Integrative literature review

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The headings listed below must be used to delineate the sections of content. These sections include the following: a clear introduction that provides a general review and organizes the research in a meaningful way; a discussion in which the evidence is presented through analysis, critique, and synthesis; and a conclusion in which the discussion is drawn together in a meaningful way, the claims of the introduction are brought to a logical closure, and new research is proposed(1)Introduction:Provide a conceptual framework for the review.Describe how the review will be organized. The questions below may be used to guide this section.What are the guiding theories within the domains?How are the domains connected?Are there competing points of view across the domains?Why is the integration of these domains important?What is the history of these domains?What are the related theories or findings?Describe how the literature was identified, analyzed, and synthesized.How and why was the literature chosen?What is your claim or thesis statement?(2)Discussion:Provide the analysis, critique, and synthesis for the review?(3)Analysis:Examine the main ideas and relationships presented in the literature across the four domains?Integrate concepts from the four different content domains within the larger field of psychology?What claim(s) can be made in the introduction?What evidence supports the claim(s) made in the introduction?(4)Critique:Evaluate the reliability, validity, and generalizability of the chosen research findings.How well does the literature represent the issues across the four domains?Identify the strengths and the key contributions of the literature.What, if any, deficiencies exist within the literature?Have the authors omitted any key points and/or arguments?What, if any, inaccuracies have been identified in the literature?What evidence runs contrary to the claims proposed in the introduction, and how might these be reconciled with the claims presented?Explain how the APA’s Ethical Principles of Psychologists and Code of Conduct might influence the reliability and/or generalizability of the chosen findings.Did the ethical issues influence the outcomes of the research?Were ethical considerations different across the domains?(5)Synthesis:Integrate existing ideas with new ideas to create new knowledge and new perspectives?Describe the research that has previously been done across these domains, as well as any controversies or alternate opinions that currently exist?Relate the evidence presented to the major conclusions being made?Construct clear and concise arguments using evidence-based psychological concepts and theories to posit new relationships and perspectives on the topics within the domains?(6)Conclusion:Provide a conclusion and present potential future considerations?State your final conclusion(s)?Synthesize the findings described in the discussion into a succinct summary?What questions remain?What are the possible implications of your argument for existing theories and for everyday life?Are there novel theories and/or testable hypothesizes for future research?What do the overarching implications of the studies show?Where should the research go from this point to further the understanding of these domains and the greater study of psychology?

Psychopathology

Feist, G. J., Dostal, D., & Kwan, V. (2021). Psychopathology in world-class artistic and scientific creativity. Psychology of Aesthetics, Creativity, and the Arts. https://doi.org/10.1037/aca0000440.supp (Supplemental)

Comment by Figure E:

Gazzillo, F., Fimiani, R., De Luca, E., Dazzi, N., Curtis, J. T., & Bush, M. (2020). New developments in understanding morality: Between evolutionary psychology, developmental psychology, and control-mastery theory. Psychoanalytic Psychology, 37(1), 37.

Lee, S. A., & Jobe, M. C. (2022). Does fear mediate the neuroticism-psychopathology link for adults living through the COVID-19 pandemic? Clinical Medicine Insights: Psychiatry, 1–5. https://doi.org/10.1177/11795573211069912

Lantagne, A., & Furman, W. (2021). A dyadic perspective on psychopathology and young adult physical dating aggression. Psychology of Violence, 11(6), 569–579. https://doi.org/10.1037/vio0000386.supp (Supplemental)

Schreuder, M. J., Wigman, J. T. W., Groen, R. N., Wichers, M., & Hartman, C. A. (2021). On the transience or stability of subthreshold psychopathology. Scientific Reports, 11(1), 23306. https://doi.org/10.1038/s41598-021-02711-3

Hawkins-Elder, H., & Ward, T. (2021). Describing disorder: The importance and advancement of compositional explanations in psychopathology. Theory & Psychology, 31(6), 842–866. https://doi.org/10.1177/09593543211021157

Terry, C., & Lecci, L. (2021). Examining cognitive performance and psychopathology in individuals undergoing parental competency evaluations. Professional Psychology: Research and Practice. https://doi.org/10.1037/pro0000436

Developmental Psychology

Bauger, L., & Bongaardt, R. (2018). Structural developmental psychology and health promotion in the third age. Health Promotion International, 33(4), 686–694. https://doi.org/10.1093/heapro/daw104

Comment by Figure E:

Comas-Díaz, L. E., & Rivera, T. (2020). Liberation psychology: Theory, method, practice, and social justice (pp. xx-314). American Psychological Association.

Legare, C. H., Clegg, J. M., & Wen, N. J. (2018). Evolutionary developmental psychology: 2017 redux. Child Development, 89(6), 2282–2287. https://doi.org/10.1111/cdev.13018

Bland, A. M., & DeRobertis, E. M. (2020). Maslow’s unacknowledged contributions to developmental psychology. Journal of Humanistic Psychology, 60(6), 934–958. https://doi.org/10.1177/0022167817739732

Cochet, H., & Guidetti, M. (2018). Contribution of developmental psychology to the study of social interactions: Some factors in play, joint attention and joint action and implications for robotics. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.01992

Koops, W., & Kessel, F. (2017). Developmental psychology without positivistic pretentions: An introduction to the special issue on historical developmental psychology. European Journal of Developmental Psychology, 14(6), 629–646. https://doi.org/10.1080/17405629.2017.1382344

Kline, M. A., Shamsudheen, R., & Broesch, T. (2018). Variation is the universal: making cultural evolution work in developmental psychology. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 373(1743). https://doi.org/10.1098/rstb.2017.0059

Cognitive Psychology

Schmidt, H. G., & Mamede, S. (2020). How cognitive psychology changed the face of medical education research. Advances in Health Sciences Education, 25(5), 1025–1043. https://doi.org/10.1007/s10459-020-10011-0

Lloyd, M. E. (2020). Sometimes a demo is not just a demo: When demonstrating cognitive psychology means confronting assumptions. Scholarship of Teaching and Learning in Psychology. https://doi.org/10.1037/stl0000192

Comment by Figure E:

Huitt, W., & Hummel, J. (2003). Piaget’s theory of cognitive development. Educational Psychology Interactive. Valdosta, GA: Valdosta State University. Retrieved [date] from http://www.edpsycinteractive.org/topics/cognition/piaget.html

Yao, N., & Wang, L. (2020). Application of game activities in mental health education of kindergartens based on cognitive psychology. Revista Argentina de Clínica Psicológica, 29(2), 871–877.

Xie, D. (2020). Application of psychological preference and emotional guidance in the performance of film and television art: An analysis based on based on cognitive psychology. Revista Argentina de Clínica Psicológica, 29(2), 854–859.

Li, Y. (2020). Analysis on uncertainties in judicial decision based on cognitive psychology. Revista Argentina de Clínica Psicológica, 29(1), 1016–1021.

Corral, D., Healy, A. F., Rozbruch, E. V., & Jones, M. (2019). Building a testing-based training paradigm from cognitive psychology principles. Scholarship of Teaching and Learning in Psychology, 5(3), 189–208. https://doi.org/10.1037/stl0000146.supp (Supplemental)

Psychopharmacology

Lopez-Vergara, H. I., Zapolski, T. C. B., & Leventhal, A. M. (2021). Intersection of minority health, health disparities, and social determinants of health with psychopharmacology and substance use. Experimental and Clinical Psychopharmacology, 29(5), 427–428. https://doi.org/10.1037/pha0000522

Bilbul, M., Paparone, P., Kim, A. M., Mutalik, S., & Ernst, C. L. (2020). Psychopharmacology of COVID-19. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 61(5), 411–427. https://doi.org/10.1016/j.psym.2020.05.006

MARVASTI, J. A., & OLIVIER, C. C. (2020). Psychopharmacology for the Psycho-Historian: The Evils of “Big Pharma,” Lobbying, Corruption and Serious Side Effects of Medications. Journal of Psychohistory, 48(2), 100–115.

Caixeta, L., & Caixeta, V. M. (2019). Therapeutic synergism: How can psychopharmacology improve cognitive rehabilitation? Dementia & Neuropsychologia, 13(4), 422–426. https://doi.org/10.1590/1980-57642018dn13-040009

Brandl, E. J., Dietrich, N., Mell, N., Winkler, J. G., Gutwinski, S., Bretz, H. J., & Schouler-Ocak, M. (2020). Attitudes towards psychopharmacology and psychotherapy in psychiatric patients with and without migration background. BMC Psychiatry, 20(1), 176. https://doi.org/10.1186/s12888-020-02585-1

Potter, D. R., Stockdale, S., & O’Mallon, M. (2020). A Case Study Approach: Psychopharmacology for Atypical Antidepressants Snap Shot. International Journal of Caring Sciences, 13(1), 764–769.
Comment by Figure E:

Baldessarini, R. J. (2014). The Impact of Psychopharmacology on Contemporary Psychiatry. The Canadian Journal of Psychiatry, 59(8), 401–405. https://doi.org/10.1177/070674371405900801

Integrative Literature Review

Wayne Natoya

Capstone Psychology in Arts of Master :99PSY6

Tyler Tolanda Dr. Instructor:

Campus Global Arizona of University

Feb 14, 2022

Introduction

For this Integrative Literature Review, the four domains of psychology selected are very

important and for each domain six articles were thoroughly researched. The first domain selected

is psychopathology and this is because it is very significant when it comes to diagnosis of patients.

The second one is developmental psychology which is important in understanding the average

cognitive abilities in the individuals of different ages. The third domain is the cognitive

psychology, and this explains what causes differences in cognitive abilities in some individuals.

The last domain that was selected is the psychopharmacology where the use of different drugs to

act on psychological issues was investigated.

Psychopathology

Feist, G. J., Dostal, D., & Kwan, V. (2021). Psychopathology in world-class artistic and

scientific creativity. Psychology of Aesthetics, Creativity, and the Arts.

https://doi.org/10.1037/aca0000440.

This article is relevant to the domain because it talks about the importance of psychopathology

in creative achievement. Looking at the reliability of the research, it is reliable because it uses a

research methodology that is consistent in the production of the results; the research conducted an

in-depth analysis of some published biographies of creative artists and compared the biographies

-creative athletes and according to the research, the creative athletes have high levels of alcoholism

and mental health issues when compared to the creative artists.

Hawkins-Elder, H., & Ward, T. (2021). Describing disorder: The importance and advancement

of compositional explanations in psychopathology. Theory & Psychology, 31(6), 842–866.

https://doi.org/10.1177/09593543211021157

This article is credible, and peer reviewed, and this makes it ideal for the literature review of

the psychopathology domain. The results can be considered as valid because the methodology

which was selected was effective and consistent. The researchers observed all the APA ethical

principled during the research. Additionally, this article was selected because it explains about the

makeup of mental disorders. This contributes so much to the field of psychopathology in general

which aims at understanding the abnormal mental state of humans.

Lantagne, A., & Furman, W. (2021). A dyadic perspective on psychopathology and young

adult physical dating aggression. Psychology of Violence, 11(6), 569–579.

https://doi.org/10.1037/vio0000386.

The purpose of this research was to examine whether the psychopathology of the partners

during dating and an impact on dating aggression, looking and the individual psychopathology of

each partner and the combined psychopathology for all the partners. The findings from the research

showed that the externalizing and the internalizing symptoms of partners can be associated with

dating aggression. The findings from the research contribute to the psychopathology domain and

the findings are valid and statistically significant which means that they can be generalized to the

population of the romantic partners.

Lee, S. A., & Jobe, M. C. (2022). Does fear mediate the neuroticism-psychopathology link for

adults living through the COVID-19 pandemic? Clinical Medicine Insights: Psychiatry, 1–

5. https://doi.org/10.1177/11795573211069912

The research shows that the fear of death and the anxiety that is associated with the ongoing

covid-19 pandemic display the relationship that exists between the neuroticism and depression

symptoms. The results from the study are reliable because they are consistent with previous

research conclusions and findings. Also, the results shed light to the light to psychological

constructs that are useful to mental health professionals and other researchers on the topic. The

results from the study are valid and statistically significant and can be generalized to the larger

population.

Schreuder, M. J., Wigman, J. T. W., Groen, R. N., Wichers, M., & Hartman, C. A. (2021). On

the transience or stability of subthreshold psychopathology. Scientific Reports, 11(1),

23306. https://doi.org/10.1038/s41598-021-02711-3

The purpose of the research was to investigate how the stability of psychopathological

symptoms change according to the severity symptoms and the findings show that stability is the

same across different severity levels. The model for research that was used was generalized

additive models which is a valid model and the data analysis for the data collected was done using

a regression analysis. Regression analysis was a good choice because it is effective in showing the

relationship between different variables. The research is reliable and can be applied to the general

population.

Terry, C., & Lecci, L. (2021). Examining cognitive performance and psychopathology in

individuals undergoing parental competency evaluations. Professional Psychology:

Research and Practice. https://doi.org/10.1037/pro0000436

The research looks at a very important and valid topic in psychopathology and this is because

the competency of a parent is very important when it comes to the outcomes in their children and

even the rate of brain development in the children. The sample that was used in the research

includes mothers that had lower cognitive level and lower educational level. The research shows

that the cognitive functioning of parents plays a big role in the determination of whether they are

referred for parental competency evaluations which are done using a range of online tests and

evaluations.

Developmental psychology

Bauger, L., & Bongaardt, R. (2018). Structural developmental psychology and health

promotion in the third age. Health Promotion International, 33(4), 686–694.

https://doi.org/10.1093/heapro/daw104

The third age is an age group of people who are retiring, and the research describes them as

successfully ageing. The research shows the important of health promotions when it comes to this

age group. Some of the benefits include longevity of life and the people taking their health and

medical wellbeing seriously. The research participants included the people in their retirement age.

The research is reliable since the authors have the necessary credentials and authority to write

about developmental psychology.

Bland, A. M., & DeRobertis, E. M. (2020). Maslow’s unacknowledged contributions to

developmental psychology. Journal of Humanistic Psychology, 60(6), 934–958.

https://doi.org/10.1177/0022167817739732

Maslow talks about the hierarchy of needs in human beings highlighting some of the various

needs of humans. This research talks about some of the contributions that Maslow made to

developmental psychology that are not recognized and according to the research the dynamic

systems approach to healthy human development developed by Maslow was a preliminary for the

research that has been done on apparel constructs in developmental psychology. This research is

valid, and the methodology used produced consistent results. The findings of the research can be

used as a background for further research in developmental psychology.

Cochet, H., & Guidetti, M. (2018). Contribution of developmental psychology to the study of

social interactions: Some factors in play, joint attention and joint action and implications

for robotics. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.01992

Developmental psychology aims at looking at the development of human beings from birth in

a range of areas such as social, emotional and their cognitive abilities. According to the source,

there are various activities that accelerate the rate of development in children such as play which

helps a child development, social, language and communication skills but giving the child a chance

for them to interact well with the environment. The research is significant to the domain and

focuses on three dimensions which are motor precision, coordination, and anticipatory learning.

The research article is peer reviewed and scholarly which makes it reliable and a credible source.

Koops, W., & Kessel, F. (2017). Developmental psychology without positivistic pretentions:

An introduction to the special issue on historical developmental psychology. European

Journal of Developmental Psychology, 14(6), 629–646.

https://doi.org/10.1080/17405629.2017.1382344

This article looks at the significance of understanding children and their development as

cultural inventions. The article is peer reviewed and very reliable when it comes to the topic of

developmental psychology. Findings from the article show that critical thinking is needed to

understand developmental psychology. The methodology used in the research is valid since it is

consistent in measuring what it has been created for. The research is reliable, and the findings

can be applied to the general discipline of developmental psychology.

Kline, M. A., Shamsudheen, R., & Broesch, T. (2018). Variation is the universal: making

cultural evolution work in developmental psychology. Philosophical Transactions of the

Royal Society of London. Series B, Biological Sciences, 373(1743).

https://doi.org/10.1098/rstb.2017.0059

This article investigates how culture is a source of variations when it comes to

developmental psychology. According to the article the development of humans is shaped by

their ability to acquire information and their ability to interact with others. The article makes

various assumptions to understand the variations which result from the differences in the culture

and environment that one is brought up in. The article is relevant to the research because it talks

about an important factor in developmental psychology and can be used by researchers as a

background for their further research.

Legare, C. H., Clegg, J. M., & Wen, N. J. (2018). Evolutionary developmental psychology:

2017 redux. Child Development, 89(6), 2282–2287. https://doi.org/10.1111/cdev.13018

The research is significant to the domain as it talks about evolutionary developmental

psychology which states that extended childhood is very significant because it helps people acquire

the skills that are needed to deal with the complexities associated with human and social life.

Evolutionary developmental psychology is very significant and has shaped the direction of various

research that have been done on development and the psychological developmental stages of

humans. The results are valid and reliable, also, they can be generalized to the larger population

since the findings are consistent with observations made by various research.

Cognitive psychology

Corral, D., Healy, A. F., Rozbruch, E. V., & Jones, M. (2019). Building a testing-based

training paradigm from cognitive psychology principles. Scholarship of Teaching and

Learning in Psychology, 5(3), 189–208. https://doi.org/10.1037/stl0000146.

There are various cognitive psychology principles, and they can be used in developing a

training program; this article attempts to explain how. The authors of this research are credible

and there is much data and information on them and the contributions which they have made to

research. This research article is very accurate and gives sufficient details when it comes to

cognitive psychology and different principles in the domain. The article findings can be

generalized to an entire population, and this is because the findings are statistically significant

and valid.

Li, Y. (2020). Analysis on uncertainties in judicial decision based on cognitive psychology.

Revista Argentina de Clínica Psicológica, 29(1), 1016–1021.

The author of the research has published various articles on cognitive psychology and

psychology in general. The article looks at the uncertainties in judicial decisions regarding

cognitive psychology. The judicial decisions in most cases are made based on the cognitive

abilities to understand whether an accused person is in their right mental state as at when they

allegedly committed a crime. This research article is relevant to the domain of cognitive

psychology and because it contributes so much information that can be used as a basis or a

background when it comes to psychological research.

Lloyd, M. E. (2020). Sometimes a demo is not just a demo: When demonstrating cognitive

psychology means confronting assumptions. Scholarship of Teaching and Learning in

Psychology. https://doi.org/10.1037/stl0000192

When it comes to research, sometimes in psychology and other fields assumptions are made

as a guideline for research. This article demonstrates how in some cases the assumptions that are

made about a population could be wrong. The research is valid because the results obtained

correspond to the observations that are made in the real world. The methods and models used are

also reliable, the research is credible because it’s published by a known journal and the author has

the credentials and authority to talk about developmental psychology.

Schmidt, H. G., & Mamede, S. (2020). How cognitive psychology changed the face of

medical education research. Advances in Health Sciences Education, 25(5), 1025–1043.

https://doi.org/10.1007/s10459-020-10011-0

Cognitive psychology looks at the various mental processes in humans. The area of

developmental psychology has grown over the years with so many findings on the topic. The

research that has been conducted in developmental psychology contributes so much to medical

education research and this is because understanding patients and medical conditions require a

comprehensive cognitive level understanding of different patients. The research is valid and can

be generalized to explain cognitive psychology and its interaction with various fields in medicine.

Xie, D. (2020). Application of psychological preference and emotional guidance in the

performance of film and television art: An analysis based on based on cognitive

psychology. Revista Argentina de Clínica Psicológica, 29(2), 854–859.

Psychology and emotional abilities of individuals have significant impact on personal and

career lives and this article is significant because it shows the application of psychological abilities

and emotional capabilities in the film and television industry which is one of the biggest industries.

The research findings ca be generalized to TV stars and the different players in the film industry.

Cognitive performance and emotional capabilities are very important because they help improve

the productivity of individuals since any issues in cognition disrupt the normal day to day life of

individuals.

Yao, N., & Wang, L. (2020). Application of game activities in mental health education of

kindergartens based on cognitive psychology. Revista Argentina de Clínica Psicológica,

29(2), 871–877.

Mental health education is not only important to adults but also to children and young people.

This article investigates this issue by explaining how game activities can be used in the mental

health education programs in kindergartens. It demonstrates significance of teachers understanding

the cognitive abilities and development in children. The article is reliable and the research findings

for the research can be applied to psychology as a field. The article explains the way game activities

and play are significant in the assessment of children and can also be used in special education to

explain the cognitive abnormalities in children.

Psychopharmacology

Bilbul, M., Paparone, P., Kim, A. M., Mutalik, S., & Ernst, C. L. (2020). Psychopharmacology

of COVID-19. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 61(5),

411–427. https://doi.org/10.1016/j.psym.2020.05.006

The ongoing covid-19 pandemic came with a lot of psychological issues and according to this

article, some of the issues include psychological disorders from stress and anxiety that is associated

with the pandemic. The pandemic resulted into most people losing their employment and even

others having their relationships broken. The article looks at how understanding the underlying

issues can be used in the medication and the corrective interventions on the individuals that have

cognitive problems. The article offers great insights, validity and in-depth analysis of the pandemic

and the psychopharmacology related to the pandemic.

Brandl, E. J., Dietrich, N., Mell, N., Winkler, J. G., Gutwinski, S., Bretz, H. J., & Schouler-

Ocak, M. (2020). Attitudes towards psychopharmacology and psychotherapy in psychiatric

patients with and without migration background. BMC Psychiatry, 20(1), 176.

https://doi.org/10.1186/s12888-020-02585-1

There are psychological issues faced by the people who have a migration background, and

this is because some of them have had to be separated from their homes and their loved ones. This

article investigates the attitudes that these individuals have towards psychopharmacology medical

interventions and compares the attitudes with those of the people that have no migration history.

The article concludes that there are myths which are associated with psychopharmacology

psychological interventions that discourage people from seeking medications when they are faced

with psychological issues. This article is very relevant, and the findings can be applied in

psychopharmacology treatment of migrants for psychological disorders.

Caixeta, L., & Caixeta, V. M. (2019). Therapeutic synergism: How can psychopharmacology

improve cognitive rehabilitation? Dementia & Neuropsychologia, 13(4), 422–426.

https://doi.org/10.1590/1980-57642018dn13-040009

The article investigates cognitive rehabilitations which explains the procedures and processes

that are used in corrective cognitive challenges in patients and restoring them to their normal lives.

This research is comprehensive and extensive and talks about how psychopharmacology can

contribute to improvements in the rehabilitations. This is because psychopharmacology helps

understand the way different people will respond to the different interventions based on the

different cognitive disorders in individuals. This article contributes valid knowledge that can be

used in improving rehabilitations using more effective medication in the patients.

Lopez-Vergara, H. I., Zapolski, T. C. B., & Leventhal, A. M. (2021). Intersection of minority

health, health disparities, and social determinants of health with psychopharmacology and

substance use. Experimental and Clinical Psychopharmacology, 29(5), 427–428.

https://doi.org/10.1037/pha0000522

Psychopharmacology involves the use of various interventions and medications towards the

alleviation of the behavioral problems in individuals. There are various factors that determine the

type of intervention used in a patient and this article investigates the way social factors and health

disparities contribute towards the choice of intervention to address all symptoms and risk factors.

This is a quality and valid research article because it offers valid and in-depth analysis of the issues

of psychopharmacology. The article can be easily generalized to the entire population.

MARVASTI, J. A., & OLIVIER, C. C. (2020). Psychopharmacology for the Psycho-Historian:

The Evils of “Big Pharma,” Lobbying, Corruption and Serious Side Effects of Medications.

Journal of Psychohistory, 48(2), 100–115.

The big pharma is a conspiracy theory that most of the big pharmaceuticals work against the

good of the public. Issues such as the big pharma, lobbying, corruption and the adverse medications

associated with some of the medical interventions in psychopharmacology are some of the reasons

why most people will become very reluctant to seeking medical interventions when they have

psychological issues. This article findings are very applicable to the general population, and this

can be seen in how much people have a fear of getting medical attention when they have

psychological issues and also the myths that people have formed towards psychiatric hospitals.

Potter, D. R., Stockdale, S., & O’Mallon, M. (2020). A Case Study Approach:

Psychopharmacology for Atypical Antidepressants Snapshot. International Journal of

Caring Sciences, 13(1), 764–769.

Anti-depressants are very useful for people that have depression and want to lead a normal

and healthy life because they help reduce the depressive symptoms in the patients. This article

explores the psychopharmacology of antidepressants and how they work including how they act

on stress and depression. It also acts as a psychopharmacological guideline for individuals that

might need to use these drugs and have personal reservations about them. This article explores the

psychopharmacological effects of the use of the drugs on patients and why it is important for

patients to use the drugs. This is an important and valid article as it talks about a significant matter

when it comes to the psychopharmacology of anti-depressants that are very common and highly

consumed for mental health issues.

References

Bauger, L., & Bongaardt, R. (2018). Structural developmental psychology and health promotion

in the third age. Health Promotion International, 33(4), 686–694.

https://doi.org/10.1093/heapro/daw104

Bland, A. M., & DeRobertis, E. M. (2020). Maslow’s unacknowledged contributions to

developmental psychology. Journal of Humanistic Psychology, 60(6), 934–958.

https://doi.org/10.1177/0022167817739732

Bilbul, M., Paparone, P., Kim, A. M., Mutalik, S., & Ernst, C. L. (2020). Psychopharmacology

of COVID-19. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 61(5),

411–427. https://doi.org/10.1016/j.psym.2020.05.006.

Brandl, E. J., Dietrich, N., Mell, N., Winkler, J. G., Gutwinski, S., Bretz, H. J., & Schouler-Ocak,

M. (2020). Attitudes towards psychopharmacology and psychotherapy in psychiatric

patients with and without migration background. BMC Psychiatry, 20(1), 176.

https://doi.org/10.1186/s12888-020-02585-1

Caixeta, L., & Caixeta, V. M. (2019). Therapeutic synergism: How can psychopharmacology

improve cognitive rehabilitation? Dementia & Neuropsychologia, 13(4), 422–426.

https://doi.org/10.1590/1980-57642018dn13-040009

Cochet, H., & Guidetti, M. (2018). Contribution of developmental psychology to the study of

social interactions: Some factors in play, joint attention, and joint action and

implications for robotics. Frontiers in Psychology, 9.

https://doi.org/10.3389/fpsyg.2018.01992.

Corral, D., Healy, A. F., Rozbruch, E. V., & Jones, M. (2019). Building a testing-based training

paradigm from cognitive psychology principles. Scholarship of Teaching and Learning

in Psychology, 5(3), 189–208. https://doi.org/10.1037/stl0000146.

Feist, G. J., Dostal, D., & Kwan, V. (2021). Psychopathology in world-class artistic and

scientific creativity. Psychology of Aesthetics, Creativity, and the Arts.

https://doi.org/10.1037/aca0000440.

Hawkins-Elder, H., & Ward, T. (2021). Describing disorder: The importance and advancement

of compositional explanations in psychopathology. Theory & Psychology, 31(6), 842–

866. https://doi.org/10.1177/09593543211021157.

Kline, M. A., Shamsudheen, R., & Broesch, T. (2018). Variation is the universal: making

cultural evolution work in developmental psychology. Philosophical Transactions of

the Royal Society of London. Series B, Biological Sciences, 373(1743).

https://doi.org/10.1098/rstb.2017.0059.

Koops, W., & Kessel, F. (2017). Developmental psychology without positivistic pretentions: An

introduction to the special issue on historical developmental psychology. European

Journal of Developmental Psychology, 14(6), 629–646.

https://doi.org/10.1080/17405629.2017.1382344.

Lantagne, A., & Furman, W. (2021). A dyadic perspective on psychopathology and young adult

physical dating aggression. Psychology of Violence, 11(6), 569–579.

https://doi.org/10.1037/vio0000386.

Lee, S. A., & Jobe, M. C. (2022). Does fear mediate the neuroticism-psychopathology link for

adults living through the COVID-19 pandemic? Clinical Medicine Insights:

Psychiatry, 1–5. https://doi.org/10.1177/11795573211069912.

Legare, C. H., Clegg, J. M., & Wen, N. J. (2018). Evolutionary developmental psychology: 2017

redux. Child Development, 89(6), 2282–2287. https://doi.org/10.1111/cdev.13018.

Li, Y. (2020). Analysis on uncertainties in judicial decision based on cognitive psychology.

Revista Argentina de Clínica Psicológica, 29(1), 1016–1021.

Lloyd, M. E. (2020). Sometimes a demo is not just a demo: When demonstrating cognitive

psychology means confronting assumptions. Scholarship of Teaching and Learning in

Psychology. https://doi.org/10.1037/stl0000192.

Lopez-Vergara, H. I., Zapolski, T. C. B., & Leventhal, A. M. (2021). Intersection of minority

health, health disparities, and social determinants of health with psychopharmacology

and substance use. Experimental and Clinical Psychopharmacology, 29(5), 427–428.

https://doi.org/10.1037/pha0000522.

MARVASTI, J. A., & OLIVIER, C. C. (2020). Psychopharmacology for the Psycho-Historian:

The Evils of “Big Pharma,” Lobbying, Corruption and Serious Side Effects of

Medications. Journal of Psychohistory, 48(2), 100–115.

Potter, D. R., Stockdale, S., & O’Mallon, M. (2020). A Case Study Approach:

Psychopharmacology for Atypical Antidepressants Snapshot. International Journal of

Caring Sciences, 13(1), 764–769.

Schmidt, H. G., & Mamede, S. (2020). How cognitive psychology changed the face of medical

education research. Advances in Health Sciences Education, 25(5), 1025–1043.

https://doi.org/10.1007/s10459-020-10011-0.

Schreuder, M. J., Wigman, J. T. W., Groen, R. N., Wichers, M., & Hartman, C. A. (2021). On

the transience or stability of subthreshold psychopathology. Scientific Reports, 11(1),

23306. https://doi.org/10.1038/s41598-021-02711-3.

Terry, C., & Lecci, L. (2021). Examining cognitive performance and psychopathology in

individuals undergoing parental competency evaluations. Professional Psychology:

Research and Practice. https://doi.org/10.1037/pro0000436.

Xie, D. (2020). Application of psychological preference and emotional guidance in the

performance of film and television art: An analysis based on based on cognitive

psychology. Revista Argentina de Clínica Psicológica, 29(2), 854–859.

Yao, N., & Wang, L. (2020). Application of game activities in mental health education of

kindergartens based on cognitive psychology. Revista Argentina de Clínica

Psicológica, 29(2), 871–877.

  • Integrative Literature Review

Thesis Statement for the Integrative Literature Review

Wayne Natoya

Capstone Psychology in Arts of Master :99PSY6

Tyler Tolanda Dr. Instructor:

Campus Global Arizona of University

Feb 27, 2022

Introduction

Psychology is a very diverse field that contain multiple domains. Some studies show that

professionals in each domain of psychology are limited to outcomes from diverse research and

studies for their effectiveness for various interventions and therapeutic treatments. Additionally,

studies also show that some professionals may also be open to new innovative approaches that

may not be evidenced-based but beneficial for clients and patients.

The domain psychopathology is very significant when it comes to diagnosis of patients while

developmental psychology is important in understanding the average cognitive abilities in the

individuals of different ages and life stages. The domain cognitive psychology explains what

causes differences in cognitive abilities in some individuals while psychopharmacology domain

explains the use and investigation of different drugs and how they act on psychological issues.

Thesis statement

An integrative review of literature on the different psychological domains is important in

understanding how life complexities change as people grow. Identifying this knowledge enables

psychologists to pave a way to enlighten the population on this issue. Psychologists have

identified the domain of developmental psychology as the scientific approach that targets

explaining the change, growth, and consistency that occurs in an individual’s lifetime (Sell, J.

2018). The domains of developmental psychology are an important area of focus as they tend to

perceive development as continuous progress from modest into more complex understandings of

oneself and the entire world with time. Progress can be continuous or happen in stages, but

constant progress towards more complex understandings is most common. According to Comas-

Diaz and Rivera (2020), these concepts, learning is a continuous process that strives to see the

world learning through increasing complications throughout the lifespan. Although progress

towards development tends to happen all the time, the transitions that occur are gradual, and

psychologists can only perceive it to be moved from one stage to the other.

For this purpose, this domain focuses on reflecting on how individuals feel, think and how

their behaviors change throughout their lives. The main goals of developmental psychology are

to explain, describe and optimize development which is important in understanding normal

patterns of change and personal variations in terms of development which many people will

follow. For this reason, psychologists must seek to explain the changes they have observed in

association with the normative procedures and personal differences.

On the other hand, psychopathologists focus on stressing the possibility that an individual

can move between non-pathological or pathological types of functioning. Even in the middle of

psychopathology, an individual may portray maladaptive and adaptive aspects so that they can

delimit their presence, boundaries, and the attributes of the underlying psychotherapy. Moreover,

psychopathology tends to originate from the perspective that is particularly applicable to the

researcher’s transitional turning point during life development (Gazzillo et al., 2020).

Another domain is cognitive psychology, which functions on two primary assumptions,

including human cognition, that should be the least principle. It must be explored using a

scientific method that comprises mental procedures that are easily recognizable and understood.

Cognitive psychology also assumes that internal mental procedures can be defined in terms of

principles of algorithms within the information processing models. From Piaget’s point of view

on cognitive psychology, schema entails a broad category of knowledge and the entire process of

acquiring that knowledge (Huitt, W., & Hummel, J. 2003).

On the other hand, psychopharmacology relates to the study of how medications tend to

influence behavior. From this perspective, psychologists analyze the impact a drug has on an

individual, including how it interferes with perception or how an individual thinks. These

changes arise due to the drug’s impact on the individual’s brain and the central nervous system.

According to Baldessarini R. J. (2014),there is a common debate that new

psychopharmacology drugs might alter symptoms in patients to limit their pain and suffering,

but some psychiatrists argue that they might left inconclusive competency of what was required

to bring about foremost and sustained changes in patients’ behavior and thinking than the

previous decades of drugs that were introduced in the 1950s and 1960s. It is crucial for

professionals in the psychopharmacology domain to continue research studies and debates about

psychopharmacology treatment approaches because it does affect the ethics for patients’

assessment and comprehensive care (Baldessarini R. J. 2014).

In conclusion, the domains developmental, psychopathology, cognitive and

psychopharmacology psychology all contribute towards important aspect of our lives as each

one of them takes a different point of view to describe the course of human development and

psychological functioning. Such knowledge will thus help psychologists and other professionals

in the psychology and psychiatry field with groundbreaking innovative research for treatment

interventions and therapies.

References

Baldessarini R. J. (2014). The impact of psychopharmacology on contemporary psychiatry.

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(8), 401–405.

https://doi.org/10.1177/070674371405900801.

Comas-Díaz, L. E., & Rivera, T. (2020). Liberation psychology: Theory, method, practice, and

social justice (pp. xx-314). American Psychological Association.

Gazzillo, F., Fimiani, R., De Luca, E., Dazzi, N., Curtis, J. T., & Bush, M. (2020). New

developments in understanding morality: Between evolutionary psychology,

developmental psychology, and control-mastery theory. Psychoanalytic

Psychology, 37(1), 37.

Huitt, W., & Hummel, J. (2003). Piaget’s theory of cognitive development. Educational

psychology interactive, 3(2).

Sell, J. (2018). Definitions and the development of theory in social psychology. Social

Psychology Quarterly, 81(1), 8-22.

  • Thesis Statement for the Integrative Literature Review

THE FOUR DOMAINS ARE PSYCHOPATHOLOGY, DEVELOPMENTAL PSYCHOLOGY, COGNITIVE PSYCHOLOGY AND PSYCHOPHARMACOLOGY. I HAVE ATTACHED 26 REFERENCES TO USE AND THESE TWO BELOW YOU HAVE THEM BECAUSE YOU USED THEM FOR THE THESIS STATEMENT.
Comment by Figure E:

Comas-Díaz, L. E., & Rivera, T. (2020). Liberation psychology: Theory, method, practice, and social justice (pp. xx-314). American Psychological Association.

Comment by Figure E:

Gazzillo, F., Fimiani, R., De Luca, E., Dazzi, N., Curtis, J. T., & Bush, M. (2020). New developments in understanding morality: Between evolutionary psychology, developmental psychology, and control-mastery theory. Psychoanalytic Psychology, 37(1), 37.

The headings listed below must be used within the paper to delineate the sections of content. These sections include the following: a clear introduction that provides a general review and organizes the research in a meaningful way; a discussion in which the evidence is presented through analysis, critique, and synthesis; and a conclusion in which the discussion is drawn together in a meaningful way, the claims of the introduction are brought to a logical closure, and new research is proposed.

Introduction

Provide a conceptual framework for the review.

Describe how the review will be organized. The questions below may be used to guide this section.

What are the guiding theories within the domains?

How are the domains connected?

Are there competing points of view across the domains?

Why is the integration of these domains important?

What is the history of these domains?

What are the related theories or findings?

Describe how the literature was identified, analyzed, and synthesized.

How and why was the literature chosen?

What is your claim or thesis statement?

Discussion

Provide the analysis, critique, and synthesis for the review.


Analysis

Examine the main ideas and relationships presented in the literature across the four domains.

Integrate concepts from the four different content domains within the larger field of psychology.

What claim(s) can be made in the introduction?

What evidence supports the claim(s) made in the introduction?


Critique

Evaluate the reliability, validity, and generalizability of the chosen research findings.

How well does the literature represent the issues across the four domains?

Identify the strengths and the key contributions of the literature.

What, if any, deficiencies exist within the literature?

Have the authors omitted any key points and/or arguments?

What, if any, inaccuracies have been identified in the literature?

What evidence runs contrary to the claims proposed in the introduction, and how might these be reconciled with the claims presented?

Explain how the APA’s Ethical Principles of Psychologists and Code of Conduct might influence the reliability and/or generalizability of the chosen findings.

Did the ethical issues influence the outcomes of the research?

Were ethical considerations different across the domains?


Synthesis

Integrate existing ideas with new ideas to create new knowledge and new perspectives.

Describe the research that has previously been done across these domains, as well as any controversies or alternate opinions that currently exist.

Relate the evidence presented to the major conclusions being made.

Construct clear and concise arguments using evidence-based psychological concepts and theories to posit new relationships and perspectives on the topics within the domains.

Conclusion

Provide a conclusion and present potential future considerations.

State your final conclusion(s).

Synthesize the findings described in the discussion into a succinct summary.

What questions remain?

What are the possible implications of your argument for existing theories and for everyday life?

Are there novel theories and/or testable hypothesizes for future research?

What do the overarching implications of the studies show?

Where should the research go from this point to further the understanding of these domains and the greater study of psychology?

The Integrative Literature Review

Must be 20 to 30 double-spaced pages in length (not including title and references pages) and formatted according to APA style 7

Must include a separate title page with the following:

Title of paper

Student’s name

Course name and number

Instructor’s name

Date submitted

Must begin with an introductory paragraph that has a succinct thesis statement.

Must address the topic of the paper with critical thought.

Must end with a conclusion that reaffirms your thesis.

Must use at least 28 peer-reviewed sources,

Must document all sources in APA style 7

Must include a separate reference list that is formatted according to APA style 7

Professional Psychology: Research and Practice
Examining Cognitive Performance and Psychopathology in Individuals
Undergoing Parental Competency Evaluations
Christian Terry and Len Lecci
Online First Publication, December 23, 2021. http://dx.doi.org/10.1037/pro0000436

CITATION
Terry, C., & Lecci, L. (2021, December 23). Examining Cognitive Performance and Psychopathology in Individuals
Undergoing Parental Competency Evaluations. Professional Psychology: Research and Practice. Advance online
publication. http://dx.doi.org/10.1037/pro0000436

Examining Cognitive Performance and Psychopathology in
Individuals Undergoing Parental Competency Evaluations

Christian Terry and Len Lecci
Department of Psychology, University of North Carolina Wilmington

In the determination of parental fitness, or competency of an individual to care for a child, psychological
assessments are often utilized. Moreover, research suggests that parental competency examinees are distinct
from child custody examinees with respect to psychopathology and should be studied as a separate group.
To that end, the present study examined the cognitive functioning of 136 parental competency examinees
who were undergoing court-ordered evaluations, as well as examined the relationship between cognitive
functioning (as assessed by the Wechsler Adult Intelligence Scale-IV [WAIS-IV]) and psychopathology (as
assessed by the Minnesota Multiphasic Personality Inventory-2 [MMPI-2]). Overall, the parental compe-
tency sample had lower education and lower cognitive functioning (particularly Full Scale Intelligence
Quotient [FSIQ] and Working Memory Index [WMI]) than the normative sample. MMPI-2 scores
paralleled those of previous findings for parental competency examinees, and MMPI-2 Scales 8, 0, and
7 were significantly related to WAIS-IV performance, with lower cognitive scores associated with greater
psychopathology. Implications include recognition of the role that cognitive functioning may play in parents
being referred for parental competency evaluations, the interaction of comorbid psychopathology and lower
cognitive functioning, as well as informing treatment recommendations for individuals with co-occurring
psychopathology and cognitive deficits.

Public Significance Statement
Parental competency examinees appear to have significantly lower scores in overall intellectual
functioning and working memory on the Wechsler Adult Intelligence Scale-IV (WAIS-IV) relative
to normative values, and lower cognitive functioning was found to be associated with higher
psychopathology on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales related to unusual
thoughts/attitudes, social isolation, and anxiety. These findings indicate co-occurring psychopathology
and cognitive deficits in those referred for parental competency evaluations and this can inform
treatment recommendations.

Keywords: parental competency evaluation, psychopathology, cognition, MMPI-2, WAIS-IV

In evaluating parental fitness, or competency of an individual to
care for a child, psychological assessments are often utilized to aid in
this determination (Budd, 2001; Conley, 2004). Two formal assess-
ments that may be included as part of a parental competency test
battery are the Minnesota Multiphasic Personality Inventory-2
(MMPI-2; Butcher, 2010) and the Wechsler Adult Intelligence
Scale-IV (WAIS-IV; Wechsler, 2008). Despite the MMPI-2 and
WAIS-IV being among the most commonly administered psycho-
logical assessment instruments in the United States (Ball et al.,
1994), there has been limited research on their relationship with one

another. Indeed, although it has been shown that psychopathology
predicts executive functioning (Snyder et al., 2015), it is unclear
whether MMPI-2 scores meaningfully relate to WAIS-IV perfor-
mance and how this may manifest specifically for parental compe-
tency examinees. Moreover, little is known regarding cognition in
individuals referred for parental competency evaluations. The pres-
ent study seeks to examine the following three issues in a parental
competency sample: (a) levels of cognitive functioning as assessed
by the WAIS-IV, (b) psychopathology as assessed by the MMPI-2,
and (c) the potential overlap among these constructs. Thus, the

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Christian Terry https://orcid.org/0000-0002-3904-0371
CHRISTIAN TERRY received his MA in psychology from the University of

North Carolina Wilmington (UNCW). He is presently completing his
internship at Larned State Hospital in Larned, Kansas to attain his PhD in
clinical psychology from UNCW. His areas of professional interest include
clinical neuropsychological assessment, psychological assessment, and
mindfulness-based interventions.
LEN LECCI received his PhD in clinical psychology from Arizona State

University. He is presently a professor of psychology at the University of

North Carolina Wilmington and director of clinical services at MARS
Memory-Health Network. His research and clinical work focuses on assess-
ment, memory disorders, concussion, health anxiety, and bias.
The authors have no known conflicts of interest to disclose.
Anonymous data used in this study are available at the following link:

https://osf.io/7j6rx/?view_only=baae7d98065a4c47b996c14d34b1b5b1.
CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Len

Lecci, Department of Psychology, University of North Carolina Wilmington,
P.O. Box 5612, 601 S College Road, Wilmington, NC 28403, United States.
Email: [email protected]

Professional Psychology: Research and Practice

© 2021 American Psychological Association
ISSN: 0735-7028 https://doi.org/10.1037/pro0000436

1

purpose of this investigation is to highlight the value of a broader
psychological assessment that includes cognitive testing for parental
competency evaluations, as both cognitive difficulties and their
comorbidity with psychopathology can otherwise be overlooked
(Meyer, 2002).

Parental Competency Evaluations and Intellectual
Functioning

The process of evaluating competency of an individual to parent
is complex. As McGaw et al. (2010) outline, it is typically the case
that parents undergo a competency evaluation secondary to con-
cerns related to neglect rather than intentional abuse. The neglect
often co-occurs with and/or stems from substance use or other
mental health disorders (Resendes & Lecci, 2012), and the latter
can include intellectual limitations.
Although ranges for Intellectual Quotients (IQ) were previously

used to categorize individuals into mild, moderate, and severe
levels of intellectual disabilities using the fourth edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV;
American Psychiatric Association, 1994), the most recent edition of
the DSM removes IQ ranges as a criterion and instead emphasizes
the consideration of other aspects of client functioning in relation to
their objective cognitive performance to aid in diagnoses (American
Psychiatric Association, 2013). Using the new criteria, the severity
of an individual’s intellectual disability is determined based on
their cognitive performance (Criterion A), evidence that these
cognitive deficits are impairing the individuals’ ability to function
(Criterion B), and onset of these deficits within the developmental
period (Criterion C). Thus, while IQ testing can aid in documenting
impaired cognitive performance (Criterion A), identifying that an
individual’s intellectual functioning is such that they may be unable
to care for a child may also contribute to meeting Criterion B.
Of course, this interpretation is made only when comparing multi-
ple sources of evidence, as IQ testing alone is insufficient to
determine high-risk versus low-risk parents (McGaw et al.,
2010). Moreover, given the potential comorbidity of cognitive
limitations and psychopathology, it is imperative to elucidate the
relation between psychopathology and cognition in parental com-
petency examinees. Unpacking this relationship may aid any
psychological assessor in considering the intersection of cognition
and psychopathology in their patients and making appropriate
recommendations for needed interventions and prognosis for
change.
Originally, it was argued that parental competency and custody

examinees are functionally equivalent (Stredny et al., 2006). How-
ever, more recent research has determined that there are fundamental
differences at least in regard to psychopathology as measured by the
MMPI-2 (Resendes & Lecci, 2012). Specifically, competency ex-
aminees relative to child custody examinees tend to exhibit a
different pattern of defensiveness (elevated L, but lower K),
more inconsistent responding (elevated variable response inconsis-
tency [VRIN]; true response inconsistency [TRIN]), more unusual
responses (elevated F and Fb), and psychopathology related to
social introversion, depressive symptoms, difficulty incorporating
and accepting societal standards, and unusual thoughts or attitudes
(i.e., elevated MMPI-2 Scales 0, 2, 4, and 8, respectively, with
differences reflecting large effect sizes ranging from Cohen’s
d values of 1.01–1.21).

According to Resendes and Lecci (2012),

parental competency evaluations typically involve a legal intervention
by a government agency in order to protect the child (e.g., allegations of
abuse, neglect, etc.), and criminal charges may co-occur. In contrast,
child custody evaluations are civil cases that largely involve parental
disagreement about legal and/or physical custody, without necessarily
involving problems with the basic parenting abilities of either par-
ent. (p. 1055)

In the former, the utilization of both cognitive and psychopatho-
logical assessment is necessary to answer referral questions, such as
those related to neglect that may occur secondary to cognitive
limitations (e.g., WAIS-IV) and psychological/substance use dis-
orders (e.g., MMPI-2).

Cognitive Functioning and Psychopathology

With respect to the overlap between psychopathology and cog-
nitive abilities, poorer cognitive functioning is often a specific
symptom of a psychological disorder (e.g., diminished concentra-
tion in major depressive disorder [MDD], disorganized speech and
behavior in schizophrenia). Further, the literature consistently
shows that greater psychopathology is associated with lower exec-
utive functioning. For instance, Stordal et al. (2005) determined that
those experiencing more depressive or schizophrenia-related symp-
toms as measured by the Brief Psychiatric Rating Scale-Expanded
(Overall & Gorham, 1962) and the General Psychopathology
Subscale of the Positive and Negative Syndrome Scale (Kay et al.,
1987) exhibited poorer executive function skills as measured by the
Wisconsin Card Sorting Test (Heaton et al., 1991), Stroop Color
Word Test (Stroop, 1992), Paced Auditory Serial Addition Test
(Gronwall, 1977), Digits Backwards subscale of the WAIS-IV
(Wechsler, 2008), and Controlled Oral Word Association Test
(Benton et al., 1994). Gass (1991) found that anxiety, as measured
by MMPI Scale 7, significantly predicted poorer performance on the
Speech Perception Test of the Halstead–Reitan (Broshek & Barth,
2000) above and beyond age and education. In all though, other
MMPI clinical scales were generally not associated with cognitive
performance in their sample of veterans.

Snyder et al. (2015) performed a comprehensive literature review
of studies assessing the relationship between various psychopathol-
ogies and executive functioning, including inhibition, attentional
shifting, updating, and working memory. They identified that the
diagnosis of schizophrenia was the strongest predictor of diminished
performance for each of these constructs of executive functioning,
and that bipolar and MDD inversely predicted executive function,
albeit to a lesser degree. Findings were mixed on the relationship
between anxiety and executive functioning (Snyder et al., 2015),
and for MDD, the findings corroborate research explicitly focusing
on the WAIS-IV (Wechsler, 2008). Finally, the initial validation
of the WAIS-IV included investigating the cognitive abilities of
“special groups” (Wechsler, 2008), one of which was individuals
diagnosed with MDD. Results indicated that those with MDD
scored lower than matched controls on the Processing Speed Index
(PSI; Cohen’s d = .26), and these findings align with prior research
(Gorlyn et al., 2006).

Only one known study has directly assessed WAIS profiles of
parental competency examinees (McCartan & Gudjonsson, 2016).
Researchers analyzed 144 individuals who were evaluated for

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2 TERRY AND LECCI

parental competency in the U.K. (i.e., Child Care Proceedings) and
who were administered the WAIS-III. Results indicated that their
parental competency sample had Full Scale Intelligence Quotient
(FSIQ) scores just over 1 SD (M = 83.64) below the normative
sample (M = 100, SD = 15). The study also assessed gender
differences in personality and psychopathology as measured by
the Millon Clinical Multiaxial Inventory, 3rd Edition (MCMI-III)
but did not assess the association between cognition and psychopa-
thology. This review turns now to the only known studies to directly
evaluate the relationship between psychopathology assessed with
the MMPI and cognitive performance as measured by the WAIS.
Gass and Gutierrez (2017) sought to compare the MMPI-2 with

the WAIS-IV in male veterans using the content scales of the
MMPI-2. Inclusion criteria for the MMPI-2 were that they com-
pleted at least 557 of the 567 items, did not respond randomly or
display a response bias (i.e., VRIN and TRIN < 80 T), did not
exaggerate symptoms (i.e., F < 90 T, Fb < 100 T), and did not
respond defensively (i.e., K < 60 T). Because the researchers
performed correlation analyses between the WAIS-IV indices
and MMPI-2 content scales, they condensed the 15 MMPI-2 content
scales into three factors of Internalized Emotional Dysfunction
(IED; e.g., low self-esteem, low energy, depression), Externalized
Emotional Dysfunction (EED; e.g., antisocial attitudes, aggres-
siveness, poor anger control), and Fear (i.e., physical health worries,
paranoia, and intense fearfulness). None of the WAIS-IV indices
correlated with IED and EED, however the Fear factor was signifi-
cantly inversely correlated with Perceptual Reasoning Index (PRI),
Verbal Comprehension Index (VCI), and FSIQ. The authors also
found that those with T-scores greater than 64 on the MMPI-2 Fear
factor scales performed more poorly on the VCI and FSIQ indices
relative to those with T-scores below 56. It was noted that the Fear
factor correlated most strongly with clinical Scales 8, 7, and 3 (Gass
& Gutierrez, 2017).
Contrary to Gass and Gutierrez’s (2017) findings, Morasco et al.

(2006) found no significant relationships among WAIS-III indices
and MMPI-2 clinical scales in a sample of young adults receiving
psychoeducational evaluations. Thus, it appears that there is limited
and inconsistent evidence of any association between these two
frequently employed measures, and the findings may be specific to
the population under investigation.

The Present Study

Although research has established connections between specific
disorders and executive function abilities, limited research has
assessed whether degree of psychopathology (as opposed to the
dichotomous presence/absence of a disorder) may influence cogni-
tion more broadly. Further, explorations of the relationship between
psychopathology and cognition have been very limited in parental
competency samples, and past research examining the association
between WAIS and MMPI scores (e.g., Gass & Gutierrez, 2017)
may have been limited by employing stringent validity cutoff scores.
The latter issue may be especially relevant for parental competency
evaluations, as some degree of defensiveness has been documented
in such samples (e.g., Resendes & Lecci, 2012). Moreover, average
L scale scores for child custody examinees have also been shown to
be as high as 60 (Bagby et al., 1999, as cited in Graham, 1990).
Given the high comorbidity of psychopathology in those with lower
cognitive functioning (Peña-Salazar et al., 2018), it is critical to

examine the interaction of comorbities in psychological examinees,
especially given that psychopthology and cognitive difficulties can
both individually and in combination undermine functional abilities,
including with respect to parenting. Further, the effect of these
comorbidites on treatment outcomes should be considered when
providing treatment recommendations. Thus, the present study
seeks to document the cognitive (WAIS-IV) scores of parental
competency examinees, their level of psychopathology as assessed
by the MMPI-2, and overlap thereof by making the following
predictions:

1. Given that cognitive limitations are sometimes noted
among the referral questions from Child Protective Services,
average WAIS-IV performance for the competency sample
is predicted to be below that of the normative sample across
all WAIS-IV indices and subscales. Lower WAIS scores
(by approximately 1 SD) would replicate the findings from a
similar U.K. sample (McCartan & Gudjonsson, 2016).

2. To evaluate representativeness with respect to psychopa-
thology, the present competency sample will be compared
to scores obtained in previous parental competency samples
(Resendes & Lecci, 2012; Stredny et al., 2006). It is predicted
that (a) the present sample will generally align with prior
samples and (b) that the present competency sample will
be significantly different from Bathurst et al.’s (1997)
custody sample across all MMPI-2 validity and clinical
scales, reinforcing the argument that competency and cus-
tody examinees require separate interpretive considerations
with respect to psychopathology.

3. We will explore correlations among WAIS-IV indices and
MMPI-2 clinical scale scores. Based on prior findings
regarding MDD and diminished PSI performance, it is
predicted that greater scores on MMPI-2 clinical Scale 2
will predict poorer performance on the WAIS-IV PSI
beyond age and education (Gorlyn et al., 2006). Further,
the relationship between MMPI-2 Scale 8 and WAIS-IV
performance will be explored, given prior findings indicating
a negative relationship between thought disorders (e.g.,
schizophrenia) and cognitive functioning (Snyder et al.,
2015; Stordal et al., 2005).

Method

Participants and Procedure

Participants were 136 individuals aged 19–67 (Mage = 31.93,
SD = 8.93) whom the court system required to complete a psycho-
logical evaluation to aid in the determination of parental compe-
tency. The majority already had their child(ren) removed from the
home due to concerns from Child Protective Services that one or
more problematic circumstances may be present which limit the
individual’s ability to parent. These circumstances included sus-
pected domestic violence (41.9%), substance use (56.6%), child
neglect (37.5%), physical abuse (14%), sexual abuse (6.6%), psy-
chiatric instability (44.9%), and cognitive incompetence (14.7%).
(Note: These reflect nonmutually exclusive concerns, as 73% of
individuals had more than one listed problem). Participants were
predominantly female (70.6%) and Caucasian (53.7%), followed by

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PARENTAL COMPETENCY WAIS-IV AND MMPI-2 SCORES 3

African American (37.5%) and Native American (1.5%). Average
education was 11.65 years (SD = 1.89) and ranged from 6 to 16 years.
The psychological evaluations were completed by a licensed clinical
psychologist over the course of approximately 5 hr, reflecting
consecutive evaluations occurring from 2012 to 2019. Data were
archivally extracted and analyzed using SPSS Statistics software, and
the study was approved by the University of North Carolina Wil-
mington’s Institutional Review Board (IRB; #20-0110). Anonymous
data used in this study are available at the following link: https://osf
.io/7j6rx/?view_only=baae7d98065a4c47b996c14d34b1b5b1

Measures

Wechsler Adult Intelligence Scale-IV

The fourth edition of the WAIS-IV (Wechsler, 2008) is one of the
most widely used measures of cognitive performance/intelligence
and includes the administration of 10 standard scales which take
approximately 1.5–2 hr to complete. These 10 scales load onto four
broader indices: VCI, PRI, Working Memory Index (WMI), and
PSI. These four indices load onto a primary factor called the FSIQ
(Wechsler, 2008).

Minnesota Multiphasic Personality Inventory-2

The second edition of the MMPI (i.e., MMPI-2) is a 567-item
measure of personality and psychopathology which takes approxi-
mately 1–2 hr to complete (Graham, 1990). It contains embedded
validity measures to defensive responding (e.g., K, S, and L scales),
possible exaggeration (e.g., F, Fp, FBS scales), or indiscriminate
responding (e.g., VRIN, TRIN scales). Additionally, 10 clinical scales
are related to a range of psychological tendencies and possible
psychopathology (e.g., hypochondriasis, depression, somatization in
response to stress, antisocial traits, traditional masculine/feminine
roles, paranoia, psychological turmoil, thought disturbances, hypoma-
nia, and social introversion). The present study focuses on the validity
and primary clinical scales. Typically, a T-score of 65 (1.5 SDs >
average) is the clinical cutoff for clinical interpretation (Graham,
1990), but scores below 65 can indicate meaningful variability.
Although not presented here, participants also completed semi-

structured clinical and parenting interviews and a mental status
exam, and records were available from other providers.

Results

Because the present research focuses on the cognitive functioning
of a parental competency sample, and because cognitive functioning
is related to educational attainment (Kaufman et al., 2009), it is
important to examine the educational background of the present
sample relative to the normative sample for the WAIS-IV to rule this
out as a confounding variable. To determine whether our sample
matched the normative sample in terms of average education, we
first aggregated the percentages of those within each age and
education group reported in the WAIS-IV technical manual. We
then compared these percentages for our sample.
Level of education in the present competency sample is much

lower than in the WAIS-IV normative sample. Specifically, 18.5%
of the competency sample had less than 9 years of education,
compared to only 4.6% of the normative sample. About 14.9%
of the competency sample had 9–11 years of education, compared to

8.7% of the normative sample. While most of the competency
(65.9%) and normative (60.1%) samples had between 12 and
15 years of education, less than 1% of the competency sample
had greater than 15 years of education, compared to 26.6% of the
normative sample. A chi-square analysis was conducted among the
percentage of individuals in the normative versus competency
sample across each educational category and this was significant,
χ2 (3, N = 136) = 56.03, p < .001. These differences suggest that the
present competency sample has a significantly greater number of
individuals with less than 12 years of education than the normative
WAIS-IV sample.

Also, 12.5% of the competency sample scored in the extremely
low range of cognitive functioning (i.e., FSIQ < 70), whereas
approximately 2% of the normative sample had FSIQ scores in
this range. The 12.5% extremely low FSIQ percentage aligns with
the fact that cognitive concerns were noted in the Child Protective
Services referrals for 14.7% of the sample. Given that cognitive
concerns are a common issue in competency evaluations (identified
in 12.5% of the referred cases), this subset of individuals is a
contributing factor to the overall competency sample’s WAIS-IV
index scores being lower than the normative sample.

Because educational attainment has consistently been shown to
positively predict cognition, we first examined this relationship in
our competency sample. A bivariate correlation was performed
between total years of education and WAIS-IV indices and revealed
significant positive correlations between education and VCI:
r(134) = .23, p = .008; PRI: r(134) = .20, p = .018; WMI: r(134) =
.32, p < .001; PSI: r(134) = .24, p = .005; and FSIQ: r(134) = .29,
p < .001. Considering the significant correlation between education
and all WAIS-IV indices, and that the education of the competency
sample is markedly lower than that of the normative sample, we
controlled for education in later analyses that included WAIS-IV
scores as a variable.

Hypothesis 1

To compare the WAIS-IV scores of the competency sample with
normative values, single-sample t-tests were conducted. All
WAIS-IV index scores and FSIQ were significantly lower in the
competency sample compared to the normative sample (i.e., stan-
dard score of 100; see Table 1). The lowest index scores were the
WMI, M = 88.30, t(135) = −9.30, p < .001, Cohen’s d = −0.80, and
FSIQ, M = 87.79, t(135) = −9.65, p < .001, Cohen’s d = −0.83.
Across WAIS-IV indices, our competency sample performs
between the 21st and 28th percentile on average. Single-sample
t-tests were also conducted between subscale scores and normative
(i.e., 10) scaled scores. Again, all subscale scores were significantly
lower than the normative scores, with the lowest being Arithmetic
and Coding (see Table 1). This indicates that the parental compe-
tency sample shows consistently lower cognitive functioning rela-
tive to normative standards. These findings persisted after
controlling for education.1

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1 Single-sample t-tests performed in Hypothesis 1 were also conducted
using education-adjusted means obtained from an analysis of covariance
(ANCOVA). However, education-adjusted means were minimally different
than nonadjusted means (i.e., changes were less than one standard point), and
results were minimally different. Thus, these findings are not explicated here.

4 TERRY AND LECCI

Hypothesis 2

MMPI-2 validity and clinical scale scores for the present sample
were compared with those from two prior parental competency
samples (Resendes & Lecci, 2012; Stredny et al., 2006). The
hypothesis that scores would be the same between these samples
was largely supported (see Table 2), except that when comparing the
present sample to Stredny et al.’s (2006) competency sample, Scale
8 is significantly higher and Scale 7 is marginally higher for the
present sample. Thus, while slight elevations are seen on two
MMPI-2 scaled scores related to anxiety and unusual thoughts/
attitudes, scores for the present sample are largely the same as those
from two previous parental competency samples, suggesting that
this is a representative sample with respect to MMPI-2-assessed
psychopathology.
The second portion of this hypothesis, that the present compe-

tency sample will be significantly different from Bathurst et al.’s
(1997) custody sample across all MMPI-2 validity and clinical scale
scores, was also supported. Moreover, the observed differences
resulted in at least medium and in most cases large effect sizes. This
finding reinforces the argument that competency and custody ex-
aminees are markedly different (i.e., 12 of 14 comparisons resulted
in statistically significant and substantial differences) and thus likely
require separate interpretive considerations.

Hypothesis 3

As Gass and Gutierrez (2017) have emphasized, obtaining an
accurate analysis of the relationship between psychopathology and
cognitive performance may only be done when examinees are as
effortful as possible when taking the test. In the case of parental
competency evaluations, it is quite typical for examinees to exhibit

full effort on the WAIS-IV while also exhibiting a degree of
defensiveness evidenced by elevations on MMPI-2 validity scales
L and to a lesser degree K. Therefore, inclusion criteria for Hypoth-
esis 3 based on the MMPI-2 are that participants completed at least
557 of the 567 items, did not respond randomly or display a response
bias (i.e., VRIN and TRIN < 80), did not exaggerate symptoms (i.e.,
F < 90, Fb < 100; which would be extremely rare for such court-
ordered parental competency evaluations), and did not respond in a
highly defensive manner (i.e., L and K < 80). Three participants
(2.9%2) were excluded due to VRIN T-scores greater than or equal
to 80, 11 (10.7%) for TRIN T-scores greater than or equal to 80, 12
(8.8%) for F T-scores greater than or equal to 90, eight (6.5%) for Fb
T-scores greater than or equal to 100, 24 (17.6%) for L T-scores
greater than or equal to 80, and one (0.7%) for a K T-score greater
than or equal to 80. These exclusions were not mutually exclusive
and after applying the above criteria, 92 of the 136 participants were
left for the exploratory correlations.

A partial correlation, controlling for education, was conducted
(see Table 3). The most prominent finding was that Scale 8 (unusual
thoughts/attitudes) was significantly negatively correlated with all
WAIS-IV indices, with the strongest correlation occurring with
WMI, r(90) = −.40, p < .01. This correlation was explored further
via hierarchical regression, entering education into Block 1 and
Scale 8 into Block 2 to predict WMI. Assumptions for performing
the analysis were met. Scatterplots indicated linearity, no skew or
kurtosis was detected on p-p and q-q plots, data were homoscedastic,
and no violations of independence were noted (e.g., Durbin–
Watson = 1.66). Moreover, multicollinearity was not detected.
The regression indicated that both education (7.1%, β = 2.53,
p < .01, power = .99) and MMPI-2 Scale 8 (13.6%, β = −.48,
p < .001, power = .99) significantly explained 20.7% of the variance
in WMI performance, R2 = .207, F(2, 89) = 12.85, p < .001. This
indicates that after controlling for premorbid cognitive achievement
(education), at least one form of MMPI-2-assessed psychopathology
predicts poorer cognitive efficiency (working memory) as assessed
by the WAIS-IV.

The second most noteworthy finding was the consistently nega-
tive correlations between Scale 0 (social introversion) and all
WAIS-IV indices, that is, r(90) = −.30 to −.33, p < .01, except
for PSI, r(90) = −.18, p > .05. The final MMPI-2 scale to
significantly correlate with a majority of WAIS-IV indices was
Scale 7 (psychasthenia), which negatively correlated with PRI,
r(90) = −.27, p < .05; WMI, r(90) = −.28, p < .01; and FSIQ,
r(90) = −.24, p < .05. The latter two findings indicate that social
introversion and anxiety are both associated with decreased cogni-
tive performance. Four other modest correlations emerged between
MMPI-2 scales and WAIS-IV indices. Specifically, Scale 9 (hypo-
manic activation) was negatively correlated with VCI and FSIQ,
Scale 1 (hypochondriasis) was negatively correlated with PSI, and
Scale 3 (hysteria) was positively correlated with VCI (this was the
only significant positive correlation to emerge).

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Table 1
Independent Samples t-Tests Between WAIS-IV Normative and
Competency Sample Means

WAIS-IV df
Competency sample

M (SD)
Independent samples t-test

(Cohen’s d)

VCI 135 90.63 (14.91) −7.33* (−0.63)
PRI 135 90.22 (14.95) −7.63* (−0.65)
WMI 135 88.30 (14.68) −9.30* (−0.80)
PSI 135 90.10 (14.25) −8.10* (−0.69)
FSIQ 135 87.79 (14.75) −9.65* (−0.83)
BD 135 7.99 (2.96) −7.92* (−0.68)
SI 135 8.17 (2.86) −7.48* (−0.64)
DS 135 8.18 (2.85) −7.45* (−0.64)
MR 135 9.00 (3.24) −3.60* (−0.31)
VC 135 8.07 (2.83) −7.97* (−0.68)
AR 106 7.10 (2.42) −12.37* (−1.20)
SS 131 8.45 (3.23) −5.53* (−0.48)
CD 133 7.81 (2.66) −9.52* (−0.82)
CO 131 8.83 (3.22) −4.17* (−0.36)

Note. Independent samples t-tests were conducted between normative
scores and competency samples’ scores. WAIS-IV = Wechsler Adult
Intelligence Scale-IV; df = degrees of freedom; VCI = Verbal
Comprehension Index; PRI = Perceptual Reasoning Index; WMI =
Working Memory Index; PSI = Processing Speed Index; FSIQ = Full
Scale Intelligence Quotient; BD = Block Design; SI = Similarities; DS =
Digit Span; MR = Matrix Reasoning; VC = Vocabulary; AR = Arithmetic;
SS = Symbol Search; CD = Coding; CO = Comprehension.
* p < .01.

2 Percentages of excluded cases were based on the total (i.e., n = 136)
sample for F, L, and K but were based on a smaller subset of individuals for
VRIN (n = 103), TRIN (n = 103), and Fb (n = 124) due to unavailability of
T-scores for the remaining participants as they only completed the first 370
items of the MMPI-2. For these latter three scales, those with missing data
were still included in the exploratory correlations as long as F, L, and K were
valid.

PARENTAL COMPETENCY WAIS-IV AND MMPI-2 SCORES 5

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a)
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*
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.

6 TERRY AND LECCI

Contrary to the previous literature and our prediction, no corre-
lation was found between Scale 2 (depressive symptoms) and PSI.
This effect also failed to emerge when dichotomizing MMPI-2
Scale 2 scores into high and low, to be more commensurate with the
previous literature (Gass & Gutierrez, 2017). Thus, depressive
symptoms and processing speed were unrelated.

Discussion

The rationale for examining the cognitive abilities of those
undergoing parental competency evaluations is that limited cogni-
tive functioning has been raised as a concern by Child Protective
Services. Moreover, when evaluating parental competency more
broadly, cognitive functioning is often at the forefront. For example,
court cases pertaining to termination of parental rights cite low IQ on
behalf of the parent as a barrier to parenting in the majority of cases
(Callow et al., 2017). Despite this reliance on intellectual abilities,
cognition alone is a poor predictor of parental competency (McGaw
et al., 2010). Instead, a combination of low intellectual functioning
with co-occurring risk factors (e.g., increased psychopathology) and
lack of protective factors (e.g., low social support) is more predictive
of child outcome and, hence, parental competency (Feldman et al.,
2012). Thus, the present study sought to examine (a) levels of
cognitive functioning as assessed by the WAIS-IV, (b) psychopa-
thology as assessed by the MMPI-2, and (c) the potential overlap
among these constructs, as it presents in parental competency
evaluations.
As expected, the parental competency sample had lower educa-

tion than the normative WAIS-IV sample and had a greater inci-
dence of individuals with extremely low cognitive functioning (i.e.,
12.5%) compared to the normative sample (i.e., 2%). Moreover, our
sample’s WAIS-IV performance was over half a standard deviation
below that of the normative sample. This finding indicates that
parental competency examinees score on average in the 21st to 28th
percentile of cognition. The fact that our sample’s cognitive perfor-
mance aligns with another (i.e., McCartan & Gudjonsson, 2016)
parental competency sample’s performance, and that a notable (i.e.,
12.5%) portion of this sample exhibited extremely low cognitive

function, suggests that similar rates may exist in other parental
competency samples elsewhere. Though prior findings suggest
that parental competency assessors are including standardized cog-
nitive measures in their test batteries (Conley, 2004), assessment
of cognitive functioning is not an explicit recommendation
found in parental competency assessment guidelines (American
Psychological Association [APA], 2013; Steinhauer, 1983) and
therefore these areas of potentially problematic functioning may
be overlooked. Such an oversight may lead to attributing problem-
atic parenting behaviors (e.g., neglect) to more nefarious explana-
tions (i.e., intentional neglect), when in fact the provision of
parenting classes and/or supportive services could remedy such
behaviors. Notably, when examining our sample, 35% of those with
FSIQ scores less than 70 were referred due to concerns of neglect.

Aside from the FSIQ, the WMI was normatively the lowest index
and was 0.80 SDs below average. Given that the WMI was strongly
associated with MMPI-2 Scales 7, 8, and 0, it is possible that the
WMI difficulties tend to manifest in the context of mood and thought
disturbances (Snyder et al., 2015; Stordal et al., 2005). Moreover, it
is also reasonable to assume that the more problems that a parent has
(i.e., difficulties affecting multiple domains, such as cognition and
psychopathology) the more likely they will experience dysfunction
in general and come to the attention of Child Protective Services
(e.g., recall that 14.7% of examinees in our sample were referred
for cognitive concerns, and 12.5% scored in the extremely low
range of cognitive functioning). Thus, although diminished cogni-
tion and psychopathology are each factors that may prompt or
contribute to Child Protective Services intervention, they likely
have a compounding effect on one another. This effect highlights
the importance of considering the interaction of cognition with
psychopathology.

The underperformance on WAIS-IV subscales, particularly
Arithmetic and Vocabulary, aligns with prior findings indicating
that lower education corresponds to underperformance on these
WAIS subscales (Shuttleworth-Edwards et al., 2004). In our sample,
34.6% of participants performed more than 1 SD below the norma-
tive average on Vocabulary, and 45.8% for Arithmetic. This under-
performance suggests that both reading literacy and numerical
literacy issues may also be common in parental competency cases.
Thus, careful consideration should be made regarding a client’s
educational attainment and literacy and the effect that it may have in
suppressing cognitive performance, especially in evaluations as
consequential as those pertaining to parental competency. Adapta-
tions may be necessary when illiteracy is of concern (e.g., reading
aloud questionnaires to the examinee instead of having them read for
themselves when dealing with surveys, etc.). Moreover, limitations
associated with literacy may be more amenable to interventions as
compared to cognitive limitations that may be associated with
congenital or developmental disorders.

The present sample’s scores on the MMPI-2 were largely similar
to those of two prior parental competency samples (Resendes &
Lecci, 2012; Stredny et al., 2006) with the exception that, when
compared to Stredny et al.’s (2006) competency sample, Scale 8 is
significantly higher in the present sample. This difference is likely
attributable to the present sample having more individuals with
disturbances in thinking than in Stredny et al.’s (2006) sample,
particularly given the lack of difference on Scale 8 between the
present sample and Resendes and Lecci’s (2012) sample. Significant
elevations on Scale 8 (i.e., T > 75) raises the possibility of a

T
h
is
d
o
cu
m
en
t
is
co
p
y
ri
g
ht
ed

b
y
th
e
A
m
er
ic
an

P
sy
ch
o
lo
g
ic
al

A
ss
o
ci
at
io
n
o
r
o
n
e
o
f
it
s
al
li
ed

p
u
b
li
sh
er
s.

T
h
is
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
p
er
so
n
al

u
se

o
f
th
e
in
di
v
id
u
al

u
se
r
an
d
is
n
o
t
to

b
e
d
is
se
m
in
at
ed

b
ro
ad
ly
.

Table 3
Partial Correlation Between WAIS-IV Indices and MMPI-2 Clinical
Scale Scores, Controlling for Education

MMPI-2 VCI PRI WMI PSI FSIQ

1 (Hs) −.03 −.06 −.15 −.25* −.12
2 (D) 0.0 −.11 −.06 −.10 −.08
3 (Hy) .25* .16 .08 .09 .18
4 (Pd) .17 .12 .04 .14 .15
5 (Mf) −.05 −.16 −.02 −.01 −.08
6 (Pa) −.07 −.11 −.18 −.16 −.13
7 (Pt) −.15 −.27* −.28** −.11 −.24*
8 (Sc) −.23* −.28** −.40** −.29** −.33**
9 (Ma) −.25* −.12 −.21 −.19 −.21*
0 (Si) −.31** −.31** −.30** −.18 −.33**

Note. WAIS-IV =Wechsler Adult Intelligence Scale-IV;MMPI-2 = Minnesota
Multiphasic Personality Inventory-2; VCI = Verbal Comprehension Index; PRI =
Perceptual Reasoning Index; WMI = Working Memory Index; PSI = Processing
Speed Index; FSIQ = Full Scale Intelligence Quotient. Scales 1–0 correspond to
MMPI-2 clinical scale T-scores.
* p < .05. ** p < .01.

PARENTAL COMPETENCY WAIS-IV AND MMPI-2 SCORES 7

psychotic disorder (Graham, 1990) or at least disturbances in
thinking about oneself or others. Schizophrenia and other psychotic
disorders are usually characterized as maintaining a chronic course,
high comorbidity with substance use and other psychiatric disorders,
and frequently necessitate formal and/or informal assistance with
daily living activities (American Psychiatric Association, 2013).
The impact of these disorders on daily functioning likely increases
the chance of a parent with such a disorder, especially when
undiagnosed and/or untreated, to come to the attention of Child
Protective Services and thereby may account for the greater inci-
dence of Scale 8 elevations in parental competency samples. The
replication of Resendes and Lecci’s (2012) findings regarding the
substantial difference between parental competency and custody
samples further highlights that parental competency examiners
should not use parental custody data as a means of comparison,
and vice versa.
Following the precautions recommended by Gass and Gutierrez

(2017), we excluded participants who exhibited invalid response
sets on the MMPI-2 prior to conducting the exploratory correlations
in Hypothesis 3. It is noteworthy that upwards of 17% of respon-
dents had invalid protocols, though this aligns with a previous
competency sample (Resendes & Lecci, 2012). As a follow-up
exploratory analysis, we sought to examine whether intellectual
functioning (i.e., WAIS-IV FSIQ) is related to MMPI-2 invalidity.
Independent samples t-tests were conducted separately between
those who were and were not excluded due to L, TRIN, and F
invalidity. FSIQ scores were significantly lower for those excluded
based on elevated TRIN and F T-scores, with the differences
reflecting large effect sizes (Cohen’s d values of 1.3 and 1.1,
respectfully). Though nonsignificant, those who were excluded
due to elevated L T-scores had lower FSIQ scores (M = 83.67)
than those who were not excluded (M = 88.68). Despite causality
being unclear, these findings implicate low intellectual functioning
as a potential source of MMPI-2 invalidity regarding TRIN, atypical
responding (F), and possibly defensiveness (L). Clinicians should
therefore be mindful to not assume that an invalid MMPI-2 profile
indicates a blatant attempt by the examinee to subvert the
assessment.
The relationship between Scale 8, 0, and 7 and WAIS-IV indices

has important implications for assessing parental competency ex-
aminees. For instance, Scale 8 is consistently negatively correlated
with WAIS-IV indices suggesting that diminished cognition may be
an accompanying factor for individuals with a greater propensity to
experience unusual thinking/attitudes. Importantly, only six parti-
cipants scored at a level on Scale 8 which would more strongly
suggest the presence of a thought disorder (T-score > 75) and a
relatively wide range of T-scores (32–93) was obtained. Thus, the
relationship between Scale 8 and WAIS-IV indices was likely not
solely (or at all) attributable to individuals with thought disorders.
Although we considered cognition to be the dependent variable in

our analyses (e.g., Scale 8 predicted WMI), the directionality of the
relationship between psychopathology and cognition is unclear. For
example, working memory deficits are a common feature of schizo-
phrenia (Eryilmaz et al., 2016), yet whether these deficits are a
consequence of or comorbid with schizophrenia is not established.
Despite nebulous causality, our findings support previous literature
indicating that impaired working memory on the WAIS-IV is seen in
individuals with disturbances of thinking, as measured by MMPI-2
Scale 8 (Snyder et al., 2015; Stordal et al., 2005). Our findings even

partially support those of Gass and Gutierrez (2017) regarding the
impact of fear-related MMPI-2 content scales (which includes
Bizarre Mentation, a scale strongly correlated with clinical
Scale 8) on the WAIS-IV PRI, VCI, and FSIQ. However, the
fact that their Fear factor did not correlate with WMI is less
consistent with present findings.

The broad negative correlation between social introversion (Scale
0) and all WAIS-IV indices except for PSI is consistent with the fact
that diminished social engagement has been found to occur in
individuals with significant psychopathology, such as those with
schizophrenia spectrum disorders (Green et al., 2018). Further, it
may also be the case that those with lower cognitive functioning
have lower social support and, thus, are more socially isolated
(Graham, 1990). Regardless of causality, the co-occurrence of low
cognition and social introversion implicates the need to provide
supportive services (e.g., support groups and other tangible inter-
personal help) to individuals with lower cognition and elevated
psychopathology.

A significant negative relationship also emerged between
MMPI-2 Scale 7 and perceptual reasoning, working memory,
and FSIQ. As a measure of psychological turmoil and anxiety, it
is reasonable that individuals elevated on this scale would exhibit
impaired cognitive performance; particularly given consistent find-
ings that anxiety can impact performance on tasks of working
memory and attention (Dorenkamp & Vik, 2018). Though some
additional, small correlations emerged, these findings must be
interpreted with caution given the exploratory nature of the analysis,
and future studies can better determine whether these relationships
are robust.

Finally, the prediction that MMPI-2 Scale 2 would negatively
correlate with PSI was not supported despite depressive symptoms
commonly predicting low processing speed in the literature (Gorlyn
et al., 2006; Snyder et al., 2015; Wechsler, 2008). One explanation
that may account for this is in the measurement of depression. While
prior studies utilized the diagnosis of MDD as a predictor for PSI,
we used a continuous measure of depressive symptoms. It may be
the case that no relationship emerged because MMPI-2 Scale 2
linearly measures depressive symptoms, rather than as a clinically
significant diagnosis (e.g., does not include a measure of significant
impairment in daily functioning). Other factors related to undergo-
ing parental competency examinations may have also contributed to
the lack of a relationship between Scale 2 and PSI, such as greater
effort typically seen in parental competency examinees, whereas
amotivation is a common symptom of depression and may manifest
more readily in other assessment contexts. The relationship between
MMPI-2 Scale 2 and PSI performance should be assessed in more
diverse samples to account for sampling bias.

