modeling and a cross-sectional design to examine the mediating effects of marital discord and inconsistent, overcontrolling parenting on the correlation between parental drinking behavior and children's maladjustment. The findings from this study are of clinical relevance in demonstrating a role of marital conflict in accounting for the association between problem drinking and family dysfunction in a community sample. Parental problem drinking was linked to marital dysfunction, poor parenting practices, and child adjustment problems. The results highlight the potentially insidious effects of escalations in parents‘ drinking even within otherwise well-functioning typical families, and also point to marital conflict as a problem and target for change in problem-drinking families.
Turning to broader contexts outside of the immediate family environment, the adversities that are faced by parents and children accumulate more rapidly, and are more acute at any given time, in contexts in which there are few socioeconomic resources. Families who must adapt to the challenges of inadequate housing, deteriorating and dangerous neighborhoods, and who live in poverty and lack education or access to educational opportunities are at greater risk for many deleterious physical and mental health outcomes. One of the studies in the current issue touches on methodological and conceptual issues regarding the effects on youth health and well-being of variations in socioeconomically deprived neighborhoods and communities. Barnes and her colleagues examined the heterogeneity of the localized, highly disadvantaged areas of England comprising Sure Start Local Programmes that were designated to reduce poverty and its consequences for youth and families. The researchers tackle several complex questions, including whether and how the likely remarkable heterogeneity of community-wide resource deprivation and its effects can be ascertained. Contextual factors included parent age and ethnicity, family structure, economic deprivation, and adult health problems, and youth and family outcomes included child health problems, achievement, school exclusions and truancies, and child welfare (e.g., Social Services referrals). The key findings from their analyses are that there are identifiable and distinctive sub-groups of Sure Start Local Programmes, and that examination of these sub-groups reveals important differences in the associations between contextual factors and youth outcomes. Though all of these communities included many families living in poverty, there was astounding variety in the clustering of risk and protective factors, and in apparent developmental processes, lending credence to the idea that identification of ecological niches will further improve specification of empirical models of the needs of, and effectiveness of services delivered to, individual children and families.
Another paper considers family- and neighborhood-level risk factors underlying incidences of autism, with emphasis on familial risk and the possible impact of urbanization. Lauritsen, Pedersen, and Mortensen examined rates of autism diagnoses in a large population database in Denmark. Consistent with the growing literature on autism spectrum disorders, there was clear evidence of powerful genetic influences, as seen in substantial relative risk for those having a sibling with autism or a related disorder. The researchers also found that having a mother with a history of psychiatric disorder increased relative risk of an autism diagnosis. Interestingly, a similar effect size was found for the level of urbanization of the child's place of birth, with greater risk incremented by more urban settings. The authors point out that past research in Denmark and elsewhere rules out community-level variations in typical parents’ socioeconomic status as an explanation, and they point to other potential causal factors that cannot be ruled out (e.g., perinatal risks, teratogen exposure).
As always, the current issue of the journal includes a collection of papers covering a wide range of topics beyond those described above. The volume begins with an annotated review of economic factors surrounding child and adolescent mental health services (Romeo, Byford, and Knapp), and ends with an investigation of borderline personality disorder diagnoses in girls and boys (Bradley, Zittel, and Westen). Several other papers focus on aspects of cognitive and neural processes and psychopathology, including behavioral evidence of orbital frontal cortex impairment in psychopathy (Budhani and Blair), evidence of biases in executive control of attention in adolescent depression (Pössel, Baldus, Horn, Groen, and Hautzinger), and individual differences in self-referent social cognitions in adolescent depression (Kyte, Goodyer, and Sahakian). Taken together, the papers in this issue describe some of the newest and most innovative approaches to investigating the development of psychopathology and the interventions that may serve to ameliorate problems in mental health and functioning.