PsyDactic - Child and Adolescent Psychiatry Board Study Edition
Using the American Board of Psychiatry and Neurology content outline for the Child and Adolescent Psychiatry board exam, starting with the most high yield, Dr. O'Leary has created this podcast for anyone interested in CAPS and also to help him study for the boards. Enjoy!
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PsyDactic - Child and Adolescent Psychiatry Board Study Edition
008 - Temperament - Part 1 - Alexander Thomas and Stella Chess
While it may seem quaint today, the radical contribution that Alexander Thomas and Stella Chess made to child development was to look at children as unique individuals with very different innate approaches to the world that were present at birth. While processes like attachment and their psychosocial context help to determine a child’s outcome, what Thomas and Chess emphasized was a child’s temperament, their own style of thinking and of interacting with the world.
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Welcome to PsyDactic - CAPs board study edition. I am your host, Dr. O'Leary, a child and adolescent psychiatry fellow in the national capital region. This is a podcast I designed to help myself and other CAPs fellows study for their boards. Anyone interested in human development and mental health will likely also get something out of it. For a run-down on how it is produced, please see Episode 001. I am using AI to assist me with the content creation. However, all the content in the podcast should be considered my opinion and no one else's. If you find errors in the content, I would love it if you could go to PsyDactic.Com and fill out a form there to let me know.
In the past few episodes, I discussed Piaget’s theory of cognitive development, Erik Erickson’s view of psychosocial development, various attachment theorists such as Bowlby, Ainsworth, Schaffer and Emerson. What set these researchers apart from their psychoanalytic forebearers was simple: They actually studied the things that they attempted to understand in order to try to understand them. To understand children, they actually watched them, studied them. This was something that the early psychoanalysts resisted, in part due to the fact that they thought their theories had already figured all the basic psychic processes out, and the only thing to do now was apply them to individuals. By actually watching children, the psychoanalytic rebels noticed that children appeared to go through different stages and had individual traits that could not be explained by the psychic determinism of the psychoanalysts. Children all seemed to differ along many continuous variables, and there was little evidence that the vast majority of human diversity could be explained by psychosexual conflicts, object relations or even mere attachment.
While it may seem quaint today, the radical contribution that Alexander Thomas and Stella Chess made to child development was to look at children as unique individuals with very different innate approaches to the world that were present at birth. While processes like attachment and their psychosocial context helped to determine a child’s outcome, what Thomas and Chess emphasized was a child’s temperament, their own style of thinking and of interacting with the world.
Temperament
Several theories have contributed to our understanding of child temperament. Here are some of the key ones:
The New York Longitudinal Study
The New York Longitudinal Study (NYLS), which included 141 children, was initiated in 1956 by Alexander Thomas and Stella Chess.
1. Identified Key Temperament Dimensions:
- Through detailed interviews with parents about their children's behavior, Thomas and Chess identified nine key dimensions of temperament: activity level, rhythmicity (regularity), approach/withdrawal, adaptability, intensity of reaction, threshold of responsiveness, quality of mood, distractibility, and attention2 span/persistence.3 These dimensions4 provided a framework for describing individual differences in children's behavioral styles.5
2. Introduced the Concept of "Goodness of Fit":
- The NYLS highlighted the importance of the "goodness of fit" between a child's temperament and their environment.6 They showed that children's adjustment depended not just on their temperament, but also on how well their temperament matched the demands and expectations of their caregivers and surroundings. This concept revolutionized how we think about child development, emphasizing the interplay between nature and nurture.7
3. Classified Temperament Types:
- Based on their observations, Thomas and Chess categorized children into three broad temperament types: easy, difficult, and slow-to-warm-up. While these categories are not absolute, they provided a useful way to understand common patterns in children's behavior and predict potential challenges.8
4. Highlighted the Stability of Temperament:
- The longitudinal nature of the NYLS allowed researchers to follow children over time.9 They found that temperament traits showed considerable stability from infancy to adolescence, suggesting that temperament is a relatively enduring aspect of individual differences. It is part of someone’s personality.
5. Influenced Subsequent Research:
- The NYLS sparked a surge of research on temperament, inspiring other researchers to investigate the biological basis of temperament, develop new measurement tools, and explore the long-term implications of temperament for personality development, social adjustment, and mental health.
6. Impact on Parenting and Education:
- The findings of the NYLS have had a significant impact on parenting practices and educational approaches.10 Parents and educators are now more aware of individual differences in temperament and the importance of creating environments that support children's unique needs and strengths.
In summary, the New York Longitudinal Study was a landmark investigation that laid the foundation for modern temperament theory.11 It provided a comprehensive framework for understanding individual differences in children's behavior, highlighted the importance of the "goodness of fit" between temperament and environment, and spurred decades of research on the development and implications of temperament.
Thomas and Chess Theory
- Theory: They proposed that temperament is a biologically based individual difference in behavioral style. They identified nine dimensions of temperament: activity level, regularity, initial reaction, adaptability, intensity, mood, distractibility, persistence, and sensory threshold.
- Activity Level: This refers to a child's overall level of energy and movement. Some children are constantly on the go, while others are more calm and subdued.
- Regularity: This refers to the predictability of a child's biological rhythms, such as sleep and eating patterns. Some children have very regular routines, while others are more irregular.
- Initial Reaction: This refers to a child's initial response to new situations or stimuli. Some children are cautious and hesitant, while others are more outgoing and eager to explore.