We argue that the above findings underscore the need to consider
comorbidities and the interactions thereof that may be present in
psychological assessments of parental competency examinees. The
present study specifically highlights the cross section between
cognition and psychopathology, but there are countless other
comorbid factors that examiners must consider, including most
notably substance use disorders.

Limitations

Several limitations should be noted. First, our sample was a
parental competency sample with a majority of females, and thus our

T
h
is
d
o
cu
m
en
t
is
co
p
y
ri
g
ht
ed

b
y
th
e
A
m
er
ic
an

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sy
ch
o
lo
g
ic
al

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ss
o
ci
at
io
n
o
r
o
n
e
o
f
it
s
al
li
ed

p
u
b
li
sh
er
s.

T
h
is
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
p
er
so
n
al

u
se

o
f
th
e
in
di
v
id
u
al

u
se
r
an
d
is
n
o
t
to

b
e
d
is
se
m
in
at
ed

b
ro
ad
ly
.

8 TERRY AND LECCI

findings regarding cognition and psychopathology have limited
generalizability beyond this population. However, the fact that
some relationships align with findings in other populations, such
as the relationship between Scale 8 and WMI, indicates this may be a
robust finding. It should also be noted that the majority of the sample
being female is likely due to the greater tendency of females to take a
primary role in caring for the child, rather than females being more
likely to have compromised parenting. Further, our sample was
obtained archivally and, thus, we were unable to collect other
information which may have informed these analyses, such as
stand-alone validity tests or psychiatric diagnoses. Comparing
cognitive performance with both continuous measures of psycho-
pathology (e.g., MMPI-2) in addition to discrete diagnoses would
provide important insight into the relationship between psychopa-
thology and cognition. That is, identifying thresholds at which
psychopathology impacts cognition may inform decisions for
when and to what extent to provide interventions. Finally, the
newest (third) edition of the MMPI has recently been released,
and development of the fifth edition of the WAIS is underway. We
utilized the MMPI-2 instead of the MMPI-2-Restructured Form or
MMPI-3 because the data collection began in 2012, which predated
the newer versions. However, the findings of the present study
should be replicated with the MMPI-3 and WAIS-V, when avail-
able, to determine whether these relationships persist despite revi-
sions to the instruments.

Implications and Applications

Evaluations and research of parental competency should be done
with adherence to the Ethics Code (American Psychological
Association, 2017) and to guidelines laid out for conducting psy-
chological evaluations related to child protection (APA, 2013).
These guidelines include, but are not limited to, maintaining impar-
tiality, practicing with competence, using multiple data-gathering
approaches, and basing conclusions on actuarial data. The present
study provides additional actuarial data specific to parental compe-
tency evaluations when the WAIS-IV and MMPI-2 are used. These
data may inform such assessments and facilitate adherence to ethical
guidelines.
It should also be noted that, although there is a clear rationale for

the use of tests like the WAIS-IV in parental competency evalua-
tions, as cognitive limitations can contribute to less than optimal
functioning and coping, there are also clear limitations in using such
tests, especially for child custody evaluations (e.g., Brodzinsky,
1993). Measures such as the WAIS-IV and MMPI-2 are by them-
selves insufficient to inform whether an individual should be
considered to have low parental competence (McGaw et al., 2010).
Rather, assessors must integrate multiple sources of data (e.g., social
support, occupation) and consider the interaction of the examinee’s
risk and protective factors when highlighting possible areas of
strengths and weaknesses for parental competency examinees
(Callow et al., 2017; Feldman et al., 2012).
This study represents the first attempt to identify relationships

between psychopathology as measured by the MMPI-2 and cogni-
tion as measured by the WAIS-IV for parental competency exam-
inees. Additionally, we have made WAIS-IV index and subscale
data of parental competency examinees available for the first time,
which may aid evaluators in future parental competency assess-
ments as a point of comparison. The data may also be used to

determine a client’s intellectual abilities relative to the average
parental competency examinee and whether this may predict paren-
tal fitness, in conjunction with MMPI-2 performance.

Of clinical relevance is the co-occurrence of diminished cognition
in those with psychopathology, which suggests that the effective-
ness of interventions for individuals with disturbances in thinking
and/or mood is inversely related to cognitive scores. The presence of
borderline intellectual functioning in those who may evidence
symptoms of a thought disorder does not bar an individual from
being able to effectively participate in treatment (Pitschel-Walz
et al., 2009). Rather, the provision of interventions to those with
greater psychopathology and/or lower intellectual abilities may be
most effective when it is conveyed in a concrete and easily under-
stood manner, focuses on skills-based techniques (e.g., dialectical
behavior therapy), and minimizes interventions requiring high
cognitive demand (e.g., cognitive or insight-oriented therapies).
Unsurprisingly, decreased functioning has been observed in
higher-severity psychotic disorders with comorbid intellectual dys-
function compared to those with similar psychotic disorders without
intellectual impairment (Bouras et al., 2004). Thus, a good under-
standing of cognitive functioning is critical to parental competency
assessments to inform prognosis and treatment recommendations.

Importantly, noncompliance or poor treatment outcome may be
perceived as a volitional behavior on the part of the patient to not
engage in treatment. However, our findings suggest that comorbid
conditions may contribute to this noncompliance. For example, a
common treatment recommendation for parental competency ex-
aminees is to participate in parenting classes. However, if borderline
or impaired intellectual functioning is present (and especially if it
goes undetected), then the ability of that individual to understand
and engage in the course material may be jeopardized. In the very
least, lower cognitive functioning can undermine the informational
benefit that can be derived from such classes. As such, a recom-
mendation for one-on-one parent training, as opposed to a group
format, may be more appropriate. Such an understanding may
additionally foster a more compassionate approach to treatment
on behalf of the individual administering the intervention when they
encounter treatment barriers with the patient. In all, clinicians should
consider all risk (e.g., cognitive impairment, psychopathology, lack
of employment/housing) and protective (e.g., social support, dis-
ability/other assistive services) factors in evaluations of parental
competency, and treatment recommendations should likewise be
guided by such factors.

References

American Psychiatric Association. (1994). Diagnostic and statistical manual
of mental disorders (DSM-IV).

American Psychiatric Association. (2013). Diagnostic and statistical manual
of mental disorders (DSM-5®). American Psychiatric Pub.

American Psychological Association [APA]. (2013). Guidelines for psycho-
logical evaluations in child protection matters. American Psychologist,
68(1), 20–31. https://doi.org/10.1037/a0029891

American Psychological Association. (2017). Ethical principles of psychol-
ogists and code of conduct (2002, amended effective June 1, 2010, and
January 1, 2017). https://www.apa.org/ethics/code/

Bagby, R. M., Nicholson, R. A., Buis, T., Radovanovic, H., & Fidler, B. J.
(1999). Defensive responding on the MMPI-2 in family custody and
access evaluations. Psychological Assessment, 11(1), 24–28. https://
doi.org/10.1037/1040-3590.11.1.24

T
h
is
d
o
cu
m
en
t
is
co
p
y
ri
g
ht
ed

b
y
th
e
A
m
er
ic
an

P
sy
ch
o
lo
g
ic
al

A
ss
o
ci
at
io
n
o
r
o
n
e
o
f
it
s
al
li
ed

p
u
b
li
sh
er
s.

T
h
is
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
p
er
so
n
al

u
se

o
f
th
e
in
di
v
id
u
al

u
se
r
an
d
is
n
o
t
to

b
e
d
is
se
m
in
at
ed

b
ro
ad
ly
.

PARENTAL COMPETENCY WAIS-IV AND MMPI-2 SCORES 9

Ball, J. D., Archer, R. P., & Imhof, E. A. (1994). Time requirements of
psychological testing: A survey of practitioners. Journal of Personality
Assessment, 63(2), 239–249. https://doi.org/10.1207/s15327752jpa
6302_4

Bathurst, K., Gottfried, A. W., & Gottfried, A. E. (1997). Normative data for
the MMPI-2 in child custody litigation. Psychological Assessment, 9(3),
205–211. https://doi.org/10.1037/1040-3590.9.3.205

Benton, A. L., deS, K., & Sivan, A. (1994). Multilingual aphasia examina-
tion. AJA Associates.

Bouras, N., Martin, G., Leese, M., Vanstraelen, M., Holt, G., Thomas, C.,
Hindler, C., & Boardman, J. (2004). Schizophrenia-spectrum psychoses in
people with and without intellectual disability. Journal of Intellectual
Disability Research, 48(6), 548–555. https://doi.org/10.1111/j.1365-2788
.2004.00623.x

Brodzinsky, D. M. (1993). On the use and misuse of psychological testing in
child custody evaluations. Professional Psychology, Research and Prac-
tice, 24(2), 213–219. https://doi.org/10.1037/0735-7028.24.2.213

Broshek, D. K., & Barth, J. T. (2000). The halstead-reitan neuropsychologi-
cal test battery. In G. Groth-Marnat (Ed.), Neuropsychological assessment
in clinical practice: A guide to test interpretation and integration (pp.
223–262). Wiley.

Budd, K. S. (2001). Assessing parenting competence in child protection
cases: A clinical practice model. Clinical Child and Family Psychology
Review, 4(1), 1–18. https://doi.org/10.1023/A:1009548509598

Butcher, J. N. (2010). Minnesota multiphasic personality inventory. The
Corsini Encyclopedia of Psychology, 1–3. https://doi.org/10.1002/
9780470479216.corpsy0573

Callow, E., Tahir, M., & Feldman, M. (2017). Judicial reliance on parental IQ
in appellate-level child welfare cases involving parents with intellectual
and developmental disabilities. Journal of Applied Research in Intellectual
Disabilities, 30(3), 553–562. https://doi.org/10.1111/jar.12296

Conley, C. (2004). A review of parenting capacity assessment reports.
Journal of the Ontario Association of Children’s Aid Societies, 47(3),
16–23. https://www.oacas.org/pubs/oacas/journal/2003_2004winter/
2003_2004winter.pdf

Dorenkamp, M. A., & Vik, P. (2018). Neuropsychological assessment
anxiety: A systematic review. Practice Innovations, 3(3), 192–211.
https://doi.org/10.1037/pri0000073

Eryilmaz, H., Tanner, A. S., Ho, N. F., Nitenson, A. Z., Silverstein, N. J.,
Petruzzi, L. J., Goff, D. C., Manoach, D. S., & Roffman, J. L. (2016).
Disrupted working memory circuitry in schizophrenia: Disentangling
fMRI markers of core pathology vs other aspects of impaired performance.
Neuropsychopharmacology, 41(9), 2411–2420. https://doi.org/10.1038/
npp.2016.55

Feldman, M., McConnell, D., & Aunos, M. (2012). Parental cognitive
impairment, mental health, and child outcomes in a child protection
population. Journal of Mental Health Research in Intellectual Disabilities,
5(1), 66–90. https://doi.org/10.1080/19315864.2011.587632

Gass, C. S. (1991). Emotional variables and neuropsychological test
performance. Journal of Clinical Psychology, 47(1), 100–104. https://
doi.org/10.1002/1097-4679(199101)47:1<100::AID-JCLP2270470116>
3.0.CO;2-H

Gass, C. S., & Gutierrez, L. (2017). Psychological variables and Wechs-
ler adult intelligence scale-IV performance. Applied Neuropsychology.
Adult, 24(4), 357–363. https://doi.org/10.1080/23279095.2016
.1185427

Gorlyn, M., Keilp, J. G., Oquendo, M. A., Burke, A. K., Sackeim, H. A., &
John Mann, J. (2006). The WAIS-III and major depression: Absence of
VIQ/PIQ differences. Journal of Clinical and Experimental Neuropsy-
chology, 28(7), 1145–1157. https://doi.org/10.1080/13803390500246944

Graham, J. R. (1990). MMPI-2: Assessing personality and psychopathology.
Oxford University Press.

Green, M. F., Horan, W. P., Lee, J., McCleery, A., Reddy, L. F., & Wynn,
J. K. (2018). Social disconnection in schizophrenia and the general

community. Schizophrenia Bulletin, 44(2), 242–249. https://doi.org/10
.1093/schbul/sbx082

Gronwall, D. M. (1977). Paced auditory serial-addition task: A measure of
recovery from concussion. Perceptual and Motor Skills, 44(2), 367–373.
https://doi.org/10.2466/pms.1977.44.2.367

Heaton, R. K., Grant, I., & Matthews, C. G. (1991). Comprehensive norms
for an expanded Halstead-Reitan Battery: Demographic corrections,
research findings, and clinical applications. Psychological Assessment
Resources.

Kaufman, A. S., Kaufman, J. C., Liu, X., & Johnson, C. K. (2009). How do
educational attainment and gender relate to fluid intelligence, crystallized
intelligence, and academic skills at ages 22–90 years?. Archives of
Clinical Neuropsychology, 24(2), 153–163. https://doi.org/10.1093/
arclin/acp015

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative
syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin,
13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261

McCartan, D., & Gudjonsson, G. (2016). Gender differences in MCMI-III
and WAIS-III scores in parental competency examinees. Personality and
Individual Differences, 102, 36–40. https://doi.org/10.1016/j.paid.2016
.06.035

McGaw, S., Scully, T., & Pritchard, C. (2010). Predicting the unpredictable?
Identifying high-risk versus low-risk parents with intellectual disabilities.
Child Abuse & Neglect: The International Journal, 34(9), 699–710.
https://doi.org/10.1016/j.chiabu.2010.02.006

Meyer, G. J. (2002). Implications of information-gathering methods for a
refined taxonomy of psychopathology. In L. E. Beutler & M. L. Malik
(Eds.), Rethinking the DSM: A psychological perspective (pp. 69–105).
American Psychological Association; https://doi.org/10.1037/10456-003

Morasco, B. J., Gfeller, J. D., & Chibnall, J. T. (2006). The relationship
between measures of psychopathology, intelligence, and memory among
adults seen for psychoeducational assessment. Archives of Clinical
Neuropsychology, 21(4), 297–301. https://doi.org/10.1016/j.acn.2006
.03.005

Overall, J. E., & Gorham, D. R. (1962). The brief psychiatric rating scale.
Psychological Reports, 10(3), 799–812. https://doi.org/10.2466/pr0.1962
.10.3.799

Peña-Salazar, C., Arrufat, F., Santos, J. M., Novell, R., & Valdés-Stauber, J..
(2018). Psychopathology in borderline intellectual functioning: A narra-
tive review. Advances in Mental Health and Intellectual Disabilities,
12(1), 22–33. https://doi.org/10.1108/AMHID-07-2017-0031

Pitschel-Walz, G., Bäuml, J., Froböse, T., Gsottschneider, A., & Jahn, T.
(2009). Do individuals with schizophrenia and a borderline intellectual
disability benefit from psychoeducational groups?. Journal of Intellectual
Disabilities, 13(4), 305–320. https://doi.org/10.1177/1744629509353237

Resendes, J., & Lecci, L. (2012). Comparing the MMPI-2 scale scores of
parents involved in parental competency and child custody assessments.
Psychological Assessment, 24(4), 1054–1059. https://doi.org/10.1037/
a0028585

Shuttleworth-Edwards, A. B., Kemp, R. D., Rust, A. L., Muirhead, J. G.,
Hartman, N. P., & Radloff, S. E. (2004). Cross-cultural effects on IQ test
performance: A review and preliminary normative indications on WAIS-III
test performance. Journal of Clinical and Experimental Neuropsychology,
26(7), 903–920. https://doi.org/10.1080/13803390490510824

Snyder, H. R., Miyake, A., & Hankin, B. L. (2015). Advancing understand-
ing of executive function impairments and psychopathology: Bridging the
gap between clinical and cognitive approaches. Frontiers in Psychology,
6, Article 328. https://doi.org/10.3389/fpsyg.2015.00328

Steinhauer, P. D. (1983). Assessing for parenting capacity. American
Journal of Orthopsychiatry, 53(3), 468–481. https://doi.org/10.1111/j
.1939-0025.1983.tb03391.x

Stordal, K. I., Mykletun, A., Asbjørnsen, A., Egeland, J., Landrø, N. I.,
Roness, A., Rund, B. R., Sundet, K. S., Lundervold, A. J., & Lund, A.
(2005). General psychopathology is more important for executive

T
h
is
d
o
cu
m
en
t
is
co
p
y
ri
g
ht
ed

b
y
th
e
A
m
er
ic
an

P
sy
ch
o
lo
g
ic
al

A
ss
o
ci
at
io
n
o
r
o
n
e
o
f
it
s
al
li
ed

p
u
b
li
sh
er
s.

T
h
is
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
p
er
so
n
al

u
se

o
f
th
e
in
di
v
id
u
al

u
se
r
an
d
is
n
o
t
to

b
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d
is
se
m
in
at
ed

b
ro
ad
ly
.

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functioning than diagnosis. Acta Psychiatrica Scandinavica, 111(1), 22–
28. https://doi.org/10.1111/j.1600-0447.2004.00389.x

Stredny, R. V., Archer, R. P., & Mason, J. A. (2006). MMPI-2 and MCMI-III
characteristics of parental competency examinees. Journal of Personality
Assessment, 87(1), 113–115. https://doi.org/10.1207/s15327752jpa8701_10

Stroop, J. R. (1992). Studies of interference in serial verbal reactions. Journal
of Experimental Psychology: General, 121(1), 15–23. https://doi.org/10
.1037/0096-3445.121.1.15

Wechsler, D. (2008). Wechsler adult intelligence scale-Fourth Edition
(WAIS-IV) [Database record]. APA PsycTests. https://doi.org/10.1037/
t15169-000

Received April 16, 2021
Revision received September 20, 2021

Accepted September 28, 2021 ▪

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PARENTAL COMPETENCY WAIS-IV AND MMPI-2 SCORES 11

A Dyadic Perspective on Psychopathology and
Young Adult Physical Dating Aggression

Ann Lantagne and Wyndol Furman
Department of Psychology, University of Denver

Objective: Although psychopathology has been broadly implicated as a risk factor for dating aggression,
very little work has examined the externalizing and internalizing symptoms of both romantic partners to
more fully understand associations between psychopathology and physical dating aggression among young
adult couples. The present study examined the effects of each partner’s psychopathology on physical dating
aggression, the conjoint influence of both partners’ psychopathology, and whether the effects of psycho-
pathology on aggression depended upon the nature of the relationship. Method: Actor Partner Interdepen-
dence Models were used to examine associations between psychopathology and physical dating aggression
among 127 young adult couples (M age = 22.04 years). Actor Partner Interdependence Moderation Models
(APIMoMs) were then tested to determine whether negative relationship characteristics exacerbated the
effects of psychopathology on aggression. Results: Both males’ and females’ externalizing and internaliz-
ing symptoms were associated with dating aggression. Evidence of homophily was found, and actor partner
interactions revealed that couples in which both partners had high externalizing symptoms were at greater
risk, whereas when either partner had low symptoms, the risk was mitigated. Relationship risk factors
interacted with externalizing symptoms to predict female physical dating aggression, and with internalizing
symptoms to predict partner aggression. Conclusion: Findings lend support to the merits of using a dyadic
approach to examine individual risk factors and combinations of individual and relationship risk factors in
predicting young adult physical dating aggression. Results could potentially inform clinical work on
patterns and combinations of risk factors characteristic of high-risk young adult couples.

Keywords: dating aggression, dating violence, intimate partner violence, romantic relationships, dating

Supplemental materials: https://doi.org/10.1037/vio0000386.supp

Rates of physical dating aggression peak among young adult
couples; in fact, more than half of individuals ages 18–24 report that
they have experienced violence in a relationship (Halpern et al.,
2001; O’Leary, 1999). Psychopathology is a known risk factor for
such aggression (Devries et al., 2013). Indeed, elevated externaliz-
ing symptoms, such as conduct problems and delinquency, and
internalizing symptoms, such as depression and anxiety, are associ-
ated with dating aggression during young adulthood (Vezina &
Hebert, 2007). Existing work, however, has primarily focused on
only one individual’s psychopathology and links with aggression
(Capaldi et al., 2012). Notably, each partner’s characteristics shape
the relationship: among young adult couples, both partners’ antiso-
cial behaviors and depressive symptoms are uniquely associated
with male and female physical dating aggression (Kim & Capaldi,
2004). Young adults also tend to select partners with similar levels

of psychopathology, suggesting that certain combinations of part-
ners may be at greater risk (Kim & Capaldi, 2004). By examining
risk among couples, physical dating aggression can be predicted
above and beyond a single individual’s risk, yet limited work has
taken such a dyadic approach during young adulthood.

One of the primary purposes of the present study was to supple-
ment the limited dyadic work examining both partners’ psychopa-
thology and physical dating aggression during this time. By including
both partners’ risk factors, the present study sought to further our
understanding of whether individual risk factors for dating aggression
can be conceptualized as a dyadic process; specifically, we examined
whether partner psychopathology contributed above and beyond the
association between an individual’s psychopathology and their own
dating aggression. We also examined whether partner similarity
(homophily) occurred for psychopathology and explored the conjoint
influence of both romantic partners’ psychopathology on the risk for
aggression. Finally, the present study extended existing research by
testing a dyadic moderation model to investigate whether relationship
risk factors exacerbated associations between psychopathology and
aggression. Results have the potential to further our understanding of
psychopathology as a risk factor for physical dating aggression
among young adult couples.

A Dyadic Approach to Dating Aggression

The dynamic developmental systems perspective (DDS; Capaldi
et al., 2005) provides a dyadic conceptualization of young adult
physical dating aggression across multiple levels of risk factors.

This article was published Online First April 29, 2021.

Ann Lantagne https://orcid.org/0000-0002-9435-7080
Preparation of this manuscript was supported by Grant 050106 from the

National Institute of Mental Health (Wyndol Furman, P.I.) and Grant 049080
from the National Institute of Child Health and Human Development
(Wyndol Furman, P.I.). Appreciation is expressed to the Project Star staff
for their assistance in collecting the data, and to the Project Star participants
and their partners, friends and families.
Correspondence concerning this article should be addressed to Ann

Lantagne, Department of Psychology, University of Denver, Denver,
CO 80209, United States. Email: [email protected]

Psychology of Violence

© 2021 American Psychological Association 2021, Vol. 11, No. 6, 569–579
ISSN: 2152-0828 https://doi.org/10.1037/vio0000386

569

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At the core level of the perspective are the individual characteristics
and behaviors each partner brings to the relationship, such as
psychopathology or personality traits. The next level incorporates
the relationship risk factors associated with aggression, including
characteristics such as conflict, jealousy, attachment styles, and
satisfaction (Capaldi et al., 2012). The DDS perspective emphasizes
that to understand the risk for dating aggression, the effect of both
partners’ risk factors on their own and their partner’s aggression
must be examined. The perspective also posits that interactions
between the individual and relationship levels can occur (Capaldi
et al., 2012; Kim & Capaldi, 2004; Whitaker et al., 2010).
One statistical approach that allows researchers to examine both

partners’ risk factors and the associations with dating aggression is
the Actor Partner Interdependence Model (APIM; Kenny, 1996). In
APIM, actor effects determine how much each individual’s psycho-
pathology influences their own physical dating aggression, and
partner effects reflect associations between an individual’s psycho-
pathology and the partner’s physical dating aggression. Actor
effects are measured while controlling for partner effects, and
vice versa. Actor partner interactions take into account the interplay
between the two romantic partners’ risk and assess whether combi-
nations of partners’ risk factors result in a greater risk (Figure 1).
Finally, additional moderators can be incorporated into APIM as
well (Garcia et al., 2015).

Psychopathology as a Risk Factor

Two domains of psychopathology associated with physical dating
aggression are externalizing and internalizing symptoms. First, a
number of externalizing symptoms, including delinquency, antiso-
cial behaviors, conduct problems, and general aggression are known
risk factors for young adult dating aggression (Andrews et al., 2000;
Ehrensaft et al., 2003). Across dyadic studies, discrepant patterns
have been found. Among adult cohabiting couples, male and female
antisocial behaviors predict female physical aggression but not male
aggression (Marshall et al., 2011). In contrast, among young adult

couples in which male partners were at high risk for delinquency,
male and female antisocial behaviors predict male physical aggres-
sion, whereas only female antisocial behaviors predict female
aggression (Kim & Capaldi, 2004). Second, internalizing symptoms
are associated with greater reactivity, irritability, withdrawal, nega-
tivity, and perceived alienation, which may underlie an increased
risk for aggression (McCabe & Gotlib, 1993). Dyadic studies
including adult couples highlight significant partner effects, such
that males’ depressive symptoms predict female aggression and
females’ depressive symptoms predict male aggression (Marshall
et al., 2011). Among young adult couples, only females’ depres-
sive symptoms predict male and female aggression concurrently
(Kim & Capaldi, 2004).

Moreover, young adults and their partners tend to have similar
levels of psychopathology, a phenomenon known as homophily
(Kim & Capaldi, 2004; Merikangas, 1982). Homophily can occur by
either assortative mating, in which individuals select partners with
similar levels of psychopathology, or socialization, in which part-
ners exert an influence on one another. Such pairing can increase the
number of couples composed of two individuals who each have a
higher risk for dating aggression. Furthermore, interactions between
the partners’ psychopathology can occur, resulting in higher risk for
aggression. Existing work among young adults has found additive
effects of each partner’s psychopathology on aggression but may
have been underpowered to find interactions between partners
(Kim & Capaldi, 2004).

To date, dyadic studies have focused on psychopathology and
physical dating aggression exclusively among adult couples that
were cohabiting or among high-risk young adult couples that had
lasting relationships (Kim & Capaldi, 2004; Marshall et al., 2011).
During young adulthood, dating aggression often culminates in
breakups, on-again-off-again dynamics, and relationship instability
(Halpern-Meekin et al., 2013; Rhoades et al., 2011). It will there-
fore be informative to supplement existing work by examining
patterns across a range of young adult relationships. Additionally,
by testing the conjoint influence of both partners’ psychopathology
in an adequately powered sample, the field will have a better
understanding of whether certain young adult couples may be at
greater risk.

Relationship Characteristics as Moderators

Although psychopathology is a relatively stable characteristic
(Ferdinand et al., 1995), aggression fluctuates within relationships.
Fifteen percent of individuals who did not initially engage in
physical dating aggression became aggressive a year and a half
later within that relationship, whereas around half of individuals
who were aggressive remained aggressive over time (O’Leary et al.,
1989). As such, psychopathology’s associations with dating aggres-
sion may be exacerbated by the presence of contextual variables
such as relationship characteristics, which vary in young adult
relationships (Ferdinand et al., 1995; Karney & Bradbury, 1995).

Notably, the Vulnerability Stress Adaptation model posits that
individuals with vulnerabilities such as psychopathology who also
experience stressful relationships are most likely to have poor
relationship outcomes (Karney & Bradbury, 1995; Marshall et al.,
2011). The intersection of multiple risk factors could cause a tipping
point in which aggression becomes more likely (Foran & O’Leary,
2008). To the best of our knowledge, only one study has examined

Figure 1
The Actor-Partner Interdependence Model (APIM)

Note. Paths labeled a indicate actor effects and paths labeled p indicate
partner effects. Paths label axp reflect actor partner interactions. Double-
headed arrows represented correlated variables. e1 and e2 represent residual
(explained) portion of perpetration score.

570 LANTAGNE AND FURMAN

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both individual and relationship risk factors. Woodin et al. (2013)
found that lower perceived relationship bond interacted with depres-
sion to predict dating aggression among college couples; however,
existing work has not examined additional relationship risk factors,
explored the interaction with both internalizing and externalizing
symptoms, or used a dyadic approach. By examining the moderating
effect of relationship characteristics, the field can obtain a better
understanding of the roles of both individual and relationship risk
factors and identify potential targets for prevention and intervention.

The Present Study

Existing work has typically examined risk factors for physical
dating aggression by focusing on only one partner; about 5% of
studies have examined risk factors among couples (Capaldi et al.,
2012). In a prior study (Lantagne & Furman, 2020), we used a
dyadic approach to examine the relationship level risk factors from
the Dynamic Developmental Systems theory and found that rela-
tionship characteristics had main effects on dating aggression.
Specifically, our findings demonstrated that both partners’ anxious
relational styles and jealousy predicted male and female aggression;
female satisfaction and female negative interactions predicted male
and female aggression, and each individual’s avoidant style pre-
dicted their partner’s aggression.
The present study used this same dyadic sample as our prior study

to further contribute to the limited dyadic work on risk factors for
dating aggression by first examining a separate level of risk factors
from the Dynamic Developmental Systems theory—the individual
level. We used APIMs to determine associations between each
romantic partner’s externalizing and internalizing symptoms, as
well as interactions between partners’ psychopathology, in predict-
ing young adult physical dating aggression. We then applied an
innovative statistical technique, the Actor Partner Interdependence
Moderation Model (APIMoM) to determine whether interactions
can occur across levels of risk factors. Specifically, we examined the
moderating effect of relationship characteristics on the links
between psychopathology and aggression within couples.
The present study extends our prior work and other existing work

in several important directions. First, a dyadic approach furthers our
understanding of a known risk factor by determining the unique and
conjoint influence of both partners’ psychopathology on young
adult dating aggression. The present study also extends existing
work on psychopathology by examining whether homophily occurs
and whether there are interactions between both partners’ psycho-
pathology, which could place some couples at particularly high risk.
Additionally, by using a dyadic approach to examine individual risk
factors for dating aggression, we determine the utility, and therefore
the generalizability, of such an approach across a variety of risk
factors and multiple levels of risk. Finally, the present study extends
existing dyadic models by incorporating additional variables as
moderators for risk factors for dating aggression. An examination
of such moderation enables us to obtain a more nuanced conceptu-
alization of the role of psychopathology as a risk factor by helping us
to understand whether the effects of psychopathology on dating
aggression have a differing association depending upon the presence
of relationship risk factors. This could lend support to existing
theories that posit that there can be an interplay between levels of
risk factors for aggression.

Hypotheses

Hypotheses included that homophily would occur, such that
individuals would pair with partners who had similar levels of
psychopathology (Hypothesis 1). We hypothesized that higher
physical dating aggression would be associated with higher levels
of an individual’s externalizing symptoms (Hypothesis 2; “a” or
actor path in Figure 1) and their partner’s externalizing symptoms
Hypothesis 3; “p”or partner path in Figure 1). Parallel hypotheses
were posited for internalizing symptoms (Hypothesis 4 & Hypoth-
esis 5). We anticipated female and male psychopathology would
interact to predict physical dating aggression above and beyond the
main effects of each individual’s psychopathology (Hypothesis 6;
“axp” or actor partner interaction path in Figure 1). Moderation
effects were also expected, such that associations between psycho-
pathology and aggression would be strongest when partners expe-
rienced both elevated psychopathology and stressful relationship
characteristics (Hypothesis 7, high psychopathology × high nega-
tive interactions; Hypothesis 8, high psychopathology × high
jealousy; Hypothesis 9, high psychopathology × high anxious
styles; Hypothesis 10, high psychopathology × high avoidant styles;
Hypothesis 11, high psychopathology × low satisfaction, “X1M1”
and “X2M2” paths in Figure 2).

Method

Participants

The participants included in this study and our prior dyadic study
(Lantagne & Furman, 2020) were a dyadic subsample drawn from a
larger longitudinal study examining the role of adolescent and
young adult interpersonal relationships on psychosocial adjustment
(Project STAR; see Furman et al., 2009). Two hundred 10th graders
(100 females) were recruited from a Western metropolitan area in
the United States. To obtain a diverse sample, letters were sent to
families across 36 zip codes of ethnically diverse neighborhoods and
brochures were distributed to students enrolled in three high schools
Interested families were contacted and compensated $25 to hear a
description of the project, with the goal of selecting a quota sample
with a distribution of racial and ethnic groups that approximated that
of the U.S. and had equal rates of males and females. As many
families were contacted who did not have a 10th grader, an
ascertainment rate could not be determined. 85.5% of the families
that heard a description of the project expressed interest and
participated in the Wave 1 assessment. In Wave 1, scores for the
overall sample were compared to comparable national norms of
representative samples for eleven measures of adjustment. Our
sample was more likely to have tried marijuana (54% vs. 40%);
otherwise, sample scores did not differ from national scores on the
other 11 measures, including frequency of marijuana usage (see
Furman et al., 2009).

Procedure and Selection of Dyadic Sample

The dyadic sample from Lantagne & Furman (2020) was used in
the present study. Participants were eligible to invite their romantic
partners to participate in our study if the romantic relationship was
currently three months or longer. 75.7% of the eligible partners
participated (N = 293 of 387). Independent samples t tests were
used to assess for differences between the participants whose partner

PSYCHOPATHOLOGY AND AGGRESSION 571

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participated and those whose partner did not. Those whose partner
participated reported more committed relationships, t(387) = 4.37,
p = .01 and more dating aggression perpetration and victimization,
t(387) = 2.14, p = .01 & t(387) = 2.90, p = .01, respectively. There
were no differences in internalizing and externalizing symptoms.
The dyadic sample was drawn from the first wave during young

adulthood (Waves 5–8) in which the participant had a romantic
partner complete questionnaires. Data were reorganized into scores
for males and females and only heterosexual dating couples were
included to allow APIM analyses of distinguishable dyads. Ten
LGBQ couples were excluded; additionally, seven married couples
were excluded. The resulting sample consisted of 127 couples
(participants’ M age = 22.04 yrs., range = 19.54—26.87 yrs;
average relationship length = 17.77 months, SD = 16.42); 31.5%
of the dyads were cohabiting/engaged. 74% were White, non-
Hispanic, 7.7% African American, 1.85% Asian American, 12.1%
Hispanic,0.7% Native American, and 3.65% biracial. The local
Institutional Review Board approved the study. U.S. Department
of Health and Human Services Certificates of Confidentiality pro-
tected the confidentiality of the data.

Measure

Psychopathology

Each partner completed 35 externalizing and 39 internalizing
items from the Adult Self-Report (Achenbach, 1997); the external-
izing scale included items about aggressive behavior, rule-breaking,
and intrusiveness, whereas the internalizing scale included items
about anxiety/depression, withdrawal, and somatic complaints.

Participants rated how descriptive each item was on a 3-point scale
ranging from 0 = not true of me to 2 = very true or often true of me.
Higher scores indicated greater symptomatology. The ASR has
acceptable internal reliability and construct validity (mean Cron-
bach’s α= .82 for externalizing & α = .88 for internalizing).

Relationship Characteristics

The following relationship characteristics were included in the
present study as moderators. These characteristics were selected
from the prior dyadic study by Lantagne & Furman (2020) because
they were the theoretically driven measures in our data set that
allowed us to examine the constructs of interest and to permit
comparisons across the two studies.

Negative Interactions. Each partner completed the Network
of Relationships Inventory: Behavioral Systems Version (NRI;
Furman & Buhrmester, 2009). Six items assessed negative inter-
actions in the romantic relationship, including conflict, criticism,
and antagonism (e.g., “How much do you and this person get on
each other’s nerves?”). Ratings were made on a 5-point Likert scale
ranging from 1 = Strongly Disagree to 5 = Strongly Agree. Items
were averaged to create a total score; higher scores represented
greater negative interactions; M Cronbach’s α = .91. Validational
evidence is presented in Furman & Buhrmester (2009).

Relationship Satisfaction. A version of Norton’s (1983) Qual-
ity of Marriage Index was adapted to assess young adult relationship
satisfaction. A sample item was “My romantic partner and I have a
good relationship.” The measure consists of five 7-point Likert items
(1 = Strongly Disagree/Not at all true to 7 = Strongly Agree/Very
true), and one 10-point Likert item that assessed overall satisfaction

Figure 2
Actor Partner Interdependence Moderation Model (APIMoMs) for Interaction Between Externalizing Symptoms and Relationship
Satisfaction on Dating Aggression

Male Physical
Dating Aggression (Y1)

Female Physical
Dating Aggression (Y2)

Male Externalizing
Symptoms (X1)

Female Externalizing
Symptoms (X2)

Male Relationship
Satisfaction (M1)

Female Relationship
Satisfaction (M2)

Female Externalizing x
Female Satisfaction (X2M2)

Male Externalizing x
Male Satisfaction (X1M1)

e1

e2

Note. Double-headed arrows represent correlations; e1 and e2 represent residual portion of dating aggression.

572 LANTAGNE AND FURMAN

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with relationship (1 = Extremely Unhappy, 10 = Extremely
Happy). Scores were transformed to a 5-point scale so all items
had the same range and averaged to derive a total score, with higher
scores indicating greater satisfaction; M Cronbach’s α = .95. The
measure has acceptable internal reliability and construct validity
(Baxter & Bullis, 1986).
Jealousy. Pfeiffer and Wong’s (1989) Multidimensional Jeal-

ousy Scale assessed emotional, cognitive, and behavioral jealousy.
Each partner used a 5-point Likert scale (1 = Never to 5 = All the
time) to rate 24 items; a sample item was “I suspect my romantic
partner may be attracted to someone else”; M Cronbach’s α = .89.
The scale has good convergent and discriminant validity (Pfeiffer &
Wong, 1989).
Relational Styles. The Behavioral Systems Questionnaire as-

sessed romantic relational styles (BSQ; Furman & Wehner, 1999).
Each partner used a 5-point Likert scale to rate agreement with 27
statements ranging from 1 = Strongly Disagree to 5 = Strongly
Agree. Two scores were calculated based on previous factor analy-
ses (see Jones & Furman, 2011): (a) an avoidant score, consisting of
the average of 9 dismissing items (e.g., I do not ask my romantic
partner to comfort me) and 9 secure items (reverse scored) and (b)
an anxious score, consisting of the average of 9 preoccupied
items (e.g., I am afraid that my romantic partner thinks I am
too dependent). The scales have acceptable internal reliability
(M Cronbach’s α = .89 for avoidant & .84 for anxious styles)
and validity (Furman et al., 2002).

Physical Dating Aggression

Participants reported on their own and their partner’s use of
physical aggression using Simon and Furman’s (2010) adaptation
of Kurdeck’s Conflict Resolution Style Inventory (Kurdeck, 1994).
Four items assessed physical aggression (Forcefully pushing or
shoving, Slapping or hitting, Throwing items that could hurt, and
Kicking, biting or hair pulling). The items were similar in content to
items on the Conflict Tactics Scale (Straus et al., 1996), but used the
CRSI’s 7-point format (ranging from 1=never; 7= always) to assess
how often each partner engaged in such aggression in arguments
during the past year (M α = .82 for perpetration & .91 for victimi-
zation). Higher scores indicated greater frequency of dating aggres-
sion. Both partners’ reports were used to yield male physical dating
aggression (male self-report & partner report of females, r = .56,
p = .001) and female aggression (female self-report & partner
report of males, r = .35, p = .001). This measure has demonstrated
construct validity over several studies (Collibee et al., 2018;
Collibee & Furman, 2016; Novak & Furman, 2016; Simon &
Furman, 2010) and finds similar rates of dating aggression as other
measures (e.g., 46% of adolescents experienced victimization and
52% perpetration; see Novak & Furman, 2016).

Data Analysis Plan

All variables were examined to ensure acceptable skew and
kurtosis (Behrens, 1997), and outliers were Winsorized. Hypotheses
were tested using MPlus 8.0 (Muthén & Muthén, 2012). Per
guidelines around standardizing dyadic data in SEM (Kenny
et al., 2006), predictor and outcome variables were standardized
by grand mean centering across the entire sample and dividing by
the standard deviation across entire sample. APIMoMs were

conducted to determine whether the effects of an individual’s
psychopathology on their own and their partner’s physical dating
aggression is stronger depending on the nature of the relationship.

Power was assessed using APIM Power R (Ackerman & Kenny,
2016). Given medium-size effects (β = .30) and an alpha of .05, the
power for internalizing and externalizing with 127 dyads is .95 and
.96. Power exceeded .80 for β’s of .25 or greater. APIM Power R
does not assess interaction effects, but Kenny & Cook (1999) noted
that the sample size requirements for multiple regression analyses
apply to APIMs estimated via SEM. Thus, we examined the power
of interaction effects using Cohen’s (1988) calculations for multiple
regression. The estimates of power for the interactions were virtually
identical to those for the main effects.

Results

Descriptive statistics and bivariate correlations are presented in
Table 1. 24.4% of couples endorsed male physical perpetration and
34.6% endorsed female perpetration. Rates of female and male
physical dating aggression were highly correlated, r = .75,
p < .001. Regarding clinical cutoffs, 11.8% of our sample were
in the clinical range for internalizing symptoms and 9.3% were in the
clinical range for externalizing symptoms. Males reported higher
levels of externalizing symptoms than females, t(123) = 1.99,
p = .04; females reported higher levels of internalizing symptoms
than males, t(123) = −3.05, p = .003. Evidence of homophily was
found (Hypothesis 1): male and female externalizing symptoms
were correlated (r = .28, p < .01) and male and female internaliz-
ing symptoms were also correlated (r = .23, p = .02).

Psychopathology

Overall, higher psychopathology was associated with higher
physical dating aggression. Female externalizing symptoms had
an actor effect on female aggression, and male externalizing symp-
toms had an actor effect on male aggression (Hypothesis 2; β = .25,
p < .01 & β = .33, p = .001, respectively). Male externalizing
symptoms had a partner effect on female aggression as well
(Hypothesis 3; β = .40, p < .001). Additionally, male internalizing
symptoms had an actor effect on male aggression, and female
internalizing symptoms had an actor effect on female aggression
(Hypothesis 4; β = .28, p = .001 & β = .21, p = .03, respectively).
Both male and female internalizing symptoms had partner effects
(Hypothesis 5; β = .39, p < .001 & β = .16, p = .05, respectively).

Regarding actor partner interactions, the product terms of male by
female externalizing or internalizing symptoms were then exam-
ined. Significant interactions were interpreted using Preacher et al.’s
(2006) computational tools. The estimated effect of one individual’s
psychopathology on their dating aggression was plotted at three
levels of their partner’s psychopathology: low levels (one standard
deviation below the mean), average levels (at the mean), and high
levels (one standard deviation above the mean). Consistent with our
hypothesis (Hypothesis 6), male and female externalizing symptoms
interacted to predict both male (β = .14, p = .04) and female
aggression (β = .25, p < .001; Figure 3). For couples in which
females had average or high externalizing symptoms, male aggres-
sion increased as male externalizing symptoms increased, t(121) =
2.94, p < .01 for average female externalizing; t(121) = 3.81,
p < .001 for high). Similarly, for couples in which males had average

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or high externalizing symptoms, female aggression increased as female
externalizing symptoms increased, t(121) = 3.21, p = .002 for aver-
age male externalizing; t(121) = 4.46, p < .001 for high male exter-
nalizing). Contrary to hypotheses, there were no interactions between
male and female internalizing symptoms.

Relationship Characteristics as Moderators

Relationship characteristics were then examined as moderators of
associations between psychopathology and dating aggression.

Product interaction terms were created as follows: (1) female
externalizing (or internalizing) symptoms by female relationship
characteristic and (2) male externalizing (or internalizing) symp-
toms by male relationship characteristic (Figure 2). All product
interaction terms were entered after main effects to avoid the
limitations of interpreting conditional main effects (Cohen et al.,
2003; Little, 2013). Main effects of relationship characteristics were
reported in Lantagne and Furman (2020) and thus not presented
here. Due to the number of interaction effects found, only significant
simple slopes are reported in the text; however, nonsignificant
simple slopes are presented as supplemental material.

Female Externalizing Symptoms

Female satisfaction interacted with female externalizing symp-
toms to predict female aggression (see Figure 2, β = −.18, p = .02;
Hypothesis 11), and female jealousy interacted with female exter-
nalizing symptoms to predict female aggression (β = .22, p = .01;
Hypothesis 8). As female externalizing symptoms increased, female
aggression increased for females with low satisfaction, t(115) =
2.76, p = .01. As female externalizing symptoms increased, female
aggression increased for females with high jealousy, t(115) =
2.69, p = .01.

Male Externalizing Symptoms

Male satisfaction interacted with male externalizing symptoms to
predict female aggression (see Figure 2, β = −.22, p = .002;
Hypothesis 11), and male jealousy interacted with male externaliz-
ing symptoms to predict female aggression (β = .18, p = .003;
Hypothesis 8). Male anxious styles and negative interactions inter-
acted with male externalizing symptoms to predict female and
male aggression (β = .16, p = .03 for male anxious styles to
male aggression; β = .26, p = .001 for male anxious styles to
female aggression; β = .17, p = .007 for male negative interactions

Table 1
Means and Standard Deviations of Psychopathology, and Bivariate Correlations of Psychopathology
With Relationship Characteristics and Dating Aggression

Variables 1 2 3 4

Male internalizing symptoms (1) —
Female internalizing symptoms (2) .23* —
Male externalizing symptoms (3) .63** .24** —
Female externalizing symptoms (4) .25** .72** .28** —
Male negative interactions (5) .29** .25** .37** .40**
Female negative interactions (6) .25** .51** .31** .58**
Male satisfaction (7) −.33** −.30** −.27** −.35**
Female satisfaction (8) −.29** −.38** −.21* −.40**
Male jealousy (9) .37** .11 .31** .21*
Female jealousy (10) .18* .44** .26** .49**
Male anxious styles (11) .46** .23* .50** .32**
Female anxious styles (12) .26** .52** .23* .41**
Male avoidant styles (13) .23** .18* .28** .14
Female avoidant styles (14) .11 .15 .14 .15
Male dating aggression (15) .34** .25** .33** .22*
Female dating aggression (16) .38** .27** .46** .37**
Mean (SD in parentheses) 0.28 (0.24) 0.38 (0.26) 0.33 (0.22) 0.28 (0.22)

Note. The correlations were conducted on the measures prior to standardizing them for the APIM analyses. Please
see Lantagne and Furman (2020) for correlations among relationship characteristics and dating aggression.
† p < .10. * p < .05. ** p < .01. *** p < .001.

Figure 3
Actor by Partner Interactions Between Male and Female External-
izing Symptoms on Male Physical Dating Aggression

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to male aggression; β = .25, p < .001 for male negative inter-
actions to female aggression; Hypothesis 9 & Hypothesis 7,
respectively).
First, as male externalizing symptoms increased, female aggres-

sion increased for males with low or average satisfaction (low
t(115) = 5.25, p < .0001 & average t(115) = 4.24, p < .0001).
Next, as male externalizing symptoms increased, female aggression
increased for males with high or average levels of jealousy (high
t(115) = 5.28, p = .0001 & average t(115) = 4.14, p < .0001).
For anxious styles, as male externalizing symptoms increased,

female aggression increased for males with high or average anxious
styles, t(115) = 4.21, p = .0001 for high & t(115) = 2.58, p = .01
for average. Similar patterns were found for predicting male aggres-
sion: as male externalizing symptoms increased, male aggression
increased for males with high anxious styles, t(115) = 2.63,
p = .01. Finally, as males’ externalizing symptoms increased,
female aggression also increased for males with high or average
negative interactions, t(115) = 4.95, p <.001 for high & t(115) =
3.30, p < .001 for average. Regarding male physical dating aggres-
sion, as males’ externalizing symptoms increased, male aggression
increased for males with high negative interactions, t(115) =
2.92, p = .004.

Female Internalizing Symptoms

Female satisfaction and avoidant relational styles interacted with
female internalizing symptoms to predict male dating aggression
(β = −0.17, p = .008 for satisfaction & β = .23, p = .004 for
avoidant styles; Hypothesis 11 & Hypothesis 10 respectively).
As female internalizing symptoms increased, male aggression
increased for females with low satisfaction, t(115) = 2.47,
p = .02. Next, as female internalizing symptoms increased, male
aggression increased for females with high or average avoidant
styles, t(115) = 4.20, p < .001 for high & t(115) = 2.33, p =.02 for
average.

Male Internalizing Symptoms

Male satisfaction and anxious relational styles interacted with
male internalizing symptoms to predict female aggression
(β = −.30, p = .001 for satisfaction & β = .20, p = .01 for anxious
relational styles; Hypothesis 11 & Hypothesis 9 respectively).
Male negative interactions interacted with male internalizing symp-
toms to predict female and male aggression (β = .30, p < .001
for female aggression & β = .16, p = .01 for male aggression;
Hypothesis 7).
First, as female internalizing symptoms increased, female

aggression increased for males with low or average satisfaction,
t(115) = 3.86, p = .001 for low & t(115) = 2.25, p = .03 for
average. Next, as male internalizing symptoms increased, female
aggression increased for males with high anxious styles,
t(115) = 2.34, p = .02. Finally, as male internalizing symptoms
increased, female aggression increased for males with high or
average negative interactions, t(115) = 4.71, p = .001 for high &
t(115) = 2.29, p < .02 for average. Similarly, as male internalizing
symptoms increased, male aggression increased for males with high
reports of negative interactions, t(115) = 3.12, p = .002.

Discussion

The present study contributes to the limited work examining
associations between psychopathology and dating aggression in
young adult couples. Each partner’s psychopathology was associ-
ated with their own and their partner’s aggression. Males and
females externalizing symptoms interacted to predict both partners’
aggression, placing certain couples at greater risk. Additionally,
relationship characteristics interacted with externalizing symptoms
to predict female aggression, and with internalizing symptoms to
predict partner aggression. Present findings add merit to conceptu-
alizing the risk for young adult dating aggression as dyadic,
depending on both partners’ psychopathology and the nature of
the relationship.

Main Effects of Psychopathology and Actor by Partner
Interactions

One goal of the present study was to extend the limited dyadic
work examining young adult psychopathology and physical dating
aggression. Present findings are largely consistent with existing
work on externalizing symptoms (Kim & Capaldi, 2004) and with
our second and third hypotheses: males’ externalizing symptoms
predicted male aggression and both partners’ externalizing symp-
toms predicted female aggression. Whereas existing work has
shown that only females’ depressive symptoms predict male aggres-
sion (Kim & Capaldi, 2004), present findings were also consistent
with our fourth and fifth hypotheses and indicated that both partners’
internalizing symptoms are associated with male and female aggres-
sion. Prior research has focused on relationships of high-risk young
adult males; the present study may have found different patterns due
to greater variability in psychopathology within our community
sample. Despite differences, overall findings demonstrate that both
partners’ psychopathology are risk factors for male and female
physical dating aggression.

Regarding gender, past work has also found that male internaliz-
ing symptoms are less influential in predicting dating aggression
(Kim & Capaldi, 2004). Notably, the present study demonstrated
that both male and female internalizing symptoms predict each
partner’s aggression. In fact, both partners’ externalizing symptoms
also uniquely predicted male and female aggression, highlighting
the importance of a dyadic approach. The present study may have
uncovered effects for both males’ and females’ psychopathology
because we examined each individual’s risk factor on aggression
while controlling for the partner’s effect.

Moreover, consistent with our sixth hypothesis regarding actor
partner interactions, rates of aggression were highest when homo-
phily occurred and both partners had high levels of externalizing
symptoms. Hostile and aggressive patterns of interacting may be
more prevalent and prolonged for these couples, as both partners
could have lower impulse control and emotion regulation abilities
(Capaldi & Kim, 2007; Keenan-Miller et al., 2007). In contrast,
when one partner had low levels of externalizing symptoms, the
other partner’s level of symptoms was not predictive of aggression.
For such couples, the effects of the partner’s externalizing symp-
toms on aggression were mitigated. Findings are consistent with
existing work, which has found that if an individual pair with a
normative partner, adaptive functioning improves, whereas if an

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individual couple with a deviant partner, maladaptive functioning
continues (Pickles & Rutter, 1991; Quinton et al., 1993).

Interactions Between Psychopathology and Relationship
Characteristics

The present study then examined relationship characteristics as
moderators. Male satisfaction and negative interactions interacted
with externalizing symptoms to predict male aggression. Female
satisfaction and jealousy interacted with externalizing symptoms to
predict female aggression. The risk for aggression is high for those
with externalizing symptoms; when combined with low satisfaction,
high conflict, or high jealousy, it may reach a tipping point where the
impulse exceeds inhibition (Reyes et al., 2015). Additionally, con-
sistent with our hypotheses on the moderating role of relationship
characteristics, male negative interactions, jealousy, anxious styles,
and satisfaction interacted with externalizing symptoms to predict
female aggression (Hypothesis 7, Hypothesis 8, Hypothesis 9, &
Hypothesis 1, respectively). As discussed in our prior dyadic study
of this sample (Lantagne & Furman, 2020), such characteristics may
be indices of relationship insecurity. Relationships in which males
experience both higher insecurity and externalizing behaviors may
cultivate a particularly taxing interpersonal context. Such relation-
ship dynamics may also challenge the use of effective communica-
tion strategies within the dyad (Capaldi et al., 2005). Females have
reported that one of the most pervasive explanations for their own
aggression is to show anger, which may be salient in such relation-
ships (O’Keefe, 1997).
Findings for internalizing symptoms were consistent with exist-

ing literature (Longmore et al., 2014), and showed that internalizing
symptoms predicted partner aggression, an association that was
most pronounced in the presence of negative relationship character-
istics. Female avoidant styles and low satisfaction interacted with
internalizing symptoms to predict male aggression (Hypothesis 10 &
Hypothesis 11, respectively). Male negative interactions, jealousy,
anxious styles, and low levels of satisfaction interacted with
internalizing symptoms to predict female aggression (Hypothesis 7,
Hypothesis 8, Hypothesis 9, & Hypothesis 11, respectively). Inter-
nalizing symptoms may impede an individual’s sense of self-
efficacy and self-worth, increasing the odds of entering or remaining
in an unhealthy relationship (Cleveland et al., 2003; Vezina &
Hebert, 2007). Studies suggest that individuals who feel depressed
often stay in poor relationships to avoid losing an interpersonal
connection (Vicary et al., 1995). Additionally, internalizing symp-
toms can impair interpersonal competence (Longmore et al., 2014;
Stroud et al., 2008). Indeed, individuals with high internalizing
symptoms often demonstrate poor problem-solving in romantic
relationships (Vujeva & Furman, 2011). Individuals with poor
communication skills or problem-solving abilities, who are also
in a romantic relationship with negative characteristics may also
experience greater escalation in conflict, resulting in dating aggres-
sion (Riggs & O’Leary, 1989). Globally, for couples in which one
partner has high internalizing symptoms, romantic interactions are
rated by objective outsiders as displaying greater hostility, irritabil-
ity, negative affect, and negative communication (McCabe &
Gotlib, 1993). Thus, the impact of psychopathology on relationship
interactions, when combined with the presence of a negative
relationship may result in greater risk.

Across internalizing and externalizing symptoms, seven signifi-
cant interactions between relationship characteristics and psycho-
pathology were found for males and four for females. Disinhibitory
psychopathology has been found to be a unique risk factor for males
(Ehrensaft et al., 2003), whereas other factors were uniquely pre-
dictive for females. It may be that for males, the combination of
psychopathology and relationship characteristics culminates in dis-
inhibition, whereas other processes are at play for females. Notably,
across genders, the interplay between characteristics and psychopa-
thology suggests that not all individuals who experience psychopa-
thology are involved in aggressive relationships. Rather, consistent
with a theory of multifinality (Cicchetti & Rogosch, 1996), complex
combinations of male and female psychopathology and relationship
characteristics culminate in both partners’ aggression.

In sum, the interactions between individual and relationship risk
factors highlight the interplay across multiple levels of the dynamic
developmental systems theory (Capaldi et al., 2012). In a previous
study of this same sample (Lantagne & Furman, 2020), we identified
a number of relationship characteristics that were dyadic risk factors;
here we found internalizing and externalizing symptoms were
additional dyadic risk factors. However, the risk for dating aggres-
sion is not simply a linear or additive risk: relationship character-
istics appear to work synergistically with psychopathology (Moffitt
et al., 2001) such that individuals who have high levels of psycho-
pathology and who are in stressful relationships are at greater risk for
aggression. Present findings are consistent with theories on multiple
risk factors, which posit that the presence of any single risk factor for
dating aggression can be exacerbated by the presence of additional
risk factors (Kim & Capaldi, 2004). Finally, our findings also add
merit to conceptualizing risk for dating aggression as dynamic
(Collibee & Furman, 2016). The majority of existing studies
have examined the risk for dating aggression as an invariant and
static factor rather than as a risk that changes over time and across
partners. Notably, the degree of current psychopathology and
relationship characteristics can vary between and within young
adult relationships, underscoring the dynamic nature of risk.

Limitations

The present study had several limitations. First, it was cross-
sectional; longitudinal research examining dyadic models of dating
aggression over time is needed to test the temporal order of the
associations between psychopathology and aggression. Externaliz-
ing and internalizing symptoms also tend to co-occur, and indivi-
duals who experience both often have the poorest overall adjustment
(Capaldi & Stoolmiller, 1999). While participant and partner reports
of dating aggression were included, we only incorporated self-
reports of predictors. Additionally, our measure of dating aggression
assesses a range of conflict tactics but has been used less often in
studies of dating aggression. It will be important to replicate the
actor and partner effects with other measures such as the Conflict
Tactics Scale 2 (Straus et al., 1996).

We conducted a number of statistical analyses and thus, it is likely
that some Type I errors may have occurred. Statisticians have
persuasively argued that corrections for Type I error do not solve
the problem and, in fact, present other problems (Garamszegi, 2006;
Nakagawa, 2004; Rothman, 1990; Saville, 1990). Thomas (1998)
argues that simply describing which tests of significance have been
performed and why is the best way to manage multiple comparisons.

576 LANTAGNE AND FURMAN

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In that respect, 24 of our 52 tests of actor, partner, and interaction
effects were significant.
Finally, because the present study drew from a community

sample, there is greater generalizability of our findings than
much existing work. However, our sample consisted of early adult
couples, and it will be important to replicate findings across
adolescence and adulthood to determine developmental differences
in associations. Additionally, our study exclusively included het-
erosexual couples. Dating aggression is also prevalent among
LGBQ couples and it will be imperative to extend dyadic ap-
proaches to LGBQ couples.

Research Implications

Findings from the present study lend additional support to the
utility of using a dyadic approach to more fully understand the
complex relationship among risk factors and dating aggression in
young adult couples. Not only were actor and partner effects found,
but actor partner interactions were found. The effects of high levels
of externalizing symptoms were mitigated when the partner had low
levels. Results also demonstrated that the combination of psycho-
pathology and poor relationship characteristics substantially
increased the likelihood of dating aggression. Our findings under-
score that dating aggression should be conceptualized as a multi-
determined behavior (Capaldi et al., 2012; Foran & O’Leary, 2008);
future studies should expand analyses to include an array of pre-
dictors for both male and female dating aggression, as well as the
interplay among variables, to further our understanding of this
complex phenomenon.

Clinical Implications

Present findings imply that there are several critical points of
intervention. One point would be to focus on decreasing psychopa-
thology; studies indicate that individuals with lower levels of
depression are less likely to be victimized (Halpern et al., 2009).
Alternatively, as different patterns of relationship characteristics
moderated internalizing and externalizing symptoms, relationship
prevention programs that target multiple risk factors may be most
effective (Longmore et al., 2014). Finally, findings could shift the
focus of existing prevention programs from individuals to young
couples (Capaldi & Kim, 2007). Programs may be most effective if
targeting both partners’ externalizing symptoms, as present findings
indicate risk for dating aggression is higher for couples in which
both partners have elevated symptoms.

Conclusion

Taken together, the current study makes several notable con-
tributions to the field on young adult physical dating aggression.
Findings highlight that both partners’ psychopathology is risk
factor. The interplay between partners’ externalizing symptoms
underscores that when couples consist of two individuals with
high externalizing symptoms, the risk for dating aggression in-
creases. Results also demonstrate that psychopathology does not
inevitably lead to dating aggression; rather, the co-occurrence of
individual and relationship characteristics shapes risk. In sum, by
considering combinations of risk factors among couples, researchers
may be better able to predict who is at greatest risk for physical

dating aggression, with which partners, and in which relationships
(Collibee & Furman, 2016; Reese-Weber & Johnson, 2013).

References

Achenbach, T. M. (1997). Manual for the Young Adult Self-Report & Young
Adult Behavior Checklist. University of Vermont Department of
Psychiatry.

Ackerman, R. A., & Kenny, D. A. (2016, December). APIMPower: An
interactive tool for Actor-Partner Interdependence Model power analysis
[Computer software]. https://robert-a-ackerman.shinyapps.io/apimpower/

Andrews, J. A., Foster, S. L., Capaldi, D., & Hops, H. (2000). Adolescent
and family predictors of physical aggression, communication, and satis-
faction in young adult couples: A prospective analysis. Journal of
Consulting and Clinical Psychology, 68(2), 195–208. https://doi.org/10
.1037/0022-006X.68.2.195

Baxter, L. A., & Bullis, C. (1986). Turning points in developing romantic
relationships. Human Communication Research, 12(4), 469–493. https://
doi.org/10.1111/j.1468-2958.1986.tb00088.x

Behrens, J. T. (1997). Principles and procedures of exploratory data analysis.
Psychological Methods, 2(2), 131–160. https://doi.org/10.1037/1082-
989X.2.2.131

Capaldi, D. M., & Kim, H. K. (2007). Typological approaches to violence in
couples: A critique and alternative conceptual approach. Clinical Psychol-
ogy Review, 27(3), 253–265. https://doi.org/10.1016/j.cpr.2006.09.001

Capaldi, D. M., Knoble, N. B., Shortt, J. W., & Kim, H. K. (2012). A
systematic review of risk factors for intimate partner violence. Partner
Abuse, 3(2), 231–280. https://doi.org/10.1891/1946-6560.3.2.231

Capaldi, D. M., Shortt, J. W., & Kim, H. K. (2005). A lifespan developmental
systems perspective on aggression toward a partner. In W. M. Pinsof &
J. L. Lebow (Eds.), Family psychology: Art of the science (pp. 141–167).
Oxford University Press.

Capaldi, D. M., & Stoolmiller, M. (1999). Co-occurrence of conduct
problems and depressive symptoms in early adolescent boys: III. Predic-
tion to young-adult adjustment. Development and Psychopathology,
11(1), 59–84. https://doi.org/10.1017/S0954579499001959

Cicchetti, D., & Rogosch, F. A. (1996). Equifinality and multifinality in
developmental psychopathology. Development and Psychopathology,
8(4), 596–600. https://doi.org/10.1017/S0954579400007318

Cleveland, H. H., Herrera, V. M., & Stuewig, J. (2003). Abusive males and
abused females in adolescent relationships: Risk factor similarity and
dissimilarity and the role of relationship seriousness. Journal of Family
Violence, 18, 325–339. https://doi.org/10.1023/A:1026297515314

Cohen, J. (1988). Statistical power analysis for the behavioral sciences
(2nd ed.). Lawrence Erlbaum.

Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple
regression/correlation analysis for the behavioral sciences (3rd ed.).
Lawrence Erlbaum.

Collibee, C., & Furman, W. (2016). Chronic and acute relational risk factors
for dating aggression in adolescence and young adulthood. Journal of
Youth and Adolescence, 45, 763–776. https://doi.org/10.1007/s10964-
016-0427-0

Collibee, C., Furman, W., & Shoop, J. (2018). Risky interactions: Relational
and developmental moderators of substance use and dating aggression.
Journal of Youth and Adolescence, 48, 102–113. https://doi.org/10.1007/
s10964-018-0950-2

Devries, K. M., Mak, J. Y., Bacchus, L. J., Child, J. C., Falder, G., Petzold,
M., Astbury, J., & Watts, C. (2013). Intimate partner violence and incident
depressive symptoms and suicide attempts: A systematic review longitu-
dinal studies. PLoS Medicine, 10(5), Article e1001439. https://doi.org/10
.1371/journal.pmed.1001439

Ehrensaft, M. K., Cohen, P., Brown, J., Smailes, E., Chen, H., & Johnson,
J. G. (2003). Intergenerational transmission of partner violence: A 20 year

PSYCHOPATHOLOGY AND AGGRESSION 577

T
h
is
d
o
cu
m
en
t
is
co
p
y
ri
g
ht
ed

b
y
th
e
A
m
er
ic
an

P
sy
ch
o
lo
g
ic
al

A
ss
o
ci
at
io
n
o
r
o
n
e
o
f
it
s
al
li
ed

p
u
b
li
sh
er
s.

T
h
is
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
p
er
so
n
al

u
se

o
f
th
e
in
di
v
id
u
al

u
se
r
an
d
is
n
o
t
to

b
e
d
is
se
m
in
at
ed

b
ro
ad
ly
.

prospective study. Journal of Consulting and Clinical Psychology, 71(4),
741–753. https://doi.org/10.1037/0022-006X.71.4.741

Ferdinand, R. F., Verhulst, F. C., & Wiznitzer, M. (1995). Continuity and
change of self-reported problem behaviors from adolescence into young
adulthood. Journal of the American Academy of Child & Adolescent
Psychiatry, 34(5), 680–690. https://doi.org/10.1097/00004583-199505000-
00020

Foran, H. M., & O’Leary, K. D. (2008). Alcohol and intimate partner
violence: A meta-analytic review. Clinical Psychology Review, 28(7),
1222–1234. https://doi.org/10.1016/j.cpr.2008.05.001

Furman, W., & Buhrmester, D. (2009). Methods and measures: The network
of relationships inventory: Behavioral systems version. International
Journal of Behavioral Development, 33(5), 470–478. https://doi.org/10
.1177/0165025409342634

Furman, W., Low, S., & Ho, M. (2009). Romantic experience and psycho-
social adjustment in middle adolescence. Journal of Clinical Child and
Adolescent Psychology, 38(1), 75–90. https://doi.org/10.1080/
15374410802575347

Furman, W., Simon, V. A., Shaffer, L., & Bouchey, H. A. (2002). Adoles-
cents’ working models and styles for relationships with parents, friends,
and romantic partners. Child Development, 73(1), 241–255. https://
doi.org/10.1111/1467-8624.00403

Furman, W., & Wehner, E. A. (1999). The behavioral systems questionnaire-
revised [Unpublished measure]. University of Denver.

Garamszegi, L. Z. (2006). Comparing effect sizes across variables: Gener-
alization without the need for Bonferroni correction. Behavioral Ecology,
17(4), 682–687. https://doi.org/10.1093/beheco/ark005

Garcia, R. L., Kenny, D. A., & Ledermann, T. (2015). Moderation in the
actor-partner interdependence model. Personal Relationships, 22(1), 8–
29. https://doi.org/10.1111/pere.12060

Halpern, C. T., Oslak, S. G., Young, M. L., Martin, S. L., & Kupper, L. L.
(2001). Partner violence among adolescents in opposite-sex romantic
relationships: Findings from the National Longitudinal Study of Adoles-
cent Health. American Journal of Public Health, 91(10), 1679–1685.
https://doi.org/10.2105/AJPH.91.10.1679

Halpern, C. T., Spriggs, A. L., Martin, S. L., & Kupper, L. L. (2009). Patterns
of intimate partner violence victimization from adolescence to young
adulthood in a nationally representative sample. Journal of Adolescent
Health, 45(5), 508–516. https://doi.org/10.1016/j.jadohealth.2009.03.011

Halpern-Meekin, S., Manning, W. D., Giordano, P. C., & Longmore, M. A.
(2013). Relationship churning, physical violence, and verbal abuse in
young adult relationships. Journal of Marriage and Family, 75(1), 2–12.
https://doi.org/10.1111/j.1741-3737.2012.01029.x

Jones, M. C., & Furman, W. (2011). Representations of romantic relation-
ships, romantic experience and sexual behavior in adolescence. Personal
Relationships, 18(1), 144–164. https://doi.org/10.1111/j.1475-6811.2010
.01291.x

Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital
quality and stability: A review of theory, methods, and research. Psycho-
logical Bulletin, 118(1), 3–34. https://doi.org/10.1037/0033-2909.118.1.3

Keenan-Miller, D., Hammen, C., & Brennan, P. (2007). Adolescent psycho-
social risk factors for severe intimate partner violence in young adulthood.
Journal of Consulting and Clinical Psychology, 75(3), 456–463. https://
doi.org/10.1037/0022-006X.75.3.456

Kenny, D. A. (1996). Models of non-interdependence in dyadic research.
Journal of Social and Personal Relationships, 13(2), 279–294. https://
doi.org/10.1177/0265407596132007

Kenny, D. A., & Cook, W. (1999). Partner effects in relationship research:
Conceptual issues, analytic difficulties, and illustrations. Personal
Relationships, 6(4), 433–448. https://doi.org/10.1111/j.1475-6811.1999
.tb00202.x

Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis.
Guilford Press.

Kim, H. K., & Capaldi, D. M. (2004). The association of antisocial behavior
and depressive symptoms between partners and risk for aggression in
romantic relationships. Journal of Family Psychology, 18(1), 82–96.
https://doi.org/10.1037/0893-3200.18.1.82

Kurdeck, L. A. (1994). Conflict resolution styles in gay, lesbian, heterosex-
ual nonparent, and heterosexual parent couples. Journal of Marriage and
the Family, 56(3), 705–722. https://doi.org/10.2307/352880

Lantagne, A., & Furman, W. (2020). More than the sum of two partners: A
dyadic perspective on young adult physical dating aggression. Psychology
of Violence, 10(4), 379–389. https://doi.org/10.1037/vio0000267

Little, T. D. (2013). Longitudinal structural equation modeling. Guilford
Press.

Longmore, M. A., Manning, W. D., Giordano, P. C., & Copp, J. E. (2014).
Intimate partner victimization, poor relationship quality, and depressive
symptoms during young adulthood. Social Science Research, 48, 77–89.
https://doi.org/10.1016/j.ssresearch.2014.05.006

Marshall, A. D., Jones, D. E., & Feinburg, M. (2011). Enduring vulner-
abilities, relationship attributions, and couple conflict: An integrative
model of the occurrence and frequency of intimate partner violence.
Journal of Family Psychology, 25(5), 709–718. https://doi.org/10.1037/
a0025279

McCabe, S. B., & Gotlib, I. H. (1993). Interactions of couples with and
without a depressed spouse: Self-reported and observations of problem-
solving situations. Journal of Social and Personal Relationships, 10(4),
589–599. https://doi.org/10.1177/0265407593104007

Merikangas, K. R. (1982). Assortative mating for psychiatric disorders and
psychological traits. Archives of General Psychiatry, 39(10), 1173–1180.
https://doi.org/10.1001/archpsyc.1982.04290100043007

Moffitt, T. E., Robins, R. W., & Caspi, A. (2001). A couples analysis of
partner abuse with implications for abuse-prevention policy. Criminology &
Public Policy, 1(1), 5–36. https://doi.org/10.1111/j.1745-9133.2001
.tb00075.x

Muthén, L. K., & Muthén, B. O. (2012). Mplus.
Nakagawa, S. (2004). A farewell to Bonferroni: The problems of low
statistical power and publication bias. Behavioral Ecology, 15(6),
1044–1045. https://doi.org/10.1093/beheco/arh107

Norton, R. (1983). Measuring marital quality: A critical look at the depen-
dent variable. Journal of Marriage and the Family, 45(1), 141–151.
https://doi.org/10.2307/351302

Novak, J., & Furman, W. (2016). Partner violence during adolescence and
young adulthood: Individual and relationship level risk factors. Journal of
Youth and Adolescence, 45, 1849–1861. https://doi.org/10.1007/s10964-
016-0484-4

O’Keefe, M. (1997). Predictors of dating violence among high school
students. Journal of Interpersonal Violence, 12(4), 546–568. https://
doi.org/10.1177/088626097012004005

O’Leary, K. D. (1999). Developmental and affective issues in assessing and
treating partner aggression. Clinical Psychology: Science and Practice,
6(4), 400–414. https://doi.org/10.1093/clipsy.6.4.400

O’Leary, K. D., Barling, J., Arias, I., Rosenbaum, A., Malone, J., & Tyree, A.
(1989). Prevalence and stability of physical aggression between spouses:
A longitudinal analysis. Journal of Consulting and Clinical Psychology,
57(2), 263–268. https://doi.org/10.1037/0022-006X.57.2.263

Pfeiffer, S. M., & Wong, P. T. P. (1989). Multidimensional jealousy. Journal
of Social and Personal Relationships, 6(2), 181–196. https://doi.org/10
.1177/026540758900600203

Pickles, A., & Rutter, M. (1991). Statistical and conceptual models
of “turning points” in developmental processes. In D. Magnusson, L.
Bergman, G. Rudinger, & B. Torestad (Eds.), Problems and methods in
longitudinal research: Stability and change (pp. 131–165). Cambridge
University Press.

Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for
probing interactions in multiple linear regression, multilevel modeling,

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.

and latent curve analysis. Journal of Educational and Behavioral Statis-
tics, 31(4), 437–448. https://doi.org/10.3102/10769986031004437

Quinton, D., Pickles, A., Maughan, B., & Rutter, M. (1993). Partners, peers,
and pathways: Assortative pairing and continuities in conduct disorder.
Development and Psychopathology, 5(4), 763–783. https://doi.org/10
.1017/S0954579400006271

Reese-Weber, M., & Johnson, A. I. (2013). Examining dating violence from
the relational context. In H. R. Cunningham & W. F. Berry (Eds.),
Handbook on the psychology of violence (pp. 53–76). Nova Publishing.

Reyes, H. L., Foshee, V. A., Tharp, A. T., Ennett, S. T., & Bauer, D. J.
(2015). Substance use and physical dating violence: The role of contextual
moderators. American Journal of Preventive Medicine, 49(3), 467–475.
https://doi.org/10.1016/j.amepre.2015.05.018

Rhoades, G. K., Kamp-Dush, C. M., Atkins, D. C., Stanley, S. M., &
Markman, H. J. (2011). Breaking up is hard to do: The impact of
unmarried relationship dissolution on mental health and life satisfaction.
Journal of Family Psychology, 25(3), 366–374. https://doi.org/10.1037/
a0023627

Riggs, D. S., & O’Leary, K. D. (1989). The development of a model of
courtship aggression. In M. A. Pirog-Good & J. E. Stets (Eds.), Violence in
dating relationships: Emerging social issues (pp. 53–71). Praeger.

Rothman, K. (1990). No adjustments are needed for multiple comparisons.
Epidemiology (Cambridge, Mass.), 1(1), 43–46.

Saville, R. (1990). Multiple comparison procedures: The practical solution.
The American Statistician, 40(2), 174–180.

Simon, V. A., & Furman, W. (2010). Interparental conflict and adolescents’
romantic relationships. Journal of Research on Adolescence, 20(1), 188–
209. https://doi.org/10.1111/j.1532-7795.2009.00635.x

Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996).
The revised conflict tactics scale (CTS2): Development and preliminary
psychometric data. Journal of Family Issues, 17(3), 283–316. https://
doi.org/10.1177/019251396017003001

Stroud, C. B., Davila, J., & Moyer, A. (2008). The relationship between
stress and depression in first onsets versus recurrences: A meta analytic
review. Journal of Abnormal Psychology, 117(1), 206–213. https://
doi.org/10.1037/0021-843X.117.1.206

Thomas, V. P. (1998). What’s wrong with Bonferroni adjustments. British
Medical Journal, 316(1236), 1236–1238. https://doi.org/10.1136/bmj.316
.7139.1236

Vezina, J., & Hebert, M. (2007). Risk factors for victimization in romantic
relationships of young women: A review of empirical studies and im-
plications for prevention. Trauma, Violence & Abuse, 8(1), 33–66. https://
doi.org/10.1177/1524838006297029

Vicary, J. R., Klingaman, L. R., & Harkness, W. L. (1995). Risk
factors associated with date rape and sexual assault of adolescent girls.
Journal of Adolescence, 18(3), 289–306. https://doi.org/10.1006/jado
.1995.1020

Vujeva, H. M., & Furman, W. (2011). Depressive symptoms and romantic
relationship qualities from adolescence through emerging adulthood: A
longitudinal examination of influences. Journal of Clinical Child and
Adolescent Psychology, 40(1), 123–135.

Whitaker, D. J., Le, B., & Niolon, P. H. (2010). Persistence and desistance of
the perpetration of physical aggression across relationships: Findings from
a national study of adolescents. Journal of Interpersonal Violence, 25(4),
591–609. https://doi.org/10.1177/0886260509334402

Woodin, E. M., Caldeira, V., & O’Leary, K. D. (2013). Dating aggression in
emerging adulthood: Interactions between relationship processes and
individual vulnerabilities. Journal of Social and Clinical Psychology,
32(6), 619–650. https://doi.org/10.1521/jscp.2013.32.6.619

Received October 27, 2019
Revision received February 20, 2021

Accepted March 8, 2021 ▪

PSYCHOPATHOLOGY AND AGGRESSION 579

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  • A Dyadic Perspective on Psychopathology and Young Adult Physical Dating Aggression
    • Outline placeholder
      • A Dyadic Approach to Dating Aggression
      • Psychopathology as a Risk Factor
      • Relationship Characteristics as Moderators
      • The Present Study
      • Hypotheses
    • Method
      • Participants
      • Procedure and Selection of Dyadic Sample
      • Measure
        • Psychopathology
        • Relationship Characteristics
          • Negative Interactions
          • Relationship Satisfaction
          • Jealousy
          • Relational Styles
      • Physical Dating Aggression
      • Data Analysis Plan
    • Results
      • Psychopathology
      • Relationship Characteristics as Moderators
        • Female Externalizing Symptoms
        • Male Externalizing Symptoms
        • Female Internalizing Symptoms
        • Male Internalizing Symptoms
    • Discussion
      • Main Effects of Psychopathology and Actor by Partner Interactions
      • Interactions Between Psychopathology and Relationship Characteristics
      • Limitations
      • Research Implications
      • Clinical Implications
      • Conclusion
    • References

Clinical Medicine Insights: Psychiatry
Volume 13: 1–5
© The Author(s) 2022
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/11795573211069912

Does fear mediate the neuroticism-psychopathology
link for adults living through the COVID-19 pandemic?

Sherman A. Lee1 and Mary C. Jobe2
1Christopher Newport University, Newport News, VA, USA.
2The George Washington University, Washington, DC, USA.

ABSTRACT

BACKGROUND: COVID-19 has globally increased psychological distress. Although research has shown a clear link between neuroticism and
psychopathology, pandemic fears—manifesting as fear of death and coronavirus anxiety, have not been examined as mediating factors for
explaining this connection during the pandemic.

METHODS: Therefore, to fill this void in the literature, this study examined 259 U.S. MTurk adult workers in May 2020 using an online questionnaire.
The study used the Patient Health Questionnaire, the 8-item Big Five Inventory neuroticism subscale, a single-item fear of death measure, and the
Coronavirus Anxiety Scale as well as collected demographic information to perform correlational and meditation analyses.

RESULTS: The results showed that both coronavirus anxiety and fear of death partially mediated the relationship between neuroticism and
symptoms of depression and generalized anxiety. The results also found that those high in trait neuroticism who were fearful of death or had
coronavirus anxiety showed heightened levels of depression and general anxiety.

CONCLUSION: This study’s findings were consistent with previous research and current work on pandemic-related distress. In addition, the results
of these findings can help bring to light the connectedness of these psychopathological constructs with fears surrounding the pandemic—which
can be useful to both researchers and mental health professionals alike.

KEYWORDS: Neuroticism, COVID-19, fear of death, coronavirus, anxiety, depression

RECEIVED: February 7, 2021. ACCEPTED: December 10, 2021.

TYPE: Original Research

DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential conflicts
of interest with respect to the research, authorship, and/or publication of this article.

FUNDING: The author(s) received no financial support for the research, authorship, and/or
publication of this article.

ETHICAL APPROVAL: All procedures performed in this study were in accordance with the ethical
standards of Christopher Newport University’s ethics and IRB approval committee. In addition, the
procedures are in accordance with the Declaration of Helsinki or ethical equivalent. In addition,
informed consent was obtained from all individual adult participants included in the study.

