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History =[edit | edit source]

Anna Freud, daughter of Sigmund Freud, was a leading early child psychologist. One of her most famous works is The role of bodily illness in the mental life of children.[1]

Mind/body Problem[edit | edit source]

The mind/body problem, simply put, examines how the mind and body interact.? Are they separate from each other or do they interact? Over the course of history, there have been many views as to how the two entities operated. In order to better understand the origins and views of pediatric psychology a firm grasp of this philosophical issue is of utmost importance.

The presence of trephination in pre-history cultures suggests that early humans may have viewed the mind and body as interrelated in some fashion.[2] The ancient Greeks were the next group to address the issue of the mind and the body. They attributed illness to an imbalance in the body. According to the four humours theory of illness, the fluids in the body (blood, black bile, yellow bile, and phlegm, were out of balance with each other and therefore caused an illness.[2] From the Greeks, the two major approaches to this problem were proposed: monism and dualism.

Monism[edit | edit source]

Monism was Aristotle's reaction to Plato's dualism. Aristotle did not believe in the pure forms, ideas that exist in a person's mind, untainted by the physical world, which had heavily influenced Plato. As a result Aristotle believed that the body and the soul (mind) were the same.[3] Aristotle often described the soul is the same as the person's physical body. There is no separation between the essentially the individual's nature as a human . While Aristotle did believe that the mind and body were one entity he noted that the intellect was different in that it must be able to identify all forms of an object (e.g., identify that both a soccer ball and basketball are a form of the object ball). With this idea in hand it becomes apparent that the mind was considered to be in control of the body. For a long time this belief that the body was a puppet and the mind its master was considered to be true.[3] However, with a new era of intellectual fervor dualism would soon become the accepted theory.

Dualism[edit | edit source]

Dualism originated with Plato and his view on metaphysics. He believed that the intellect (e.g., the mind) was ephemeral and strove to leave the physical body.[4] The main idea behind dualism is that the mind and the body are completely separate entities.[3]

With the dawning of the Renaissance and the great strides in science and philosophy many new scholars addressed this problem, the most prolific being Rene Descartes. While his views were dualistic in nature, he deviated from the normal path by expressing that there was a mutual interaction between the two, and the body had a greater influence on the mind.[3] This declaration would have been seen as extremely radical in Descartes's time.

Biopsychosocial Model & Health Psychology[edit | edit source]

In the past, most physicians followed the biomedical model which posited that all illness can be explained by improper functioning of the biological systems. By 1977, With the large leaps in medical science forced and changing views of health and illness ddoctors and psychologists to begin, alike, began to questioning their old methods of treating patients.[2] This new method of thought is the biopsychosocial model and it was heavily influenced by two main issues: the specificity problem and the base rate problem.[2]

Specificity Problem[edit | edit source]

This problem address the fact one environmental stressor is often associated with many different disorders .[2] An example of this would be work stress. Being stressed out at work can lead to hypertension; however, it can also lead to coronary heart disease. It is nearly impossible to tell which path will be taken as a result of the stress, and it could result in both.[2]

Base Rate Problem[edit | edit source]

This problem states that it is very hard to predict whether the presence of a stressor will lead to the development of a disorder. The reason behind this is that experiencing the environmental stressor may lead to developing the disorder. However, diagnosing a patient on this alone would result in an absurd amount of false positives.[2] An example of this would be smoking and cancer. If doctors were to diagnose everyone who ever smoked a cigarette or a cigar with cancer it would quickly become apparent that it is an ineffective diagnostic criterion because many individuals would not develop lung cancer.

Holistic Method[edit | edit source]

The main premise of the biopsychosocial model is that you cannot separate the biological factors from the environmental factors when addressing an illness; you must view a person as part of a whole, or a system.[2] The system theory is one of the best methods in which to observe this holistic model. The systems theory states that an individual exists within a hierarchy of subsystems (e.g. cells, person, family, society, etc.), and all of these subsystems interact.[2] For example, if one were to lose a family member the individual may feel stressed which in turn may weaken his immune system and cause him or her to catch a cold. While the cold is considered biological in nature (i.e. a bacterium or a virus), it was aided by outside factors. This is a great example of how the biopsychosocial model approaches medical conditions. In order to effectively assess an illness one must identify and treat all contributing factors as well as the actual biological factors. This need to address physical, mental, and social needs (among many others) lead to health psychology, and from this the field of pediatric psychology.

