Development of Child Psychopathology

The field of developmental psychopathology allows researchers the unique opportunity to probe issues pertaining to both developmental course and etiology of psychopathology. It also provides the opportunity to understand the complexities and establish boundaries for normative development. The role of emotion in childhood psychopathology has not been systematically investigated. Carolyn Zahn-Waxler is one of the leading developmentalists who stresses the role emotions play in childhood pathology, and she examines both the externalizing and the internalizing disorders through a common emotional framework. Zahn-Waxler's work on parental depression as a risk factor for childhood pathology has been central to formulations of fundamental questions regarding the role of emotion in childhood psychopathology as well as in the development of both observational and experimental methodology.

In this chapter, we will examine the implications of Zahn-Waxler's theoretical and empirical work for our understanding of the links between emotion and psychopathology. First, we will examine the framework she has utilized to investigate the role of emotions in various normative and nonnormative developmental phenomena. Second, we will examine how the concept of emotion dysregulation comes to play a central role in linking emotion processes to the development of pathology. We will try to show how the use of this concept of emotion dysregulation fails to live up to its promise of linking emotion and pathology in several ways. Third, we will offer several ways in which the use of concepts from the temperament domain can reduce our reliance on problematic explanatory constructs such as dysregulation. Finally, we will examine how studies on the mechanisms of transmission of parental psychopathology may have ignored some central questions about emotion-related processes.

Various researchers who study the role of emotions in psychopathology, either at the symptom or syndrome level, adopt a particular scheme in conceptualizing emotions (Clark, in press). These conceptualizations are not only central to the measures and assessments subsequently generated, but they also have

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implications for the questions formulated on the role of emotions in psychopathology. We will first introduce the theoretical components of Zahn-Waxler's emotion framework and then examine how they have been reflected in her empirical work with at-risk populations. We will draw heavily on some of the findings from her empirical work with at risk populations to illustrate several points on both the nature of her contribution to the field, and the questions it raises about our current understanding of emotion and psychopathology relations.

Emotion Scheme

In Cole and Zahn-Waxler (1994), we find that discrete emotion theory constitutes the core of the framework Zahn-Waxler has adopted in investigating emotions and their role in childhood pathology (Ekman, 1984; Izard, 1977; Tomkins, 1984). The following four discrete emotions take the center stage in this framework: anger, sadness, fear, and joy. Embedded in this framework are further distinctions within anger that are based on its contextual elicitors. Among these contextual elicitors are goal frustration, self-assertion, and rage, which refers to anger expression in the absence of clear elicitors or provocation. Similar distinctions within anger have been discussed by other researchers as well (Kagan, 1981; Tomkins, 1963).

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In contrast, there are no contextually based distinctions within the sadness and fear systems, although many other researchers have distinguished between fear of novelty and social fear/shyness (Campos, Barrett, Lamb, Goldsmith, & Sternberg, 1983; Goldsmith & Campos, 1982, 1990; Goldsmith & Rothbart, 1991; Kagan, 1981). Thus, in this form the scheme primarily adheres to formulations of the discrete emotion theorists.

In examining how this framework has come to play a role in Zahn-Waxler's empirical work, we find that some components of the model have weighed more heavily than others. For example, distinctions drawn within anger have figured consistently in her studies with at-risk populations. The value of these distinctions within anger become apparent as we examine how they have been operationalized and have helped differentiate later behavior problems. Four forms of anger expressions have been proposed as reflecting both rage and anger in contexts of goal frustration and self-assertion. For example, we find that interpersonal physical aggression and object struggles with peers have been viewed as tapping anger expression in response to goal frustration and/or self-assertion (Zahn-Waxler, lannotti, Cummings, & Denham, 1990). On the other hand, physical aggression toward an unfamiliar adult and undirected or out-of-control aggression are proposed to tap the third form of anger expression, namely rage (Zahn-Waxler, Cummings, McKnew, & Radke-Yarrow, 1984; Zahn-Waxler et al., 1990). Thus, we find that what is empirically retained are normative and non-normative expressions of anger. Out-of-control aggression and aggression toward an unfamiliar adult are viewed as examples of nonnormative expressions of anger. In fact, when the factor structure of these four distinct forms of aggression is examined, the distinction between normative and nonnormative expressions of anger empirically holds up (Zahn-Waxler et al., 1990). Furthermore, these nonnormative forms of anger expression were shown to be correlates (Zahn-Waxler et al., 1984, 1990) and predictors of externalizing problems 3–4 years later, above and beyond the maternal diagnosis (i.e., depression) and sex of the child (Zahn-Waxler et al., 1990).

