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During the course of the past four decades, developmental psychopathology has emerged as a new science that integrates various disciplines, the efforts of which had previously been distinct and separate. The distinctiveness and uniqueness of a developmental psychopathology approach lie in its focus on normal and abnormal, adaptive and maladaptive, developmental processes. A developmental analysis presupposes change and novelty, highlights the critical role of timing in the organization of behavior, underscores multiple determinants, and cautions against expecting invariant relations between causes and outcomes. A developmental analysis is essential for tracing the roots, etiology, and nature of maladaptation so that interventions may be timed and guided as well as being developmentally appropriate. Moreover, a developmental analysis proves useful for discovering the compensatory mechanisms – biological, psychological, and social-contextual – that may promote resilient functioning despite the experience of significant adversity. Inherent to a developmental psychopathology approach is a commitment to the importance of applying knowledge of normal development to the study of typical populations. Even prior to the emergence of a mental disorder, certain pathways signify adaptational failures in normal development that probabilistically forebode subsequent psychopathology. The approach suggested by a developmental psychopathology framework requires a comprehensive assessment of functioning including multidisciplinary, multidomain, multilevel, and multicontextual measurement strategies. Additionally, developmental psychopathology is a lifespan perspective, because it is only by examining a range of conditions from infancy through adulthood that developmental continuities and discontinuities can be elucidated fully.
Early irritability predicts a broad spectrum of psychopathology spanning both internalizing and externalizing disorders, rather than any particular disorder or group of disorders (i.e. multifinality). Very few studies, however, have examined the developmental mechanisms by which it leads to such phenotypically diverse outcomes. We examined whether variation in the diurnal pattern of cortisol moderates developmental pathways between preschool irritability and the subsequent emergence of internalizing and externalizing symptoms 9 years later.
When children were 3 years old, mothers were interviewed about children's irritability and completed questionnaires about their children's psychopathology. Six years later, children collected saliva samples at wake-up and bedtime on three consecutive days. Diurnal cortisol patterns were modeled as latent difference scores between evening and morning samples. When children were approximately 12 years old, mothers again completed questionnaires about their children's psychopathology.
Among children with higher levels of irritability at age 3, a steeper diurnal cortisol slope at age 9 predicted greater internalizing symptoms and irritability at age 12, whereas a blunted slope at age 9 predicted greater externalizing symptoms at age 12, adjusting for baseline and concurrent symptoms.
Our results suggest that variation in stress system functioning can predict and differentiate developmental trajectories of early irritability that are relatively more internalizing v. those in which externalizing symptoms dominate in pre-adolescence.
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