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Causality and PsychopathologyFinding the Determinants of Disorders and their Cures$
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Patrick Shrout, Katherine Keyes, and Katherine Ornstein

Print publication date: 2011

Print ISBN-13: 9780199754649

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199754649.001.0001

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Causal Thinking in Developmental Disorders

Causal Thinking in Developmental Disorders

11 Causal Thinking in Developmental Disorders
Causality and Psychopathology

E. Jane Costello

Adrian Angold

Oxford University Press

In this chapter we (1) lay out a definition of development as it relates to psychopathology; (2) make the case that nearly all psychiatric disorders are ‘‘developmental’’; and (3) examine, with some illustrations, methods from developmental research that can help to identify causal mechanisms leading to mental illness. The philosopher Ernst Nagel (1957, p. 15) defined development in a way that links it to both benign and pathological outcomes: . . . The concept of development involves two essential components: the notion of a system possessing a definite structure and a definite set of pre-existing capacities; and the notion of a sequential set of changes in the system, yielding relatively permanent but novel increments not only in its structure but in its modes of operation. . . . As summarized by Leon Eisenberg (1977, p. 220), "the process of development is the crucial link between genetic determinants and environmental variables, between individual psychology and sociology." It is characteristic of such systems that they consist of feedback and feedforward loops of varying complexity. Organism and environment are mutually constraining, however, with the result that developmental pathways show relatively high levels of canalization (Angoff, 1988; Cairns, Gariépy, & Hood, 1990; Gottlieb & Willoughby, 2006; Greenough, 1991; McGue, 1989; Plomin, DeFries, & Loehlin, 1977; Scarr & McCartney, 1983). Like individual ‘‘normal’’ development, diseases have inherent developmental processes of their own—processes that obey certain laws and follow certain stages even as they destroy the individual in whom they develop (Hay & Angold, 1993). A developmental approach to disease asks what happens when developmental processes embodied in pathogenesis collide with the process of ‘‘normal’’ human development. The progression seen in chronic diseases (among which we categorize most psychiatric disorders) has much in common with this view of development. It is "structured" by the nature of the transformation of the organism that begins the process, and in general, it follows a reasonably regular course, although with wide variations in rate.

Keywords:   Confounding, Dose–response relationship, Fetal origins hypothesis, Great Smoky Mountains study, Mediation analysis, Quasi-experimental design

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