CORRESPONDING AUTHOR: Mary C. Jobe, The George Washington University, 2125 G Street
NW, Washington, DC, 20052, USA. Email: [email protected]

Introduction
As the pandemic persists, so does the worsening of people’s

mental health and well-being.1 For example, during the first

months of the pandemic, 24.4% of Americans reported clinical

levels of depression, while 29.8% reported clinical levels of

anxiety.2 One factor that has been found to be strongly associated

with depression and generalized anxiety during the COVID-19

pandemic is neuroticism.3 According to the Five-Factor model,

neuroticism describes a broad dimension of personality concerned

with tendencies to experience negative affect, and disturbed

thoughts and behaviors that accompany emotional distress.4 The

finding that neuroticism is associated with adjustment difficulties

during the COVID-19 pandemic should not be surprising given

that individuals high in this personality trait have long been

known to suffer from a wide-range of mental and physical health

conditions5 as well as psychological distress during previous

pandemics.6,7 However, what is not clear is what the psycho-

logical mechanisms are that explain why individuals high in this

trait are experiencing heightened levels of psychological distress

during this particular global health crisis.

The COVID-19 pandemic has been shrouded by fear and

anxiety with millions of people dead from this highly infectious

disease. Consequently, many people living in this pandemic fear

for their lives and the coronavirus itself, as the virus can lead to

the death and suffering of oneself and their loved ones. Ac-

cordingly, research during this pandemic has shown that both

death anxiety and coronavirus anxiety are both positively cor-

related with depression and generalized anxiety.8,9 Moreover,

past7 and current research3,10 has shown that neuroticism is

strongly tied to pandemic-related fears and psychopathology.

That said, although research has shown a clear link between

neuroticism and psychopathology (i.e., anxiety and depression),

pandemic fears—such as fear of death and coronavirus anxiety,

have not been examined as mediating factors for explaining this

connection during the pandemic. Thus, this study will aim to

address this; we anticipate that fear of death and coronavirus

anxiety will mediate the relationship between neuroticism and

psychopathology in a sample of adults during the COVID-19

pandemic. These causal implications can enlighten the rela-

tionships these constructs hold—helping researchers better

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial
4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without

further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

understand COVID-19’s psychological impacts and possible

avenues for treatment.

Method
Participants and procedures

Data from 259 adult MTurk
11

workers in the U.S. who

completed an online survey on May 15 and 16, 2020 were used

in this IRB approved study. The sample consisted of 116

women and 143 men, with a median age of 33.00 years (ranging

from 18 to 65). Most of the participants were White (n = 165;

63.7%), had earned at least a Bachelor’s degree (n = 190; 73.4%),

had not tested positive for COVID-19 (n = 227; 87.6%), and

did not know someone with COVID-19 (n = 147; 56.8%). The

participants provided consent and received payment ($0.50) for

their involvement in this study.

Measures

Background information. Participants were asked to report their

age, gender, race, level of education, diagnosis of COVID-19,

and personal knowledge of someone with COVID-19.

Psychopathology. Symptoms of psychopathology were mea-

sured using the four-item Patient Health Questionnaire-4.12

Participants indicated how frequently they experienced symp-

toms of depression (e.g., feeling down, depressed, or hopeless; α =
.80) and generalized anxiety (e.g., feeling nervous, anxious, or on

edge; α = .78) over the last 2 weeks using a 4-point scale.
Neuroticism. The generalized tendency to experience negative

emotions was measured using the 8-item neuroticism subscale of

the Big Five Inventory.
13

Participants indicated how much they

agreed or disagreed with descriptions of neuroticism (e.g., I see

myself as someone who worries a lot) using a 4-point scale (α = .81).
Fear of Death. Fear of death was measured using a single-item

Fear of Death measure.14 Although a single-item, it has been

found to reliably assess fear of death and moderately be associated

with multi-item death anxiety scales.14 For the item, participants

indicated how much they agreed or disagreed with the statement,

“I am afraid of death” using a 4-point scale. Most of the par-

ticipants reported that they agree a little (28.2%), followed by

neither agree nor disagree (19.7%), strongly agree (18.9%), disagree

a little (17.8%), and strongly disagree (15.4%) to the item.

Coronavirus anxiety. Dysfunctional anxiety over the coro-

navirus was measured using the 5-item Coronavirus Anxiety

Scale.15 Participants indicated how frequently they experienced

physiologically based symptoms of fear and anxiety over the

coronavirus (e.g., I felt dizzy, lightheaded, or faint, when I read or

listened to news about the coronavirus) over the last 2 weeks using

a 4-point scale (α = .94).

Statistical procedures

Statistical analyses were calculated using SPSS version 26.0,

except for the mediation analyses, which were run using AMOS

version 25.0. We tested mediators one at a time to determine

independent effects16 and employed bias-corrected bootstrap

procedures using 2,000 resamples to the models.17 We chose a

bootstrap resampling method because its calculation of confi-

dence intervals is not biased by sample size, effect size, or level of

statistical significance.18

Results
Correlations

Zero-order correlations were run to examine the bivariate asso-

ciations between the measures of psychopathology, neuroticism,

and the proposed mediators of fear of death and coronavirus

anxiety (see Table 1). The results revealed that depression was

correlated with neuroticism (r = .64), fear of death (r = .40),

coronavirus anxiety (r = .66), and generalized anxiety (r = .76).

Generalized anxiety was also correlated with neuroticism (r =

.68), fear of death (r = .47), and coronavirus anxiety (r = .62).

Neuroticism was correlated with fear of death (r = .40), and

coronavirus anxiety (r = .42). Fear of death was correlated with

coronavirus anxiety (r = .33), supporting their related but

distinct expressions of pandemic fear. These intercorrelation

patterns support the inclusion of the variables in the mediation

analyses.

Mediation analyses

Four mediation analyses were conducted to examine the sep-

arate influences of proposed mediators on the association be-

tween neuroticism and psychopathology (i.e., depression and

generalized anxiety). The first model tested coronavirus anxi-

ety’s mediating influence on the relationship between neurot-

icism and depression (see Figure 1). The bootstrap results

showed that the standardized indirect (mediated) effect of

neuroticism on depression was significantly different from zero

(P = .001, 95% CI [.15, .27]). Therefore, this model demon-

strated that coronavirus anxiety partially mediated the

neuroticism-depression link (β from .64 to .44) with a stan-
dardized indirect effect of .20.

The second model tested coronavirus anxiety’s mediating

influence on the relationship between neuroticism and gener-

alized anxiety (see Figure 2). The bootstrap results showed that

the standardized indirect (mediated) effect of neuroticism on

generalized anxiety was significantly different from zero (P =

.001, 95% CI [.12, .23]). Therefore, this model demonstrated

that coronavirus anxiety partially mediated the neuroticism-

generalized anxiety link (β from .68 to .51) with a standardized
indirect effect of .17.

The third model tested death anxiety’s mediating influence

on the relationship between neuroticism and depression (see

Figure 3). The bootstrap results showed that the standardized

indirect (mediated) effect of neuroticism on depression was

significantly different from zero (P = .001, 95% CI [.03, .12]).

Therefore, this model demonstrated that fear of death partially

2 Clinical Medicine Insights: Psychiatry
n n

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mediated the neuroticism-depression anxiety link (β from .64
to .57) with a standardized indirect effect of .07. The last

model tested fear of death’s mediating influence on the re-

lationship between neuroticism and generalized anxiety (see

Figure 4). The bootstrap results showed that the standardized

indirect (mediated) effect of neuroticism on generalized

anxiety was significantly different from zero (P = .001, 95%

CI [.05, .15]). Therefore, this model demonstrated that fear

of death partially mediated the neuroticism-generalized

anxiety link (β from .68 to .59) with a standardized indi-
rect effect of .09.

Discussion
Overall, the COVID-19 pandemic has had an impact on mental

health. In addition, past literature has demonstrated that in

general and during pandemic times, neuroticism may play a role

in who may be more likely to experience such psychopathology

(i.e., anxiety and depression).5,19-21 Our study aimed to assess

what other mechanisms may help to explain this neuroticism-

psychopathology relationship—by exploring pandemic fears,

specifically fear of death and coronavirus anxiety. In sum, the

results demonstrated that the potential mediators explained

some of the reason as to why individuals high in trait neu-

roticism experienced elevated psychopathology symptoms

during the COVID-19 crisis. Our findings are consistent with

Nikčević and colleagues’ (2021) predicted model for COVID-19

anxiety as a mediator in the neuroticism-generalized anxiety and

neuroticism-depression relationships; however, the results of their

study did not yield significant findings between these variables.22

Moreover, our study’s findings support past literature and provide

further analysis, for using mediations to explain the fear rela-

tionships, within the pandemic context, between these commonly

associated variables: neuroticism and psychopathology. In addition,

the results demonstrate that those high in trait neuroticism, in

particular, who are fearful of death or have coronavirus anxiety may

also show these heightened levels of depression and general

anxiety. Literature has shown such psychopathology has been

increasing during COVID-1923,24 and that those high in trait

neuroticism are a vulnerable population during pandemics.7,25 This

study synthesizes these relationships, supporting Lee and Crunk

(2020)3 in showing how fears can explain these associations. After

accounting for pandemic specific fears, researchers and mental

health professionals are able to understand the bigger picture as to

why individuals high in trait neuroticism may be especially sus-

ceptible to such psychopathology, using these findings.

There are many possible approaches to treating people with

depression, generalized anxiety, and issues associated with

neuroticism during the COVID-19 pandemic. One method that

has been shown to successfully treat individuals suffering from

psychological distress and high in neuroticism, while considering

pandemic spatial distancing practices, has been the use of

Figure 4. Mediating effect of fear of death on the association between
neuroticism and generalized anxiety. Note. Two-sided bias-corrected

bootstrap procedure (95% confidence intervals; 2,000 samples). Above

values reflect standardized regression coefficients. *** P < .001.

Figure 3. Mediating effect of fear of death on the association between
neuroticism and depression. Note. Two-sided bias-corrected bootstrap

procedure (95% confidence intervals; 2,000 samples). Above values reflect

standardized regression coefficients. *** P < .001.

Figure 2. Mediating effect of coronavirus anxiety on the association between
neuroticism and generalized anxiety. Note. Two-sided bias-corrected

bootstrap procedure (95% confidence intervals; 2,000 samples). Above

values reflect standardized regression coefficients. *** P < .001.

Figure 1. Mediating effect of coronavirus anxiety on the association between
neuroticism and depression. Note. Two-sided bias-corrected bootstrap

procedure (95% confidence intervals; 2,000 samples). Above values reflect

standardized regression coefficients. *** P < .001.

4 Clinical Medicine Insights: Psychiatry
n n

telehealth. Hedman et al (2014)26 found that using internet-

based cognitive behavior therapy, especially for individuals high

in neuroticism, has shown to be effective in and even lessened

both psychological distress and tendencies of those high in trait

neuroticism. Adopting this method of therapy to address pan-

demic fears and psychopathology for individuals high in trait

neuroticism may be both practical and beneficial, especially as the

pandemic persists and mental health issues rise.

This research has a major limitation worth noting. Specif-

ically, this study was constrained by a relatively small conve-

nience sample. Future research would benefit from a probability

sampling approach that would result in obtaining a large,

representative sample where more sophisticated mediation

analyses that examines both independent and simultaneous

effects could be applied. In addition, fear of death was only

assessed using a single item; further research could examine this

construct using longer measures. Further this research was

conducted using self-report measures, which could be subject to

possible social desirability. Notwithstanding these limitations,

our research reports important data that contribute to our

understanding of the mental health consequences of the pan-

demic. By understanding the causal implications of this study’s

findings, researchers can further explore COVID-19’s psy-

chological effects in relation to psychopathology and pandemic

fears; and mental health professionals can examine the effects of

neuroticism when adopting telehealth therapy and other ef-

fective approaches to help address these fears.(26)

Acknowledgements
The authors would like to thank those who participated.

ORCID iD
Mary C. Jobe  https://orcid.org/0000-0001-7106-7120

REFERENCES
1. Panchal N, Kamal R, Orgera K, et al. Mental health and substance abuse. Kaiser

Family Foundation. 2020. https://www.kff.org/coronavirus-covid-19/issue-brief/

the-implications-of-covid-19-for-mental-health-and-substance-use/.

2. Centers for Disease Control and Prevention. The household pulse survey. CDC.

2020. https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm.

3. Lee SA, Crunk EA. Fear and psychopathology during the COVID-19 crisis:

Neuroticism, hypochondriasis, reassurance-seeking, and coronaphobia as fear fac-

tors. Omega J Death Dying 2020;1-14. doi:10.1177/0030222820949350. https://

doi.org/10.1177/0030222820949350.

4. McCrae RR, Costa PT. Validation of the five-factor model of personality across

instruments and observers. J Pers Soc Psychol. 1987;52(1):81-90. doi:10.1037/0022-

3514.52.1.81.

5. Lahey BB. Public health significance of neuroticism. Am Psychol. 2009;64(4):

241-256. doi:10.1037/a0015309.

6. Lung F-W, Lu Y-C, Chang Y-Y, Shu B-C. Mental symptoms in different health

professionals during the SARS Attack: A follow-up study. Psychiatr Q. 2009;80:

107-116.

7. Taylor S. The Psychology of Pandemics: Preparing for the Next Global Outbreak of

Infectious Disease. Newcastle upon Tyne, United Kingdom: Cambridge Scholars

Publishing; 2019.

8. Lee SA, Jobe MC, Mathis AA, Gibbons JA. Incremental validity of coronaphobia:

Coronavirus anxiety explains depression, generalized anxiety, and death anxiety. J

Anxiety Disord. 2020;74:102268. doi:10.1016/j.janxdis.2020.102268.

9. Yildirim M, Güler A. Positivity explains how COVID-19 perceived risk increases

death distress and reduces happiness. Pers Indiv Differ. 2020;168:110347. doi:10.

1016/j.paid.2020.110347.

10. Menzies RE, Menzies RG. Death anxiety in the time of COVID-19: Theoretical

explanations and clinical implications. The Cognitive Behaviour Therapist. 2020;13:

e19. doi:10.1017/S1754470X20000215.

11. Buhrmester MD, Talaifar S, Gosling SD. An evaluation of Amazon’s mechanical

turk, its rapid rise, and its effective use. Perspect Psychol Sci. 2018;13(2):149-154. doi:

10.1177/1745691617706516.

12. Kroenke K, Spitzer RL, Williams JBW, Lowe B. An ultra-brief screening scale for

anxiety and depression: The PHQ-4. Psychosomatics. 2009;50(6):613-621.

13. John OP, Srivastava S. The big five trait taxonomy: History, measurement, and

theoretical perspectives. In: Pervin LA, John OP, eds. Handbook of Personality:

Theory and Research. 2nd ed.. New York, NY: Guilford Press; 1999:102-138.

14. Abdel-Khalek AM. Single- versus multi-item scales in measuring death anxiety.

Death Stud. 1998;22(8):763-772. doi:10.1080/074811898201254.

15. Lee SA. Coronavirus anxiety scale: A brief mental health screener for COVID-19

related anxiety. Death Stud. 2020;44(7):393-401. doi:10.1080/07481187.2020.

1748481.

16. Kenny DA. Mediation; 2016. http://davidakenny.net/cm/mediate.htm.

17. Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: New

procedures and recommendations. Psychol Methods. 2002;7(4):422-445. doi:10.

1037/1082-989X.7.4.422.

18. Mallinckrodt B, Abraham WT, Wei M, Russell DW. Advances in testing the

statistical significance of mediation effects. J Counsel Psychol. 2006;53(3):372-378.

doi:10.1037/0022-0167.53.3.372.

19. Savolanien I, Oksa R, Savela N, Celuch M, Oksanen A. COVID-19 anxiety—a

longitudinal survey study of psychological and situational risks among Finnish

workers. Int J Environ Res Publ Health. 2021;18(2):794. doi:10.3390/

ijerph18020794.

20. Roelofs J, Huibers M, Peeters F, Arntz A. Effects of neuroticism on depression and

anxiety: Rumination as a possible mediator. Pers Indiv Differ. 2008;44(3):576-586.

doi:10.1016/j.paid.2007.09.019.

21. Choi EPH, Hui BPH, Wan EYF. Depression and anxiety in Hong Kong during

COVID-19. Int J Environ Res Publ Health. 2020;17(10):3740. doi:10.3390/

ijerph17103740.

22. Nikčević AV, Marino C, Kolubinski DC, Leach D, Spada MM. Modelling the

contribution of the Big Five personality traits, health anxiety, and COVID-19

psychological distress to generalised anxiety and depressive symptoms during the

COVID-19 pandemic. J Affect Disord. 2020;279(15):578-584.

23. Ettman CK, Abdalla SM, Cohen GH, Sampson L, Vivier PM, Galea S. Prevalence

of depression symptoms in US adults before and during the COVID-19 pandemic.

JAMA Netw Open. 2020;3(9):e2019686. doi:10.1001/jamanetworkopen.2020.

19686.

24. Salari N, Hosseinian-Far A, Jalali R, et al. Prevalence of stress, anxiety, depression

among the general population during the COVID-19 pandemic: A systematic

review and meta-analysis. Glob Health. 2020;16(57):57. doi:10.1186/s12992-020-

00589-w.

25. Khorsravi M. Neuroticism as a marker of vulnerability to COVID-19 infection.

Psychiatry Investigation. 2020;17(7):710-711. doi:10.30773/pi.2020.0199.

26. Hedman E, Andersson G, Lindefors N, et al. Personality change following internet-

based cognitive behavior therapy for severe health anxiety. PLoS One. 2014;9(12):

e113871. doi:10.1371/journal.pone.0113871.

5Lee and Jobe
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  • Does fear mediate the neuroticism-psychopathology link for adults living through the COVID-19 pandemic?
    • Introduction
    • Method
      • Participants and procedures
      • Measures
      • Statistical procedures
    • Results
      • Correlations
      • Mediation analyses
    • Discussion
    • Acknowledgements
    • ORCID iD
    • References

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On the transience or stability
of subthreshold psychopathology
Marieke J. Schreuder*, Johanna T. W. Wigman, Robin N. Groen, Marieke Wichers &
Catharina A. Hartman

Symptoms of psychopathology lie on a continuum ranging from mental health to psychiatric
disorders. Although much research has focused on progression along this continuum, for most
individuals, subthreshold symptoms do not escalate into full-blown disorders. This study investigated
how the stability of psychopathological symptoms (attractor strength) varies across severity levels
(homebase). Data were retrieved from the TRAILS TRANS-ID study, where 122 at-risk young adults
(mean age 23.6 years old, 57% males) monitored their mental states daily for a period of six months
(± 183 observations per participant). We estimated each individual’s homebase and attractor strength
using generalized additive mixed models. Regression analyses showed no association between
homebases and attractor strengths (linear model: B = 0.02, p = 0.47, R2 < 0.01; polynomial model:
B < 0.01, p = 0.61, R2 < 0.01). Sensitivity analyses where we (1) weighed estimates according to their
uncertainty and (2) removed individuals with a DSM-5 diagnosis from the analyses did not change
this finding. This suggests that stability is similar across severity levels, implying that subthreshold
psychopathology may resemble a stable state rather than a transient intermediate between mental
health and psychiatric disorder. Our study thus provides additional support for a dimensional view on
psychopathology, which implies that symptoms differ in degree rather than kind.

Psychopathology is increasingly recognized as a dimensional phenomenon1–5. From such a dimensional perspec-
tive, psychiatric disorders reflect the extreme end of a severity continuum ranging from the absence of symptoms
to the presence of severe symptoms. Along this continuum lie subthreshold symptoms, which fall short of the
diagnostic criteria for a clinical disorder but may still cause burden and functional impairments3,6,7.

A dimensional view on psychopathology implies that the differences between subthreshold symptoms and
their full-threshold counterparts are quantitative rather than qualitative. This is supported by studies showing
that subthreshold symptoms and full-blown psychiatric disorders have a similar etiology, structure (based on
symptom interrelations8), and treatment response (i.e., phenomenological continuity9). For instance, mild psy-
chiatric traits and disorders share similar genetic risk factors, illustrated by the finding that 80% of the covariance
between subthreshold symptoms and psychiatric disorders is attributable to genetic overlap10. Similarly, the brain
regions associated with subthreshold and clinical manifestations of psychopathology are largely overlapping11.
Environmental risk factors, such as childhood abuse and stressful life events, have also been related to both
sub- and full-threshold expressions of psychopathology6,12 Finally, like psychiatric disorders, subthreshold symp-
toms are associated with distress and declined functioning6,7,12,13, which can improve following psychological
treatment14. In sum, there is substantive evidence that the distinction between subthreshold symptoms and
psychiatric disorders seems to be a matter of degree—e.g., reflected in the number of symptoms and affected
individuals—rather than kind15,16.

Subthreshold symptoms are commonly considered clinically relevant not only because of the above-men-
tioned similarities to psychiatric disorders, but also because of their prognostic significance1. That is, individuals
with subthreshold symptoms are two to five times more likely to develop a psychiatric disorder compared to
individuals without such symptoms1,17,18. This implies that, for some individuals, subthreshold symptoms reflect a
temporary phase between having no symptoms and having a psychiatric disorder. Yet, longitudinal cohort studies
have shown that for the majority of individuals, subthreshold symptoms do not escalate into full-blown disorders.
Specifically, the proportion of individuals with subthreshold symptoms that meet the criteria for a psychiatric
disorder when assessed several years later ranges between 14 and 35% (depression1,2,19), 14–15% (anxiety1,20),
32% (bipolar disorder21), 25% (psychosis22), and 36–38% (substance abuse1). For other individuals, subthresh-
old symptoms may either remit or persist. Such persistence contradicts the common notion that subthreshold
symptoms are transient. Instead, subthreshold symptoms could—at least for some individuals—reflect stable

OPEN

Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University
Medical Center Groningen, University of Groningen, Hanzeplein, 19713 GZ Groningen, The Netherlands. *email:
[email protected]

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states rather than transient transitionary phenomena. This introduces the possibility of yet another qualitative
similarity between subthreshold symptoms and psychiatric disorders: both might be stable phenotypes.

So far, the stability of psychopathological symptoms has mostly been investigated across very short timescales
(e.g., hour-to-hour) and relatively long timescales (e.g., year-to-year). The present study aims to investigate the
day-to-day stability of psychopathological symptoms across six months using a complex systems perspective23–26.
According to this perspective, symptoms might manifest as stable states, for instance labelled as mental health,
subthreshold psychopathology, or psychiatric disorder27–29. These stable states—commonly referred to as attrac-
tors—can be thought of as the set point to which systems tend to return again and again upon perturbations (i.e.,
stressful or pleasant events). In healthy individuals, for instance, events may lead to temporary dips or uplifts in
mood, but eventually, a state of mental health (i.e., their attractor) is restored. Attractors result from regulatory
processes, reflected in interactions between elements of the system (e.g., feedback loops between mental states24).
In the presence of strong regulatory processes, systems are resistant to change. This translates to a strong tendency
to remain in an attractor (e.g., one with low symptom severity). As regulatory processes weaken, transitions from
one attractor to another become more likely. Hence, the stability of an attractor can be inferred from regulatory
processes, known as attractor strength30. Strong attractors (or, attractors with high attractor strength) can be
considered stable and persistent. Weaker attractors, in contrast, are less stable and may therefore quickly disap-
pear. It follows that strong attractors without symptoms of psychopathology can be considered favorable, as they
reflect stable mental health. Strong attractors featured by severe symptoms of psychopathology, in contrast, may
be unfavorable, as they reflect persistent mental ill-health. Finally, weak attractors can be considered transient
conditions that easily disappear.

If subthreshold symptoms indeed reflect a stable attractor that behaves similar to the attractors with low
and high symptom severity, the strengths of these attractors should be similar. This would mean that there is no
clear association between the symptom severity of attractors (referred to as homebases) and attractor strengths
(Fig. 1a). If, on the other hand, subthreshold symptoms reflect more transient phenomena (i.e., temporary states
between low and severe symptoms), there should be a quadratic relation between homebases and attractor
strengths (Fig. 1b). We investigated this hypothesis in an intensive longitudinal study where 122 at-risk young
adults monitored transdiagnostic (subthreshold) symptoms daily for a period of six months. Since subthreshold
symptoms are considered diffuse, representing a mix of symptoms from different psychopathological domains,
we focused on attractors of overall symptom severity, rather than attractors of specific symptom domains31.

Materials and methods
Participants. Participants were recruited from the clinical cohort of an ongoing study, named TRacking
Adolescents’ Individual Lives Survey (TRAILS32). At the time of inclusion in the clinical cohort of TRAILS
(TRAILS-CC), participants were between 10 and 12  years old and had been referred to mental health care
services. Because of this history, they were considered at increased risk to develop mental health problems.
Since their inclusion, participants completed bi- or tri-annual follow-up assessments. When TRAILS-CC par-
ticipants were approximately 23.6  years old (range 21–24), they were invited to take part in an add-on diary

Figure 1. Illustration of the association between homebases and attractor strengths under two different
scenarios. The homebase corresponds to the severity of symptoms that characterize an attractor. (A) If the
subthreshold attractor is comparable to the healthy and disordered attractors in strength, there is no clear
association between homebases and attractor strengths. (B) If the subthreshold attractor is transient, there is a
quadratic relation between homebases and attractor strengths.

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study (TRAILS TRANS-ID). Of the 443 eligible participants, 134 (30.2%) were included in TRAILS TRANS-ID.
The present study included the 122 individuals who completed the diary period. A more elaborate description
of these participants, as well as other methodological details, has been published elsewhere33. All participants
provided written informed consent. This study was approved by the medical ethics committee of the University
Medical Center Groningen (reference no. 2017/203). All procedures contributing to this work comply with the
ethical standards of the relevant national and institutional committees on human experimentation and with the
Helsinki Declaration of 1975, as revised in 2008.

Procedure. Participants completed daily questionnaires every evening for a period of six consecutive
months. Each questionnaire consisted of 58 items pertaining to the past day (e.g., ‘Today, I felt tired’) that were
rated on a visual analogue scale (VAS) ranging from 0 to 100. These questionnaires, or diaries, were sent via a
text messages to participants’ mobile phones. Prior to and immediately after the diary period (i.e., at baseline and
post), a semi-structured diagnostic interview was orally administered (mini-SCAN). This interview was used to
assess whether individuals met the diagnostic criteria for a DSM-5 disorder (for details on the procedure, please
see33). The post assessment covered the entire diary period, and therefore, this assessment was used for sensitiv-
ity analyses (see “Data analysis” and Supplement).

Data analysis. The diary procedure yielded a maximum of 183 measurements of 58 mental states per indi-
vidual, for 122 individuals (i.e., > 1.2 million observations in total). The data pertaining to the 35 negative mental
states assessed in our study—listed in the Supplement—were selected for analyses. Together, these mental states
were considered reflective of individuals’ overall symptom severity. We estimated overall symptom severity (sx)
for individual i at time t by computing the mean rating across the individual’s negative mental states (ms) at time
t, so that sxi,t = Σmsi,t/35. Subsequently, a generalized additive mixed model (GAMM) was fitted34,35. Specifically,
symptom severity of individual i at time t was predicted by this individual’s (1) intercept, (2) autoregressive
parameter, and (3) non-linear trend in symptom severity over time (for details, see supplementSupplement).
This model yielded an estimated homebase and attractor strength for each individual separately, while taking
into account each individual’s change in symptoms over time. The homebase is given by the person-specific
intercept (which is conceptually similar, but not equal to, the person’s mean), and reflects the symptom sever-
ity that characterizes an individual’s attractor36. As such, relatively low homebases can be considered adaptive,
while higher homebases may be maladaptive. The attractor strength reflects the regulatory forces that maintain
the attractor, and is given by person-specific estimates of the inversed autoregressive parameter (i.e., the effect of
symptom severity at t-1 on symptom severity at t)36. This operationalization of homebases and attractor strengths
has also been adopted in earlier studies36,37, and can be considered a discrete-time translation of the parameters
described in the DynAffect model30 and the PersDyn model38, which are formalized in continuous time.

The relation between homebases and attractor strengths was tested with regression analyses. Specifically, we
compared models where attractor strength was predicted by homebase vs. squared homebase (i.e., polynomial
regression). This allowed for differentiating between the scenarios displayed in Fig. 1. We repeated these regres-
sion analyses in two sensitivity analyses. First, we fitted weighted regressions to account for the uncertainty in
the estimates and attractor strengths. The weights in these models were proportional to the sum of the range of
the confidence intervals around the homebases and attractor strengths. Second, we checked the effect of (co-
morbid) full-blown disorders by omitting individuals who met the criteria for at least one DSM-5 diagnosis
from the analyses. This was done to allow for the possibility that mental states, and the stability thereof, might
have a different meaning for individuals with versus without psychiatric disorders39. By re-running analyses in
individuals without disorders, we could verify whether findings followed from between-individual differences in
e.g., the “threshold” for reporting a certain mental state. Individuals with a DSM-5 diagnosis were selected based
on the mini-SCAN assessed at post, which covered the presence of psychiatric disorders during the entire diary
period. All analyses were performed in R (version 4.0.2) using the package mgcv (version 1.8.33).

Results
Participants (N = 122, 56.6% male) were on average 23.64 years old (SD = 0.67, range = 22.26–24.81) and had on
average completed 163.39 diary assessments (88.6%, SD = 17.12, range = 116–190). At baseline, 37 individuals
(30.33%) met the criteria for at least one DSM-5 diagnosis. After the diary period, 34 individuals (27.87%) had
a DSM-5 disorder, of whom 23 (67.65%) were also diagnosed at baseline. Most prevalent were mood disorders
(n = 24 and 23 at baseline and post, respectively), followed by anxiety disorders (n = 6 and 12) and ADHD (n = 6
and 8).

The fitted values and the distribution of residuals indicated that assumptions of the GAMM were not violated
(see Supplement for details). The GAMM had an adjusted R2 of 77% and yielded homebases that varied between
2.85 and 46.51, with a mean of 17.81 (SD = 9.80). Attractor strengths varied between 1.52 and 28.83 (mean = 4.16,
SD = 3.35). Neither homebases nor attractor attractor strengths were related to the within-person variability in
observations (Supplement 2, GAMM details). Individuals who met criteria for a DSM-5 diagnosis at post had a
higher homebase (mean = 21.57) compared to non-diagnosed individuals (mean = 16.36, t(120) = 2.70, P < 0.01,
Cohen’s d = 0.55), but did not differ in terms of attractor strength (mean = 4.26 vs. 4.12, respectively; t(120) = 0.21,
P = 0.84, Cohen’s d = 0.04).

Regression analyses indicated that there was no clear association between homebase and attractor strength
(linear model: B = 0.02, P = 0.47, R2 < 0.01; polynomial model: B < 0.01, P = 0.61, R2 < 0.01; Fig. 2). This finding
did not change after taking into account the uncertainty in the estimates nor after removing individuals with a
DSM-5 diagnosis from the analyses (see Supplement).

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Discussion
Symptoms of psychopathology have been proposed to lie on a severity continuum, where the absence of symp-
toms and psychiatric disorders mark the extreme ends. This has been supported by the notion that subthreshold
and full-threshold psychopathological symptoms show a comparable etiology6,9–12 and treatment outcome14. This
study investigated the stability of psychopathological symptoms, i.e., their attraction strength, along the severity
continuum. We found that the stability of symptoms assessed daily over a period of six months is independent of
the severity of symptoms. This provides additional support for a dimensional view on psychopathology, which
implies that subthreshold and full-threshold psychopathological symptoms differ in degree (i.e., severity) rather
than in kind (e.g., stability). In conclusion, just like some individuals may experience constant mental health
or psychopathology, others may get stuck in subthreshold psychopathology. Subthreshold symptoms may thus
resemble stable states, rather than transient conditions that mark the progression from relatively healthy towards
disordered states (or vice versa).

A dimensional view on psychopathology does not necessarily preclude the existence of discrete, stable states
along the severity continuum15,40. Present findings show that such states not only lie on the extreme ends of
the continuum—reflecting mental health and mental disorder—but may just as well occupy the regions in
between these extremes—reflecting subthreshold psychopathology. It follows that the clinical relevance of sub-
threshold symptoms does not just lie in their associated burden3,6,7 and their tendency to precede full-threshold
symptoms1,17,18 (their prognostic significance), but also in their stability. Stability here refers to a property of
an attractor in a complex dynamic system, namely attractor strength. In the context of psychopathology, an
attractor can be considered a set of mental states to which a system tends to return upon perturbations (e.g.,
pleasant/stressful events23,27,29). An attractor has a certain homebase, which may describe mild vs. more severe
psychopathological symptoms, and strength, which reflects the regulatory processes that maintain the attractor.
Relatively strong (stable) attractors with low homebase can be considered adaptive, as they illustrate a healthy
system that is resilient to external perturbations. In contrast, attractors with higher symptom severity may be
maladaptive, illustrated by the current finding that individuals with a DSM-5 disorder had higher homebases
than those without a disorder.

We have shown that maladaptive attractors do not differ from more adaptive attractors in terms of strength.
Yet, previous work has reported that individuals with a psychiatric disorder may have weaker attractors compared
to healthy controls, implying a negative association between attractor strengths and homebases36,37. Similarly,
studies that used alternative measures of stability (i.e., adjusted square of successive differences41–43 and prob-
ability of acute change42,43) found higher instability in patients compared to controls. However, this difference was
likely driven by the standard deviation, meaning that patients and controls may differ primarily in the dispersion
of mental states as opposed to the stability of mental states41,44. An explanation for the discrepancy between earlier

Figure 2. Association between the homebase and attractor strength of symptoms of psychopathology.
Homebases and attractor strengths were estimated from a generalized additive mixed model using six months
of daily diary data from 122 young adults. Individuals who received any DSM-5 diagnosis after the diary period
are printed in blue. The black line shows the association between homebases and attractor strengths based
on a linear model; the grey line shows the fit of a polynomial model. Neither model indicated an association
between homebases and attractor strengths. For illustrative purposes, four outliers (individuals with an attractor
strength of > 10) were omitted from this figure. Including these individuals did not change the results (see the
Supplemented Figure).

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and present findings could be that the at-risk youth in the present study are more impaired than the healthy
controls and/or less impaired than the patient samples in former studies36,37, which in turn may have restricted
the ranges in attractor strengths and homebases in the current study. However, the large variability in symptom
severity in the present sample suggests that a restricted range of psychopathological symptom severity is unlikely
to underlie current findings. Instead, the differences across studies concerning attractor strengths potentially
follow from considerable differences in sampling frequency (i.e., assessments with a 1-day interval vs. 15-min/1-
h interval) and duration (i.e., 6 months vs. one to two days): while individuals with psychiatric disorders may
have a lower hour-to-hour stability of emotions compared to non-affected individuals36,37, their day-to-day
stability of mental states may be, as indicated by the current findings, similar. Hence, while stability on a short
timescale could be adaptive—for instance because it signals adequate emotional responsivity to environmental
cues45—the meaning of stability on a longer timescale depends on the homebase that is maintained. Specifically,
stability on a longer timescale can be either adaptive (when it maintains mental health) or maladaptive (when
it maintains sub- or full-threshold psychopathological symptoms). In conclusion, the meaning of psychological
dynamics—such as the stability of mental states—crucially depends on the timescale under consideration. An
important goal for further research is therefore to investigate the timescale at which dynamics such as attractor
strengths are informative of psychopathology.

Besides the timescale of assessments, the dynamics of psychopathological symptoms might be affected by the
type of symptoms under consideration. It could for instance be hypothesized that certain symptom domains (e.g.,
anxiety) are more stable than others (e.g., psychosis, mania46). At present, little is known about such between-
domain differences: it has been reported that panic disorder and major depression show higher homebases (but
similar attractor strengths) compared to borderline, post-traumatic stress and eating disorders37,47, while nega-
tive psychotic symptoms may have a stronger attraction (but similar homebase) compared to positive symptoms
of psychosis48. However, small sample sizes and methodological heterogeneity preclude firm conclusions. To
investigate dissociations between homebases and attractor strengths across clinical stages and psychopathological
domains, future studies should aim to include individuals with a wide range of symptoms of varying severity. The
current study did so by including youth who experienced a widely varying degree of (mental health) problems
and a wide variety of mental states.

It should be noted that although we collected intensive longitudinal data—which allows for addressing within-
individual processes, including changes in homebases or attractor strengths over time within individuals—we
investigated differences in homebases and attractor strengths between individuals. Our approach fits the notion
that the boundaries between mental health, subthreshold psychopathology, and full-threshold psychopathology
are based on differences between rather than within individuals. This can be illustrated as follows: if an individual
consistently experiences more mental health problems than others (i.e., between-person difference), without
ever deviating from their own homebase (i.e., without within-person differences), they can still meet the criteria
for a mental disorder. Conversely, another individual who substantially differs from their own homebase (i.e.,
within-person difference), but not from mentally healthy individuals (i.e., without between-person differences),
will not qualify for a mental disorder. Hence, it makes sense to study subthreshold psychopathology at a between-
individual level, while adjusting for within-person fluctuations in symptoms over time. Nevertheless, it would
be interesting to extend the current work by investigating the within-person association between the severity
and stability of psychopathological symptoms. A second consideration is that, unlike the majority of earlier
studies on subthreshold symptoms, the present study considered attractors on a continuum of symptom sever-
ity, and did not classify individuals into subgroups based on pre-set cut-offs. This is particularly advantageous
given the considerable heterogeneity in definitions of “subthreshold” psychopathology that plagues research
on this topic7,13,49. Arguably, our decision to not categorize came at the cost of an unclear clinical significance
of the homebase estimates, which were based on daily ratings of negative mental states. However, the fact that
individuals with a DSM-5 diagnosis had significantly higher homebases than those without a diagnosis sup-
ports our inferences. Another potential limitation of the current study is that the aggregation of symptoms into
global psychopathology might have obscured domain-specific associations between the homebase and strength
of attractors. However, our operationalization was in line with the notion that subthreshold psychopathology
may not be domain-specific31, and therefore, fitted with our aim to study the dynamics of symptoms of varying
severity. Finally, our estimates of attractor strengths require that the timescale of assessments (daily) matches the
timescale of the process of interest (i.e., strength of attraction, or the speed with which a homebase is restored).
This issue is not specific to the current study, but rather applicable to all intensive longitudinal studies: within-
person dynamics (including homebases and attractor strengths) can only be estimated with sufficient sampling
frequency50. Although the present timescale (daily) is in line with our interest in long-term stability of symp-
toms—as opposed to momentary fluctuations in emotions41,44—further work on the role of timescales in studies
on symptom dynamics is hopefully awaited (for a recent example, see Sperry and Kwapil42).

The lack of an association between homebases and attractor strengths found in the present study implies
that individuals can get stuck anywhere on the severity continuum. Attractors do not, however, eternally persist:
they may change over time, and such changes may involve a shift from subthreshold to full-threshold psycho-
pathological symptoms or vice versa. Future research is needed to establish what triggers such shifts. After a
shift towards a maladaptive attractor (one with a high homebase) has occurred, it is imperative to understand
what maintains the attractor. A complex systems perspective on psychopathology implies that attractors emerge
from interactions between mental states—meaning that individuals with stronger attractors would be expected
to show greater connectivity between mental states24. An alternative avenue for further research concerns the
comparison of attractors of different domains of psychopathology, which could expose how specific domains
progress and persist, and may inform treatment.

6

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Scientific Reports | (2021) 11:23306 | https://doi.org/10.1038/s41598-021-02711-3

www.nature.com/scientificreports/

Received: 14 July 2021; Accepted: 18 November 2021

References
1. Shankman, S. A. et al. Subthreshold conditions as precursors for full syndrome disorders: A 15-year longitudinal study of multiple

diagnostic classes. J. Child Psychol. Psychiatry 50, 1485–1494 (2009).
2. Fergusson, D. M., Horwood, L. J., Ridder, E. M. & Beautrais, A. L. Subthreshold depression in adolescence and mental health

outcomes in adulthood. Arch. Gen. Psychiatry 62, 66–72 (2005).
3. Keenan, K. et al. Subthreshold symptoms of depression in preadolescent girls are stable and predictive of depressive disorders. J.

Am. Acad. Child Adolesc. Psychiatry 47, 1433–1442 (2008).
4. McGorry, P. D., Hartmann, J. A., Spooner, R. & Nelson, B. Beyond the “at risk mental state” concept: Transitioning to transdiag-

nostic psychiatry. World Psychiatry 17, 133–142 (2018).
5. McGorry, P. D., Hickie, I. B., Yung, A. R., Pantelis, C. & Jackson, H. J. Clinical staging of psychiatric disorders: A heuristic frame-

work for choosing earlier, safer and more effective interventions. Aust. N. Z. J. Psychiatry 40, 616–622 (2006).
6. Wesselhoeft, R., Sørensen, M. J., Heiervang, E. R. & Bilenberg, N. Subthreshold depression in children and adolescents: A systematic

review. J. Affect. Disord. 151, 7–22 (2013).
7. Haller, H., Cramer, H., Lauche, R., Gass, F. & Dobos, G. J. The prevalence and burden of subthreshold generalized anxiety disorder:

A systematic review. BMC Psychiatry 14, 128 (2014).
8. Groen, R. N., Wichers, M., Wigman, J. T. W. & Hartman, C. A. Specificity of psychopathology across levels of severity: A transdi-

agnostic network analysis. Sci. Rep. 9, 1–10 (2019).
9. Markon, K. E., Chmielewski, M. & Miller, C. J. The reliability and validity of discrete and continuous measures of psychopathology:

A quantitative review. Psychol. Bull. 137, 856–879 (2011).
10. Taylor, M. J. et al. Association of genetic risk factors for psychiatric disorders and traits of these disorders in a Swedish population

twin sample. JAMA Psychiat. 76, 280–289 (2019).
11. Besteher, B., Gaser, C. & Nenadić, I. Brain structure and subclinical symptoms: A dimensional perspective of psychopathology in

the depression and anxiety spectrum. Neuropsychobiology 79, 270–283 (2020).
12. Meeks, T. W., Vahia, I. V., Lavretsky, H., Kulkarni, G. & Jeste, D. V. A tune in “a minor” can “b major”: A review of epidemiology,

illness course, and public health implications of subthreshold depression in older adults. J. Affect. Disord. 129, 126–142 (2011).
13. Balázs, J. & Keresztény, Á. Subthreshold attention deficit hyperactivity in children and adolescents: A systematic review. Eur. Child

Adolesc. Psychiatry 23, 393–408 (2014).
14. Cuijpers, P., Smit, F. & van Straten, A. Psychological treatments of subthreshold depression: A meta-analytic review. Acta Psychiatr.

Scand. 115, 434–441 (2007).
15. Meehl, P. E. Factors and taxa, traits and types, differences of degree and differences in kind. J. Pers. 60, 117–174 (1992).
16. Flett, G. L., Vredenburg, K. & Krames, L. The continuity of depression in clinical and nonclinical samples. Psychol. Bull. 121,

395–416 (1997).
17. Lee, Y. Y. et al. The risk of developing major depression among individuals with subthreshold depression: A systematic review and

meta-analysis of longitudinal cohort studies. Psychol. Med. 49, 92–102 (2018).
18. Bertha, E. A. & Balazs, J. Subthreshold depression in adolescence: a systematic review. Eur. J. Child Adolesc. Psychiatry 22, 589–603

(2013).
19. Tuithof, M. et al. Course of subthreshold depression into a depressive disorder and its risk factors. J. Affect. Disord. 241, 206–215

(2018).
20. Bosman, R. C. et al. Prevalence and course of subthreshold anxiety disorder in the general population: A three-year follow-up

study. J. Affect. Disord. 247, 105–113 (2019).
21. Papachristou, E. et al. The predictive value of childhood subthreshold manic symptoms for adolescent and adult psychiatric out-

comes. J. Affect. Disord. 212, 86–92 (2017).
22. Kaymaz, N. et al. Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-

based samples? A systematic review and meta-analysis, enriched with new results. Psychol. Med. 42, 2239–2253 (2012).
23. Wichers, M., Schreuder, M. J., Goekoop, R. & Groen, R. N. Can we predict the direction of sudden shifts in symptoms? Transdi-

agnostic implications from a complex systems perspective on psychopathology. Psychol. Med. 49, 380–387 (2019).
24. Cramer, A. O. J. et al. Major depression as a complex dynamic system. PLoS ONE 11, 1–20 (2016).
25. Olthof, M. et al. Critical fluctuations as an early-warning signal for sudden gains and losses in patients receiving psychotherapy

for mood disorders. Clin. Psychol. Sci. https:// doi. org/ 10. 1177/ 21677 02619 865969 (2019).
26. Schiepek, G. Complexity and nonlinear dynamics in psychotherapy. Eur. Rev. 17, 331–356 (2009).
27. Jeronimus, B. F. Dynamic system perspectives on anxiety and depression. In Psychosocial Development in Adolescence: Insights

from the Dynamic Systems Approach (eds Kunnen, E. S. et al.) (Routledge, 2019). https:// doi. org/ 10. 1128/ MCB. 01405- 08.
28. Shapiro, Y. & Scott, J. R. Dynamical systems therapy (DST): Complex adaptive systems in psychiatry and psychotherapy. In Hand-

book of Research Methods in Complexity Science (eds Mitleton-Kelly, E. et al.) (Edward Elgar Publishing Limited, 2018).
29. Hayes, A. M. & Andrews, L. A. A complex systems approach to the study of change in psychotherapy. BMC Med. 18, 1–13 (2020).
30. Kuppens, P., Oravecz, Z. & Tuerlinckx, F. Feelings change: Accounting for individual differences in the temporal dynamics of affect.

J. Pers. Soc. Psychol. 99, 1042–1060 (2010).
31. van Os, J. The dynamics of subthreshold psychopathology: Implications for diagnosis and treatment. Am. J. Psychiatry 170, 695–698

(2013).
32. Huisman, M. et al. Cohort profile: The dutch “tracking adolescents” individual lives’ survey’; TRAILS. Int. J. Epidemiol. 37, 1227–

1235 (2008).
33. Schreuder, M. J., Groen, R. N., Wigman, J. T. W., Hartman, C. A. & Wichers, M. Measuring psychopathology as it unfolds in daily

life: Addressing key assumptions of intensive longitudinal methods in the TRAILS TRANS-ID study. BMC Psychiatry 20, 1–14
(2020).

34. Wood, S. N. Generalized Additive Models: An Introduction with R (Springer, 2006).
35. Hastie, T. & Tibshirani, R. Generalized additive models. Stat. Sci. 1, 297–318 (1986).
36. Ebner-Priemer, U. W. et al. Unraveling affective dysregulation in borderline personality disorder: A theoretical model and empirical

evidence. J. Abnorm. Psychol. 124, 186–198 (2015).
37. Santangelo, P. S. et al. Analyzing subcomponents of affective dysregulation in borderline personality disorder in comparison to

other clinical groups using multiple e-diary datasets. Borderline Pers. Disord. Emotion Dysregul. 3, 1–13 (2016).
38. Sosnowska, J., Kuppens, P., de Fruyt, F. & Hofmans, J. A dynamic systems approach to personality: The personality dynamics

(PersDyn) model. Pers. Individ. Differ. 144, 11–18 (2019).
39. Helmchen, H. & Linden, M. Subthreshold disorders in psychiatry: Clinical reality, methodological artifact, and the double-

threshold problem. Compr. Psychiatry 41, 1–7 (2000).
40. Linscott, R. J. & van Os, J. Systematic reviews of categorical versus continuum models in psychosis: Evidence for discontinuous

subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annu. Rev. Clin. Psychol.
6, 391–419 (2010).

7

Vol.:(0123456789)

Scientific Reports | (2021) 11:23306 | https://doi.org/10.1038/s41598-021-02711-3

www.nature.com/scientificreports/

41. Koval, P., Pe, M. L., Meers, K. & Kuppens, P. Affect dynamics in relation to depressive symptoms: variable, unstable or inert?.
Emotion 13, 1132–1142 (2013).

42. Sperry, S. H. & Kwapil, T. R. Bipolar spectrum psychopathology is associated with altered emotion dynamics across multiple
timescales. Emotion https:// doi. org/ 10. 1037/ emo00 00759 (2020).

43. Trull, T. J., Lane, S. P., Koval, P. & Ebner-Priemer, U. W. Affective dynamics in psychopathology. Emot. Rev. 7, 355–361 (2015).
44. Bos, E. H., de Jonge, P. & Cox, R. F. A. Affective variability in depression: Revisiting the inertia–instability paradox. Br. J. Psychol.

https:// doi. org/ 10. 1111/ bjop. 12372 (2018).
45. Kashdan, T. B. & Rottenberg, J. Psychological flexibility as a fundamental aspect of health. Clin. Psychol. Rev. 30, 865–878 (2010).
46. Sperry, S. H., Walsh, M. A. & Kwapil, T. R. Emotion dynamics concurrently and prospectively predict mood psychopathology. J.

Affect. Disord. 261, 67–75 (2020).
47. Heller, A. S., Davidson, R. J. & Fox, A. S. Parsing affective dynamics to identify risk for mood and anxiety disorders. Emotion 19,

283–292 (2019).
48. Westermann, S. et al. Untangling the complex relationships between symptoms of schizophrenia and emotion dynamics in daily

life: Findings from an experience sampling pilot study. Psychiatry Res. 257, 514–518 (2017).
49. Cuijpers, P. & Smit, F. Subthreshold depression as a risk indicator for major depressive disorder: A systematic review of prospective

studies. Acta Psychiatr. Scand. 109, 325–331 (2004).
50. Haslbeck, J. M. B. & Ryan, O. Recovering within-person dynamics from psychological time series. Multivariate Behav. Res. 56,

1–32 (2021).

Acknowledgements
We thank everyone who contributed to this study.

Author contributions
M.J.S. and R.N.G. collected data. M.J.S. performed analyses and interpreted results together with J.T.W.W. and
C.A.H. M.J.S. drafted the manuscript. M.W. collected funding. All authors revised the manuscript and approved
of the final version.

Funding
The infrastructure for the TRacking Adolescents’ Individual Lives Survey (TRAILS) is funded by the Nether-
lands Organization for Scientific Research (NWO), ZonMW, GB-MaGW, the Dutch Ministry of Justice, the
European Science Foundation, the European Research Council, BBMRI-NL, and the participating universities.
Additionally, this research was supported by the Netherlands Organization for Scientifc Research (NWO) (R.N.
Groen, research talent Grant Number 406.16.507 and J.T.W. Wigman Veni Grant Number 016.156.019), and the
European Research Council (ERC) under the European Union’s Horizon 2020 research and innovative program
(M. Wichers, Grant Number 681466).

Competing interests
The authors declare no competing interests.

Additional information
Supplementary Information The online version contains supplementary material available at https:// doi. org/
10. 1038/ s41598- 021- 02711-3.

Correspondence and requests for materials should be addressed to M.J.S.

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  • On the transience or stability of subthreshold psychopathology
    • Materials and methods
      • Participants.
      • Procedure.
      • Data analysis.
    • Results
    • Discussion
    • References
    • Acknowledgements

https://doi.org/10.1177/09593543211021157

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2021, Vol. 31(6) 842 –866

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Describing disorder: The
importance and advancement
of compositional explanations
in psychopathology

Hannah Hawkins-Elder and Tony Ward
Victoria University of Wellington

Abstract
Understanding the makeup of mental disorders has great value for both research and practice
in psychopathology. The richer and more detailed our compositional explanations of mental
disorder—that is, comprehensive accounts of client signs and symptoms—the more information
we have to inform etiological explanations, classification schemes, clinical assessment, and
treatment. However, at present, no explicit compositional explanations of psychopathology
have been developed and the existing descriptive accounts that could conceivably fill this role—
DSM/ICD syndromes, transdiagnostic and dimensional approaches, symptom network models,
historical accounts, case narratives, and the Research Domain Criteria (RDoC)—fall short in
critical ways. In this article, we discuss what compositional explanations are, their role in scientific
inquiry, and their importance for psychopathology research and practice. We then explain why
current descriptive accounts of mental disorder fall short of providing such an explanation and
demonstrate how effective compositional explanations could be constructed.

Keywords
composition, description, explanation, symptoms, theory

Mental disorder represents a serious and expanding global health problem; demonstrat-
ing high prevalence internationally (Steel et al., 2014) and accounting for a considerable
proportion of global disease burden (Whiteford et al., 2015). Being able to assess and
treat these problems effectively is therefore critically important. Researchers and clini-
cians also have an ethical obligation to seek accurate understandings of mental disorders,
so as not to provide mistaken accounts of people’s genuine concerns. Both goals rely

Corresponding author:
Hannah Hawkins-Elder, Victoria University of Wellington, Kelburn Parade, Wellington, 6140, New Zealand.
Email: [email protected]

1021157TAP0010.1177/09593543211021157Theory & PsychologyHawkins-Elder and Ward
research-article2021

Article

Hawkins-Elder and Ward 843

heavily on the explanations we have for mental disorders: our theoretical accounts of
how they originated and why they persist.

Explanations are invaluable: they tell us what to look for in assessment, what to target
in treatment, and how to do so successfully. At present, however, psychopathological
explanations are often unsound: constructed in idiosyncratic ways and containing numer-
ous conceptual flaws (see Hawkins-Elder & Ward, 2020a, 2020b,). The comprehensive
description of explanatory targets—known as compositional explanation—is signifi-
cantly underemphasized, and often neglected, in psychopathology (Gillett, in press).
Describing the nature of psychopathological symptoms and signs holds significant value
for explanation, classification, research, and practice (Wilshire et al., in press). Despite
this, no explicit compositional explanations of psychopathological phenomena have
been created and existing descriptive accounts present relatively poor alternatives; lack-
ing sufficient depth, theoretical structure, or evidence base.

Current diagnostic syndromes provide only a short list of vaguely defined “core”
features (e.g., DSM-5, American Psychiatric Association, 2013; ICD-11, World Health
Organization, 2019), thereby limiting the richness of information theorists possess
about the disorder. Alternative classificatory perspectives, such as transdiagnostic,
dimensional, and symptom network models, although in some cases providing greater
taxonomic validity, still fail to richly describe psychopathological problems at all the
relevant levels. In contrast, more “clinical” descriptions, such as historical accounts
(i.e., the first identification or early scientific conceptualizations of a disorder) and
clinical case narratives (e.g., case studies) tend to describe disorders in more depth, but
lack detail and theoretical organization and are often empirically outdated. The
Research Domain Criteria (RDoC; Cuthbert & Insel, 2013) is perhaps the current
option that most closely approximates a compositional explanation. However, criti-
cally, this framework is not geared towards the theoretical conceptualization of psy-
chopathological phenomena and therefore, although excellent at guiding empirical
investigation into psychopathology, is unable to provide coherent compositional expla-
nations—at least, not on its own.

Our intentions with this article are therefore threefold. First, to highlight the impor-
tance of compositional explanations of psychopathology by outlining their role in scien-
tific inquiry and clinical practice. Second, to demonstrate that none of our current
descriptive accounts (i.e., DSM/ICD syndromes, transdiagnostic and dimensional classi-
fications, symptom network models, historical accounts, case narratives, and the RDoC)
are capable of successfully acting as compositional explanations. Finally, based on this
discussion, to suggest how we could construct effective compositional explanations of
psychopathology.

Compositional explanations: What they are and what they do

In this section, we discuss the nature of compositional explanations and their role in
scientific inquiry and clinical practice. However, we first must clarify what we mean by
“explanation.”

844 Theory & Psychology 31(6)

What is an “explanation”?

There is some disagreement in science over what exactly constitutes an explanation, as
well as how exactly explanations relate to models and theories. Trout (2016) provides a
simple and helpful definition of explanation: “an explanation is the description of under-
lying causal factors that bring about an effect” (p. 18). More specifically, an explanation
is an account that provides an understanding of a phenomenon’s causes, composition,
context, or consequences (Faye, 2014; Ruphy, 2016). Models and theories, in contrast,
are conceptual representations of phenomena in the world: tools that can be put to the
task of explanation (Mantzavinos, 2016; Savulescu et al., 2020).

For our purposes, a theory is an integrated system of concepts and ideas that can be
used to explain why some phenomena occur and persist. Theories are more general than
models, usually detailing more abstract phenomena (e.g., “human behaviour” in general
vs. specific types or instances) and able to explain different subsets of phenomena
(Bailer-Jones, 2003). Models, in contrast, represent more concrete empirical phenomena
(i.e., identified factors, systems, or processes such as “clinical depression” or “binge eat-
ing”); typically, in idealized and simplified ways (Bailer-Jones, 2003; Haig, 2014).
Theories may inform the development of models, and models may represent localized
applications of theories (Bailer-Jones, 2003). For example, the coercion cycle model
represents the localized application of operant conditioning theory to the phenomenon of
child conduct problems (Dishion & Patterson, 2015).

We define an explanation herein as the entire bank of explanatory knowledge about a
phenomenon—that is, the most complete explanatory account (Craver & Kaplan, 2020).
A model or theory may serve as an explanation if it represents the entire bank of knowl-
edge about a phenomenon: when it adequately represents all aspects of the phenomenon
without being overly complicated or sacrificing critical detail. However, this is rarely the
case. More often, models and theories represent partial explanations (Bailer-Jones,
2003). When the phenomenon of interest is more complex, multiple theories and models
will typically be needed to fully explain it (Kendler et al., 2020).

What are compositional explanations?

Philosophers of science make a distinction between causal and compositional explana-
tions (e.g., Craver, 2007; Kaiser & Krickel, 2016). A causal explanation depicts the fac-
tors that result in a subsequent effect—for example, heating water (a cause) until it boils
(an effect). A psychopathological example is the proposition that traumatic experience
can cause individuals to experience intrusive memories, elevated arousal, and avoidance
behaviour (i.e., a “posttraumatic stress” syndrome). Causal explanations in psychopa-
thology may also include accounts of relations that maintain the disorder, such as mutual
reinforcement between symptoms (e.g., insomnia and low mood; Konjarski et al., 2018)
or behavioural reinforcement “cycles” (e.g., the coercion cycle; Dishion & Patterson,
2015).

In contrast, a compositional explanation describes underlying structures and interac-
tions that make up a phenomenon; viewed as part of it rather than “causing” it (Craver,
2007; Gillett, in press; Kendler et al., 2020). For example, the symptom “low mood” is

Hawkins-Elder and Ward 845

likely to be composed of processes at the phenomenological, subpersonal, neurobiologi-
cal, and physiological levels (Ward & Clack, 2019). It is important to note that composi-
tional explanations may, in some cases, contain causal relations, depending on the
phenomenon being explained. For example, a compositional explanation of a syndrome,
like clinical depression, would necessarily include description of causal relations between
symptoms (e.g., low mood and insomnia), as these relationships are part of the constitu-
tion of that syndrome (although arguably do not cause it). However, these same relations
could form part of an etiological explanation depending on the focus of inquiry. For
instance, if, instead of describing the composition of depression, we were trying to
explain the development and persistence of low mood in depressed individuals, we might
ascribe causal or etiological significance to insomnia somewhere within that explana-
tion, but we would not say that insomnia in any way constituted low mood. Hence, the
role of factors and processes within an explanation varies depending on the question
being asked.

What is the role of compositional explanation in theory, research, and
practice?

Compositional explanations play a critical role in all aspects of clinical inquiry. First,
they hold significant value for etiological explanation. The more detailed our composi-
tional understanding of a phenomenon, the more information we have to provide clues
about its etiology (Hawkins-Elder & Ward, 2020b). For example, if we were trying to
explain the existence of a cake—knowing only that it was a cake—we could reason that
its etiology probably involved components and processes common to most cakes (e.g.,
flour, sugar, being baked). However, with further detail about how it is composed—for
example, chocolate sponge, cream-filled—we have additional clues to help refine our
etiological reasoning; strengthening ideas about the involvement of some factors and
processes (e.g., flour, being baked) and suggesting new ones (e.g., whipping cream,
cocoa). When our compositional understandings are “thin” (less detailed) it can promote
errors in causal reasoning: relevant causal factors and processes may be neglected or
deliberately omitted, and flawed or irrelevant ones may be included. For example, we
could develop multiple etiological theories about our cake, hypothesizing various baking
processes, when all the while we were dealing with an ice cream cake—a type of cake
indeed, but one involving none of our postulated causal processes.

Compositional explanations also hold value for research and practice. Their primary
value for research is via classification. Although compositional explanations are attempts
to describe disorder phenomena, they do not claim to know the best method of classify-
ing the psychopathological phenomena with which they are concerned. However,
because of their informational value, compositional explanations are highly useful for
those aiming to develop taxonomies of mental disorder (Wilshire et al., in press): their
rich descriptions may help to signal connections between syndromes or symptoms, and
thereby suggest novel and improved ways of organizing them. Compositional explana-
tions lay out the psychopathological landscape in comprehensive detail, allowing it to be
thoroughly surveyed by those who wish to classify it.

846 Theory & Psychology 31(6)

In clinical practice, compositional explanations hold value for both assessment and
treatment. For one, their value for etiological explanations and classification systems has
flow-on effects for assessment and treatment. Improvement of classification systems will
likely be beneficial for diagnosis and the prescription of appropriate clinical interven-
tions. Likewise, better etiological explanations will likely improve clinical formulations
and intervention strategies based on them. Compositional explanations also hold inde-
pendent value for clinical practice. Possessing more information about a psychopatho-
logical problem provides us with more features to look for in assessment. It may also
help identify potential therapeutic issues. For example, knowing that a particular disor-
der often involves cognitive inflexibility or poor attentional control might contraindicate
interventions requiring high levels of cognitive effort. Likewise, knowing that a particu-
lar symptom involves difficulty sensing physical sensations may influence how an inter-
vention is administered (e.g., devoting extra time during a mindfulness intervention to
helping the client identify physical sensations).

Current “approximate” compositional explanations

There are several types of account within the psychopathology space that, due to their
descriptive nature, could potentially serve as compositional explanations: namely, (a)
DSM-5/ICD-11, (b) transdiagnostic and dimensional approaches, (c) symptom network
models, (d) historical accounts, (e) clinical case narratives, and (f) the Research Domain
Criteria (RDoC) framework. We will now address each in turn and explain why, on our
view, none effectively serve as compositional explanations.

Diagnostic syndromes: DSM-5 and ICD-11. The DSM-5 (American Psychiatric Associa-
tion, 2013) and ICD-11 (World Health Organization, 2019) are perhaps the most promi-
nent attempts to conceptualize and describe mental disorders. Both group disorders into
discrete syndromes (collections of symptoms and signs) comprising a set of diagnostic
criteria (e.g., borderline personality disorder, anorexia nervosa). They are frequently
used as compositional explanations in research and theory: empirical inquiry is often
oriented around DSM-5 categories and etiological models commonly use them as the
foundation for explanation. However, these syndromes fall short of providing a compo-
sitional explanation in two important ways.

First, DSM/ICD syndromes lack explanatory scope. Each is characterized by a rela-
tively small number of descriptively “thin” criteria spanning but a few levels of analysis
(e.g., behavioural, cognitive, emotional). For example, the criteria for anorexia nervosa
(listed in Table 1) describe only a few features, despite research identifying many others
common to these individuals, such as alexithymia (Nowakowski et al., 2013; Westwood
et al., 2017), interoceptive deficits (Stinson, 2019), cognitive deficits (Hedges et al.,
2019), and autistic traits (Westwood et al., 2016). Furthermore, both the DSM and ICD
outline only those features that are most clinically salient—that is, those most readily
observable in practice or perceived as “most central” to the disorder’s pathology.
Although appropriate and often useful in practice, this omits other relevant features that
may be harder to identify (e.g., emotional comprehension, executive functioning,

Hawkins-Elder and Ward 847

interoceptive ability) or have less apparent relevance (e.g., attentional bias, central coher-
ence), but are nonetheless characteristic of the disorder.

Second, DSM/ICD syndromes lack explanatory depth, as the features/symptoms
listed by them are typically thinly described. For instance, “disturbance in the way in
which one’s body weight or shape is experienced” (American Psychiatric Association,
2013, p. 339) is a necessary criterion for anorexia nervosa (see Table 1), however there
is no detail about the exact nature of this “disturbance.” For example, is it a distortion in
sensory perception or cognitive evaluation (Mölbert et al., 2017)? Does it encompass the
body in general or does it tend to be focused on specific areas (Cash & Deagle, 1997)?
Body image is recognized to be a “multi-faceted construct consisting of a variety of
measured dimensions” (Thompson, 2004, p. 8), including perceptual, conceptual, and

Table 1. DSM-5 diagnostic criteria for anorexia nervosa and bulimia nervosa.

DSM criteria: Anorexia Nervosa

A. Restriction of energy intake relative to requirements, leading to a significantly low
body weight in the context of age, sex, developmental trajectory, and physical health.
Significantly low weight is defined as a weight that is less than minimally normal or, for
children and adolescents, less than that minimally expected.

B. Intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes
with weight gain, even though at a significantly low weight.

C. Disturbance in the way in which one’s body weight or shape is experienced, undue
influence of body weight or shape on self-evaluation, or persistent lack of recognition of
the seriousness of the current low body weight.

Specifiers:
Restricting type: during the last 3 months, the individual has not engaged in recurrent episodes
of binge eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives,
diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished
primarily through dieting, fasting, and/or excessive exercise.
Binge-eating/purging type: during the last 3 months, the individual has engaged in recurrent
episodes of binge eating or purging behaviour (i.e., self-induced vomiting or the misuse of
laxatives, diuretics, or enemas).
DSM criteria: Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of

the following:
1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that

is definitely larger than what most individuals would eat in a similar period of time under
similar circumstances.

2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot
stop eating or control what or how much one is eating).

B. Recurrent inappropriate compensatory behaviours in order to prevent weight gain, such
as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or
excessive exercise.

C. The binge eating and inappropriate compensatory behaviours both occur, on average, at
least once a week for 3 months.

D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

848 Theory & Psychology 31(6)

emotional (Stinson, 2019). Therefore, the precise nature of any proposed “disturbance”
would need to be more specifically detailed.

Transdiagnostic approaches and dimensional approaches. Transdiagnostic approaches
advocate dispensing with existing diagnostic syndromes in favour of broader classifica-
tions based on shared characteristics. In some cases, this involves collapsing said syn-
dromes into a broader disorder category (e.g., anxiety disorders), in others basing
classification on some common factor (e.g., the internalizing/externalizing model; Krue-
ger & Eaton, 2015). Dimensional approaches are based around spectra or “scales” rather
than discrete categories, such as the Five Factor Model of personality disorders (Widiger
& Costa, 2013). Approaches may be both dimensional and transdiagnostic, such as the
Hierarchical Taxonomy of Psychopathology (HiTOP) model: a hierarchical organization
of mental disorder, consisting of transdiagnostic spectra at the top (e.g., general psycho-
pathology, internalizing/externalizing) and syndromal subfactors (e.g., eating problems),
shared symptoms/signs, and traits at progressively lower levels (see Kotov et al., 2017).

Although transdiagnostic and dimensional approaches may provide useful alternative
means for classifying psychological problems, they do not necessarily describe psycho-
pathological phenomena any more fully than diagnostic syndromes. In some cases, they
even provide weaker descriptions. For example, the internalizing/externalizing model,
although highlighting links between diagnostic categories and thus traversing arbitrary
diagnostic boundaries, provides even less information about mental disorders. Describing
a problem as an “internalizing disorder,” although useful for some purposes, gives very
little information about its precise nature (e.g., whether it involves anxiety, mood, eating,
etc.), or the minutiae of its presentation (i.e., the factors and mechanisms that comprise
the problem). The HiTOP model provides somewhat more information than diagnostic
syndromes thanks to its hierarchical structure, which conceptualizes psychopathological
problems at both more general levels (e.g., spectra levels) and more specific levels (e.g.,
symptoms, signs, and traits). However, this model still lacks the richness of information
necessary for a compositional explanation: symptoms, signs, and traits are not broken
down into lower level factors or mechanisms, nor are any relevant relationships between
them modelled. Furthermore, although disorders are conceptualized at broader, transdi-
agnostic scales, they are not described contextually at higher levels of analysis (e.g.,
sociocultural, interpersonal, political); layers of meaning necessary to fully comprehend
any psychopathological problem.

Symptom network models. The network theory of mental disorder proposes that psycho-
pathological symptoms should be conceptualized as causing each other (e.g., persecu-
tory delusions resulting in paranoia, subsequently leading to social withdrawal) rather
than caused by an underlying “disease” process (e.g., delusions, paranoia, and social
withdrawal as arising from a common cause, such as a neurobiological dysfunction or
genetic mutation; Borsboom, 2017). Symptom network models (SNMs) apply this the-
ory to specific syndrome clusters—often, but not always, DSM/ICD syndromes. A net-
work structure is generated by depicting the causal links between symptoms of that
condition, including their strength and direction (Borsboom, 2017). SNMs can also
model the relationships between symptoms across disorders (e.g., eating disorders and

Hawkins-Elder and Ward 849

depression/anxiety; Smith et al., 2018), which makes them particularly useful in account-
ing for comorbidity (Fried et al., 2017). However, although SNMs provide a useful and
interesting description of psychopathological symptom relationships, they still fail to
provide effective compositional explanations.

SNMs, like DSM/ICD syndromes, lack explanatory scope and depth. Although the
relationships between symptoms are elaborated within these models, the nature of the
symptoms themselves is not fully explained: each is represented largely at the phenom-
enological level, rather than at each level of analysis (e.g., molecular, neural, physiologi-
cal, cognitive/psychological, interpersonal, sociocultural). For example, anhedonia, a
key symptom of depression, can be represented at the phenomenological level as involv-
ing both decreased “liking” and decreased “wanting,” at the cognitive level as a reduced
hedonic capacity, reduced reward motivation, and errors in reward learning, at the neural
level as dysfunction in the “hedonic network” and mesolimbic pathways, and at the
molecular level as reductions in opioid and dopaminergic activity (see Clack & Ward,
2020). Compared to a full analysis such as this, the descriptions of symptoms given in
SNMs are significantly underpowered. They may act as partial compositional explana-
tions, certainly—as models depicting the relationships between psychopathological
symptoms—but lack the depth of detail required to fully explain the constitution of the
disorders with which they are concerned.

Historical accounts. We refer here to descriptions of disorder states that accompanied the
first identification of a psychiatric syndrome or were developed around the time of the
DSM-III (published in 1980), which represented a paradigm shift towards our current
conceptualization of mental disorders (Mayes & Horwitz, 2005). Examples include Rus-
sell’s (1979) initial characterization of bulimia nervosa and Bruch’s (1973, 1978/1982)
early descriptive accounts of anorexia nervosa,1 considered the first “modern descrip-
tion” of the disorder (Marks, 2019). These sorts of accounts typically consist of a set of
clinical case studies from which the author draws broader conclusions. For example,
Russell’s (1979) initial characterization of bulimia nervosa involved 30 patients, three of
whom were presented as illustrative case studies, from which he drew conclusions about
the disorder’s typical features, such as demographics, symptomology, medical complica-
tions, and psychopathological correlates. These accounts are often more descriptively
comprehensive than the classificatory approaches above. However, they are nevertheless
unsuitable to serve as compositional explanations.

Most problematic is that their explanatory scope extends beyond composition.
Although they do describe the presentation of a disorder—as a compositional explana-
tion should—they often branch into hypothesizing its etiology as well. For example, as
well as describing the disorder’s presentation, Bruch’s (1978/1982) account of anorexia
nervosa makes numerous etiological claims—for example, “the child’s inability for con-
structive self-assertion and the associated deficits in personality development are the
outcome of interactional patterns that began early in life” (p. 37)—including several
chapters highlighting precipitating factors and speculating on the causal role of family
dynamics (e.g., chapters “The Perfect Childhood” and “How It Starts”). Although this
information may hold relevance in a clinical context, theoretically it conflates the theo-
retical tasks of compositional and etiological explanation. Although these tasks are

850 Theory & Psychology 31(6)

related—each informing the other—they are conceptually distinct, requiring different
modes of theoretical reasoning: causal versus compositional (see above). Attempting to
achieve both within a single account is therefore likely to create convolution and pro-
mote logical errors, thereby impairing the integrity of each task.

Historical accounts also tend to lack empirical foundation: being either the first or one
of the earliest descriptions of a disorder, there was typically little empirical research to
inform their construction. They are therefore most often based on a small number of case
studies which, although potentially the best option available at the time, falls short of
modern scientific standards. For example, there is typically extensive sampling bias:
samples are generally comprised solely of the author’s existing patients, and therefore
(due to reduced access to psychiatric treatment at the time; Mechanic, 2007) likely to be
skewed towards those of higher socioeconomic status and European descent. Furthermore,
cases are often aggregated in pseudoscientific or anecdotal ways to illustrate the author’s
points, rather than analysed in a valid statistical manner.

There has been little structured effort to update or expand such accounts in line with
contemporary research, despite many still being used to inform it. Although some aspects
of historical accounts can now be empirically verified, there are still many claims that
current research fails to support or actively refutes. For example, Bruch’s (1978/1982)
account of anorexia nervosa describes the disorder as affecting “the daughters of well-to-
do, educated, and successful families, not only in the United States but in many other
affluent countries” (p. vii), implying that anorexia nervosa exclusively affects WEIRD
populations (i.e., Western Educated Industrialized Rich Democratic; Henrich et al.,
2010). However, research now indicates anorexia nervosa is not a culture-bound syn-
drome (Keel & Klump, 2003; Pike et al., 2014), and shows no reliable association with
ethnicity or socioeconomic status (Hadassah Cheng et al., 2018; Schaumberg et al.,
2017).

Finally, as with DSM/ICD syndromes, historical accounts tend to refer to only the
most salient features of a disorder (i.e., the phenomenological level) and therefore neglect
those that are more deep-seated and less easily observed (e.g., neural network dysfunc-
tion, alterations in hormone or neurotransmitter systems), though nonetheless relevant.

Case narratives. Case narratives are often provided to students and clinicians in text-
books or treatment manuals to demonstrate how a disorder typically presents. Their
descriptions usually include information about the characteristic symptoms and signs,
demographics (e.g., age, gender), relevant history (e.g., familial, medical, psychiatric),
and triggers for that disorder. For example:

Anna, a 15-year old girl of European descent, presented with extreme weight loss and low
appetite. Her BMI had fallen from 19 (healthy for her age group) to 16 within the last six
months, such that she was substantially underweight. A recent check-up revealed no underlying
medical explanations for her weight-loss. Anna’s mother reported she had been refusing to join
family meals, confining herself often to her bedroom, and eating a drastically reduced diet. She
had also stopped spending as much time with friends and increased her exercise regime
significantly—running for 1–2 hours every day, in addition to competitive swimming training.
When her parents expressed their concerns to Anna, she tended to either burst into tears or

Hawkins-Elder and Ward 851

shout at them. Anna was unconcerned about her weight-loss and denied that her eating or
exercise behaviour was a problem. She expressed significant body dissatisfaction and drive for
thinness, complaining she was “too fat” and wishing she were thinner. According to her mother,
Anna had had many challenges throughout her development and had previously seen a child
psychologist for anxiety.

As with both diagnostic syndromes and historical accounts, case narratives tend to
refer only to features of the disorder that are most clinically salient. For example, the
exemplar above refers largely to the phenomenological experience of the client, Anna,
and neglects to include information about any physiological, neural, or molecular pro-
cesses. This makes sense given that such accounts are intended as prototypical examples
of clinical presentation, and in practice one would not routinely engage in the methods of
investigation required to identify more deep-seated structural phenomena (e.g., fMRI,
CSF sampling). However, as previously discussed, it significantly limits their explana-
tory value.

Furthermore, although case narratives refer to significantly more features of the dis-
order than most classificatory approaches, they still lack depth in their descriptions. They
fail to go into any features in detail—relying on brief, superficial descriptions despite the
fact that these constructs are often multidimensional (e.g., body image; see above)—and
continue to refer to the thinly defined constructs entrenched within psychopathological
research (e.g., “drive for thinness,” “body image dissatisfaction”). Case examples are
also just that: examples. Each presents a specific instance of a disorder. Hence, although
many features may be represented, it is unlikely that all features relevant to the disorder
will be included, as real-life cases seldom (if ever) present with every feature associated
with the condition.

The Research Domain Criteria (RDoC). The RDoC is a clinically independent research
framework intended to guide empirical investigation into psychological mechanisms
(Cuthbert & Insel, 2013). It was developed as a reaction to the publication of the DSM-5,
which many perceived as being a conservative development on the previous edition
(DSM-IV) that retained many of the problems originally identified (e.g., reification;2
Whooley, 2014). The RDoC presents an “alternative nosological framework” (Whooley,
2014, p. 100) that seeks to advance psychopathology research—specifically, neurobio-
logical investigation (Cuthbert & Insel, 2013; Whooley, 2014). The RDoC assumes that
mental disorders are “brain disorders” born out of dysfunctions in neural circuitry, and
therefore aims to build a nosology of mental disorder from the “bottom-up” using current
neuroscience research (Cuthbert & Insel, 2013; Whooley, 2014). The hope is that by
doing so we will develop more valid diagnostic categories, anchored in neurobiology
(Lilienfeld, 2014; Whooley, 2014).

The RDoC framework provides a two-dimensional “matrix” to guide psychopathol-
ogy research, consisting of six psychological “domains” of investigation—(a) negative
valance systems (e.g., threat, loss), (b) positive valence systems (e.g., approach motiva-
tion, reward learning), (c) cognitive systems (e.g., attention, working memory), (d) sys-
tems for social processes (e.g., attachment, social communication), (e) sensorimotor
systems (e.g., action selection, initiation, execution, habit development), and (f) arousal/

852 Theory & Psychology 31(6)

modulatory systems (e.g., sleep-wake, arousal)—as well as seven “units of analysis”—
(a) genes, (b) molecules, (c) cells, (d) neural circuits, (e) physiology, (f) behaviour, and
(g) self-report (Cuthbert & Insel, 2013; Lilienfeld, 2014). The RDoC assumes that men-
tal disorders result from disruptions in the normal-range functioning of these processes
and thus applies basic understandings of psychology and neuroscience to psychopatho-
logical problems (Lilienfeld, 2014).

It is important that the role of the RDoC within the scientific inquiry process be accu-
rately understood. The RDoC is a research framework intended to scaffold investigation
into psychological processes—both their function and dysfunction—in order to obtain
insight into psychopathology and thereby “inform future classification schemes [empha-
sis added]” (Insel et al., 2010, p. 748). Hence, although able to generate substantial data
about psychological and psychopathological processes, the RDoC does not work to con-
ceptualize these theoretically—that is, to create a coherent compositional account that
links these findings together in relevant and meaningful ways. It therefore does not
directly produce compositional explanations.

Even if it did include such a synthesis, the RDoC matrix is not directly geared towards
studying psychopathological processes. Although intended to provide insight into mental
disorder, one of the core philosophies of the RDoC is that investigation should be directed
towards broader psychological processes (e.g., positive valence systems, cognitive sys-
tems)—how they both function and malfunction, and thereby may contribute to the
development and maintenance of mental disorder—rather than specific psychopatho-
logical problems (Cuthbert & Insel, 2013). Hence, the picture developed by the RDoC
framework is more likely to be a comprehensive understanding of these systems—
including their role in psychopathology—rather than synthesized descriptions of particu-
lar mental disorders. This is not to say the RDoC cannot contribute valuably to the
development of compositional explanations—the wealth of compositional data the
framework has the power to generate would have great value for their construction.
However, it is critical to note that the RDoC also encompasses etiological investigation
(e.g., genetic research), and does not clearly distinguish between these two processes. As
previously discussed, this conflates two distinct theoretical tasks (i.e., causal vs. compo-
sitional explanation) and may lead to problems farther along in the explanatory
process.

