There is considerable evidence that the development of jointattention and pretend play skills are impaired in children withautism. Some accounts of autistic psychopathology give a crucial roleto early impairments in joint attention and suggest that these lead toimpoverished development of the representational abilities thatunderlie the later emerging impairments in pretend play and theory ofmind. Other accounts of impairments in joint attention and pretendplay see them merely as symptoms of a more basic underlying cognitivedeficit, in attention or executive function. This review examines theevidence for the possible relationships that may exist between jointattention and pretend play and the later development of a theory ofmind. It also suggests directions for future work to clarify therelationship between the two skills and to identify the nature of theunderlying primary deficit in autism.

Maternal cocaine use during pregnancy can affect the infant directly through toxic effects orindirectly through cocaine's influence on maternal psychological status. We followed 160cocaine exposed and 56 nonexposed infants and their mothers identified at birth throughinterview and/or urine screen. Although cocaine exposure defined the groups, infantexposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% AfricanAmerican and poor. All mothers completed the Brief Symptom Inventory (BSI) and infants weregiven the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected ageof 17 ± 8 months. Both MDIs (94 ± 17 vs. 103 ± 16) and PDIs (101± 16 vs. 108 ± 12) were lower for cocaine exposed infants. Psychologicaldistress was greater in cocaine using mothers. Hierarchical multiple regression was used to assessthe relative effects of gestational age, maternal psychological distress, and cocaine and polydrugexposure on infant outcomes. Both psychological distress and cocaine and alcohol exposurepredicted lower MDIs after controlling for prematurity. Neither psychological distress noralcohol exposure predicted motor outcome, while cocaine had a significant effect. Tobacco andmarijuana exposure were unrelated to outcome. These findings provide further support for directeffects of cocaine and alcohol on infant development, as well as highlight the need for studies todocument maternal psychological factors, which may increase child risk for pooreroutcomes.

The interdisciplinary science of developmental psychopathology has evolved from itshistorical roots in a variety of fields including: sociology; epidemiology; embryology; theneurosciences and psychobiology; psychoanalysis; clinical, developmental, and experimentalpsychology; and psychiatry (Cicchetti, 1990) into an increasingly mature integrative frameworkwithin which the contributions of these heretofore largely separate disciplines could be fullyrealized within the broader context of understanding individual development and functioning,both normal and abnormal (see chapters in Cicchetti & Cohen, 1995a, 1995b; see alsoCicchetti & Toth, in press). In one of the early statements concerning the goals of this field,Cicchetti (1990) asserted that: “Developmental psychopathology ... should bridge fieldsof study, span the life cycle, and aid in the discovery of important new truths about the processesunderlying adaptation and maladaptation, as well as the best means of preventing or amelioratingpsychopathology. Moreover, this discipline should contribute greatly to reducing the dualismsthat exist between the clinical study of and research into childhood and adult disorders, betweenthe behavioral and biological sciences, between developmental psychology and psychopathology,and between basic and applied science” (p. 20).

The concepts of self-organization, state changes, and energy flow are central to dynamicsystems theory. In this work I suggest that to apply these general principles to the study of normaland abnormal development, these constructs must be specifically defined in reference to currentknowledge of brain development. Toward that end, I present an overview of the properties ofself-organizing developmental systems, and then propose a model of attachment dynamics assynchronized energy exchanges that cocreate nonlinear changes of state, discuss the roles ofbioamines and energy-generating brain mitochondria in state regulation, and describe theenergy-dependent imprinting of synaptic connectivity and neural circuitry in the infant brain. Inthis application of nonlinear concepts to developmental models of both resistance against andvulnerability to mental disorders, particular emphasis is placed upon the experience-dependentmaturation of a system in the orbital prefrontal cortex that regulates psychobiological state andorganismic energy balance. This frontolimbic system is expanded in the nonlinear righthemisphere that generates stress-regulating coping strategies, and it serves as the hierarchicalapex of the limbic and autonomic nervous systems. Early forming microstructural alterations andenergetic limitations of this regulatory system are suggested to be associated with apredisposition to psychiatric disorders.

Previous research has documented differences in the pattern of EEG activation between3-month-old infants of depressed mothers and infants of nondepressed mothers. In the presentstudy, EEG was recorded in even younger 1-month-old infants of depressed and nondepressedmothers. The infants of depressed mothers exhibited greater relative right frontal EEGasymmetry (due to reduced left frontal activation), and this pattern at 1 month was significantlyrelated to 3-month EEG asymmetry. Right frontal EEG asymmetry was also related to morefrequent negative facial expressions (sad and pre-cry faces) during the Brazelton exam. Finally,the infants of depressed mothers showed more indeterminate sleep, were less active, and criedless than infants of nondepressed mothers.

