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Ontwikkelingsmodellen en persoonlijkheidspathologie

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Abstract

Ontwikkeling kan vanuit verschillende invalshoeken bestudeerd worden. Gergen (1977) onderscheidt in dit verband drie perspectieven: een dat de nadruk legt op stabiliteit van bepaalde eigenschappen van een persoon (bijv. intelligentie), een tweede dat de nadruk legt op de onvoorspelbaarheid van ontwikkelingsuitkomsten, en een derde dat het accent legt op het opsporen van geordende verandering. In dit hoofdstuk wordt dit laatste perspectief gehanteerd om de ontwikkeling van persoonlijkheidspathologie te benaderen. De afgelopen twee decennia is een macroparadigma naar voren gekomen waarmee een dergelijke invalshoek centraal wordt gesteld en bovendien het verband tussen normale en verstoorde ontwikkeling steeds benadrukt wordt. Dit paradigma wordt aangeduid met de term ontwikkelingspsychopathologie (‘developmental psychopathology’; zie bijvoorbeeld Sameroff, Lewis & Miller, 2000). Het is een interdisciplinaire invalshoek: ontwikkelingspsychologie, klinische (neuro)psychologie en psychiatrie werken samen. In paragraaf 3.2 bepreken wij de basisprincipes van deze benadering en geven de implicaties aan voor de bestudering van persoonlijkheidsstoornissen. In paragraaf 3.3 worden enkele algemene aspecten van persoonlijkheidsontwikkeling aan de orde gesteld. In paragraaf 3.4 besteden wij aandacht aan de klinische, persoonsgerichte benadering van persoonlijkheidsstoornissen en aan de variabele gerichte en dimensionale benadering (‘Big Five’). Longitudinaal empirisch onderzoek naar de ontwikkeling van specifieke persoonlijkheidsstoornissen is zeer schaars. In paragraaf 3.5 bespreken wij een dergelijke studie. Ten slotte komen wij in paragraaf 3.6 terug op de in paragraaf 3.2 besproken basisprincipes van de ontwikkelingspsychopathologie. In deze laatste paragraaf maken wij de balans op.

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Van Aken, M. A. G. (2006). Children’s personality. Development and consequences, Kind en Adolescent, 27 (4), 204-215. The article focuses on individual differences between children, as indicated by the concepts of temperament and personality. It is discussed that the personality of children is clearly visible from an early age, and shows moderate stability. It is also shown how personality, together with environmental factors, determine the child’s functioning through person-environment correlations as well as person-environment interactions. Several possible connections between personality and psychopathology in children are illustrated. To conclude, the implications of all the above for interventions with children are discussed.
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Dit artikel geeft een overzicht van de ontwikkelingen op het gebied van de diagnostiek van persoonlijkheidspathologie bij adolescenten, waarbij gepoogd wordt een brug te slaan tussen recente wetenschappelijke inzichten in de ontwikkeling van persoonlijkheid en van persoonlijkheidspathologie en de klinische praktijk. Persoonlijkheidspathologie wordt in een ontwikkelingspsychologisch perspectief geplaatst en de auteurs beschouwen tevens een aantal belangrijke theoretische modellen voor de diagnostiek van persoonlijkheidspathologie. Ten slotte worden er aanbevelingen gedaan voor verder onderzoek om de diagnostiek van persoonlijkheidspathologie te verbeteren.
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This review discusses conceptual issues in relating temperament to psychopathology, including the disputed relation of temperament to personality in children. A potential integrative framework is discussed that links trait and biological markers of temperament (reactive, incentive-response tendencies) with regulatory processes. This framework is utilized to highlight potential temperamental pathways to specific forms of psychopathology, noting that in some instances their relations may reflect a spectrum model (with psychopathology closely related as an extreme of a temperament-based trait), but in many instances it likely reflects a vulnerability-transaction set of processes. Conduct disorder involves at least two temperamental paths, one emanating from low fear response and one from either high incentive approach or high anger reactivity. Attention deficit hyperactivity disorder also involves at least two temperament pathways, one involving extremely low effortful control and the other likely involving strong approach. Anxiety disorders appear to result from the confluence of high negative emotionality and low effortful control. Hypotheses for future research are presented and limitations discussed.
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