Origins[edit | edit source]

World War II gave way to a rise in the amount of psychologists that worked in medical schools. The pediatric population doctors worked with had a variety of problems in addition to their illnessDoctors had children as patients with a variety of problems (e.g., developmental, behavioral, academic). Patients needs, and their families, were not receiving adequate attention from psychology clinics at the time.[5]

To meet the needs of pediatric patients Jerome Kagan requested a "new marriage" between psychology and pediatrics, stressing early detection of psychopathology and psychosocial problems. Understanding prenatal- and perinatal factors relating to psychological problems was also emphasized.[5]

The term "pediatric psychology" was first used in 1967 by Logan Wright in the article "The Pediatric Psychologist: A Role Model," and was defined as "dealing primarily with children in a medical setting which is nonpsychiatric in nature".[6] Wright emphasized the importance of:

  • group identity for the pediatric psychology field (formal organization, distributing newsletter)
  • specifications for training future pediatric psychologists
  • body of knowledge accumulated by means of applied research [5]

Organizational developments[edit | edit source]

Pediatric psychologists established a group identity with the Society of Pediatric Psychology (SPP). SPP was initially an interest group in the Clinical Child Psychology division of the APA. As membership elevated, SPP was recognized by the APA as a group whose purpose was to "exchange information on clinical procedures and research, and to define training standards for the pediatric psychologist".[7] With this new-found recognition, division 54 of the APA was created. Some of the main goals of this organization are to promote the unique research and clinical contributions from pediatric psychology.[8]

The Journal of Pediatric Psychology was founded in 1976, and it has helped to further the professional recognition of the field. It allowed for clinicians, teachers, and researchers alike to exchange ideas and new discoveries.[5] It is a respected scholarly journal which aims to increase the knowledge regarding children who suffer from acute and chronic illness, and attempt to identify and resolve the contributing factors in order to yield optimal outcomes.[8]

History of pediatric psychology[edit | edit source]

The "official" history of pediatric psychology dates to 1968 when the Society of Pediatric Psychology was established within the American Psychological Association. However, its origins date back to the early 1900s and Lightner Witmer. Often considered the father of clinical psychology, Witmer spent a good deal of his time working in tandem with physicians to improve children's behaviors. Considering the roughly 70 years between Witmer and the formation of the SPP, this merging of medicine and psychology was a slow progression.[9]

In 1911, the APA conducted a survey of medical schools regarding their view of psychology within medicine. While responses were favorable to the benefit of psychology in the medical school setting, there was no action to implement such teachings. This action started following the Second World War, when there was an increase in federal funding for clinical psychology and the employment of psychologists in medical schools.[9] In fact, 80 percent of schools surveyed in 1951-1952 reported employing psychologists. However, it was thought that most were in psychiatric settings, not pediatric psychology positions [10] Specific to pediatric psychology, in 1930, Anderson presented to the American Medical Association that he thought pediatrics and child psychology should work together on mutually important issues, but there was apparently limited response. The 1960s saw a growing number of pediatricians fielding questions regarding parent training. As a result, in 1964, the then president of the American Pediatric Society, Julius Richmond, suggested that pediatricians hire clinical psychologists to work with behavioral problems in children.[9]

The field was advanced when Kagan [11] identified a number of areas the psychologist could be of help in the "new marriage" of pediatrics and psychology. He addressed psychologists' role in early identification of disorders and interventions. Much like a clinical-child psychologist, Kagan believed this role included a wide range of psychopathology. Wright,[6] however, had a different idea of what a pediatric psychologists job should address. Narrower in scope, he suggested pediatric psychologists take a more behavioral approach and deal with issues of parent training, child development, and short-term therapy.[12] With the public and professional momentum for pediatric psychology forged by Logan Wright, the APA formed a committee to determine whether a formal organization was needed. The committee, consisting of Logan Wright, Lee Salk, and Dorothea Ross, discovered a need would be filled, and at the annual APA convention in 1968, formed the "Society for Pediatric Psychology." [13] The following year, SPP was recognized as an affiliate of APA Division 12 (Clinical Psychology), Section 1 (Clinical Child Psychology) [1]. At the inaugural SPP meeting in 1969, Logan Wright was elected the first president.