The RDoC is also significantly neurocentric; asserting that mental disorders be con-
sidered “brain disorders” born out of dysfunctions in neurocircuitry (Cuthbert & Insel,
2013; Lilienfeld, 2014; Whooley, 2014). Although this approach has some benefits—for
example, highlighting the role of neurobiological processes in mental disorder (at times
discounted or neglected) and providing a platform for investigating neurobiological
aspects of psychopathology—it largely sidelines other levels of explanation (e.g., phe-
nomenological, sociocultural) despite their equal relevance to mental disorder. Of the
seven “units of analysis” prescribed by the RDoC, five are biologically based—genes,
molecules, cells, neurocircuitry, physiology—implying that neurobiological factors hold
far greater explanatory weight (Lilienfeld, 2014).

Furthermore, even though one of the investigative domains concerns social/interper-
sonal phenomena (i.e., systems for social processes), broader sociocultural structures and
influences are not addressed within the framework. Cultural factors are well-evidenced

Hawkins-Elder and Ward 853

as playing a significant role in multiple aspects of psychopathology (e.g., etiology, main-
tenance, symptom expression) and we would argue that mental disorders cannot be
understood independently of their social and cultural context. For example, some symp-
toms associated with posttraumatic stress disorder can be viewed as adaptive when
viewed within specific contexts, including the precipitating trauma event (e.g., hyper-
vigilance, physical hyperarousal, and emotional detachment may be useful in combat
situations). Hence, even though the RDoC might lead to richer neurobiological under-
standings of psychopathology, it also risks decontextualizing mental distress such that
lower levels of analysis (e.g., cellular, neural) are not considered within the broader
context of the problem and higher levels (e.g., psychological, phenomenological, socio-
cultural, etc.) end up significantly underspecified despite their explanatory relevance
(Whooley, 2014).

Building better descriptions

As we have seen, current options for compositional explanation are insufficient; failing
to demonstrate the necessary empirical adequacy, depth, and scope. In this section there-
fore, we demonstrate how we believe effective compositional explanations could be con-
structed. To begin, we first outline the theoretical framework used to guide these ideas:
the Phenomena Detection Method (PDM; Ward & Clack, 2019).

Guiding framework: The phenomena detection method

The PDM (Ward & Clack, 2019) is a metatheoretical framework for the detection and
modelling of “clinical phenomena” (e.g., symptoms) which is not dependent on existing
classification systems such as the DSM-5 or ICD (discussed above). Critically, it empha-
sizes the importance of developing compositional explanations of symptoms, making it
highly relevant to the current problem. It has four phases: (1) formulating client com-
plaints and/or accompanying signs, (2) discerning and analysing patterns in data related
to these symptoms (i.e., detecting clinical phenomena), (3) constructing multiple models
of the phenomenon using different levels or units of analysis, and (4) linking in etiologi-
cal factors to develop causal explanations. Phases 1–3 are relevant to the construction of
compositional explanations and thus inform our reasoning in this section.

Another important aspect of the PDM is its promotion of, and adherence to, a plural-
istic account of scientific explanation, which states that scientific explanations should
involve a collection of theoretical models that represent the constitution or causes of a
symptom at and across different spatial and temporal scales, instead of trying to repre-
sent everything using a single model. This approach is known as model pluralism and has
been widely recognized as a promising way forward in both the biological and social
sciences, in which the phenomena of interest are of a high level of complexity (Hochstein,
2016; Mitchell & Dietrich, 2006; Potochnik, 2010; Ruphy, 2016). The PDM endorses
this by prescribing the construction of multiple compositional or causal models of the
explanatory target at a range of spatial scales and levels of abstraction.

854 Theory & Psychology 31(6)

From syndromes to symptoms

A key impediment to current descriptive accounts acting as compositional explanations
is the fact that most are built around DSM/ICD syndromes, which are widely acknowl-
edged to possess numerous conceptual flaws, such as symptomatic heterogeneity and
rampant comorbidity (e.g., Nielsen & Ward, 2020; Whooley, 2014). Building composi-
tional explanations using these constructs is therefore problematic: any resultant descrip-
tion, no matter how rich or detailed, will lack a certain amount of validity as the very
construct being described is conceptually flawed. Continuing to use these constructs
theoretically also further entrenches them in research and practice, thereby impeding the
development of better classificatory approaches. Hence, on our view, the first step
towards building better compositional explanations is to transition away from these syn-
dromes as the foci of explanation.

Several theorists argue that, to move forward, psychological explanation should, at
least for now, focus on symptoms rather than syndromes (Berrios, 2013; Borsboom,
2017; Ward & Clack, 2019; Wilshire et al., in press). For instance, instead of trying to
describe and explain the syndrome bulimia nervosa, which comprises a cluster of diverse
symptoms, one would instead focus on a single symptom of that pathology, such as binge
eating. This approach makes sense conceptually, as symptoms and signs have greater
validity than DSM/ICD syndromes; arguably representing genuine phenomena as
opposed to artificial categories. Compared to these syndromes, symptoms have more
defined boundaries, less heterogeneity, and greater stability. For example, the symptom
binge eating is more obviously distinct from other symptoms (e.g., self-starvation, purg-
ing) than the syndrome bulimia nervosa is from other eating disorder diagnoses (e.g.,
anorexia nervosa). A client shifting from this symptom presentation to an alternative
presentation (e.g., self-starvation) or to a state of recovery is also likely to be much more
psychologically meaningful than a transition from one eating disorder diagnosis to
another, which can currently be accomplished by changes in arbitrary factors like BMI.
Practically, it is also useful to reduce the scope of our explanatory focus: it is much easier
to detail the composition of a single symptom than a large and diverse collection of them
(i.e., a syndrome).

Symptoms and signs also make for more appropriate foci at an ethical level, as they
represent the actual concerns of clients: each is a valid and important aspect of the cli-
ent’s difficulties that we should aim to understand. At the coarser grain size of syn-
dromes, although we are getting a concise and practical account, we may neglect the
description and explanation of some symptoms in favour of providing a brief and
uncomplicated overall account. At finer grain sizes, such as the neurobiological (e.g.,
the RDoC), although generating useful and detailed information that can be used to
inform theoretical conceptualization of clinical phenomena, we are no longer centring
our accounts on client problems—which arguably should be our paramount concern as
clinicians—and risk decontextualizing their distress (Whooley, 2014). Although to
fully describe symptoms we no doubt need to investigate and describe phenomena at
smaller scales (e.g., neurobiological, molecular) and consider their relationship to
other symptoms (e.g., syndromes, symptom networks), we argue that the appropriate

Hawkins-Elder and Ward 855

starting point for compositional explanations should, at least for now, be psychopatho-
logical symptoms.

Starting with data

Compositional explanations should be constructed using empirical evidence: reasoning
abductively from data to identify constructs and processes relevant to the phenomenon in
question (Haig, 2014). This begins with an unbiased gathering of relevant data—for
example, cross-sectional research from a variety of disciplines involving those present-
ing with that symptom/sign—that is of high methodological quality—for example,
RCTs, meta-analyses, systematic reviews, methodologically rigorous single studies—
which is then mined for patterns that might represent compositional constructs or pro-
cesses (Hawkins-Elder & Ward, 2020b).

For instance, within the symptom binge eating, we may theorize the existence of the
phenomenon impaired inhibitory control based on meta-analyses and systematic reviews
showing that individuals who exhibit binge eating demonstrate poorer performance on
planning (e.g., Farstad et al., 2016), decision-making (e.g., Guillaume et al., 2015; Wu
et al., 2016), and set-shifting tasks (e.g., Wu et al., 2016), higher self-reported impulsiv-
ity (e.g., Farstad et al., 2016; Steward et al., 2017), and frequent engagement in other
impulsive or reckless behaviours (e.g., self-harm, substance abuse; Peebles et al., 2011).
Having a range of different, and methodologically robust, data all pointing to the exist-
ence of impaired inhibitory control means we can be more confident that this phenome-
non is genuinely present, rather than the false product of biased reasoning or
methodological error. A full model constructed in this manner will therefore be a more
accurate representation of the phenomenon of interest.

Multilevel explanation

Compositional explanations should describe their phenomenon at all relevant levels of
analysis—for example, molecular, neurological, cognitive, phenomenological, interper-
sonal, contextual/sociocultural, and so forth. Indeed, Zachar (2008) describes psycho-
pathological phenomena as structures with “many overlapping levels” and argues that
“having alternative models better reflects the domain of psychiatric disorders” (pp. 339–
340). Compositional explanations should therefore be similarly multilevel in order to
adequately reflect this.

To accomplish this, we recommend building models in a “stacked” format, beginning
with the phenomenological level (at which the symptom/sign is reported/observed) and
moving outwards, considering each level of analysis in turn, to identify factors and pro-
cesses that might be constitutionally relevant. This is useful because factors and pro-
cesses at one level may partially constitute or be otherwise related to those at another and
building outwards in this manner may help the researcher to make these connections.

Consider the symptom binge eating: at the phenomenological level, we can recount
how this symptom is experienced by the client based on self-report data from empirical
research: privacy is important (secretive eating; Lydecker & Grilo, 2019), emotion is
often involved (emotional eating; e.g., Leehr et al., 2015; Ricca et al., 2012), individuals

856 Theory & Psychology 31(6)

typically perceive a lack of control over their eating (e.g., Colles et al., 2008), and may
experience strong physical hunger and hedonic craving for food (e.g., Ng & Davis, 2013;
Witt & Lowe, 2014; see Figure 1). From this level, we can then consider factors and
processes suggested by empirical research at lower levels that may comprise this symp-
tom. For example, at a cognitive level, the reported hunger and craving could be repre-
sented as a heightening of appetite3 (see Figure 1). This may be partially constituted at
the physiological level by an impaired appetite feedback system (e.g., imbalances in
hunger and satiety hormones, Culbert et al., 2016; altered vagal nerve transmission,
Peschel et al., 2016) and at the neurological level by interoceptive network deficits (e.g.,
insular dysfunction, Gasquoine, 2014; Klabunde et al., 2017) and alterations in reward
pathways (e.g., Avena & Bocarsly, 2012; Frank, 2013; Wierenga et al., 2014). Further
down at the molecular level, serotonin dysregulation (e.g., Compan et al., 2012) may be
partially responsible for the experience of hunger surrounding a binge (due to its role in
appetite regulation; e.g., Lam et al., 2010), and the experience of intense craving may be
influenced by dysregulation in opioid and dopaminergic systems implicated in reward
and addiction (e.g., Berridge, 2009; Majuri et al., 2017). At a higher level, it is also worth
considering how sociocultural factors may influence how the symptom is experienced
(e.g., enabling or inhibiting certain behaviours, altering symptom content). For instance,
overeating, for metabolic or hedonic reasons, is somewhat dependent on socioeconomic
food security (e.g., Anderson-Fye, 2018), as food must be available in reasonable abun-
dance for it to be overconsumed. Similarly, the content of cravings is likely to be influ-
enced by the individual’s cultural environment (e.g., Osman & Sobal, 2006).

We can conduct the same process for each aspect of a symptom to build a multilevel
explanation of its constitution (see Figure 1). Such an explanation provides a rich descrip-
tion of the symptom, as it details the relevant factors and processes at all levels and
considers how these may comprise or influence each other.

Detailing domains

An adequate compositional explanation should describe all aspects of the phenomenon
in a high level of detail. One way of doing this is to build smaller compositional models
of constructs “nested” within the larger account. This helps to avoid overcomplicating
the broader model with specifics, allowing it to present a streamlined overview, but
ensures that all constructs are sufficiently outlined and the overall explanation is descrip-
tively rich.

Consider the multilevel model of binge eating previously sketched out: although this
model provides a good overview of constitutional factors and processes at each level, the
constructs referred to within each domain are still in need of further definition. By con-
structing nested “submodels” of these phenomena, we can more clearly define the factors
and processes invoked and thereby enrich the overall account. For example, consider
heightened appetite (identified at the cognitive level). Based on the literature, we can
construct a more detailed compositional submodel of this construct (see Figure 2).

Individuals who binge eat are more sensitive to the effects of reward (e.g., Harrison
et al., 2010; Wierenga et al., 2014), including reward from food (e.g., Schag et al., 2013).
They are therefore likely to have greater hedonic hunger (e.g., Witt & Lowe, 2014) than

Hawkins-Elder and Ward 857

nonbinge-eating individuals. Binge eaters also demonstrate impaired satiety (e.g., Sysko
et al., 2007). Their metabolic hunger is therefore also likely greater, as they have less
indication when they are full. Finally, binge eaters reliably demonstrate poorer interocep-
tion—ability to sense and interpret internal sensations—than nonbinge eaters (e.g.,
Jenkinson et al., 2018; Klabunde et al., 2017). They may therefore struggle to detect
physical cues, including appetitive signals, and accurately interpret them, sometimes
misattributing physical sensations as hunger or satiety. This may make it harder for them
to appropriately modulate eating behaviour according to their body’s metabolic needs
(e.g., Herbert & Pollatos, 2018).

Submodels at one level can also be linked to submodels at other levels to further
enrich the explanation. For example, we might construct a physiological submodel of the
impaired appetite feedback system (see Figure 3), involving alterations in the baseline
levels and responses of appetitive hormones (e.g., Culbert et al., 2016; Prince et al.,
2009), increased gastric capacity and delayed gastric emptying (e.g., Klein & Walsh,

Figure 1. Illustration of a multilevel approach to compositional explanation, using the
symptom binge eating.

858 Theory & Psychology 31(6)

2004), and decreased ascending vagal nerve transmission (e.g., Simmons & DeVille,
2017). This can then be linked to the cognitive model by relating the lower level physi-
ological processes to those at the higher level. For example, the impaired satiety described
at the cognitive level is likely partially constituted by these hormonal and gastric differ-
ences (see Figure 3; e.g., Berthoud, 2008; Zanchi et al., 2017). Aberrant hormonal func-
tioning could also partially comprise the increased sensitivity to food-related reward due
to the influence of some hormones on dopaminergic networks (e.g., leptin; Cassioli et al.,
2020). Vagal nerve dysregulation may likewise play a part in impaired interoception, as
it plays a key role in transmitting sensory information from the body to the brain (Craig,
2002). This kind of intermodel linking further enriches the overall compositional picture,
contributing to a more in-depth account of the symptom’s composition.

Conclusion

In this article, we suggested how better compositional explanations could be constructed
by focusing on symptoms rather than syndromes, using empirical research, and creating
detail-rich models spanning all levels of analysis. At present, we lack theoretically ori-
ented and descriptively rich accounts of how psychopathological problems are consti-
tuted. The absence of these compositional explanations is of significant concern, as they
hold genuine value for both research and practice. The kind of nested modelling outlined
above is a good example of how originally conceptually thin phenomena can be elabo-
rated into rich, multilayered compositional accounts. Developing a network of composi-
tional models at different levels of analysis may yield insight into the structures and
processes constituting disorders that could, ultimately, result in stronger etiological
explanations, more accurate taxonomies, and more precisely targeted treatment. In our
view, greater attention to the compositional explanation of psychopathological symp-
toms is a crucial step towards ameliorating the social costs and personal suffering of
mental illness.

Figure 2. Example of a compositional submodel within the symptom binge eating, detailing the
nested cognitive phenomenon heightened appetite.

Hawkins-Elder and Ward 859

Acknowledgements

The authors would like to thank the EPC Lab at Victoria, as well as Alexander Moses for his assis-
tance in designing the figures for the paper.

Declaration of Conflicting Interests

The authors declare that there is no conflict of interest.

Funding

The authors received no financial support for the research, authorship, and/or publication of this
article.

ORCID iDs

Hannah Hawkins-Elder https://orcid.org/0000-0002-3511-3908
Tony Ward https://orcid.org/0000-0002-6292-2364

Figure 3. Example model linking cognitive (heightened appetite) and physiological (impaired
appetite feedback system) submodels within the symptom binge eating.

860 Theory & Psychology 31(6)

Notes

1. The most well-known of these being her book The Golden Cage: The Enigma of Anorexia
Nervosa (Bruch, 1978/1982), first published in 1978.

2. Reification refers to the process of considering or representing an abstract concept or idea as
a material or concrete entity (Hyman, 2010).

3. “Appetite” refers to an individual’s drive to eat, for either hedonic or metabolic purposes
(Booth, 2003).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Anderson-Fye, E. P. (2018). Cultural influences on body image and eating disorders. In W. S.
Agras & A. Robinson (Eds.), The Oxford handbook of eating disorders (2nd ed.). Oxford
University Press.

Avena, N. M., & Bocarsly, M. E. (2012). Dysregulation of brain reward systems in eating dis-
orders: Neurochemical information from animal models of binge eating, bulimia nervosa,
and anorexia nervosa. Neuropharmacology, 63(1), 87–96. https://doi.org/10.1016/j.neurop-
harm.2011.11.010

Bailer-Jones, D. M. (2003). When scientific models represent. International Studies in the
Philosophy of Science, 17(1), 59–74. https://doi.org/10.1080/02698590305238

Berridge, K. C. (2009). “Liking” and “wanting” food rewards: Brain substrates and roles in
eating disorders. Physiology & Behavior, 97(5), 537–550. https://doi.org/10.1016/j.phys-
beh.2009.02.044

Berrios, G. E. (2013). Formation and meaning of mental symptoms: History and epistemology.
Dialogues in Philosophy, Mental and Neuro Sciences, 6(2), 39–48. https://philarchive.org/
rec/BERFAM-2

Berthoud, H. (2008). Vagal and hormonal gut–brain communication: From satiation to satis-
faction. Neurogastroenterology & Motility, 20(s1), 64–72. https://doi.org/10.1111/j.1365-
2982.2008.01104.x

Booth, D. A. (2003). Food, nutrition, and appetite. In B. Caballero (Ed.), Encyclopedia of food
sciences and nutrition (2nd ed.; pp. 5098–5102). Academic Press. https://www.sciencedirect.
com/referencework/9780122270550/encyclopedia-of-food-sciences-and-nutrition

Borsboom, D. (2017). A network theory of mental disorders. World Psychiatry, 16(1), 5–13.
https://doi.org/10.1002/wps.20375

Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa and the person within. Basic Books.
Bruch, H. (1982). The golden cage: The enigma of anorexia nervosa. Harvard University Press.

(Original work published 1978)
Cash, T. F., & Deagle, E. A. (1997). The nature and extent of body-image disturbances in anorexia

nervosa and bulimia nervosa: A meta-analysis. International Journal of Eating Disorders,
22(2), 107–125. https://doi.org/10.1002/(SICI)1098-108X(199709)22:2<107::AID-
EAT1>3.0.CO;2-J

Cassioli, E., Rossi, E., Squecco, R., Baccari, M. C., Maggi, M., Vignozzi, L., Comeglio, P., Gironi,
V., Lelli, L., Rotella, F., Monteleone, A. M., Ricca, V., & Castellini, G. (2020). Reward and
psychopathological correlates of eating disorders: The explanatory role of leptin. Psychiatry
Research, 290, Article 113071. https://doi.org/10.1016/j.psychres.2020.113071

Clack, S., & Ward, T. (2020). Modeling the symptoms of psychopathology: A pluralistic
approach. New Ideas in Psychology, 59, Article 100799. https://doi.org/10.1016/j.newidea-
psych.2020.100799

Hawkins-Elder and Ward 861

Colles, S. L., Dixon, J. B., & O’Brien, P. E. (2008). Loss of control is central to psychologi-
cal disturbance associated with binge eating disorder. Obesity, 16(3), 608–614. https://doi.
org/10.1038/oby.2007.99

Compan, V., Laurent, L., Jean, A., Macary, C., Bockaert, J., & Dumuis, A. (2012). Serotonin
signalling in eating disorders. Wiley Interdisciplinary Reviews: Membrane Transport and
Signaling, 1(6), 715–729. https://doi.org/10.1002/wmts.45

Craig, A. D. (2002). How do you feel? Interoception: The sense of the physiological condition of
the body. Nature Reviews Neuroscience, 3(8), 655–666. https://doi.org/10.1038/nrn894

Craver, C. F. (2007). Explaining the brain: Mechanisms and the mosaic unity of neuroscience.
Oxford University Press.

Craver, C., & Kaplan, D. M. (2020). Are more details better? On the norms of completeness for
mechanistic explanations. The British Journal for the Philosophy of Science, 71(1), 287–319.
https://doi.org/10.1093/bjps/axy015

Culbert, K. M., Racine, S. E., & Klump, K. L. (2016). Hormonal factors and disturbances in
eating disorders. Current Psychiatry Reports, 18(7), 65–81. https://doi.org/10.1007/s11920-
016-0701-6

Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pil-
lars of RDoC. BMC Medicine, 11(1), Article 126. https://doi.org/10.1186/1741-7015-11-126

Dishion, T. J., & Patterson, G. R. (2015). The development and ecology of antisocial behavior in
children and adolescents. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathol-
ogy: Vol. 3. Risk, disorder, and adaptation (2nd ed., pp. 503–541). John Wiley & Sons.

Farstad, S. M., McGeown, L. M., & von Ranson, K. M. (2016). Eating disorders and person-
ality 2004–2016: A systematic review and meta-analysis. Clinical Psychology Review, 46,
91–105. https://doi.org/10.1016/j.cpr.2016.04.005

Faye, J. (2014). The nature of scientific thinking: On interpretation, explanation, and understand-
ing. Palgrave Macmillan.

Frank, G. K. W. (2013). Altered brain reward circuits in eating disorders: Chicken or egg? Current
Psychiatry Reports, 15(10), Article 396. https://doi.org/10.1007/s11920-013-0396-x

Fried, E. I., van Borkulo, C. D., Cramer, A. O. J., Boschloo, L., Schoevers, R. A., & Borsboom,
D. (2017). Mental disorders as networks of problems: A review of recent insights. Social
Psychiatry and Psychiatric Epidemiology, 52(1), 1–10. https://doi.org/10.1007/s00127-016-
1319-z

Gasquoine, P. G. (2014). Contributions of the insula to cognition and emotion. Neuropsychology
Review, 24(2), 77–87. https://doi.org/10.1007/s11065-014-9246-9

Gillett, C. (in press). Using compositional explanations to understand compositional levels: An
integrative account. In D. S. Brooks, J. DiFrisco, & W. C. Wimsatt (Eds.), Levels of organiza-
tion in the biological sciences. MIT Press.

Guillaume, S., Gorwood, P., Jollant, F., Van den Eynde, F., Courtet, P., & Richard-Devantoy,
S. (2015). Impaired decision-making in symptomatic anorexia nervosa and bulimia ner-
vosa patients: A meta-analysis. Psychological Medicine, 45(16), 3377–3391. https://doi.
org/10.1017/S003329171500152X

Hadassah Cheng, Z., Perko, V. L., Fuller-Marashi, L., Gau, J. M., & Stice, E. (2018). Ethnic differ-
ences in eating disorder prevalence, risk factors, and predictive effects of risk factors among
young women. Eating Behaviors, 32, 23–30. https://doi.org/10.1016/j.eatbeh.2018.11.004

Haig, B. D. (2014). Investigating the psychological world: Scientific method in the behavioural
sciences. The MIT Press.

Harrison, A., O’Brien, N., Lopez, C., & Treasure, J. (2010). Sensitivity to reward and punish-
ment in eating disorders. Psychiatry Research, 177(1–2), 1–11. https://doi.org/10.1016/j.psy-
chres.2009.06.010

862 Theory & Psychology 31(6)

Hawkins-Elder, H., & Ward, T. (2020a). Explanations for eating disorders: A critical analysis.
Behaviour Change, 37(2), 93–110. https://doi.org/10.1017/bec.2020.6

Hawkins-Elder, H., & Ward, T. (2020b). Theory construction in the psychopathology
domain: A multiphase approach. Theory & Psychology, 30(1), 77–98. https://doi.org/
10.1177/0959354319893026

Hedges, D., Farrer, T. J., Bigler, E. D., & Hopkins, R. O. (2019). Cognition in anorexia nervosa and
bulimia nervosa. In D. Hedges, T. J. Farrer, E. D. Bigler, & R. O. Hopkins (Eds.), The brain at
risk: Associations between disease and cognition (pp. 67–83). Springer Nature Switzerland.

Henrich, J., Heine, S. J., & Norenzayan, A. (2010). Beyond WEIRD: Towards a broad-based behav-
ioral science. Behavioral and Brain Sciences, 33(2–3), 111–135. https://doi.org/10.1017/
S0140525X10000725

Herbert, B. M., & Pollatos, O. (2018). The relevance of interoception for eating behavior and eat-
ing disorders. In M. Tsakiris & H. De Preester (Eds.), The interoceptive mind: From homeo-
stasis to awareness (pp. 165–186). Oxford University Press.

Hochstein, E. (2016). One mechanism, many models: A distributed theory of mechanistic explana-
tion. Synthese, 193(5), 1387–1407. https://doi.org/10.1007/s11229-015-0844-8

Hyman, S. E. (2010). The diagnosis of mental disorders: The problem of reification. Annual Review of
Clinical Psychology, 6, 155–179. https://doi.org/10.1146/annurev.clinpsy.3.022806.091532

Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., & Wang,
P. (2010). Research domain criteria (RDoC): Toward a new classification framework for
research on mental disorders. American Journal of Psychiatry, 167(7), 748–751. https://doi.
org/10.1176/appi.ajp.2010.09091379

Jenkinson, P. M., Taylor, L., & Laws, K. R. (2018). Self-reported interoceptive deficits in eat-
ing disorders: A meta-analysis of studies using the eating disorder inventory. Journal of
Psychosomatic Research, 110, 38–45. https://doi.org/10.1016/j.jpsychores.2018.04.005

Kaiser, M. I., & Krickel, B. (2016). The metaphysics of constitutive mechanistic phenomena. The
British Journal for the Philosophy of Science, 68(3), 745–779. https://doi.org/10.1093/bjps/
axv058

Keel, P. K., & Klump, K. L. (2003). Are eating disorders culture-bound syndromes? Implications
for conceptualizing their etiology. Psychological Bulletin, 129(5), 747–769. https://doi.
org/10.1037/0033-2909.129.5.747

Kendler, K. S., Parnas, J., & Zachar, P. (2020). (Eds.). Levels of analysis in psychopathology:
Cross-disciplinary perspectives. Cambridge University Press.

Klabunde, M., Collado, D., & Bohon, C. (2017). An interoceptive model of bulimia nervosa: A
neurobiological systematic review. Journal of Psychiatric Research, 94, 36–46. https://doi.
org/10.1016/j.jpsychires.2017.06.009

Klein, D. A., & Walsh, B. T. (2004). Eating disorders: Clinical features and pathophysiology.
Physiology & Behavior, 81(2), 359–374. https://doi.org/10.1016/j.physbeh.2004.02.009

Konjarski, M., Murray, G., Lee, V. V., & Jackson, M. L. (2018). Reciprocal relationships between
daily sleep and mood: A systematic review of naturalistic prospective studies. Sleep Medicine
Reviews, 42, 47–58. https://doi.org/10.1016/j.smrv.2018.05.005

Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., Brown,
T. A., Carpenter, W. T., Caspi, A., Clark, L. A., Eaton, N. R., Forbes, M. K., Forbush, K. T.,
Goldberg, D., Hasin, D., Hyman, S. E., Ivanova, M. Y., Lynam, D. R., Markon, K., Miller, J.
D., . . . Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP):
A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4),
454–477. https://doi.org/10.1037/abn0000258

Krueger, R. F., & Eaton, N. R. (2015). Transdiagnostic factors of mental disorders. World
Psychiatry, 14(1), 27–29. https://doi.org/10.1002/wps.20175

Hawkins-Elder and Ward 863

Lam, D. D., Garfield, A. S., Marston, O. J., Shaw, J., & Heisler, L. K. (2010). Brain serotonin
system in the coordination of food intake and body weight. Pharmacology Biochemistry and
Behavior, 97(1), 84–91. https://doi.org/10.1016/j.pbb.2010.09.003

Leehr, E. J., Krohmer, K., Schag, K., Dresler, T., Zipfel, S., & Giel, K. E. (2015). Emotion regu-
lation model in binge eating disorder and obesity—A systematic review. Neuroscience &
Biobehavioral Reviews, 49, 125–134. https://doi.org/10.1016/j.neubiorev.2014.12.008

Lilienfeld, S. O. (2014). The Research Domain Criteria (RDoC): An analysis of methodologi-
cal and conceptual challenges. Behaviour Research and Therapy, 62, 129–139. https://doi.
org/10.1016/j.brat.2014.07.019

Lydecker, J. A., & Grilo, C. M. (2019). I didn’t want them to see: Secretive eating among adults
with binge-eating disorder. International Journal of Eating Disorders, 52(2), 153–158.
https://doi.org/10.1002/eat.23002

Majuri, J., Joutsa, J., Johansson, J., Voon, V., Alakurtti, K., Parkkola, R., Lahti, T., Alho, H.,
Hirvonen, J., Arponen, E., Forsback, S., & Kaasinen, V. (2017). Dopamine and opioid neu-
rotransmission in behavioral addictions: A comparative PET study in pathological gambling
and binge eating. Neuropsychopharmacology, 42(5), 1169–1177. https://doi.org/10.1038/
npp.2016.265

Mantzavinos, C. (2016). Explanatory pluralism. Cambridge University Press.
Marks, A. (2019). The evolution of our understanding and treatment of eating disorders over the

past 50 years. Journal of Clinical Psychology, 75(8), 1380–1391. https://doi.org/10.1002/
jclp.22782

Mayes, R., & Horwitz, A. V. (2005). DSM-III and the revolution in the classification of men-
tal illness. Journal of the History of the Behavioral Sciences, 41(3), 249–267. https://doi.
org/10.1002/jhbs.20103

Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6), 1548–1550.
https://doi.org/10.1377/hlthaff.26.6.1548

Mitchell, S. D., & Dietrich, M. R. (2006). Integration without unification: An argument for plural-
ism in the biological sciences. The American Naturalist, 168(Suppl. 6), S73–S79. https://doi.
org/10.1086/509050

Mölbert, S. C., Klein, L., Thaler, A., Mohler, B. J., Brozzo, C., Martus, P., Karnath, H., Zipfel,
S., & Giel, K. E. (2017). Depictive and metric body size estimation in anorexia nervosa and
bulimia nervosa: A systematic review and meta-analysis. Clinical Psychology Review, 57,
21–31. https://doi.org/10.1016/j.cpr.2017.08.005

Ng, L., & Davis, C. (2013). Cravings and food consumption in binge eating disorder. Eating
Behaviors, 14(4), 472–475. https://doi.org/10.1016/j.eatbeh.2013.08.011

Nielsen, K., & Ward, T. (2020). Phenomena complexes as targets of explanation in psychopathol-
ogy: The relational analysis of phenomena approach. Theory & Psychology, 30(2), 164–185.
https://doi.org/10.1177/0959354320906462

Nowakowski, M. E., McFarlane, T., & Cassin, S. E. (2013). Alexithymia and eating disorders:
A critical review of the literature. Journal of Eating Disorders, 1(1), Article 21. https://doi.
org/10.1186/2050-2974-1-21

Osman, J. L., & Sobal, J. (2006). Chocolate cravings in American and Spanish individuals:
Biological and cultural influences. Appetite, 47(3), 290–301. https://doi.org/10.1016/j.
appet.2006.04.008

Peebles, R., Wilson, J. L., & Lock, J. D. (2011). Self-injury in adolescents with eating disor-
ders: Correlates and provider bias. Journal of Adolescent Health, 48(3), 310–313. https://doi.
org/10.1016/j.jadohealth.2010.06.017

864 Theory & Psychology 31(6)

Peschel, S. K. V., Feeling, N. R., Vögele, C., Kaess, M., Thayer, J. F., & Koenig, J. (2016).
A meta-analysis on resting state high-frequency heart rate variability in bulimia nervosa.
European Eating Disorders Review, 24(5), 355–365. https://doi.org/10.1002/erv.2454

Pike, K. M., Hoek, H. W., & Dunne, P. E. (2014). Cultural trends and eating disorders. Current
Opinion in Psychiatry, 27(6), 436–442. https://doi.org/10.1097/yco.0000000000000100

Potochnik, A. (2010). Levels of explanation reconceived. Philosophy of Science, 77(1), 59–72.
https://doi.org/10.1086/650208

Prince, A. C., Brooks, S. J., Stahl, D., & Treasure, J. (2009). Systematic review and meta-analysis
of the baseline concentrations and physiologic responses of gut hormones to food in eating
disorders. American Journal of Clinical Nutrition, 89(3), 755–765. https://doi.org/10.3945/
ajcn.2008.27056

Ricca, V., Castellini, G., Fioravanti, G., Lo Sauro, C., Rotella, F., Ravaldi, C., Lazzeretti, L., &
Faravelli, C. (2012). Emotional eating in anorexia nervosa and bulimia nervosa. Comprehensive
Psychiatry, 53(3), 245–251. https://doi.org/10.1016/j.comppsych.2011.04.062

Ruphy, S. (2016). Scientific pluralism reconsidered. University of Pittsburgh Press.
Russell, G. (1979). Bulimia nervosa: An ominous variant of anorexia nervosa. Psychological

Medicine, 9(3), 429–448. https://doi.org/10.1017/s0033291700031974
Savulescu, J., Roache, R., & Davies, W. (Eds.). (2020). Psychiatry reborn: Biopsychosocial psy-

chiatry in modern medicine. Oxford University Press.
Schag, K., Teufel, M., Junne, F., Preissl, H., Hautzinger, M., Zipfel, S., & Giel, K. E. (2013).

Impulsivity in binge eating disorder: Food cues elicit increased reward responses and dis-
inhibition. PLOS ONE, 8(10), Article e76542. https://doi.org/10.1371/journal.pone.0076542

Schaumberg, K., Welch, E., Breithaupt, L., Hübel, C., Baker, J. H., Munn-Chernoff, M. A.,
Yilmaz, Z., Ehrlich, S., Mustelin, L., Ghaderi, A., Hardaway, A. J., Bulik-Sullivan, E. C.,
Hedman, A. M., Jangmo, A., Nilsson, I. A. K., Wiklund, C., Yao, S., Seidel, M., & Bulik, C.
M. (2017). The science behind the academy for eating disorders’ nine truths about eating dis-
orders. European Eating Disorders Review, 25(6), 432–450. https://doi.org/10.1002/erv.2553

Simmons, W. K., & DeVille, D. C. (2017). Interoceptive contributions to healthy eating and obesity.
Current Opinion in Psychology, 17, 106–112. https://doi.org/10.1016/j.copsyc.2017.07.001

Smith, K. E., Crosby, R. D., Wonderlich, S. A., Forbush, K. T., Mason, T. B., & Moessner,
M. (2018). Network analysis: An innovative framework for understanding eating disorder
psychopathology. International Journal of Eating Disorders, 51(3), 214–222. https://doi.
org/10.1002/eat.22836

Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014).
The global prevalence of common mental disorders: A systematic review and meta-analysis
1980–2013. International Journal of Epidemiology, 43(2), 476–493. https://doi.org/10.1093/
ije/dyu038

Steward, T., Mestre-Bach, G., Vintro-Alcaraz, C., Aguera, Z., Jimenez-Murcia, S., Granero, R.,
& Fernandez-Aranda, F. (2017). Delay discounting of reward and impulsivity in eating dis-
orders: From anorexia nervosa to binge eating disorder. European Eating Disorders Review,
25(6), 601–606. https://doi.org/10.1002/erv.2543

Stinson, C. (2019). The absent body in psychiatric diagnosis, treatment, and research. Synthese,
196, 2153–2176. https://doi.org/10.1007/s11229-017-1507-8

Sysko, R., Devlin, M. J., Walsh, B. T., Zimmerli, E., & Kissileff, H. R. (2007). Satiety and test meal
intake among women with binge eating disorder. International Journal of Eating Disorders,
40(6), 554–561. https://doi.org/10.1002/eat.20384

Thompson, J. K. (2004). The (mis)measurement of body image: Ten strategies to improve assess-
ment for applied and research purposes. Body Image, 1(1), 7–14. https://doi.org/10.1016/
S1740-1445(03)00004-4

Hawkins-Elder and Ward 865

Trout, J. D. (2016). Wondrous truths: The improbable triumph of science. Oxford University Press.
Ward, T., & Clack, S. (2019). From symptoms of psychopathology to the explanation of clini-

cal phenomena. New Ideas in Psychology, 54, 40–49. https://doi.org/10.1016/j.newidea-
psych.2019.01.004

Westwood, H., Eisler, I., Mandy, W., Leppanen, J., Treasure, J., & Tchanturia, K. (2016). Using
the autism-spectrum quotient to measure autistic traits in anorexia nervosa: A systematic
review and meta-analysis. Journal of Autism and Developmental Disorders, 46(3), 964–977.
https://doi.org/10.1007/s10803-015-2641-0

Westwood, H., Kerr-Gaffney, J., Stahl, D., & Tchanturia, K. (2017). Alexithymia in eating dis-
orders: Systematic review and meta-analyses of studies using the Toronto Alexithymia
Scale. Journal of Psychosomatic Research, 99, 66–81. https://doi.org/10.1016/j.jpsy-
chores.2017.06.007

Whiteford, H. A., Ferrari, A. J., Degenhardt, L., Feigin, V., & Vos, T. (2015). The global burden
of mental, neurological and substance use disorders: An analysis from the global burden of
disease study 2010. PLOS ONE, 10(2), Article e0116820. https://doi.org/10.1371/journal.
pone.0116820

Whooley, O. (2014). Nosological reflections: The failure of DSM-5, the emergence of RDoC, and
the decontextualization of mental distress. Society and Mental Health, 4(2), 92–110. https://
doi.org/10.1177/2156869313519114

Widiger, T. A., & Costa, P. T., Jr. (Eds.). (2013). Personality disorders and the five-fac-
tor model of personality (3rd ed.). American Psychological Association. https://doi.
org/10.1037/13939-000

Wierenga, C. E., Ely, A., Bischoff-Grethe, A., Bailer, U. F., Simmons, A. N., & Kaye, W. H.
(2014). Are extremes of consumption in eating disorders related to an altered balance
between reward and inhibition? Frontiers in Behavioral Neuroscience, 8, Article 410. https://
doi.org/10.3389/fnbeh.2014.00410

Wilshire, C. E., Ward, T., & Clack, S. (2021). Symptom descriptions in psychopathology: How
well are they working for us? Clinical Psychological Science. Advance online publication.
https://doi.org/10.1177/2167702620969215

Witt, A. A., & Lowe, M. R. (2014). Hedonic hunger and binge eating among women with eating
disorders. International Journal of Eating Disorders, 47(3), 273–280. https://doi.org/10.1002/
eat.22171

World Health Organization. (2019). International statistical classification of diseases and related
health problems (11th ed.). https://icd.who.int/

Wu, M., Brockmeyer, T., Hartmann, M., Skunde, M., Herzog, W., & Friederich, H. (2016). Reward-
related decision making in eating and weight disorders: A systematic review and meta-
analysis of the evidence from neuropsychological studies. Neuroscience and Biobehavioral
Reviews, 61, 177–196. https://doi.org/10.1016/j.neubiorev.2015.11.017

Zachar, P. (2008). Real kinds but no true taxonomy: An essay in psychiatric systematics. In K. S.
Kendler & J. Parnas (Eds.), Philosophical issues in psychiatry: Explanation, phenomenology,
and nosology (pp. 327–367). Johns Hopkins University Press.

Zanchi, D., Depoorter, A., Egloff, L., Haller, S., Mählmann, L., Lang, U. E., Drewe, J., Beglinger,
C., Schmidt, A., & Borgwardt, S. (2017). The impact of gut hormones on the neural circuitry
of appetite and satiety: Systematic review. Neuroscience and Biobehavioral Reviews, 80,
457–475. https://doi.org/10.1016/j.neubiorev.2017.06.013

866 Theory & Psychology 31(6)

Author biographies

Hannah Hawkins-Elder, BSc (Hons), is a PhD and clinical psychology student in the school of
psychology at Victoria University of Wellington. Her thesis focuses on the explanation of disor-
dered eating; specifically, taking a metatheoretical approach to how explanations of eating disor-
der phenomena are constructed and utilized in practice. Her recent publications include “The
Explanation of Eating Disorders: A Critical Analysis” in Behaviour Change (2020) and (with T.
Ward) “From Competition to Co-Operation: Shifting the ‘One Best Model’ Perspective” in Theory
& Psychology (2021).

Tony Ward, DipClinPsyc, PhD, is a professor of clinical psychology in the school of psychology
at Victoria University of Wellington, New Zealand. He has over 430 research publications and his
current research focuses on the development of explanatory models in psychopathology and foren-
sic psychology. His recent publications include “Why Theoretical Literacy is Essential for Forensic
Research and Practice” in Criminal Behaviour and Mental Health (2020), “The Classification of
Crime: Towards Pluralism” in Aggression and Violent Behavior (2020), and “Modeling the
Symptoms of Psychopathology: A Pluralistic Approach” in New Ideas in Psychology (2020).

Psychology of Aesthetics, Creativity, and the Arts
Psychopathology in World-Class Artistic and Scientific Creativity
Gregory J. Feist, Daniel Dostal, and Victor Kwan
Online First Publication, October 21, 2021. http://dx.doi.org/10.1037/aca0000440

CITATION
Feist, G. J., Dostal, D., & Kwan, V. (2021, October 21). Psychopathology in World-Class Artistic and Scientific Creativity.
Psychology of Aesthetics, Creativity, and the Arts. Advance online publication. http://dx.doi.org/10.1037/aca0000440

Psychopathology in World-Class Artistic and Scientific Creativity

Gregory J. Feist1, Daniel Dostal2, and Victor Kwan1
1 Department of Psychology, San Jose State University

2 Department of Psychology, Faculty of Arts, Palacký University Olomouc

The role of psychopathology in creative achievement has long been a debated topic in both popular culture
and academic discourse. Yet the field is settling on various robust trends that show there is no one answer.
Conclusions vary by level and kind of creativity and level and kind of psychopathology. The current study
sought to replicate previous findings that linked lifetime rates of psychopathology to world-class levels of crea-
tivity. A total of 199 biographies of eminent professionals (creative artists, creative scientists, eminent athletes)
were rated by raters who were blind to the identity of the eminent person on 19 mental disorders using a 3-
point scale of not present (0), probable (1), and present (2). Athletes served as an eminent but not creative
comparison group to discern whether fame, independently of creativity, was associated with psychopathology.
Results showed that artists exhibited higher lifetime rates of psychopathology than scientists and athletes in the
more inclusive criterion for psychopathology (i.e., it was either probable or present), whereas both artists and
athletes exhibited higher rates than scientists in the stricter criterion for psychopathology (i.e., it was present).
Apart from anxiety disorder, athletes did not differ from the U.S. population in lifetime rates of psychopathol-
ogy, whereas artists differed from the population in terms of alcoholism, anxiety disorder, drug abuse, and
depression. These data generally corroborate and replicate previous biographical research on the link between
artistic creativity and life-time rates of psychopathology.

Keywords: creativity, mental illness, psychopathyology, artists, scientists

Supplemental materials: https://doi.org/10.1037/aca0000440.supp

The stereotype of the mad genius has been a popular notion for
quite some time. Brilliant yet mad artists, such as Vincent van
Gogh, innovators such as Howard Hughes, and mathematicians
such as Isaac Newton have inspired this view throughout history
(Brownstein & Solyom, 1986; Jeste et al., 2000; Perry, 1947). The
list of geniuses with mental illness could go on and on. Of course,
the list of creative geniuses not afflicted with mental illness would
no doubt be at least as long. The range of conclusions on the ques-
tions are highlighted in the following four quotes: “There is no

great genius without some mixture of madness” (Aristotle, as para-
phrased by Seneca, 2007; cf. Motto & Clark, 1992).

Thus the creative genius may be at once naïve and knowledgeable,
being at home equally to primitive symbolism and to rigorous logic.
He is both more primitive and more cultured, more destructive and
more constructive, occasionally crazier and yet adamantly saner, than
the average person. (Barron, 1963, p. 224)

“Psychopathology and creativity are closely related, sharing
many traits and antecedents, but they are not identical, and out-
right psychopathology is negatively associated with creativity”
(Simonton, 2006). “Despite centuries of professional attention, the
link between creativity and madness remains more stereotype than
science” (Schlesinger, 2017, p. 60).

Anecdotal evidence is just that—anecdotal. But is there truly a
legitimate empirical link between psychopathology and creative
genius? Over the last 10 to 15 years, the field has begun to settle
on various robust trends that show there is no one answer to the
question of creativity and mental health. Conclusions vary by level
and kind of creativity and level and kind of psychopathology
(Baas et al., 2016; Beaussart et al., 2017; Fisher, 2015; Glazer,
2009). As Simonton (2014, 2017a, 2017b, 2019) has recently dem-
onstrated, all of these positions may have validity, with both linear
and nonlinear relationships. As is true of all entrenched scientific
debates, there must be some truth to each side otherwise one side
would die off very quickly. The current study sought to replicate
and extend previous biographical findings that linked lifetime rates
of psychopathology to world-class levels of creativity by examin-
ing the moderating effects of the relationship.

Gregory J. Feist https://orcid.org/0000-0002-3123-1069
Daniel Dostal https://orcid.org/0000-0001-5489-7907
This research was in partial fulfillment of the Master’s Thesis for Victor

Kwan. Portions of these findings were presented in 2019 at the Southern
Oregon University Creativity Conference, Ashland, Oregon, and in 2016 to the
Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland.
The authors thank Abiola Awolowo, Brian Barbaro, Kimya Behrouzia,

Catherine Erickson, Evander Eroles, Janet Dai, Adrian Davis, Sheila
Greenlaw, Jennifer Kang, Illhame Khabar, Thomas Lu, Caitlyn Ma, Dat
Nguyen, Elizabeth Shallal, Kimia Sohrabi, Eldita Tarani, Ryan Willard,
and Laura Weber. Data collection was sponsored by a grant from the
Research Foundation, San Jose State University. We have no conflicts of
interest to disclose.
Correspondence concerning this article should be addressed to Gregory

J. Feist, Department of Psychology, San Jose State University, One
Washington Square, San Jose, CA 95192-0120, United States. Email: greg
[email protected]

1

Psychology of Aesthetics, Creativity, and the Arts

© 2021 American Psychological Association
ISSN: 1931-3896 https://doi.org/10.1037/aca0000440

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Creativity

Creativity researchers have most regularly described creativity as
consisting of two qualities, namely originality/novelty and mean-
ingfulness/usefulness (Amabile, 1996; Feist, 2017; Runco & Jaeger,
2012; Sternberg, 1988). A creative endeavor must not only be dif-
ferent from what has been previously performed in a given domain
but also useful. In this case, the term “usefulness” can also mean
beautiful or provocative for artwork and literature. Some have
argued that the term “usefulness” could be replaced by the word
“meaningful” (Feist, 2017). With this change in terminology, the
need to qualify “useful” as also beautiful or provocative is no longer
necessary. Products of both art and science can be meaningful,
whereas a piece of artwork would not necessarily be useful. Mean-
ingful makes clear that the meaning is in the evaluator, and this can
be the general public, experts, peers, or historians, among others.
In the last 10 years, however, a few creativity researchers have

argued for three, rather than two, factor definitions of creativity.
Simonton (2013, 2016), for example, has proposed a logical quan-
titative model whereby a creative idea or solution is a multiplica-
tive function its originality, utility, and surprisingness. More
formally, and omitting the i subscript for each individual idea, cre-
ativity c = (1 – probability p) utility u (1 – prior knowledge of util-
ity v) and where p, u, v, and c each range from 0 to 1. The
compelling aspect of this formulation is its multiplicative function,
whereby any value of 0 for p, u, or v results in an idea that is not at
all creative.

Psychopathology and Creativity

Research and theory on psychopathology and creativity are
growing and contentious. A recent edited volume entitled Creativ-
ity and Mental Illness captures the history, current state of the
field, and the wide range of views on the topic (Kaufman, 2017).
Although the ancient Greeks (Aristotle in particular) were the first
people in the Western world to examine the nature of creativity
and its association with “melancholia,” it was not until the Roman-
tics in literature in the 1830s that the argument was made for any
connection between serious mental affliction and creative genius
(Becker, 2017).
The modern literature on the topic was jumpstarted in the 1980s and

1990s with the work of Andreasen, Jamison, Richards, and Ludwig. In
her early investigations, Andreasen (1978, 1987) reported qualified
relationships between creativity, especially literary creativity, and men-
tal illness, making use of historical, familial, and genetic studies. Jami-
son (1996) reported historical, biographical, and literary evidence for
the association between artistic creativity and mood disorders, most
specifically bipolar disorder. Jamison et al., (1980) also examined the
relationship between creativity and bipolar illness in noncreative peo-
ple and found that the hypomanic period led to heightened creativity.
Richards and colleagues (1988) also found that it was mild levels of
mania (hypomania) and bipolar (cyclothymia) that were most strongly
associated with creative thinking. Large-scale biographical examina-
tions by Ludwig and Post in the 1990s reported associations between
artistic creativity and lifetime rates of mental illness. Ludwig (1992,
1995) examined more than 1,000 eminent professionals, including, but
not limited to, artists, writers, scientists, and musicians and revealed
that extremely creative individuals, especially in the visual and literary
arts, exhibited elevated rates of various lifetime psychopathologies.

Post (1994) also drew a similar conclusion from biographical analysis
of more than 200 world-famous creative people. The sample in this
study was restricted to deceased subjects of biographies reviewed by
the New York Times. These biographies were then examined for signs
of psychopathology in each eminent professional and correlated with
each domain of expertise. The results showed that people who excelled
at creative endeavors such as poetry and fiction writing experienced
higher rates of psychopathology than scientists or politicians.

To be sure, partly owing to inconsistent empirical results, not all
scholars agree there is a connection between high levels of creativ-
ity and psychopathology (Sawyer, 2011; Schlesinger, 2009, 2017;
Thys et al., 2014). The most outspoken and harshest critique
comes from Schlesinger (2009, 2012, 2017). She essentially dis-
misses the entire field and literature on creativity and “madness”
as based on nothing more than poorly conducted and flawed
research (e.g., biographies are dismissed as little more than “gos-
sip”), even going so far as to call it a “hoax” (Schlesinger, 2012).
She takes particular issue with three of the key figures in the field,
Andreasen, Jamison, and Ludwig. Andreasen (1987) had too few
participants, relied on personal relationships with participants, and
overgeneralized results. Jamison’s (1996) “autopsy subjects” of
166 deceased artists, writers, and musicians is challenged. Schle-
singer critiques three of the 166 subjects (Michelangelo, Emerson,
and Cole Porter) and yet fails to provide a more general and struc-
tured critique of the participant selection. Her methodological
criticisms have some validity because no research is without limi-
tations and flaws, but Schlesinger does her arguments a disservice
when she makes many absolutist statements that no one really
claims, such as the supposedly common belief that “no one
receives the gift of genius without the curse of depression” (Schle-
singer, 2017, p. 60) or that much of the research gets propagated
without people reading the original articles.

Moderating Effects in the Relationship Between
Creativity and Psychopathology

The apparent contradictory set of results gains clarity when we
begin to look more closely at the reasons for the mixed, moderat-
ing, and complex findings. One study, for example, reported that
gender moderates the relationship between creativity and psycho-
pathology, with positive results only holding for men (Martín-Bru-
fau & Corbalán, 2016). More general findings highlight four
common moderating effects in the relationship between creativity
and psychopathology (Baas et al., 2016; Beaussart et al., 2017;
Feist, 2012; Fisher, 2015; Glazer, 2009; Silvia & Kaufman, 2010;
Simonton, 2017a, 2019):

• degree of creativity
• domain of creativity (art v. science)
• degree of psychopathology
• domain of psychopathology

Degree of Creativity

Creative achievement exists on a wide spectrum, from minor to
major contribution. For decades, researchers who study creativity
have realized there is a need for distinguishing levels of creativity.
To label someone creative is nearly meaningless if it does not dif-
ferentiate historical genius global level creativity from minor, indi-
vidual, everyday creativity. As Kaufman and Beghetto (2009)

2 FEIST, DOSTAL, AND KWAN

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argued, there are at least four distinct levels of creativity that are
more or less developmental. First, there is mini-c creativity, that
is, personal level of creativity, where someone is creating ideas or
behaviors that are novel and meaningful to him or her only. If that
person goes on to produce novel products, ideas, or behaviors that
involve solving everyday problems creatively, we would call that
little-c creativity. This could involve activities such as making a
new meal, creatively making use of materials around the house to
build a play structure, or writing an essay for a class. Next, we
move to people who make a living doing creative work, such as
writers, musicians, scientists, architects, actors, and painters, but
whose acclaim and impact are regional rather than national or
international. This is Pro-C creativity, for “professional.” In other
words, the circle of people who find it meaningful or useful is rela-
tively narrow. It has not yet changed the course of the discipline or
started a new branch of the discipline. Lastly, there is Big-C crea-
tivity, or genius level or historically significant creativity. These
are people who change the course of their fields, may have biogra-
phies written about them, and often earn award and recognition
from their peers for doing the best work in their field, and some-
times are studied by historians. In short, these four levels of the
creative spectrum move from smallest to largest social/cultural
circle: self, family, region, and nation/world.
As we discussed at the outset, there are different degrees of cre-

ativity, different kinds of creativity, and how one defines and
measures it matters (Reiter-Palmon & Schoenbeck, 2020). One
reason for conflicting results in the literature on creativity and psy-
chopathology is the fact that degrees of creativity are conflated.
The size of the effect seems to be directly related to the degree or
level of creativity, with the effect being largest in Big-C creative
samples and smallest in little-c creative people. Moreover, method
of research is related to these two levels, with most little-c samples
being studied psychometrically or experimentally and Big-C or
Pro-C samples being studied historiometrically, biographically, or
epidemologically (Johnson et al., 2012; Paek et al., 2016; Rich-
ards, 1990; Silvia & Kimbrel, 2010; Taylor, 2017). For example,
in a large Swedish national-population sample that included tens
of thousands professional (Pro-C) creative artists and scientists,
Kyaga and colleagues (2011) reported significant associations
between creative professions and being treated for bipolar disorder
or having a sibling or parent treated for schizophrenia. Moreover,
in a study of an undergraduate (little-c creativity) sample, Silvia
and Kimbrel (2010) found that anxiety and depression could only
explain 3% of the variance in creative thinking. Finally, Johnson
and colleagues (2012) conducted an extensive qualitative review
of the literature on bipolar disorder and creativity and found stron-
ger effects with Big-C than little-c creativity.

Domain of Creativity (Art Versus Science)

One of the main empirical findings from the literature on creativ-
ity and psychopathology is the stronger effect size between artistic
than scientific creativity and psychopathology (Damian & Simon-
ton, 2015; Ludwig, 1995, 1998; Post, 1994). Trauma, stress, mood
disorders, and fear of death each seem to motivate artistic creativity
in a way they do not motivate scientific creativity or innovation in
business. For instance, Ludwig’s later analyses (Ludwig, 1998)
made clear that lifetime rates of psychopathology are mostly ele-
vated in the arts compared with the sciences, and in the expressive

arts in particular (writing (fiction and nonfiction), poetry, and visual
arts; see Figure 1). The performing artists (musicians and dancers)
had moderately elevated rates of psychopathology, whereas the for-
mal artists (architects) were not different from the general popula-
tion. He argued and reported, therefore, that it is the more
expressive, intuitive, and subjective creative professions where psy-
chopathology and creativity should be and was most likely to be
associated. The more formal, logical, precise, and objective profes-
sions should be and were less likely to see psychopathology. In
short, in the expressive arts, personal meaning, subjectivity, and
emotion play a motivational role in ways not common in the more
formal creative professions. Further analysis within the artistic
forms revealed consistently higher rates of psychopathology in the
emotive/expressionistic styles than in the formal/realism styles. To
be sure, these are correlational findings, so whether those with men-
tal and mood disorders are drawn to artistic careers or the other way
around has yet to be established.

Other scholars have reported similar patterns whereby scientists
suffer relatively low lifetime rates of psychopathology, whereas
the other professions, especially the arts, had elevated rates of
mental illness compared with base-rates in the general population
(Damian & Simonton, 2015; Post, 1994; Simonton, 2014). A bio-
graphical replication of the mental health status of 40 jazz musi-
cians from the 1940s and 1950s replicated Ludwig’s basic finding
(Wills, 2003). Wills found elevated rates on chemical dependency,
mood disorders, and anxiety disorders in jazz musicians. Heroin
addiction was also elevated in Will’s jazz sample, with 52% sam-
ple having heroin problems at some point during their lives.

The one exception to this general finding with scientists may be
autism-spectrum disorder (ASD), predominantly in the high-func-
tioning range (Baron-Cohen et al., 2007; Billington et al., 2007;
Focquaert et al., 2007; Thomson et al., 2015; Wei et al., 2017). We
should point out, however, that most of this research on ASD and
science and technology is with interest and careers in STEM (sci-
ence, technology, engineering, and math) and not necessarily highly
creative scientists and technologists. We are interested in examining
whether this relationship holds at high levels of scientific achieve-
ment and creativity.

Although Ludwig (1992) argued that psychopathology explained
very little variance in terms of scientific achievement, there are cer-
tain circumstances where psychopathology may exist in scientific
creativity. A good demonstration of this is the analysis by Ko and
Kim (2008) of 76 scientific geniuses from Simonton’s sample. Ko
and Kim predicted and found that the relationship between scien-
tific creativity and psychopathology would be moderated by the
kind of contribution the scientist made, namely whether it preserved
or rejected paradigms. Specifically, scientists without pathology
were more creative when they made paradigm-preserving than par-
adigm-rejecting contributions. Paradigm-preserving is a contribu-
tion that advances but does to change a field’s direction. Paradigm-
rejecting contributions do in fact change a field’s direction. Those
with psychopathology, especially psychotic disorders, were more
creative (based on biographical/encyclopedia index ratings) when
they made paradigm-rejecting rather than paradigm-preserving
contributions. In addition, this moderator analysis more than
doubled the variance explained (18% vs 8%) by psychopathol-
ogy in scientific creativity compared with Ludwig’s (1992) sam-
ple. An implication of these results is that psychopathology may

PSYCHOPATHOLOGY AND CREATIVITY 3

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be detrimental to their creative contribution only to scientists
who make paradigm preserving contributions.
Taylor (2017) discussed important ways how art and science

may be different: art requires less formal education and has more
flexible work schedules (Simonton, 2010; Simonton & Song,
2009) and hence does not exclude people with mood disorder;
poets, writers, and so forth more likely to experience trauma, men-
tal health problems in childhood; Ludwig (1998) suggests “occu-
pational drift” owing to emotional expressiveness required for
different professions. In addition, we argue for internal versus
external experiences and meaning and understanding. That is, art
—especially the expressive arts of literature and visual arts—is of-
ten based in internal emotional/traumatic/stressful personal experi-
ences that lead to a need/motive to understand, give meaning to, or
to express these experiences in artistic form, whether it be music,
dance, poetry, visual art, or fiction writing (Akinola & Mendes,
2008; Gardner, 1973; Forgeard et al., 2017; Thomson, 2017). It
may not always be traumatic experiences, but at the least involves
a need or desire to express one’s perceptions of the world and their
place in it (Forgeard et al., 2017). Science, on the other hand, is of-
ten driven by a need to understand and figure out the external
world, especially in the physical sciences. Scientists most often
ask: “What is that? Why? How can we explain that?” That is a

search for meaning and understanding, to make sense of one’s
external rather than world.

Degree of Psychopathology

It has become clear with the accumulation of research that high
levels of mental illness are generally at odds with high levels of
creativity in any field, including art. Even when creativity and ill-
ness go together in certain people, it is mostly during periods of
relative calm and milder dysfunction that creative behavior may
coexist with pathology. In short, there is a nonlinear relationship
between illness and creativity, with mild to moderate levels of pa-
thology being most associated with creative achievement (Abra-
ham, 2017; Acar et al., 2018; Feist, 2012; Kinney & Richards,
2017; Simonton, 2017a; Swain & Swain, 2017; Wuthrich & Bates,
2001). Jamison’s well-known book Touched With Fire (Jamison,
1996), for instance, presented historical evidence for an associa-
tion between bipolar disorder and creativity, especially in literature
(i.e., Big-C creative people). However, she also made clear that it
was those with milder forms (cyclothymia) that were most crea-
tive. Other researchers have come to the same conclusion, namely
that the relationship between creativity and bipolar disorder, schiz-
ophrenia, and schizotypy is mostly curvilinear (Acar et al., 2018;
Cox & Leon, 1999; Gostoli et al., 2017; LeBoutillier et al., 2014;

Figure 1
Categories of the Arts and Sciences and Prevalence of Mental Illness

Note. Dark Gray: . 70%. Light Gray: . 60% , 70% White: , 60%. Adapted from Ludwig,
1998. See the online article for the color version of this figure.

4 FEIST, DOSTAL, AND KWAN

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Ruiter & Johnson, 2015). For instance, Kinney and Richards
(2017) reported support for the nonlinear inverted-U hypothesis in
which creative thought and behavior were maximum at mild levels
of bipolar disorder (cyclothymia) and were relatively low at the
low and high ends of the disorder. Moreover, it was first degree
relatives of those suffering from bipolar who tended to exhibit
highest levels of creativity.
After reviewing literature on affective traits and creativity, Feist

proposed a quadratic model of mental health and creativity, that
makes clear the complex relationship (cf. Feist, 2012; see Figure 2).
The peaks of creativity tend to be with little and moderate levels of
psychopathology, with valleys of creativity coming when psycho-
pathology is low-medium and again high (cf. Feist, 2012).

Domain of Psychopathology

Not only degree but also domain of pathology matters. In gen-
eral, it is clear from research that particular forms of psychopathol-
ogy are more associated with high levels of creative achievement
than other forms. The milder forms of mood disorders, including
depression and bipolar disorder as well as milder forms of psy-
chotic disorders (schizotypy), appear to be among the more robust
correlates of creative achievement.

Mood Disorders

Of all psychological disorders, perhaps none is more often empiri-
cally connected to creativity than mood disorders, especially bipolar
depression (and its less severe offshoot, cyclothymia). The general
finding is there is an elevated rate of bipolar disorder exists among
creative people compared with general population (Andreasen, 1987;
Andreasen & Glick, 1988; Fodor & Laird, 2004; Furnham, Batey,
Anand, & Manfield, 2008; Gostoli et al., 2017; Jamison, 1996; Jami-
son et al., 1980; Johnson et al., 2012; Johnson, Murray, et al., 2015;
Johnson, Tharp, et al., 2015; Nowakowska et al., 2005; Ramey &
Weisberg, 2004; Richards, 1994; Taylor, 2017). Taylor’s (2017)

meta-analysis of studies published between 1987 and 2014 that
examined mood disorders (bipolar, cyclothymia, major depression)
in creative samples reported a Hedges g = .64 (95% CI [.45, .82]),
meaning creative people are nearly two thirds of a standard deviation
higher in mood disorder than noncreative people. When examining
simple correlational studies on creativity scales and mood disorder in
students and adults, however, Taylor (2017) reported a very small
effect (g = .09; 95% CI [.01, .17]). In short, the effect size was mod-
erated by level of creativity. Flaherty (2005) reviewed a large range
of neuroscientific evidence suggesting that frontal-temporal-limbic
brain activity as well as dopaminergic activation are implicated in the
relationship between creative drive and mood disorders. More specif-
ically, Flaherty proposed a two-dimensional model with frontal-tem-
poral activity being on the x axis and dopaminergic activity being on
the y axis. As abnormal temporal lobe activity and dopaminergic ac-
tivity both increase, mania, psychosis, and creative drive increase. As
abnormal frontal activity increases and dopaminergic activity
decreases, creative blocks become more likely.

The relationship holds in the other direction too. Other studies
have reported higher rates of creativity among bipolar patients
(Richards, 1994; Richards et al., 1988; Santosa et al., 2007; Simeo-
nova et al., 2005). For example, when compared with healthy con-
trols, patients with bipolar disorder scored higher on the Barron-
Welsh Art Scale (BWAS) measure of creativity (Santosa et al.,
2007; Simeonova et al., 2005). Of note, however, is Taylor’s
(2017) finding that people with mood disorder are not necessarily
more creative than those without mood disorder (g = .08; 95% CI
[�.00, .16]). Kaufmann and Kaufmann (2017) reviewed research
on the complex association between mood, mood disorders, and
creative thought and behavior. Both positive and negative affect
and mood can be associated with creativity.

An important qualification to the bipolar-creativity connection is
that it seems to be more mania than depression that is associated
with creative thought and behavior (Andreasen & Glick, 1988;
Jamison, 1996; Jamison et al., 1980). Given the quickness and

Figure 2
Nonlinear Model of Degree of Creativity and Psychopathology

PSYCHOPATHOLOGY AND CREATIVITY 5

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fluency of ideas that occur during mania, its relationship with crea-
tivity is understandable (Jamison, 1996; Richards, 1994). Moreover,
numerous studies support the idea that milder hypomanic states are
most clearly correlated to creative thinking and achievement (Furn-
ham et al., 2008; Ruiter & Johnson, 2015; Schuldberg, 1990).
The relationship between unipolar depression and creativity is

less robust than bipolar. Paek and colleagues (2016) conducted a
meta-analysis that included 27 studies that reported results on
depression and creativity. These 27 studies consisted of 103 effect
sizes on over 14,000 participants. The mean effect size was essen-
tially zero (r = .04; 95% CI [�.08, .16]). Silvia and Kimbrel
(2010) reported the same very small effects between depression
and various forms of creativity in a college student sample. Some
research that broke nonclinical depression down into components
of rumination, self-reflective pondering, and brooding found that
rumination and self-reflective pondering but not brooding were
associated with creativity (Verhaeghen et al., 2005, 2014). Note,
however, that all of these studies were conducted with students
and were little-c creative samples.
Similar small effects between trait anxiety and creativity have

been reported (Silvia & Kimbrel, 2010). For example, Paek and col-
leagues (2016) also included in their meta-analysis research 32
studies that reported results on anxiety and creativity. These 32
studies consisted of 60 effect sizes on more than 15,000 partici-
pants. As was true with depression, the mean effect size between
anxiety and creativity was not significantly different from zero (r =
�.05; 95% CI [�.16, .06]).
Psychotic Disorders

The psychotic disorders—schizophrenia, schizotypy, schizoaf-
fective disorder, among others—also have a complex and not easy
to summarize relationship with creativity. With anecdotal excep-
tions such as John Nash, full blown schizophrenia is seldom linked
to creativity (cf. Nasar, 2011; Rothenberg, 1990). Kyaga and col-
leagues (2011) reported that people who had first degree relatives
suffering from schizophrenia and bipolar disorder were overrepre-
sented in creative professions. Moreover, Eysenck (1993, 1995)
proposed and found some support for the idea that the nonclinical
personality trait and psychoticism is associated with creative
thought and behavior. Psychoticism is a nonpathological rather
than clinical personality trait consisting of consistent social isola-
tion, aloofness, hostility, and unusual thoughts and behaviors.
Feist (1998) found support for this idea in a meta-analysis on the
personality correlates of creativity.
As numerous scholars have pointed out, however, psychoticism

is too broad and diverse a construct to consistently be related to cre-
ative thought and behavior (Batey & Furnham, 2008; Carson et al.,
2003; Mason et al., 1995; Nettle, 2006). They argue that psychoti-
cism’s specific and somewhat more clinical cousin, schizotypy, is
more robustly related to creativity. Schizotypy is a personality dis-
order in which subclinical symptoms of psychosis are exhibited,
such as unusual experiences, magical thought, eccentric behavior,
and cognitive disorganization (Claridge et al., 1996). In little-c crea-
tive and Big-C creative samples, schizotypy is associated with crea-
tive thought (Acar & Runco, 2012; Acar & Sen, 2013; Baas et al.,
2016; Batey & Furnham, 2008; Burch et al., 2006; LeBoutillier et
al., 2014; Nettle, 2006; Schuldberg, 1990). Baas and colleagues
(2016), for instance, argued for a moderation effect by type of

pathology in the association between creativity and mental illness.
More specifically, they proposed and found meta-analytic evidence
that approach-based pathologies (positive schizotypy and risk of
bipolar) were more strongly and positively associated with high lev-
els of creativity. Positive schizotypy consists of unusual experiences
and impulsive nonconformity, whereas negative schizotypy consists
of cognitive disorganization and withdrawn schizoid traits. In addi-
tion, avoidance-based pathologies (e.g., anxiety, negative schizo-
typy, and depressive mood) were associated with lower levels of
creativity. Similarly, Acar and Sen (2013) in a meta-analysis found
small negative effect sizes between creativity and negative schizo-
typy (r = �.09; 95% CI [�.12, �.06]; k = 76) and a small positive
association with positive schizotypy and creativity (r = .14; 95% CI
[.12, .17]; k = 121).

The Current Study

The primary purpose of the current study is to update and
attempt to replicate the results of Ludwig (1992, 1995, 1998) and
to test a more complex model of creativity and psychopathology.
Not only is the Ludwig sample itself over 25 years old, but the
subjects examined were required to be deceased, further distancing
them from their contemporaries. Therefore, an update and exten-
sion of the study is now in order. Additionally, the professional
categories proposed in Ludwig (1992, 1995, 1998) required
reworking in the current study. For instance, several of the profes-
sions listed under social sciences, such as historian and philoso-
pher, are not actually sciences at all and are frequently grouped
with humanities. The current study also improves on the previous
methodology, which was vulnerable to researcher bias owing to
the investigator’s awareness of the hypotheses (Ludwig, 1992).
Another goal of the current study is to see whether Ludwig’s find-
ings from 20 years ago and with a different sample still hold and
replicate in a more current sample. More importantly, Ludwig did
not compare eminent famous creative people against eminent fa-
mous noncreative people, and simply analyzed his data with chi-
squares for inequalities between groups. We decided, therefore, to
hold fame constant in our comparison group of famous athletes
(with published biographies) to determine whether fame more than
creativity could explain the presence or absence of mental illness
in our sample. In short, by having a control group that was eminent
and famous (i.e., biography-worthy) and yet not creative, we could
rule out pure fame and eminence as a confounding explanation in
any relationship between creativity and psychopathology.

Hypotheses

1. World-class creative artists will have elevated rates of any
lifetime mental illness relative to creative scientists and famous
athletes (controls).

2. The mental health difference between artists and scientists
will be most pronounced on mood/affective disorders (anxiety,
depression, bipolar) and chemical dependency, with artists
expected to have higher rates than scientists.

3. Creative scientists should show elevated rates of being on the
high functioning end of the autism spectrum relative to athlete
controls.

6 FEIST, DOSTAL, AND KWAN

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Method

Subjects and Materials

The list of potential creative and eminent scientists, artists, and
athletes for inclusion in the study came from rankings in diction-
aries, encyclopedias, and best-of lists. The original list, after merg-
ing 163 source lists and removing duplicates, contained 17,689
distinct names. Each “best-of” source list was ranked by a member
of the research team (D.D.) on a 3-point scale for trustworthiness,
with a 1 being of questionable validity, 2 being more subjective,
and a 3 being very trustworthy. The primary criterion for a code of
3 was whether the list was created by experts in the field and/or
was of international award such as the Nobel Prize. A code of 2
was awarded if the list were created by professionals in the field
(e.g., a poll among more than a hundred contemporary leading
physicists conducted by Physics World magazine, Dunani &
Rodgers, 1999), whereas a code of 1 was awarded for lists made
by amateurs or based on unclear methodology. One such example
of an unclear methodology is the “Greatest Mathematicians of All
Time” list published on server thetoptens.com.1

Next, an index of eminence was calculated for each potential
subject within each domain as a sum of trustworthiness scores of
all lists in the domain containing the subject’s name. To prevent
overlap with Ludwig’s (1992) sample, subjects must have either
died after 1950 or been born before 1980, if they were still alive.
The 45 most eminent professionals in each domain were selected
as potential subjects in the sample. Individuals who tied for the
45th most eminent position were included in the sample. This pro-
cedure led to a total of 766 potential subjects. Professionals in
multiple domains were sorted in the category in which they ranked
in a higher position.
After the list of potential subjects was obtained, the next step

was to determine whether or not a viable and relevant biography
was written about that person. When available, e-versions (Kindle)
of biographies were purchased. If no e-version was available, hard
copies were purchased, had their bindings removed, and were digi-
tally scanned via optical character recognition (OCR) conversion.
To be selected for study, biographies had to be written for an adult
audience and include information on the creator’s personal life
and were not solely intellectual or work biographies. Moreover,
autobiographies, biographies written by close relatives, biographi-
cal chapters, letters, and memoires were excluded. Of the 766
potential subjects, 391 did not have appropriate biographies writ-
ten about them, leaving a potential sample of 375. If there were
more than one biography written about a person, we chose the one
that had the most life-history information. Owing to time and
resource constraints, 199 of the 375 biographies were purchased
for coding (18% female).2 Analyses revealed that the 199 biogra-
phies were representative of the larger 375 sample on proportion
of artists, scientists, and athletes as well as proportion of deceased
subjects. The proportion of women however increased from 13%
to 17.5% in the final sample of 199, v2(1) = 9.45, p = .002. Never-
theless, the proportion of women in each subgroup did not change,
v2(2) = 1.34, p = .510. In the final sample, there was a higher per-
centage of women in the arts than sciences or sports, 28%, 7% and
4% respectively, v2(2) = 16.11, p , .01. The overall sample was
83% White-Caucasian, 13% Black/African American, 2% Latinx,

and 1.5% Asian-Pacific Islander. In 2016 when the data were col-
lected, the U.S. demographics were 60% White-Caucasian, 18.5%
Latinx, 13% Black/African American, 6% Asian American (U.S.
Census Bureau, 2019).

Each subject was placed into either a scientific, artistic, or ath-
letic domain. Scientific domains were defined as technology/
invention, mathematics, physics, chemistry, biology/medicine,
psychology, and social sciences (anthropology and sociology).
Earth scientists (e.g., geologists, oceanographers, climatologists)
were excluded because of a lack of biographies. Artistic domains
were defined as visual arts, fiction writing, poetry, acting, musical
performance, and musical composition. Using these career group-
ings, the current sample consisted of 104 artists, 68 scientists, and
27 athletes (see Table 1). The entire sample had a median year of
birth of 1919 with an average birth year of 1921. The range of
birth years was 1873 to 1979. Of the 199 subjects in the final list,
46 (23%) were alive at end of data collection in 2016. For the 153
participants who had died, the average age of death was 72 (me-
dian = 75; mode = 81; range 25 to 98). For the 46 participants who
were alive, the average age was 71.70 (median = 73; mode = 75;
range 41 to 89). Ninety-three percent of the sample was married at
least once (mean age of first marriage = 27.13). There was no ca-
reer domain difference in mean age of first marriage. Artists
(59%) were more likely to have divorced than scientists (38%).

Procedure

Biography Selection and Preparation

After the subject-pool was narrowed down to subjects who had
usable biographies written about them, we purchased each biogra-
phy either in digital or bound format. If the book was in bound for-
mat, we then detached its binding and scanned the entire body of
the text (excluding front- and rear-matter) into readable ORC/digital
format. Next, we cleaned the digital books by removing all images,
headings, footers, foot notes and most tables and equations.

Pathology Selection

Before ratings of pathologies could be made, the research team
discussed and decided which specific diagnostic illnesses would
be coded. For this process we mostly followed Ludwig by obtain-
ing the original variable list. Ludwig’s team coded mental health
status of immediate family members as well as the creative person.
We coded only the creative person. Moreover, we also added a
few illness categories that we believed Ludwig missed and might
be relevant as exploratory analyses, such as Asperger’s syndrome
(high functioning autism) and synesthesia. The final list consisted
of 19 diagnostic illnesses listed in the Diagnostic and Statistical
Manual of Mental Disorders, 5th edition (DSM–5; American Psy-
chiatric Association, 2013; see Table 2).

Paragraph Selection

After each of the 199 biographies was scanned and cleaned, a
linguistic analysis program was created by the second author to

1
For complete Best of Lists, Awards, and Rankings, see https://doi.org/

10.17605/OSF.IO/TFYDK.
2
Raw data are posted on Open Science Framework at https://doi.org/10

.17605/OSF.IO/TFYDK.

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automatically locate and highlight any of the 175 relevant key-
words related to 19 mental illness categories (see Appendix A in
the online supplemental materials). The initial list was based on
words used by Ludwig (1995) but was expanded through a discus-
sion between the investigators after a review of the DSM–5 and
Stein and colleagues (2010). From either the biographical or pub-
lic websites we obtained the following demographic variables:
profession/career, date of birth, date of death (if deceased), year of
mother’s death, year of father’s death, birth order, race/ethnicity,
gender, year of marriage (first), year of marriage (second), country
of birth.
Two trained graduate students further narrowed the biographical

texts to include only paragraphs relevant for assessment of mental
health of subject in question. For example, “depression” may have
been tagged by the program, but if it referred to the economic period
of the 1930s then that paragraph would be excluded from further rat-
ing. Similarly, if key terms were tagged but referred to someone
other than the target creator, those paragraphs were also de-selected
for further rating.

Pathology Ratings

In the fifth and final step, seven raters were selected and
trained to identify possible psychopathologies in each biography
excerpt. Raters could only begin once they met the .80 interrater
reliability with training data from Ludwig’s (1992, 1995). Poten-
tial raters were given paragraphs selected from a biography then
asked to code the given reading material for the psychopatholo-
gies described above. Ratings were compared against the origi-
nal coding data from Ludwig’s study. Interrater reliability was
measured using Gwet’s agreement coefficient AC1 (Gwet, 2008),
which was preferred over Cohen’s kappa coefficient as it pro-
vides unbiased estimate even in case of strongly uneven occur-
rences of categories (Gwet, 2002; Wongpakaran, Wongpakaran,
Wedding, & Gwet, 2013). To keep raters blind and free of any
previous bias, the name of the subject in question was replaced
with the word “Creator” in all biography excerpts. Subjects were
coded for lifetime prevalence of any of 19 psychopathologies.

Psychopathologies were rated on a 3-point scale of not present
(0), probable (1), and present (2) if they occurred at any point in
the creator’s lifetime. Rating present was used in cases where
DSM–5 criteria were clearly met or where the subject was diag-
nosed professionally during their lifetime. If not enough infor-
mation was given in the biography to provide a clear diagnosis
from DSM–5 criteria and yet there was some evidence that a dis-
order was suspected, then raters gave that a probable rating. In
short, a probable rating was provided whenever there was some
but not overwhelming evidence of a disorder. Present was pro-
vided when a professional diagnosis was made during the per-
son’s lifetime or when the biographical evidence was very clear.
During training on the Ludwig sample, if raters initially fell
below the .80 reliability criterion, research meetings were held
with other raters and the lead researcher (G.J.F.) to discuss dis-
crepancies and to reach consensus. For final nontraining ratings,
two independent and randomly assigned raters coded each biog-
raphy. Any disagreement was adjudicated by a third rater (G.J.
F.) to establish the final rating.

Results

Previous and Current Lifetime Rates of Disorders

For sake of comparison, in Table 3 we present the population
estimates of lifetime rates of psychological disorders published in
the literature. Two studies have reported large-scale national popu-
lation estimates of lifetime rates of any disorder. Kessler, Berglund,
and colleagues (2005) reported a rate of 46.4% and Lev-Ran and
colleagues (2013) reported a rate of 33.7% for any mood, anxiety,
personality or psychotic disorder. In this context, the lifetime rate in
our sample for creative artists and scientists was 49.7% (85 of 171)
and for athletes was 48.1% (13 of 27), v2(2) = 2.39, ns. For artists
only, the percentage of “present” cases was 61/103 (59.2%), and
for scientists it was 24/68 (35.3%). Over the course of their lifetime,
artists were more likely to have at least one form of psychopathol-
ogy than scientists, v22(1) = 9.38, p = .002. Artists were not more
likely to have a lifetime bout of psychopathology compared with
athletes (59% versus 48%, respectively) , v2(1) = 1.07, ns.