In contrast, when we examine how other components of the model have figured in Zahn-Waxier's empirical work, we find that differences in sadness, fear, and joy have been examined as a function of risk status in only one study of children with bipolar parents (Zahn-Waxler et al., 1984). The findings from this small sample suggest, however, that there may be no significant differences in overall mean levels of joy, sadness, and fear expressions as a function of risk status. One fruitful endeavor that would further probe differences between sadness and fear would be to capitalize on distinctions within contextual elicitors of sadness and fear similar to those made for anger. For example, novelty- or object-based fear versus social fear toward mildly friendly though unfamiliar adults or peers have both been empirically shown to be independent dimensions in the general population (Campos et al., 1983; Goldsmith & Campos, 1990; Kagan, 1981; Kagan, Reznick, & Gibbons, 1989; Kochanska, 1991). There is also some speculation and some suggestive evidence that sadness is often a co-occurring response in situations typically associated with anger. Goldsmith (personal communication, 1993) has suggested that this may be a reflection of attributional biases in the development of a sense of self (e.g., low self-esteem), where some children exhibit sadness rather than anger when the integrity of the self is socially challenged.

These studies show that the application of this framework has proven useful in understanding emotion-based predictors of externalizing tendencies (Zahn-Waxler et al., 1990) with at-risk populations. It is also the case, as these findings illustrate, that the distinctions within anger are largely responsible for this improvement in prediction. Another central element of these studies is the concept of emotion dysregulation. Zahn-Waxler evokes this concept as an explanatory construct in linking emotion to psychopathology. However, its utility is questionable in further elucidating the relationship between emotion and risk for childhood pathology. Thus we will next examine in detail the different uses of this concept in an effort to show its limited utility.

Dysregulation Concept

The concept of emotion dysregulation has been evoked in research on developmental psychopathology by numerous researchers and also by those who study normative developmental processes (Calkins, 1994; Cole, Michel, & Teti, 1994). As Thompson (1994) has entitled his recent chapter, the concept of dysregulation continues to be a theme in search of a definition. The intuitive appeal of the term “dysregulation” is partly to blame for its frequent use. It has been evoked to discuss ineffective coping strategies as well as to explain deviations from the average or established norms for emotion-laden behavior in a variety of domains. Thus it has become a central construct in discussions regarding links between emotion and the development of psychopathology. This concept has also been evoked in several empirical and theoretical contexts in Zahn-Waxler's work. The two distinct uses of this concept by Zahn-Waxler are in many ways exhaustive of how many other researchers view and define emotion dysregulation.

According to Zahn-Waxler, context-inappropriate expressions of affective behavior can be viewed as emotion dysregulation. For instance, aggression toward an unfamiliar adult and out-of-control aggression are viewed as

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dysregulation in the anger system. The concept of dysregulation is also applied to con-text-inappropriate expressions of joy. Here, examples are drawn from the literature on disruptive behavior disorders where joy responses are observed, when empathic concern at another's distress or guilt at wrongdoing is called for (Cole & Zahn-Waxier, 1994). Thus, dysregulation in this use of the term applies to activation of a particular emotion in inappropriate situations.