Self-organization can be approached in terms of developmental processes occurring withinand between component systems of temperament. Within-system organization involvesprogressive shaping of cortical representations by subcortical motivational systems. As corticalrepresentations develop, they feed back to provide motivational systems with enhanced detectionand guidance capabilities. These reciprocal influences may amplify the underlying motivationalfunctions and promote excessive impulsivity or anxiety. However, these processes also dependupon interactions arising between motivational and attentional systems. We discuss thesebetween-system effects by considering the regulation of approach motivation by reactiveattentional processes related to fear and by more voluntary processes related to effortful control.It is suggested that anxious and impulsive psychopathology may reflect limitations in these dualmeans of control, which can take the form of overregulation as well as underregulation.

Developmental psychopathology stands poised at the close of the 20th century on the horns of a major scientific dilemma. The essence of this dilemma lies in the contrast between its heuristically rich open system concepts on the one hand, and the closed system paradigm it adopted from mainstream psychology for investigating those models on the other. Many of the research methods, assessment strategies, and data analytic models of psychology's paradigm are predicated on closed system assumptions and explanatory models. Thus, they are fundamentally inadequate for studying humans, who are unparalleled among open systems in their wide ranging capacities for equifinal and multifinal functioning. Developmental psychopathology faces two challenges in successfully negotiating the developmentalist's dilemma. The first lies in recognizing how the current paradigm encourages research practices that are antithetical to developmental principles, yet continue to flourish. I argue that the developmentalist's dilemma is sustained by long standing, mutually enabling weaknesses in the paradigm's discovery methods and scientific standards. These interdependent weaknesses function like a distorted lens on the research process by variously sustaining the illusion of theoretical progress, obscuring the need for fundamental reforms, and both constraining and misguiding reform efforts. An understanding of how these influences arise and take their toll provides a foundation and rationale for engaging the second challenge. The essence of this challenge will be finding ways to resolve the developmentalist's dilemma outside the constraints of the existing paradigm by developing indigenous research strategies, methods, and standards with fidelity to the complexity of developmental phenomena.

Two experiments were conducted to evaluate symbolic-deficit andmemory-deficit hypotheses to account for the cognitive problems seenin children with autism. Experiment 1 tested imitation, in immediateand deferred conditions, of familiar actions with different sets ofobjects representing the developmental progression from functional tosymbolic play. The results showed that the autism group and both theirreceptive language and nonverbal IQ-matched controls imitated familiaractions with realistic objects (evidence for functional play) andplaceholder objects (evidence for symbolic play) after delays rangingfrom 24 hr to 3 weeks. Experiment 2 tested familiar three-step eventsequences in which a placeholder object was substituted for the secondstep in half the events. The results showed that the autism groupremembered as many of the actions with the placeholder objects astheir language-matched controls and as many correctly orderedsequences, a finding that supports a symbolic-delay (rather thandeficit) hypothesis. These results were obtained in highly structuredtest situations and sharply contrast with the impairments seen inchildren with autism who are observed in naturalistic settings. Twointerpretations of these findings are offered. First, structured testsettings minimize distractions that typically occur in naturalisticsettings that may interfere or disrupt symbolic play in children withautism. Second, the results are consistent with an executive functiondeficit in that the autistic group demonstrated more knowledge in thetest settings than they demonstrate spontaneously in naturalisticones.

The authors review the constraints of current mental disorder classification systems that rely upon descriptive symptom-based approaches, and weigh the benefits and hazards of these classification and diagnostic strategies. By focusing principally on superficial descriptions of symptoms, current systems fail to address the complex nature of persons' transactions within and adaptations to difficult environments. While attempting to be atheoretical, current systems exclude types of information that may elucidate individuals' functioning across various contexts, often because it is difficult to obtain such data reliably. With current approaches, misdiagnosis is likely, particularly when diagnostic criteria are applied to persons in nonclinical settings. Alternative approaches that take fuller advantage of clinicians' expertise and other forms of clinical data are reviewed, and recommendations are made for the next generation of classification systems. Application of evolutionary theory to psychiatry and psychology, as well as development of a theory and nosology of context in terms of persons' adaptations, are needed to expand our knowledge of normal and abnormal human development and psychopathology.

