When a socioeconomic or sociocultural subgroup becomes progressively underrepresented, the results of the study are no longer generalizable to those subgroups. Similarly, the most at-risk families may be the ones most easily lost to the study, which will compromise the usefulness of the study for these populations.
1.3. To what extent is a dialog or coming together possible between developmental psychology and psychoanalysis? Between the observable and the repressed
Psychoanalysis and developmental psychology have been the two main avenues for approaching the mental functioning of children.
Psychoanalysis operates by reconstructing clinical data obtained during the treatment of children or adults. Developmental psychology seeks to highlight individual differences through observation or comparisons of groups of children, or by studying their developmental trajectories. The psychoanalytical approach to children, which is often therapeutic, focuses on a small number of cases, while the second approach is more experimental and based on statistics.
Are the two approaches completely irreconcilable, or is a coming together, a dialog, possible?
Some psychoanalysts do not think this dialog is possible, such as André Green, who spoke of the “true child” of psychoanalysis deduced from reconstructions and the “real child” of observation, where it was not possible to reach what was repressed. Nevertheless, other authors, such as Pierre Fédida, desire a “unified science” of development, where the results obtained by either of the approaches can be enlightened by the other.
Attachment is one of the most successful examples of the dialog between psychoanalysis and developmental psychology. This theme has brought together approaches as diverse as Bowlby‘s theory of attachment (presented later in this book), Lacan’s family complexes, Bion’s maternal alpha function, Winnicott’s good enough mother, Brazelton’s competence of the baby in communicating with its environment from birth, Lebovici and Golse’s transgenerational mandate, Balint’s primary attunement and Stern’s interpersonal world of the infant.
Between Bowlby’s theory of attachment and Melanie Klein’s objectal relations theory, a coming together is possible and was developed by Didier Anzieu with his “pulsion d’attachement” and “Moi-Peau” concepts.
1.4. Between psychology and epidemiology, developmental psychopathology
Unfortunately, due to lack of time and interest, psychoanalysts do not read articles on behavioral genetics and behavioral geneticists do not read articles on psychoanalysis, not even those about particular behaviors, alcoholism or delinquency. Yet these two bodies will influence generations of pediatricians, specialized journalists and therefore parents. Ideally, we need to take a step back, to look at the “big picture”, to consider what connects and what does not mutilate knowledge, as Edgar Morin says. We have evoked (Assailly, 2007) the idea of a “river thought”, that is, a thought capable of carrying all the alluvium that is brought to us by the currents of thought on the child.
This “river thought” is one of interaction: from the first cell division, each fact, each biological, psychological or sociological event defines us; some weigh very heavily, such as the early relationship with our mother; others, very little, such as a temporary family stress, but the approach must integrate all these elements
For example, what can epidemiology (the science that studies phenomena at the population level) contribute to psychology (the science that studies phenomena at the individual level), and vice versa? In fact, one needs the other: epidemiology needs the observations of psychology in order to understand, within the broad variability of human behavior, what does or does not emerge from pathology; to launch hypotheses on the relationships between the problems of children and the factors that explain these problems, to understand how what it calls “risk” or “protection” is constructed. Psychology needs epidemiology to ensure that what it has observed in a small selected sample of subjects can be found elsewhere, at another time.
These are complementary, rather than conflicting disciplines, each fulfilling its function at different times in the research process. Between these two disciplines, there is a space to create a median approach: developmental psychopathology, in other words, the developmental approach to psychopathological and maladaptive phenomena.
Although this approach is recent, it is already 40 years old and aims to integrate models from various fields (such as genetics, neuroscience, developmental psychology and systems theory) to inform research on the relevant processes of normal and atypical development. These developmental processes are reciprocal and transactional.
Major questions structure this approach.
1.4.1. The origins and trajectories of adaptation
We need to understand the steps and mechanisms that lead to the final state. There is an “arborescence” of paths or trajectories that start from birth and can then schematically intersect with a four-entry table of cases:
– continuity of positive factors leading to adaptation (fulfillment);
– continuity of negative factors leading to problems (chronicity);
– initially positive situation which then deteriorates (trouble);
– initially negative situation which then improves (resilience).
The same point of arrival can thus be reached by two different paths, two different developmental processes, which is expressed as the “equifinality” concept. For example, when two children become delinquent, it may be for completely different reasons and not for the same cause.
Conversely, two different futures (or associated futures, as in comorbidity) can have the same starting point, which we will express as the “multiple purposes” concept. Such mechanisms are not specific to child psychology; they can be seen at work in neurobiology, genetics, etc.
Risk factors are those variables that increase the likelihood of the onset, exacerbation or maintenance of a condition.
There are three types of protective factors, those internal or external resources that modify or mitigate the impact of risk factors: dispositional protective factors (temperament, social orientation, cognitive skills and coping skills); protective factors from the family environment (such as relationships and supervision) and protective factors from the extra-familial environment (such as social support).
Of course, these factors work in combination. Two powerful and classically observed protective factors are: having a good relationship with at least one adult caregiver and having good intellectual abilities.
Risk and protective factors operate either in an “additive” (simple, direct effect of a risk factor) or an “interactive” (protective factors play only in interaction with risk factors: they come into play less when stress is low, much more when stress is high) model.
In an additive model, what is important is the notion of cumulative risk factors. It is often observed that it is the accumulation of several stresses rather than a single family stress that causes serious consequences. There is therefore a threshold effect beyond which the child’s resistance gives way.
In an interactive model, certain risk factors only come into play in the presence or absence of another risk factor, as do protective factors: for example, a child’s difficult temperament only produces harmful effects if it is combined with a mother’s rejection. Another example: poverty and exclusion have a more negative impact on native-born children than on immigrants, because the latter develop more solidarity strategies.
1.4.2. Mediation and moderation
These are effects of a characteristic of the family environment. In the case of mediation, two variables interact to affect