Emotion dysregulation has also been used to refer to nonnormative patterns in the modulation of emotional responses with changing environmental demands. This latter use of the term is distinct from dysregulation as context-in-appropriate expressions of emotions in many ways. To illustrate these distinctions it is important to elaborate upon a paradigm that has been used to observe dynamic modulation in multiple emotional reactions. This paradigm has been frequently used in studies of children's affective responses to interadult anger, where the interest has been to extrapolate children's emotional reactions to marital conflict (Cummings, 1987; Cummings, Zahn-Waxler, & Radke-Yarrow, 1984; Cummings, Pellegrini, Notarius, & Cummings, 1989). Typically, children are exposed to a series of stressful and neutral background events, while the changes in their affective reactions are observed. Zahn-Waxler has utilized this paradigm to compare differences in emotional reactions of toddlers from bipolar and depressed families, and their peers from control families (Zahn-Waxler et al., 1984, 1990).

These designs are advantageous to quantifying multiple parameters in emotional reactions. For example, one approach may be to aggregate the frequency with which given discrete emotions are expressed without respect to the nature of the background events. A second approach is to select particular background situations in which to examine differences in the intensity or frequency of particular kinds of emotional responses. For example, aggression toward an unfamiliar adult is often observed in such selected circumstances. This latter kind of approach thus yields differences in the extent to which children express normative versus nonnormative anger expressions as a function of their risk status (Zahn-Waxler et al., 1984, 1990).

A third approach is to partition differences in emotional reactions as a function of the changes in the affective tone of background events. This kind of approach gives rise to indices where modulation in emotional responding in relation to changing situational demands can be examined. In fact, Zahn-Waxler et al. (1984) found that children from control families showed an increased tendency to express joy following shifts in background events from stressful to neutral situations. On the other hand, these same control children did not show any comparable decrease or increase in the level of anger, fear, or sadness expressions. In contrast, children with bipolar parents did not show any increased tendency to express joy in

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response to shifts from stressful to neutral background situations. They were, however, similar in their patterns of sadness, anger, and fear expressions, that is, there was no increase or decrease in mean levels of these negatively valenced emotions. Thus, dysregulation in this latter case refers to inadequate modulation in affective responses given changing contextual demands. In contrast, dysregulation in its former use, as context-inappro-priate expressions of a given discrete emotion, refers to overall mean level differences across a variety of situations.

The use of the term dysregulation, both as context-inappropriate expressions of discrete emotions and as an inability to modulate emotional reactions in response to changes in environmental demands, summarizes many developmentalists' views on what emotion regulation and dysregulation are. For example, Calkins (1994) defines regulations as “…processes and strategies which are used to manage arousal so that successful interpersonal functioning is possible” (p. 53). Similarly, Cole et al. (1994) define regulation as “an ongoing process of individual's emotion patterns in relation to moment-by-moment contextual demands” (p. 74). These definitions describe the function of regulation and suggest consequences for dysregulation. However, they fall short of elucidating what may go awry in the generation of the observed emotional response. For example, context-inappropriate expressions of anger, such as aggression toward an unfamiliar adult, refer to the occurrence of a discrete emotion in “unlikely” circumstances. Similarly, there may be multiple factors in a child's inadequate modulation of emotional responding with changing situational demands. For example, dysregulation may arise from failure to appraise changes in the affective tone of a number of situations in general, or it may be limited to a difficulty in appraising shifts only from stressful to neutral or positive affective backgrounds. It may also have very little to do with appraisals; rather, it may reflect individual differences in the propensity to express and experience positive affect. In all of these putative situations as well as in the definitions, the use of the term dysregulation fails to specify what it may be that gets dysregulated in the generation of an emotional response.

The objective here is not to underestimate the value of these findings with respect to our understanding of the ways in which emotional behavior is associated with risk status for later psychopathology. In fact, these dysregulation studies have important descriptive value in elucidating aspects of emotional behavior that seem to be associated with risk status. However, they have very limited explanatory power for our understanding of the ways in which emotion may be a factor in the development of behavior problems. To lend specificity to this point, let us take as an example the additional unique and predictive variance explained by nonnormative patterns in anger expressions after sex and parental psychopathology have been partialled out. This unique variance points to context-inappropriate forms of toddler anger expression as a predictor of externalizing problems. But such unique variance does not identify what parameters in the generation of such emotional responses are indicative of dysregulation. Thus, dysregulation fails to become distinct from the individual differences in the propensity to express these parameters of emotionality.