The purpose of this study was to examine the relation of maternal interaction styles to thedevelopment of a sample of 56 toddlers (19 low risk, 37 high risk) seen at 12 and 24 months ofage. At 12 months, videotapes of mother–child interaction were coded for directiveness,sensitivity, and elaborativeness. At 12 and 24 months, cognitive and language measures werecollected. A directive maternal style was negatively correlated with sensitivity andelaborativeness, whereas sensitive and elaborative ratings were positively correlated, suggestinga facilitative style. Regression models significantly predicted receptive language and cognitivedevelopment at 24 months but not expressive language. Maternal directiveness at 12 months wasnegatively related to later receptive language skills, whereas elaborativeness at 12 months waspositively predictive of later cognitive development. Child status variables and maternalinteractional styles contributed about equally to the prediction of later cognitive and languageoutcomes.

Evidence from the evolution of human cultural behavior and learning, embryology andgenetics of the brain, and the behavior of human infants indicates that the critical and uniquelyhuman motives for cooperative imagination and joint interest in objects and tasks are determinedby expression of genes and epigenetic neural systems elaboration long before birth, along withessential peripheral organs of perception and motor expression that will serve in communicationby rhythmic facial, vocal, gestural, and body movement signals. These cerebral motives continueto exercise their influence on neural development and behavior throughout life, transforming thebehaviors of the developing individual through a succession of phases to which other individualsand cultural institutions are constrained to adapt. We discuss the theory of innate intersubjectivityand relate it to the hypothesis of an Innate Motive Formation that emerges in brain developmentas regulator of morphogenesis in neural systems, and that continues to function, postnatally, asgenerator of motives and emotions by which human contacts and relationships are regulated. Wesuggest that differentiates of the primary motive formation in the embryo brain later serve togenerate intelligent exploration of the objective environment, and the emergence of an additionaldialogic mechanism that represents the self-subject as a partner for an other-subject,intersubjectively. Intersubjective communication in infancy leads, through systematic age-relatedtransformations of the brain and behavior, to preverbal mimetic negotiation of cooperativeawareness and joint task performance. Finally we discuss, in relation to this theory,interpretations of faulty communication and development at different stages of the life cycle thatresult from maternal postnatal depression, autism, premature birth, and schizophrenia.

Accelerated longitudinal analyses revealed both similarities anddifferences between the developmental trajectories of empiricallybased aggressive versus delinquent syndromes in childhood andadolescence. Syndromes were scored from standardized ratings obtainedfrom parents five times at 2-year intervals for seven birth cohorts ofDutch children initially assessed at ages 4 to 10 years. Scores forboth the aggressive and delinquent syndromes declined from ages 4 to10. After about age 10 years, scores for the aggressive syndromecontinued to decline, but scores for the delinquent syndrome increaseduntil about age 17. The aggressive syndrome was significantly morestable than the delinquent syndrome. Long-term predictive correlationsbetween matched subjects from different cohorts were as high aspredictive correlations between scores obtained by the same subjects,thus supporting the validity of accelerated longitudinal analyses. Theresults highlight important developmental distinctions betweenaggressive versus delinquent conduct problems. Failure to distinguishbetween aggressive and delinquent conduct problems could generatemisleading conclusions about their respective developmental coursesand limit the generalizability of results.

The aim of the current investigation was to identify victimizedchildren's responses to peers' aggression that may beassociated with reduced versus persistent victimization. To addressthis aim, 199 5–6-year-old children (96 boys, 103 girls) wereinterviewed twice during kindergarten (fall and spring) about theirown victimization experiences and peers' responses toaggression. Observational ratings of children's victimizationexperiences were used to examine the validity of the self-reportedvictimization scores. Relations between response strategies andsubsequent victimization status were significant only for boys:“having a friend help” was associated with reducedvictimization, whereas “fighting back” was related tostable victimization. Implications for future research on peervictimization and intervention with young victimized children arediscussed.

The paper traces the relationship between attachment processes and the development of thecapacity to envision mental states in self and others. We suggest that the ability to mentalize, torepresent behavior in terms of mental states, or to have “a theory of mind” is a keydeterminant of self-organization which is acquired in the context of the child's early socialrelationships. Evidence for an association between the quality of attachment relationship andreflective function in the parent and the child is reviewed and interpreted in the context of currentmodels of theory of mind development. A model of the development of self-organization isproposed which has at its core the caregiver's ability to communicate understanding of thechild's intentional stance. The implications of the model for pathological self-developmentare explored, with specific reference to the consequences of maltreatment.

Construct validity of the newly developed Preschool Assessment of Attachment (PAA) wasexamined in a sample of depressed and nondepressed mothers and their preschoolers, focusingon attachment related differences in children's general caregiving environments, maternalpsychosocial functioning, and child behavior during interactions with mother. Mothers of securechildren were more emotionally and verbally responsive to their children than were mothers ofinsecure children, and secure children were emotionally more positive to their mothers than wereinsecure children. Mothers of secure children also reported higher levels of social supports thandid mothers of insecure children. Finally, dyads with children who lacked unitary, coherentattachment strategies (i.e., anxious depressed, defended/coercive, and insecure other)showed the worst functioning in all domains relative to all other attachment groups. Similar butslightly less robust findings were obtained with socioeconomic variables statistically controlled.These results lend support to the PAA as a valid system for the conceptualization andmeasurement of quality of attachment among preschoolers. Future research applications with thePAA are discussed.

