Research on child Psychopathology- Research designs, Ethical issues

Mental health professionals working with children and families are guided by ethical principles
and professional standards developed and monitored by their professional organizations.
Psychologists’ scientific, educational, and professional activities are guided by an ethics code
(Ethical Principles of Psychologists and Code of Conduct) developed by the American
Psychological Association. The most recent amended revision of the ethics code (American
Psychological Association, 2010) includes a set of general guiding principles, as well as specific
standards to be enforced across a wide variety of psychological. Psychiatrists continually make
judgments about what is appropriate material to include in the psychiatric report, the medical
record, the case report, and other written communications about a patient. Such judgments often
involve ethical issues.
The five general principles are considered to be aspirational goals. Although these general
principles are not considered enforceable rules, they provide the foundation for psychologists to
seek direction in making ethically based decisions.
The five general principles are as follows:
• Beneficence and nonmaleficence (do not harm)
• Fidelity and responsibility (maintain relationships of trust and ethical compliance)
• Integrity
• Justice (fairness, equality, minimization of bias, and recognition of boundaries of
professional competence)
• Respect for rights and dignity of other's roles (clinical, counseling, school psychology),
and
applied practices (research, education, test construction, and design, or administrative or
supervising capacities).

Ethical Dilemmas
Ethical principles become very important when practitioners are faced with ethical challenges,
such as ethical dilemmas. These principles can result in challenging decision-making choices
that can become even more complex when one of the clients is a child.

ETHICAL ISSUES IN ASSESSING, TREATING, AND CONDUCTING RESEARCH

WITH CHILDREN
One of the key clinical considerations in obtaining children’s consent for involvement in
assessment, treatment, or research is determining their level of competence in understanding the
nuances and nature of what they are agreeing to. However, although the concepts of competency
and informed consent overlap to a degree, one argument could be that competency is actually a
necessary pre-cursor to obtaining informed consent.
Ethical Considerations in Research
• Research programs involving children as subjects must adhere to stan- dards set by professional
organizations such as the American Psychological Association (2010), NASP (2010), and the
Society for Research in Child Development (2007).
• Another safeguard is a requirement that the research program be subject to an ethical review
board to ensure compliance with the American Psy- chological Association’s guidelines for
research with human subjects and to evaluate the benefits and any potential risks. If there is no
ethical review committee, NASP (2010) suggests the use of peer review (“preferably a school
psychologist”) of the research proposal and methodology.
• Children with physical vulnerabilities due to their diminutive size and cog- nitive limitations
may also have a limited ability to comprehend significant issues such as the full nature of their
participation or inherent appearance/ reality distinctions.
• Due to cognitive limitations, informed consent for participation is obtained from the parents of
children who are minors. However, even under these circumstances, the child’s assent, or consent
and willingness to participate, should be obtained by providing explanations of the process to the
child in language suited to the child’s developmental level.

The American Psychological Association’s ethical standards cover issues in 12 areas of practice,
including resolving ethical issues, competence, human relations, privacy and confidentiality,
advertising and public statements, record keeping and fees, education and training, research and
publications, assessment, and therapy.

Ethical Considerations in Practice

Since children rarely self-refer, therapists are most often asked to see a child at the request of an
adult (parent, teacher, guardian). Although parents or guardians are assumed to be acting in the
best interests of the child, many situations can place professionals in a position of a conflict of
interest.
● Issues of Confidentiality
In the vast majority of cases, parents or legal guardians of children under 18 years of age
(or the given age of majority in the practicing state or province) are responsible for
signing releases of information and/or obtaining or releasing reports pertaining to a
child’s medical or educational records. However, ethical issues can often result,
especially when working with parents and adolescents regarding the limits of
confidentiality. Clinicians working with adolescents or older children should always
define the limits of confidentiality at the onset of the therapeutic relationship. Limits of
confidentiality include ethical duties to report any indications of harm to self or others or
reports of abuse. However, the limits of confidentiality with respect to parent access to
the information discussed during therapy sessions may be far more difficult to address.
 Confidentiality does not outweigh the therapist’s mandated duty to report.
The majority of mental health practitioners are legislated by state law to report issues of
child abuse, neglect, or abandonment. Lack of reporting a sus- pected case of abuse can
often result in legal ramifications.