When the less exclusive “probable” cases were also included, the
frequency of psychopathology increased to 126 of 171 (73.7%) in
the creative groups compared with 16 of 27 (59.3%) athletes, v2(1) =
2.39, ns. The observed frequencies on “probable” lifetime psychopa-
thology for artists (83%), scientists (59%), and athletes (59%) were

Table 1
Specific Domains and group Sizes

Domain % White N of Men N of Women Total N

Artists 75 29 104
Visual arts 100.0 8 1 9
Fiction writing 85.7 26 9 35
Poetry writing 90.9 9 4 11
Acting 95.0 11 9 20
Music performance 46.2 18 8 26
Music composition 100.0 3 0 3

STEM 63 5 68
Technology/Invention 100.0 9 1 10
Mathematics 100.0 7 0 7
Physics 100.0 19 0 19
Biology/Medicine 100.0 6 1 7
Chemistry 100.0 4 1 5
Psychology 100.0 11 0 11
Social Sciences 100.0 7 2 9

Comparison group 26 1 27
Athletes 55.6 26 1 27

Total 164 35 199

Table 2
List of Rated Psychopathologies

Rated psychopathologies

Adjustment disorder Obsessive-compulsive disorder
Alcoholism Paraphilia
Anxiety disorder Personality disorder (of any kind)
Autism spectrum disorder Posttraumatic stress disorder
Conduct disorder Schizophrenia/Psychotic disorders
Depression/Depressive disorder Sleep disorders
Drug use/dependency Somatic disorder
Eating disorder Suicide/Suicide attempt
Gambling disorder Synesthesia
Kleptomania

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different from chance, v2(2) = 14.68, p = .001. This effects stems
from artists having a higher lifetime rate than both scientists, v2(1) =
12.86, p , .001, and athletes, v2(1) = 7.45, p = .006.
Even though the overall frequency of any psychopathology was

extraordinarily high, relative frequencies of individual disorders
rarely exceeded a few percent. Occurrences higher than 5% were
only observed in depression/depressive disorders (26%), alcoholism
(16%), drug use/dependency (12%), and anxiety disorder (11%).
These compare with the rates of 28.8% for anxiety, 20.8% for
mood, and 14.6% for substance abuse in the general population
(Kessler et al., 2007; Kessler, Berglund, et al., 2005).
For a more sophisticated analyses of these trends, for each listed

psychopathology, a null hypothesis about the uniform distribution of
its occurrences in compared groups was tested. In each comparison, a
chi-squared test with a Monte Carlo simulated p value was used
because it has no assumptions about minimal expected frequencies
(estimates were done with 106 replicates; Hope, 1968). We have
included both present and probable occurrences of psychopathology
without differentiating between them into analysis. Observed frequen-
cies for each category and resulting p values are detailed in Table 4.
The results suggest that there are unequal frequencies between the do-
main of eminent individual and the occurrence of Alcoholism, Drug
use/dependency, Gambling disorder, Suicide/suicide attempt and also
Depression/depressive disorders, Anxiety disorder, Sleep disorder and
Autism spectrum disorder. Note that there were 21 significance tests
performed, which results in substantial increase in familywise first
type error rate. To keep familywise error rate under 5% Bonferroni
corrected p-values can be used. This correction suggests that the fre-
quencies in Autism spectrum disorder (pBonf. = .271), Suicide/suicide
attempt (pBonf. = . 282), and Gambling disorder (pBonf. = .169) are not
different from expected, so we should not consider those results as

conclusive. Finally, 52% of the artists and 24% scientists experienced
the loss of a parent in childhood, v2(1) = 15.04, p , .001.

Planned Analyses

Recall, the three main predictions were that compared with athletes
and scientists, artists as a whole would have elevated lifetime rates of
psychopathology, especially in the mood disorders and substance
abuse categories. We also predicted that scientists would have ele-
vated rates of high functioning autism compared with athlete controls.

To test these hypotheses, a Bayesian logistic regression3 was
used to model the relationship between mental disorder presence
and creativity domain. The dependent variable was an occurrence
of particular mental disorder. We have used two separate models
with differently defined dependent variables for each disorder. In
the first one, the present cases only were coded as 1. In the second
one, both present and probable cases were coded as 1. The values
of the dependent variable were predicted with categorical factor

Table 3
Published Population Estimates of Lifetime Rates of Psychological Disorders

Author(s), Date Disorder Percent of population

Baca-Garcia et al. (2010) Suicide attempted: Male 1.75%
Suicide attempted: Female 2.95%
Suicide ideation: Male 6.00%
Suicide ideation: Female 7.60%

Hudson et al. (2007) Eating disorder: Male 2.80%
Eating disorder: Female 5.90%

Lev-Ran et al. (2013) Any mood, anxiety, psychotic, personality disorder 33.7%
Kessler, Berglaund, et al. (2005) Anxiety disorder 28.80%

Mood disorder 20.80%
Impulse-control disorder 24.80%
Substance abuse 14.60%
Any disorder 46.40%

Merikangas et al. (2007) Bipolar I 1.00%
Bipolar II 1.10%
Subthreshold bipolar 2.40%

Nock and Kessler (2006) Suicide (ideation/attempt) 2.70%
Perälä et al. (2007) Psychotic disorder (any kind) 2.29%
Robins et al. (1984) Any disorder 28.8% to 38.0%

Anxiety disorder 10.4% to 25.1%
Substance abuse disorder 15.0% to 18.1%
Affect-mood disorder 6.1% to 9.5%
Psychotic disorder 1.1% to 2.0%
Personality disorder 2.1% to 3.3%
Eating disorder 0.0% to 0.1%

Note. Robins et al. (1984), consisted of three samples from New Haven, CT, Baltimore, MD, and St. Louis, MO, and interviews were conducted between
1980 and 1982. Bolded text highlights the overall “any disorder” category.

3
Computations were performed in statistical program R with the

rstanarm package (Stan Development Team, 2016). The student t-
distribution with 7 degrees of freedom and a scale parameter 2.5 was
chosen as a prior for all regression weights. The student distribution was
preferred from the normal distribution because its heavy-tailedness enables
substantial differences from expected value. The location was set to zero in
all parameters with the exception of the intercepts in which case logits of
population prevalences according to Kessler, Berglund, and colleagues
(2005) and Nock and Kessler (2006) were used. The parameter estimations
were computed with NUTS sampling method (Hoffman & Gelman, 2014)
on 8 MCMC chains each performing 6,000 iterations (2,000 in burning
phase). The e-values in favor of null hypothesis stating that odds ratio
equals one were computed using fbst package (Kelter, 2020). Above
mentioned priors were used as the reference functions. For details see
Pereira and Stern (2020).

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domain with seven levels listed in Table 1. Dummy variable cod-
ing was used with the group of athletes used as a reference group.
Besides the categorical independent variable, the gender and two
quantitative covariates were included in the model to hold them
constant: year of birth of each subject and the length of their life.
If any biography was published during the life of the subject, the
age of the subject in the year of publication was used instead of
age of their death, as the biography author did not have informa-
tion about the subjects’ lives from that point. Both quantitative
covariates were centered and scaled to the z-score format.
The hypotheses about model parameters were tested with Full

Bayesian Significance test (FBST; Pereira & Stern, 1999). This pro-
cedure uses e value (evidence value) as a measure of statistical signif-
icance (Pereira & Stern, 2020). In its simplest form, e-value in favor
of the null hypothesis stating parameter equals zero is close to the
idea proposed by Thulin (2014): what is the maximal value of a
resulting in 1 � a posterior credible interval not containing zero.
Keeping in mind this analogy between p values/confidence intervals
and e values/credible intervals, we also used value .05 for rejection
of the null hypothesis.
Figure 3 shows the prevalence interval estimates (95% highest

density regions) of the selected present or probable psychopatholo-
gies. Each creative domain was also compared with the control
group of athletes. The odds ratios of psychopathology occurrence in
each group compared with the control are represented in the figures
as text labels. The asterisk notation indicates e values lower than
.05, .01, and .001, respectively. Dot indicates nonsignificant result
with e value lower than .1. Figure 3 reports that artists were more
than 2.71 times more likely to experience any mental illness over
the course of their life compared with eminent athletes, whereas

scientists had approximately the same odds as athletes. Artists were
most at risk for depression/bipolar (ORs = 6.28 and 9.19 for present
and present/probable, respectively) compared with controls. The
only disorder for which scientists were at elevated risk was the more
inclusive present/probable rate for depression/bipolar (OR = 4.53).
For all other disorders, scientists were either equally likely or less
likely to experience them compared with athlete controls. For exam-
ple, creative scientists were significantly less likely (ORs = .21 – .23)
to be afflicted with substance related and addictive disorders than
athletes.

In Figure 4 we present results broken down by subgroups. As is
evident in Figure 4, the elevated risk of mental illness in the artist
group primarily is a result of writers and visual artists. Looking at
only “present” rates of specific disorders, writers and visual artists
were 4.52 times more likely than athletes to suffer from any pres-
ent mental illness over the course of their lifetime. In fact, no other
subgroup was more or less at risk compared with athlete controls.
In addition, it was primarily the writers and visual artists who
were at increased risk of depression/bipolar (OR = 8.11), anxiety
(OR = 7.53), and suicide/attempt (OR = 15.79).

When we expand the analysis to include “probable” or “pres-
ent” rates, results were much the same except for depression and
substance abuse. Musicians, actors, writers, visual artists, poets,
mathematicians, and technologists were all more likely to be sus-
pected of having depression and/or bipolar compared with fa-
mous athletes (ORs = 3.82 – 10.86). Visual artists, writers and
poets were more likely to suffer anxiety disorder (OR = 3.58)
and be suicidal or attempt suicide (OR = 6.18) than athletes.
Moreover, physicists and chemists were less likely than athletes
to suffer substance related and addictive disorders (OR = .04).

Table 4
Sample Frequencies of Lifetime Rates of Psychopathology Across Professional Domains

Disorder
Athletes
(n = 26)

Biologists
(n = 7)

Math. and
Technol.
(n = 17)

Musicians and
Actors
(n = 50)

Physicists
and Chemists

(n = 24)

Psych. &
Social
Science
(n = 21)

Visual Artists,
Writers, and

Poets
(n = 54) p

Synesthesia 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.2) 0.0 (0.0) 0.0 (0.0) 18.5 (18.5) 1.00
Adjustment disorder 0.0 (0.0) 0.0 (0.0) 0.0 (17.6) 0.0 (0.4) 0.0 (4.2) 0.0 (0.0) 0.0 (7.4) .152
Alcoholism 7.7 (11.5) 0.0 (0.0) 11.8 (11.8) 20.0 (14) 0.0 (4.2) 9.5 (9.5) 27.8 (38.9) .002
Drug use/dependency 7.7 (7.7) 0.0 (0.0) 5.9 (11.8) 26.0 (16) 0.0 (0.0) 4.8 (4.8) 11.1 (11.1) .002
Depressive disorders 7.7 (7.7) 14.3 (28.6) 23.5 (41.2) 20.0 (19) 20.8 (41.7) 23.8 (42.9) 48.1 (64.8) ,.001
Bipolar disorder 7.7 (7.7) 0.0 (0.0) 5.9 (11.8) 0.0 (0.4) 4.2 (4.2) 0.0 (0.0) 18.5 (5.6) .770
Anxiety disorder 7.7 (11.5) 0.0 (0.0) 11.8 (17.6) 0.8 (24.0) 8.3 (20.8) 0.0 (14.3) 13 (38.9) .046*
Obsessive compulsive 0.0 (0.0) 0.0 (0.0) 0.0 (11.8) 0.2 (0.6) 0.0 (4.2) 0.0 (0.0) 0.0 (5.6) .526
Schizophrenia 7.7 (7.7) 0.0 (0.0) 5.9 (5.9) 0.0 (0.2) 0.0 (0.0) 0.0 (4.8) 18.5 (18.5) .909
Somatic disorder 7.7 (11.5) 0.0 (0.0) 0.0 (5.9) 0.0 (0.4) 0.0 (0.0) 0.0 (4.8) 18.5 (3.7) .587
Autism spectrum disorder 0.0 (0.0) 0.0 (0.0) 0.0 (5.9) 0.0 (0.0) 0.0 (12.5) 0.0 (0.0) 0.0 (1.8) .038*
Suicide/suicide attempt 0.0 (0.0) 0.0 (0.0) 0.0 (5.9) 0.0 (0.4) 4.2 (12.5) 0.0 (0.0) 7.4 (11.1) .227
Sleep disorder 7.7 (15.4) 0.0 (14.3) 0.0 (5.9) 0.4 (1.2) 0.0 (0.0) 0.0 (0.0) 3.7 (16.7) .185
Eating disorder 0.0 (0.0) 0.0 (0.0) 0.0 (5.9) 0.0 (0.6) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) .242
Personality disorder 7.7 (7.7) 0.0 (0.0) 5.9 (11.8) 0.6 (7) 8.3 (16.7) 0.0 (4.8) 0.0 (3.7) .261
Gambling disorder 15.4 (19.2) 0.0 (0.0) 0.0 (0.0) 0.2 (0.2) 0.0 (0.0) 0.0 (0.0) 3.7 (3.7) .008*
Conduct disorder 7.7 (7.7) 0.0 (0.0) 0.0 (0.0) 0.2 (0.4) 4.2 (16.7) 0.0 (0.0) 3.7 (3.7) .106
Kleptomania 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (18.5) 1.00
Posttraumatic stress 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.2) 0.0 (0.0) 0.0 (0.0) 18.5 (3.7) .852
Paraphilia 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.2) 0.0 (0.0) 0.0 (0.0) 3.7 (3.7) .852
Any psychopathology 46.1 (57.7) 14.3 (28.6) 52.9 (70.6) 52.0 (78.0) 33.3 (62.5) 33.3 (57.1) 66.7 (87.0) .003*

Note. Percentages outside brackets involve present cases of psychopathology occurrence. Percentages inside the brackets include both present and proba-
ble cases. Column p contains Monte Carlo simulated p values testing null hypothesis that relative frequencies of present or probable psychopathology
occurrences are uniformly distributed across compared domains.
*pBonf . .05.

10 FEIST, DOSTAL, AND KWAN

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There were no differences between the creative groups and ath-
letes in sleep disorders.

Discussion

The intention of the current study was to examine the more com-
plicated and moderated relationships between creativity and psycho-
pathology by updating and replicating Ludwig’s (1992) biographical
analysis of world-class creative artists and scientists. Our expectation
was that artistic creative professions in general would possess higher
levels of psychopathology than creative scientists. We also predicted
that scientists would not differ from the base rates of psychopathol-
ogy found in the U.S. population, whereas artists would.
The current study controlled for researcher bias by removing

the biographical material of its subjects’ identities. The previous
study conducted by Ludwig (1992) was executed with the
researcher knowing the identity of each subject, and may have
been biased by previous working knowledge of each professional.
Certain professions that were given new classifications as the older
categorizations, as designated in Ludwig (1992, 1995), may have
been incorrectly assigned. For example, historians and philoso-
phers were considered scientists by Ludwig. Although history and

philosophy are scholarly subjects, they are not typically considered
sciences.

The current study also sought to streamline the process of finding
relevant information in books by digitizing each biography into a
searchable digital media. This would allow for the researchers to oper-
ate at an increased pace by eliminating irrelevant text very quickly.
Transforming each book into a digital format also made it possible to
censor the names of each creator to limit any previous knowledge that
could bias the rating group.

The results of the current study generally corroborated the findings
reported in Ludwig’s and other studies, lending further support to
previously established hypotheses. Despite using an entirely new set
of subjects, not included in Ludwig’s (1992) sample, artists still pos-
sessed higher rates of psychopathological traits than scientists, ath-
letes, and the U.S. population in general. Scientists were consistently
rated lower on symptoms of psychopathology than artists, despite
equal eminence. These results held true in both inclusive and exclu-
sive requirements for classification into the mentally ill group. How-
ever, the difference between artists and athletes was not significant in
the more exclusive interpretation of the data. Rates of drug abuse and
anxiety also differed between artists, scientists, and athletes depend-
ing on whether inclusive or exclusive criterion were used to define
what constituted psychopathology. In both cases, fewer subjects

Figure 3
Prevalence of Selected Mental Disorders (Present and/or Probable) in Creative Artists and Scientists Compared
With Eminent Athletes

PSYCHOPATHOLOGY AND CREATIVITY 11

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Figure 4
Prevalence of Selected Mental Disorders (Present and/or Probable) in Creative Domains and Athletes

Note. Text labels indicate odds ratios for psychopathology occurrence in creative domains compared to the athletes. The aster-
isks indicate whether the 1-a centered highest density region for posterior density of regression weight contains zero (no effect)
when a equals 5% (*), 1% (**), or 0.1% (***).

12 FEIST, DOSTAL, AND KWAN

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qualified for inclusion into the mentally ill group when exclusive cri-
teria were used. However, the differences between groups grew
larger in the case of anxiety and smaller in the case of drug use, thus
moderating the results.
Artists also showed greater rates of alcoholism, drug abuse,

depression, and OCD than those found in the U.S. population. Again,
statistical significance changed for a few of psychopathologies
depending on the strictness of criterion for inclusion. Anxiety among
artists was considered lower in the stricter assessment but still gained
significance due to the high rate of anxiety reported in the U.S. popu-
lation. Rates of OCD also fell for artists and scientists under stricter
criterion and detectable differences were no longer found.
Because we had a small comparison sample of famous but not

professionally creative athletes, we could also address the question
of whether fame itself—isolated from creativity—is a contributing
factor to psychopathology. Because athletes were generally less
likely than artists and even scientists to develop psychopathology
at some point during their lives, we can tentatively conclude that
fame per SE is not the driving force behind psychopathology.
There was one exception to this, namely anxiety. Athletes exhib-
ited higher lifetime rates of anxiety disorders than the general pop-
ulation. An interesting question therefore becomes “Do higher
rates of anxiety precede or follow athletic fame?” That is, is anxi-
ety a cause or effect of athletic eminence?
Assuming the relationship between some forms of creativity

and some forms of pathology are robust and real, then the ques-
tion becomes why might these two traits covary? Recent litera-
ture from biological and evolutionary approaches have
suggested biological bases and even potentially adaptive func-
tions of the relationship between creative thought and behavior
and psychopathology. For instance, research has reported a pol-
ymorophism of a particular gene involved in psychosis that is
associated with high levels of creativity and high IQ (Kéri,
2009). The gene in question is neuregulin 1, which is a candi-
date gene for psychosis and affects neuroplasticity, glial func-
tion, and neuronal development in general. One form of the
gene, the T/T genotype, was related to both high creativity and
risk for psychosis. Based on this and other evidence, Kozbalt
and colleagues (2017) argued that one possible reason why a
maladaptive trait may still exist in humans is its shared genetic
linkage with creative behavior (cf. Akiskal & Akiskal, 2007;
Greenwood, 2020; Nettle, 2001, 2006; Power et al., 2015). Sim-
ilarly, other empirical and theoretical evidence supports the idea
that the milder levels of mental illness, for example cyclothy-
mia, confer advantages such as increase fluency of ideas that
make creative thought more likely (Carson, 2011; 2014; Green-
wood, 2020). Carson (2011, 2014), in fact, proposed that the
“shared vulnerability” traits of openness, impulsivity, schizo-
typy, cognitive disinhibition, hypomania, and cyclothymia are
the traits that connect psychopathology (risk factors) and crea-
tive (protective factors) behavior. In sum, there are various neu-
rological, evolutionary, and adaptive factors that may undergird
the associations between some forms and degrees of creativity
and some forms and degrees of psychopathology.

Caveats and Limitations

A number of confounding variables limit the results of this
study. One such limitation is sample bias. In the case of the current

study, writers and publishers may be more inclined to pursue biog-
raphies for particularly interesting people to tell more compelling
stories. Because someone with a history of psychopathology may
serve as a more desirable subject for a biography than someone
who is not, healthier professionals may have fewer books written
about them. Indeed, the study also contained a much smaller num-
ber of scientists than artists, which may be due to writers and pub-
lishers favoring more artists rather than scientists since the latter
may be perceived as less interesting or hold less recognition in the
general public.

The level of fame could not be held constant through all three
groups. Although some scientists such as Stephen Hawking and
Richard Feynman are particularly well known, not all eminent sci-
entists are easily recognizable to the public (e.g., Alfred Tarski,
Grigori Perelman, George Beadle). Most of the actors (e.g., Mar-
lon Brando, Robert DeNiro, Sophia Loren) and musicians (e.g.,
Ella Fitzgerald, Prince, Diana Ross, Johnny Cash) were well
known to the general public. Athletes, although more recognizable
than scientists, tend to dwindle in fame after retirement. Because
the careers of most athletes are particularly short, their highest
point of fame tends to come earlier in their lives rather than later.
This is incongruent with scientists as fame for their achievements
tend to come later, after their work has been recognized. Both ath-
letes and scientists may also possess lower levels of fame than per-
formance artists such as musicians and actors.

Another limitation of the current study is the gender imbalance
in the creative sample. The biographies of men in the sample out-
numbered women 164 to 35 (18% female). There are historically
fewer biographies written about women than men, especially the
sciences. Moreover, women have been less likely to reach the
highest levels of their professions, whether they have biographies
written about them or not—the famous “glass ceiling.” For exam-
ple, women have historically been seriously underrepresented in
mathematics and sciences. Only 8.8% 15.8% of tenure-track posi-
tions among top universities are held by women in math-centric
domains (Ceci & Williams, 2011), and only 20% of physics PhDs
were awarded to women as recently as 2017 (Porter & Ivie, 2019).
During the time that many eminent people in this sample were
most active professionally—the 1950s to 1980s—the percentage
of women earning PhDs in physics was between 3% to 7% (Porter
& Ivie, 2019). Yet not all professions are so imbalanced. For
example, our sample had five women of 68 (7%) in the STEM dis-
ciplines but 29 of 104 (28%) women in the arts. In acting, the cur-
rent sample had a ratio of nine of 20 (45%), and in musical
performance it was eight of 26 (31%).

This finding begs the question of why are women underrepre-
sented in certain fields more than others and in particular at the top
of their fields? There is an extensive scientific literature on this
question that goes well-beyond the scope of this article (Cheung &
Halpern, 2010). Suffice it to say that social and cultural biases
about marriage, child rearing, and performance play a very large
role in “glass ceiling” effect (Cheung & Halpern, 2010). For
example, in a nationwide study, biology, chemistry, and physics
professors were found to consider men as both more hirable and
competent (Moss-Racusin et al., 2012).

Similarly, the sample was skewed racially, with being of
White-European ancestry (83% of our sample, compared with
60% in the U.S. population). Indeed, 100% of the Science-Tech-
nology group was White. Part of this bias comes from the bias in

PSYCHOPATHOLOGY AND CREATIVITY 13

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published biographies, especially during the time frame of our
study. Moreover, basing research on biographies will inherently
require older samples given the delay between creative accom-
plishments and publication of a biography. Future research will
need to continue to determine whether these trends hold with
more ethnically diverse samples.
Additionally, determining how to interpret historical and bio-

graphical texts is a challenge for psychological study (Citlak,
2016; Czechowski et al., 2016). Biographies still require interpre-
tation as historians of certain types of professions may differ from
others in what report. Some professions may encourage exagger-
ated stories, particularly of drug use, to sell their fame (Lucijani�c
et al., 2010). Musicians such as rappers and rock stars may benefit
from rumors of psychopathology as increased notoriety would
increase exposure and thus raise the likelihood of album sales. Sci-
entists do not typically benefit from fame in the same way artists
do, as they typically work to discover new knowledge rather than
sell products or develop a fan-base, thus there is less incentive to
exaggerate claims of illness or drug use.
Furthermore, we must acknowledge the fact that different disor-

ders are easier to rate from biographies than others and are more
likely to show up in biographies than others. The former consists of
more behaviorally expressed disorders such as drug or alcohol
addiction, violence, suicide, and depression, whereas the latter con-
sists of more internalized or private disorders, such as PTSD, sleep
disorders or even more moderate degrees of anxiety disorders.
We also need to make clear that our raters were not licensed

clinical psychologists but rather trained undergraduate research
assistants. To be sure, they had to go through a reliability training
process that involved learning the DSM–5 criteria for the 19 disor-
ders and they could not begin rating until they obtained the .80
interrater reliability threshold. Finally, the raters were blind to the
subject of the biography, and we had two independent raters code
each biography. Nevertheless, these are not assessments by li-
censed clinical psychologists.

Future Directions

We make little claim that this investigation settles the “debate”
over the “mad-genius.” At best, it confirms one aspect of it,
namely the higher rate of pathology and the different pathologies
in the creative arts than other creative domains. Many questions
remain. For example, as we mentioned above, the biggest question
left unresolved is the gender question. Are these patterns that we
found in a heavily male-dominated sample the same in famous
creative women? Our dataset does not allow this question to be
satisfactorily answered. Moreover, because of the restricted sam-
ple size, certain analyses were not possible among smaller groups
and specific professions. Additionally, no comparisons could be
made for fiction writers against nonfiction writers, limiting the
conclusions that could be made. Thus, more specific examinations
of individual professions can be made as the dataset grows larger.
Additional demographic variables that may influence professional
vocation and creative output will also be collected. These variables
include birth order, religious affiliation, ethnicity, and marital sta-
tus of parents. Owing to time constraints, the collection of these
data lay beyond the scope of the current study.
In conclusion, the results of this study provide support and repli-

cation for the findings of previous biographical investigations of

highly creative people. The use of digital resources allowed for the
researchers to limit bias through the use of censors to hide the
identity of each creator. The classification and grouping of each
profession were also reworked for further accuracy. As is true of
all research, however, for each question answered, others arise and
await further attention from future investigators. The topic of psy-
chopathology and world-class creative achievement is a rich and
complex topic and will provide material for researchers for years
to come.

References

Abraham, A. (2017). Neurocognitive mechanisms underlying creative
thinking: Indications from studies of mental illness. In J. C. Kaufman
(Ed.), Creativity and mental illness (pp. 79–101). Cambridge University
Press.

Acar, S., Chen, X., & Cayirdag, N. (2018). Schizophrenia and creativity: A
meta-analytic review. Schizophrenia Research, 195, 23–31. https://doi
.org/10.1016/j.schres.2017.08.036

Acar, S., & Runco, M. A. (2012). Psychoticism and creativity: A meta-ana-
lytic review. Psychology of Aesthetics, Creativity, and the Arts, 6(4),
341–350. https://doi.org/10.1037/a0027497

Acar, S., & Sen, S. (2013). A multilevel meta-analysis of the relationship
between creativity and schizotypy. Psychology of Aesthetics, Creativity,
and the Arts, 7(3), 214–228. https://doi.org/10.1037/a0031975

Akinola, M., & Mendes, W. B. (2008). The dark side of creativity: Biolog-
ical vulnerability and negative emotions lead to greater artistic creativ-
ity. Personality and Social Psychology Bulletin, 34(12), 1677–1686.
https://doi.org/10.1177/0146167208323933

Akiskal, H. S., & Akiskal, K. K. (2007). In search of Aristotle: Temperament,
human nature, melancholia, creativity and eminence. Journal of Affective
Disorders, 100(1–3), 1–6. https://doi.org/10.1016/j.jad.2007.04.013

Amabile, T. M. (1996). Creativity in context: Update to the social psychol-
ogy of creativity. Westview Press.

American Psychiatric Association. (2013). Diagnostic and statistical
manual of mental disorders (5th ed.).

Andreasen, N. C. (1987). Creativity and mental illness: Prevalence rates in
writers and their first-degree relatives. The American Journal of Psychi-
atry, 144(10), 1288–1292. https://doi.org/10.1176/ajp.144.10.1288

Andreasen, N. C. (1978). Creativity and psychiatric illness. Psychiatric
Annals, 8(3), 23–45. https://doi.org/10.3928/0048-5713-19780301-05

Andreasen, N. C., & Glick, I. D. (1988). Bipolar affective disorder and cre-
ativity: Implications and clinical management. Comprehensive Psychia-
try, 29(3), 207–217. https://doi.org/10.1016/0010-440X(88)90044-2

Baas, M., Nijstad, B. A., Boot, N. C., & De Dreu, C. K. W. (2016). Mad
genius revisited: Vulnerability to psychopathology, biobehavioral
approach-avoidance, and creativity. Psychological Bulletin, 142(6),
668–692. https://doi.org/10.1037/bul0000049

Baca-Garcia, E., Perez-Rodriguez, M. M., Keyes, K. M., Oquendo, M. A.,
Hasin, D. S., Grant, B. F., & Blanco, C. (2010). Suicidal ideation and
suicide attempts in the United States: 1991-1992 and 2001-2002. Molec-
ular Psychiatry, 15(3), 250–259. https://doi.org/10.1038/mp.2008.98

Baron-Cohen, S., Wheelwright, S., Burtenshaw, A., & Hobson, E. (2007).
Mathematical talent is linked to autism. Human Nature, 18(2), 125–131.
https://doi.org/10.1007/s12110-007-9014-0

Barron, F. (1963). Creativity and psychological health. D. Van Nostrand.
Batey, M., & Furnham, A. (2008). The relationship between measures of

creativity and schizotypy. Personality and Individual Differences, 45(8),
816–821. https://doi.org/10.1016/j.paid.2008.08.014

Beaussart, M. L., White, A. E., Pullman, A., & Kaufman, J. C. (2017).
Reviewing recent empirical findings on creativity and mental illness. In
J. C. Kaufman (Ed.), Creativity and mental illness (pp. 42–59). Cam-
bridge University Press.

14 FEIST, DOSTAL, AND KWAN

T
hi
s
do
cu
m
en
t
is
co
py
ri
gh
te
d
by

th
e
A
m
er
ic
an

P
sy
ch
ol
og
ic
al
A
ss
oc
ia
ti
on

or
on
e
of

it
s
al
li
ed

pu
bl
is
he
rs
.

T
hi
s
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
pe
rs
on
al
us
e
of

th
e
in
di
vi
du
al
us
er

an
d
is
no
t
to

be
di
ss
em

in
at
ed

br
oa
dl
y.

Becker, G. (2017). A socio-historical overview of the creativity-pathology
connection: From antiquity to contemporary times. In J. C. Kaufman (Ed.),
Creativity and mental illness (pp. 3–24). Cambridge University Press.

Billington, J., Baron-Cohen, S., & Wheelwright, S. (2007). Cognitive style
predicts entry into physical sciences and humanities: Questionnaire and
performance tests of empathy and systemizing. Learning and Individual
Differences, 17(3), 260–268. https://www.doi.org/10.1016/j.lindif.2007.02
.004

Brownstein, M., & Solyom, L. (1986). The dilemma of Howard Hughes:
Paradoxical behavior in compulsive disorders. Canadian Journal of Psy-
chiatry, 31(3), 238–240. https://doi.org/10.1177/070674378603100311

Burch, G. S. J., Pavelis, C., Hemsley, D. R., & Corr, P. J. (2006). Schizo-
typy and creativity in visual artists. British Journal of Psychology, 97(Pt
2), 177–190. https://doi.org/10.1348/000712605X60030

Carson, S. (2014). Leveraging the “mad genius” debate: Why we need a
neuroscience of creativity and psychopathology. Frontiers in Human
Neuroscience, 8, 771. https://doi.org/10.3389/fnhum.2014.00771

Carson, S. H. (2011). Creativity and psychopathology: A shared vulner-
ability model. Canadian Journal of Psychiatry, 56(3), 144–153. https://
doi.org/10.1177/070674371105600304

Carson, S. H., Peterson, J. B., & Higgins, D. M. (2003). Decreased latent
inhibition is associated with increased creative achievement in high-
functioning individuals. Journal of Personality and Social Psychology,
85(3), 499–506. https://doi.org/10.1037/0022-3514.85.3.499

Ceci, S. J., & Williams, W. M. (2011). Understanding current causes of
women’s underrepresentation in science. Proceedings of the National
Academy of Sciences of the United States of America, 108(8),
3157–3162. https://doi.org/10.1073/pnas.1014871108

Cheung, F. M., & Halpern, D. F. (2010). Women at the top: Powerful lead-
ers define success as work þ family in a culture of gender. American
Psychologist, 65(3), 182–193. https://doi.org/10.1037/a0017309

Citlak, A. (2016). The Lvov-Warsaw School: The forgotten tradition of
historical psychology. History of Psychology, 19(2), 105–124. https://
doi.org/10.1037/hop0000029

Claridge, G., McCreery, C., Mason, O., Bentall, R., Boyle, G., Slade, P., &
Popplewell, D. (1996). The factor structure of “schizotypal’ traits: A
large replication study. British Journal of Clinical Psychology, 35(1),
103–115. https://doi.org/10.1111/j.2044-8260.1996.tb01166.x

Cox, A. J., & Leon, J. L. (1999). Negative schizotypal traits in the relation
of creativity to psychopathology. Creativity Research Journal, 12(1),
25–36. https://doi.org/10.1207/s15326934crj1201_4

Czechowski, K., Miranda, D., & Sylvestre, J. (2016). Like a rolling stone:
A mixed- methods approach to linguistic analysis of Bob Dylan’s lyrics.
Psychology of Aesthetics, Creativity, and the Arts, 10(1), 99–113.
https://doi.org/10.1037/aca0000045

Damian, R. I., & Simonton, D. K. (2015). Psychopathology, adversity, and
creativity: Diversifying experiences in the development of eminent Afri-
can Americans. Journal of Personality and Social Psychology, 108(4),
623–636. https://doi.org/10.1037/pspi0000011

Dunani, M., & Rodgers, P. (1999). Physics: Past, present, future. Physics
World, 12(12), 7–14. https://doi.org/10.1088/2058-7058/12/12/2

Eysenck, H. (1993). Creativity and personality: Suggestions for a theory.
Psychological Inquiry, 4(3), 147–178. https://doi.org/10.1207/s15327
965pli0403_1

Eysenck, H. J. (1995). Genius: The natural history of creativity (Vol. 12).
Cambridge University Press. https://doi.org/10.1017/CBO9780511752247

Feist, G. J. (1998). A meta-analysis of personality in scientific and artistic
creativity. Personality and Social Psychology Review, 2(4), 290–309.
https://doi.org/10.1207/s15327957pspr0204_5

Feist, G. J. (2012). Affective states and affective traits in creativity: Evi-
dence for non-linear relationships. In M. A. Runco (Ed.), The creativity
research handbook (Vol. 3, pp. 61–102). Hampton Press.

Feist, G. J. (2017). The creative personality: Current understandings and
debates. In J. Plucker (Ed.), Creativity and innovation: Current under-
standings and debates (pp. 181–198). Prufrock Press.

Fisher, J. E. (2015). Challenges in determining whether creativity and men-
tal illness are associated. Frontiers in Psychology, 6, 163. https://doi
.org/10.3389/fpsyg.2015.00163

Flaherty, A. W. (2005). Frontotemporal and dopaminergic control of idea
generation and creative drive. The Journal of Comparative Neurology,
493(1), 147–153. https://doi.org/10.1002/cne.20768

Focquaert, F., Steven, M. S., Wolford, G. L., Colden, A., & Gazzaniga, M.
S. (2007). Empathizing and systemizing cognitive traits in the sciences
and humanities. Personality and Individual Differences, 43(3), 619–625.

Fodor, E. M., & Laird, B. A. (2004). Therapeutic intervention, bipolar in-
clination, and literary creativity. Creativity Research Journal, 16(2–3),
149–161. https://doi.org/10.1080/10400419.2004.9651449

Forgeard, M. J. C., Mecklenburg, A. C., Lacasse, J. J., & Jayawickreme, E.
(2017). Bringing the whole universe to order: Creativity, healing, and
posttraumatic growth. In J. C. Kaufman (Ed.), Creativity and mental ill-
ness (pp. 321–342). Cambridge University Press.

Furnham, A., Batey, M., Anand, K., & Manfield, J. (2008). Personality,
hypomania, intelligence and creativity. Personality and Individual Dif-
ferences, 44(5), 1060–1069. https://doi.org/10.1016/j.paid.2007.10.035

Gardner, J. (1973). The arts and human development. Wiley.
Glazer, E. (2009). Rephrasing the madness and creativity debate: What is

the nature of the creativity construct? Personality and Individual Differ-
ences, 46(8), 755–764. https://doi.org/10.1016/j.paid.2009.01.021

Gostoli, S., Cerini, V., Piolanti, A., & Rafanelli, C. (2017). Creativity,
bipolar disorder vulnerability and psychological well-being: A prelimi-
nary study. Creativity Research Journal, 29(1), 63–70. https://doi.org/10
.1080/10400419.2017.1263511

Greenwood, T. A. (2020). Creativity and bipolar disorder: A shared genetic
vulnerability. Annual Review of Clinical Psychology, 16, 239–264.
https://doi.org/10.1146/annurev-clinpsy-050718-095449

Gwet, K. (2002). Inter-rater reliability: Dependency on trait prevalence
and marginal homogeneity. Statistical Methods for Inter-Rater Reliabil-
ity Assessment Series, 2(1), 9.

Gwet, K. L. (2008). Computing inter-rater reliability and its variance in the
presence of high agreement. British Journal of Mathematical & Statistical
Psychology, 61(Pt 1), 29–48. https://doi.org/10.1348/000711006X126600

Hoffman, M. D., & Gelman, A. (2014). The No-U-turn sampler: Adap-
tively setting path lengths in Hamiltonian Monte Carlo. Journal of
Machine Learning Research, 15(1), 1593–1623.

Hope, A. C. A. (1968). A simplified Monte Carlo significance test proce-
dure. Journal of the Royal Statistical Society: Series B, Methodological,
30, 582–598. https://doi.org/10.1111/j.2517-6161.1968.tb00759.x

Hudson, J. I., Hiripi, E., Pope, H. G., Jr., & Kessler, R. C. (2007). The
prevalence and correlates of eating disorders in the National Comorbid-
ity Survey Replication. Biological Psychiatry, 61(3), 348–358. https://
doi.org/10.1016/j.biopsych.2006.03.040

Jamison, K. R. (1996). Touched with fire. Simon & Schuster.
Jamison, K. R., Gerner, R. H., Hammen, C., & Padesky, C. (1980). Clouds

and silver linings: Positive experiences associated with primary affective
disorders. The American Journal of Psychiatry, 137(2), 198–202.
https://doi.org/10.1176/ajp.137.2.198

Jeste, D. V., Harless, K. A., & Palmer, B. W. (2000). Chronic late-onset
schizophrenia-like psychosis that remitted: Revisiting Newton’s psycho-
sis? The American Journal of Psychiatry, 157(3), 444–449. https://doi
.org/10.1176/appi.ajp.157.3.444

Johnson, S. L., Murray, G., Fredrickson, B., Youngstrom, E. A., Hinshaw,
S., Bass, J. M., Deckersbach, T., Schooler, J., & Salloum, I. (2012). Cre-
ativity and bipolar disorder: Touched by fire or burning with questions?
Clinical Psychology Review, 32(1), 1–12. https://doi.org/10.1016/j.cpr
.2011.10.001

PSYCHOPATHOLOGY AND CREATIVITY 15

T
hi
s
do
cu
m
en
t
is
co
py
ri
gh
te
d
by

th
e
A
m
er
ic
an

P
sy
ch
ol
og
ic
al
A
ss
oc
ia
ti
on

or
on
e
of

it
s
al
li
ed

pu
bl
is
he
rs
.

T
hi
s
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
pe
rs
on
al
us
e
of

th
e
in
di
vi
du
al
us
er

an
d
is
no
t
to

be
di
ss
em

in
at
ed

br
oa
dl
y.

Johnson, S. L., Murray, G., Hou, S., Staudenmaier, P. J., Freeman, M. A.,
& Michalak, E. E., & the CREST.BD. (2015). Creativity is linked to
ambition across the bipolar spectrum. Journal of Affective Disorders,
178, 160–164. https://doi.org/10.1016/j.jad.2015.02.021

Johnson, S. L., Tharp, J. A., & Holmes, M. K. (2015). Understanding crea-
tivity in bipolar I disorder. Psychology of Aesthetics, Creativity, and the
Arts, 9(3), 319–327. https://doi.org/10.1037/a0038852

Kaufman, J. C. (2017). Creativity and mental illness. Cambridge Univer-
sity Press.

Kaufman, J. C., & Beghetto, R. A. (2009). Beyond big and little: The four
c model of creativity. Review of General Psychology, 13(1), 1–12.
https://doi.org/10.1037/a0013688

Kaufmann, G., & Kaufmann, A. (2017). When good is bad and bad is
good: Mood, bipolarity, and creativity. In J. C. Kaufman (Ed.), Creativ-
ity and mental illness (pp. 205–235). Cambridge University Press.

Kelter, R. (2020). fbst: The Full Bayesian Significance Test and the e-Value
(R package version 1.0). https://CRAN.R-project.org/package=fbst

Kéri, S. (2009). Genes for psychosis and creativity: A promoter polymor-
phism of the neuregulin 1 gene is related to creativity in people with high
intellectual achievement. Psychological Science, 20(9), 1070–1073.
https://doi.org/10.1111/j.1467-9280.2009.02398.x

Kessler, R. C., Angermeyer, M., Anthony, J. C., DE Graaf, R.,
Demyttenaere, K., Gasquet, I., DE Girolamo, G., Gluzman, S., Gureje,
O., Haro, J. M., Kawakami, N., Karam, A., Levinson, D., Medina Mora,
M. E., Oakley Browne, M. A., Posada-Villa, J., Stein, D. J., Adley
Tsang, C. H., Aguilar-Gaxiola, S., . . . Ustün, T. B. (2007). Lifetime
prevalence and age-of-onset distributions of mental disorders in the
world health organization’s world mental health survey initiative. World
Psychiatry, 6(3), 168–176.

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., &
Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribu-
tions of DSM–IV disorders in the National Comorbidity Survey Replica-
tion. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/10
.1001/archpsyc.62.6.593

Kinney, D., & Richards, R. (2017). Creativity as “compensatory advant-
age”: bipolar and schizophrenic liability, the inverted-U hypothesis, and
practical implications. In J. C. Kaufman (Ed.), Creativity and mental ill-
ness (pp. 295–317). Cambridge University Press.

Ko, Y., & Kim, J. (2008). Scientific geniuses’ psychopathology as a mod-
erator in the relation between creative contribution types and eminence.
Creativity Research Journal, 20(3), 251–261. https://doi.org/10.1080/
10400410802278677

Kozbalt, A., Kaufman, S. B., Walder, D. J., Ospina, L. H., & Kim, J. U.
(2017). The evolutionary genetics of the creativity-psychosis connec-
tion. In J. C. Kaufman (Ed.), Creativity and mental illness (pp.
102–132). Cambridge University Press.

Kyaga, S., Lichtenstein, P., Boman, M., Hultman, C., Långström, N., &
Landén, M. (2011). Creativity and mental disorder: Family study of
300,000 people with severe mental disorder. The British Journal of Psy-
chiatry, 199(5), 373–379. https://doi.org/10.1192/bjp.bp.110.085316

LeBoutillier, N., Barry, R., & Westley, D. (2014). The role of schizotypy
in predicting performance on figural and verbal imagery-based measures
of creativity. Creativity Research Journal, 26(4), 461–467. https://doi
.org/10.1080/10400419.2014.961778

Lev-Ran, S., Imtiaz, S., Rehm, J., & Le Foll, B. (2013). Exploring the asso-
ciation between lifetime prevalence of mental illness and transition from
substance use to substance use disorders: Results from the National Epi-
demiologic Survey of Alcohol and Related Conditions (NESARC). The
American Journal on Addictions, 22(2), 93–98. https://doi.org/10.1111/j
.1521-0391.2013.00304.x

Lucijani�c, M., Breitenfeld, D., Mileti�c, J., Buljan, D., Ozimec-Vulinec, Š.,
& Akrap, A. (2010). Rock musicians’ Club 27. Alcoholism: Journal on
Alcoholism and Related Addictions, 46(2), 109–113.

Ludwig, A. (1995). The price of greatness: Resolving the creativity and
madness controversy. Guilford Press.

Ludwig, A. (1998). Method and madness in the arts and sciences. Creativity
Research Journal, 11(2), 93–101. https://doi.org/10.1207/s15326934crj1102_1

Ludwig, A. M. (1992). Creative achievement and psychopathology: Com-
parison among professions. American Journal of Psychotherapy, 46(3),
330–356. https://doi.org/10.1176/appi.psychotherapy.1992.46.3.330

Martín-Brufau, R., & Corbalán, J. (2016). Creativity and psychopathology:
Sex matters. Creativity Research Journal, 28(2), 222–228. https://doi
.org/10.1080/10400419.2016.1165531

Mason, O., Claridge, G., & Jackson, M. (1995). New scales for the assess-
ment of schizotypy. Personality and Individual Differences, 18(1),
7–13. https://doi.org/10.1016/0191-8869(94)00132-C

Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld,
R. M., Petukhova, M., & Kessler, R. C. (2007). Lifetime and 12-month
prevalence of bipolar spectrum disorder in the National Comorbidity
Survey replication. Archives of General Psychiatry, 64(5), 543–552.
https://doi.org/10.1001/archpsyc.64.5.543

Moss-Racusin, C. A., Dovidio, J. F., Brescoll, V. L., Graham, M. J., &
Handelsman, J. (2012). Science faculty’s subtle gender biases favor
male students. Proceedings of the National Academy of Sciences of the
United States of America, 109(41), 16474–16479. https://doi.org/10
.1073/pnas.1211286109

Motto, A. L., & Clark, J. R. (1992). The paradox of genius and madness:
Seneca and his influence. Cuadernos de filología clásica. Estudios Lat-
inos, (2), 189–200.

Nasar, S. (2011). A beautiful mind. Simon & Schuster.
Nettle, D. (2001). Strong imagination: Madness, creativity and human na-

ture. Oxford University Press.
Nettle, D. (2006). Schizotypy and mental health amongst poets, visual

artists, and mathematicians. Journal of Research in Personality, 40(6),
876–890. https://doi.org/10.1016/j.jrp.2005.09.004

Nock, M. K., & Kessler, R. C. (2006). Prevalence of and risk factors for suicide
attempts versus suicide gestures: Analysis of the National Comorbidity Sur-
vey. Journal of Abnormal Psychology, 115(3), 616–623. https://doi.org/10
.1037/0021-843X.115.3.616

Nowakowska, C., Strong, C. M., Santosa, C. M., Wang, P. W., & Ketter,
T. A. (2005). Temperamental commonalities and differences in euthy-
mic mood disorder patients, creative controls, and healthy controls.
Journal of Affective Disorders, 85(1-2), 207–215. https://doi.org/10
.1016/j.jad.2003.11.012

Paek, S. H., Abdulla, A. M., & Cramond, B. (2016). A meta-analysis of the
relationship between three common psychopathologies—ADHD, anxiety,
and depression—and indicators of little-c creativity. Gifted Child Quar-
terly, 60(2), 117–133. https://doi.org/10.1177/0016986216630600

Perälä, J., Suvisaari, J., Saarni, S. I., Kuoppasalmi, K., Isometsä, E.,
Pirkola, S., Partonen, T., Tuulio-Henriksson, A., Hintikka, J., Kieseppä,
T., Härkänen, T., Koskinen, S., & Lönnqvist, J. (2007). Lifetime preva-
lence of psychotic and bipolar I disorders in a general population. Ar-
chives of General Psychiatry, 64(1), 19–28. https://doi.org/10.1001/
archpsyc.64.1.19

Pereira, C. A. B., & Stern, J. M. (1999). Evidence and credibility: Full
Bayesian significance test for precise hypotheses. Entropy, 1(4),
99–110. https://doi.org/10.3390/e1040099

Pereira, C. A. B., & Stern, J. M. (2020). The e-value: a fully Bayesian sig-
nificance measure for precise statistical hypotheses and its research pro-
gram. São Paulo Journal of Mathematical Sciences. Advance online
publication. https://doi.org/10.1007/s40863-020-00171-7

Perry, I. H. (1947). Vincent van Gogh’s illness: — case record. Bulletin of
the History of Medicine, 21, 146–172.

Porter, A. M., & Ivie, R. (2019). Women in physics and astronomy, 2019.
https://www.aip.org/statistics/reports/women-physics-and-astronomy-2019
#:�:text=Highlights,and%2040%25%20of%20astronomy%20doctorates

16 FEIST, DOSTAL, AND KWAN

T
hi
s
do
cu
m
en
t
is
co
py
ri
gh
te
d
by

th
e
A
m
er
ic
an

P
sy
ch
ol
og
ic
al
A
ss
oc
ia
ti
on

or
on
e
of

it
s
al
li
ed

pu
bl
is
he
rs
.

T
hi
s
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
pe
rs
on
al
us
e
of

th
e
in
di
vi
du
al
us
er

an
d
is
no
t
to

be
di
ss
em

in
at
ed

br
oa
dl
y.

Post, F. (1994). Creativity and psychopathology. A study of 291 world-fa-
mous men. The British Journal of Psychiatry, 165(1), 22–34. https://doi
.org/10.1192/bjp.165.1.22

Power, R. A., Steinberg, S., Bjornsdottir, G., Rietveld, C. A., Abdellaoui,
A., Nivard, M. M., Johannesson, M., Galesloot, T. E., Hottenga, J. J.,
Willemsen, G., Cesarini, D., Benjamin, D. J., Magnusson, P. K. E.,
Ullén, F., Tiemeier, H., Hofman, A., van Rooij, F. J. A., Walters, G. B.,
Sigurdsson, E., . . . Stefansson, K. (2015). Polygenic risk scores for
schizophrenia and bipolar disorder predict creativity. Nature Neuro-
science, 18(7), 953–955. https://doi.org/10.1038/nn.4040

Ramey, C. H., & Weisberg, R. W. (2004). The” poetical activity” of Emily
Dickinson: A further test of the hypothesis that affective disorders foster
creativity. Creativity Research Journal, 16(2-3), 173–185. https://doi
.org/10.1080/10400419.2004.9651451

Reiter-Palmon, R., & Schoenbeck, M. (2020). Creativity equals creativity-
–or does it? How creativity is measured influences our understanding of
creativity. In V. Dorfler & M. Stierand (Eds.), Handbook of research
methods on creativity (pp. 290–300). Edward Elgar Publishing. https://
doi.org/10.4337/9781786439659.00031

Richards, R. (1990). Everyday creativity, eminent creativity, and health:
‘Afterview’ for CRJ issues on creativity and health. Creativity Research
Journal, 3(4), 300–326. https://doi.org/10.1080/10400419009534363

Richards, R. (1994). Creativity and bipolar mood swings: Why the associa-
tion? In M. P. Shaw & M. A. Runco (Eds.), Creativity and affect (pp.
44–72). Ablex Publishing.

Richards, R., Kinney, D. K., Lunde, I., Benet, M., & Merzel, A. P. (1988).
Creativity in manic-depressives, cyclothymes, their normal relatives,
and control subjects. Journal of Abnormal Psychology, 97(3), 281–288.
https://doi.org/10.1037/0021-843X.97.3.281

Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E.,
Burke, J. D., Jr., & Regier, D. A. (1984). Lifetime prevalence of specific
psychiatric disorders in three sites. Archives of General Psychiatry, 41(10),
949–958. https://doi.org/10.1001/archpsyc.1984.01790210031005

Rothenberg, A. (1990). Creativity and madness: New findings and old ster-
eotypes. Johns Hopkins University Press.

Ruiter, M., & Johnson, S. L. (2015). Mania risk and creativity: A multi-
method study of the role of motivation. Journal of Affective Disorders,
170(1), 52–58. https://doi.org/10.1016/j.jad.2014.08.049

Runco, M., & Jaeger, G. J. (2012). The standard definition of creativity.
Creativity Research Journal, 24(1), 92–96. https://doi.org/10.1080/
10400419.2012.650092

Santosa, C. M., Strong, C. M., Nowakowska, C., Wang, P. W., Rennicke,
C. M., & Ketter, T. A. (2007). Enhanced creativity in bipolar disorder
patients: A controlled study. Journal of Affective Disorders, 100(1–3),
31–39. https://doi.org/10.1016/j.jad.2006.10.013

Sawyer, R. K. (2011). Explaining creativity: The science of human innova-
tion. Oxford University Press.

Schlesinger, J. (2009). Creative myth conceptions: A closer look at the evi-
dence for the “mad genius” hypothesis. Psychology of Aesthetics, Crea-
tivity, and the Arts, 3(2), 62–72. https://doi.org/10.1037/a0013975

Schlesinger, J. (2012). The insanity hoax: Exposing the myth of the mad
genius. Shrinktunes Media.

Schlesinger, J. (2017). Building connections on sand: The cautionary chap-
ter. In J. C. Kaufman (Ed.), Creativity and mental illness (pp. 60–75).
Cambridge University Press.

Schuldberg, D. (1990). Schizotypal and hypomanic traits, creativity, and
psychological health. Creativity Research Journal, 3(3), 218–230.
https://doi.org/10.1080/10400419009534354

Seneca. (2007). Dialogues and essays: Tranquility of mind (J. Davie,
Trans.). Oxford.

Silvia, P. J., & Kaufman, J. C. (2010). Creativity and mental illness. In
J. C. Kaufman & R. J. Sternberg (Eds.), The Cambridge handbook of
creativity (pp. 381–394). Cambridge University Press. https://doi.org/10
.1017/CBO9780511763205.024

Silvia, P. J., & Kimbrel, N. A. (2010). A dimensional analysis of creativity
and mental illness: Do anxiety and depression symptoms predict creative
cognition, creative accomplishments, and creative self-concepts? Psy-
chology of Aesthetics, Creativity, and the Arts, 4(1), 2–10. https://doi
.org/10.1037/a0016494

Simeonova, D. I., Chang, K. D., Strong, C., & Ketter, T. A. (2005). Crea-
tivity in familial bipolar disorder. Journal of Psychiatric Research,
39(6), 623–631. https://doi.org/10.1016/j.jpsychires.2005.01.005

Simonton, D. K. (2006). Creativity and madness. Talk presented to Psy-
chology Forum, The Commonwealth Club, San Francisco, CA.

Simonton, D. K. (2010). So you want to become a creative genius? You
must be crazy. In D. H. Cropley, A. J. Cropley, J. C. Kaufman, & M. A.
Runco (Eds.), The dark side of creativity (pp. 218–234). Cambridge Uni-
versity Press. https://doi.org/10.1017/CBO9780511761225.012

Simonton, D. K. (2013). Creative thought as blind variation and selective
retention: Why creativity is inversely related to sightedness. Journal of
Theoretical and Philosophical Psychology, 33(4), 253–266. https://doi
.org/10.1037/a0030705

Simonton, D. K. (2014). More method in the mad-genius controversy: A
historiometric study of 204 historic creators. Psychology of Aesthetics,
Creativity, and the Arts, 8(1), 53–61. https://doi.org/10.1037/a0035367

Simonton, D. K. (2016). Defining creativity: Don’t we also need to define
what is not creative? Journal of Creative Behavior, 52, 80–90. https://
doi.org/10.1002/jocb.137

Simonton, D. K. (2017a). Creative genius and psychopathology: Creativity
as positive and negative personality. In G. J. Feist, R. Reiter-Palmon, &
J. C. Kaufman (Eds.), The Cambridge handbook of creativity and per-
sonality research (pp. 235–250). Cambridge University Press. https://
doi.org/10.1017/9781316228036.013

Simonton, D. K. (2017b). The mad (creative) genius: What do we know af-
ter a century of historiometric research? In J. C. Kaufman (Ed.), Creativ-
ity and mental illness (pp. 25–41). Cambridge University Press.

Simonton, D. K. (2019). Creativity and psychopathology: The tenacious
mad-genius controversy updated. Current Opinion in Behavioral Scien-
ces, 27, 17–21. https://doi.org/10.1016/j.cobeha.2018.07.006

Simonton, D. K., & Song, A. V. (2009). Eminence, IQ, physical and men-
tal health, and achievement domain: Cox’s 282 Geniuses revisited. Psy-
chological Science, 20(4), 429–434. https://doi.org/10.1111/j.1467-9280
.2009.02313.x

Stan Development Team. (2016). rstanarm: Bayesian applied regression
modeling via Stan. R package version 2.13.1. http://mc-stan.org/

Stein, D. J., Phillips, K. A., Bolton, D., Fulford, K. W. M., Sadler, J. Z., &
Kendler, K. S. (2010). What is a mental/psychiatric disorder? From
DSM–IV to DSM-V. Psychological Medicine, 40(11), 1759–1765.
https://doi.org/10.1017/S0033291709992261

Sternberg, R. J. (1988). A three-facet model of creativity. In R. J. Sternberg
& R. J. Sternberg (Eds.), The nature of creativity: Contemporary psycho-
logical perspectives (pp. 125–147). Cambridge University Press.

Swain, J. E., & Swain, J. D. (2017). Non-linearity in creativity and mental
illness: The mixed blessings of chaos, catastrophe, and noise in brain
and behavior. In J. C. Kaufman (Ed.), Creativity and mental illness (pp.
133–144). Cambridge University Press.

Taylor, C. L. (2017). Creativity and mood disorder: A systematic review
and meta-analysis. Perspectives on Psychological Science, 12(6),
1040–1076. https://doi.org/10.1177/1745691617699653

Thomson, P. (2017). Trauma, attachment, and creativity. In T. Marks-
Tarlow, M. Solomon, & D. J. Siegel (Eds.), Play and creativity in psy-
chotherapy (pp. 167–190). W.W. Norton.

Thomson, N. D., Wurtzburg, S. J., & Centifanti, L. C. (2015). Empathy or
science? Empathy explains physical science enrollment for men and
women. Learning and Individual Differences, 40(2), 115–120.

Thulin, M. (2014). Decision-theoretic justifications for Bayesian hypothe-
sis testing using credible sets. Journal of Statistical Planning and Infer-
ence, 146(3), 133–138. https://doi.org/10.1016/j.jspi.2013.09.014

PSYCHOPATHOLOGY AND CREATIVITY 17

T
hi
s
do
cu
m
en
t
is
co
py
ri
gh
te
d
by

th
e
A
m
er
ic
an

P
sy
ch
ol
og
ic
al
A
ss
oc
ia
ti
on

or
on
e
of

it
s
al
li
ed

pu
bl
is
he
rs
.

T
hi
s
ar
ti
cl
e
is
in
te
nd
ed

so
le
ly

fo
r
th
e
pe
rs
on
al
us
e
of

th
e
in
di
vi
du
al
us
er

an
d
is
no
t
to

be
di
ss
em

in
at
ed

br
oa
dl
y.

Thys, E., Sabbe, B., & De Hert, M. (2014). Creativity and psychopathol-
ogy: A systematic review. Psychopathology, 47(3), 141–147. https://doi
.org/10.1159/000357822

U.S. Census Bureau. (2019). Quick facts: United States. Race and
Hispanic Origin. https://www.census.gov/quickfacts/fact/table/U.S
./PST045219

Verhaeghen, P., Joorman, J., & Khan, R. (2005). Why we sing the blues:
The relation between self-reflective rumination, mood, and creativity.
Emotion, 5(2), 226–232. https://doi.org/10.1037/1528-3542.5.2.226

Verhaeghen, P., Joormann, J., & Aikman, S. N. (2014). Creativity, mood,
and the examined life: Self-reflective rumination boosts creativity,
brooding breeds dysphoria. Psychology of Aesthetics, Creativity, and the
Arts, 8(2), 211–218. https://doi.org/10.1037/a0035594

Wei, X., Yu, J. W., Shattuck, P., & Blackorby, J. (2017). High school math and
science preparation and postsecondary STEM participation for students with
an autism spectrum disorder. Focus on Autism and Other Developmental
Disabilities, 32(2), 83–92. https://doi.org/10.1177/1088357615588489

Wills, G. I. (2003). Forty lives in the bebop business: Mental health in a
group of eminent jazz musicians. The British Journal of Psychiatry,
183(3), 255–259. https://doi.org/10.1192/bjp.183.3.255

Wongpakaran, N., Wongpakaran, T., Wedding, D., & Gwet, K. L. (2013).
A comparison of Cohen’s Kappa and Gwet’s AC1 when calculating
inter-rater reliability coefficients: A study conducted with personality
disorder samples. BioMed Central Medical Research Methodology, 13,
61. https://doi.org/10.1186/1471-2288-13-61

Wuthrich, V., & Bates, T. C. (2001). Schizotypy and latent inhibition:
Non-linear linkage between psychometric and cognitive markers. Per-
sonality and Individual Differences, 30(5), 783–798. https://doi.org/10
.1016/S0191-8869(00)00071-4

Received December 10, 2020
Revision received July 22, 2021

Accepted August 13, 2021 n

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Linked Articles:
Bjorklund; doi: 10.1111/cdev.13019
Bjorklund; doi: 10.1111/cdev.13020
Frankenhuis and Tiokhin; doi: 10.1111/cdev.13021

Evolutionary Developmental Psychology: 2017 Redux

Cristine H. Legare
The University of Texas at Austin

Jennifer M. Clegg
Texas State University

Nicole J. Wen
The University of Texas at Austin

Bjorklund is a pioneer in bringing evolutionary
theory to developmental psychology. In doing so,
he has made major contributions to the field,
including publishing a widely adopted and influ-
ential textbook (Bjorklund & Causey, 2017). We
commend him for his groundbreaking research
and strongly agree that it is “undeniable that evolu-
tionary thinking has seeped into the minds of many
cognitive developmental psychologists” (Bjorklund,
2018, p. 14).

We suggest that evolutionary theory has
impacted developmental psychology even more
strongly than Bjorklund suggests. Many of the most
influential recent programs of research in the field
of developmental psychology, cognitive and other-
wise, take an evolutionary approach to understand-
ing the ontogeny of cognition and behavior (as just
a few recent examples: Barrett et al., 2013; Blake
et al., 2015; Broesch, Rochat, Olah, Broesch, & Hen-
rich, 2016; Clay & Tennie, 2017; Gopnik et al., 2017;
Hamlin, 2014; Henrich, 2015a; Heyes, in press;
House et al., 2013; Nielsen & Haun, 2016; Rosati &
Warneken, 2016; Santos & Rosati, 2015; van Leeu-
wen, Call, & Haun, 2014; Warneken & Tomasello,
2017; Wertz & Wynn, 2014). Additional evidence of
impact can be found in recent programs at major
conferences in the field. The Society for Research in
Child Development, the Cognitive Development
Society, and the International Congress for Infant

Studies have all featured evolutionary research in
preconferences and invited addresses in recent
years. In fact, evolution has been so successful as a
metatheory within developmental psychology,
many doing research within this tradition do not
use this label to identify their area of expertise or
theoretical approach.

Perhaps as a result of developmental psycholo-
gists conducting research that is increasingly guided
by evolutionary theory, but not explicitly labeled as
such, there is a large body of recent literature not
reviewed by Bjorklund. To give one example, the
best research on cognitive obstacles to understand-
ing evolution and recommendations for how to
teach it comes from research programs in cognitive
and developmental psychology that draw on evolu-
tionary theory. This research demonstrates that intu-
itive cognitive bias such as essentialism and
teleological reasoning impede understanding of evo-
lutionary concepts (e.g., Emmons, Smith, & Kele-
men, 2016; Evans, in press; Heddy & Sinatra, 2013;
Legare, Lane, & Evans, 2013; Lombrozo, 2013; Short
& Hawley, 2015; Shtulman, Neal, & Lindquist, 2016).

Another increasingly influential trend within
developmental, cognitive, and comparative research
guided by evolutionary theory, not covered in
Bjorklund’s review, is to examine the origins of
complexity and variability in human culture. Tack-
ling interdisciplinary questions of this kind requires
understanding the differences between human and

Commentary on Bjorklund (2017). Child Development.
Correspondence concerning this article should be addressed to

Cristine H. Legare, The University of Texas at Austin, Depart-
ment of Psychology, 1 University Station #A8000, Austin, TX,
78712. Electronic mail may be sent to [email protected]

© 2018 The Authors
Child Development © 2018 Society for Research in Child Development, Inc.
All rights reserved. 0009-3920/2018/8906-0026
DOI: 10.1111/cdev.13018

Child Development, November/December 2018, Volume 89, Number 6, Pages 2282–2287

nonhuman social learning capacities, the ontogeny
of those capacities, and their expression across
diverse human populations. We propose that only
the combination of these perspectives will enable us
to fully understand the roots of human culture. We
and others advocate for a triadic approach to
understanding the evolution and ontogeny of cul-
tural learning by integrating comparative, cross-
cultural, and developmental psychological research,
with all of these lines drawing heavily on evolu-
tionary theory (Legare, 2017; Nielsen & Haun,
2016).

Our research differs from Bjorklund’s not because
we disagree about the importance and impact of evo-
lutionary theory within developmental psychology,
but instead is based on the relative emphasis we
place on the scientific importance of understanding
cultural transmission and variation. Examining cul-
tural variation would enrich Bjorklund’s discussion
of developmental cognitive neuroscience and cogni-
tive development. Claims about the universality and
ontogeny of cognitive mechanisms without data on
global diversity are unwarranted (Nielsen, Haun,
Kaertner, & Legare, 2017). Prioritizing studying cul-
tural diversity in programs of research would also
encourage researchers to utilize cutting-edge and
state-of-the-art methodologies and tools, elevating
evolutionary developmental science programs.
Below we describe an example of a comparative,
cross-cultural, and developmental program of
research on cultural learning and social group cogni-
tion and behavior, all based on evolutionary theory.

Comparative Perspectives on Cultural Learning

Cultural variation in humans is unique among ani-
mals and differs dramatically even from our closest
primate relatives (Boyette & Hewlett, 2017; Henrich,
2015b; Lew-Levy, Reckin, Lavi, Crist�obal-Azkarate,
& Ellis-Davies, 2017; Mesoudi, Chang, Murray, &
Lu, 2015; Terashima & Hewlett, 2016). Here culture
is defined as “group-typical behaviors shared by
members of a community that rely on socially
learned and transmitted information” (Laland &
Hoppitt, 2003). Although nonhuman animals may
have the ability to learn social information (Aplin,
2015; Leadbeater, 2015; Perry et al., 2003; Plotnik,
Lair, Suphachoksahakun, & de Waal, 2011; White-
head & Rendell, 2015) and to transmit group-speci-
fic behavior (Cantor et al., 2015; Garland et al.,
2013; Laland & Galef, 2009), humans display a
much wider repertoire of socially acquired and
transmitted behaviors that vary more across groups

than nonhuman animals (Dean, Vale, Laland,
Flynn, & Kendal, 2014; Johnson-Pynn, Fragaszy, &
Cummins-Sebree, 2003).

How does human cognition differ from non-
human primate cognition? One potential candidate is
cross-species variation in social cognition (van Schaik
& Burkart, 2011). Our prolonged early development
also sets humans aside from other primates. As
Bjorklund and others suggest, natural selection
favored an extended childhood to allow for increased
flexibility in cognitive development (Bjorklund, 2018;
Bjorklund & Ellis, 2014). During this extended juve-
nile period, our offspring are dependent on adults
for survival, and in turn, this dependency increases
opportunities for interaction with caregivers and
enables social learning (Hublin, 2005).

The technological and social complexity of
human populations is due to our ability for cumu-
lative cultural transmission, a process by which the
discoveries and inventions of others are built upon
to create increasingly complex reserves of socially
heritable knowledge (Henrich, 2015b). Human psy-
chological flexibility allows us to build upon estab-
lished behaviors by relinquishing old solutions and
flexibly switching to more productive or efficient
ones (Davis, Vale, Schapiro, Lambeth, & Whiten,
2016). Evidence for culture in nonhuman species
continues to grow, but there is little evidence for
the accumulation of cultural innovation in nonhu-
man animals. Recent comparative research has
examined the development of social learning and
imitative flexibility across hominin evolutionary his-
tory (Whiten, 2017). Comparative research on this
topic will increase our knowledge of how cognitive
capacity may constrain young children’s and chim-
panzees’ learning potential and technological skill,
as well as elucidating the diverse learning heuristics
that children and chimpanzees employ. Although
largely absent from Bjorklund’s commentary, re-
search contrasting children’s and other primates’
social cognition adds to our understanding of the
origins of cumulative culture in humans and evolu-
tionary theory more broadly.

Development and Diversity of Cultural Learning

Young children are adept at acquiring the beliefs
and practices of whatever group they are born into,
a cognitive capacity that requires substantial flexi-
bility. We agree with Bjorklund that the sociocogni-
tive mechanisms that children display are not the
“derivatives of ‘hard’ cognition” but a set of critical
psychological adaptations in their own right

Evolutionary Developmental Psychology 2283

(Bjorklund, 2018, p. 15). For example, children have
a number of cognitive biases that aid in the acquisi-
tion of their specific cultural practices. These biases
include preferences for learning from those who are
from similar social groups (Kinzler, Dupoux, &
Spelke, 2007), those who conform (Haun & Over,
2014) and display behavioral or cognitive consensus
with others (Claidi�ere & Whiten, 2012; Corriveau,
Fusaro, & Harris, 2009; Herrmann, Legare, Harris,
& Whitehouse, 2013), and those who display
prestige (Chudek, Heller, Birch, & Henrich, 2012;
Henrich, 2009).

Missing from Bjorklund’s commentary on the
development of the sociocognitive brain and the
social brain hypothesis (Bjorklund, 2018, p. 15) is a
discussion of the flexibility and diversity of chil-
dren’s social learning. We argue that studying the
flexibility and diversity of children’s sociocognitive
development provides insight into the evolution
and ontogeny of human culture. This same flexibil-
ity and diversity provides an interesting evolution-
ary problem—if children’s capacity for social
learning explains cultural transmission, the psycho-
logical mechanisms should be universal, but these
psychological mechanisms must also be respon-
sive to diverse ontogenetic contexts and cultural
ecologies (Apicella & Barrett, 2016; Hrdy, 2009;
Legare & Harris, 2016; Nielsen et al., 2017). To
address this problem, we must first ask: H is cul-
ture acquired?

Children possess cognitive and communication
systems that evolved to acquire the complicated
technical and social skills characteristic of human
cultures. They are attentive to social input and learn
important skills and information through observa-
tion. Another way that children acquire cultural
knowledge and practices is through imitation. As
Bjorklund mentions, we know that children are also
precocious imitators and “overimitation” may be an
adaptive learning strategy to promote the high-fide-
lity acquisition and transmission of behavior. Is
high fidelity copying an adaptation that provides
the psychological foundation of human cultural
transmission? What is the function of imitation? We
have developed an integrated cognitive psychologi-
cal and ontogenetic account of how imitation and
innovation work in tandem to drive cultural learn-
ing and facilitate our capacity for cumulative cul-
ture. We propose that the unique demands of
acquiring instrumental skills (based on physical
causation) and rituals (based on social convention)
provide insight into when children imitate, when
they innovate, and to what degree. For instrumental
learning, with an increase in experience, high-fidelity

imitation decreases and innovation increases. In con-
trast, for conventional learning, imitative fidelity
stays high, regardless of experience, and innovation
stays low (Legare & Nielsen, 2015).

What distinguishes instrumental from ritual prac-
tices is a matter of interpretation based on contextual
information and social cues. We have used both
quantitative and qualitative methodologies to exam-
ine the kind of information children use to determine
when an event provides an opportunity for learning
instrumental skills versus learning cultural conven-
tions (Clegg & Legare, 2016b; Legare, Wen, Her-
rmann, & Whitehouse, 2015), the implications of
learning instrumental skills versus learning cultural
conventions for social group behavior (Watson-Jones
& Legare, 2016; Watson-Jones, Legare, Whitehouse,
& Clegg, 2014; Wen, Herrmann, & Legare, 2016), and
socialization of instrumental skills versus cultural
conventions in early childrearing environments
(Clegg & Legare, 2017; Clegg, Wen, & Legare, 2017).
Data from cross-cultural research have demonstrated
that children use imitation flexibly to acquire the
specific practices, beliefs, and values of their groups
(Clegg & Legare, 2016a).

To understand the ontogeny of human social
learning, we must examine how it changes over the
life span and how it varies in a strategically selected
set of cultural contexts that differ along theoretically
relevant variables. How do caregiver socialization
practices and the development of social learning
capacities enable and structure cumulative cultural
transmission? We are addressing the question by
studying the impact of diverse childrearing environ-
ments, practices, and social dynamics on the devel-
opment of cultural learning. For example, we
conduct research in educational settings and home
environments in both the United States (Austin,
Texas) and Vanuatu (Tanna; Clegg & Legare,
2016a). Vanuatu, a Melanesian island nation in the
South Pacific, is one of the most remote, culturally
and linguistically diverse, and understudied coun-
tries in the world. Vanuatu provides a unique
opportunity to explore the development of cultural
learning in populations that vary in extent of Wes-
tern influence. Conducting this research cross-cultu-
rally in Vanuatu and the United States allows us to
examine the imitative foundations of cultural learn-
ing in contexts that represent key aspects of the
diversity of human childrearing practices.

Humans are uniquely able to accumulate and
build upon the cultural innovations of previous
generations (Kurzban & Barrett, 2012; Pagel, 2012;
Pradhan, Tennie, & van Schaik, 2012; Whiten &
Erdal, 2012). Teaching and imitation work in tandem

2284 Legare, Clegg, and Wen

to conserve and transmit group-specific cultural
knowledge, increasing the likelihood for modifica-
tions and innovations, thus enhancing cultural com-
plexity (Enquist, Strimling, Eriksson, Laland, &
Sjostrand, 2010). Developing a comprehensive
understanding of teaching and imitation requires the
systematic study of cultural variation in childrearing
practices (Nielsen et al., 2017). We can enrich our
understanding of the developmental origins of
cumulative cultural transmission by conducting
cross-cultural research on cognitive and social devel-
opment (Legare & Harris, 2016).

In sum, comparative, developmental, and cross-
cultural research guided by evolutionary theory
provides insight into the evolution and ontogeny of
human cognition and behavior. Evolutionary theory
has made a profound and permanent impact on the
field of developmental psychology, shaping our
own research programs, as well as those of many
others. Bjorklund deserves substantial credit for this
striking scientific success story and should be feel-
ing very well indeed.

References

Apicella, C. L., & Barrett, H. C. (2016). Cross-cultural
evolutionary psychology. Current Opinion in Psychol-
ogy, 7, 92–97. https://doi.org/10.1016/j.copsyc.2015.08.
015

Aplin, L. M. (2015). Experimentally induced innovations
lead to persistent culture via conformity in wild birds.
Nature, 518, 538–541. https://doi.org/10.1038/nature
13998

Barrett, H. C., Broesch, T., Scott, R. M., He, Z., Baillargeon,
R., Wu, D., . . . Laurence, S. (2013). Early false-belief
understanding in traditional non-Western societies. Pro-
ceedings of the Royal Society B: Biological Sciences, 280,
20122654. https://doi.org/10.1098/rspb.2012.2654

Bjorklund, D. F. (2018). A metatheory for cognitive devel-
opment (or “Piaget is dead” revisited). Child Develop-
ment, 89, 2288–2302. https://doi.org/10.1111/13019

Bjorklund, D. F., & Causey, K. (2017). Children0s thinking:
Cognitive development and individual differences (6th ed.).
Thousand Oaks, CA: Sage.

Bjorklund, D. F., & Ellis, B. J. (2014). Children, childhood,
and development in evolutionary perspective. Develop-
mental Review, 34, 225–264. https://doi.org/10.1016/j.d
r.2014.05.005

Blake, P. R., McAuliffe, K., Corbit, J., Callaghan, T. C.,
Barry, O., Bowie, A., . . . Warneken, F. (2015). The
ontogeny of fairness in seven societies. Nature, 528,
258–261. https://doi.org/10.1038/nature15703

Boyette, A. H., & Hewlett, B. S. (2017). Teaching in hun-
ter-gatherers. Review of Philosophy and Psychology.
https://doi.org/10.1007/s13164-017-0347-2

Broesch, T., Rochat, P., Olah, K., Broesch, J., & Henrich, J.
(2016). Similarities and differences in maternal respon-
siveness in three societies: Evidence from Fiji, Kenya,
and the United States. Child Development. https://doi.
org/10.1111/cdev.12501

Cantor, M., Shoemaker, L. G., Cabral, R. B., Flores, C. O.,
Varga, M., & Whitehead, H. (2015). Multilevel animal
societies can emerge from cultural transmission. Nature
Communications, 6, 8091. https://doi.org/10.1038/nc
omms9091

Chudek, M., Heller, S., Birch, S., & Henrich, J. (2012).
Prestige-biased cultural learning: Bystander’s differen-
tial attention to potential models influences children’s
learning. Evolution and Human Behavior, 33(1), 46–56.
https://doi.org/10.1016/j.evolhumbehav.2011.05.005

Claidi�ere, N., & Whiten, A. (2012). Integrating the study
of conformity and culture in humans and nonhuman
animals. Psychological Bulletin, 138, 126–145. https://
doi.org/10.1037/a0025868

Clay, Z., & Tennie, C. (2017). Is overimitation a uniquely
human phenomenon? Insights from human children as
compared to bonobos. Child Development. https://doi.
org/10.1111/cdev.12857

Clegg, J. M., & Legare, C. H. (2016a). A cross-cultural
comparison of children’s imitative flexibility. Develop-
mental Psychology, 52, 1435–1444. https://doi.org/10.
1037/dev0000131

Clegg, J. M., & Legare, C. H. (2016b). Instrumental and con-
ventional interpretations of behavior are associated with
distinct outcomes in early childhood. Child Development,
87, 527–542. https://doi.org/10.1111/cdev.12472

Clegg, J. M., & Legare, C. H. (2017). Parents scaffold flexi-
ble imitation during early childhood. Journal of Experi-
mental Child Psychology, 153, 1–14. https://doi.org/10.
1016/j.jecp.2016.08.004

Clegg, J. M., Wen, N. J., & Legare, C. H. (2017). Is non-
conformity WEIRD? Cultural variation in adults’ beliefs
about children’s competency and conformity. Journal of
Experimental Psychology: General, 146, 428–441.
https://doi.org/10.1037/xge0000275

Corriveau, K. H., Fusaro, M., & Harris, P. L. (2009).
Going with the flow: Preschoolers prefer nondissenters
as informants. Psychological Science, 20, 372–377.
https://doi.org/10.1111/j.1467-9280.2009.02291.x

Davis, S. J., Vale, G. L., Schapiro, S. J., Lambeth, S. P., &
Whiten, A. (2016). Foundations of cumulative culture in
apes: Improved foraging efficiency through relinquish-
ing and combining witnessed behaviours in chim-
panzees (Pan troglodytes). Scientific Reports, 6, 35953.
https://doi.org/10.1038/srep35953

Dean, L. G., Vale, G. L., Laland, K. N., Flynn, E. G., &
Kendal, R. L. (2014). Human cumulative culture: A
comparative perspective. Biological Review Cambridge
Philosophical Society, 89, 284–301. https://doi.org/10.
1111/brv.12053

Emmons, N. A., Smith, H., & Kelemen, D. (2016). Chang-
ing minds with the story of adaptation: Strategies for
teaching young children about natural selection. Early

Evolutionary Developmental Psychology 2285

Education and Development, 27, 1205–1221. https://doi.
org/10.1080/10409289.2016.1169823

Enquist, M., Strimling, P., Eriksson, K., Laland, K., &
Sjostrand, J. (2010). One cultural parent makes no cul-
ture. Animal Behaviour, 79, 1353–1362. https://doi.org/
10.1016/j.anbehav.2010.03.009

Evans, E. M. (2016). Bridging the gap: From intuitive to
scientific reasoning-the case of evolution. In K. Rutten,
S. Blancke, & R. Soetaert (Eds.), Perspectives on science
and culture West Lafayette, IN: Purdue University
Press.

