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Developmental psychiatry: is there any other kind?
1Department of Psychiatry, Children's Hospital, Boston, MA 02115, USA.
Abstract:
This paper describes the importance of the developmental perspective in psychiatry and addresses the lack of a developmental focus in the DSM-based descriptive empirical model. Although the publication of DSM-III in 1980 represented a "breakthrough" in psychiatry, the revisions of its diagnostic framework over the subsequent two decades have not adapted to the rapidly evolving changes in the field. In this paper we argue that, like once-grand theories, the breakthroughs in the diagnostic framework need to transform. The developmental perspective provides an interdisciplinary and conceptual framework linking facts and theories. It is inherent in different aspects of psychiatry and readily accommodates the descriptive-empirical model by means of inclusive concepts borrowed from developmental psychopathology and psychobiology. It also makes important contributions to a process-oriented approach to measurement. Developmentally operationalized and multidimensional constructs stand to broaden psychiatric domains beyond diagnosable disorders. This argues for preventive and early treatment interventions for a variety of mild, subthreshold, or delayed symptoms of various conditions, based on an understanding of the causal mechanisms and developmental processes involved.
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