There are, however, multiple ways in which we can relate emotion to risk for childhood psychopathology without relying on the concept of dysregulation. We can gain both specificity and explanatory power if we adopt parameters that are used to characterize individual differences in emotionality. Individual differences in emotionality represent the primary topic of interest for temperament researchers. Despite the variability in the current conceptualizations of temperament, most agree that temperament refers to biologically based propensities in the expression of emotion and activity level (Campos et al., 1983; Goldsmith, Buss, Plomin, Rothbart, Thomas, Chess, Hinde, & McCall, 1987). Temperament researchers use a variety of parameters in characterizing individual differences in emotionality. Among the parameters used are the following: latency to, intensity of, and recovery to a neutral baseline state (Campos et al., 1983; Rothbart, 1989b). These parameters have also been adopted by researchers to focus on the processes of emotion regulation and provide a sound link among

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concepts in the emotion nomological network. The use of these parameters can help reduce our reliance on fuzzy concepts such as dysregulation, because they can elucidate which aspects of the observed variability in emotion expression are associated with risk status.

These parameters are often utilized in the item pool of temperament assessment instruments such as the Infant Behavior Questionnaire (IBQ), Toddler Behavior Assessment Questionnaire (TBAQ), and Children's Behavior Questionnaire (CBQ) (Campos et al., 1983; Goldsmith & Rothbart, 1991; Goldsmith, 1996; Rothbart, 1981, 1989a, 1989b; Rothbart & Ahadi, 1994; Rothbart, Ahadi, & Hershey, 1994). For example, recovery to a neutral baseline state is construed as a separate dimension of individual differences and forms a separate scale on Rothbart's IBQ and CBQ. Another important component of the item pool in temperament assessment instruments has to do with the variety of situations in which a given emotion is expressed. For example, a child's propensity for anger expression is sampled in situations that involve both goal frustration in nonsocial situations and self-assertive behaviors in more social situations. Temperament researchers often refer to situational consistency in emotional responding as reactivity within a given discrete emotion (Bates, 1989; Rothbart, 1989b). As already noted, research on childhood inhibition has also shown that forming further distinctions in situational consistency is a meaningful enterprise, where consistency or reactivity in fearful behavior from social to nonsocial or novel situations appears distinct. Situational consistency in a given discrete emotion may also have little to do with other parameters such as average peak intensity in expression. For example, children who frequently get angry in a variety of limited situations may not, on average, show higher intensity of anger expressions compared to those who tend to get angry in a significantly fewer number of contexts. Thus, parameters such as latency to, reactivity, recovery from, and intensity are partially nonredundant parameters along which one may examine individual differences in discrete emotionality (Goldsmith, personal communication; Losoya, Lemery, Bowden, & Goldsmith, 1992).

The argument here is that the use of these parameters may be sufficient in elucidating what may be normative and nonnormative (or “dysregulated”) in the generation of discrete emotions. Thus, specificity in measurement of emotional reactions along these parameters can describe and help disentangle what may go awry with the emotional responding of at-risk children. We would like to illustrate the consequences of unspecificity in measurement in attempting to explain the links between emotion and pathology. We will take as an example the association between the anger reactions of toddlers to unfamiliar adults during brief encounters and risk status (i.e., depressed mother). This association points to anger reactions in “unlikely” circumstances. We would like to suggest three possible but distinct underlying processes that may give rise to such reactions.