Garland, E. C., Gedamke, J., Rekdahl, M. L., Noad, M. J.,
Garrigue, C., & Gales, N. (2013). Humpback whale
song on the Southern Ocean feeding grounds: Implica-
tions for cultural transmission. PLoS ONE, 8. https://d
oi.org/10.1371/journal.pone.0079422

Gopnik, A., O’Grady, S., Lucas, C. G., Griffiths, T. L.,
Wente, A., Bridgers, S., . . . Dahl, R. E. (2017). Changes
in cognitive flexibility and hypothesis search across
human life history from childhood to adolescence to
adulthood. Proceedings of the National Academy of
Sciences of the United States of America, 114, 7892–7899.
https://doi.org/10.1073/pnas.1700811114

Hamlin, J. K. (2014). Context-dependent social evaluation
in 4.5-month-old human infants: The role of domain-
general versus domain-specific processes in the devel-
opment of social evaluation. Frontiers in Psychology, 5,
1–10. https://doi.org/10.3389/fpsyg.2014.00614

Haun, D. B. M., & Over, H. (2014). Like me: A homo-
phily-based account of human culture. In T. Breyer
(Ed.), Epistemological dimensions of evolutionary psychol-
ogy (pp. 117–130). New York, NY: Springer.

Heddy, B. C., & Sinatra, G. M. (2013). Transforming mis-
conceptions: Using transformative experience to pro-
mote positive affect and conceptual change in students
learning about biological evolution. Science Education,
97, 723–744. https://doi.org/10.1002/sce.21072

Henrich, J. (2009). The evolution of costly displays, coop-
eration and religion: Credibility enhancing displays and
their implications for cultural evolution. Evolution and
Human Behavior, 30, 244–260. https://doi.org/10.1016/
j.evolhumbehav.2009.03.005

Henrich, J. (2015a). Culture and social behavior. Current
Opinion in Behavioral Sciences, 3, 84–89. https://doi.org/
10.1016/j.cobeha.2015.02.001

Henrich, J. (2015b). The secret of our success: How culture is
driving human evolution, domesticating our species, and
making us smarter. Princeton, NJ: Princeton University
Press.

Herrmann, P. A., Legare, C. H., Harris, P. L., & White-
house, H. (2013). Stick to the script: The effect of witness-
ing multiple actors on children’s imitation. Cognition,
129, 536–543. https://doi.org/10.1016/j.cognition.2013.
08.010

Heyes, C. M. (in press). Enquire within: Cultural evolu-
tion and cognitive science. Philosophical Transactions of
the Royal Society: B.

House, B. R., Silk, J. B., Henrich, J., Barrett, H. C., Scelza,
B. A., Boyette, A. H., . . . Laurence, S. (2013). Ontogeny
of prosocial behavior across diverse societies. Proceed-
ings of the National Academy of Sciences of the United
States of America, 110, 14586–14591. https://doi.org/10.
1073/pnas.1221217110

Hrdy, S. B. (2009). Mothers and others: The evolutionary ori-
gins of mutual understanding. Cambridge, MA: Harvard
University Press.

Hublin, J. J. (2005). Evolution of the human brain and
comparative paleoanthropology. In S. Dehaene, J.-R.
Duhamel, M. D. Hauser, & G. Rizzolatti (Eds.), In from
monkey brain to human brain: A Fyssen Foundation sympo-
sium (pp. 57–71). Cambridge, MA: MIT Press.

Johnson-Pynn, J., Fragaszy, D., & Cummins-Sebree, S.
(2003). Common territories in comparative and devel-
opmental psychology: Quest for shared means and
meaning in behavioral investigations. International Jour-
nal of Comparative Psychology, 16, 1–27.

Kinzler, K. D., Dupoux, E., & Spelke, E. S. (2007). The native
language of social cognition. Proceedings of the National
Academy of Sciences of the United States of America, 104,
12577–12580. https://doi.org/10.1073/pnas.0705345104

Kurzban, R., & Barrett, H. C. (2012). Origins of cumula-
tive culture. Science, 335, 1056. https://doi.org/10.
1126/science.1219232

Laland, K. N., & Galef, B. (2009). The question of animal
culture. Cambridge, MA: Harvard University Press.

Laland, K. N., & Hoppitt, W. (2003). Do animals have
culture? Evolutionary Anthropology, 12, 150–159.
https://doi.org/10.1002/evan.10111

Leadbeater, E. (2015). What evolves in the evolution of
social learning? Journal of Zoology, 295(1), 4–11.
https://doi.org/10.1111/jzo.12197

Legare, C. H. (2017). Cumulative cultural learning:
Development and diversity. Proceedings of the National
Academy of Sciences of the United States of America, 114,
7877–7883. https://doi.org/10.1073/pnas.1620743114

Legare, C. H., & Harris, P. L. (2016). The ontogeny of cul-
tural learning. Child Development, 87, 633–642. https://
doi.org/10.1111/cdev.12542

Legare, C. H., Lane, J. D., & Evans, E. M. (2013). Anthro-
pomorphizing science: How does it affect the develop-
ment of evolutionary concepts? Merrill-Palmer Quarterly,
59, 168–197. https://doi.org/10.1353/mpq.2013.0009

Legare, C. H., & Nielsen, M. (2015). Imitation and innova-
tion: The dual engines of cultural learning. Trends in
Cognitive Sciences, 19, 688–699. https://doi.org/10.
1016/j.tics.2015.08.005

Legare, C. H., Wen, N. J., Herrmann, P. A., & White-
house, H. (2015). Imitative flexibility and the develop-
ment of cultural learning. Cognition, 142, 351–361.
https://doi.org/10.1016/j.cognition.2015.05.020

Lew-Levy, S., Reckin, R., Lavi, N., Crist�obal-Azkarate, J.,
& Ellis-Davies, K. (2017). How do hunter-gatherer chil-
dren learn subsistence skills? Human Nature. https://
doi.org/10.1007/s12110-017-9302-2

2286 Legare, Clegg, and Wen

Lombrozo, T. (2013). Evolution challenges: Integrating
research and practice in teaching and learning about
evolution. Reports of the National Center for Science Edu-
cation, 33, 5.

Mesoudi, A., Chang, L., Murray, K., & Lu, H. J. (2015).
Higher frequency of social learning in China than in
the West shows cultural variation in the dynamics of
cultural evolution. Proceedings of Biological Sciences, 282,
20152209.

Nielsen, M., & Haun, D. (2016). Why developmental psy-
chology is incomplete without comparative and cross-
cultural perspectives. Philosophical Transactions of the
Royal Society of London. Series B, Biological Sciences, 371,
20150071. https://doi.org/10.1098/rstb.2015.0071

Nielsen, M., Haun, D. B. M., Kaertner, J., & Legare, C. H.
(2017). The persistent sampling bias in developmental
psychology: A call to action. Journal of Experimental
Child Psychology, 162, 32–38.

Pagel, M. (2012). Evolution: Adapted to culture. Nature,
482, 297–299. https://doi.org/10.1038/482297a

Perry, S., Baker, M., Fedigan, L., Gros-Louis, J., Jack, K.,
MacKinnon, K. C., . . . Rose, L. (2003). Social conven-
tions in wild white-faced capuchin monkeys: Evidence
for traditions in a neotropical primate. Current Anthro-
pology, 44, 241–268. https://doi.org/10.1086/345825

Plotnik, J. M., Lair, R., Suphachoksahakun, W., & de Waal,
F. B. M. (2011). Elephants know when they need a help-
ing trunk in a cooperative task. Proceedings of the National
Academy of Sciences of the United States of America, 108,
5116–5121. https://doi.org/10.1073/pnas.1101765108

Pradhan, G. R., Tennie, C., & van Schaik, C. P. (2012).
Social organization and the evolution of cumulative
technology in apes and hominins. Journal of Human Evo-
lution, 63, 180–190. https://doi.org/10.1016/j.jhevol.
2012.04.008

Rosati, A. G., & Warneken, F. (2016). How comparative psy-
chology can shed light on human evolution: Response to
Beran et al.’s discussion of “Cognitive capacities for
cooking in chimpanzees.” Learning & Behavior, 44,
109–115. https://doi.org/10.3758/s13420-016-0220-7

Santos, L. R., & Rosati, A. G. (2015). The evolutionary
roots of human decision making. Annual Review of Psy-
chology, 66, 321–347. https://doi.org/10.1146/annurev-
psych-010814-015310

Short, S. D., & Hawley, P. H. (2015). The effects of evolu-
tion education: Examining attitudes toward and knowl-
edge of evolution in college courses. Evolutionary
Psychology, 13(1), 67–88. https://doi.org/10.1177/
147470491501300105

Shtulman, A., Neal, C., & Lindquist, G. (2016). Children’s
ability to learn evolutionary explanations for biological
adaptation. Early Education and Development, 27, 1222–
1236. https://doi.org/10.1080/10409289.2016.1154418

Terashima, H., & Hewlett, B. S. (2016). Social learning and
innovation in contemporary hunter-gatherers. Springer.
Retrieved from http://www.springer.com/series/11816

van Leeuwen, E. J. C., Call, J., & Haun, D. (2014). Human
children rely more on social information than chim-
panzees do. Biology Letters, 10, 20140487. https://doi.
org/10.1098/rsbl.2014.0487

van Schaik, C. P., & Burkart, J. M. (2011). Social learning
and evolution: the cultural intelligence hypothesis. Phi-
losophical Transactions of the Royal Society B: Biological
Sciences, 366, 1008–1016. http://doi.org/10.1098/rstb.
2010.0304

Warneken, F., & Tomasello, M. (2017). Altruistic helping
in human infants and young chimpanzees. Science,
311, 1301–1303. https://doi.org/10.1126/science.
1121448

Watson-Jones, R. E., & Legare, C. H. (2016). The social
functions of group rituals. Current Directions in Psycho-
logical Science, 25(1), 42–46. https://doi.org/10.1177/
0963721415618486

Watson-Jones, R. E., Legare, C. H., Whitehouse, H., &
Clegg, J. M. (2014). Task-specific effects of ostracism on
imitative fidelity in early childhood. Evolution and
Human Behavior, 35, 204–210. https://doi.org/10.1016/
j.evolhumbehav.2014.01.004

Wen, N. J., Herrmann, P. A., & Legare, C. H. (2016).
Ritual increases children’s affiliation with in-group
members. Evolution and Human Behavior, 37, 54–60.
https://doi.org/10.1016/j.evolhumbehav.2015.08.002

Wertz, A. E., & Wynn, K. (2014). Thyme to touch: Infants
possess strategies that protect them from dangers
posed by plants. Cognition, 130(1), 44–49. https://doi.
org/10.1016/j.cognition.2013.09.002

Whitehead, H., & Rendell, L. (2015). The cultural lives of
whales and dolphins. Chicago, IL: University of Chicago
Press.

Whiten, Andrew (2017). Culture extends the scope of evo-
lutionary biology in the great apes. Proceedings of the
National Academy of Sciences, 114(30), 7790–7797. http://
www.pnas.org/content/114/30/7790.

Whiten, A., & Erdal, D. (2012). The human socio-cogni-
tive niche and its evolutionary origins. Philosophical
Transactions of the Royal Society of London B: Biological
Sciences, 367, 2119–2129. https://doi.org/10.1098/rstb.
2012.0114

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Journal of Humanistic Psychology
2020, Vol. 60(6) 934 –958

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Regular Article

Maslow’s
Unacknowledged
Contributions to
Developmental
Psychology

Andrew M. Bland1 and Eugene M. DeRobertis2,3

Abstract
Few readily identify Maslow as a developmental psychologist. On the other
hand, Maslow’s call for holistic/systemic, phenomenological, and dynamic/
relational developmental perspectives in psychology (all being alternatives to
the limitations of the dominant natural science paradigm) anticipated what
emerged both as and in the subdiscipline of developmental psychology. In
this article, we propose that Maslow’s dynamic systems approach to healthy
human development served as a forerunner for classic and contemporary
theory and research on parallel constructs in developmental psychology
that provide empirical support for his ideas—particularly those affiliated
with characteristics of psychological health (i.e., self-actualization) and the
conditions that promote or inhibit it. We also explore Maslow’s adaptation
of Goldstein’s concept of self-actualization, in which he simultaneously: (a)
explicated a theory of safety versus growth that accounts for the two-steps-
forward-one-step-back contiguous dynamic that realistically characterizes
the ongoing processes of being-in-becoming and psychological integration
in human development/maturity and (b) emphasized being-in-the-world-with-
others with the intent of facilitating the development of an ideal society

1Millersville University, Millersville, PA, USA
2Brookdale College, Lincroft, NJ, USA
3Rutgers University–Newark, Newark, NJ, USA

Corresponding Author:
Eugene M. DeRobertis, Department of Psychology, Brookdale College, MAN 126c, Lincroft,
NJ 07738, USA.
E-mail: [email protected]

739732 JHPXXX10.1177/0022167817739732Bland and DeRobertisBland and DeRobertis
research-article2017

Bland and DeRobertis 935

by promoting protective factors that illustrate Maslow’s safety, belonging,
and esteem needs. Finally, we dialogue with the extant literature to clarify
common misgivings about Maslow’s ideas.

Keywords
Maslow, self-actualization, developmental psychology, dynamic systems

Few readily identify Maslow as a developmental psychologist. Both he and
the humanistic movement are almost always excluded from developmental
textbooks (DeRobertis, 2008), and an EBSCO search in February 2017
yielded a dearth of relevant articles. In the rare instances in which Maslow is
included, his ideas are typically misrepresented. On the other hand, as we
have previously suggested (Bland & DeRobertis, 2017; DeRobertis, 2012),
Maslow and other founding humanistic psychologists’ calls for holistic/sys-
temic, phenomenological, and dynamic/relational developmental perspec-
tives in psychology (as alternatives to the dominant natural science paradigm)
anticipated what emerged both as and in the subdiscipline of developmental
psychology. Accordingly, herein, we propose that classic and contemporary
theory and research in developmental psychology provide empirical support
for Maslow’s ideas, particularly those affiliated with characteristics of psy-
chological health (i.e., self-actualization) and the factors that promote or
inhibit it.

Maslow (1999) observed that “from a developmental point of view,” self-
actualizing individuals “are more fully evolved” insofar as they are “not fix-
ated at immature or incomplete levels of growth” (p. 172). They strive toward
“unity of personality” and “spontaneous expressiveness” as well as “seeing
the truth rather than being blind,” “being creative,” and demonstrating “seren-
ity, kindness, courage, honesty, love, unselfishness, and goodness” (Maslow,
1999, p. 171). Using growth and health as his baseline, Maslow helped usher
in a focus on normative and transformative developmental processes in psy-
chology. At the same time, he acknowledged the role of regressive forces and
the potential for stagnation, often as the outcome of inadequate environmen-
tal conditions.

Maslow’s Developmentally Oriented Adaptation of
Goldstein’s Self-Actualization

Maslow (1987) adapted the construct of self-actualization from Goldstein, an
organismic-oriented neurologist–psychiatrist. According to Whitehead (2017),

936 Journal of Humanistic Psychology 60(6)

Goldstein’s construct was built on three axioms. First, self-actualization refers
to a process of individuation (i.e., the ongoing emergence and regeneration of
a self as an active, creative authority distinct from other biochemical systems)
that, second, must be conceptualized holistically and not in isolation (i.e., it is
only through the organism–environment relationship that the meaning behind
behavior, pathology, personality, motivation, emotion, etc., can be under-
stood). Third, Goldstein proposed that behavior is invariantly motivated in
terms of self-actualization (i.e., is not synonymous with tension reduction or
mere self-preservation or survival).

Whereas Goldstein (1934/1995, 1963) primarily focused on self-actual-
ization vis-à-vis the resilient reorganization of a person’s capacities in
response to brain injury or psychopathology, Maslow further included over-
coming obstacles (real and perceived) and living authentically despite one’s
personal, environmental, and historical shortcomings as functions of healthy
development. Maslow (1999) explicated a theory of safety versus growth
that accounts for the two-steps-forward-one-step-back contiguous dynamic
that realistically characterizes the ongoing process of being-in-becoming
and of graded experiential awareness and psychological integration in
human maturity. Beginning in childhood and continuing throughout the
lifespan, individuals negotiate a dialectic between homeostasis (i.e., defen-
sively clinging to the familiar and predictable, irrespective of how stagnant,
disappointing, or precarious the outcome) and morphogenic enactment “of
all [their] capacities, toward confidence in the face of the external world at
the same time that [they] can accept [their] deepest, real, unconscious Self”
(Maslow, 1999, p. 55).

Maslow challenged the classical Freudian assumption of homeostasis as
an end state. Instead, like Erikson (1959/1994), he argued that “healthy chil-
dren enjoy growing and moving forward, gaining new skills, capacities and
powers” that evolve into “authentic selfhood, [i.e., knowing] what one really
wants and doesn’t want, what one is fit for and what one is not fit for”
(Maslow, 1999, pp. 30, 213). Taken together, Maslow’s focus on the dialecti-
cal relationship between a process of continuous improvement and ongoing
integration, organization, and self-consistency (see Frick, 1971) reflects
Goldstein’s aforementioned first axiom.

In addition, Maslow emphasized that self-actualization entails a sense of
being-in-the-world-with-others, interindividuality, community feeling, and
interest in making changes for an ideal society. These points are synonymous
with Adler’s (1931/1998) social interest and parallel Erikson’s (1959/1994)
emphasis on participating in (rather than struggling against) society as both
conducive to and reflective of healthy social and emotional development.
Maslow distinguished between uniqueness and distinctiveness in relation to

Bland and DeRobertis 937

others (Koydemir, Şimşek, & Demir, 2014), drawing from and making best
use of one’s potentials to benefit the collective:

Authentic or healthy [individuals] may be defined not . . . by [their] own
intrapsychic and non-environmental laws, not as different from the
environment, independent of it or opposed to it, but rather in environment-
centered terms. . . . Self-actualization . . . paradoxically makes more possible
the transcendence of . . . self-consciousness and of selfishness. It makes it
easier for [one] . . . to merge as a part in a larger whole. (Maslow, 1999, pp.
199, 231, italics added in first sentence)

This relational viewpoint is commensurate with Goldstein’s second axiom.
With regard to Goldstein’s third axiom, Maslow (1987) eschewed reduc-

tionistic explanations of behavior and emphasized that behavior is “overde-
termined or multimotivated,” reflecting combinations of needs in striving
toward self-actualization. As an organizing principle, Maslow (1987, 1999)
proposed a hierarchical structure from physiological to security to belonging
to self-esteem. Each set of needs is gratified on a continuum from more exter-
nalized (lower, more basic needs) to more intrinsic (higher, more idiosyn-
cratic needs). Furthermore, Maslow (1999) emphasized that one’s essential
“core” involves “potentialities, not final actualizations” that are “weak, sub-
tle, and delicate, very easily drowned out by learning, by cultural expecta-
tions, by fear, by disapproval, etc.” and can therefore become “forgotten,
[i.e.,] neglected, unused, overlooked, unverbalized, or suppressed” (pp. 212-
213). To illustrate:

[Children] who [are] insecure, basically thwarted, or threatened in [their] needs
for safety, love, belongingness, and self-esteem . . . will show more selfishness,
hatred, aggression, and destructiveness. . . . This implies a reactive, instrumental,
or defensive interpretation of hostility rather than an instinctive one. (Maslow,
1987, p. 86)

Maslow (1987) emphasized that fulfillment of the basic needs is neither a
lockstep progression nor confined to specific ages/phases of life, but rather is
a holistic process:

[The statement that] if one need is satisfied, then another emerges . . . might
give the false impression that a need must be satisfied 100% before the next
need emerges. In actual fact, most [individuals] are partially satisfied in all
their basic needs and partially unsatisfied in all their basic needs at the same
time. A more realistic description of the hierarchy would be in terms of
decreasing percentages of satisfaction as we go up the hierarchy of prepotency.

938 Journal of Humanistic Psychology 60(6)

. . . The emergence [of a new need] is not a sudden, saltatory phenomenon, but
rather a gradual emergence by slow degrees. (pp. 27-28, italics added)

Thus, Rowan (1999) used the analogy of Russian nesting dolls to illustrate
the idea that the lower needs are transcended but also included within the
higher ones, that is, they are never lost.

Dynamic Systems Developmental Orientation

Perhaps one reason that Maslow is not typically included in developmental
textbooks and research articles is that his quotidian vision of psychology as a
human science was not fully congruent with either discontinuous stage mod-
els or the continuous, quantitatively driven perspectives that constituted the
majority of the traditional developmental psychology literature during the
second half of the 20th century. Meantime, taken out of context, his emphasis
on self-actualization reeks of Western individualism and therefore generally
has been dismissed (or, at best, overlooked) by most sociocultural theorists in
the new millennium. On the other hand, during the past decade, dynamic
systems models—the paradigm with which Maslow’s (1987) “holistic-
dynamic” thinking aligned (p. 15)—have gained legitimacy in psychology
(see Bland & Roberts-Pittman, 2014; DeRobertis, 2011b; Gelo & Salvatore,
2016), and they were included as a theoretical category in Bergen’s (2008)
textbook on human development.

Dynamic systems models incorporate concepts of complexity, plasticity,
and recursive nested features (Bergen, 2008). Maslow (1971) emphasized
that self-actualizing should be conceptualized iteratively (i.e., as a verb) and
not as an achievement or trait (i.e., as a noun). Moreover, dynamic systems
models are built on the assumptions that (a) complex, chaotic systems (e.g.,
human beings) have the ability to self-organize into purposeful behaviors and
that (b) sensitive dependence on initial conditions—in which a small input in
a system may yield disparate results—can explain developmental change
(Bergen, 2008). Maslow (1987) accounted for the possibility of quantum
leaps in development, in which significant changes at one need level can
incite substantive changes at the subsequent levels.

Congruent with Maslow’s aforementioned safety versus growth principle
(two-steps-forward-one-step-back), Skalski and Hardy (2013) noted that
such quantum transformation is typically propagated by individuals’ under-
standings of themselves and the world becoming disintegrated by stress, rela-
tional difficulties, hopelessness, losing control/holding on, and psychological
turmoil and then enhanced by the presence of a trusted other who provides
corrective experiences (see Bland, 2014; Castonguay & Hill, 2012). To

Bland and DeRobertis 939

illustrate, DeRobertis’ (2016) study on children’s education implied that
quality teachers can serve not only as extensions of attachment relationships
(when they already exist) but also as surrogates thereof (when they do not).
In addition, whereas Graber, Turner, and Madill (2015) hypothesized that
during adolescence family support would moderate the significance of friend-
ships as a risk or protective mechanism, they discovered instead that, irre-
spective of family, having just one fulfilling friendship prevents relational,
emotional, and behavior problems.

Furthermore, dynamic systems models can be characterized as prototheo-
retical rather than fully developed, falsifiable theories and are supported by
research methods that involve collecting minute process data (Bergen, 2008).
Maslow’s aforementioned initial study on the characteristics of self-actualiz-
ing people (included in Maslow, 1987) and his research on peak experiences
(included in Maslow, 1999) employed iterative qualitative analyses (see Wertz
et al., 2011). These involved him extracting themes from biographies and
interviews with purposive samples to critically catalog and describe their
common attributes which he then triangulated with extant theory and empiri-
cal research in conjunction with quantitative and qualitative studies he had
conducted during his early career (see Hoffman, 1988; Maslow, 1973).
Maslow’s emphases on self-actualization and on values in psychology set the
stage for psychologists acknowledging the realities of plasticity and of multi-
dimensional, multidirectional developmental principles that value the whole
person in context and that are now underscored in developmental textbooks
(e.g., Capuzzi & Stauffer, 2016; Music, 2017). It is crucial to note that
Maslow’s theories were built as an outcome of his research (not the other way
around), that he was flexible, open to criticism, and constantly expanding and
revising his ideas, and that he emphasized the need for them to be empirically
tested and reworked as appropriate (see Frick, 1971; Maslow, 1971, 1999).

Finally, Maslow’s nonexclusive vision also paved the way for develop-
mental psychology’s resolution of long-held (stereotypically Western) con-
ceptual bifurcations (see Music, 2017). For example, with regard to nature
versus nurture, Maslow (1987) remarked as follows:

How can it be said that a complex set of reactions is either all determined by
heredity or not at all determined by heredity? There is no structure, however,
simple . . . that has genetic components alone. At the other extreme it is also
obvious that nothing is completely free of the influence of heredity, for humans
are a biological species. (p. 48)

Maslow (1966, 1971, 1987, 1999) also emphasized moving beyond the antin-
omies of free will versus determinism, continuity versus change, universality

940 Journal of Humanistic Psychology 60(6)

versus cultural specificity, and experimentalism versus experientialism in
understanding human development.

Classic and Contemporary Empirical Support

Physiological

Maslow’s working class upbringing as the eldest son of Russian Jewish
immigrants influenced his lifelong focus on social justice (Hoffman, 1988).
According to Anne Richards (personal communication, 2003), in his classes
during the 1960s, Maslow advocated for the development of reduced-price
meals in schools (now a given in most communities in the United States) as a
means of minimizing obstacles to impoverished children’s growth and
empowerment. Maslow’s suggestion brought awareness of how issues of
social policy and both availability and quality of resources at Bronfenbrenner’s
(1994) exosystemic, macrosystemic, and chronosystemic levels influence
individuals’ development, whereas the principal focus of psychology at mid-
20th century was almost exclusively at the individual and microsystemic
levels.

Accordingly, since Maslow’s day, developmental researchers have come
to emphasize the connections between malnutrition and children’s: (a) ability
to sustain attention (which in turn affects cognitive development and aca-
demic performance); (b) levels of irritability and self-regulation (which affect
social development); and (c) propensity to diagnosable mental health condi-
tions as well as susceptibility to infectious disease, obesity, and eventual dia-
betes and heart issues (as summarized in Arnett, 2016; Broderick & Blewitt,
2015). Congruent with the dynamic systems assumption that a small change
can spawn sustentative outcomes, Broderick and Blewitt (2015) commented,
“When we intervene to reduce one risk factor, such as malnutrition, we may
actually [also] reduce the impact of other negative influences” (p. 56). In
addition, Prince and Howard (2002) extended Maslow’s thinking on the
developmental implications of physiological needs to include access to ade-
quate health care, insurance, and living environments safe from toxicity (e.g.,
exposure to lead). Furthermore, Desmond’s (2016) ethnographic research
addressed the systemic challenges in tenants’, landlords’, and social service
agencies’ abilities to uphold sustainable living environments and the devel-
opmental impacts for both children and adults.

Maslow (1987; Maslow & Mittelmann, 1951) also noted that healthy
growth and development involves not only gratification of the basic needs
but also the ability to withstand reasonable deprivation. “Increased frustra-
tion tolerance through early gratification” enables individuals to “withstand

Bland and DeRobertis 941

food deprivation” because they “have been made secure and strong in the
earliest years,” which reciprocates into them remaining secure and strong
thereafter (Maslow, 1987, p. 27). As applied to the physiological needs,
Erikson (1959/1994) suggested that a developmental task of infancy is to
establish confidence in one’s caregivers to eventually attend to one’s needs
even if caregivers are unable to drop what they are doing the moment one
expresses a need. Accordingly, secure interactions between parent and child
moderate the relationship between low socioeconomic status and develop-
mental outcomes (Bronfenbrenner, 1994).

Safety

Maslow (1987) defined the safety needs as “security; stability; dependency;
protection; freedom from fear, anxiety, and chaos [and] need for structure,
order, law, and limits” (p. 18). In contrast with conventional wisdom in (par-
ticularly) American parenting practices that emphasize independence as
quickly as possible, models such as attachment parenting (Miller & Commons,
2010) promote the value of strong bonding early in life, congruent with less
ruggedly individualistic cultures around the globe (see Maté, 2011; Morelli &
Rauthbaum, as cited in Arnett, 2016). Researchers have noted that such
highly responsive caregiving practices: (a) mitigate potentially overwhelm-
ing negative emotional states (e.g., preventable fear, anger, distress) and
therefore propagate appropriate emotional regulation; (b) reduce exposure to
stressors that adversely affect brain development and self-regulation and that
contribute to eventual mental health problems; (c) are associated with fewer
expressions of distress; and (d) promote empathy, perspective-taking, social
competence, cooperative behavior, and engagement in school life (see
Broderick & Blewitt, 2015; Campa, 2013; Miller & Commons, 2010). In
contrast, executive functioning becomes impaired “when young children are
exposed to chronically stressful situations” insofar as:

the brain development of the lower portions of the brain, responsible for “fight
or flight” reactions, are strengthened while the development in the cortex
regions of the brain, which are responsible for functions such as abstract and
rational thinking, are weakened. (Prince & Howard, 2002, pp. 29-30)

Thus, paradoxically, a strong sense of attachment early on facilitates
appropriate levels of differentiation of self (Bowen, 1978; Firestone,
Firestone, & Catlett, 2013) and autonomy (Erikson, 1959/1994)—all of
which include mindful self-regulation and approaching unfamiliar situations
with curiosity and interest rather than as threatening. Accordingly, they are

942 Journal of Humanistic Psychology 60(6)

conducive to self-sufficiency (comfort in one’s skin and with one’s own
beliefs, attitudes, and preferences) and assertiveness (vs. aggression, passiv-
ity, or passive-aggression).

Attachment. Secure attachment (Ainsworth, as summarized and updated in
Siegel, 2012; also see Music, 2017), marked by caregivers’ sensitivity and
responsiveness to infants’ cues, is associated with curiosity and differentia-
tion of self by early childhood (i.e., preschool and kindergarten age), with
positive social interactions and stronger academic performance during school
age, and with appropriate self-esteem and a strong sense of identity as adults
(all prerequisites for, though not necessarily characteristics of, self-actualiz-
ing, Maslow, 1987). On the other hand, with respect to insecure attachment,
Maslow observed that when safety needs are not met, behavior and motiva-
tion are disposed to stagnation or regression:

Since others are so important and vital for the helpless baby and child, fear of
losing them (as providers of safety, food, love, respect, etc.) is a primal,
terrifying danger. Therefore [children], faced with a difficult choice between
[their] own delight experiences and the experience of approval from others,
must generally choose approval from others, and then handle [their] delight by
repression or letting it die, or not noticing it or controlling it by willpower. In
general, along with this will develop a disapproval of the delight experience, or
shame and embarrassment and secretiveness about it, with finally, the inability
to even experience it. (Maslow, 1999, pp. 59-60)

This can lend itself to rigidity; to efforts to distract oneself from inner experi-
ence (Frankl, 1978; Harris, 2006); to engagement in addictive and/or compul-
sive behaviors as surrogates for meaningful interaction (Maté, 2010); and/or
to involvement in (sometimes precarious) relationships (Campa, 2013) and/or
institutional affiliations (May, 1967) that offer the illusion of security.

Parenting Styles. Maccoby and Martin (1983) noted that authoritative parent-
ing (see Gordon, 1975; Shapiro & White, 2014)—characterized by a balance
of emotional warmth and high expectations (demandingness); associated
with secure attachment and, later, identity achievement (Erikson, 1959/1994;
Marcia, 1966)—promotes the development of assertiveness, competence and
self-confidence, social responsibility, healthy achievement orientation, adapt-
ability, and so on (all qualities of Maslovian self-actualizing people). In con-
trast, children of authoritarian parents (high demandingness, low warmth;
associated with avoidant attachment and, later, identity foreclosure) are prone
to conformity, dependency, perfectionism, resentful anxiety, and susceptibil-
ity to bullying. Children of permissive/indulgent parents (high warmth, low

Bland and DeRobertis 943

demandingness; associated with ambivalent attachment and, later, chronic
moratorium) are at risk for becoming impulsive, egocentric, low in self-reli-
ant decision making, underachieving, and easily frustrated by authority
(being unaccustomed to structure). Neglectful/uninvolved parenting (low
warmth and low demandingness; associated with disorganized attachment
and, later, identity diffusion) is predictive of delinquency and children devel-
oping a symptomatic presentation consisting of both externalizing (impulsiv-
ity, aggression) and internalizing (moodiness, low self-esteem) qualities.

Maslow (1999) alluded to authoritative parenting by saying that children
should “be directed . . . both toward cultivation of controls and cultivation of
spontaneity and expression” (p. 219) and noted that “youngsters need a world
that is just, fair, orderly, and predictable” and that “only strong parents can
supply these important qualities” (Maslow, 1996, p. 46). Maslow also cau-
tioned against both excessively authoritative and permissive parenting styles.
With regard to the former, Maslow (1999) suggested as follows:

It is necessary in order for children to grow well that adults have enough trust
in them and in the natural processes of growth, i.e., [to] not interfere too much,
not make them grow, or force them into predetermined designs, but rather let
them grow and help them grow in a Taoistic rather than an authoritarian way.
(p. 219)

With regard to the dangers of permissive parenting:

Children, especially younger ones, essentially need, want, and desire external
controls, decisiveness, discipline, and firmness . . . to avoid the anxiety of being
on their own and of being expected to be adultlike because they actually
mistrust their own immature powers. (Maslow, 1996, p. 45)

Maslow (1971) continued that this anxiety eventually manifests into the
defense mechanism of desacrilizing (i.e., mistrusting the possibility of values
and virtues associated with self-actualization) based on having felt “swindled
or thwarted in their lives” and therefore coming to “despise their elders” (p.
48). Similarly, Horney (1945) proposed that to deal with this anxiety, based
on their particular formative experiences, individual children develop means
of coping via moving toward others (compliance), against them (aggression),
or away from them (withdrawal).

Love and Belonging

Maslow (1987) conceptualized the love needs as “giving and receiving affec-
tion” without which one “will hunger for relations with people in general—for

944 Journal of Humanistic Psychology 60(6)

a place in the group or family—[because] the pangs of loneliness, ostracism,
rejection, friendlessness, and rootlessness are preeminent” (pp. 20-21). He
(Maslow & Mittelmann, 1951) continued that love needs include the abilities
to form sustainable emotional ties; to empathize, enjoy oneself, and laugh with
(vs. at) others; and to express resentment without losing control (i.e., one can
love others and be angry with them at the same time), as well as having valid
reasons for being unhappy (vs. harboring resentment). Concerning the place-
ment of love and belonging at the same hierarchical level, he stated, “It is clear
that, other things being equal, a person who is safe and belongs and is loved
will be healthier . . . than one who is safe and belongs, but who is rejected and
unloved” (Maslow, 1987, p. 38). For an example of the latter, consider gang or
cult membership.

Sociometric Status. Coie and Dodge (1988) and subsequent researchers explored
the relationship between how children are perceived by their peers (i.e., liked
vs. disliked) and their behavior. Popular children, most often rated as liked by
their peers, tend to be cooperative, friendly, sociable, and interpersonally sensi-
tive. Rejected children, typically boys, are most often rated as disliked and
rarely as liked by peers. They fall into one of two groups: (a) rejected-aggres-
sive children (most typical), who have reputations for bullying and disruptive-
ness and (b) rejected-withdrawn children (about 10% to 20% of cases), who are
perceived by others as depressed. Neglected children, typically girls, are rated
neither as liked nor disliked; however, their peers typically misremember them.
Average children are not rated at either extreme (they are neither popular nor
unpopular) but they are known for being socially skilled. Finally, controversial
children are rated as liked by some and disliked by others; they have reputa-
tions as class clowns and as leaders with disregard for social rules.

Ollendick, Weist, Borden, and Greene (1992) noted that teachers tend to
rate rejected children at highest risk of engaging in problematic behaviors
during ninth grade based on their sociometric status at fourth grade, followed
by, in order, controversial, neglected, and popular children—and average
children at minimal risk. With regard to actual engagement in behaviors that
led to suspension or legal issues, rejected children were highest. Perhaps
more notably, 20% of average children dropped out, whereas none of the
neglected children dropped out. Arguably, teachers’ reaching out to children
who had been neglected by their peers may have contributed to a sense of
belonging. In contrast, the average children, being overlooked by both teach-
ers and peers, were less likely to “identify with the establishments of schools”
and therefore drop out due to feeling “out of place” (Prince & Howard, 2002,
p. 30). Furthermore, Prinstein (2017) differentiated between popularity and
likability; Maslow would have regarded the former as deficiency (D-) love/

Bland and DeRobertis 945

belonging, and the latter as indicative of appropriately fulfilled (being, B-)
love/belonging.

Identity, Intimacy, and Generativity. Maslow’s love and belonging needs also are
implicated in Erikson’s (1959/1994) developmental tasks of adolescence and
adulthood. The mission of adolescence is to search for and settle on a sense
of stability and continuity in individuals’ personality amid confusion, change,
and uncertainty. One dimension of identity development is clarification of
their values and vocation—not only to earn money but also to strive for an
honest sense of accomplishment within the lens of their culture. Like Maslow
(1971, 1999), Erikson cautioned that American society’s overemphasis on
standardization and conformity places adolescents at risk of helplessness and
foreclosure, while its oversaturation of choices begets stagnation and avoid-
ance of responsibility. On the other hand, when the process goes well, adoles-
cents arrive at a sense of belonging and of congruence between their actual
self and the contributions they make to their society by employing their
potentials and abilities. Also, they become more at ease in multiple roles
across several life domains (e.g., work, family, community, etc.). Cordeiro,
Paixão, Lens, Lacante, and Luyckx (2016) noted that Portuguese adolescents’
perceived parental support (Maslow’s love/belonging) is a protective factor
in career decision making, while parental thwarting is a risk factor. Both are
mediated by adolescents’ subjective feelings of having their love/belonging
needs met, which result in either confidence in proactive exploration and
commitment making or in endless rumination over identity options.

As individuals enter adulthood, the development during childhood and
adolescence of a strong sense of self is necessary to merge identities with
another in a loving adult relationship without fear of losing their own identity,
autonomy, and integrity. Erikson (1959/1994) noted that disconnection and
repeated failed marriages arise out of failure to establish an intimate connec-
tion. On the other hand, when the process goes well, individuals are able to
engage in authentic relationships (vs. overly formal or stereotyped ones and/
or isolation). By middle adulthood, healthy development involves an increased
shift in focus from self toward other and toward guiding the next generation as
an expression of their belief in the species (not just their immediate social
network). On the other hand, if Maslow’s security and love/belonging needs
have not been adequately satisfied, Erikson (1959/1994) noted that people fall
into self-absorption and mechanical, unfulfilling routines.

Self-Esteem

“If . . . the person wins respect and admiration and because of this develops
self-respect, then he or she is still more healthy, self-actualizing, or fully

946 Journal of Humanistic Psychology 60(6)

human,” Maslow (1987) wrote; thus, “satisfaction of the self-esteem need
leads to feelings of self-confidence, worth, strength, capability, and adequacy,
of being useful and necessary in the world” (pp. 38, 21). Maslow (1987;
Maslow & Mittelmann, 1951) conceptualized self-esteem as a multifaceted
construct that includes (a) some originality, individuality, and independence
from group opinions—that is, real self instead of idealized pseudo-self
(Horney, Rogers, Winnicott, as cited in DeRobertis, 2008), differentiated self
instead of emotional cutoff (Bowen, 1978); (b) having achievable, realistic,
and compatible goals which involve some good to society as well as reason-
able persistence of effort to achieve them; (c) absence of excessive need for
reassurance and approval; (d) desire for adequacy, mastery, competence, and
achievement; (e) a sense of confidence in the face of the world—which, like
Adler (1927/2010; see also DeRobertis, 2011a), Maslow (1987) distinguished
from sheer willpower and determination; (f) positive (vs. negative) freedom;
(g) desire for dignity, appreciation, and deserved respect from others—which
Maslow distinguished from external fame, celebrity, and unwarranted adula-
tion; (h) appreciation of cultural differences; and (i) realistic appraisal of per-
sonal strengths, limitations, motivations, desires, goals, ambitions, inhibitions,
defenses, compensations, and so on.

With regard to acceptance of one’s imperfections and defenses as well as
one’s strengths, Neff (2011) proposed the construct of self-compassion as an
alternative to both the hubristic and fleeting images of self-esteem propa-
gated by American culture and psychology in the interest of self-enhance-
ment—which Maslow would have classified as D-esteem. Rather,
self-compassion emphasizes nonjudgmental, mindful self-awareness as a
means of overcoming self-consciousness and improving self-efficacy and
well-being. Maslow (1999) noted that “fear of knowledge of oneself is very
often isomorphic with, and parallel with, fear of . . . any knowledge that could
cause us to despise ourselves or to make us feel inferior, weak, worthless,
evil, shameful” (p. 71). Cultivating self-compassion can result in lower self-
condemnation and higher self-forgiveness (Cornish & Wade, 2015) as well as
in decreased maladaptive dependency and increased sense of connectedness
(Chui, Zilcha-Mano, Dinger, Barrett, & Barber, 2016).

Self-Actualization

When conditions are favorable and the intrinsic self is heeded, the possibility
of self-actualizing comes into focus for the developing person. Maslow
(1971) noted that “self-actualization means experiencing fully, vividly, self-
lessly, with full concentration and total absorption” and therefore “being
more easily [oneself]” and “expressing rather than coping,” that is, directing
one’s energies toward the best uses of one’s potentials and abilities and

Bland and DeRobertis 947

feeling discontent and restless when one is not doing what one was uniquely
fitted for (pp. 44, 290). Maslow (1999) identified several interrelated quali-
ties of self-actualizing people:

Clearer, more efficient perception of reality; more openness to experience;
increased integration, wholeness, and unity of the person; increased spontaneity,
expressiveness, full functioning, aliveness; a real self, firm identity, autonomy,
uniqueness; increased objectivity, detachment, transcendence of self; recovery
of creativeness; ability to fuse concreteness and abstractness; democratic
character structure; ability to love, etc. (pp. 172-173; see also Maslow, 1987)

Maslow’s description of self-actualizing people is consistent with R. Walsh’s
(2015) conceptualization of wisdom, which involves the following: (a) peo-
ple’s abilities to “more deeply and accurately . . . see into themselves, reality,
and [their] existential challenges and limitations” and to embrace “ethicality
and benevolence [as] appropriate ways to live”; (b) the motivation to benefit
others; and (c) operating on the awareness that “the deeper the kind of bene-
fits they can offer, . . . the more skillfully they may offer them” (p. 289).

Propriate Striving. As noted earlier, self-actualizing is an outcome of healthy
personality development, which entails an ongoing process of striving for
still greater improvement and growth as opposed to an end state, as synony-
mous with Allport’s (1955) propriate striving. Self-actualizing people assume
the courage and freedom to create/recreate aspects of their personality based
on new life experiences and interactions with others—especially those that
test their ordinary ways of thinking, being, and relating and which liberate
and integrate their intellect, emotions, and body—rather than remain homeo-
statically fixated in their comfort zones. This paves the way for self-transcen-
dence (Maslow, 1971). Likewise, McAdams (2015) proposed that personality
development involves a tripartite emerging process of social actor (disposi-
tional traits, temperament), motivated agent (personal goals, projects, plans,
values), and autobiographical author (narrative identity).

Social Interest. Self-actualizing involves a greater sense of identification with
humanity and therefore compassion and altruism, devoting one’s “energies
and thoughts to socially meaningful interests and problems” beyond one’s
own self-interest and/or need gratification (Maslow, 1999, p. 22). Because
healthier people “need less to receive love [and] are more capable to give
love, [they] are more loving people” (Maslow, 1999, p. 47). Therefore, they
demonstrate increased comfort being alone and enhanced self-discipline ver-
sus gregariously exuberant disposition (Maslow, 1987). At the same time,

948 Journal of Humanistic Psychology 60(6)

they are more democratic, interdependent, and problem focused; have better
interpersonal relations; are more accepting and forgiving of others; and are
able to extend these capacities to a variety of relationships (Maslow, 1999;
Maslow & Mittelmann, 1951). Toumbourou (2016) outlined a framework for
identifying and evaluating beneficial action (i.e., altruistic and prosocial
behavior) based on developmental and contextual influences that resemble
Maslow’s needs theory.

Resilience. Maslow (1999) wrote, “Self-actualization does not mean a tran-
scendence of all human problems. Conflict, anxiety, frustration, sadness,
hurt, and guilt all can be found in healthy human beings”; on the other hand,
“with increasing maturity,” one’s focus shifts “from neurotic pseudo-prob-
lems to the real, unavoidable existential problems” (p. 230). Maslow (Maslow
& Mittelmann, 1951) emphasized the abilities to constructively adapt to cir-
cumstances beyond one’s control, to sustainably and nondefensively remain
collected in the face of crisis, and to withstand setbacks as opportunities for
growth (instead of as threatening). “The child with a good basis of safety,
love, and respect-need-gratification is able to profit from . . . frustrations and
become stronger thereby” (Maslow, 1999, p. 220). Maslow (1996) also
accentuated that tragedy is conducive to growth insofar as it “confronts [indi-
viduals] with the ultimate values, questions, and problems that [they] ordi-
narily forget about in everyday existence” (p. 56). Likewise, F. Walsh (2016)
defined resilience as follows:

“Struggling well,” experiencing both suffering and courage, effectively
working through difficulties both internally and interpersonally, . . . [striving]
to integrate the fullness of the experience of . . . life challenges into the fabric
of [one’s] individual and collective identity, influencing how we go on with our
lives. (p. 5)

Aldwin (2007) cited cognitive skills (insight, creativity, humor, morality),
temperament (independence and initiative), and social integration (all remi-
niscent of self-actualizing people) as factors that characterize resilient chil-
dren irrespective of social class or ethnicity. Furthermore, Masten (2014)
identified attributes and outcomes of a supportive, accepting, and enriching
but also appropriately challenging family, school, and community environ-
ment (i.e., Maslow’s safety, belonging, and esteem needs) as protective fac-
tors that promote resilience.

Postconventional Morality. In self-actualizing people, locus of control shifts from
externalized to intrinsic, and both motivation and ethics follow suit. They are

Bland and DeRobertis 949

“not only or merely [their institutional and/or national affiliation] but also mem-
bers at large of the human species” and “[looking] within for the guiding values
and rules to live by” (Maslow, 1999, p. 201). Being strongly focused on prob-
lems outside themselves, their focus broadens to include matters reflecting a
desire for truth, justice, beauty, and so on. In addition, being comfortable in their
skin, they are inclined to do what is right versus what is easy even if it goes
against the tide (i.e., resistance to enculturation and transcendence of one’s envi-
ronment). Using Kohlberg’s (1984) model of moral development, postconven-
tional morality is characterized first by right action based on compromise and
reciprocity. The letter of the law is considered insufficient to uphold a society;
rather, rules are broken and/or revised when one is faced with situations in which
the rules interfere with human rights or needs. Second, right/wrong is based on
universal ethical principles of fairness and equality, and individuals turn to their
inner conscience with respect for diversity, dignity, and human welfare and for
balancing individual and social concerns. Similarly, Gilligan (1982) proposed a
parallel concept, a morality of nonviolence (i.e., preventing harm to self and oth-
ers), as the telos of her feminist moral development model.

Postformal Cognition and Psychological Flexibility. Maslow (1999) emphasized that
cognition associated with self-actualizing people is marked by “[sharpened]
awareness of the limitations of purely abstract thinking, of verbal thinking, and
of analytic thinking” and by “dichotomies [becoming] resolved, opposites . . .
seen to be unities, and the whole dichotomous way of thinking . . . recognized
to be immature” (pp. 227-228). Post-Piagetian psychologists (e.g., Basseches,
Kitchener, Labouvie-Vief, Perry, Sinnot, etc., as cited in Arnett, 2016; Broder-
ick & Blewitt, 2015) emphasized that, when conditions are favorable, the for-
mal operational thought of adolescence gives way to more flexible, complex,
and integrated postformal cognition characterized by pragmatism (adapting
idealistic, logical thinking to the practical constraints of real-life situations),
dialectical thought (awareness that problems often have no clear solution), and
reflective judgment, relativism, and postskeptical rationalism. Decisions are
based on situational circumstances, and emotion is integrated with logic to
form context-dependent principles. Accordingly, the legitimacy of competing
points of view and of psychological flexibility (Wilson, Bordieri, & Whiteman,
2012) is recognized and favored over making arguments for the justification of
only one true/accurate perspective at the exclusion of others (Schneider, 2013).
Maslow (1966) discussed how these principles could be applied to develop a
more humanistic approach to science.

Emotional Intelligence. Maslow (1999) observed that “the ability to be aggres-
sive and angry is found in all self-actualizing people, who are able to let it

950 Journal of Humanistic Psychology 60(6)

flow forth freely when the external situation ‘calls for’ it” (p. 216). They are
accepting of the full range of human impulses without rejecting them in the
interest of reducing tension. Like postformal cognition, Goleman’s (1995;
see also Dalai Lama, 2012) emotional intelligence theory emphasizes mov-
ing away from Western dualistic assumptions about emotions as inherently
positive (approach, pleasant) or negative (withdrawal, unpleasant) and
instead recognizing that each emotion has both beneficial (constructive) and
afflictive (destructive) elements. For example, fear can signal legitimate
threats and promote survival, and righteous anger is necessary and appropri-
ate for confronting injustice. The ability to accept emotions as they are rather
than deny, repress, or project them also promotes empathy and compassion
(toward both self and others), consistent with Maslow’s simultaneous focus
on propriate striving and social interest.

Creativity. Maslow (1999) recognized creativity as the dialectic integration of
primary (childlike, Dionysian) and secondary (rational, Apollonian) pro-
cesses, a conceptualization that was elaborated by Arieti (1976) and explored
in a qualitative inquiry by Bland (2003). Specifically, Maslow focused on the
nonduality between young and old (i.e., a sense of playfulness and the ability
to integrate imagination with practical wisdom). In addition, he emphasized
that creativity (a) is not limited to production of products (i.e., art, music,
literature, scientific work) but also includes the propriate process of individu-
als’ growth and development and (b) serves to benefit society by providing
alternatives to the limitations of convention. Sternberg (2016) proposed a
triangular theory of creativity that involves defying the crowd (i.e., the beliefs,
values, and practices of one’s field despite the short-term interpersonal risks),
defying oneself (self-challenging and self-transcending by moving beyond
one’s own earlier values, practices, and beliefs), and defying the zeitgeist (i.e.,
the unconsciously accepted presuppositions and paradigms in a field). In
addition, consistent with Maslow’s suggestions for social conditions that are
conducive to self-actualization (i.e., a consistent and nurturing environment
that enables one to express oneself rather than cope and conform), Ren, Li,
and Zhang (2017) noted that while Chinese adolescents’ creativity is enhanced
by behavioral control from their parents, it is stifled by parents’ psychologi-
cal control over them.

Dialogue With the Extant Literature

Maslow’s work has been met with ongoing criticism and confusion since he
initially introduced his ideas at mid-20th century. His association with the
worst of 1960s counterculture (about which he publicly expressed

Bland and DeRobertis 951

frustration; see Maslow, 1964/1970; 1984; 1987) arguably contributed to his
work being dismissed (or at best ignored) today by many conventional psy-
chologists as a historical relic. In addition, since Maslow’s death in 1970, the
more complex and nuanced aspects of his thinking have become distorted or
lost due to oversimplified and/or inaccurate portrayals of his work in second-
ary sources that resemble an academic game of “telephone” (Bland &
DeRobertis, 2017).

Applied to this article, perhaps the most troubling misrepresentation of
Maslow’s work has been the attempt by developmentally oriented research-
ers to reformulate his dynamic systems approach as a discontinuous stage
model with clearly defined categorical phases. For example, some have
attempted to equate each level of his needs hierarchy with specific stages in
extant models (e.g., Bauer, Schwab, & McAdams, 2011; D’Souza & Gurin,
2016; Harrigan & Commons, 2015), and others with factors on assessment
measures (e.g., Reiss & Haverkamp, 2005). We find these efforts problem-
atic, as they fail to uphold Maslow’s emphasis on holistic conceptualization
and his cautioning against misunderstanding fulfillment of the basic needs as
a simplistic, lockstep progression (“not a sudden, saltatory phenomenon,”
Maslow, 1987, p. 27) but rather as a dynamic process in which fulfillment of
the higher needs is proportional to fulfillment of the lower needs. Accordingly,
we agree with Rowan’s (1998) call to “[do] away with the triangle!” (p. 88).
First, Maslow never actually represented his theory with a pyramid (Eaton,
2012)—at least in the way that it is commonly presented in textbooks (see
Bland, 2013). More important, while such a visual image is convenient for
instructional purposes, it implies that maturation has an end point, which
belies Maslow’s foci on propriate striving and on self-transcendence (Rowan,
1998). As an alternative, we propose the aforementioned image of Russian
nesting dolls, an expanding spiral or helix, or a lightning bolt, all of which
better convey the two-steps-forward-one-step-back, contiguous dynamic of
maturation as an ongoing process (see Kegan, 1982).

Another criticism leveled at Maslow (e.g., see Hanley & Abell, 2002) is
his emphasis on hedonistic values and on culture-biased notions of self-
esteem and self-actualization. However, numerous international studies have
directly (e.g., Koydemir et al., 2014; Winston, Maher, & Easvaradoss, 2017)
or indirectly (see citations throughout the previous section of this article)
demonstrated the cross-cultural validity of Maslow’s theorizing.

Furthermore, others have (a) made pleas for a more dynamic interactional
self as an alternative to Maslow’s proposition of an instinctoid self in his
adaptation of Goldstein (Frick, 1982; Morley, 1995) and (b) accused Maslow
of “[emphasizing] the importance of maintaining a unified, coherent self,”
whereas “the self-concept differentiates with maturity, [incorporating] both

952 Journal of Humanistic Psychology 60(6)

the private and the more public sides of our nature, accommodating our abil-
ity to keep our own counsel and still be known to others by virtue of our
interactions with them” (Broderick & Blewitt, 2015, pp. 169-170). These cri-
tiques tend to focus on the individuating aspects of self-actualization (i.e.,
Goldstein’s first and third axioms) without adequately acknowledging
Maslow’s emphasis on maturity within a social–environmental context
(Goldstein’s second axiom), which has been more properly acknowledged by
Sassoon (2015). Maslow (1987, 1999) accentuated that the difference
between merely healthy individuals and self-actualizing ones who genuinely
embody social interest is mediated in part by adequate cultural–societal con-
ditions. Likewise, he insinuated that, paradoxically, individuals are simulta-
neously both more externalized and ego-centered at the lower end of his
needs hierarchy, whereas at the higher end they are guided by more idiosyn-
cratic/intrinsic aims while also becoming more self-transcendent.

Conclusion

In this article, we have employed Maslow’s needs hierarchy as a dynamic
systems process framework for situating parallel developmental constructs
that serve as empirical support for his ideas at multiple ages and in various
contexts, and we have sought to clarify common misgivings about his ideas on
psychological health (i.e., self-actualization) and the factors that promote or
inhibit it. Our intent has been to legitimize Maslow’s unacknowledged contri-
butions to developmental psychology in an effort to overcome the “recurrent
Maslow bashing that one finds in the literature” (Winston et al., 2017, p. 309).
We further reach the conclusion that Maslow ought to be counted as a forerun-
ner of contemporary existential–humanistic developmental thought (see
DeRobertis, 2008, 2012, 2015; DeRobertis & McIntyre, 2016).

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publi-
cation of this article.

References

Adler, A. (1998). What life could mean to you. Center City, MN: Hazelden. (Original
work published 1931)

Bland and DeRobertis 953

Adler, A. (2010). Understanding human nature. Eastford, CT: Martino. (Original
work published 1927)

Aldwin, C. M. (2007). Stress, coping, and development: An integrative perspective
(2nd ed.). New York, NY: Guilford.

Allport, G. W. (1955). Becoming: Basic considerations for a psychology of personal-
ity. New Haven, CT: Yale University Press.

Arieti, S. (1976). Creativity: The magic synthesis. New York, NY: Basic.
Arnett, J. J. (2016). Human development: A cultural approach (2nd ed.). Boston, MA:

Pearson.
Bauer, J. J., Schwab, J. R., & McAdams, D. P. (2011). Self-actualizing: Where ego

development finally feels good? The Humanistic Psychologist, 39, 121-136. doi:
10.1080/08873267.2011.564978

Bergen, D. (2008). Human development: Traditional and contemporary theories.
Upper Saddle River, NJ: Prentice Hall.

Bland, A. (2003). The tree of life: A theory of musical creativity and its role in per-
sonal and social development (Unpublished master’s thesis). University of West
Georgia, Carrollton.

Bland, A. (2013, April-May). Toward a definition of psychological health:
Appreciating Maslow’s conceptual vision. AHP Perspective, 6-11.

Bland, A. M. (2014). Corrective experiences in corrections counseling. Journal of
Theoretical & Philosophical Criminology, 6, 46-74.

Bland, A. M., & DeRobertis, E. M. (2017). The humanistic perspective. In V. Zeigler-
Hill & T. K. Shackelford (Eds.), Encyclopedia of personality and individual dif-
ferences. doi:10.1007/978-3-319-28099-8_1484-1

Bland, A. M., & Roberts-Pittman, B. J. (2014). Existential and chaos theory: “Calling”
for adaptability in career decision-making. Journal of Career Development, 41,
382-401. doi:10.1177/0894845313498303

Bowen, M. (1978). Family therapy in clinical practice. New York, NY: Aronson.
Broderick, P. C., & Blewitt, P. (2015). The life span: Human development for helping

professionals (4th ed.). Boston, MA: Pearson.
Bronfenbrenner, U. (1994). Ecological models of human development. In T. Husen &

T. N. Postlethwaite (Eds.), International encyclopedia of education (2nd ed., Vol.
3, pp. 1643-1647). Oxford, England: Pergamon.

Campa, M. I. (2013). Developmental trends and bonding milestones: From parents
to partners. In C. Hazan & M. I. Campa (Eds.), Human bonding: The science of
affectional ties (pp. 74-100). New York, NY: Guilford.

Capuzzi, D, & Stauffer, D. (Eds.). (2016). Human growth and development across the
lifespan: Applications for counselors. Hoboken, NJ: Wiley.

Castonguay, L. G, & Hill, C. E. (Eds.). (2012). Transformation in psychotherapy:
Corrective experiences across cognitive-behavioral, humanistic, and psychody-
namic approaches. Washington, DC: American Psychological Association.

Chui, H., Zilcha-Mano, S., Dinger, U., Barrett, M. S., & Barber, J. P. (2016).
Dependency and self-criticism in treatments for depression. Journal of Counseling
Psychology, 63, 452-459. doi:10.1037/cou0000142

954 Journal of Humanistic Psychology 60(6)

Coie, J. D., & Dodge, K. A. (1988). Multiple sources of data on social behavior and
social status in the school: A cross-age comparison. Child Development, 59, 815-
829. doi:10.2307/1130578

Cordeiro, P. M. G., Paixão, M. P., Lens, W., Lacante, M., & Luyckx, K. (2016).
Parenting styles, identity development, and adjustment in career transitions:
The mediating role of psychological needs. Journal of Career Development, 45,
83-97. doi:10.1177/0894845316672742

Cornish, M. A., & Wade, N. G. (2015). Working through past wrongdoing:
Examination of a self-forgiveness counseling intervention. Journal of Counseling
Psychology, 62, 521-528. doi:10.1037/cou0000080

Dalai Lama. (2012). Beyond religion: Ethics for a whole world. New York, NY:
Houghton Mifflin.

DeRobertis, E. M. (2008). Humanizing child developmental theory: A holistic
approach. Bloomington, IN: iUniverse.

DeRobertis, E. M. (2011a). Deriving a third force approach to child development
from the works of Alfred Adler. Journal of Humanistic Psychology, 51, 492-515.
doi:10.1177/0022167810386960

DeRobertis, E. M. (2011b). Existential-humanistic and dynamic systems approaches
to child development in mutual encounter. The Humanistic Psychologist, 39, 3-
23. doi:10.1080/08873267.2011.539934

DeRobertis, E. M. (2012). The whole child: Selected papers on existential-humanistic
child psychology. Charleston, SC: CreateSpace.

DeRobertis, E. M. (2015). Toward a humanistic-multicultural model of develop-
ment. In K. J. Schneider, J. F. Pierson, & J. F. T. Bugental, (Eds.), Handbook of
humanistic psychology: Theory, research, and practice (2nd ed., pp. 227-242).
Thousand Oaks, CA: Sage.

DeRobertis, E. M. (2016). Becoming enthusiastic about learning for the first time
as a child. Journal of Humanistic Psychology, 56, 394-413. doi:10.1177/
0022167815574430

DeRobertis, E. M., & McIntyre, S. (2016). Development through a humanistic lens.
In R. Bargdill & R. Broomé (Eds.), Humanistic contributions for Psychology
101: Growth, choice, and responsibility (pp. 117-132). Colorado Springs, CO:
University Professors Press.

Desmond, M. (2016). Evicted: Poverty and profit in the American city. New York,
NY: Crown.

D’Souza, J., & Gurin, M. (2016). The universal significance of Maslow’s concept
of self-actualization. The Humanistic Psychologist, 44, 210-214. doi:10.1037/
hum0000027

Eaton, S. E. (2012). Maslow’s hierarchy of needs: Is the pyramid a hoax? Retrieved from
Maslow’s Hierarchy of Needs – Is the pyramid a hoax?

Erikson, E. H. (1994). Identity and the life cycle. New York, NY: Norton. (Original
work published 1959)

Firestone, R. W., Firestone, L., & Catlett, J. (2013). The self under siege: A therapeu-
tic model for differentiation. New York, NY: Routledge.

Bland and DeRobertis 955

Frankl, V. E. (1978). The unheard cry for meaning: Psychotherapy and humanism.
New York, NY: Washington Square.

Frick, W. (1971). Humanistic psychology: Interviews with Maslow, Murphy, and
Rogers. Columbus, OH: Merill.

Frick, W. (1982). Conceptual foundations of self-actualization: A contribution to
motivation theory. Journal of Humanistic Psychology, 22, 33-52.

Gelo, O. C. G., & Salvatore, S. (2016). A dynamic systems approach to psychotherapy:
A meta-theoretical framework for explaining psychotherapy change processes.
Journal of Counseling Psychology, 63, 379-395. doi:10.1037/cou0000150

Gilligan, C. (1982). In a different voice: Psychological theory and women’s develop-
ment. Cambridge, MA: Harvard University Press.

Goldstein, K. (1963). Human nature in the light of psychopathology. New York, NY:
Shocken.

Goldstein, K. (1995). The organism: A holistic approach to biology derived from
pathological data in man. New York, NY: Zone. (Original work published 1934)

Goleman, D. (1995). Emotional intelligence. New York, NY: Bantam.
Gordon, T. (1975). Parent effectiveness training. New York, NY: Plume.
Graber, R., Turner, R., & Madill, A. (2015). Best friends and better coping: Facilitating

psychological resilience through boys’ and girls’ closest friendships. British
Journal of Psychology, 107, 338-358. doi:10.1111/bjop.12135

Hanley, S. J., & Abell, S. C. (2002). Maslow and relatedness: Creating an interper-
sonal model of self-actualization. Journal of Humanistic Psychology, 42, 37-57.
doi:10.1177/002216702237123

Harrigan, W. J., & Commons, M. L. (2015). Replacing Maslow’s needs hierarchy
with an account based on stage and value. Behavioral Development Bulletin, 20,
24-31. doi:10.1037/h0101036

Harris, R. (2006). Embracing your demons: An overview of acceptance and commit-
ment therapy. Psychotherapy in Australia, 12, 70-76.

Hoffman, E. (1988). The right to be human: A biography of Abraham Maslow. Los
Angeles, CA: Tarcher.

Horney, K. (1945). Our inner conflicts. New York, NY: Norton.
Kegan, R. (1982). The evolving self: Problem and process in human development.

Cambridge, MA: Harvard University Press.
Kohlberg, L. (1984). The psychology of moral development: The nature and validity

of moral stages (Essays on moral development, Vol. 2). New York, NY: Harper
& Row.

Koydemir, S., Şimşek, Ő. F., & Demir, M. (2014). Pathways from personality to hap-
piness: Sense of uniqueness as a mediator. Journal of Humanistic Psychology,
54, 314-335. doi:10.1177/0022167813501226

Maccoby, E. E., & Martin, J. A. (1983). Socialization in the context of the family:
Parent-child interaction. In E. M. Hetherington (Ed.), Handbook of child psy-
chology, Vol. IV: Socialization, personality, and social development (4th ed., pp.
1-102). New York, NY: Wiley.

956 Journal of Humanistic Psychology 60(6)

Marcia, J. E. (1966). Development and validation of ego identity status. Journal of
Personality and Social Psychology, 3, 551-558. doi:10.1037/h0023281

Maslow, A. H. (1966). The psychology of science: A reconnaissance. New York, NY:
Gateway.

Maslow, A. H. (1970). Religions, values, peak experiences. New York, NY: Penguin.
(Original work published 1964)

Maslow, A. H. (1971). The farther reaches of human nature. New York, NY: Penguin.
Maslow, A. H. (1973). Dominance, self-esteem, self-actualization: Germinal papers

of A. H. Maslow. Monterey, CA: Brooks/Cole.
Maslow, A. H. (1984). Politics 3. In T. Greening (Ed.), American politics and human-

istic psychology (pp. 80-96). Dallas, TX: Saybrook Institute Press.
Maslow, A. H. (1987). Motivation and personality (3rd ed.). New York, NY:

HarperCollins.
Maslow, A. H. (1996). Future visions: The unpublished papers of Abraham Maslow.

Thousand Oaks, CA: Sage.
Maslow, A. H. (1999). Toward a psychology of being (3rd ed.). New York, NY: Wiley.
Maslow, A. H., & Mittelmann, B. (1951). Principles of abnormal psychology: The

dynamics of psychic illness (2nd ed.). New York, NY: Cotler.
Masten, A. S. (2014). Ordinary magic: Resilience in development. New York, NY:

Guilford.
Maté, G. (2010). In the realm of hungry ghosts: Close encounters with addiction.

Berkeley, CA: North Atlantic.
Maté, G. (2011). Dr. Gabor Maté on attachment and conscious parenting. Retrieved

from https://www.youtube.com/watch?v=_tdljIW86e8
May, R. (1967). Psychology and the human dilemma. Princeton, NJ: Von

Nostrand.
McAdams, D. P. (2015). The art and science of personality development. New York,

NY: Guilford.
Miller, P. M., & Commons, M. L. (2010). The benefits of attachment parenting for

infants and children: A behavioral developmental view. Behavioral Development
Bulletin, 16, 1-14. doi:10.1037/h0100514

Morley, J. (1995). Holistic biology and the organismic foundations of humanistic
psychology. The Humanistic Psychologist, 23, 358-364. doi:10.1080/08873267
.1995.9986836

Music, G. (2017). Nurturing natures: Attachment and children’s emotional, sociocul-
tural, and brain development. New York, NY: Routledge.

Neff, K. (2011). Self-compassion. New York, NY: Morrow.
Ollendick, T. H., Weist, M. D., Borden, M. C., & Greene, R. W. (1992). Sociometric

status and academic, behavioral, and psychological adjustment: A five-year
longitudinal study. Journal of Consulting and Clinical Psychology, 60, 80-87.
doi:10.1037/0022-006x.60.1.80

Prince, D. L., & Howard, E. H. (2002). Children and their basic needs. Early
Childhood Education Journal, 30, 27-31. doi:10.1023/a:1016589814683

Bland and DeRobertis 957

Prinstein, M. (2017). Popular: The power of likability in a status-obsessed world.
New York, NY: Viking.

Reiss, S., & Haverkamp, S. M. (2005). Motivation in developmental context: A new
method for studying self-actualization. Journal of Humanistic Psychology, 45,
41-53. doi:10.1177/0022167804269133

Ren, F., Li, Y., & Zhang, J. (2017). Perceived parental control and Chinese mid-
dle school adolescents’ creativity: The mediating role of autonomous motiva-
tion. Psychology of Aesthetics, Creativity, and the Arts, 11, 34-42. doi:10.1037/
aca0000078

Rowan, J. (1998). Maslow amended. Journal of Humanistic Psychology, 38, 81-92.
doi:10.1177/00221678980381008

Rowan, J. (1999). Ascent and descent in Maslow’s theory. Journal of Humanistic
Psychology, 39, 125-133. doi:10.1177/0022167899393010

Sassoon, J. (2015). The humanist society: The social blueprint for self-actualization.
Bloomington, IN: iUniverse.

Schneider, K. J. (2013). The polarized mind: Why it’s killing us and what we can do
about it. Colorado Springs, CO: University Professors Press.

Shapiro, S., & White, C. (2014). Mindful discipline: A loving approach to set-
ting limits and raising an emotionally intelligent child. Oakland, CA: New
Harbinger.

Siegel, D. J. (2012). The developing mind: How relationships and the brain interact
to shape who we are (2nd ed.). New York, NY: Guilford.

Skalski, J. E., & Hardy, S. A. (2013). Disintegration, new consciousness, and dis-
continuous transformation: A qualitative investigation of quantum change. The
Humanistic Psychologist, 41, 159-177. doi:10.1080/08873267.2012.724271

Sternberg, R. J. (2016). A triangular theory of creativity. Psychology of Aesthetics,
Creativity, and the Arts, 12, 50. doi:10.1037/aca0000095

Toumbourou, J. W. (2016). Beneficial action within altruistic and prosocial behavior.
Review of General Psychology, 20, 245-258. doi:10.1037/gpr0000081

Walsh, F. (2016). Strengthening family resilience (3rd ed.). New York, NY: Guilford.
Walsh, R. (2015). What is wisdom? Cross-cultural and cross-disciplinary syntheses.

Review of General Psychology, 19, 278-293. doi:10.1037/gpr0000045
Wertz, F. J., Charmaz, K., McMullen, L. M., Josselson, R., Anderson, R., &

McSpadden, E. (2011). Five ways of doing qualitative analysis. New York, NY:
Guilford.

Whitehead, P. M. (2017). Goldstein’s self-actualization: A biosemiotic view. The
Humanistic Psychologist, 45, 71-83. doi:10.1037/hum0000047

Wilson, K. G., Bordieri, M., & Whiteman, K. (2012). The self and mindfulness. In
L. McHugh & I. Stewart (Eds.), The self and perspective taking: Contributions
and applications from modern behavioral science (pp. 181-197). Oakland, CA:
New Harbinger.

Winston, C. N., Maher, H., & Easvaradoss, V. (2017). Needs and values: An explora-
tion. The Humanistic Psychologist, 45, 295-311. doi:10.1037/hum0000054

958 Journal of Humanistic Psychology 60(6)

Author Biographies

Andrew M. Bland is a member of the graduate clinical psy-
chology faculty at Millersville University in Lancaster County,
PA. He received a master’s degree from the University of West
Georgia’s humanistic-existential-transpersonal psychology pro-
gram in 2003 and a PhD in counseling psychology from Indiana
State University in 2013. He is a licensed psychologist; since
2004, he has provided therapeutic services in a variety of set-
tings in four states, currently at Samaritan Counseling Center in
Lancaster, PA. His research interests include the practical appli-
cation of themes from contemporary existential-humanistic

psychology in the domains of love, work, social justice, the processes of therapy and
education, creativity, spirituality, and human development. His passions include lis-
tening to and creating music, gardening, traveling, and spending time with his wife
and their two young children.

Eugene M. DeRobertis is a professor of psychology at
Brookdale College and a Lecturer at Rutgers University–
Newark in New Jersey. He holds a BA in philosophy from St.
Peter’s University and a PhD in psychology from Duquesne
University. He is the author of Humanizing Child Developmental
Theory: A Holistic Approach (2008), The Whole Child: Selected
Papers on Existential-Humanistic Child Psychology (2012),
Existential-Phenomenological Psychology: A Brief Introduction
(2012), Profiles of Personality: An Approach-Based Companion
(2013), and The Phenomenology of Learning and Becoming:
Enthusiasm, Creativity, and Self-Development (2017).

Perspectives

Structural developmental psychology and health

promotion in the third age

Lars Bauger1,* and Rob Bongaardt2

1Department of Nursing and Health Sciences and 2Department of Health, Social and Welfare Studies,

Faculty of Health and Social Sciences, University College of Southeast Norway, Porsgrunn, Norway

*Corresponding author. E-mail: [email protected]

Summary

In response to the ever-increasing longevity in Western societies, old age has been divided into two

different periods, labelled the third and fourth age. Where the third age, with its onset at retirement,

mostly involves positive aspects of growing old, the fourth age involves functional decline and in-

creased morbidity. This article focuses on the entry to the third age and its potential for health promo-

tion initiatives. Well-being is an important factor to emphasize in such health promotion, and this arti-

cle views the lifestyle of third agers as essential for their well-being. The structural developmental

theory of Robert Kegan delineates how a person’s way of knowing develops throughout the life

course. This theory is an untapped and salient perspective for health promotion initiatives in the third

age. This article outlines Kegan’s approach as a tool for developing psychologically spacious health

promotion, and suggests future directions for research on the topic.

Key words: health promotion programs, quality of life, qualitative methods, older people

INTRODUCTION

Retiring from work is a major transition in life and in

many countries. It is the social marker of entering into

old age (Kloep and Hendry, 2006). The conception of

old age altered dramatically during the late 20th century

as people lived increasingly longer. As one consequence

of this, researchers now distinguish between the ‘third

age’ and ‘fourth age’ (Baltes, 1997; Baltes and Smith,

2003; Laslett, 1996). In gerontology the last stage of a

person’s life is often called the fourth age (Koss and

Ekerdt, 2016), which is a period characterized by func-

tional decline and an increased dependency. The third

age, with its onset in retirement, is seen as a period of

relatively good health with the potential of active social

engagement forming a solid base for healthy ageing

(Robinson, 2013). Even though the third age has a posi-

tive ring to it, it may come with some challenges that are

specific for this period of life. Retirement itself, whether

it comes voluntarily or, as may happen, involuntarily,

may be experienced as troubling (Daatland and Solem,

1995) and can have a negative effect on the well-being

of the retiree (Wang, 2007). Studies of retirement effects

on the person’s well-being have demonstrated that be-

tween 9-25% experience negative effects to their well-

being after retirement (Wang, 2007; Pinquart and

Schindler, 2007). In their recent review, Wang and Shi

(2014) highlighted different factors pre, during and post

VC The Author 2017. Published by Oxford University Press.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/),

which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Health Promotion International, 2018;33:686–694

doi: 10.1093/heapro/daw104

Advance Access Publication Date: 11 January 2017

Perspectives

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retirement that affected the well-being of the retiree.

The negative factors were ill health, involuntary retire-

ment, a concern with the maintenance of social status

and contacts, and strongly identifying with one’s work

role (Wang and Shi, 2014). Health promotion may help

retirees to find a suitable place in society and improve

well-being in spite of these negative factors. In addition,

health promotion will prolong this third age period and

as a consequence likely compress morbidity during the

fourth age period (Whitehead, 2011). Whitehead (2011)

also suggests that during the fourth age, persons may

draw on existential forces to overcome adversity, forces

that are built up during earlier stages of life, including

the third age. Health promotion is apt to endorse such

existential forces. In other words, health promotion dur-

ing the third age may postpone the onset of the fourth

age, make it shorter and more endurable once the person

faces adversity.

Health promotion typically targets large populations

and may be unable to address individual differences.

The third age population, however, is characterized by

an immense heterogeneity (George, 2011; Wang, 2007),

and many third agers have acquired a unique profes-

sional competence, a specific way of living, and a net-

work that intertwines two or three generations of family

and friends. Ideally, health promotion should be individ-

ually tailored to the needs of each third ager. However,

the group’s heterogeneity renders that unfeasible. In this

article we outline a feasible approach to shaping health

promotion, directed at the intermediate range between a

large population and the unique individual. We do so by

introducing the structural developmental theory to the

healthy ageing discourse and linking this to the policy

making and practice of healthy lifestyle promotion. The

specific purpose of this article, then, is to outline a struc-

tural developmental approach to the field of health pro-

motion that targets the well-being of third agers. Before

presenting the structure of the rest of this article, we will

first delineate some central concepts.

The structural developmental theory focuses on con-

secutive stages of mental structures in a person’s life.

Such a theory is perhaps best introduced by contrasting

it to phase theories of life course development that

emphasize normative phases of life, such as birth, child-

hood, education, young adulthood, marriage, parent-

hood, working life and retirement (e.g. Erikson, 1980).

Whereas the phase developmental theory focuses on the

content of age-dependent periods of life, structural de-

velopmental stage theory underscores how this content

is put into perspective by the person – i.e. the extent to

which one takes responsibility for the unfolding of

events, and, ultimately, how the story of one’s life is told

at any particular moment in time. The development of

these perspectives is referred to as the development or

growth of complexity of mind (Kegan, 1994).

The field of health promotion often refers to the life

style concept. However, definitions of the lifestyle con-

cept abound. We assume that lifestyle is made of the fab-

ric of a person’s attitudes, manners, behaviours and

practices, which are all woven into a Gestalt

(Cockerham, 2005; Elstad, 2000). In our view, a per-

son’s complexity of mind underpins his or her lifestyle.

We thereby emphasize coherence in what are often pre-

sented as separate lifestyle ‘factors’, such as smoking,

diet, exercise, etc. (cf. Veal, 1993). Furthermore, lifestyle

and well-being can be seen as reciprocally related – well-

being is embedded in lifestyle and takes shape through

it. Well-being is a heavily debated topic within health

psychology and we are not advocating for any of its

schools of thought. In this article, we take a broad per-

spective and focus on the subjective experience of the

phenomenon. Nevertheless, our use of well-being is in

line with how Huppert (2009 p.137) defines psychologi-

cal well-being, i.e. ‘the combination of feeling good and

functioning effectively’. Feeling good, then, is not just

concerned with happiness and contentment but addi-

tional emotions such as ‘interest, engagement, confi-

dence and affection’ (2009, p. 138), whereas functioning

effectively captures ‘the development of one’s potential,

having some control over one’s life, having a sense of

purpose (e.g. working towards valued goals), and

experiencing positive relationships’ (2009, p. 138).

The structure of this article is as follows. We first re-

view and present the key concepts of our article; the

third age, health promotion and lifestyle. Then we sum-

marize Kegan’s theory of structural development of the

mind. After that, we present the design of a study that

addresses the experience of well-being premised on com-

plexity of mind, and, finally, discuss the logical implica-

tions of a psychological developmental approach to

tailoring health promotion for third agers.

HEALTH PROMOTION AT THE ONSET OF
THE THIRD AGE

A positive perspective on the third age is well captured

by the gerontology term ‘successful ageing’. The term

gained popularity during the last decades of the 20th

century (Baltes and Smith, 2003). It was introduced by

Rowe and Kahn (1987) who reacted to the tendency in

gerontology to distinguish only between older people

with disease or disability and those without such condi-

tions. They introduced successful ageing as a positive

concept in order to address high cognitive and physical

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functioning and an active engagement with life, in addi-

tion to a low probability of disease and disability. In the

newfound optimism in the field of gerontology, the per-

ception of ageing changed from a passive experience to a

process of active engagement and participation (Baltes

and Baltes, 1990).

This more optimistic perspective on ageing has influ-

enced political discourse (Villar, 2012), as witnessed by

the introduction of the term ‘active ageing’ by the World

Health Organization (2002). The WHO defines active

ageing as ‘the process of optimizing opportunities for

health, participation and security in order to enhance

quality of life as people age’ (2002, p. 6). The WHO pol-

icy is to promote active ageing as a way to address socie-

tal and economic challenges stemming from an ageing

population as well as individual challenges associated

with getting older (World Health Organization, 2002).

Here the focus is on adding ‘more life to years, not just

years to life’ (Vaillant, 2004, p. 561), which is a hallmark

of health promotion in the third age. Wilson and Palha

(2007) argue that health promotion during this transi-

tional period will not only assist in maintaining existing

health but could also improve health and well-being sim-

ply because this is a period when one has more time to at-

tend to health-related needs than when one was working.

The third age is a period where one is left more to one’s

own devices with few established social structures and so-

cially defined roles (Freund et al., 2009). People are often

more free to do what they want, but those who do not

know or have not planned for what to do with this new

freedom could easily become ‘passive and couch ridden’

(Solem, 2012, p. 88; our translation).