RESEARCH METHODS IN CHILD PSYCHOPATHOLOGY

Research in the field of child health psychology began with clinical case studies and
single-participant designs; investigators were primarily interested in describing specific
psychological phenomena or conditions in particular pediatric populations with chronic health
conditions or developmental disabilities. This research was pervasive throughout the 1970s.
Subsequently, as research in the field of child health psychology took on a more conceptual or
theoretical framework, correlational studies became the basis for a greater number of research
questions. Correlational studies dominated the field of child clinical health psychology up until
the mid-1990s. As correlational studies became more sophisticated, and more rigorous
theoretical frameworks were carefully tested, researchers also began to ask questions about
factors influencing the magnitude of the relationship between variables (Baron & Kenny, 1986;
Holmbeck et al., 1997, 2002).
“Moderating” processes are posited when conducting studies of risk, protective, and resilience
factors are conducted (Holmbeck, Zebracki, & McGoron, 2009), whereas a “mediator” variable
is conceptualized as the mechanism through which one variable influences another variable.

Quasi-experimental designs, observational research designs, single-participant designs, and

meta-analytic techniques predominated in the research literature throughout the 1990s, until the
field entered a tertiary phase of investigation or experimental designs. These randomized
controlled clinical trials actually served to test the various correlational models pervasive in the
extant literature throughout the 1980s and the early to mid-1990s; in other words, they served as
true experimental tests of the various theoretical tenets in the field that had been demonstrated
primarily by means of correlational research (Thompson & Gustafson, 1996).
The randomized controlled clinical trial is now considered the “gold standard” with regard to
research methodology in the field, and in testing the various theoretical models, it has provided a
compelling theoretical framework within the field. These randomized controlled clinical trials
have given rise to empirically based practice that has attained burgeoning support in recent years,
both within the field of child health psychology and in the broader field of clinical psychology
(Nelson & Steele, 2009).

Researchers are primarily concerned with seeking answers to nomothetic truths, regarding the
causes, nature, course, and treatment of childhood disorders.
Clinical child researchers seek scientific truths guided by the four objectives of the scientific
method: description, prediction, control (prevention), and understanding. Hypothesis testing can
take two broad forms:
1. An investigation of the relationship among a set of variables (e.g., age, gender, aggression,
leisure habits), known as correlational research
2. Attempts to demonstrate a cause-and-effect relationship between two or more variables (e.g.,
how leisure activities might influence aggressive tendencies)

The Experimental Method

In conducting a true experiment, the researcher puts his or her hypothesis(hunch) about behavior
to the test. The researcher manipulates the experimental situation by randomly assigning subjects
to one of two grouping conditions: a control group (which is not exposed to the variable in
question) and an experimental group (which is exposed to the variable).

Quasi-Experimental Design
In clinical studies, randomized placement is often difficult to achieve, and in some cases may not
be advised. One way to circumvent this problem is the use of a matched control group.

Research Methods
Infants and children—especially younger children—cannot be studied using the same research
methods used in studies with adults. Researchers, therefore, have developed many creative ways
to collect information about infant and child development. Some of the methods that have been
used by researchers who study infants and older children, separating them into three distinct
categories: involuntary or obligatory responses, voluntary responses, and psychophysiological
responses.

Involuntary or obligatory responses

One of the primary challenges in studying very young infants is that they have limited motor
control– they cannot hold their heads up for short amounts of time, much less grab an interesting
toy, play the piano, or turn a door knob. As a result, infants cannot actively engage with the
environment in the same way as older children and adults. For this reason, developmental
scientists have designed research methods that assess involuntary or obligatory responses. These
are behaviors in which people engage without much conscious thought or effort. When infants
hear the voice of their mother, for instance, their heart rate increases – whereas if they hear the
voice of a stranger, their heart rate decreases. Researchers study involuntary behaviors to better
understand what infants know about the world around them.

An infant lies on its back with its eyes fixed on a nearby object.
Even when infants are so young that they have very little motor control, researchers can observe
and record involuntary responses, such as an infant's eye movements, to get valuable insight into
what they understand about the world around them.
One research method that capitalizes on involuntary or obligatory responses is a procedure
known as habituation. In habituation studies, infants are presented with a stimulus such as a
photograph of a face over and over again until they become bored with it. When infants become
bored, they look away from the picture. If infants are then shown a new picture--such as a
photograph of a different face-- their interest returns and they look at the new picture. This is a
phenomenon known as dishabituation.