First, it may reflect high reactivity in the anger system. For example, the toddler may show activation in the anger system in a variety of situations both context inappropriate and appropriate. Second, it may reflect an alternative, although distinct, kind of reactivity in the anger system. For example, the toddler may not be particularly likely to express anger during object struggles and goal frustrative contexts; rather the child may show a tendency to express anger during brief encounters with unfamiliar adults, when the more likely response in the general population may be to show inhibition. Third, these observed mean

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differences in anger expressions during brief encounters with adults may not have much to do with individual differences in the anger system at all. Rather, these differences may reflect low reactivity in the fear system, especially in social situations, which hinders the more normative inhibitory response to novel situations. Alternatively, these differences may reflect low reactivity in the joy system, which is partially supported by the inadequate increases in joy expressions with the removal of stressful stimuli found with at-risk children. Clearly, this example elucidates the necessity of specificity of measurement when examining normative and nonnormative processes in the emotion systems. Specifically, both situational consistency of emotional reactions and parame-ters—such as latency to and recovery from—must be measured in order to disentangle what appears nonnormative or “dysregulated.”

This example also underscores the importance of certain unconventional data-analytic strategies in approaching links between emotion and pathology. Variable-centered approaches to understanding links between individual differences in emotion and risk for pathology—such as regression—are the first to present themselves to researchers. However, such regression-based approaches may be limited in their ability to empirically separate the three distinctions just drawn. Regression-based data-analytic approaches emphasize the relative standing of individuals on multiple variables taken one at a time. Thus, these approaches are most fruitful when there is a relatively “significant” or large degree of nonredundancy among variables that are to be evaluated for their unique contribution to the outcome variability. For example, maternal reports of temperament from instruments that contain largely independent scales, such as Goldsmith's TBAQ (Goldsmith, 1996), Rothbart's IBQ (Rothbart, 1981), andCBQ (Rothbart & Ahadi, 1994; Rothbart et al., 1994), are ideal for these variable-cen-tered approaches. These instruments capitalize on specific sets of situations in which proneness to a variety of emotional reactions is likely to be expressed rather than the overall impressions of the caregiver. Hence, proneness to angry arousal and fearful arousal scales are largely independent of each other and can be distinguished from a general distress proneness dimension.

However, such independence is often meaningless at the level of the individual. In other words, such independence points to the fact that for the items that comprise these instruments there are equal numbers of individuals who are likely to be high in both fearful and angry arousal, and those who are likely to be high in one and not the other. Such distinctions are crucial to our understanding of the links between emotion and pathology. Person-centered data-an-alytic techniques can overcome this shortcoming by empirically examining and forming clusters of individuals in the multidimensional space across a variety of emotional domains. Thus, each cluster is composed of individuals who are similar in their standing on various trait measures of emotionality. For example, children who are both prone to angry and fearful arousal and low in positive affectivity form a distinct cluster from those who are prone to both angry arousal and positive affectivity, but low in tearfulness. Thus, individuals who are at risk for psychopathology can be associated with particular emotion profiles. The rigorous use of such cluster-analytic techniques may be especially relevant to our understanding of the relations between emotional precursors and later diagnostic status, which is also categorical in nature.

We tried to emphasize two very important points in understanding emotion and pathology links without evoking a broad construct such as dysregulation.

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The first and foremost among these is the necessity of acquiring specificity in measurement of both the situational context and the emotional reactions. Parameters such as latency to, reactivity across situations, and recovery from or intensity should prove useful in distinguishing among emotional reactions. The second point was that we should consider more unconventional data-analytic techniques such as cluster analysis to render our findings and inferences both clearer and more relevant to understanding the totality of an individual's emotional profile. These techniques can also help bridge the gap between the categorical nature of clinical assessment and the continuous measures typically generated in research settings.

Thus, movement away from general, nonspecific concepts is necessary if we are to explain, rather than simply describe, differences that appear to be associated with risk status. The use of concepts from the emotion process—tem-perament—help lend validity and specificity to our theoretical discussions about links between emotion and pathology. Other issues of interest to temperament researchers may also serve to alert us to questions relevant to the relationship between emotion and psychopathology. We will touch upon two issues of interest to temperament researchers and try to elucidate ways in which these issues may help our discussion in linking emotion and pathology without reliance on fuzzy concepts such as dysregulation.