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Affect Regulation and the Development of Psychopathology.

Year: 2003
Type: article
Abstract: Dr. Susan Bradley is at her best in this landmark contribution to the sciences of developmental psychology, child psychiatry, and clinical psychopathology. The title of this book captures the thesis statement and its most important contribution is to offer a model that integrates biological and psychosocial approaches. In this case, tying up the genesis of affect regulation, its progression in the normal course of events, and how a deviant regulation of affect can be linked with psychopathology. This is a unique model. There exists several paradigms to explain affect dysregulation (e.g., attachment disturbance, neurobiological, stress reactivity etc.), however this is probably one of the rare works where the clinician is offered this pearl of knowledge and carefully unfolds psychopathology with one consistent thesis, well supported by sound review of scientific studies. The book is divided into four parts. The first part provides an excellent overview of the model. The author makes it clear that the “model places affect regulation in a central position in the development of psychopathology.” The second part, which is divided in six chapters, is the primer for understanding affect regulation. This part is essential reading to understand the model. The evidence for the support of the model is carefully developed and supported with literature reviews including recent publications. This core section explains how affect regulation occurs in infancy. It also describes the influence of genetic and constitutional factors, the care-giving environment, effects of stress and trauma, and how mastery is achieved in regulating affect. The most captivating chapter was on the neurobiology of affect regulation. The author did not leave any stone unturned. There is a thorough description from neuroanatomy to neurotransmitters linking how affect regulation can be understood on a neurobiological basis. Part three of this book is the clinician’s dream come true. Internalizing disorders, externalizing disorders and psychotic disorders are all explained with the same rigor. The links presented to affect regulation and these clinical disorders all make sense. For example, arousal modulation dysfunction is presented as the main feature in schizophrenia; stress reactivity is implicated in internalizing disorders. In externalizing disorders, a complex interaction of genetic and constitutional psychological and neurobiological factors is implied. Part four of this book describes future directions. There are approximately 650 references and a well-planned index. The author is fully cognizant of the changing nature of scientific evidence, especially in the neurobiological field. In several places she mentions the need to reformulate some of the ideas. This flexibility is not to be seen as a weakness of the model. On the contrary, these statements offer authenticity. The model (affect regulation) is the culmination of best scientific evidence at the time and seems to be flexible enough to modulate itself with new emerging scientific evidence. This book is useful for adult and child therapists alike. The pyschopathology is explained in developmental terms and applied to adult clinical syndromes as well. It should be read under guidance of senior clinicians for the young entrants in the study of psychopathology. The model has a philosophy that is different from other theories and models to which an average student of psychology or psychiatry will be exposed in an undergraduate training program. This philosophy needs to be incorporated in clinical teaching by indepth examination, and thorough understanding. For senior clinicians, it offers an opportunity to understand their clients/patients in a way that will lead to the use of evidence based, and cost effective interventions. This book has the potential of becoming a classic reference source and is a must in the postgraduate level of teaching in developmental psychology or psychiatry. I did find Dr. Bradley’s first person narration of many parts the book perplexing. This stylistic approach brings the author very close to the reader, however, one wonders if sometimes extremely high quality of scientific evidence gets buffed with this unexpected familiarity. My overall ranking, you guessed it, is 10 out of 10.
Author: Prat Reebye
Language: English
Field: Psychology
Open Access status: green
OpenAlex ID: W102623400
FWCI:
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Cited by: 3
Related to: 10