Editorial in Hungarian

Prof. Dr. Perczel-Forintos Dóra


Developmental psychopathology is a relatively new discipline which aims to synthetize theories
and empirical results of multiple disciplines focusing on development or psychopathology
(developmental psychology, psychopathology, neuroscience, genetics, personality psychology,
evolutionary psychopathology, etc.), in order to uncover mechanisms responsible for normative
development and its alterations (psychopathology). We aim to give an introduction into three
main themes of developmental psychopathology: models of evolutionary psychopathology,
mechanisms of the complex interplay of genetic and environmental factors contributing
normal and abnormal development, and the age-specifi c characteristics of mental disorders,
as well as their continuities and discontinuities across the lifespan. The perspective of
developmental psychopathology adds to our deeper understanding of the aetiology and
course of mental disorders, and their recognition and treatment.

Keywords: development, psychopathology, developmental psychopathology, life-span

Developmental psychopathology perspective of Social Anxiety Disorder

Flóra Strell-Zimonyi, Anna Kovács  & Mónika Miklósi


This review aims to present social anxiety disorder from a developmental psychopathological
perspective. Evolutionary theories share the view that social anxiety might be adaptive in
specifi c contexts, and suggest several mechanisms of dysfunction (adaptive trade-off , mismatch,
individual diff erences). The aetiology of social anxiety disorder is characterized by a complex
interplay of genetic and environmental factors including gene-environment interactions,
correlations and epigenetic mechanisms. Although the main diagnostic criteria of social
anxiety disorder are the same throughout the lifespan, developmental characteristics alter its
presentation. In children, behavioural symptoms are common. We can view refusal of speech as
a specifi c manifestation of avoidant behaviour related to young age. Therefore, some researchers
suggest that selective mutism is an age-specifi c subtype of the disorder. Even though the
majority of researchers agree that behavioural inhibition is an age-specifi c temperamental
risk factor of social anxiety disorder, it might also be viewed as an early, subclinical form of the
disorder. In adolescence, as part of the normal development, there is a temporary increase of
social anxiety. In this age group, however, there is also an increase in the prevalence of social
anxiety disorder. Adult-onset social anxiety disorder is rare. In adults, social anxiety disorder has
to be diff erentiated from avoidant personality disorder. Social anxiety disorder is characterized
by strong homotypic continuity, but evidence for a heterotypic continuity is also available,
especially with other anxiety disorders and major depression, probably due to shared genetic
factors. The developmental psychopathological approach of social anxiety – developmental
paths, age-specifi c characteristics, etc. – may contribute to an early recognition of the disorder
and facilitate more eff ective therapeutic interventions.

Keywords: social anxiety, social anxiety disorder, social phobia, development, psychopathology

Borderline personality disorder in the light of developmental psychopathology

Judit Mezei , Anita Juhász , Tünde Kilencz & Gabriella Vizin


incidence of borderline personality disorder (BPD) in psychiatric care has shown growing
tendencies. Despite its frequency, it is an underdiagnosed disease. Profound knowledge of
etiological factors of BPD is essential for the proper diagnosis and treatment.
The present study aims to provide a developmental psychopathological analysis of borderline
personality disorder, which includes a thorough review of genetic and environmental etiological
factors, an introduction to the functionalist approach of evolutionary perspective, and an
overview of age specifi c characteristics of borderline symptoms.
Recent research suggests that in addition to neurobiological and psychosocial factors, genetic
vulnerability may be responsible for the development of BPD. Psychosocial background includes
childhood trauma, maternal mental illness, maladaptive parenting styles and dysfunctional
parent-child relationship, all of which are recognized as contributing factors to the development
of insecure or disorganized attachment styles in the infant. Regarding the neurobiological
background, changes in the hypothalamic-pituitary-adrenal axis, neurotransmission, endogenous
opioid system, and neuroplasticity play a prominent role, the development of which is also
aff ected by childhood traumatic events. Brain imaging studies reveal diff erences in the limbic
system (hippocampus, amygdala) and frontal cortex, which are also involved in stress response,
cognition, memory function, and emotion regulation. Early developmental processes may also
play an important role in the development of the disorder, as depression during pregnancy or
increased stress aff ects the quality of maternal care and may also aff ect gene expression through
epigenetic mechanisms. With respect to the gene-environment interaction, the interaction of
the child’s impulsive traits and the invalidating family environment can be highlighted, which
can lead to disruption of emotion regulation. The persistence of BPD symptoms is supported by
the evolutionary approach concerning several aspects. Fear of abandonment can be explained
by the anticipation of exclusion and maladaptive attempts to avoid it.
Developmental psychopathological analysis contributes to the development of eff ective
prevention and intervention tools through a better understanding of the background of borderline
personality disorder. In terms of prognosis, as a result of eff ective treatments, symptoms can be
reduced, so improvement can be achieved in a large proportion of patients.