Voluntary responses
A woman inspects tomatoes as she puts them into a shopping bag.
Filling one’s basket at the supermarket is an example of voluntary response behavior. The
choices one makes are under our control.
As infants and children age, researchers are increasingly able to study their understanding of the
world through their voluntary responses. Voluntary responses are behaviors that a person
completes by choice.
Researchers study the voluntary responses of infants and young children in many ways. For
example, developmental scientists study recall memory in infants and young children by looking
at voluntary responses. Whereas older children and adults are simply asked to talk about their
past experiences, recall memory has to be studied in a different way in infants and very young
children who cannot discuss the past using language. To study memory in these subjects
researchers use a behavioral method known as elicited imitation (Lukowski & Milojevich, in
press).

Psychophysiology
Behavioral studies have taught us important information about what infants and children know
about the world. Research on behavior alone, however, cannot tell scientists how brain
development or biological changes impact (or are impacted by) behavior. For this reason,
researchers may also record psychophysiological data, such as measures of heart rate, hormone
levels, or brain activity. These measures may be recorded by themselves or in combination with
behavioral data to better understand the bidirectional relations between biology and behavior.

One manner of understanding associations between brain development and behavioral advances
is through the recording of event-related potentials, or ERPs. ERPs are recorded by fitting a
research participant with a stretchy cap that contains many small sensors or electrodes. These
electrodes record tiny electrical currents on the scalp of the participant in response to the
presentation of particular stimuli, such as a picture or a sound (for additional information on
recording ERPs from infants and children, see DeBoer, Scott, & Nelson, 2005). The recorded
responses are then amplified thousands of times using specialized equipment so that they look
like squiggly lines with peaks and valleys. Some of these brain responses have been linked to
psychological phenomena.
The use of ERPs has provided important insight as to how infants and children understand the
world around them.

Parent-report questionnaires

Parents spend countless hours together with children observing their behavior. Developmental
psychologists sometimes use surveys to collect information from parents that can be used to
answer important research questions.

Developmental science has come a long way in assessing various aspects of infant and child
development through behavior and psychophysiology – and new advances are happening every
day.

One commonly used parent-report questionnaire is the Child Behavior Checklist (CBCL;
Achenbach & Rescorla, 2000). Parents complete the preschooler version of this questionnaire by
answering questions about child strengths, behavior problems, and disabilities, among other
things. The responses provided by parents are used to identify whether the child has any
behavioral issues, such as sleep difficulties, aggressive behaviors, depression, or attention
deficit/hyperactivity problems.

Interview techniques
Whereas infants and very young children are unable to talk about their own thoughts and
behaviors, older children and adults are commonly asked to use language to discuss their
thoughts and knowledge about the world. In fact, these verbal report paradigms are among the
most widely used in psychological research. For instance, a researcher might present a child with
a vignette or short story describing a moral dilemma, and the child would be asked to give their
own thoughts and beliefs (Walrath, 2011).

Children can provide written or verbal answers to different types of scenarios. They can also
offer their perspectives on issues ranging from attitudes towards drug use to the experience of
fear while falling asleep to their memories of getting lost in public places – the possibilities are
endless. Verbal reports such as interviews and surveys allow children to describe their own
experiences of the world.

Research Design
Research methods are the tools that are used to collect information. But it is easy to confuse
research methods and research design. Research design is the strategy or blueprint for deciding
how to collect and analyze information. Research design dictates which methods are used and
how.

Researchers typically focus on two distinct types of comparisons when conducting research with
infants and children. The first kind of comparison examines change within individuals. As the
name suggests, this type of analysis measures the ways in which a specific person changes (or
remains the same) over time.

Longitudinal research designs

Longitudinal research designs are used to examine behavior in the same infants and children over
time.

Example of longitudinal research design

Longitudinal studies may be conducted over the short term (over a span of months, as in Wiebe,
Lukowski, & Bauer, 2010) or over much longer durations (years or decades, as in Lukowski et
al., 2010). For these reasons, longitudinal research designs are optimal for studying stability and
change over time. Longitudinal research also has limitations, however. For one, longitudinal
studies are expensive: they require that researchers maintain continued contact with participants
over time, and they necessitate that scientists have funding to conduct their work over extended
durations (from infancy to when participants were 19 years old in Lukowski et al., 2010). An
additional risk is attrition. Attrition occurs when participants fail to complete all portions of a
study. Participants may move, change their phone numbers, or simply become disinterested in
participating over time. Researchers should account for the possibility of attrition by enrolling a
larger sample into their study initially, as some participants will likely drop out over time.

