The Integration of Pediatric Psychology and Developmental Psychopathology: A Theoretical Perspective and Empirical Demonstration Restricted; Files Only

Abstract

This dissertation seeks to both theoretically and empirically demonstrate the value of integrating pediatric psychology and developmental psychopathology. The first paper is a theoretical perspective in which I delineate gaps between pediatric psychology and developmental psychopathology, outline key principles of developmental psychopathology within the context of pediatric medical conditions, illustrate existing examples of successful integration efforts, generate questions for future research at the intersections of pediatric psychology and developmental psychopathology, and suggest practical steps to enhance communication and collaboration between these fields. The second paper is an empirical demonstration in which I aim to capitalize upon the guiding themes of the first paper to conduct an original study at the convergence of pediatric psychology and developmental psychopathology. Specifically, I examined the relationship between early life health adversity– as opposed to more general forms of early life adversity as traditionally conceptualized– and internalizing disorders present in the transition from adolescence to adulthood. A sample of 705 mother-child dyads participated in this prospective, longitudinal study. Mothers reported on a variety of child health problems from birth through 5 years of age and completed psychiatric interviews while youth completed interview measures of psychiatric disorders, social relationships, and ongoing health adversity throughout adolescence and early adulthood. Results suggest a unique and long-lasting association between health problems experienced within the first 5 years of life and anxiety disorders present between 15 and 20 years of age. Furthermore, results suggest that youth who are exposed to both early health life adversity and maternal depression are at heightened risk for developing depressive disorders. These findings suggest a distinct role of early life health problems, as well as their interaction with maternal depression, in contributing to internalizing disorders in the transition from adolescence to adulthood. Overall, the methods and results of the empirical paper demonstrate the added value of efforts to integrate pediatric psychology and developmental psychopathology, as well as the practical utility of such efforts. This dissertation concludes with a general discussion, in which I critically evaluate the second paper’s attempt to integrate pediatric psychology and developmental psychopathology, highlighting strengths, limitations, and future directions.

 

Table of Contents

Table of Contents

General Introduction………………………………………………………………………………1

Paper 1: Pediatric Psychology and Developmental Psychopathology: Pathways to Integration

           Title Page………………………………………………………………………………….6

           Abstract……………………………………………………………………………………7

           Introduction………………………………………………………………………………..8

The Current State: Identifying the Gap……………………………………………………9

Key Principles of Developmental Psychopathology in the Context of Pediatric

Medical Conditions………………………………………………………………………11

Integrating Pediatric Psychology and Developmental Psychopathology

Perspectives to Enhance Science and Society: Select Illustrations……………………...13

           Psychobiological Mechanisms…………………………………………………...13

           Sensitive Periods in Development……………………………………………….18

           From Risk to Resilience………………………………………………………….21

Practical Steps: A Call to Action………………………………………………………...26

Paper 2: Early Life Health Adversity and Internalizing Disorders in the Transition from Adolescence to Adulthood

           Title Page………………………………………………………………………………...28            Abstract…………………………………………………………………………………..29

           Introduction………………………………………………………………………………31

                       The Current Study………………………………………………………………..36

           Methods…………………………………………………………………………………..36

                       Participants and Procedure……………………………………………………….36

                       Measures………………………………………………………………………....38

                       Data Analytic Plan……………………………………………………………….44

           Results……………………………………………………………………………………46

           Discussion………………………………………………………………………………..48

                       Conclusions………………………………………………………………………56

General Discussion………………………………………………………………………………57

References……………………………………………………………………………………….64

Tables and Figures……………………………………………………………………………….88

           Paper 1:

                       Figure 1…………………………………………………………………………..88

                       Table 1…………………………………………………………………………...89

                       Table 2…………………………………………………………………………...92

           Paper 2

                       Table 1…………………………………………………………………………...93

                       Table 2…………………………………………………………………………...94

                       Table 3…………………………………………………………………………...95

Table 4…………………………………………………………………………...96

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School	Laney Graduate School
Department	Psychology
Subfield / Discipline	Clinical Psychology
Degree	Ph.D.
Submission	Dissertation
Language	English
Research Field	Psychology, Developmental Psychology, Clinical
Keyword	Developmental Psychopathology Early Life Health Adversity Pediatric Psychology Interdisciplinary Pediatrics Early Life Adversity
Committee Chair / Thesis Advisor	Patricia A. Brennan, Emory University
Committee Members	Ruchi S. Gupta, Northwestern University Robyn Fivush, Emory University Megan R. Gunnar, University of Minnesota Sherryl H. Goodman, Emory University Arri Eisen, Emory University

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