Keywords: borderline personality disorder, developmental psychopathology, genetics, evolution,


This review aims to give an insight into the developmental psychopathology perspective
of attention-defi cit/hyperactivity disorder (ADHD). According to evolutionary theories,
phenotypes associated with ADHD might have been adaptive in the past but became
dysfunctional in modern life (mismatch theory). Genome-wide association studies have
supported this theory. Multiple developmental pathways lead to ADHD (equifi nality), and risk
factors associated with ADHD may lead to diff erent outcomes (multifi nality). Heritability of
ADHD is high; however, its aetiology is heterogeneous and multifactorial, including genetic
factors, gene-environment interactions and correlations, as well as epigenetic mechanism. Core
symptoms of ADHD – inattention, hyperactivity, and impulsivity – are the same throughout
the lifespan, but their presentation, as well as the comorbid profi le, show typical age-specifi c
diff erences. ADHD is characterized by strong homotypic continuity, ADHD in children persists
in a large proportion into adolescence and adulthood – underlying the importance of lifespan
perspective. Heterotypic continuity of ADHD has been described with externalizing and
internalizing disorders; research on the diff erent developmental pathways contribute to the
recognition and prevention of maladaptive outcomes.

Keywords: attention defi cit/hyperactivity disorder, ADHD, development, psychopathology

Bipolar aff ective disorder – Perspectives on Developmental Psychopathology

Judit Bencsik, Anna Mária Lisincki , Dóra Vajda , Márta Virág & Gabrella Vizin 


The prevalence of bipolar aff ective disorder is 3% in the general population, with a fi rst
occurrence around the age of 20-30. The fi rst symptoms are usually rather mild, thus it
is diffi cult to reach a decision about the diagnosis within the fi rst years. In the past years
bipolar aff ective disorder received increased attention because of the relatively high lifetime
prevalence. Nowadays experts in the fi eld try to reach a consensus in understanding the earlier
phases of the syndrome, as earlier therapeutic interventions tend to have a better result.
General developmental psychopathological factors, and gene-environment interactions or
evolutionary theories can greatly contribute to early recognition and understanding of the
The main aim of our article is to explore the possible developmental psychopathological
background of bipolar aff ective disorder through overview of the literature on general
developmental psychopathology factors, gene-environment interaction, and the evolutionary
approach, which can contribute to more effective methods of treatment.

Keywords: Bipolar affective disorder, developmental psychopathology, gene-environment
interaction, evolutionary theory

Developmental psychopathological characteristics of obsessive-compulsive disorder

Adrienne Kertész , Márton Kiss-Leizer, István Szalma , Gabriella Vizin


According to the currently available research data obsessive–compulsive disorder (OCD)
is a disorder of multifactorial etiology, the causes of which include biological, genetic and
environmental-social factors alike. Based on an etiology of that kind, it is justifi able to conduct
a developmental psychopathological review of OCD, which may lead, through an exploration
of the diff erent factors involved, to a deeper understanding of the disorder’s overall nature and
specifi c characteristics, as well as to the development of the most effi cient therapies possible.
The main objective of the present comprehensive study is the developmental psychopathological
analysis of the OCD, including the review of the evolutionary approaches and genetic and
environmental factors, as well as an exploration of OCD’s age-specifi c forms of manifestation,
based on the recent research results and analyses available in the professional literature.
According to our present knowledge, the genetic linkage of early-onset OCD is greater than
that of the late-onset variant, as the onset of the syndrome can be attributed to genetic factors
to the extent of 40-60%, coupled with the contribution of environmental factors like perinatal
disorders, reproductive cycle, childhood infections, familial circumstances, age of the parents
and traumatic life events.
Evolutionary theories address OCD from a functional perspective. They strive to attribute it
primarily to individual or group selection theories that a quite heterogeneous OCD syndrome,
which is therapeutically diffi cult to change, remains to present itself with close to identical,
invariably high prevalence in all cultures despite the diffi culties. Obsessive-compulsive disorder
is present in all ages, and it is often diffi cult to determine whether we are faced with a healthy
or a pathological behavior, as certain obsessive phenomena may appear as part of normal
development. The analysis of OCD’s etiology, a better understanding of the respective function
of specifi c symptoms, a thorough exploration of age-specifi c variants of the disorder, i.e. a
developmental psychopathological analysis of OCD, is of key importance from diagnostic,
therapeutic and vocational rehabilitation aspects alike.

Keywords: obsessive-compulsive disorder, individual selection, group selection, ritual behavior,
OCD paradox, genetic factors, environmental-social factors