Medical schools employing psychologists in pediatric settings were also on the rise. This increase in demand resulted in federal funding for the establishment of the National Institute of Child Health and Human Development in 1962. Four years later it helped fund the first pediatric psychology training program at the University of Iowa.[9]

Over the next decade, SPP would consider sectionhood with several divisions (12, 37, 38) before officially becoming Section 5 of Division 12 in 1980. ." [13] Here it would continue to grow until 2000 when it developed into Division 54 of the APA [2].

By 1984, SPP had a solid foundation with growing membership and journal recognition. While pediatric psychologists work under the science-practitioner model, the trend at this time saw more practitioners. Employed predominantly in medical settings, there was immediate need for clinical application of skills to work with severe behavior problems.[12] Kagan's vision of researcher in this setting would have to wait. Mesibov [12] noted pediatric psychologists worked frequently with developmental disorders in children. Specifically, children with "mental retardation, learning disabilities, cerebral palsy, autism, and related developmental problems.[12] When not working directly with children, pediatric psychologists role included had a few other components. The demand and importance of parent training for children with developmental problems made it the subject of the SPP programming at the APA convention for 1983. The collaboration with other professionals on site (e.g., speech and language therapists) provided education in outside domains and in working as a member of an interdisciplinary team. Furthermore, pediatric psychologists helped to create programs in the community addressing children's needs.[12]

In 1988, then SPP president Walker presented recent survey findings [14] to address current and future trends in the field regarding the areas of research, training, and clinical service. Psychologists surveyed were selected based on either serving on the Journal of Pediatric Psychology review board, or functioning as the director of a pediatric training program. Twenty-seven pediatric psychologists participated in the survey. The top three research trends ranked at the time included: chronic illness, prevention, and cost/benefit of interventions. Walker personally emphasized his concern with parenting practices with regard to prevention. In addressing children's emotional well-being, Walker stated prevention provides the best solution [15]

Clinical service trends ranked in order of importance for the future included: pediatric behavioral medicine, effective treatment protocols from common problems, and the role in medical setting. Walker attempted to assuage the contention surrounding the definition of pediatric psychologists role by teasing out the differences from clinical child psychology. Walker noted differences lie in conceptualization, intervention setting, and the intervention course of treatment, among others. While most pediatric psychologists were employed in medical schools and universities, Walker believed future trends would include more pediatric psychologists working as part of a multidisciplinary team in hospitals and health clinics.[15]

The final area of interest ranked training areas of importance for future pediatric psychologists. The top three included: brief treatment techniques, residency model, and biological and medical issues. At the time, pediatric psychology was considered a subspecialty within the field of clinical child psychology debating whether to branch out as its own field.[15]

In a brief article following his reception of the 1990 Distinguished Service Award from the SPP, Mesibov [16] reflected on three unique, or "special" characteristics he identified within the field of pediatric psychology. Specifically, he applauded the field's practical application to tackle difficult human needs, multidisciplinary approach, and character of pediatric psychologists he has worked with throughout his career.[16]

History of Journal and Newsletter[edit | edit source]

The development of SPP produced the need for formal communication among members in the field. Thanks to the work of Allan Barclay and Lee Salk, a newsletter was created.[17] The Pediatric Psychology Newsletter, distributed quarterly, was launched in 1969, with Gail Gardner acting as first editor. However, due to SPP's limited funds in the early years, publication ceased from 1970 to 1972. With the help of growing membership and generous contributions from early members, the newsletter was restarted and saw continued growth from 1972 to 1975. The quality and volume of submissions to the newsletter resulted in the transition to the Journal of Pediatric Psychology (JPP) in 1976. The newsletter per se would not emerge again until 1980, under the leadership of Michael Roberts.[13]

The JPP began steady publication in 1973 under the appointment of Diane Willis as editor. A Professor of Psychology at University at Oklahoma and psychologist at the OU Child Study Center, she served as editor from 1973 to 1975, helping create the peer review system in place today, expanding content published, and seeing it go from Newsletter to Journal.[17]

In 1976, Don Routh began serving as Editor with Gary Mesibov serving as Associate Editor. He would serve two terms. Although still under financial uncertainty, several important events occurred during this time. In 1976, Psychological Abstracts recognized the JPP. This also marked the beginning of international subscriptions requested. The following year, APA gave JPP status as a division journal.[13] The popularity of the Journal continued to grow. Common topics of the JPP included chronic pain and hyperactivity. The most important event, however, may be the successful contract negotiation with Plenum Publishing in 1979 [17] which helped alleviate the ongoing financial concerns of the organization.

