Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 3: Children and Mental Health
Overview of Mental Disorders in Children
A consideration of developmental principles enhances
understanding of mental illness in children and adolescents by reconciling the
concept of mental disorder as a stable state or condition with the ongoing
development of the child. According to these principles, a mental disorder
results from the interaction of a child and his or her environment. Thus, mental
illness often does not lie within the child alone. Within the conceptual
framework and language of integrative neuroscience, the mental disorder is
an“emergent property” of the transaction with the environment. Proper assessment
of a child’s mood, thought, and behaviors demands a simultaneous consideration
of nature and nurture, genes and environment, and biology and psychosocial
influences. These relationships are reciprocal. The brain shapes behavior, and
learning shapes the brain.
Mental disorders must be considered within the context of the family and peers,
school, home, and community. Taking the social-cultural environment into
consideration is essential to understanding mental disorders in children and
adolescents, as it is in adults. However, the changing nature of these
environments, coupled with the progressively unfolding processes of brain
development, makes the emphasis on context, as well as development, more complex
and more central in child mental health (Jensen & Hoagwood, 1997).
Thus, developmental psychopathology encourages consideration of the transactions
between the individual and the social and physical environment at the same time
that signs and symptoms of mental disorder are considered. Moreover, focusing on
diagnostic labels alone provides too limited a view of mental disorders in
children and adolescents.
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