Clinical Assessment of Child and Adolescent Personality and ...

48 CHAPTER 3 CLASSIFICATION AND DEVELOPMENTAL PSYCHOPATHOLOGYit. In particular, the constructs of interest discussedin this chapter are the emotional andbehavioral functioning of youth. The first hintat the importance of this basic understandingof psychological constructs was made in theprevious chapter on psychometrics. It shouldhave become clear that good psychometricproperties are not absolutes. They dependon the nature and characteristics of the specificpsychological construct being assessed.For example, childhood depression is frequentlycharacterized by multiple episodes ofdepression interspersed with periods of normalmood (Kovacs, 2001). Therefore, highstability estimates over lengthy time periodsshould not be expected. In fact, if such stabilityoccurs, then one is measuring somethingthat is not an episodic depression.In addition to appropriately utilizing psychometrictheory, understanding the natureof the phenomenon to be assessed is crucialto almost every aspect of a clinical assessment,from designing the assessment batteryand selecting the tests, to interpreting theinformation, and communicating it to thechild and parent. For these reasons, scienceand clinical practice are inextricably linked.There are many areas of basic research thatenhance an assessor’s ability to conduct psychologicalevaluations, but we have selectedtwo that we feel are the most critical to theclinical assessment of children and adolescents.First, a thorough understanding ofthe theories that guide the different modelsof classification are necessary because theframework used to define and classify psychologicalfunctioning determines how onedesigns and interprets an assessment battery.Secondly, the clinical assessment of childrenmust be conducted in the broad context ofdevelopmental psychopathology.Developmental psychopathology refersto an integration of two scientific disciplines:child development and childpsychopathology. The integration restson the basic assumption that the mostappropriate way to view the emotionaland behavioral functioning of children,both normal and problematic, is within acomprehensive framework that includesthe influence of developmental processes(Rutter & Garmezy, 1983). A noteddevelopmental psychopathologist, JudyGarber, summarized her views on thisfield as being “concerned with both thenormal processes of change and adaptation,and the abnormal reactions to stressor adversity, as well as the relationshipbetween the two” (Garber, 1984, p. 30).Thus, developmental psychopathology isa framework for understanding children’semotions and behaviors that has manyimplications for the assessment process.It is beyond the scope of this book toprovide an intensive and exhaustive discussionof classification theories, or the manyimportant findings in the field of developmentalpsychopathology. Instead, thischapter illustrates the criticality of thesetwo knowledge areas to the assessment process,and also provides a basic frameworkfor applying this knowledge to the assessmentof children and adolescents. The discussionthat follows highlights some of theissues in both areas that we feel have themost relevance to the assessment process.ClassificationClassification refers to the process of placingpsychological phenomena into distinctcategories according to some specifiedset of rules. There are two levels of classification.One level of classification isthe method of determining when a psychologicalfunctioning is abnormal, deviant,and/or in need of treatment, whilethe second level of classification is themethod of distinguishing among the differentdimensions or types of psychologicalfunctioning. Thus, clinical assessmentis considered partly, as a process of classification.It involves (1) determining whethersome areas of psychological functioning