- Adaptability: This refers to a child's ability to adjust to changes in their environment or routines. Some children adapt easily to new situations, while others find it more difficult.
- Intensity: This refers to the strength of a child's emotional reactions. Some children have strong, intense reactions, while others have more mild reactions.
- Mood: This refers to a child's overall emotional tone. Some children are generally positive and cheerful, while others are more negative and irritable.
- Distractibility: This refers to a child's ability to focus on a task or activity. Some children are easily distracted, while others can focus for long periods of time.
- Persistence-Attention Span: This refers to a child's ability to maintain attention and effort on a task. Some children are persistent and focused, while others give up easily.
- Sensory Threshold: This refers to a child's sensitivity to sensory stimuli, such as sounds, sights, and touch. Some children are highly sensitive to sensory input, while others are less sensitive.
- Categorization: Based on these dimensions, they categorized children into three main temperament types:
- Easy: adaptable, positive mood, regular routines
- Difficult: intense reactions, irregular routines, negative mood
- Slow-to-warm-up: cautious, slow to adapt to change
Easy Temperament
- Adaptability (High): Transitions smoothly to new routines, like switching from playtime to dinner.1 Easily adjusts to new environments, like a new daycare.2
- Approach/Withdrawal (Approaches): Excited to meet new people and try new experiences, like going to the park or trying a new food.
- Intensity of reaction (Mild): Expresses emotions in a moderate way.3 Happy and upset feelings are present but not extreme.
- Mood (Positive): Generally cheerful and upbeat. Focuses on the positive aspects of situations.
- Rhythmicity (Regular): Has predictable sleep and eating schedules.4 Naptime and mealtimes are generally at the same time each day.
Difficult Temperament
- Adaptability (Slowly adaptable): Resists changes in routines, like a change in bedtime.5 May have tantrums or meltdowns when faced with new situations.
- Approach/Withdrawal (Withdraws): Shy or hesitant in new situations.6 May cry or cling to a caregiver when meeting new people.
- Intensity of reaction (Intense): Reacts strongly to emotions.7 May have loud tantrums when frustrated and express joy very exuberantly.
- Mood (Negative): May be fussy or irritable more often. Focuses on the negative aspects of situations.
- Rhythmicity (Irregular): Unpredictable sleep and eating patterns. May have trouble falling asleep at night and skip meals.
Slow-to-Warm-Up Temperament
- Adaptability (Slowly adaptable): Needs time to adjust to new situations. May observe quietly at first but gradually participate.
- Approach/Withdrawal (Withdraws at first): Initially shy or hesitant in new situations, but warms up with time and support.
- Intensity of reaction (Mild): Reactions are typically mild. May not express strong emotions, either positive or negative.
- Mood (Slightly negative): May seem somewhat reserved or serious. Takes time to show positive emotions in new situations.
- Rhythmicity (Varies): May have some routines and regularity, but can be thrown off by new situations.
Parenting Styles and Temperaments
Parenting styles can significantly influence a child's development, and the interaction between parenting style and temperament can further shape a child's personality and behavior. Here's a breakdown of three common parenting styles and how they might interact with different temperaments:
Authoritarian Parenting
- Characteristics: High demands, low responsiveness. Authoritarian parents set strict rules, expect obedience, and use punishment to enforce their rules.
- Impact on Development: Children raised by authoritarian parents may become obedient and respectful but may also experience low self-esteem, anxiety, and difficulty making decisions.
- Interaction with Temperament:
- Easy Temperament: A child with an easy temperament may adapt well to the structure and rules of an authoritarian parenting style.
- Difficult Temperament: A child with a difficult temperament may struggle with the rigid expectations of authoritarian parenting, leading to conflict and resentment.
- Slow-to-Warm-Up Temperament: A child with a slow-to-warm-up temperament may need more time and patience to adjust to the demands of authoritarian parenting.
Permissive Parenting
- Characteristics: Low demands, high responsiveness. Permissive parents are lenient, set few rules, and avoid punishment.
- Impact on Development: Children raised by permissive parents may lack self-discipline, have difficulty with impulse control, and struggle with authority figures.
- Interaction with Temperament:
- Easy Temperament: A child with an easy temperament may thrive in a permissive environment, as they are adaptable and self-regulating.
- Difficult Temperament: A child with a difficult temperament may become demanding and manipulative in a permissive environment, as they may not learn to self-regulate.
- Slow-to-Warm-Up Temperament: A child with a slow-to-warm-up temperament may benefit from the relaxed atmosphere of permissive parenting, as it allows them to adjust at their own pace.
Authoritative Parenting
- Characteristics: High demands, high responsiveness. Authoritative parents set clear expectations, enforce rules consistently, and are responsive to their children's needs and feelings.
- Impact on Development: Children raised by authoritative parents tend to be well-adjusted, confident, and responsible.
- Interaction with Temperament:
- Easy Temperament: A child with an easy temperament may thrive in an authoritative environment, as they are adaptable and responsive to guidance.
- Difficult Temperament: An authoritative parenting style can help a child with a difficult temperament learn self-regulation and develop positive coping skills.
- Slow-to-Warm-Up Temperament: An authoritative parenting style can provide a child with a slow-to-warm-up temperament with the structure and support they need to feel secure and confident.
It's important to note that these are general trends, and individual children may respond differently to different parenting styles. Additionally, parenting styles can change over time and may vary depending on the child's age and stage of development.