When maladaptation is viewed as development rather than as disease, a transformed understanding results and a fundamentally different research agenda emerges. Within a developmental perspective, maladaptation is viewed as evolving through the successive adaptations of persons in their environments. It is not something a person “has” or an ineluctable expression of an endogenous pathogen. It is the complex result of a myriad of risk and protective factors operating over time. Key research questions within this framework center on discovery of factors that place individuals on pathways probabilistically leading to later disturbances and factors and processes which maintain individuals on, or deflect them from, such pathways once enjoined. There is an interest in recognizing patterns of maladaptation which, while not properly considered disorder themselves, commonly are precursors of disorder and also in conditions of risk that lie outside of the individual, as well as any endogenous influences. Likewise, there is a focus on factors and processes that lead individuals away from disorder that has emerged, which goes beyond interest in management of symptoms. Finally, many topics that currently are capturing attention in the field, such as “comorbidity” and “resilience,” are seen in new ways from within the perspective of development.

Interactive coordination was observed in laboratory play interactions of pairs of 29 clinicallydepressed and 14 nondepressed mothers and their 13–29-month-old children(M = 18.9 months). Nondepressed mothers and their children displayed moreinteractive coordination than depressed-mother dyads (p < .001). Depressedmothers were less likely to repair interrupted interactions, and their toddlers were less likely tomaintain interactions than nondepressed controls. Toddlers matched their nondepressed but nottheir depressed mothers' negative behavior rates. Results suggested that early interventionsfocus on training mothers to attend to, maintain, and repair mother–child interactions tomore closely approximate normal levels of interactive coordination.

The concepts of self-regulation and autonomy are examined within an organizationalframework. We begin by retracing the historical origins of the organizational viewpoint in earlydebates within the field of biology between vitalists and reductionists, from which the constructof self-regulation emerged. We then consider human autonomy as an evolved behavioral,developmental, and experiential phenomenon that operates at both neurobiological andpsychological levels and requires very specific supports within higher order social organizations.We contrast autonomy or true self-regulation with controlling regulation (a nonautonomous formof intentional behavior) in phenomenological and functional terms, and we relate the forms ofregulation to the developmental processes of intrinsic motivation and internalization.Subsequently, we describe how self-regulation versus control may be characterized by distinctneurobiological underpinnings, and we speculate about some of the adaptive advantages that mayunderlie the evolution of autonomy. Throughout, we argue that disturbances of autonomy, whichhave both biological and psychological etiologies, are central to many forms of psychopathologyand social alienation.

Children's ratings of competence and relationship quality wereused to examine the association between idealized or inflatedself-perceptions and level of aggression. Participants were 62aggressive and 53 nonaggressive second and third graders. Ratings ofcompetence were based on the Pictorial Scale of Perceived Competenceand Social Acceptance for Young Children; ratings of relationshipquality were drawn from the Social Support Appraisals Scale and theNetwork of Relationships Inventory. External ratings of competence andrelationship quality were obtained from mothers, teachers, andpeers. Compared to children who were nonaggressive, aggressivechildren were more likely to rate personal competence and relationshipquality in a perfect or idealized manner and to show lessdifferentiation in their ratings of competence and relationshipquality. Aggressive children's self-rated competence andrelationship quality were also inflated relative to the ratings madeby others, whereas the self-ratings of nonaggressive children tendedto be underestimates of their functioning. The tendency for aggressivechildren to idealize and to inflate ratings of competence andrelationship quality was associated with higher levels ofaggression. For aggressive children, a highly positive self-view isconstrued—not as a protective factor or measurement error— but as a defensive posture that places the child at added riskand that impedes the progress of psychosocial interventions.

One goal of developmental psychopathology is to understand the origins and course of mental disorders. I argue that pursuit of this goal requires a valid conceptual understanding of disorder and that this understanding can be provided by the “harmful dysfunction” analysis of the concept of disorder. The harmful dysfunction analysis holds that a disorder is a condition that is both harmful according to social values and caused by an internal dysfunction, that is, by a failure of an internal mechanism to perform a function for which it was naturally selected. This analysis explains why many of the distinctive features of developmental psychopathology are appropriate to the study of disorder. It is argued that the harmful dysfunction analysis is a necessary supplement to other proposed criteria for disorder, such as developmental deviation or predictive validity.