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Probabilistic epigenesis: an alternative causal model for conduct disorders in children and adolescents
1Department of Child and Adolescent Psychiatry, Groupe Hospitalier Pitié-Salpétrière, APHP, Université Pierre et Marie Curie, 47 bd de l'Hôpital, Paris, France. david.cohen@psl.aphp.fr
Abstract:
Most models of conduct disorders are based on a biopsychosocial perspective. In such models, genetic and/or neuropsychological determinants are assumed to have a core hierarchical role by conferring vulnerabilities during a child's development. Based on a review of recent literature, I will show that other views are attempting to integrate the diversity and complexity of factors that influence these behavioural manifestations. The model that best integrates the complexity of these different factors is a developmental model of probabilistic epigenesis. In this paper, I summarise several lines of study that support this model. In addition to the categorical approach of psychiatric nosography, I will adopt a dimensional approach of phenomenology that will help to follow and focus on specific pertinent dimensions such as clinical signs, psychological characteristics, environmental and/or genetic factors in order to study their interactions and their possible developmental outcomes. This model also permits a specific temporal focus on early interactions that many authors consider crucial in terms of developmental cues.
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