(The results from longitudinal studies may also be impacted by repeated assessments. Consider
how well you would do on a math test if you were given the exact same exam every day for a
week. Your performance would likely improve over time not necessarily because you developed
better math abilities, but because you were continuously practicing the same math problems.
This phenomenon is known as a practice effect.)

Practice effects occur when participants become better at a task over time because they have
done it again and again; not due to natural psychological development. A final limitation of
longitudinal research is that the results may be impacted by cohort effects. Cohort effects occur
when the results of the study are affected by the particular point in historical time during which
participants are tested. Cohort effects can be problematic in longitudinal research because only
one group of participants are tested at one point in time – different findings might be expected if
participants of the same ages were tested at different points in historical time.

Cross-sectional designs
Cross-sectional research designs are used to examine behavior in participants of different ages
who are tested at the same point in time. When considering our example of hide-and-seek
behaviors in children, for example, a researcher might want to examine whether older children
more often hide in novel locations (those in which another child in the same game has never
hidden before) when compared to younger children.
In this case, the researcher might observe 2-, 4-, and 6-year-old children as they play the game
(the various age groups represent the “cross sections”). This research is cross-sectional in nature
because the researcher plans to examine the behavior of children of different ages within the
same study at the same time. Based on her data, the researcher might conclude that 2-year-olds
more commonly hide in previously-searched locations relative to 6-year-olds.

A chart shows an example of a cross-sectional design. The year is 2004 and three separate
cohorts are included in a study. Participants in Cohort "A" are two tears old. Participants in
Cohort "B" are six years old. Participants in Cohort "C" are eight years old.

Example of cross-sectional research design.

Cross-sectional designs are useful for many reasons. Because participants of different ages are
tested at the same point in time, data collection can proceed at a rapid pace. In addition, because
participants are only tested at one point in time, practice effects are not an issue – children do not
have the opportunity to become better at the task over time. Cross-sectional designs are also
more cost-effective than longitudinal research designs because there is no need to maintain
contact with and follow-up on participants over time.

One of the primary limitations of cross-sectional research, however, is that the results yield
information on age-related change, not development per se. That is, although the study described
above can show that 6-year-olds are more advanced in their hiding behavior than 2-year-olds, the
data used to come up with this conclusion were collected from different children. It could be, for
instance, that this specific sample of 6-year-olds just happened to be particularly clever at
hide-and-seek. As such, the researcher cannot conclude that 2-year-olds develop into better
hiders with age; she can only state that 6-year-olds, on average, are more sophisticated hiders
relative to children 4 years younger.
Sequential research designs
Sequential research designs include elements of both longitudinal and cross-sectional research
designs. Similar to longitudinal designs, sequential research features participants who are
followed over time; similar to cross-sectional designs, sequential work includes participants of
different ages. This research design is also distinct from those that have been discussed
previously in that children of different ages are enrolled into a study at various points in time to
examine age-related changes, development within the same individuals as they age, and account
for the possibility of cohort effects.

A chart of a sequential design: The study begins in 2002 with Cohort "A" who are two years old.
The study continues in 2004. Cohort "A" are now fours years old. They are joined in the study by
Cohort "B" who are two years old. The final year of the study is 2006. Cohort "A" is six years
old, Cohort "B" is four years old, and third cohort is added, Cohort "C" who are two years old.

Example of sequential research design

Studies with sequential designs are powerful because they allow for both longitudinal and
cross-sectional comparisons. This research design also allows for the examination of cohort
effects.

Because they include elements of longitudinal and cross-sectional designs, sequential research
has many of the same strengths and limitations as these other approaches. For example,
sequential work may require less time and effort than longitudinal research, but more time and
effort than cross-sectional research. Although practice effects may be an issue if participants are
asked to complete the same tasks or assessments over time, attrition may be less problematic
than what is commonly experienced in longitudinal research since participants may not have to
remain involved in the study for such a long period of time.

When considering the best research design to use in their research, scientists think about their
main research question and the best way to come up with an answer.

CONCLUSION

New scientific information relevant to the health and development of children is always of
interest to the general public. Parents of very young children are particularly eager for
authoritative guidance, and this insatiable thirst provides a highly receptive environment for both
responsible education and irresponsible manipulation. Within this context, research-based
knowledge can be both informative and useful, but the reality of childrearing is always more of
an art than a science.
Helping the public to understand the science of early childhood development is not an easy task.
This challenge can be facilitated by differentiating among established knowledge, reasonable
hypotheses, and unwarranted assertions.