It is evident that retirement is seen as an important

period for health promotion efforts. However,

retirement-specific research on health promotion is still

in its early stages. Reviewing the research, Wilson and

Palha (2007) identified 20 studies on the topic. Their

content analysis of these studies revealed four major

themes in the research on health promotion at the onset

of the third age, i.e. retirement: (1) the considerable ef-

fect of retirement and the need to support positive retire-

ment, (2) the identification and overcoming of barriers

to health promotion at retirement, (3) the best methods

to promote and sustain healthy lifestyle changes among

retirees and (4) the short and long-term benefits of

health promotion at retirement (Wilson and Palha,

2007). Given the aim of the present article, we will elab-

orate on theme (3), which links successful ageing to the

promotion of healthy lifestyles.

We emphasized above that the Gestalt of a person’s

attitudes, manners, behaviours and practices can be seen

as his or her lifestyle. A lifestyle approach to health

promotion builds on the assumption that the individual

can amend this lifestyle (Elstad, 2000; Nutbeam, 1998).

Although studies show that adopting a healthy lifestyle

may be beneficial for healthy ageing, the literature re-

ports some difficulty in promoting a healthy lifestyle

through interventions (Zhang et al., 2013). The main fo-

cus has been restricted to financial planning (Osborne,

2011), whereas psychological or social changes that

might occur after retirement have received hardly any

attention (Kloep and Hendry, 2006). Health promotion

initiatives usually communicate messages about healthy

lifestyles to a large target population through health ed-

ucation booklets or pamphlets. Kreuter et al. (1999)

have criticized this way of promoting health for its ‘one-

size-fits-all’ approach, with little consideration of indi-

vidual needs and personal relevance. In response to this

criticism, there has been a growing interest in tailoring

interventions to different individual users and user

groups (Davis, 2008; Orji and Mandryk, 2014). We

share this interest and wish to contribute. Our contribu-

tion to the development of tailor-made methods to pro-

mote and sustain healthy lifestyle changes among

retirees is based on structural developmental theory,

which we describe in the following section.

STRUCTURAL DEVELOPMENTAL THEORY

Neo-Piagetian psychologist Robert Kegan developed a

structural developmental theory (1982, 1994) which

proposes that individuals interpret and make meaning of

their world in qualitatively different ways. These ways

of meaning-making develop throughout the life course

along an invariant path whereby more complex ways of

meaning-making build upon and transform earlier ways

of meaning-making. The ways of meaning-making are

termed structures or orders of mind. Kegan (1982) has

described three orders of mind that capture most of the

adult population. He refers to these orders as the social-

ized, the self-authoring, and the self-transforming mind

(Kegan, 1994). Each order captures what an individual

can take as an object – can see ‘in front of’ him or her –

and what an individual is subject to – is part of and

thereby lacks a perspective on.

Individuals who have developed a socialized order of

mind can think in abstract terms and have the capacity

to internalize the meaning systems of others, such as

family values, social values, professional culture, etc.

They have the ability to subordinate their own desires

and be guided by the norms and standards in the ideolo-

gies, institutions or people that are most important to

them (Fitzgerald and Berger, 2002). At this order of

mind, one easily sees beyond one’s own needs and can

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adopt a larger picture, in which one is part of a socially

defined reality. Even though one has the capacity to in-

ternalize others’ points of view, one is embedded in these

points of view and is essentially dependent on them.

That is to say, the individual’s experience of being a per-

son or ‘self’ is entangled with ‘the quality of . . . internal

experiences of others’ experiences of them’ (Lewis,

2011, location 692). This means that at this order of

mind one does not ‘have the capacity to stand apart

from the values, beliefs, expectations, or definitions of

one’s tribe, community, or culture and make indepen-

dent judgments about them’ (Kegan, 1998, p. 201).

Individuals who make meaning with a self-authoring

mind have distanced themselves from the sense of being

entangled in others’ feelings and ideas about themselves.

They now have the capacity to be in charge of their own

feelings and generate an internal personal meaning sys-

tem, theory or ideology. Thus, one is able to take as an

object the values, beliefs and expectations of others

(one’s ‘tribe’, local community, or culture) that one was

subject to earlier. Individuals making meaning with this

order of mind perceive others as independent entities,

with their own integrity, distinct from themselves.

Unlike individuals at the socialized order of mind who

may struggle heavily with conflicting internalized views,

the self-authoring mind tolerates such conflicts or re-

solves these by invoking a system of self-authored values

and knowledge. This system has typically developed

over a period of years, gradually integrating the experi-

ences and reflections of personal encounters with a wide

variety of other knowledge and value systems (Kegan,

1994). This system of ‘self’ requires strong boundaries,

which may prevent the person from recognizing the con-

structed nature of the system itself. When meeting this

construction of self, others may experience it as a some-

what distant way of being, an obstacle to gaining direct

contact. However, ‘[t]his greater psychological indepen-

dence does not mean that [the person is] any less com-

mitted to you and to . . . other close relationships’

(Lewis, 2011, location 1111).

Those individuals who make meaning according to

the self-transforming mind have gained a perspective of

their own identity construction, and are no longer

‘blind’ to their self-authored identity. At this order, the

construction of identity is object to them. This implies

that they are now hesitant to see personhood as coincid-

ing with ‘a single system or form’ (Kegan, 1994, p. 313),

but rather see their system of self as incomplete and in

continuous development. At this order, individuals view

the ‘other as part of oneself’ (Souvaine et al., 1990, p.

253) and they are characterized by their embeddedness

in a multisystem perspective (Rosen, 1991). These

individuals are less likely to view the world in dichoto-

mies, and ‘suspicious of their own tendency to feel

wholly identified with one side of any opposite and to

identify the other with the other side of that opposite’

(Kegan, 1994, pp. 311-312). Meaning-making with this

order of mind concerns the reflections on the process of

making meaning itself more than the outcomes of this

process. The individual reflects on his or her own need

for meaning while acknowledging that knowledge is al-

ways partial, and he or she thrives on ‘rending every

new veil that comes into awareness, because . . . closure

and fixed boundaries [are] restrictive’ (Cook-Greuter,

1999, p. 107).

In his book In over our heads: The mental demands

of modern life, Kegan (1994) asks whether people make

meaning in accordance with society’s demands. In other

words, he asks what order of mind is required to suc-

cessfully parent, partner, work, learn, heal, and collabo-

rate as modern society frames these life tasks. He shows

that society implicitly demands a self-authoring mind

for all these tasks. In a composite study sample of adults

(Kegan, 1994, p. 195), about half of the persons did not

construct their experiences as complexly as the self-

authoring mind.

What are the mental demands on ageing in our mod-

ern Western society? Does the ageing population meet

these demands? Currently, hardly any empirical research

exists that answers these questions. Newhouse (as refer-

enced in Kegan, 1998) suggests a number of tasks and

expectations typical of the third age: giving up a central

identity formed around work and a career, changing

from a highly structured to a less structured everyday

life, needing to create new friendships after the loss of a

ready-made social network, and remaining relatively in-

dependent of the care-taking resources of family or soci-

ety. Kegan infers from Newhouse’s list that it is ‘the self-

authoring mind that constitutes the implicit mental

threshold for successfully handling this curriculum, a

threshold many adults will not yet have reached in old

age, and not having done so, will be ‘at risk’ for poorer

outcomes thereby’ (1998, p. 209; italics in original).

Therefore, he argues that it may be ‘an absolutely crucial

educational or mental health goal serving as a protective

factor against decline and depression in old age’ (Kegan,

1998, p. 212) to develop a self-authoring mind since it is

with this order of mind that one can meet the demands

of ageing. Moreover, if it is true that more people

make meaning with a self-authoring mind, then the so-

cial institutions relevant to the third age are challenged

to provide the space for the personal paths and demands

that are so typical for individuals with this order of

mind.

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It is against the backdrop of Kegan’s theory and its

possible implications for the third age that we now turn

to outlining the research we envision. In the following

section, we juxtapose the promotion of healthy lifestyles

during the third age with Kegan’s psychological develop-

ment theory.

DEVELOPING HEALTH PROMOTION FOR
THIRD AGERS

Structural developmental theory has informed classroom

practice in educational psychology, where developmen-

tally conscious teachers are teaching in ways that en-

courage students to make meaning in an increasingly

complex way, while also meeting students at their stage

of development (Helsing et al., 2004). In the context of

business coaching and counselling, Berger (2012) refers

to this practice as keeping conversations ‘psychologi-

cally spacious’. Inspired by such thinking, we envision

health promotion initiatives to be psychologically spa-

cious and tailored to a person’s order of mind. Neither

our aim nor our interest is in highlighting or facilitating

the development towards one specific order of mind

(e.g. self-authoring). Our contribution is rather to raise

awareness of the qualitatively different ways of making

meaning in the world, and, where possible, outline how

health promotion can be formulated in developmentally

spacious ways, to enable more people to be reached and

feel included.

In order to do so, we require a knowledge base that

links a person’s lifestyle to his or her stage of structural

development. Our research will hopefully help to estab-

lish this knowledge base. The rationale for our research

is that much information can be gained from the experi-

ences of individuals who report that they have recently

transitioned successfully into the third age. In other

words, our preferred starting point is narratives concern-

ing a successful lifestyle during retirement, i.e. one that

leads to an experience of well-being. True to this

experience-oriented bottom-up approach, we employ no

specific definition of well-being. The next logical step in

our rationale is to relate these situation-specific experi-

ences to a person’s order of mind. Kegan’s measure of

order of mind indicates in general terms how a person

structures his or her life in terms of responsibility alloca-

tion and perspective taking, that is, how a person under-

stands him- or herself to play a role in his or her own

life. The assumption is that persons with different orders

of mind structure retirement-specific experiences in dif-

ferent ways, because lifestyle and the ensuing experience

of well-being are dependent upon order of mind.

More concretely, our research will unfold as follows.

We will recruit participants recently retired from work-

ing life and reporting having done so satisfactorily ac-

cording to their own expectations and standards. To

assess the participants’ orders of mind, we will conduct

subject-object interviews (SOI) (Lahey et al., 1988/

2011) with all our participants. During the SOI, ten

emotionally laden probes (e.g. ‘Can you tell me of a re-

cent experience of being quite angry about something?’)

are presented to a participant, and he or she is asked to

write down recent experiences brought to mind by the

probes. The participant then selects some of the experi-

ences to elaborate on. During the interview, the inter-

viewer listens sympathetically and confirms the content

of the participant’s experience, while also probing for

the structuring of the experience. The combination of

the emotionally laden probes and the why-questions in-

vites the participants to describe their experiences at the

borderline between what is and is not explicitly reflected

upon. An analysis of transcripts from the interview al-

lows the researcher to score where participants are on

their developmental journey according to Kegan’s devel-

opmental theory (1982, 1994). This score indicates

whether the participants are currently at one order of

mind or in transition between two orders of mind,

where four sub-stages can be distinguished. The inter-

rater reliability for the SOI ranges between 0.82 to 1.00

for agreement within one discrimination unit (Kegan,

1994; Lahey et al., 1988/2011). We have completed

training in subject-object interviewing, are experienced

and reliable scorers, and we will establish and report on

our inter-rater reliability within this study. If a partici-

pant scores at a transitional order of mind, we will allo-

cate him or her according to the dominant order. We are

interested to include all adult orders of mind in this

study, preferably three participants within each order.

However, we are aware of the difficulty of recruiting

persons who make meaning at the self-transforming

mind as they are few and far between (Kegan, 1994).

Knowing this, and given the resources necessary to con-

duct and analyse such SOIs, it is unlikely that we will be

able to recruit enough participants at the self-

transforming mind. It is likely that we can include at

least three persons at the socialized mind and three at

the self-authoring mind, as these are the two orders

where most of the adult population makes meaning

(Kegan, 1994).

We will conduct an in-depth phenomenological inter-

view with each of the participants. This form of the

open qualitative interview will allow us to reveal the

phenomenon of well-being as it emerges in the partici-

pants’ descriptions of their experiences of the

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phenomenon (Giorgi, 2009). We have found that three

such interviews suffice to make valid inferences about

the participants’ experiences with the phenomenon un-

der investigation. That is mainly because a descriptive

phenomenological analysis makes use of all data mate-

rial and is not guided by themes that are established be-

forehand. We will analyse the descriptions separately for

each of the orders of mind, resulting in so-called general

meaning structures. Such a general meaning structure re-

veals the shared meaning across many variations of how

participants experience the phenomenon in their daily

life (Giorgi, 2009). In a final analysis, we will compare

and discuss differences and similarities in the general

meaning structure of the phenomenon between the or-

ders of mind. The results of this will feed into the next

stage of the project.

SHAPING STRUCTURAL
DEVELOPMENTAL HEALTH PROMOTION

We referred earlier to a quote that a hallmark of health

promotion is the aim to bring ‘more life to years, not

just years to life’ (Vaillant, 2004, p. 561). One way to

bring more life to years is to facilitate experiences of

well-being through the promotion of a lifestyle pervaded

by such experiences. We will endeavour to make our re-

search results accessible to retirees as well as to the

policy-makers and welfare and health promotion profes-

sionals who are engaged in their well-being. What do we

expect to be able to tell them? What does our research

underscore or explicate? In the following, we present a

preliminary sketch along three lines of the contribution

value of the rationale presented above.

First, both forms of interview will most likely pro-

vide information about the shift from working life to re-

tirement. The phenomenological interview aims to

capture the general meaning structure of well-being dur-

ing early retirement. The SOI explores how the individ-

ual structures some of his or her recent experiences with

change, success, feeling torn, etc. A change of lifestyle

that comes with a major shift (such as retiring) appears

in the light of a structural developmental approach as ei-

ther solving a technical problem or overcoming an adap-

tive challenge (Heifetz and Linsky, 2002). The latter

implies a change in order of mind, whereas the former

means that the person maintains the same order of mind

while incorporating new activities in his or her daily life.

For instance, the third age could be lived so that time is

increasingly spent on previously well-established activi-

ties, or it could incorporate new activities that facilitate

or emerge with the structural development of mind. An

awareness of the differences between these changes

assists the retiree, welfare professional and policy-maker

alike in choosing or recommending one activity in fa-

vour of another.

Second, both types of interview will provide informa-

tion about how well-being takes shape in different orders

of mind. Following Labouvie-Vief et al. (1989), Noam,

Young, and Jilnina (2006) have argued that people at var-

ious levels of mental complexity may experience and un-

derstand their well-being in qualitatively different ways.

Bauer (2011) researched the content of the growth stories

told by persons with late stages of mental growth (with

what he refers to as ‘postconventional selves’). He found

that, on average, later stages of development do not nec-

essarily make a person more happy as measured by estab-

lished quantitative measures of well-being (Diener et al.,

1985), which is consistent with Kegan’s theoretical as-

sumptions. One finding, however, stands out, namely

that the individuals with the highest score of mental com-

plexity had indeed higher levels of well-being on average

when compared to the other stages (Bauer et al., 2011).

However, Bauer et al. (2011) findings are preliminary,

given the relatively small number of participants who

scored in the highest stage. Mental complexity, Bauer and

colleagues confirm, taps into different aspects of well-

being, but their research is inconclusive as to how the

first-person experience of well-being relates to mental

growth, especially concerning individuals who have not

reached the very late stages of development, i.e. the ma-

jority of the population.

Kegan (1982, pp. 267-268) has looked into what can

be called psychological ‘ill-being’ and its relation to

mental complexity. He analysed patient journals at a

psychiatric hospital and inferred three different kinds of

depression, characterized by three types of loss, respec-

tively: a loss of one’s own needs or the increasing costs

of trying to satisfy these needs, a loss of an interpersonal

relationship leading to loneliness or even a loss of parts

of oneself, and loss of control over meeting one’s own

standards. Upon first measuring mental complexity and

then relating it to these three types of depression, a

strong association between type of depression and men-

tal complexity was observed.

We aim to follow up on the interest of Noam et al.

(2006) and Bauer et al. in the link between mental com-

plexity and well-being, and use a research design in-

spired by Kegan’s study of depression. Here we will first

divide our participants up into groups according to their

SOI score, and then interview them to discover how they

experience well-being.

Third, the combination of both interviews will pro-

vide essential information to suggest new opportunities

for tailoring interventions to the intermediate range

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between the unique individual and larger cohorts of the

population. Tailored interventions have been defined as

follows: ‘Any combination of information or change

strategies intended to reach one specific person, based

on characteristics that are unique to that person, related

to the outcome of interest, and have been derived from

an individual assessment’ (Kreuter and Skinner, 2000,

p. 1; italics in original). For our purposes, this may be an

unattainable ideal considering the amount of resources

required. At the other end of the continuum, health pro-

motion that is specific to cohorts, though economically

more manageable, may risk not reaching all the mem-

bers of the targeted population. Consequently, we prefer

an intermediate range at which to target the population

of retirees. In other words, understanding how individ-

uals with different orders of mind experience well-being

differently allows programme developers to tailor psy-

chologically spacious programmes while avoiding indi-

vidual time-consuming assessments. Moreover, health

care and welfare professionals will benefit from an

awareness of structural development, lest they under- or

overshoot their communication with the target popula-

tion concerning health promotion activities. Therefore,

our research may also help to provide these profes-

sionals with knowledge of lifelong development and

learning as well as active ageing.

CONCLUSION

In this article we have outlined perspectives which have

as yet not been combined. We have emphasized the no-

tion of adding more life to years as well as the potential

for structural developmental thinking in health promo-

tion initiatives. This is an area largely untouched in the

health promotion literature, and we see its inclusion as a

contribution to extending the positive period of the third

age while also aiding the compression of the fourth age.

We have underscored the reciprocity of well-being

and lifestyle and have argued that the experience of

well-being may have quite different manifestations for

different persons when seen through the lenses of a

structural development approach. We have sketched a

feasible mid-range approach to tailoring health promo-

tion initiatives. This approach attends to the orders of

the mind within the target group and has the potential

to overcome the practical difficulties of developing

unique individual health promotion initiatives.

We have presented one structural developmental the-

ory within the neo-Piagetian tradition as a contrasting

view to the current phase theories employed in ageing

research, but there are many others which we have not

discussed. Notable examples of others in this tradition

are Kohlberg (1969), Fowler (1981), Commons et al.

(1998), Gilligan (1982), Basseches and Mascolo (2009),

Cook-Greuter (1999) and Loevinger and Blasi (1976).

Kegan’s theory of adult development in health promo-

tion serves our purpose well, which is why we have not

focused on other potentially appropriate theories of

adult development or mental growth. We conclude that

a sensitivity towards the complexity of mind with re-

spect to the experience of well-being will provide health-

care professionals and policy-makers with a powerful

tool in their health promotion toolbox.

ACKNOWLEDGEMENTS

We wish to thank the two reviewers for their insightful com-

ments and specific points of improvements for the article.

REFERENCES

Baltes, P. B. (1997) On the incomplete architecture of human on-

togeny: Selection, optimization, and compensation as foun-

dation of developmental theory. American Psychologist 52,

366–380.

Baltes, P. B. and Baltes, M. M. (1990). Successful ageing: A psy-

chological model. In Baltes P. B. & Baltes M. M. (Eds.),

Successful aging: Perspectives from the Behavioral Sciences

(pp. 1–34). Cambridge: Cambridge University Press.

Baltes, P. B. and Smith, J. (2003) New frontiers in the future of

aging: From successful aging of the young old to the di-

lemmas of the fourth age. Gerontology 49, 123–135.

Basseches, M. and Mascolo, M. F. (2009). Psychotherapy as a

Developmental Process. New York, NY: Routledge

Bauer, J. J. (2011). The postconventional self: Ego maturity,

growth stories. . . and happiness? In Pfaffenberger A. H.,

Marko P. W., & Combs A. (Eds.), The Postconventional

Personality: Assessing, Researching, and Theorizing Higher

Development (pp. 101–117). Albany, NY: SUNY Press.

Bauer, J. J., Schwab, J. R. and McAdams, D. P. (2011) Self-actu-

alizing: Where ego development finally feels good?. The

Humanistic Psychologist 39, 121–136.

Berger, J. G. (2012). Changing on the job: Developing leaders

for a complex world. Stanford, CA: Stanford Business

Books.

Cockerham, W. (2005) Health lifestyle theory and the conver-

gence of agency and structure. Journal of Health and Social

Behavior 46, 51–67.

Commons, M. L., Trudeau, E. J., Stein, S. A., Richards, F. A.

and Krause, S. R. (1998) Hierarchical complexity of tasks

shows the existence of developmental stages.

Developmental Review 18, 237–278.

Cook-Greuter, S. R. (1999). Postautonomous Ego Development:

A Study of Its Nature and Measurement. (Doctoral disserta-

tion), Harvard Graduate School of Education.

Daatland, S. O. and Solem, P. E. (1995). Velferdsgevinst eller

velferdstap ved å bli pensjonist? In Kjønstad A., Hatland

692 L. Bauger and R. Bongaardt

D
ow

nloaded from
https://academ

ic.oup.com
/heapro/article-abstract/33/4/686/2897769 by A

dam
E

llsw
orth, A

dam
E

llsw
orth on 21 S

eptem
ber 2018

A., & Halvorsen B. (Eds.), Det norske trygdesystemet:

Fortid, nåtid og framtid (pp. 85–112). Oslo: Ad Notam

Gyldendal.

Davis S. (2008) The influence of collectivistic and individualistic

value orientations on the acceptance of individually-tailored

Internet communications. Interface: The Journal of

Education, Community and Values 8, 17–32. http://com

mons.pacificu.edu/inter08/ (last accessed 28 December

2016).

Diener, E., Emmons, R. A., Larsen, R. J. and Griffin, S. (1985)

The satisfaction with life scale. Journal of Personality

Assessment 49, 71–75.

Elstad, J. I. (2000). Social inequalities in health and their expla-

nations (NOVA Report 9/00). www.hioa.no/content/down

load/45507/674888/file/2746_1.pdf (last accessed 28

December 2016).

Erikson, E. H. (1980). Identity and the Life Cycle. New York,

NY: Norton.

Fitzgerald, C. and Berger, J. G. (2002). Leadership and complex-

ity of mind: The role of executive coaching. In Fitzgerald C.

& Berger J. G. (Eds.), Executive Coaching: Practices &

Perspectives (pp. 27–57). Palo Alto, CA: Davies-Black Pub.

Fowler, J. W. (1981). Stages of faith: The psychology of human

development and the quest for meaning. San Francisco, CA:

Harper & Row.

Freund A. M., Nikitin J & Ritter J. O. (2009) Psychological

Consequences of Longevity. Human Development 52, 1–37.

George, L. K. (2011). The third age: Fact or fiction – And does it

matter. In Carr, C. D. & Komp K. (Eds.), Gerontology in

the era of the third age: implications and next steps. New

York, NY: Springer.

Gilligan, C. (1982). In a different voice. Cambridge, MA:

Harvard University Press.

Giorgi, A. (2009). The descriptive phenomenological method in

psychology: A modified Husserlian approach. Pittsburgh,

PA: Duquesne University Press.

Heifetz, R. A. and Linsky, M. (2002). Leadership on the line

staying alive through the dangers of leading. Boston, MA:

Harvard Business Shool Press.

Helsing, D., Drago-Severson, E. and Kegan, R. (2004). Applying

constructive-developmental theories of adult development

to ABE and ESOL practices. In Comings J., Garner B., &

Smith C. (Eds.), Connecting research, policy, and practice

(pp. 157–197). Mahwah, NJ: Lawrence Erlbaum.

Huppert, F. A. (2009) Psychological well-being: Evidence re-

garding its causes and consequences. Applied Psychology:

Health and Well-Being 1, 137–164.

Kegan, R. (1982). The evolving self: Problem and process in hu-

man development. Cambridge, MA: Harvard University

Press.

Kegan, R. (1994). In over our heads: The mental demands of

modern life. Cambridge, MA: Harvard University Press.

Kegan, R. (1998). Epistemology, expectation, and aging: A develop-

mental analysis of the gerontological curriculum. In Lomranz J.

(Ed.), Handbook of aging and mental health: An integrative ap-

proach (pp. 197–216). New York, NY: Plenum Press.

Kloep, M. and Hendry, L. B. (2006) Pathways into retirement:

Entry or exit?. Journal of Occupational and Organizational

Psychology 79, 569–593.

Kohlberg, L. (1969). Stage and sequence: The cognitive-

developmental approach to socialization. In Goslin D. A.

(Ed.), Handbook of socialization theory and research.

Chicago, IL: Rand McNally.

Koss, C. and Ekerdt, D. J. (2016) Residential reasoning and the

tug of the fourth age. The Gerontologist. doi:10.1093/ger-

ont/gnw010.

Kreuter, M. W. and Skinner, C. S. (2000) Tailoring: what’s in a

name?. Health Education Research 15, 1–4.

Kreuter, M. W., Strecher, V. J. and Glassman B. (1999) One size

does not fit all: The case for tailoring print materials. Annals

of Behavioral Medicine 21, 276–283.

Labouvie-Vief, G., Hakim-Larson, J., DeVoe, M. and

Schoeberlein, S. (1989) Emotions and Self-Regulation: A

Life Span View. Human Development 32, 279–299.

Lahey, L., Souvaine, E., Kegan, R., Goodman, R. and Felix, S.

(1988/2011). A guide to the subject-object interview: Its admin-

istration and interpretation. Cambridge, MA: Minds at Work.

Laslett, P. (1996). A fresh map of life: the emergence of the

Third Age. Basingstoke, UK: Macmillan.

Lewis, P. M. (2011). The discerning heart: The developmental

psychology of Robert Kegan [Kindle version]. http://www.am

azon.com/The-Discerning-Heart-Developmental-Psychology-

ebook/dp/B006F631FY (last accessed 28 December 2016).

Loevinger, J. and Blasi, A. (1976). Ego development. San

Francisco, CA: Jossey-Bass.

Noam, G. G., Young, C. H. and Jilnina, J. (2006). Social cogni-

tion, psychological symptoms, and mental health: The

model, evidence, and contribution of ego development. In

Cicchetti D. and Cohen D. J. (Eds.), Developmental psycho-

pathology, Vol 1: Theory and method (2nd ed.) (pp.

750–794). Hoboken, NJ, US: John Wiley & Sons Inc.

Nutbeam, D. (1998) Health promotion glossary. Health

Promotion International 13, 349–364.

Orji, R. and Mandryk, R. L. (2014) Developing culturally relevant de-

sign guidelines for encouraging healthy eating behavior.

International Journal of Human-Computer Studies 72, 207–223.

Osborne, J. W. (2011) Psychological effects of the transition to

retirement. Canadian Journal of Counselling and

Psychotherapy 46.

Pinquart, M. and Schindler, I. (2007) Changes of life satisfaction

in the transition to retirement: A latent-class approach.

Psychology and Aging 22, 442–455.

Robinson O. (2013). Development Through Adulthood: An

Integrative Sourcebook. Basingstoke, UK: Palgrave

Macmillan.

Rosen H. (1991). Constructivism: Personality, psychopathol-

ogy, and psychotherapy. In Keating D. P. and Rosen H.

(Eds.), Constructivist perspectives on developmental psy-

chopathology and atypical development (pp. 149–171).

Hillsdale, NJ: Erlbaum.

Rowe, J. W. and Kahn, R. L. (1987) Human aging: Usual and

successful. Science 237, 143.

Developmental psychology in health promotion for retirees 693

D
ow

nloaded from
https://academ

ic.oup.com
/heapro/article-abstract/33/4/686/2897769 by A

dam
E

llsw
orth, A

dam
E

llsw
orth on 21 S

eptem
ber 2018

Solem, P. E. (2012). Ny kunnskap om aldring og arbeid (NOVA

Rapport 6/12). www.nova.no/asset/5577/1/5577_1.pdf (last

accessed 28 December 2016).

Souvaine, E., Lahey, L. L. and Kegan, R. (1990). Life after for-

mal operations: Implications for a psychology of the self. In

Alexander C. N. & Langer E. J. (Eds.), Higher stages of hu-

man development: Perspectives on adult growth (pp.

229–257). New York, NY: Oxford university press.

Vaillant, G. E. (2004). Positive aging. In Linley P. A. & Joseph S.

(Eds.), Positive psychology in practice (pp. 561–578).

Hoboken, N.J.: Wiley.

Veal, A. J. (1993) The concept of lifestyle: A review. Leisure

Studies 12, 233–252.

Villar, F. (2012) Successful ageing and development: the contri-

bution of generativity in older age. Ageing and Society 32,

1087–1105.

Wang, M. (2007) Profiling retirees in the retirement transition

and adjustment process: Examining the longitudinal change

patterns of retirees’ psychological well-being. Journal of

Applied Psychology 92, 455–474.

Wang, M. and Shi, J. (2014) Psychological research on retire-

ment. Annual Review of Psychology 65, 209–233.

Whitehead, D. (2011) Before the cradle and beyond the grave: A

lifespan/settings-based framework for health promotion.

Journal of Clinical Nursing 20, 2183–2194.

Wilson, D. M. and Palha, P. (2007) A systematic review of pub-

lished research articles on health promotion at retirement.

Journal of Nursing Scholarship 39, 330–337.

World Health Organization. (2002). Active ageing: A policy

framework. whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_

02.8.pdf?ua¼1 (last accessed 28 December 2016).
Zhang, S., Tao, F., Ueda, A., Wei, C. and Fang, J. (2013) The in-

fluence of health-promoting lifestyles on the quality of life of

retired workers in a medium-sized city of Northeastern

China. Environmental Health and Preventive Medicine 18,

458–465.

694 L. Bauger and R. Bongaardt

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rstb.royalsocietypublishing.org

Research
Cite this article: Kline MA, Shamsudheen R,
Broesch T. 2018 Variation is the universal:

making cultural evolution work in

developmental psychology. Phil. Trans. R. Soc.

B 373: 20170059.
http://dx.doi.org/10.1098/rstb.2017.0059

Accepted: 12 December 2017

One contribution of 16 to a theme issue

‘Bridging cultural gaps: interdisciplinary studies

in human cultural evolution’.

Subject Areas:
cognition, evolution, developmental biology,

behaviour

Keywords:
cultural evolution, developmental psychology,

cross-cultural psychology, ethnocentrism,

evolution and human behaviour

Author for correspondence:
Michelle Ann Kline

e-mail: [email protected]

†The second and third authors contributed

equally to this manuscript.

& 2018 The Author(s) Published by the Royal Society. All rights reserved.

Variation is the universal: making cultural
evolution work in developmental
psychology

Michelle Ann Kline1,2, Rubeena Shamsudheen3,† and Tanya Broesch1,†

1Department of Psychology, Simon Fraser University, Burnaby, BC, Canada V5A 1S6
2Institute of Human Origins, Arizona State University, Tempe, AZ 85287-4101, USA
3Department of Cognitive Science, Central European University, Nador u. 9, 1051 Budapest, Hungary

MAK, 0000-0002-1998-6928

Culture is a human universal, yet it is a source of variation in human psy-

chology, behaviour and development. Developmental researchers are now

expanding the geographical scope of research to include populations beyond

relatively wealthy Western communities. However, culture and context still

play a secondary role in the theoretical grounding of developmental psychol-

ogy research, far too often. In this paper, we highlight four false assumptions

that are common in psychology, and that detract from the quality of both stan-

dard and cross-cultural research in development. These assumptions are: (i) the
universality assumption, that empirical uniformity is evidence for universality,
while any variation is evidence for culturally derived variation; (ii) the Western
centrality assumption, that Western populations represent a normal and/or
healthy standard against which development in all societies can be compared;

(iii) the deficit assumption, that population-level differences in developmental
timing or outcomes are necessarily due to something lacking among non-Wes-

tern populations; and (iv) the equivalency assumption, that using identical
research methods will necessarily produce equivalent and externally valid

data, across disparate cultural contexts. For each assumption, we draw on cul-

tural evolutionary theory to critique and replace the assumption with a

theoretically grounded approach to culture in development. We support

these suggestions with positive examples drawn from research in development.

Finally, we conclude with a call for researchers to take reasonable steps towards

more fully incorporating culture and context into studies of development, by

expanding their participant pools in strategic ways. This will lead to a more

inclusive and therefore more accurate description of human development.

This article is part of the theme issue ‘Bridging cultural gaps: interdisci-

plinary studies in human cultural evolution’.

1. Human development requires culture
Humans stand out among other animals because we adapt to new environments

both by being clever innovators [1] and through the accumulation of cultural

knowledge across generations [2,3]. Social learning, including intensive forms

such as teaching [4 – 6], can facilitate cumulative cultural evolution. In fact, low-

cost social learning mechanisms, as well as sources of innovation, are prerequisites

for the evolution of cumulative culture. For this reason, social learning mechan-

isms are central to the understanding of cultural evolution—and cultural

evolution is key to explaining why and how human ontogeny is so very flexible.

Culture is a human universal: all societies have shared knowledge, practices,

beliefs and rituals that are transmitted socially. At the same time, culture is also a

source of psychological and behavioural variation both within and across popu-

lations. Developmental processes that are sensitive to socio-environmental

influences are one way that flexibility can evolve [7,8], and evolution can produce

developmental processes that vary in adaptive ways in terms of the degree and

nature of their flexibility [9]. Elaborating on the relationship between culture

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and development first requires recognizing that evolution and

development are not mutually exclusive, then building on that

insight to explore how evolved developmental mechanisms

that are sensitive to cultural influence can create psychological

and behavioural variation across and within societies [8].

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Phil.Trans.R.Soc.B

373:20170059

2. Developmental psychology requires a
culturally diverse sample

Despite the importance of culture to development, develop-

mental psychology as a field retains a near-absolute focus on

development in relatively wealthy Western, English-speaking

populations. Henrich et al. [9] term general psychology’s par-
ticipant pool ‘WEIRD:’ Western, educated, industrialized, rich

and democratic. A recent review provides evidence that this

is also the case in leading developmental psychology journals:

more than 90% of study populations represented there are from

the USA, Europe and/or are English-speaking [10]. The rest of

the world is vastly underrepresented, with only approximately

7% of participant populations coming from non-Western

human populations (the remainder are non-human animal

populations). In this context, developmental psychologists

who pursue cross-cultural research are wisely expanding

the scope of research to include participants beyond predomi-

nantly Western, upper middle class and often ethnically

white participants [9,11,12]. We applaud these efforts—

anything less would only perpetuate an incomplete and

inaccurate picture of human development.

Poor sampling, however, is not the only problem in the

field. Arnett [11], and Meadon & Spurrett [13] address a lack

of inclusivity in the broader practice of psychology: theories,

studies and publications in the American Psychological Associ-

ation journals are all overwhelmingly created, reviewed and

edited by this same subset of the world’s population. This is

one reason why the sampling problem in developmental

psychology is not likely to be solved by laboratory-based

researchers making the decision to take on cross-cultural

work unilaterally, in the short term. Dropping in on commu-

nities with unfamiliar cultures to run brief, one-off studies

without a long-term reciprocal relationship with the commu-

nity can be ethically dubious [14], especially where there is a

power differential. Further, interpreting results in isolation

from a population’s daily cultural context can produce more

confusion than answers [15]. And yet avoiding these pitfalls

requires investing what can be a prohibitive amount of time,

effort and funding to start and maintain a field site. A more

plausible way to ameliorate psychology’s WEIRD problem is

to recruit, support, include and collaborate with more scientists

from beyond the WEIRD populations that have created the bias

in the first place [11,13]. Alternatively, researchers can work

with non-university populations nearby, to explore variation

among people in their own local context [14]. More generally,

researchers who study WEIRD populations must also recog-

nize that their populations are also influenced by culture and

should consider carefully how to define the specific population

from which they recruit participants. Both these strategies fit

with a broader, theoretically motivated approach to expand

the inclusiveness of sampling in developmental psychology.

This paper aims to show why developmental psychology

needs this change, and establish some guidelines for how to

study culture’s role in development, no matter how near or

far from home the study site may be.

3. Cultural evolution can motivate a better
science of developmental psychology

Cross-cultural data are expensive to get, but valuable to have.

Their rarity in developmental psychology is due to more

than a lack of interest in cross-cultural sampling, and we

cannot dissolve those very real barriers in this paper. Instead,

our goals in this paper are twofold. First, we aim to convince

researchers in the field of developmental psychology that con-

siderations of culture are relevant to their work, even if they

do not do far-flung fieldwork themselves. Second, for cross-

cultural developmental psychologists, we aim to leverage

cultural evolutionary theory to enrich the central role of

cross-cultural data to developmental psychology as a field.

To achieve these aims, we highlight four common but false

assumptions in present-day approaches to cultural variation

in developmental psychology, and critique each in turn by

drawing on cultural evolutionary theory and empirical find-

ings. This step of identifying and refuting these assumptions

will help to integrate the ‘cross-cultural’ niche within develop-

mental psychology, in general, by demonstrating how culture

and culture-based assumptions underlie some of the basic

ideas that motivate research in developmental psychology.

Those assumptions are that: (i) universality and uniformity

are equivalent: that what is universal must necessarily follow

a uniform pattern of development; (ii) Western populations

are central in human psychology; (iii) differences among

populations in development are always indicative of deficits;

(iv) methods can automatically be transported across cultural

contexts and yet maintain validity. We critique each assump-

tion in turn, by drawing both on cultural evolutionary theory

and on positive examples from the developmental psychology

literature. In our conclusion section (§8), we summarize a gen-

eral strategy for research that eschews these assumptions, and

argue that this approach can pave the way for an improved

science of developmental psychology by placing the cultural

nature of humans at its centre.

4. Problem no. 1: the universality as uniformity
assumption

The universality assumption is the belief that observed uniformity
is evidence for species-wide, biologically based universality. By

contrast, any variation is regarded as evidence for culturally

derived differences. By ‘universal’, we mean core mental or

behavioural attributes shared by humans everywhere [16].

This assumption sometimes takes the form of an explicit

claim that uniformity implies genetic underpinnings (often mis-

categorized as ‘biological’ or ‘evolutionary’), while variation

necessarily indicates ‘cultural’ influences [17]. In all its forms,

this assumption rests on the false nature/nurture dichotomy,

that culture and biology are separate, opposite and competing

explanations. In reality, human cultural capacities are part of

our biology [18,19]. Equating psychological or behavioural vari-

ation with cultural influence precludes a deeper understanding

of human behaviour, because a universally shared develop-

mental process can function to produce behavioural or

psychological variation. Instead, developmental flexibility and

culture are both parts of the biology of human development,

not alternative explanations—culture is a part of human

biology and development [8].

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This false dichotomy between nature and nurture pro-

duces two versions of the universality as uniformity

assumption: (a) that variation is equivalent to a lack of uni-

versality, and that (b) psychological/behavioural similarity

is equivalent to universality. For the sake of clarity, we

address each in turn.

(a) Variation equals cultural influence and lack
of universality

This assumption is often implicit in data analysis and study

interpretation. For example, researchers conduct cross-site com-

parisons and conclude that any between-site difference is

‘cultural’, without explaining how culture produces differences

in psychology and behaviour. In addition, researchers often

treat whole cultures as if they are a single experimental con-

dition, without considering the influence of environmental

factors, such as resource availability, wealth or differences in

the interpretation of the method (see §6 below). For example,

directly comparing norms for anonymous sharing among

wealthy Americans with those among poor, food-insecure

Polynesian populations may result in differences—but those

differences may be due to circumstances specific to resource

scarcity, rather than some underspecified aspect of culture.

This line of reasoning is not considered sufficient for studies

of culture in other animals, and leads to energetic debates

about sources of behavioural variation even in our closest

living relatives (e.g. [20 – 22]). However, the same logic is

rarely questioned in cross-cultural comparisons of human

psychology. While cross-cultural comparisons do contribute

to our knowledge of the range of variation in human behaviour,

most fall short of understanding the sources and the scale of

variation that can emerge via developmental processes—the

real question at hand.

(b) Uniformity equals genetic roots and lack of cultural
influence

The other side of the universality assumption consists of a belief

that uniformity in behaviour and psychology is indicative of

universally ‘innate’ traits that develop without cultural inputs.

When developmental psychologists ask whether a feature

is innate, and then seek to show that it emerges early and

reliably across human populations, they rely upon assump-

tions that equate sameness, universality and innateness. By

contrast, biologists have recognized notions of innateness as

useless in ecology, biology and behaviour since the early

1990s [19]. This rests on a recognition, as Barrett [8, p.157]

writes, that ‘. . .[t]here are not two kinds of things, the innate

and the non-innate, but only one, the developmental process

itself.’ Put simply, genes rely upon the environment in order

to create an organism, and vice versa. In humans, culture is

part of that ever-present environment.

(c) Improvements
The equation of sameness with universality, and the desire to

describe a general human psychology in these terms, have

long been a driving philosophy in American psychology

[11,16,23]. While valuable as a first pass, documenting simi-

larities across sociocultural contexts is a subpar strategy for

data collection when the goal is to understand culture’s role

in shaping development, or vice versa. Cultural evolutionary

theory offers an alternative perspective for shaping research

questions: that genes and culture have co-evolved in humans.

Because of this ‘dual-inheritance’ system, both genetic and cul-

tural information are essential ingredients in any explanation

of human biology. Most developmental psychologists would

not argue with this stance, but putting it into action in a

research programme is still a challenge. Cultural evolutionary

theory is useful in this practical sense, because it provides a

working definition of culture that can inform quantitative

work: ‘[c]ulture is information capable of affecting individuals’

behaviour, that they acquire from other members of their

species through teaching, imitation, and other forms of social

transmission’ [19, p. 5].

Cultural evolution’s distinction of culture as socially

learned information is useful as a research tool because it

means developmental psychologists need not ask whether

any particular trait is universal, biological and innate, versus

cultural. When biology and culture are not opposites, this

either/or is a meaningless, and therefore unanswerable,

question. Instead, developmental psychology can embrace a

transformed question: what is the relative influence of environ-

mental, cultural and other contextual factors on shaping

development of specific traits, in particular population? In

other words, how variable and flexible is the development of

this trait? Answering this context-rich question through studies

that theorize about the functional role of variation will produce

a body of evidence on how human psychological development

varies. From this, researchers can build a more complete map

of human psychological development.

This view, rooted in cultural evolutionary theory, places

flexibility at the centre of understanding what is universal

about human psychological development. This provides a

theoretically motivated way to predict when and how culture

ought to impact development, rather than simply checking

Western-based work against non-Western populations and

lumping traits that are the ‘same’ as universal, and those that

are ‘different’ as cultural.

(d) Developmental research case study
Studies of human language acquisition and socialization pro-

vide evidence for both variation in a cultural context, and

shared developmental processes. Geographically and culturally

disparate populations typically speak different languages, and

in some cases even show variation in the neurological under-

pinnings necessary to master and use different languages [24].

The cultural expectations for children as language learners

are shaped by their cultural contexts, and in some ways are inse-

parable from socialization more generally [25]. Language

acquisition processes illustrate that developmental processes

themselves—such as statistical learning [26]—can constitute

universal learning mechanisms, which in turn generate behav-

ioural and psychological variation. The same can be said for

children’s early learning environments: there are both shared

and variable features, cross-culturally. For example, Broesch &

Bryant [27,28] find that mothers and fathers across disparate

societies routinely modify the properties of their speech when

addressing young infants compared to when they address

adults, yet they do so in different ways [28]. Despite identifying

the existence of infant-directed speech by caregivers in North

America, Kenya, Fiji and Vanuatu, they also find that parents

vary cross-culturally in the form their infant-directed speech

takes. Mothers across diverse societies and rural Vanuatu

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fathers modified their speech by adjusting features of the per-

ceived pitch of their speech to infants. However, fathers in

North America only slowed down the rate of their speech, with-

out adjusting the perceived pitch [27]. The results of this study

demonstrate why researchers cannot simply search for univers-

ality by equating it with similarity: it is too broad a question,

and would lead us to ignore key details about the flexible

nature of developmental processes.

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5. Problem no. 2: the Western centrality
assumption

The Western centrality assumption is the belief that Western
populations represent a normal and/or healthy standard

against which development in all societies can and should be

compared. This assumption literally fits the original definition

of ethnocentric [29], in that it divides global populations into
two rough categories, ‘the West’ and ‘the Rest,’ with Western

societies at the centre of everything. This assumption is rarely

if ever made explicit in print, but it is worked into the foun-

dation of much developmental research, including the

cognitive and medical milestones that serve as guidelines for

both Western parents and international health agencies.

(a) Improvements
From a cultural evolutionary perspective, lumping Western and

non-Western societies into two broad categories of analysis is

simply throwing data away. The study of cultural evolution is

necessarily built on the study of the cultural history of societies

all over the world, because explaining cultural variation

requires a breadth of data across socioecological environments

([19]; see e.g. the range of sites included in Mace et al.’s edited
volume [30]). From this perspective, every cultural context is

an equally valid study site, and the importance of a particular

site is down to its specific cultural features and their relevance

to the research question. For example, Polynesia’s history of

step-wise settlement by ocean-faring canoe and its estimable

rates of contact among societies make its cultural history an

excellent case study on how population interconnectedness

can influence the accumulation of complex material culture

[31,32]. The key message from cultural evolutionary theory

here is that these studies stand alone, and do not require a

Western comparison sample to lend them value.

(b) Developmental research case study
The Western centrality assumption directly damages the accu-

racy and usefulness of developmental research. For example,

Karasik et al. [33] review how developmental textbooks and
medical guidelines employ standards for motor development

that are built exclusively on American middle-class samples

as proscriptive milestones. Karasik et al.’s data, drawn from
six different societies, document within- and between-

population variation in both the timing of the motor develop-

ment of sitting, as well as the social and material contexts that

contribute to those differences. This establishes a causal link

between context and developmental trajectories. Karasik et al.
conclude that using American-centric guidelines as if they

are universal has ‘led to a gross misrepresentation of motor

development’ ( p. 1033). Treating Western samples as a univer-

sal measuring stick for development is, unfortunately, a

pervasive practice. Greenfield et al. [34] review evidence that

developmental trajectories derived from the study of Western

populations, with their focus on independence, are unlikely

to match how children learn and grow in sociocultural contexts

where interdependence is prioritized. This is particularly true

for social development. For example, while adolescence may

be a transition to autonomy in independence-focused societies,

in an interdependent society it is instead a relational shift that

makes sense only in the context of kinship and community [34].

Likewise, classic theories of attachment [35] presuppose

that the end goal of child development is independence and

autonomy, rather than locally appropriate integration into

kinship- and community-based interdependent relationships.

In a review, Keller [36] questions whether these theories hold

up when used to explain behaviour in cultural contexts

beyond Western societies, and argues that incorporating data

from additional populations requires revising existing theory

along lines suggested by cultural and evolutionary theories

of development.

6. Problem no. 3: the deficit assumption
The deficit assumption is that population-level differences in
developmental timing or outcomes are necessarily caused by

something lacking, typically in parenting or educational

systems. This line of reasoning allows for no flexibility, and

assumes a single, inflexible developmental outcome. The

assumption rides the coattails of the Western centrality assump-

tion, in that the timeline that establishes ‘normal’ development

from ‘delayed’ development is typically anchored on data from

Western populations. However, the deficit assumption can also

apply to Western populations or subpopulations therein. For

example, Lancy [37] argues that excessive levels of teaching in

Western societies may impinge on the development of a

child’s autonomy, The deficit assumption is also sometimes

applied to subpopulations within Western societies, and so

has recently become an important domain for self-critique in

the field of developmental psychology (see [38]). However,

the deficit assumption differs from the Western centrality

assumption in two important ways. First, the deficit assump-

tion carries an extra layer of interpretation in comparison

to the Western centrality assumption. By this we mean that

researchers simultaneously judge a given pattern in deve-

lopment as deviant and also attribute that difference to

something that is lacking or missing from a family’s or a popu-

lation’s way of raising children. This carries with it a value

judgement that goes beyond a scientific approach to describing

and explaining variation, and in doing so obscures the science

itself. Second, the Western centrality assumption functions

only in one direction. By contrast, the deficit assumption can

lead researchers to claim that Western children are somehow

worse off than non-Western ones. Often this takes the form

of arguing that Western children are coddled, spoiled or

excessively dependent on direct parent intervention.

In assuming that group-level developmental differences

are due to what is lacking in schooling or parenting, research-

ers frequently fail to (a) give any evidence for this mechanism

beyond handwaving that ‘culture’ is the cause, and (b) in

doing so, fail to consider the many specific axes of varia-

tion that comprise between-population differences. When

researchers fail to give a specific cultural mechanism yet attri-

bute differences to ‘culture,’ some of the variation may be due

to situation (e.g. resource insecurity) rather than culturally

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inherited differences (e.g. collective ownership norms). Where

this is the case, it is a serious challenge to the validity of cross-

cultural comparisons, in that it fails to account for potential

confounding variables. Recognizing and controlling for poten-

tial confounds are accepted as a crucial components of high-

quality research in developmental psychology, with particular

attention to detail in experimental studies. The same standard

should be applied at the level of cross-cultural comparisons.

The risk of neglecting to recognize a confounding variable

decreases with a research team’s expertise in the local context

at their study site. Finally, the deficit assumption reinforces a

deeper-seated assumption, (c) that there is one shared, correct

outcome for various stages of development, and that this does

not vary across populations or across societies.

(a) Improvements
Cultural evolutionary theory instead presents a functionalist

perspective. This means that the focus is on how different

domains of development fit into both physical maturity and

context-dependent social, emotional and relational factors.

This emphasis on function in context is shared with dynamic

systems theories [39], but an evolutionary approach is further

motivated by understanding how developmental processes

have emerged over an evolutionary timespan and in compari-

son to other species. From this perspective, developmental

flexibility, including social learning, is part of what allows

human culture to evolve faster than the human gene pool

[40], and this in turn makes humans adaptable over short time-

scales [2]. (In contrast with dynamic systems theory, the term

‘adapt’ is almost never used in cultural evolutionary theory

to refer to the timescale of a single individual behaving flexibly,

but rather it is a population-level concept.) As a result, psycho-

logical development is pluralistic by design, and this evolved

because flexibility is incredibly useful for a wide-ranging, inva-

sive species like Homo sapiens. Barrett [8] has coined the term
‘designed emergence’ to capture the idea that developmental

processes are flexible as a result of evolution by natural selection.

Simply put, this means there is a range of healthy, functional

outcomes that emerge from developmental processes. Outside

of that range, pathology is still possible, especially in cases of

extreme abuse or neglect that fall outside the breadth of typical

human experience. Specific outcomes are not predetermined by

genes, but are instead shaped by the interaction between genes

and environment in ways that have been manufactured by

natural selection. For developmental psychologists, the take-

home message here is that shared processes of human dev-

elopment have a variety of outcomes, and this flexibility in
outcomes is a feature rather than a bug. Developmental

researchers can leverage this insight to create and evaluate

hypotheses about how the form and developmental timing of

psychological phenomena fit in functional ways with children’s

roles in varying sociocultural contexts.

(b) Developmental case study
For example, psychologists have long assumed that direct,

active teaching (often characterized by the verbal communi-

cation of abstract ideas) is the most efficient way to scaffold

learning, and that therefore it must be present in all human

societies (for review see [6]). By contrast, some anthropologists

have often conflated direct instruction with involuntary, forced

transmission, which replaces more enjoyable and (by this

account) effective forms of learning by participation

([37,41,42]; see [6] for review). For both accounts, at least

some societies have got the wrong answer to how children

learn best—and children in those societies are at a deficit.

Kline [6,43] uses cultural evolutionary theory as a foun-

dation to argue that there are many functionally distinct

types of teaching, which can be mixed and matched with learn-

ing problems. From this perspective, no single type always

provides a ‘best’ outcome for the learner, because it depends

on the learning problem at hand. This approach treats develop-

ment as an integral working part of evolutionary processes,

and prioritizes functional and causal explanations of variation.

This is in contrast with other evolutionary accounts that

explain why humans, and only humans, teach by referring to

constraints in other animals. When successful, a cultural

evolutionary approach uses the rich and culturally specific

interpretations offered by ethnographic research as insights

that can inform broader claims about the evolution and

nature of human developmental psychology. Taking a func-

tionalist, cultural evolutionary perspective offers power for

generating and testing hypotheses in developmental psychol-

ogy by incorporating the full range of human variation into

what developmental psychologists term ‘typical’ development.

7. Problem no. 4: the equivalency assumption
The equivalency assumption is that using identical research
methods, scales or questions will automatically produce equiv-

alent and externally valid data, even across disparate cultural

contexts. Arnett [11] elaborates on this rationale as the predo-

minant philosophy of science in experimental American

psychology: that in the laboratory, it does not matter who the

participants are, or where or how they live—it matters only

that the procedures within the experiment itself are sufficiently

controlled. The equivalency assumption is demonstrably false

when taken to the extreme: written methods must be trans-

lated, and translation inevitably brings up questions of

whether or not there are shared concepts and meanings,

across sociolinguistic contexts. Non-linguistic methods may

avoid the problem of translation, but the question of whether

methods and stimuli map to shared concepts, social context

and expected behaviour across cultural groups is still an impor-

tant one. Such comparisons are only useful when the meaning

of the protocol is comparable across societies [44 – 46]. Further,

assuming equivalency also means that researchers may fail to

account for culturally specific environmental factors in devel-

opment that are either present in WEIRD contexts but not at

their study site, or that are absent in WEIRD contexts and there-

fore may be unrecognized as important factors at their study

sites. For example, while direct verbal instruction may be rare

in many non-Western societies, ethnographic studies of devel-

opment in these contexts reveal a rich, interactive social context

in which learning happens via participant observation and

inclusion of children in everyday activities [37,41,47]. The

social learning mechanisms vary but learning and develop-

mental change happen in all cultural contexts.

(a) Improvements
Cultural evolutionary theory treats the human brain, mind

and behaviour as having evolved in the context of human

interaction with the world, rich with social and cultural

context. Ignoring that this cultural context affects how parti-

cipants understand and respond to methods is particularly

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problematic when transporting methodologies across sociocul-

tural contexts that differ in broad ways [16,44,48,49]. This is a

problem even for developmental psychologists who do not

venture to do cross-cultural work, because it means their

methods and their results may be culture-bound and therefore

limited in ways they have not explored.

The equivalency assumption raises a particularly difficult

challenge for cross-cultural comparisons in developmental

psychology. The standards for experimental control are strin-

gent and technically demanding. For example, effect sizes

and statistical significance for studies with infants can

depend on looking times that differ in terms of milliseconds.

These tasks often require electricity, delicate equipment,

trained personnel and quiet laboratory space to run effec-

tively. However, even a perfectly replicated and controlled

methodology cannot guarantee that participants from two

different sociocultural contexts are interpreting the situation

in similar ways and therefore the behaviours observed may

not be comparable.

As Heine and co-workers [44,50] conclude, there is no

straightforward solution for this broad problem of context-

specific methodological validity. Instead, establishing real

comparability across populations requires more context, not
less—and this means bringing ethnography into the picture

as a standard resource to inform the design and interpretation

of studies in developmental psychology. Cultural evolutionary

research may seem an unlikely resource for addressing this

methodological challenge because the field has no signature

methodology of its own: for example, its studies of learning

biases draw upon established psychological methods, and its

studies of behaviour build on human behavioural ecology

and animal behaviour. The formal mathematical models that

established the field are themselves built on established

models in epidemiology and genetics. The field is so

thoroughly interdisciplinary that some cultural evolutionists

have even proposed a division of labour within cultural evol-

utionary studies that subsumes existing disciplines [51]. We

advocate instead for a mixed-methods approach, deploying

methods in combinations that strategically compensate for

the particular shortcomings of each method, and that are

suitable for the research problem at hand. This is standard

practice in some areas of social science, including the anthropo-

logical sciences, where both qualitative and quantitative data

and analyses are used as needed [52].

(b) Developmental case study
For example, researchers often treat mutual eye gaze between

infant and caretaker as a reliable and stand-alone indicator of

joint attention in the study of infant cognition. However,

Akhtar & Gernsbacher [53] point out that the social role of

eye gaze is variable across cultural contexts, and hence is not

always a reliable indicator of joint attention. North Americans

typically privilege eye contact and verbal interaction as a key

part of parenting [54], but Gusii mothers in Kenya avert their

eyes in response to mutual eye gaze with an excited infant, in

part to keep their babies calm [55]. According to LeVine &

LeVine [55], gaze avoidance by mothers is consistent with

polite behaviour by Gusii adults, where excessive eye contact

is considered rude and sometimes even aggressive. Gaze

avoidance does not mean Gusii mothers are inattentive to

their infants, but rather that they do not use mutual gaze as a

means of establishing joint attention. Instead, they may use

more physical types of interaction—a typical Gusii mother

cosleeps with her infant, breastfeeds on demand and responds

quickly to her infant’s distress. Based on Lancy’s review of the

ethnographic literature on children and childhood [54], the

Gusii approach of using more tactile contact and gestural com-

munication may be more typical around the world than the

North American approach, which emphasizes eye contact

and verbal communication. An excessive focus on eye gaze

as the key element in joint attention (e.g. [56]) may twist the

scientific understanding of joint attention by underestimating

its prevalence in societies where eye gaze is less important

than in North American contexts.

Rather than the narrowly Western-centric cue of eye gaze,

vocal and postural behaviours may represent a more culturally

generalizable set of cues for the study of infant social cognition

[53]. In fact, gestural, postural and vocal cues may play an

important role in Western contexts, but one that is de-empha-

sized in developmental psychology as a reflection of North

American culture. However, the plurality of methodological

approaches suggested by cultural evolutionary theory means

there is another option besides searching for single (or a set

of ) cues that always indicate joint attention, across sociocul-

tural contexts. Instead, researchers should use an array of

cues, designed for particular sociocultural contexts, to compare

the prevalence and behavioural form of joint attention across

human populations. Using identical methods based on cultu-

rally specific cues will produce only superficially comparable

data, and will produce a misleading picture of the ways in

which populations vary.

8. Conclusion
For each assumption above, we offer a shift in perspective that

uses cultural evolutionary theory to pry those assumptions

loose from present-day developmental psychological research.

For standard developmental psychology, this means seeing the

culture-bound nature of the questions, methods and results,

and appropriately characterizing the generalizability of the

research given the limited samples. For cross-cultural develop-

mental psychology, this means guarding against some of the

assumptions that are common in psychology more generally,

and employing cultural evolutionary theory to improve how

cross-cultural research is designed, conducted and interpreted.

Using this approach, researchers can take some small steps to

remediate the sampling problem in developmental psychology.

Researchers working at institutions in WEIRD societies can step

off campus to create more inclusive study by sampling popu-

lations in their towns but beyond campus, and in doing so can

increase the inclusivity of their samples with a moderate level

of investment in community engagement. They can also collab-

orate with and learn from colleagues at institutions outside of

North America and Western Europe, to work with scholars

who are both highly trained academics as well as regional

experts in the societies in which they work and live. We do not

argue that researchers should avoid studying or drawing

comparisons between WEIRD populations and additional

populations around the world. Instead, we argue that carefully

specifying the meanings of cross-cultural studies, using cultural

evolutionary theory, may open up a rich avenue for compara-

tive research. This includes comparisons both within and

between populations, to look for robust relationships between

cultural variation and corresponding psychological, behavioural

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and developmental variation. This kind of data will allow

researchers to study just how flexible human psychological

development may be, because it allows us to ask whether the

same causal relationships hold for development across popu-

lations, or whether the relationships and processes themselves

are flexible. In essence, this approach ties the form of develop-

mental flexibility to the sociocultural and ecological contexts in

which human psychology functions over the lifespan.

Researchers before us have tackled the question of appro-

priate cross-cultural comparisons, with a similar emphasis on

the need for strategic selection of field sites and research

problems (see e.g. [9,16]). In addition to these existing rec-

ommendations, we caution against any approach that treats

entire ‘cultures’ or nations as indivisible wholes that are cultu-

rally, psychologically or behaviourally homogeneous. Rather

than comparing whole ‘cultures,’ researchers should aim to

map variation both within and across populations, along mea-

surable axes of variation. This is especially applicable to broad

cross-site surveys, which often include only coarse measures

of cultural variation (e.g. gross domestic product, Gini

coefficient or years of education), treat single sites as represen-

tative of entire countries, and further conflate those countries

with ‘cultures.’ However, it is equally applicable to studies

restricted to Western populations, where researchers can both

expand the inclusivity of their samples, and be more explicit

about the degrees of variation included in those samples.

Both these practices will lead to better science in developmen-

tal psychology. By placing cultural context—and the flexibility

that it entails—at the centre of this work, researchers will gain a

deeper understanding of the developmental processes that

build human cultural variation.

The overarching message from a cultural evolutionary

perspective is that developmental trajectories and endpoints

can vary due to the human ability to learn flexibly, acquire

information from others, and to recombine socially and

individually learned information in creative ways. Using

this as a springboard, developmental psychologists are well

positioned to explore the developmental mechanisms and

processes by which human children adapt to their local socio-

cultural and environmental contexts. Doing so will mean

shedding light on one of the broadest human universals of

all: variability.

Data accessibility. This article has no additional data.
Authors’ contributions. M.A.K. conceived of and drafted the manuscript.
R.S. and T.B. both made intellectual contributions prior to the manu-
script’s first draft, and made edits and contributions to manuscript
drafts. R.S. and T.B. contributed equally. All the authors approved
the final version of this manuscript.

Competing interests. We declare we have no competing interests.
Funding. This research was made possible through the support of a
grant from the John Templeton Foundation to the Institute of
Human Origins at Arizona State University (no. 14020515). The
opinions expressed in this publication are those of the authors and
do not necessarily reflect the views of the John Templeton
Foundation.

Acknowledgements. We would like to thank Central European Univer-
sity’s Department of Cognitive Science, for inviting the authors to a
Social Mind Institute Workshop, which led to the formation of
some of the early ideas for this paper.

References

1. Pinker S. 2010 The cognitive niche: coevolution of
intelligence, sociality, and language. Proc. Natl
Acad. Sci. USA 107(Suppl. 2), 8993 – 8999. (doi:10.
1073/pnas.0914630107)

2. Boyd R, Richerson PJ, Henrich J. 2011 Colloquium
Paper: The cultural niche: why social learning is
essential for human adaptation. Proc. Natl Acad. Sci.
USA 108(Suppl. 2), 10 918 – 10 925. (doi:10.1073/
pnas.1100290108)

3. Henrich J. 2015 The secret of our success: how
culture is driving human evolution, domesticating
our species, and making us smarter. Princeton, NJ:
Princeton University Press.

4. Tennie C, Call J, Tomasello M. 2009 Ratcheting up
the ratchet: on the evolution of cumulative culture.
Phil. Trans. R. Soc. B 364, 2405 – 2415. (doi:10.
1098/rstb.2009.0052)

5. Dean LG, Vale GL, Laland KN, Flynn E, Kendal RL.
2013 Human cumulative culture: a comparative
perspective. Biol. Rev. 89, 284 – 301. (doi:10.1111/
brv.12053)

6. Kline MA. 2015 How to learn about teaching: an
evolutionary framework for the study of teaching
behavior in humans and other animals. Behav. Brain
Sci. 38, 1 – 70. (doi:10.1017/S0140525X14001071)

7. Jablonka E, Lamb MJ. 2014 Evolution in four
dimensions, 2nd edn. Cambridge, MA: MIT press.

8. Barrett HC. 2014 The shape of thought. Oxford, UK:
Oxford University Press.

9. Henrich J, Heine SJ, Norenzayan A. 2010 The
weirdest people in the world? Behav. Brain Sci. 33,
61 – 83. (doi:10.1017/S0140525X0999152X)

10. Nielsen M, Haun D, Kartner J, Legare CH. 2017 The
persistent sampling bias in developmental
psychology: a call to action. J. Exp. Child Psychol.
162, 31 – 38. (doi:10.1016/j.jecp.2017.04.017)

11. Arnett JJ. 2008 The neglected 95%. Am. Psychol.
63, 602 – 614. (doi:10.1037/0003-066X.63.7.602)

12. Nielsen M, Haun D. 2015 Why developmental
psychology is incomplete without comparative and
cross-cultural perspectives. Phil. Trans. R. Soc. B
371, 20150071. (doi:10.1098/rstb.2015.0071)

13. Meadon M, Spurret D. 2010 It’s not just the
subjects—there are too many WEIRD researchers.
Behav. Brain Sci. 33, 104 – 115. (doi:10.1017/
S0140525X10000208)

14. Fernald A. 2010 Getting beyond the ‘convenience
sample’ in research on early cognitive development.
Behav. Brain Sci. 33, 91 – 92. (doi:10.1017/
S0140525X10000294)

15. Rai TS, Fiske A. 2010 ODD (observation-and
description-deprived) psychological research. Behav.
Brain Sci. 33, 106 – 107. (doi:10.1017/
S0140525X10000221)

16. Norenzayan A, Heine SJ. 2005 Psychological
universals: what are they and how can we know?
Psychol. Bull. 131, 763 – 784. (doi:10.1037/0033-
2909.131.5.763)

17. Apicella CL, Barrett HC. 2016 Cross-cultural
evolutionary psychology. Curr. Opin. Psychol. 7,
92 – 97. (doi:10.1016/j.copsyc.2015.08.015)

18. Boyd R, Richerson PJ. 1985 Culture and the
evolutionary process. Chicago, IL: University of
Chicago Press.

19. Richerson PJ, Boyd R. 2005 Not by genes alone: how
culture transformed human evolution. Chicago, IL:
University of Chicago Press.

20. Whiten A, Horner V, Marshall-Pescini S. 2003
Cultural panthropology. Evol. Anthropol. 12,
92 – 105. (doi:10.1002/evan.10107)

21. Langergraber KE, Vigilant L. 2011 Genetic differences
cannot be excluded from generating behavioural
differences among chimpanzee groups. Proc. R. Soc. B
278, 2094 – 2095. (doi:10.1098/rspb.2011.0391)

22. Langergraber K, Schubert G, Rowney C,
Wrangham R, Zommers Z, Vigilant L. 2011
Genetic differentiation and the evolution of
cooperation in chimpanzees and humans.
Proc. R. Soc. B 278, 2546 – 2552. (doi:10.1098/rspb.
2010.2592)

23. Shweder RA. 1999 Why cultural psychology? Ethos
27(1), 62 – 73. (doi:10.1525/eth.1999.27.1.62)

24. Gea J, Peng G, Lyu B, Wang Y, Zhuoe Y, Niuf Z, Tang
LH. 2015 Cross-language differences in the brain
network subserving intelligible speech. Proc. Natl
Acad. Sci. USA 112, 2972 – 29777. (doi:10.1073/
pnas.1416000112)

rstb.royalsocietypublishing.org
Phil.Trans.R.Soc.B

373:20170059

8

D
ow

nl
oa

de
d

fr
om

h
tt

ps
:/

/r
oy

al
so

ci
et

yp
ub

li
sh

in
g.

or
g/

o
n

09
F

eb
ru

ar
y

20
22

25. Schieffelin B, Ochs E. 1986 Language socialization.
Annu. Rev. Anthropol. 15, 163 – 191. (doi:10.1146/
annurev.an.15.100186.001115)

26. Saffran JR, Aslin RN, Newport EL. 1996
Statistical learning by 8-month-old infants.
Science 274, 1926 – 1928. (doi:10.1126/science.274.
5294.1926)

27. Broesch T, Bryant GA. 2017 Fathers’ infant-directed
speech in a small-scale society. Child Dev. (doi:10.
1111/cdev.12768)

28. Broesch TL, Bryant GA. 2015 Prosody in infant-
directed speech is similar across western and
traditional cultures. J. Cogn. Dev. 16, 31 – 43.
(doi:10.1080/15248372.2013.833923)

29. LeVine RA. 2001 Ethnocentrism. In International
encyclopedia of the social and behavioral sciences
(eds NJ Smelser, PB Baltes), pp. 4852 – 4854.
Oxford, UK: Oxford University Press.

30. Mace R, Holden C, Shennan S (eds). 2005 The
evolution of cultural diversity: a phylogenetic
approach. Walnut Creek, CA: Leftcoast Press.

31. Kline MA, Boyd R. 2010 Population size
predicts technological complexity in Oceania.
Proc. R. Soc. B 277, 2559 – 2564. (doi:10.1098/rspb.
2010.0452)

32. Henrich J et al. 2016 Understanding
cumulative cultural evolution. Proc. Natl Acad. Sci.
USA. 113, E6724 – E6725. (doi:10.1073/pnas.
1610005113)

33. Karasik LB, Tamis-LeMonda CS, Adolph KE,
Bornstein MH. 2015 Places and postures. J. Cross
Cult. Psychol. 46, 1023 – 1038. (doi:10.1177/
0022022115593803)

34. Greenfield PM, Keller H, Fuligni A, Maynard A. 2003
Cultural pathways through universal development.
Annu. Rev. Psychol. 54, 461 – 490. (doi:10.1146/
annurev.psych.54.101601.145221)

35. Bowlby J. 1989 Attachment theory. Los Angeles, CA:
Lifespan Learning Institute.

36. Keller H. 2013 Attachment and culture. J. Cross Cult.
Psychol 44, 175 – 194. (doi:10.1177/0022022
112472253)

37. Lancy DF. 2010 Learning ‘from nobody’: the limited
role of teaching in folk models of children’s
development. Childhood Past. 3.1, 79 – 106. (doi:10.
1179/cip.2010.3.1.79)

38. Akhtar N, Jaswal VK. 2013 Deficit or difference?
Interpreting diverse developmental paths: an
introduction to the special section. Dev. Psychol. 49,
1 – 3. (doi:10.1037/a0029851)

39. Smith LB. 1993 A dynamic systems approach to
development: applications. Cambridge, MA: The MIT
Press.

40. Perreault C. 2012 The pace of cultural evolution.
PLoS ONE 7, e45150. (doi:10.1371/journal.pone.
0045150)

41. Paradise R, Rogoff B. 2009 Side by side: learning by
observing and pitching in. Ethos 37, 102 – 138.
(doi:10.1111/j.1548-1352.2009.01033.x)

42. Rogoff B, Matusov E, White C. 1996 Models of
teaching and learning: participation in a
community of learners. In The handbook of
education and human development: New models
of learning, teaching and schooling (eds DR
Olson, N Torrance), pp. 388 – 414. Oxford, UK:
Blackwell.

43. Kline MA. 2016 TEACH: an ethogram-based method
to observe and record teaching behavior. Field
Methods 29, 205 – 220. (doi:10.1177/
1525822X16669282)

44. Heine SJ, Norenzayan A. 2006 Toward a
psychological science for a cultural species. Perspect.
Psychol. Sci. 1, 251 – 269. (doi:10.1111/j.1745-6916.
2006.00015.x)

45. Pepitone A, Triandis HC. 1987 On the universality
of social psychological theories. J. Cross Cult.
Psychol 18, 471 – 498. (doi:10.1177/0022002
187018004003)

46. Poortinga YH. 1989 Equivalence of cross-cultural
data: an overview of basic issues. Int. J. Psychol. 24,
737 – 756. (doi:10.1080/00207598908246809)

47. Rogoff B, Paradise R, Arauz R, Correa-Chávez M,
Angelillo C. 2003 Firsthand learning through intent
participation. Annu. Rev. Psychol. 54, 175 – 203.
(doi:10.1146/annurev.psych.54.101601.145118)

48. Cohen D. 2007 Methods in cultural psychology.
In Handbook of cultural psychology, pp. 196 – 236.
London, UK: The Guilford Press.

49. Greenfield PM. 1997 Culture as process: empirical
methods for cultural psychology. In Handbook of
cross-cultural psychology: theory and method (eds
JW Berry, YH Poortinga, J Pandey), pp. 301 – 346.
Boston, MA: Allyn & Bacon.

50. Heine SJ, Lehman DR, Peng K, Greenholtz J. 2002
What’s wrong with cross-cultural comparisons of
subjective Likert scales?: The reference-group effect.
J. Pers. Soc. Psychol. 82, 903 – 918. (doi:10.1037/
0022-3514.82.6.903)

51. Mesoudi A, Whiten A, Laland KN. 2006 Toward a
unified science of cultural evolution. Behav. Brain Sci.
29, 329 – 383. (doi:10.1017/S0140525X06009083)

52. Bernard HR. 2011 Research methods in
anthropology: qualitative and quantitative
approaches, 5th edn. New York, NY: Altamira Press.

53. Akhtar N, Gernsbacher MA. 2008 On privileging the
role of gaze in infant social cognition. Child Dev.
Perspect. 2, 59 – 65. (doi:10.1111/j.1750-8606.2008.
00044.x)

54. Lancy DF. 2008 The anthropology of childhood.
Cambridge, UK: Cambridge University Press.

55. LeVine RA, Levine S. 1996 Child care and culture:
lessons from Africa. Cambridge, UK: Cambridge
University Press.

56. Tomasello M, Carpenter M, Call J, Behne T, Moll H.
2005 Understanding sharing intentions: the origins
of cultural cognition. Behav. Brain Sci. 28,
675 – 735. (doi:10.1017/S0140525X05000129)

  • Variation is the universal: making cultural evolution work in developmental psychology
    • Human development requires culture
    • Developmental psychology requires a culturally diverse sample
    • Cultural evolution can motivate a better science of developmental psychology
    • Problem no. 1: the universality as uniformity assumption
      • Variation equals cultural influence and lack of universality
      • Uniformity equals genetic roots and lack of cultural influence
      • Improvements
      • Developmental research case study
    • Problem no. 2: the Western centrality assumption
      • Improvements
      • Developmental research case study
    • Problem no. 3: the deficit assumption
      • Improvements
      • Developmental case study
    • Problem no. 4: the equivalency assumption
      • Improvements
      • Developmental case study
    • Conclusion
    • Data accessibility
    • Authors’ contributions
    • Competing interests
    • Funding
    • Acknowledgements
    • References

fpsyg-09-01992 October 19, 2018 Time: 12:18 # 1

REVIEW
published: 19 October 2018

doi: 10.3389/fpsyg.2018.01992

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Université de Cergy-Pontoise, France
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Eiji Uchibe,
Advanced Telecommunications

Research Institute International (ATR),
Japan

*Correspondence:
Hélène Cochet

[email protected]

Specialty section:
This article was submitted to
Developmental Psychology,

a section of the journal
Frontiers in Psychology

Received: 13 October 2017
Accepted: 28 September 2018

Published: 19 October 2018

Citation:
Cochet H and Guidetti M (2018)

Contribution of Developmental
Psychology to the Study of Social

Interactions: Some Factors in Play,
Joint Attention and Joint Action

and Implications for Robotics.
Front. Psychol. 9:1992.

doi: 10.3389/fpsyg.2018.01992

Contribution of Developmental
Psychology to the Study of Social
Interactions: Some Factors in Play,
Joint Attention and Joint Action and
Implications for Robotics
Hélène Cochet* and Michèle Guidetti

CLLE, Université de Toulouse, CNRS, UT2J, Toulouse, France

Children exchange information through multiple modalities, including verbal
communication, gestures and social gaze and they gradually learn to plan their
behavior and coordinate successfully with their partners. The development of joint
attention and joint action, especially in the context of social play, provides rich
opportunities for describing the characteristics of interactions that can lead to shared
outcomes. In the present work, we argue that human–robot interactions (HRI) can
benefit from these developmental studies, through influencing the human’s perception
and interpretation of the robot’s behavior. We thus endeavor to describe some
components that could be implemented in the robot to strengthen the feeling of dealing
with a social agent, and therefore improve the success of collaborative tasks. Focusing
in particular on motor precision, coordination, and anticipatory planning, we discuss the
question of complexity in HRI. In the context of joint activities, we highlight the necessity
of (1) considering multiple speech acts involving multimodal communication (both
verbal and non-verbal signals), and (2) analyzing separately the forms and functions of
communication. Finally, we examine some challenges related to robot competencies,
such as the issue of language and symbol grounding, which might be tackled by
bringing together expertise of researchers in developmental psychology and robotics.

Keywords: human–robot interaction, human development, joint attention, joint action, coordination, complexity,
gestures

INTRODUCTION

Developmental psychologists aim at describing and explaining changes across the life span in a
wide range of areas such as social, emotional, and cognitive abilities. Focusing on childhood is
a way of grasping numerous changes, especially in terms of communication: infants gradually
learn to identify the common ground they have with others and engage in social interactions. The
development of such abilities relies on the personal experiences shared between partners in specific
contexts (Liebal et al., 2013), among which social play may offer particularly rich opportunities
for children to acquire joint action and joint attention skills. Studying the different forms and
functions of communication in this context paves the way for identifying the necessary ingredients

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for effective joint activities and therefore better understanding
the architecture of human–social interactions. Even though
the concept of effectiveness may cover different theoretical
frameworks, the latter objectives have several applications, for
example in supporting children with atypical development,
especially when they have difficulty communicating both verbally
and non-verbally (e.g., children with autism spectrum disorders,
ASD), but also in the field of artificial intelligence. The role of
robots in society raises indeed a lot of debates and challenges,
as they share more and more space and tasks with humans, for
instance in service robotics to assist elderly people. The robots’
ability to initiate and respond to social interactions is one of the
key factors that will shape their integration in our everyday life
in the future. Researchers in social robotics have been working
on the question of joint action for over two decades now,
sometimes in collaboration with developmental psychologists
(e.g., Scassellati, 2000), in order to improve robots’ motor
and communicative skills. Developmental models of human
communicative behavior can indeed help define the components
to implement in human–robot interactions (HRI), so as to build
rich and natural joint activities (Breazeal et al., 2004; Lemaignan
et al., 2017).

The objective of this paper is twofold. First, we intend to
present the point of view and some research perspectives of
developmental psychologists on joint attention and joint action,
in particular in the context of social play. To this end, we
will also define, starting from studies on non-human primates,
what can be regarded as complex (or rich) and natural (or
effective) interactions in both human communication and HRI.
Second, we aim to show the extent to which the above-mentioned
issues may be of interest to roboticists, in helping conceptualize
and implement some variables associated with joint attention
and joint action in the context of HRI. Collaborative tasks
involving robot and human partners, regarded as tantamount to
children’s social play, will thus be considered through the prism
of pragmatic communication, allowing researchers to dissociate
the forms and the functions of communication.

HOW DOES COMMUNICATION
DEVELOP IN THE CONTEXT OF SOCIAL
PLAY?

The definitions of play include a wide range of activities,
which makes it difficult to determine where play begins and
where it ends, even though it is traditionally associated with
positive affective valence (Garvey, 1990). Play, which occurs in
several animal species (most notably in mammals), has been
argued to allow “practice of real-world skills in a relatively safe
environment” (Byrne, 2015). We will focus here on social play
in human children, which may also enable them, as highlighted
by Bruner (1973), to “learn by doing” as they interact with
one or several partners. At the individual level, children can
indeed explore and enhance specific skills like motor control and
creativity, while developing for example cooperation abilities at
the social level. The concepts of artifact-mediated and object-
oriented action, originally formulated by Vygotsky (1999), are

particularly relevant to describe these situations: the relationship
between the child and the surrounding objects is indeed mediated
by cultural means, tools, and signs. Studying the development
of play can therefore reveal how children come to represent and
think about their environment.

Social attention is a crucial capacity for the emergence of
these play situations, allowing children to focus on some of
the other’s characteristics such as the facial expressions, gaze
direction, gestures, and vocalizations. When the direction of
another’s attention has been identified (for example through gaze
following or point following), we can shift our own attention to
focus at the same time on the same external object or event as our
partner. This process of joint attention is usually inferred from
behavioral cues, including mainly gaze alternation between one’s
partner and a specific referent (Bourjade, 2017). Joint attention
seems therefore necessary for individuals to perform joint action,
i.e., to coordinate their actions in space and time to produce a
joint outcome, whether it involves here symbolic play (with or
without objects), construction toys, board games or any other
forms of play.

Joint attention and joint action begin to appear at the end
of the first year in human development (Carpenter et al., 1998),
gradually allowing children to integrate the notion of common
ground and engage in social interactions. The development of
gaze understanding, which has been widely studied, plays a
key role in this regard. It was for example shown in a study
using habituation-of-looking-time procedure that infants start to
understand ecologically valid instances of social gaze between
two adults interacting, and to have expectations concerning gaze
target at 10 months of age (Beier and Spelke, 2012). Besides,
responsive joint attention skills (e.g., gaze following and point
following) have been reported to emerge before initiative joint
attention skills, from 8 months of age (Corkum and Moore, 1998;
Beuker et al., 2013).