The third Editor of JPP, Gerald Koocher, served from 1983 to 1987. Michael Roberts became Associate Editor. The growth of JPP was evident as approximately 100 articles were submitted annually for publication. As a result, the Journal became more selective in its acceptance, at a rate of 29 percent. Furthermore, partnership with Plenum Publishing was renegotiated, and the Editorial Board expanding membership. Chronic illness continued to be topic "de jour," but more applied research emerged.[17]

Michael Roberts served as Editor from 1988 to 1992. Associate Editors included Annette La Greca, Dennis Harper, and Jan Wallander. Under Roberts' leadership, JPP transitioned from a quarterly to bimonthly publication. While chronic pain remained the theme of most publications, more publications featured grant-funded research.[17]

Annette La Greca followed Roberts as Editor, serving from 1993 to 1997. Associate Editors across this span included Wallander, Dennis Drotar, Kathleen Lemanek, and later, Anne Kazak. The JPP continued its steady growth, and more papers were dedicated to special themes, explanatory and longitudinal in design, and nonintentional injuries. The submission rate grew and, as a result, only 16-18 percent submitted were published.[17]

Kazak took over as Editor from 1998 to 2002. Associate Editors included Lemanek, Christine Eiser, Antohony Spirito, Jack Finney, and Robert Thomposn. The JPP finished its contract with Plenum Publishing at this time and decided to sign a new contract with Oxford University Press. Her term also saw the journal increase to 8 issues a year and provide online access to its members.[17] Kazak was succeeded by Ron Brown, who served as Editor from 2003 to 2007. Drotar took taking over the editorial reins during 2008-2012 and Grayson Holmbeck served starting in 2013 [3].

See also[edit | edit source]

References[edit | edit source]

  1. Freud A. The role of bodily illness in the mental life of children. Psychoanalytic Study of the Child. 1952;7:69–81.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Taylor, S. (2012). Health psychology. (8 ed.). New York: McGraw-Hill Humanities/Social Sciences/Languages.
  3. 3.0 3.1 3.2 3.3 <Schultz, D. P., & Schultz, S. E. (2012). A history of modern psychology. (10 ed.). Belmont, CA: Wadsworth Pub Co.
  4. Robinson, H. (2003, August 19). Dualism. Retrieved from Stanford Encyclopedia of Philosophy
  5. 5.0 5.1 5.2 5.3 Aylward, B. S., Bender, J. A., Graves, M. M., & Roberts, M.C. (2009). Historical developments and trends in pediatric psychology. In M.C. Roberts & R.G. Steele (Eds.), Handbook of pediatric psychology (4th ed pp. 3-18). New York: Guilford Press.
  6. 6.0 6.1 (1967). The pediatric psychologist: A role model. American Psychologist 22 (4): 323–325.
  7. (1975). Pediatric psychology: A reflective approach. Pediatric Psychology 3.
  8. 8.0 8.1 (1999). Commentary: A view from the past and a look to the future. Journal of Pediatric Psychology 24 (5): 447–452.
  9. 9.0 9.1 9.2 9.3 (1975). The short history of pediatric psychology. Journal of Pediatric Psychology 4 (3): 6–8.
  10. (1953). Psychology in medical education. American Psychologist 8 (2): 83–85.
  11. (1965). The new marriage: Pediatrics and psychology. American Journal of Diseases in Children 110 (3): 272–278.
  12. 12.0 12.1 12.2 12.3 12.4 [[Gary B. Mesibov|]] (1984). Evolution of pediatric psychology: Historical roots to future trends. Journal of Pediatric Psychology 9 (1): 3–11.
  13. 13.0 13.1 13.2 13.3 (1991). A developmental history of the Society of Pediatric Psychology. Journal of Pediatric Psychology 16 (3): 267–271.
  14. (1989). Future directions in pediatric and clinical child psychology. Professional Psychology: Research and Practice 20 (3): 148–152.
  15. 15.0 15.1 15.2 (1988). The future of pediatric psychology. Journal of Pediatric Psychology 13 (4): 465–478.
  16. 16.0 16.1 (1991). What is special about pediatric psychology. Journal of Pediatric Psychology 16 (3): 267–271.
  17. 17.0 17.1 17.2 17.3 17.4 17.5 17.6 (2000). Journal of pediatric psychology: A brief history (1969–1999). Journal of Pediatric Psychology 25 (7): 463–470.
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