However, depending on the authors, the definitions of these
social-cognitive skills can be more or less demanding, the main
difference lying in whether or not individuals have mutual
understanding of their shared focus of attention. The ability to
“know together” that we are attending to the same thing as
our partner has sometimes been referred to as shared attention
(Emery, 2000; Shteynberg, 2015), which would develop in parallel
with shared intentionality (Tomasello and Carpenter, 2007). The
latter involves the motivation to share goals and intentions
with the other, as well as forms of cognitive representation for
doing so. This ability has been argued to constitute a hallmark
of the human species (Tomasello et al., 2005), even though it
is particularly difficult to assess when verbal language is not
available as a clue to these representations (in pre-linguistic
children or non-human primates). Similarly, joint action may
rely solely on the learning of the cues that appear significant
(e.g., gestures and eye contact) to coordinate actions in space and
time with a partner, or it may also involve, in a more demanding
perspective, the common and explicit knowledge of the objectives
of the activity and of the way to achieve them (Tomasello and
Carpenter, 2007).

Joint attention and joint action, whether they are accompanied
or not with shared and explicit intentions, thus allow children

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to participate with others in collaborative activities in which
each partner benefits from the joint outcome and/or from
the interaction in itself. In a series of experiments, the ability
to coordinate with a partner in social games was shown to
significantly improve between 18 and 24 months of age, whether
the games involved complementary or similar roles (Warneken
et al., 2006). In the first game of this study, one person had to
send a wooden block down one of a tube mounted on a box
on a 20 degrees incline, while the other person had to catch
it at the other end with a tin can that made a rattling sound.
Two tubes were mounted in parallel so that individuals could
perform in turn the different roles. In the second game, two
persons had to make a wooden block jump on a small trampoline
(67 cm diameter ring covered with cloth) by holding the rim
on opposite sides. The trampoline collapsed when being held on
only one side. Children successfully participated in both games,
although the 24 month-olds were more proficient than the 18
month-olds, and they all produced at least one communicative
attempt to reengage the adult partner when the latter stopped
participating in the activity. Children for example pointed at the
object, and/or vocalized while looking at the adult, which was
regarded as evidence for a uniquely human form of cooperation,
involving shared intentionality (Warneken et al., 2006). A less
“mentalistic” interpretation could be proposed (D’Entremont and
Seamans, 2007), but these results nevertheless highlight children’s
motivation for reinstating joint action toward a shared goal. The
development of this capacity has received much attention from
researchers, as the initiation of joint attention appears to be
strongly related to language comprehension and production in
the second and third year of life (Colonnesi et al., 2010; Cochet
and Byrne, 2016), as well as to theory of mind ability (e.g.,
Charman et al., 2000; Milward et al., 2017) in both typical and
atypical development (e.g., Adamson et al., 2017).

In addition, the observation of children’s behavior during
collaborative activities may lead to a thorough description
of multimodal communication (e.g., gaze, facial expressions,
gestures, and verbal language) and of the way its components
become coordinated. For example, the production of gestures
gradually coordinates with gaze in the course of development.
Children start to produce pointing gestures to orient the attention
of another person around 12 months of age; an object, a person
or an event can become the shared focus of attention but then
children do not usually look at their partner while they point
(Franco and Butterworth, 1996). A couple of months later, they
are able to alternate their gaze between their partner and the
object of interest, which represents a key feature of intentional
triadic interactions (Cochet and Vauclair, 2010). At 16 months of
age, gaze toward the adult can precede the production of pointing
(Franco and Butterworth, 1996), suggesting that children may
thus take into account the partner’s attentional state before
initiating communication (Lamaury et al., 2017).

Children also gradually learn to take account of their partner’s
facial expressions to infer their emotional state and adjust their
response accordingly. Infants are sensitive to the characteristics
of faces from very early on; newborns look for example
significantly longer at happy expressions than at fearful ones,
demonstrating some discrimination skills (Farroni et al., 2007).

The still-face paradigm, initially designed by Tronick et al. (1978)
also suggests that infants have expectations about interactional
reciprocity from a few months of age, partly relying on emotional
expression. This sensitivity manifests itself in specific behavioral
and physiological responses (e.g., reduced positive affect and
gazing at the parent, increased negative affect, rise in facial
skin temperature) when the mother puts on a neutral and
unresponsive face, after a period of spontaneous play with his/her
infant (Aureli et al., 2015). The ability to recognize and identify
facial expressions of basic emotions further develops in preschool
children, before they can understand a few months later the
external causes of emotions and then, around 5 years of age, the
role of other’s desires or beliefs in emotional expression (Pons
et al., 2004).

During play interactions, being attentive to the other’s facial
expressions allows each partner to consider the emotional
nature of the signals (e.g., joy, surprise, and frustration) and
to possibly modify his/her own behavior to change or maintain
this emotional state. The development of facial expression
perception thus plays a key role in the emergence of joint actions,
in coordination with other communicative modalities. Facial
expressions are indeed usually synchronized with vocalizations
and/or gestures, and this from infancy.

The vocal and the gestural modalities also become more
and more coordinated as children grow older, which represents
a key feature of human communication as we use gestures
as we speak throughout our life. Communicative gestures are
first complemented by vocalizations, whose prosodic patterns
may already code for semantic and pragmatic functions (Leroy
et al., 2009). In the second year of life, children then produce
their first gesture-word combinations, which have an important
role in the transition to the two-word stage (e.g., Butcher and
Goldin-Meadow, 2000). Pointing and conventional gestures (e.g.,
waving goodbye, gestural agreement, and refusal: Guidetti, 2002,
2005) remain in the child repertory after the two-word stage,
but other forms of gestural-vocal coordination are observed
from 3 years of age with the emergence of co-speech gestures.
Although we are usually not aware of producing or perceiving
them, co-speech gestures can lend rhythm, emphasize speech
and sometimes serve deictic or iconic functions. The deictic
presentation of pointing gesture can for example be combined
with vocal pointing, performed through syntactic or prosodic
means (Lœvenbruck et al., 2008). Such coordination between the
vocal and gestural modalities is omnipresent in adults and play a
crucial role in face-to-face communication for both speaker and
listener (e.g., McNeill, 2000; Kendon, 2004).

Moreover, the characteristics of gaze, gestures, and
vocalizations and their coordination may vary according to
the communicative function of the signal. A gesture can indeed
serve different purposes, starting with the traditional distinction
between imperative and declarative functions (Bates et al., 1975).
Imperative gestures are used to request a specific object or action
from a partner whereas declarative gestures are used to share
interest with the other about some referent or provide him/her
with information that might be useful. Imperative and declarative
pointing, which both represent powerful means of establishing
joint attention, have been extensively studied and compared:

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hand shape and body posture were shown to differ according
to the communicative function of the pointing gesture (Cochet
et al., 2014), as well as the frequency of gaze alternation between
the partner and the referent and the frequency of vocalizations
(Cochet and Vauclair, 2010). These comparisons (see section
“Pragmatics in HRI: Which Ingredients Are Necessary for
Effective Interactions?” for more detailed results) thus highlight
the strong relationship between the form of the gestures (in the
broad sense, i.e., including visual and vocal behavior in addition
to movement kinematics and hand shapes) and pragmatic
features in children, even semantic ones in adults (Cochet and
Vauclair, 2014).

To sum up, when two children are playing together or when
a child is playing with an adult, they do so in the framework
of joint action; they attend to a common situation and use
multimodal communication to initiate, maintain, or respond to
the interaction. These three different roles in the interaction
can be assessed with the Early Social Communication Scales,
in particular with the French version (Guidetti and Tourrette,
2017). In an evaluation situation, giving the child the opportunity
to initiate the interaction is particularly crucial in atypical
development, for example in children with ASD. The initiation
of shared attention is a key ability in this context as it allows joint
action coordination (Vesper et al., 2016) and has also significant
consequences on the development of cognitive and emotional
processes (Shteynberg, 2015). Whether this coordination relies
on the representation and the understanding of the other’s
intentions or only on behavioral cues is a challenging question,
as we do not have any direct access to the other’s subjectivity. In
the field of HRI, an objective that appears sufficiently ambitious
for now, or at least the one we chose to focus on in the present
review, is to design robots able to identify the observable changes
in the human’s behavior, in order to make the right inferences and
thus the appropriate decisions in the interaction. This appears as
an essential condition for a successful exchange between a robot
and a human, which can depend on the joint outcome (has the
common goal been reached?), but also on the way the interaction
has been perceived by each individual, for example in terms of
coordination between gaze and gesture and fluidity of movement
(Hough and Schlangen, 2016). The richness of communication
here lies indeed in the ability of each partner to integrate multiple
communicative cues in a way that what will seem natural to the
humans, i.e., that will be close to peer interaction in everyday life.

This appears as a complex ability and probably the most
challenging one to replicate in HRI. In pursuit of this objective,
we now need to further describe the concept of appropriateness
and propose a frame to determine the relative importance and
the relative complexity of the different behaviors observed during
joint activities such as social play.

TO WHAT EXTENT CAN INTERACTIONS
BE CHARACTERIZED AS COMPLEX?

Smith (2015) has argued that “development, like evolution and
culture, is a process that creates complexity by accumulating
change.” This perspective applies to the development of

social interactions, from the emergence of joint attention to
coordinated and multimodal communication that enable joint
action. Several attempts have been made in developmental
robotics to explore the cognitive, social, and motivational
dynamics of human interactions (Oudeyer, 2017); algorithmic
and robotic models can then be used to study the developmental
processes involved for instance in imitation (Demiris and
Meltzoff, 2008) or language (Cangelosi et al., 2010). In this
context, roboticists aim at designing systems allowing for self-
organized and “progressive increase in the complexity” of the
robot’s behavior (Oudeyer et al., 2007).

To benefit further from their exchanges, developmentalists
and roboticists may therefore need to frame the study of
HRI by disambiguating the concept of complexity. Because
“complicated systems will be best understood at the lowest
possible level” (Smith, 2015), we aim to differentiate different
levels of complexity depending on the nature of the elements to
take into account for decision making. This analysis will allow us
to go forward in the study of joint attention and joint action and
define what is implied by the qualifying terms “complex” (or rich)
and “appropriate” (or effective) when referring to interactions.

To this end, we used a categorization recently proposed in
research on animal behavior, including human and non-human
primates, to define the concept of complexity (Cochet and Byrne,
2015). Three dimensions have been described: motor precision,
coordination, and anticipatory planning, which can relate to
both individual and social activities. The authors argue that “the
complexity of a given mechanism/behavior can be assessed by
distinguishing which of these three dimensions are involved and
to what degree,” which may “clarify our understanding of animal
behavior and cognition.” Such analysis applied to joint attention
and joint action, although there may be other ways of untangling
the question of complexity, may here allow researchers to dissect
the different factors involved in social interactions for each
dimension, and thus help them assess the “manipulability” of
these factors in HRI.

In order to make appropriate decisions in a collaborative
task, i.e., decisions leading to the desired joint outcome and/or
decisions that approach the characteristics of human interactions,
the robot first needs to recognize specific patterns in his/her
partners’ behavior, without asking for agreement or information
for all actions. The robot can for example rely on gaze
direction, manual movements or body posture to identify the
human’s attentional and intentional states and thus define the
most useful role it can play in the interaction. By way of
illustration, if a human and a robot share the common goal
of building a pile with four cubes in a definite order and
putting a triangle at the top, each of them can perform different
actions: they can grasp an object (a cube or a triangle) on
the table, grasp an object on the pile, give an object to the
partner, support the pile while the partner places a cube on
it, etc. Other actions can emerge, for example if the pile
collapses or if one agent does not pile the cubes in the correct
order (Clodic et al., 2014). Individuals can then blame each
other, or give each other some instructions. In addition to
the perception of its own environment, the robot thus has to
observe the activity of the human and take his/her perspective

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(e.g., to determine whether an object is reachable for the
other).

Motor precision is therefore necessary in this context to
obtain flexible and human-aware shared plan execution (Devin
and Alami, 2016), as it enables a selective shift of attention
toward aspects of the environment that will become shared
knowledge, which has also been described as the accuracy of
shared attention states (Shteynberg, 2015). First, the emergence
of joint attention requires to properly use gaze and/or pointing
gesture to localize the object or event referred to. Verbal cues also
demand particularly fine motor skills through speech articulators.
Second, joint action necessitates some motor control to reach
the expected outcome, hence the importance of evaluating
beforehand human motor skills, especially during development,
as well as the technical capabilities of the robot. Following on
from the previous example, children’s grasping skills in relation
to the size of the cubes as well as the characteristics of robotic
gripper to handle objects have to be finely described.

Moreover, recent experimental findings have shown that
the execution of object-oriented actions is influenced by the
social context such as the relative position of another person
and the degree of familiarity with this person (Gianelli et al.,
2013). Individuals perform for example more fluent reach-to-
grasp movements, with lower acceleration peaks and longer
reaction time when a partner is located close enough to be
able to intervene on the same object than when he/she is
farther away (Quesque et al., 2013). In addition, there is a
significant relationship between the kinematic features of the
actions and the actor’s explicit social intention: movements
have longer durations, higher elevations and longer reaction
times when individuals place an object on a table for
another person than when they place the object for a later
personal use (Quesque and Coello, 2015). These variations,
although they do not seem to be intentionally produced,
have been suggested to facilitate the partner’s detection
of planned actions, thus enhancing potential interactions.
These kinematic effects were indeed shown to influence
the subsequent motor productions of an observer (Quesque
et al., 2015). The motor characteristics of actions performed
in a social context may therefore prime the perceiver to
prepare and anticipate appropriate motor responses in the
interaction.

The second dimension that can allow us to understand the
complexity of joint activities pertains to the coordination between
several communicative modalities and between interacting
individuals. Whether joint action involves complementary or
similar roles, it can be performed through several coordination
processes, which can determine the efficiency of shared
attention states (Shteynberg, 2015). Efficiency requires here a
representational shift from the first-person singular to the first-
person plural, as the partners attend to the same referent at
the same time. The ability to monitor each other’s attention
and action, using behavioral cues such as gaze direction, facial
expressions, gestures, and speech is essential for successful
coordination. The intentional production of communicative
signals, representing hints for one’s partner, is also an efficient way
of achieving joint outcomes.

Coordination is therefore necessary first at the individual level,
so that the different communicative modalities such as gestures
and gaze synchronize or follow one another in a natural order, i.e.,
acceptable with regard to human interaction patterns (see above).
Each agent can then make decisions based on these signals,
moderate their behavior accordingly and thus coordinate at the
social level to reach a common objective. The ability to adjust
one’s behavior to others’ actions during collaborative activities
(including play) has been argued to “reach a higher degree of
complexity when intentional and referential signals are directly
addressed to specific individuals” (Cochet and Byrne, 2015). In
order to build the pile of cubes, interacting partners can then
for example point toward a specific cube or ask the other to wait
before placing another cube.

In those cases, coordination processes can be enhanced by
predicting the effects of each other’s actions on joint outcomes
and by distributing tasks effectively (Vesper et al., 2016). This
ability involves the third dimension characterizing the question
of complexity, namely the dimension of anticipatory planning
(Cochet and Byrne, 2015). It requires to go beyond the immediate
perception of the environment and represent the relationship
between a sequence of actions and a precise goal. At the
individual level, planning ability implies to mentally review an
action sequence in anticipation of a future need (e.g., selecting
a specific cube in a first room in order to build a pile of cubes
in another room). At the social level, planning ability allows
individuals to predict the other’s behavior and adjust one’s own
sequence of actions, leading to a better coordination. Whether
the ability to make such inferences necessitates to mentalize about
others’ inner states (e.g., beliefs and preferences) is still subject of
debate, but again, this question may not be central in the context
of joint attention and joint action between a robot and a human.

The above-described categorization can therefore provide
a common ground between ethologists, psychologists, and
roboticists that may clarify which dimensions need to be
considered in an attempt to implement the characteristics of
motor precision, coordination and anticipatory planning in
human–robot joint activities (see Table 1 for an overview). The
objective is to approach the complexity (or richness) of human
interactions and obtain appropriate (or effective) responses from
robots with regard to these different dimensions.

PRAGMATICS IN HRI: WHICH
INGREDIENTS ARE NECESSARY FOR
EFFECTIVE INTERACTIONS?

The increasing complexity of communicative abilities
(complexity that involves the three above-mentioned
dimensions) in the course of human development leads to
a rich potential of interactions. Children actively go through
different stages allowing them to engage successfully in joint
activities, i.e., to operate within their physical environment,
coordinate with other people, plan their own behavior and
anticipate their partners’. Intending to model, at least partially,
human developmental pathway seems a fruitful way of designing
robots that can effectively initiate and respond to communicative

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TABLE 1 | Complexity in HRI: illustration of three dimensions at the individual and
social levels (adapted from Cochet and Byrne, 2015).

Individual Social

(1) Motor precision Joint attention: ability to
properly use gaze or
pointing to identify the
object or event referred to.
Joint action: human motor
skills/technical capabilities
of the robot to reach the
expected outcome

Influence of the social
context (e.g., relative
position of the individuals,
intention of the actor:
moving an object for
oneself or for another
person) on the kinematics
features of the actions
performed

(2) Coordination Coordination (including
synchronization) between
different modalities of one’s
communicative signal
(gaze, gesture,
vocalizations, etc.)

Ability to take into account
the multimodal behavioral
cues produced by a partner
to adjust one’s own
behavior

(3) Anticipatory
planning

Representation of a
sequence of actions to
anticipate a personal future
need

Ability to predict the effects
of the other’s actions on
joint outcomes to plan
one’s own behavior

situations. Such enterprise, although still recent, has given rise
to a substantial amount of literature in robotics, especially
from the 2000s, covering several sub-fields such as for example
developmental and epigenetic robotics, cognitive systems
and social robotics. Several journals, including both HRI
experimental studies and computational modeling, focus entirely
on these questions (e.g., IEEE Transactions on Cognitive and
Developmental Systems, Journal of Human-Robot Interaction,
Journal of Social Robotics), and numerous conferences also take
place every year, whose proceedings are usually available online1.

The data from developmental psychology described in the
first section, coupled with the framework proposed in the
second section to help researchers define complex and effective
HRI, may contribute to this growing body of work. To this
effect, it seems necessary (1) to consider the multimodality of
interactions and (2) to adopt a pragmatic perspective to be
based upon an accurate representation of human communicative
behaviors. Indeed, children learn to communicate through joint
activities with adults who combine various forms of expressions,
serving various functions. In the course of development, children
gradually integrate the dissociation between the form and the
function of language – they become more and more flexible in
understanding that a single form can serve different functions
and reciprocally, that a single function can be expressed through
several forms. Language is here regarded as more than a medium
to convey an information, in agreement with a proposition that
was developed in the speech act theory (Austin, 1962; Searle
and Vanderveken, 1985). Language would be way of acting on
the environment, of “doing things with words,” independently
of its structural properties. Initially aiming at describing the
relationships between the forms and functions of linguistic
utterances, this theory defines several speech acts, depending on
whether one intends to assert, comment, warn, request, deplore,

1 For example, http://www.lucs.lu.se/epirob/

etc. This theory has later been adapted to non-verbal behavior
(e.g., McNeill, 1998; Guidetti, 2002). The form still refers to
the message structure, but applies to the whole body, including
the posture, the structure of communicative gestures (kinematic
features and hand shape), gaze and facial expressions. These non-
verbal signals can be used in complementarity with speech or be
used alone for example in the case of conventional gestures (see
Guidetti, 2002). The function refers to the illocutionary force of
the speech act (what one achieves by speaking), in other words
here to the effect of these communicative acts in a specific context,
thus giving some insight into the signaller’s intention. Gestures,
and especially the conventional gestures produced by children
during the prelinguistic period, are thus regarded as genuine
communicative acts, with a propositional content that can equal
the one expressed by words. For instance, agreeing and refusing
can be expressed gesturally by nodding or shaking one’s head. The
separate analysis of the forms and functions of communication,
as well as the description of the different modalities involved
during interactions, therefore provide a key framework to help
define what capacities the robot should be equipped with to
ensure efficient collaboration with humans.

In this perspective, Mavridis (2015) has proposed a list of
“ten desiderata that human–robot systems should fulfill” to
maximize communication effectiveness. One of the guiding
lines relates to the importance of considering multiple speech
acts, for both verbal and non-verbal communication, and not
restrict the robot competencies to “motor command requests.”
In the same way as imperative gestures (see section “How
Does Communication Develop in the Context of Social Play?”)
are generally understood and produced later than declarative
gestures in human development (Camaioni et al., 2004), robotic
systems initially aimed to assign the robot a servant role, with the
human driving the interaction. Devising wider robots’ pragmatic
abilities is a first step toward the conception of human–robot
shared plans. The robot may for example comment on the pile of
cubes as it is being built (see example section “To What Extent
Can Interactions Be Characterized as complex?”) to support
or correct the human’s action, rather than just producing a
motor response to the human request. The dimension of social
coordination is thus added to that of motor precision (see
Table 1).

Similarly, flexibility in HRI also requires “mixed initiative
dialog” (Mavridis, 2015), so that the robot can both initiate and
respond to the interaction. Integrating models based on human
adaptation and probabilistic decision processes, Nikolaidis et al.
(2017) have indeed shown that the performance of human–robot
teams in collaborative tasks is improved when the robot guides
the human toward an effective strategy, compared to the common
approach of having the robot strictly adapting to the human.
The human’s trust in the robot was also facilitated by a greater
symmetry in role distribution and adaptation between the robot
and the human, which might in turn lead to greater acceptability
of HRI.

Designing such “socially intelligent and cooperative robots”
(Breazeal et al., 2004) requires specific temporal dynamics of the
interaction, which represents a considerable challenge especially
at a computational level. These dynamics convey social meanings

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to such an extent that any delay in the interaction can sometimes
question its effectiveness. Researchers here face a dilemma that
seem to bring into opposition interaction complexity (which
requires to take account of numerous parameters) and interaction
timing. The implementation of fast timescales (on the order of
100 ms) is usually considered necessary for robots to integrate
(i.e., detect, interpret, and predict) and react to social stimuli in
a timely manner through interactions (Durantin et al., 2017).
Researchers developing a storytelling robot interacting with
children aged 4–5 years have confirmed the importance of
temporal features in the pragmatics of interactions. Contingent
responses from the robot, in relation to the attentional and social
cues signaled by the children, were indeed found to facilitate
engagement of the latter (Heath et al., 2017).

The variation in some characteristics of the robot’s behaviors
according to the action performed may also illustrate further
the question of pragmatics in HRI, moving us one step closer
toward human-like interactions. For example, the morphological
differences that have been reported in young children between
pointing and reaching (Cochet et al., 2014) could be applied
to the robot. First, regarding body posture, we might expect
robots to lean closer to a given object when they intend to
grasp it than when they want to communicate about that object.
Second, depending on the robot technical possibilities (e.g., two-
or three-finger grippers, biomimetic anthropomorphic hands),
differences in the form of manual gestures produced should
be observed between imperative and declarative pointing. The
former is typically characterized by whole-hand gestures (all
the fingers are extended in the direction of the referent), while
the latter is mostly associated with index-finger gestures (the
index finger is extended toward the referent and the other
fingers are curled inside the hand) (Cochet and Vauclair, 2010;
Liszkowski and Tomasello, 2011). Hand shape is also influenced
by precision constraints: imperative gestures are likely to shift
from whole-hand pointing to index-finger pointing when the
target is surrounded by distractors (Cochet et al., 2014), which
can be the case when the robot has to identify a specific object
among several (e.g., the human can ask the robot to give him/her
the red cube). Here, the notion of iconicity, which plays a role in
both oral and sign languages, may help researchers to precisely
analyze the structure of gestures and better understand the
interface between gestures and signs (Guidetti and Morgenstern,
2017). The importance of motor precision is here directly related
to the dimensions of coordination and anticipatory planning,
therefore providing a comprehensive framework to assess the
complexity and effectiveness of HRI.

Moreover, the importance of implementing responsive social
gaze in robots has previously been highlighted (e.g., Yoshikawa
et al., 2006), but this response might also vary depending
on the communicative function involved. To mirror child
development, gaze alternation between the partner and the
referent should indeed be more frequent in declarative situations
than in imperative ones (Cochet and Vauclair, 2010). The
coordination between gestures and gaze (see also section “How
Does Communication Develop in the Context of Social Play?”) is
also an important factor, which can help the robot to estimate
the state of goals, plans, and actions from human point of

view, and allow the human to feel that he/she is involved in
fluid interactions with the robot, both facilitating the emergence
of joint outcomes. If a robot alternates its gaze between an
object and its partner before initiating a pointing gesture, the
human may for example interpret this behavior as the robot’s
willingness to take into account his/her attentional state before
gesturing, thus favoring the exchange of information. Broadly
speaking, coordinated gaze behavior could be considered as the
most fundamental modality for effective HRI, or at least as a key
prerequisite in collaborative tasks.

The consideration of facial expressions may also facilitate
turn-taking dynamics and limit miscommunication, by allowing
some inferences about the other’s affective state. Integrating the
emotional component into HRI gives each partner additional
cues to decide what is the most appropriate response in a given
situation. The development of methods for facial expression
analysis raises several issues though (e.g., Kanade et al., 2000).
Even if there have been some attempts to design facial expression
mechanism in humanoid robots (e.g., Hashimoto et al., 2006; Gao
et al., 2010), most of current robots’ facial features are still far
from the extremely rich motor possibilities of the human face.
In parallel, the development of real time coding of emotional
expressions seems to be an achievable goal (Bartlett et al., 2003),
allowing robots to directly perceive some changes in the human
facial expressions.

In addition to visual information, the auditory modality can
also play a role in influencing robots’ and humans’ decisions and
coordination processes. In children at around 2 years of age,
vocalizations accompany more frequently declarative gestures
than imperative ones (Cochet and Vauclair, 2010). More recently,
the prosody of these vocalizations was shown to gradually match
the function of pointing during the second year of life (Tiziana
et al., 2017), allowing to differentiate imperative from declarative
gestures (Grünloh and Liszkowski, 2015). Other features such
as the positioning of the object and the attentional state of the
partner have also been suggested to influence the rising and
falling tones in the vocal productions simultaneous to gestures
(Leroy et al., 2009). Prosody can therefore serve pragmatic
purposes, and changes in pitch, intensity, or duration of speech
or vocalizations can in this regard be considered as a full-fledged
component of multimodal communication.

Beyond prosody, language content may be the most effective
way for human–robot teams to coordinate. However, the design
of robots with language comprehension and production abilities
that could lead to fluid conversations with humans raises several
issues. Verbal language requires indeed symbolic representations,
which need to be connected not only to the robot’s sensory
system, but also to “mental models” of the world internalized
within its cognitive system. Mavridis (2015) has highlighted here
the question of “situated language and symbol grounding.” For
example, the relation between the verbal label “cube” uttered by
the human and the physical cube that it refers to in front of
the robot can be mediated through sensory data, but the use of
conventional signs should allow the robots to go beyond the here-
and-now and extend symbol grounding to abstract entities in
addition to objects, people, or events. To implement architecture
that can be compared to human interactions, this relation should

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be bidirectional: the visual perception of a cube should activate
the right symbol in the robot’s cognitive system, leading to the
production of the word “cube”; reciprocally, a request addressed
to the robot to give the human the cube should create a precise
representation, allowing the robot to identify the right object.

Moreover, the identification of emotion labels in the verbal
modality could also contribute, in addition to the recognition of
emotional facial expressions and acoustic properties of speech
(see Breazeal, 2004 for a complete review on emotion systems
in robots), to a better coordination between each partner of
the interaction. The haptic modality, playing an important role
in social interactions, is also regarded as a valuable medium
for expressing emotion (Yohanan and MacLean, 2012). By
developing motion capturing system and tactile sensors, the
robot may use its human partner’s positions and such “affective
touch” to estimate human intentions (Miyashita et al., 2005).
This modality, essential in human development, may be a
particularly good candidate to study complexity of HRI, involving
simultaneously motor precision, coordination and planning (see
section “To What Extent Can Interactions Be Characterized as
complex?”).

Finally, in addition to the coordination dimension, the verbal
dialog between a robot and a human would ideally imply
purposeful speech and planning (Mavridis, 2015), in order to
avoid fixed mapping between stimuli and responses. Anticipatory
planning abilities, as described in Section “To What Extent Can
Interactions Be Characterized as complex?”, would enable the
robot to make the most appropriate or efficient decisions in a
given shared activity, in conjunction with its perspective-taking
skills and the goal of the activity. If the robot can represent which
information are needed by the human to perform a specific action
(and therefore identify which information the human misses),
it can decide to express a verbal request or comment on the
situation, and/or plan a sequence of actions to coordinate with
its partner.

This last example raises the question of intrinsic motivation
in interactions: why is each partner engaged in this multimodal
coordination, and to what extent does it influence the
characteristics of the interaction? Studies in developmental
robotics have shown that intrinsic motivation systems based
on curiosity can directly impact learning skills and lead to
autonomous mental development in robots (Oudeyer et al.,
2007). Such mechanism is obviously involved in human
development and in social play in particular: children discover
and create new possibilities by exploring their physical and social
environment. Through the development of social referencing,
self-consciousness or cooperation, human social interactions may
even sometimes constitute a motivated goal per se (Tomasello,
2009), which provides some perspectives to shape robots’
intrinsic motivation with a “social reward” function.

We can see here that the relationships between theories
in developmental psychology and robotics offer bidirectional
benefits. To put it in a nutshell, some models in developmental
robotics are based on psychological theories, which are then
formalized and implemented in robots, while developmental
robotics allows researchers in psychology to go further in the
elaboration of their theories through thorough experimentations

and hypothesis testing. This applies to a variety of questions
addressed in this review, from the conditions that influence
learning process during interactions (Boucenna et al., 2014) to
the description of stages in language development (Morse and
Cangelosi, 2017). Advances in developmental robotics may thus
provide previous help in the analysis and implementation of the
processes involved in interactions.

CONCLUSION AND PERSPECTIVES

The question at stake in the present work was to improve the
effectiveness of human–robot interactions in collaborative tasks,
first in terms of joint outcomes – has the task been completed? –
but also with regard to the human’s perception and interpretation
of the interaction. Is the robot’s behavior appropriate, i.e.,
acceptable, considering the frame of human communication?
We argue here that the observation of the development and
the structure of interactions between the child and the adult,
especially in the context of social play, can help answer this
question. To shape a shared common space between the human
and the robot that could reflect the complexity of human
interactions, we have also proposed to focus on three dimensions:
motor precision, coordination, and anticipatory planning. The
specific examples developed in Section “Pragmatics in HRI:
Which Ingredients Are Necessary for Effective Interactions?”
suggest that the more robots use human-like communicative
modalities (e.g., facial expressions, gestures, and language) in
respect to these three dimensions, the more they invite interactive
behaviors that are natural to people. The interpretation of dealing
with a social agent is strengthened, which facilitates in turn
the interaction with robots. In this sense, and to paraphrase
Cangelosi et al. (2010), the integration of action and language
may constitute a roadmap to better frame and assess HRI from
a developmental point of view and with a pragmatic perspective.

However, there are still numerous obstacles before
achieving the level of details pictured in the present article,
involving mainly technological challenges, given the motor
and cognitive correlates of the above-mentioned behaviors.
To put it bluntly, developmental psychologists cannot expect
roboticists to implement in robots all the subtleties of multimodal
communication that occur in human children. There may also be
some conceptual difficulties as the attempts to approach human
realism, aiming at maintaining the human’s trust in the robot,
can sometimes be confronted with an uneasy feeling of viewing
and/or hearing a robot that looks imperfectly human. This
uncanny valley effect (Mitchell et al., 2011; Mori, 1970, 2012),
which was shown to emerge in middle childhood in relation to
developing expectations about humans and machines (Brink
et al., 2017), may complicate the design of socially interactive
robots, both in terms of appearance and behavior. Empirical
evidence for the uncanny valley seems nevertheless inconsistent
or restricted to specific conditions (Kätsyri et al., 2015), with the
definition of human-likeness mostly involving physical realism.

By contrast, anthropomorphic behavior (see Duffy, 2003), in
addition to its facilitating role in the interaction with humans (see

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above), also results in better and faster learning by the
robots. For example, in a task in which they have to
learn the meaning of words, the robots’ performances are
enhanced when they provide humans with social cues to
communicate a learning preference, as these cues influence
the tutoring of the human teacher (de Greeff and Belpaeme,
2015). We observe the same phenomena when human
children start to learn new concepts: according to Bruner’s
constructivist theory, children need scaffolding from adults
(or from children who have already acquired the concept)
in the form of active support, which may represent at
first a reduction in the choices a child might face. Such
learning processes play obviously an important role in
human development, and may also enable quick and effective
application of robotic systems. Multi-level learning may indeed
constitute a key line of research for HRI (Mavridis, 2015),
which might again benefit from research in developmental
psychology.

Reciprocally, the field of robotics provides interesting
perspectives for psychologists, especially for research on atypical
development. Atypical development might be a direct window
on typical development and vice versa: “development is the
key to understanding developmental disorders” (Karmiloff-
Smith, 1998). Joint action and joint attention are for example
usually impaired in children with ASD; the comparison
with typical development has revealed different use of social
gaze and often a lack of the declarative function, both
for verbal and non-verbal communication. The exchanges
between robotics and developmental psychology could help
conceptualize the stages of joint attention in order to better
understand how children develop joint attention and get
through the whole sequence of declarative pointing. This
will have an impact on elaborating intervention programs
for children with neurodevelopmental disorders. Moreover,
numerous intervention programs have recently been proposed

showing the added value of therapy robot for the development
of communication, play, or emotional skills (e.g., Robins et al.,
2009; Huijnen et al., 2016).

In conclusion, the combination of insights and methods in
robotics and developmental psychology allows researchers to
conceive models of HRI in which the robots can come to develop
motor, social, and cognitive skills. These models may benefit
fundamental research on joint attention and joint action in
typical development, but also early evaluation and intervention
programs for atypical development (e.g., Dautenhahn, 2007). The
continuation of these interdisciplinary discussions, which may
possibly integrate some of the elements proposed in the present
article, will undoubtedly lead to more and more solid HRI models
in the next decades.

AUTHOR CONTRIBUTIONS

HC and MG devised the conceptual ideas presented in the article.
HC drafted the manuscript. MG revised it critically and gave final
approval of the version to be submitted.

FUNDING

This article is part of the project JointAction4HRI, funded by the
French National Agency for Research (n◦16-CE33-0017).

ACKNOWLEDGMENTS

Many ideas presented in this paper stem from fruitful discussions
with R. Alami, A. Clodic, and E. Pacherie, all involved in the Joint
Action for Human-Robot Interaction project funded by French
National Agency for Research (Project No. 16-CE33-0017-01).

REFERENCES
Adamson, L. B., Bakeman, R., Suma, K., and Robins, D. L. (2017). An expanded

view of joint attention: Skill, engagement and language in typical development
and autism. Child Dev. doi: 10.1111/cdev.12973 [Epub ahead of print].

Aureli, T., Grazia, A., Cardone, D., and Merla, A. (2015). Behavioral
and facial thermal variations in 3-to 4- month-old infants during the
Still-Face Paradigm. Front. Psychol. 6:1586. doi: 10.3389/fpsyg.2015.
01586

Austin, J. (1962). How to do Things with Words. Oxford: Clarendon Press.
Bartlett, M. S., Littlewort, G., Fasel, I., and Movellan, J. R. (2003). Real time

face detection and expression recognition: development and application to
human-computer interaction. CVPR Workshop Comput. Vis. Patt. Recogn.
Hum. Comput. Interact. 5, 53–58.

Bates, E., Camaioni, L., and Volterra, V. (1975). The acquisition of performatives
prior to speech. Merrill Palmer Q. 21, 205–226.

Beier, J. S., and Spelke, E. S. (2012). Infants’ developing understanding
of social gaze. Child. Dev. 83, 486–496. doi: 10.1111/j.1467-8624.2011.
01702.x

Beuker, K. T., Rommelse, N. J., Donders, R., and Buitelaar, J. K. (2013).
Development of early communication skills in the first two years of life. Infant
Behav. Dev. 36, 71–83. doi: 10.1016/j.infbeh.2012.11.001

Boucenna, S., Anzalone, S., Tilmont, E., Cohen, D., and Chetouani, M. (2014).
Learning of social signatures through imitation game between a robot and

a human partner. IEEE Trans. Auton. Mental Dev. 6, 213–225. doi: 10.1109/
TAMD.2014.2319861

Bourjade, M. (2017). “Social attention,” in The International Encyclopedia of
Primatology, ed. A. Fuentes (New York, NY: John Wiley and Sons).

Breazeal, C. (2004). Function meets style: Insights from emotion theory applied to
HRI. IEEE Trans. Syst. Man Cybern. 34, 187–194. doi: 10.1109/TSMCC.2004.
826270

Breazeal, C., Brooks, A., Gray, J., Hoffman, G., Kidd, C., Lee, H., et al. (2004).
Humanoid robots as cooperative partners for people. Int. J. Hum. Rob. 1, 1–34.
doi: 10.3389/fnbot.2012.00003

Brink, K. A., Gray, K., and Wellman, H. M. (2017). Creepiness creeps in: Uncanny
valley feelings are acquired in childhood. Child Dev. doi: 10.1111/cdev.12999
[Epub ahead of print].

Bruner, J. S. (1973). Organization of early skilled action. Child Dev. 44, 1–11.
doi: 10.2307/1127671

Butcher, C., and Goldin-Meadow, S. (2000). “Gesture and the transition from
one- to two-word speech: when hand and mouth come together,” in Language
and Gesture, ed. D. McNeill (Cambridge: Cambridge University Press),
235–257.

Byrne, R. W. (2015). The what as well as the why of animal fun. Curr. Biol. 25,
R2–R4. doi: 10.1016/j.cub.2014.09.008

Camaioni, L., Perucchini, P., Bellagamba, F., and Colonnesi, C. (2004). The role
of declarative pointing in developing a theory of mind. Infancy 5, 291–308.
doi: 10.1207/s15327078in0503_3

Frontiers in Psychology | www.frontiersin.org 9 October 2018 | Volume 9 | Article 1992

fpsyg-09-01992 October 19, 2018 Time: 12:18 # 10

Cochet and Guidetti Joint Action in Developmental Psychology and Robotics

Cangelosi, A., Metta, G., Sagerer, G., Nolfi, S., Nehaniv, C., Fischer, K., et al. (2010).
Integration of action and language knowledge: a roadmap for developmental
robotics. IEEE Trans. Autonom. Mental Dev. 2, 167–195. doi: 10.1109/TAMD.
2010.2053034

Carpenter, M., Nagell, K., and Tomasello, M. (1998). Social cognition, joint
attention, and communicative competence from 9 to 15 months of age. Monogr.
Soc. Res. Child Dev. 63:255. doi: 10.2307/1166214

Charman, T., Baron-Cohen, S., Swettenham, J., Baird, G., Cox, A., and Drew, A.
(2000). Testing joint attention, imitation, and play as infancy precursors to
language and theory of mind. Cogn. Dev. 15, 481–498. doi: 10.1016/S0885-
2014(01)00037-5

Clodic, A., Alami, R., and Chatila, R. (2014). Key elements for human-robot joint
action. Front. Artif. Intell. Appl. 273, 23–33.

Cochet, H., and Byrne, R. W. (2015). Complexity in animal behaviour:
towards common ground. Acta Ethol. 18, 237–241. doi: 10.1007/s10211-014-
0205-5

Cochet, H., and Byrne, R. W. (2016). Communication in the second and third year
of life: relationships between nonverbal social skills and language. Infant Behav.
Dev. 44, 189–198. doi: 10.1016/j.infbeh.2016.07.003

Cochet, H., Jover, M., Oger, L., and Vauclair, J. (2014). Morphological differences
between imperative and declarative pointing: hand shape, arm extension
and body posture. J. Motor Behav. 46, 223–232. doi: 10.1080/00222895.2014.
889066

Cochet, H., and Vauclair, J. (2010). Pointing gestures produced by toddlers
from 15 to 30 months: different functions, hand shapes and laterality
patterns. Infant Behav. Dev. 33, 432–442. doi: 10.1016/j.infbeh.2010.
04.009

Cochet, H., and Vauclair, J. (2014). Deictic gestures and symbolic gestures produced
by adults in an experimental context: hand shapes and hand preferences.
Laterality 19, 278–301. doi: 10.1080/1357650X.2013.804079

Colonnesi, C., Stams, G., Koster, I., and Noom, M. J. (2010). The relation between
pointing and language development: a meta-analysis. Dev. Rev. 30, 352–366.
doi: 10.1016/j.dr.2010.10.001

Corkum, V., and Moore, C. (1998). Origins of joint visual attention in infants. Dev.
Psychol. 34, 28–38. doi: 10.1037/0012-1649.34.1.28

Dautenhahn, K. (2007). Socially intelligent robots: dimensions of human–robot
interaction. Philos. Trans. R. Soc. Lond. B Biol. Sci. 362, 679–704. doi: 10.1098/
rstb.2006.2004

de Greeff, J., and Belpaeme, T. (2015). Why robots should be social:
enhancing machine learning through social human-robot interaction. PLoS One
10:e0138061. doi: 10.1371/journal.pone.0138061

Demiris, Y., and Meltzoff, A. (2008). The robot in the crib: a developmental
analysis of imitation skills in infants and robots. Inf. Child Dev. 17, 43–53.
doi: 10.1002/icd.543

D’Entremont, B., and Seamans, E. (2007). Do infants need social cognition to
act socially? An alternative look at infant pointing. Child Dev. 78, 723–728.
doi: 10.1111/j.1467-8624.2007.01026.x

Devin, S., and Alami, R. (2016). “An implemented theory of mind to improve
human-robot shared plans execution,” in Proceedings of the 11th ACM/IEEE
International Conference HRI, New York, NY, 319–326.

Duffy, B. R. (2003). Anthropomorphism and the social robot. Rob. Auton. Syst. 42,
177–190. doi: 10.1016/S0921-8890(02)00374-3

Durantin, G., Heath, S., and Wiles, J. (2017). Social moments: a perspective on
interaction for social robotics. Front. Robot. AI 4:24. doi: 10.3389/frobt.2017.
00024

Emery, N. J. (2000). The eyes have it: The neuroethology, function and evolution of
social gaze. Neurosci. Biobehav. Rev. 24, 581–604. doi: 10.1016/S0149-7634(00)
00025-7

Farroni, T., Menon, E., Rigato, S., and Johnson, M. H. (2007). The perception
of facial expressions in newborns. Eur. J. Dev. Psychol. 4, 2–13. doi: 10.1080/
17405620601046832

Franco, F., and Butterworth, G. (1996). Pointing and social awareness: declaring
and requesting in the second year. J. Child Lang. 23, 307–336. doi: 10.1017/
S0305000900008813

Gao, J., Huang, Q., Yu, Z., Chen, X., Xu, W., and Zhang, Y. (2010). Design of the
facial expression mechanism for humanoid robots. ROMANSY 18 Rob. Design
Dynam. Control 524, 433–440.

Garvey, C. (1990). Play. Cambridge, MA: Harvard University Press.

Gianelli, C., Scorolli, C., and Borghi, A. M. (2013). Acting in perspective: the role of
body and language as social tools. Psychol. Res. 77, 40–52. doi: 10.1007/s00426-
011-0401-0

Grünloh, T., and Liszkowski, U. (2015). Prelinguistic vocalizations distinguishing
pointing acts. J. Child Lang. 42, 1312–1336. doi: 10.1017/S030500091400
0816

Guidetti, M. (2002). The emergence of pragmatics: forms and functions of
conventional gestures in young French children. First Lang. 22, 265–285. doi:
10.1177/014272370202206603

Guidetti, M. (2005). Yes or no? How do young children combine gestures
and words to agree and refuse. J. Child Lang. 32, 911–924. doi: 10.1017/
S0305000905007038

Guidetti, M., and Morgenstern, A. (2017). The gesture sign interface in language
acquisition. Lang. Interact. Acquis. 8, 1–12. doi: 10.1075/lia.8.1.01gui

Guidetti, M., and Tourrette, C. (2017). Echelle d’Evaluation de la Communication
Sociale Précoce, 1st Edn. Firenze: Giunti OS.

Hashimoto, T., Hitramatsu, S., Tsuji, T., and Kobayashi, H. (2006). Development of
the face robot Saya for rich facial expressions. Proc. IEEE SICE-ICASE Int. Joint
Conf. 5423–5428. doi: 10.1109/SICE.2006.315537

Heath, S., Durantin, G., Boden, M., Hensby, K., Taufatofua, J., Olsson, O., et al.
(2017). Spatiotemporal aspects of engagement during dialogic storytelling
child-robot interaction. Front. Robot. AI 4:27. doi: 10.3389/frobt.2017.
00027

Hough, J., and Schlangen, D. (2016). “Investigating fluidity for human-robot
interaction with real-time, real-world grounding strategies,” in Proceedings of
the 17th Annual SIGdial Meeting on Discourse and Dialogue, Los Angeles, CA,
288–298. doi: 10.18653/v1/W16-3637

Huijnen, C. A. G. J., Lexis, M. A. S., and de Witte, L. P. (2016). Matching robot
KASPAR to autism spectrum disorder (ASD): therapy and educational goals.
Int. J. Soc. Rob. 8, 445–455. doi: 10.1007/s12369-016-0369-4

Kanade, T., Cohn, J., and Tian, Y. (2000). “Comprehensive database for facial
expression analysis,” in Proceedings of the 4th International Conference Face
Gesture Recognition, London, 46–53.

Karmiloff-Smith, A. (1998). Development itself is the key to understanding
developmental disorders. Trends Cogn. Sci. 2, 389–398. doi: 10.1016/S1364-
6613(98)01230-3

Kätsyri, J., Förger, K., Mäkäräinen, M., and Takala, T. (2015). A review of
empirical evidence on different uncanny valley hypotheses: support for
perceptual mismatch as one road to the valley of eeriness. Front. Psychol. 6:390.
doi: 10.3389/fpsyg.2015.00390

Kendon, A. (2004). Gesture: Visible Action as Utterance. Cambridge: Cambridge
University Press. doi: 10.1017/CBO9780511807572

Lamaury, A., Cochet, H., and Bourjade, M. (2017). Acquisition of joint attention
by olive baboons gesturing toward humans. Anim. Cogn. doi: 10.1007/s10071-
017-1111-9 [Epub ahead of print].

Lemaignan, S., Warnier, M., Clodic, A., and Alami, R. (2017). Artificial cognition
for social human-robot interaction: an implementation. Artif. Intell. 247, 45–69.
doi: 10.1016/j.artint.2016.07.002

Leroy, M., Mathiot, E., and Morgenstern, A. (2009). “Pointing gestures,
vocalizations and gaze: two case studies,” in Studies in Language and Cognition,
eds J. Zlatev, M. Andren, M. J. Falck, and C. Lundmark (Newcastle upon Tyne:
Cambridge Scholars Publishing), 261–275.

Liebal, K., Carpenter, M., and Tomasello, M. (2013). Young children’s
understanding of cultural common ground. Br. J. Dev. Psychol. 31, 88–96.
doi: 10.1111/j.2044-835X.2012.02080.x

Liszkowski, U., and Tomasello, M. (2011). Individual differences in social,
cognitive, and morphological aspects of infant pointing. Cogn. Dev. 26, 16–29.
doi: 10.1016/j.cogdev.2010.10.001

Lœvenbruck, H., Vilain, C., and Dohen, M. (2008). From gestural pointing to vocal
pointing in the brain. Rev. Fr. Ling. Appl. 13, 23–33.

Mavridis, N. (2015). A review of verbal and non-verbal human-robot interactive
communication. J. Rob. Auton. Syst. 63, 22–35. doi: 10.1016/j.robot.2014.
09.031

McNeill, D. (1998). “Speech and gesture integration,” in The Nature and Functions
of Gesture in Children’s Communication, eds J. M. Iverson and S. Goldin-
Meadow (San Francisco, CA: Jossey-Bass).

McNeill, D. (2000). Language and Gesture: Window into Thought and Action.
Cambridge: Cambridge University Press. doi: 10.1017/CBO9780511620850

Frontiers in Psychology | www.frontiersin.org 10 October 2018 | Volume 9 | Article 1992

fpsyg-09-01992 October 19, 2018 Time: 12:18 # 11

Cochet and Guidetti Joint Action in Developmental Psychology and Robotics

Milward, S. J., Kita, S., and Apperly, I. A. (2017). Individual differences in children’s
corepresentation of self and other in joint action. Child Dev. 8, 964–978.
doi: 10.1111/cdev.12693

Mitchell, W. J., Szerszen, K. A., Lu, A. S., Schermerhorn, P. W., Scheutz, M., and
MacDorman, K. F. (2011). A mismatch in the human realism of face and voice
produces an uncanny valley. I-Perception 2, 10–12. doi: 10.1068/i0415

Miyashita, T., Tajika, T., Ishiguro, H., Kogure, K., and Hagita, N. (2005). “Haptic
communication between humans and robots,” in Proceedings of the 12th
International Symposium Robot Research, Berlin, 525–536.

Mori, M. (1970). Bukimi no tani [The uncanny valley]. Energy 7, 33–35.
Mori, M. (2012). The uncanny valley. IEEE Robot. Autom. Mag. 19, 98–100. doi:

10.1109/Mra.2012.2192811
Morse, A. F., and Cangelosi, A. (2017). Why are there developmental stages in

language learning? A developmental robotics model of language development.
Cogn. Sci. 41, 32–51. doi: 10.1111/cogs.12390

Nikolaidis, S., Hsu, D., and Srinivasa, S. (2017). Human-robot mutual adaptation
in collaborative tasks: models and experiments. Int. J. Robot. Res. 36, 618–634.
doi: 10.1177/0278364917690593

Oudeyer, P. Y. (2017). What do we learn about development from baby robots?
Wiley Interdiscip. Rev. Cogn. Sci. 8:e1395.

Oudeyer, P. Y., Kaplan, F., and Hafner, V. V. (2007). Intrinsic motivation systems
for autonomous mental development. IEEE Trans. Evol. Comput. 11, 265–286.
doi: 10.1109/TEVC.2006.890271

Pons, F., Harris, P. L., and de Rosnay, M. (2004). Emotion comprehension between
3 and 11 years: developmental periods and hierarchical organization. Eur. J.
Dev. Psychol. 1, 127–152. doi: 10.1080/17405620344000022

Quesque, F., and Coello, Y. (2015). Perceiving what you intend to do from what
you do: evidence for embodiment in social interactions. Socioaffect. Neurosci.
Psychol. 5:28602. doi: 10.3402/snp.v5.28602

Quesque, F., Delevoye-Turrell, Y., and Coello, Y. (2015). Facilitation effect of
observed motor deviants in a cooperative motor task: evidence for direct
perception of social intention in action. Q. J. Exp. Psychol. 69, 1451–1463.
doi: 10.1080/17470218.2015.1083596

Quesque, F., Lewkowicz, D., Delevoye-Turrell, Y. N., and Coello, Y. (2013). Effects
of social intention on movement kinematics in cooperative actions. Front.
Neurorobot. 7:14. doi: 10.3389/fnbot.2013.00014

Robins, B., Dautenhahn, K., and Dickerson, P. (2009). “From isolation to
communication: a case study evaluation of robot assisted play for children
with autism with a minimally expressive humanoid robot,” in Proceedings
of the 2nd International Conference Advance Computing-Human Interaction,
New York, NY.

Scassellati, B. (2000). “How robotics and developmental psychology complement
each other,” in Proceedings of the NSF/DARPA Workshop Development Learning
Michigan State University, Lansing, MI.

Searle, J. R., and Vanderveken, D. (1985). Foundations of Illocutionary Logic.
Cambridge: Cambridge University Press.

Shteynberg, G. (2015). Shared attention. Perspect. Psychol. Sci. 5, 579–590.
doi: 10.1177/1745691615589104

Smith, L. B. (2015). “Foreword,” in Developmental robotics – From babies to
robots. Cambridge, eds A. Cangelosi and M. Schlesinger (London: The MIT
Press).

Tiziana, A., Spinelli, M., Fasolo, M., Garito, M. C., Perucchini, P., and
D’Odorico, L. (2017). The pointing-vocal coupling progression in the first
half of the second year of life. Infancy 22, 801–818. doi: 10.1111/infa.
12181

Tomasello, M. (2009). Why We Cooperate. Cambridge, MA: MIT Press.
Tomasello, M., and Carpenter, M. (2007). Shared intentionality. Dev. Sci. 10,

121–125. doi: 10.1111/j.1467-7687.2007.00573.x
Tomasello, M., Carpenter, M., Call, J., Behne, T., and Moll, H. (2005).

Understanding and sharing intentions: the origins of cultural cognition. Behav.
Brain Sci. 28, 675–691. doi: 10.1017/S0140525X05000129

Tronick, E. Z., Als, H., Adamson, L., Wise, S., and Brazelton, T. B. (1978). The
infant’s response to entrapment between contradictory messages in face-to-face
interaction. J. Am. Acad. Child Psychol. 17, 1–13. doi: 10.1016/S0002-7138(09)
62273-1

Vesper, C., Schmitz, L., Safra, L., Sebanz, N., and Knoblich, G. (2016). The role
of shared visual information for joint action coordination. Cognition 153,
118–123. doi: 10.1016/j.cognition.2016.05.002

Vygotsky, L. S. (1999). “Tool and sign in the development of the child,” in The
Collected Works of L. S. Vygotsky, Vol. 6, ed. R. W. Rieber (New York, NY:
Kluwer Academic/Plenum), 3–68.

Warneken, F., Chen, F., and Tomasello, M. (2006). Cooperative activities in young
children and chimpanzees. Child Dev. 77, 640–663. doi: 10.1111/j.1467-8624.
2006.00895.x

Yohanan, S., and MacLean, K. E. (2012). The role of affective touch in
human-robot interaction: Human intent and expectations in touching the
haptic creature. Int. J. Soc. Robot. 4, 163–180. doi: 10.1007/s12369-011-
0126-7

Yoshikawa, Y., Shinozawa, K., Ishiguro, H., Hagita, N., and Miyamoto, T.
(2006). Responsive robot gaze to interaction partner. Conf. Robot. Sci. Syst. 2,
287–293.

Conflict of Interest Statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.

Copyright © 2018 Cochet and Guidetti. This is an open-access article distributed
under the terms of the Creative Commons Attribution License (CC BY). The use,
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Frontiers in Psychology | www.frontiersin.org 11 October 2018 | Volume 9 | Article 1992

  • Contribution of Developmental Psychology to the Study of Social Interactions: Some Factors in Play, Joint Attention and Joint Action and Implications for Robotics
    • Introduction
    • How Does Communication Develop in the Context of Social Play?
    • To What Extent Can Interactions Be Characterized as Complex?
    • Pragmatics in Hri: Which Ingredients Are Necessary for Effective Interactions?
    • Conclusion and Perspectives
    • Author Contributions
    • Funding
    • Acknowledgments
    • References

EuropEan Journal of DEvElopmEntal psychology, 2017
vol. 14, no. 6, 629–646
https://doi.org/10.1080/17405629.2017.1382344

INTRODUCTION

Developmental psychology without positivistic
pretentions: An introduction to the special issue on
historical developmental psychology

Willem Koopsa and Frank Kesselb

autrecht university, utrecht, the netherlands; buniversity of new mexico, albuquerque, nm, usa

ABSTRACT
Emphasizing the importance of understanding children and child development as
‘cultural inventions’, William Kessen urged developmental psychologists to forego
‘positivistic dreaming’. The first section of this paper summarizes Kessen’s central
ideas. In the second section the pretensions of positivism (classical nineteenth
century positivism as well as twentieth century neo-positivism) are analyzed.
The core critique of positivism is based on Poppers falsificationism and the so-
called Positivismusstreit within the Frankfurter Schule. Despite those and related
fundamental critiques, anti-positivism (such as Kessen’s) does not imply anti-
empiricism. One corollary – Although contemporary developmental psychology
is dominated by empirical-quantitative approaches, a wider range of philosophical
and methodological approaches are called for if the failings of lingering positivism
are to avoided. In particular, twenty-first century developmental psychology
requires critical thinking about the discipline’s foundations and history, along
with deep analyses of how childhood and child development, and the field itself,
are historically and culturally embedded (as Kessen asserted). Section 4 concludes
with several critical notes regarding, e.g., the predominantly Western orientation of
historical studies of child development and the need to recognize the unavoidable
normative, moral dimension in the study of human development. The final section
provides a brief overview of the papers that comprise this special issue on historical
developmental psychology.

ARTICLE HISTORY received 17 september 2017; accepted 17 september 2017

KEYWORDS historical developmental psychology; positivistic psychology; analytical empirical
approaches; developmental science; srcD

1. Introduction

The often-cited developmental psychologist William Kessen (1925–1999) con-
sidered the American child a ‘cultural invention’ (Kessen, 1979). Inter alia, this

© 2017 Informa uK limited, trading as taylor & francis group

CONTACT Willem Koops [email protected]

630 W. KOOPS AND F. KESSEL

implies that developmental psychology cannot function fruitfully without his-
torical analysis. And that is what this special issue seeks to demonstrate.

The first section of this introduction focuses on Kessen’s ideas. The second
section takes a closer look at the meaning of ‘positivism’, a concept and move-
ment Kessen often considered. In particular, we will assert that it is possible to
be an anti-positivist while simultaneously believing that theoretical conceptions
must be approached systematically and assessed empirically-analytically as rig-
orously as possible. In other words, while recognizing – as Kessen did later in his
career – that scientific knowledge is always contingent on time and place, schol-
arly concepts and claims must remain open to empirical inquiry. Conversely,
section three elaborates on the view that scientific thinking not only depends
on empirical-analytical research, but also requires self-reflection, in particular,
critical thinking about a discipline’s foundations and history. Section four con-
cludes with several critical notes as a bridge to brief descriptions of the papers
that comprise this special issue.

2. Kessen’s plea

During the (only) ‘International Year of the Child’ (1979), Kessen wrote an influ-
ential essay on ‘The American Child and Other Cultural Inventions’ (Kessen, 1979;
also Kessel & Siegel, 1983). Among several other central observations Kessen
pointed out that:

No other animal species has been cataloged by responsible scholars in so many
wildly discrepant forms, forms that a perceptive extraterrestrial could never see
as reflecting the same beast. (Kessen, 1983, p. 27)

Understandably scientists who study children wish to continue to pursue what
Kessen referred to as a ‘positivistic dream’, in which such multiple variations in
the definition of the child are considered the ‘removable [correctible] error of
an [as-yet-]incomplete science’ (l.c.). Kessen’s view, however, was that develop-
mental psychologists needed to finally attempt to bridge what he considered
the abyss of the positivistic nightmare. This requires them to recognize that the
upbringing and development of children, as well as the sciences of developmen-
tal psychology and pedagogy, are culturally-historically influenced in significant
ways:

For not only are American children shaped and marked by the larger cultural forces
of political maneuverings, practical economics, and implicit ideological commit-
ments (a new enough recognition); child psychology is itself a peculiar invention
that moves with the tidal sweeps of the larger culture in ways that we understand
at best dimly and often ignore. (Kessen, l.c.)

Grounding his position in historical analysis, Kessen suggested that, in the
mid-nineteenth century, the United States of America was being prepared,
socio-culturally, for the birth of what came to be known as child psychol-
ogy. Against the background of the industrial revolution, he discussed three

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 631

cultural-historical changes that have shaped the fundamental principles of
developmental psychology through to the present. And while Kessen conse-
quently spoke about American child and developmental psychology, his critique
applies to Western culture as a whole, if only because of the dominant influence
of North American developmental psychology in the twentieth and even twen-
ty-first century. He did, therefore, delete the adjective ‘American’ (from the title
‘The American Child and Other Cultural Inventions’) in his revisited version in
1983; hence: ‘The Child and Other Cultural Inventions’ (Kessen, 1983).

In Kessen’s analysis, the first cultural-historical change that led to the inven-
tion of the modern-day child was the gradual division between the domains
of work and family. When women in America between 1830 and 1840 were
excluded from the industrial workforce, this division, marked by the walls of the
family home, became increasingly impregnable (Kessen, l.c., p. 31). Work was
carried out in specialist workplaces (factories) by specialist people (men), and
home became a place where one did not work.

Second, masculinity and femininity were so strongly separated that two
different worlds arose: the ‘ugly aggressive, corrupting, chaotic, sinful and irre-
ligious’ world of men and the ‘sweet, chaste, calm, cultured, loving, protective
and godly’ world of women (Kessen, l.c.). This division made women ‘naturally’
and exclusively responsible for the upbringing of and caring for children.

A third change followed from the other two: As children no longer had access
to the grown-up professional world and home ‘took on the coloration of mother,
hearth and heaven’ (Kessen, l.c.), children became sentimentalized. They were
seen as pure, unspoiled, and even ‘heavenly’. Wordsworth’s ‘Heaven lies about
us in our infancy’ succinctly expresses this view (Stassijns & van Strijten, 2004,
pp. 138, 139). Moreover, the critical importance of early childhood for lifetime
development was canonized. Again, Wordsworth is (too) often quoted: ‘The
Child is father of the Man’ (l.c. pp. 128, 129).

Kessen’s central message is that these cultural foundations of ‘developmental
science’ are generally not recognized as such, i.e., as culturally-historically con-
tingent, and are often even regarded as fundamental laws of nature. As Kessen
argued, in developmental psychology the importance of a harmonious family,
the significant role of mothers, and the decisive role of early experience in the
development of the child are conventionally considered as principles anchored
in the laws of nature, for which researchers seek and find empirical evidence.
And the now commonplace use of ‘developmental science’ can be seen as a
final integration of developmental psychology with ‘science’, and not with the
humanities. As a key qualifying corollary, this view overlooks, or at least tends
to overlook, any and all alternative conceptions of the child and of develop-
ment in different historical epochs and socio-cultural contexts. To Kessen, this
also means that progress in developmental psychology, i.e., seeking deeper
understanding of human development, cannot be achieved by collecting more
and more empirical data but, also and as important, has to entail analyzing the

632 W. KOOPS AND F. KESSEL

basic principles and processes of the field from a cultural-historical perspective
(again, as the title of his essay so precisely states: ‘The [American] Child and
Other Cultural Inventions’.

To provide a preview of the final sections below – Working within such a phil-
osophical framework, the authors of the papers in this special issue are focused
on a particular task: Providing various insightful illustrations of a critical cultur-
al-historical approach to the (‘fundamentals’ of ) developmental psychology.

3. Positivistic and empirical-analytical approaches

As signaled above, in Kessen’s view the positivist program was and is funda-
mentally misguided; he therefore criticized ‘positivistic dreaming’, viz., the
assumption that empirical-experimental (human and social) science will yield
fundamental facts and universal, timeless principles. Given that the terms
positivism and positivistic have long been used by critics of ‘normal science’,
examining them further is warranted. In the next subsection, the origin and
meaning of the concept of positivism will be discussed, as well as a number of
its characteristics that have been subject to criticism and that, therefore connect
to the core of Kessen’s position.

As a prefatory note, it is important to underline that the assumptions and
goals of positivism can be rejected without implying an opposition to empir-
ical research (as some movements in psychology and pedagogy antithetical
to empirical science have asserted). Thus neither Kessen nor we are opposed
to systematic and reflective empirical research in (developmental) psychology
and pedagogy. On the contrary, whenever possible, and while acknowledging
limitations on the possibility of data-collection and certainty of related interpre-
tation, researchers should analyze and reflect on their theoretical assumptions
in the context of the most systematic available empirical data. Such a principled
stance of vulnerability, or humility, regarding the limits of scientific knowledge
– which can be traced back, among others, to the philosopher of science Karl
Popper (1902–1994) – will be referred to as an empirical-analytical approach.

3.1. The positivist approach

Positivism is the notion that only the empirical sciences can yield valid knowl-
edge. Positivism asserts that science is solely based on empirical facts and rejects
all metaphysical assertions and assumptions. The classical positivism from the
nineteenth century merges with the belief in the progress of the Enlightenment,
i.e., progress in science will eventually provide solutions to all possible problems
(Steel, 1989, p. 99). Positivism emerged from the confrontation of philosophy
with the successful modern (physical) sciences and the consequential view
that the certain knowledge of empirical science could not be matched by phi-
losophy (or the humanities in general). Already by the end of the eighteenth

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 633

century philosophy had begun to cede the field of nature to positivistic modern
physics and chemistry. And in the nineteenth century the humanities were also
gradually redefined as empirical sciences. Positivistic sociology appeared first,
promoted by Auguste Comte (1798–1857), considered the ‘father of positivism’
(Bourdeau, 2011); he referred to sociology as ‘social physics’ (Steel, 1989, p. 98).
Comte’s positivistic program for sociology was elaborated by his pupil Émile
Durkheim (1858–1917).

In the case of psychology, the establishment of the first psychology labo-
ratory by Wilhelm Wundt (1832–1920) in Leipzig (in 1879) has conventionally
been identified as the beginning of positivistic, i.e., scientific, experimental psy-
chology (Boring, 1950; as the canonical source). But here it is especially worth
noting that critical historians have demonstrated how such accounts com-
pletely neglected the other deep dimension of Wundt’s work (1900–1920), viz.,
his Völkerpsychologie studies of phenomena such as language, art, myths and
religions, law, culture in historical perspective, and more. (See, e.g., Blumenthal,
1977; Danziger, 1979; Leary, 1979) And it is plausible to see the spirit of the ‘other
Wundt’ expressed in the various, emerging-in-the-1990s and now-vibrant forms
of ‘Cultural (Developmental) Psychology’, for example, in the rich, paradigm-de-
fining writings and research of Michael Cole (1996), Barbara Rogoff (2003) and
Richard Shweder (1994). (See also Goodnow, Miller, & Kessel, 1995).

Comte’s positivistic program of principles was described in his writing about
the positive mind (Comte, 1844). That program also demonstrates the strong
belief in progress that was intertwined with Comte’s positivism. He believed, for
instance, that the rise of the modern sciences was a slow but inevitable process.
He formulated the law of the three stages: First, a theoretical stage when the
explanation for phenomena is sought in supernatural powers. This is followed by
humanity entering a metaphysical stage when the world is explained by referring
to abstract principles or essences. Eventually humanity enters a positive stage
when it becomes clear that only empirical science can yield real knowledge. At
this stage knowledge should be considered as accessible to all and relevant for
all daily requirements and needs. Therefore, according to Comte, positivism is
inevitable. The law of the three stages is founded on the presumed positivistic
law of progress and evolution of human thinking. Delanty and Strydom (2003,
p. 14) have extensively described positivism. Assuming access to their writing,
we will now further concentrate here on some criticisms of positivism by way
of a discussion of Popper’s ideas and the debate within the Frankfurter Schule.1

Positivists believe that scientific knowledge originates primarily via induc-
tion: By systematically observing specific perceptible phenomena one induces
general and abstract laws. This, however, is not how it appears to unfold in
scientific reality. A fundamental criticism of such a position came in the form of

1a detailed discussion of all these ideas, and those in the previous section, is contained in Koops (2016),
notably chapter 1.

634 W. KOOPS AND F. KESSEL

Popper’s falsificationism (Popper, 1935, 1959) and his classic ‘Even if one has seen
a hundred white swans, the next one could still be black’. According to Popper,
one can only falsify or refute, not ever confirm or prove a posited hypothesis.
So ‘all swans are white’, can only be refuted by encountering a black swan. It
follows then that one must first posit a certain assumption (hypothesis or H1)
and then try to refute it by rejecting the contrary hypothesis (H0). And even if
this succeeds, the basic hypothesis (H1) can only be maintained provisionally,
and never be lifted to the level of absolute knowledge through observation
alone. For Popper, then, there is no pure induction from observation to certain
knowledge.

Popper’s description of this logical asymmetry between verification and
falsification – hence Conjectures and Refutations (1963) – is a key element in
his philosophy of science. It led him to choose falsifiability as the criterion to
distinguish science from non- or pseudo-science: A theory can only be genu-
inely scientific if it is falsifiable. Falsifiability as a demarcation criterion for the
distinction between science and un-science therefore led him reject the claims
to scientific status of both Marxism and psychoanalysis, given that both theories
are not falsifiable.

In summary, Popper made it clear that induction from observation cannot
lead to true, universal knowledge, and that all scientific knowledge is tempo-
rary and provisional. This is a significant qualification of original positivist pre-
tensions. Popper’s analysis also seriously undermined the notion of inevitable
progress. As a consequence, those following Popper’s analysis have little reason
to believe that scientific knowledge automatically advances and improves; they
also do not have any reason to expect that we will ever be able to solve all social
problems purely through knowledge derived via positivistic science. In addition,
classical positivism’s assumption that knowledge can be exhaustive and that
induction one day will have yielded all important certainties about the universe
is, for Popper, an indefensible optimism.

A complementary set of ideas emerged in the 1960s, in the form of a debate
in Germany that became known as the ‘Positivismusstreit’ (the Positivism bat-
tle); this exchange deepened the critique on positivism. (See Adorno, Albert, &
Dahrendorf, 1993; Dahms, 1994) Even though it focused primarily on the meth-
odology and epistemology of sociology, the debate was particularly relevant
to positivist claim that science is value-free. The discussion between Theodor
Adorno (1903–1969) and Popper, in particular, focused on this topic. It is note-
worthy that both agree that the scientific practitioners are always embedded
in cultural history and that their minds, therefore, are pervaded or shaped by
this context. According to Popper, however, the ensuing scientific research is
meant precisely to determine empirical-analytically the tenability of the claims
of the embedded scientific researcher.

For their part, the philosophers of the so-called Frankfurter Schule, with key
representatives such as Adorno and Jürgen Habermas (born in 1929), believed

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 635

that although society as a whole could be analyzed scientifically, value-freedom
was an illusion in all respects. The members of the Frankfurter Schule built on the
theories of Marx, Hegel, and Freud (as noted, all unscientific in Popper’s view).
The fundamental assumption of the was that they could understand the struc-
ture of society as a whole and, in principle, identify the conditions to change
or entirely alter this structure consistent with certain value assumptions. This
approach was thus called Critical Theory. (In the 1960s and 1970s, widespread
social criticism from the democratization movements, particularly at universities,
was inspired by the Frankfurter Schule publications.)

The discussions that emerged during the Positivismusstreit made it clear that
the value-freedom as claimed by positivism should at least be qualified. Such
an analysis underlines that scientific researchers are members of a community
whose work is shaped by the wider society’s values. As a key corollary, these
values play a role in their theoretical and methodological choices and com-
mitments. For his part, Popper thought that falsificationism would provide the
critical means to subject the tenability of theoretical claims to empirical-ana-
lytical test; and that, in turn, could always lead to the refutation of the claims.
And the Frankfurter Schule believed that they could understand and modify
social value patterns and dynamics. However, contrary to classical positivism’s
assumption that objective observations and logical induction guarantee value
freedom, both did not deny – indeed, acknowledged – that values play a role
in science. While Popper aimed to subject value-laden theoretical notions to
scrutiny via falsificationism, the Frankfurther Schule sought to respond ‘critically’
to these values.

As a final note in this section, it is worth emphasizing that the account above
is an abbreviated, selective account of the critique of positivism. Among other
strands (emerging especially in the 1960s): Thomas Kuhn’s analysis of scien-
tific ‘paradigms’ and ‘revolutions’, and Michael Polanyi’s discussion of ‘personal
knowledge’ and ‘the tacit dimension’ (See Kessel, 1969).

3.2. The empirical-analytical approach

Whereas Adorno (1993) invented the term ‘Positivismusstreit’, Popper objected
to the term as he did not want to call himself a positivist. Or, more accurately,
he objected being considered (even) a neo-positivist.

Neo-positivism had originated during the period of the Wiener Kreis. The
Wiener Kreis (1920–1938) referred to a group of philosophers and scientists who
gathered around Moritz Schlick (1862–1936). Key figures included the econ-
omist Otto Neurath (1882–1945), and the philosophers Friedrich Waismann
(1896–1959) and Rudolf Carnap (1891–1970). Often present but not a formal
member of the group, Popper deviated from key points of the logical positiv-
ism or logical empiricism promoted by the group. Rejecting metaphysics and
epistemology as useless, the Wiener Kreis sought to unify science by making

636 W. KOOPS AND F. KESSEL

use of a common scientific language, symbolic logic. Eschewing such a common
core language, Popper described his own approach as critical rationalism. The
term ‘critical’ is rather ambiguous: The Frankfurter Schule uses it to refer to social
criticism; Popper wished to (critically) determine which theories were tenable
and which were not.

Thus Popper criticized both classical positivism and the neo-positivism of the
Wiener Kreis. Contrary to the positivistic tradition, he believed that all science is
partial (and always incomplete); that scientific knowledge does not automati-
cally advance but often has to take apparent detours; and that science cannot
ever produce complete understanding and the solution of all social issues. He
also agreed with the Frankfurter Schule that the theories and hypotheses of a
scientist are can never be value-free in the sense that they are unconnected with
the everyday lived environment (of the scientific community). But contrary to
the Frankfurter Schule, Popper deemed it possible to refute untenable assump-
tions and hypotheses via falsification, not as in the tradition of positivism via
induction. In essence, his falsificationism is an empirical-analytical tool: It aims
to examine and refute hypotheses and predictions by making use of empirical
data.2

Conducting path-breaking empirical-analytical research on infants, Kessen
in fact established his reputation in the American behaviorist tradition, a par-
adigm that more than any other institutionalized positivist assumptions in
mainstream psychology.3 He was thus certainly aware of the importance of the
empirical-analytical tradition. Later in his scholarly career, however, and based
in part on his own study of historical sources (Kessen, 1965), Kessen sought to
understand how the practice of developmental psychology and of theorizing
in general was linked to the cultural history in which it was, and is, embedded.
For him, and us, such self-critical understanding is the only way to preclude
assumptions and views about children that are, as Kessen underlined, variable
across cultural space and historical time being mistakenly considered natural,
universal phenomena.

In a related vein, we suggest that scientific questions can only be answered in
a meaningful way at the level of organization of the phenomenon being studied.
We borrow this conception of ‘level of organization’ from the Dutch psychologist,
Johannes Linschoten (1964). In a distinctive way, he made clear that questions
at one level of organization cannot be answered by data at a different level of
organization, at least not without losing relevance and understanding. As a

2such an empirical-analytical approach remains a core element of the methodology of contemporary psy-
chology. to give an example, in the second half of the twentieth century Dutch (and European) psychol-
ogy was totally redefined by De groot’s classic book (1961; English translation 1969), whose prescriptive
methodology was largely based on the ideas of popper. (see Busato, 2014 for a description of the effect
of De groot’s work.).

3Kessen was not alone in forcefully rejecting psychology’s positivist-behaviorist paradigm in which he made
his early, widely-recognized contributions. sigmund Koch serves as another compelling, still-relevant
example. (see finkelman & Kessel, 1999; leary, 2001).

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 637

corollary, Kessen’s plea for historical understanding of the child and of child
development implies that gathering and analysing only quantifiable data, we
will miss essential understanding of the historical and cultural embeddedness of
child development. Because the complexity and the time scale of historical phe-
nomena call for a different level of organization than that of the individual child
in the here-and-now (to be studied exclusively via experimental approaches),
the study of cultural historical embeddedness of human development requires
different methods and analyses.

In a similar spirit: The anthropologically informed, ethnographically sophisti-
cated developmental psychologist whose research entails making observations
of and conducting conversations with children (and their families) in diverse
cultures seeks to capture those in field notes that, in the best case, serve as
the basis for rich, meaningful narratives about the meanings of child behavior
and experience in such contexts. Such plausible stories cannot be replaced by
exclusive quantitative analysis of isolated variables. This illustrates Lischoten’s
caution: To gain understanding of local knowledge and dynamics at the level of
cultural complexity, research calls for subtle stories and not purely quantitative
analyses and models based on a certain conception of the natural sciences.

The empirical-analytically minded researcher thus tries to find the most pre-
cise answer possible at the level of complexity that defines or represents the
problem focus of the research. Even if that most precise answer is in the form
of a verbal explanation, it is still possible and even necessary to try to test the
tenability of a hypothesis by examining opposing hypotheses (as a non-numer-
ical, verbal form of Popperian falsification).

What we are advocating is best considered ‘methodological liberalism’, which
implies that, in adopting an empirical-analytical approach, the researcher seeks
to collect and fit data at the level of the organization of the object of study, and
that these data are analyzed as accurately as possible. If possible, and where
appropriate, researchers derive and analyse data using numbers/statistics; but
if this is not possible at the given level of organization, or meaningful in the
context of the problem being studied, then the researcher should turn positively
to narratives. As suggested above: At some levels of organisation mathematical
models are not feasible or even desirable, so narrative accounts are preferable.
But even then it is possible to profit from Popper’s falsification ideal: The goal
should always be to search systematically for a convincing, possibly conclusive
argument that is in conflict with the conclusion. It is, for example, acceptable
within modern psychology to test statistically whether a mathematical model
is ‘fitting’. Popper might have regretted this, for such an approach is the oppo-
site of his falsificationism. However, even within such a ‘model-fitting’ research
approach, respect could be paid to Popper’s falsificationism by systematically
exploring alternative, contrasting models.

In summary, even though – humbly echoing Kessen – we are anti-positivists,
we too are not opposed to empirically-oriented developmental psychology.

638 W. KOOPS AND F. KESSEL

Our view is that developmental psychology should be empirical-analytical
in overall methodology while recognizing and accepting that empirical data
cannot, indeed should not, be more exact than appropriate for the level of
organization of the studied phenomenon. Among other things, this means that
research methods can be qualitative or quantitative; that while data collection
and analysis seek to be as exact and detailed as possible, sometimes they will –
indeed should – consist of the systematic interpretation of texts and citations,
other times of statistical data derived via measurements. Indeed, over the past
couple of decades clear signs have emerged that qualitative methods, of various
kinds, are being accepted as both legitimate and important forms of develop-
mental inquiry (Jessor, Colby, & Shweder, 1996; Kessel, 2013; Weisner, 2005) and
psychology more broadly (Bevan & Kessel, 1994; Josselson, 2017; Packer, 2004;
Willig & Rogers, 2008).

4. Principles and history

In the previous sections, drawing on an admittedly shorthand review of some
previous ideas from the philosophy of science that undermined positivism, we
have attempted to delineate some of our ‘pluralistic’ methodological and epis-
temological convictions. As a corollary, we suggest it is still all too simplifying
and seductive to take classical, Newtonian physics as a model for the study of
human and social phenomena. Given different levels of organization (that is,
different levels of complexity of phenomena studied), we need to continue to
develop, adapt, and accept a variety of different methodologies, i.e., many forms
of descriptive-analytic narrative approaches as well as ‘conventional’ experimen-
tal-statistical methods. Nor can there be a simple formula for making insightful
decisions about which method is best suited to the topic, issue, and level of
organization at hand. And more: A critical scientific discipline will strive to be
knowledgeable about its own history and engaged in self-critical reflection on
its foundations.

It is therefore of great and immediate importance that developmental psy-
chology focuses on questions that deal with the foundations and history of the
field. This is more urgent than gathering ever more ‘empirical’ data and adding
ever more ‘empirical’ papers to myriad journals. It is particularly essential to
establish understanding of the discipline’s intellectual and institutional con-
text, rather than only accumulating further fragmented and complicating, or
worse, simplifying knowledge. To that end, in our view critical historical analysis
is essential. As the papers in this special issue make clear, past and present (and
future) empirical research on child behavior and experience is intricately con-
nected with the history of theories and assumptions about children and their
development. Moreover, self-critical knowledge of the history of the discipline
itself can help prevent the reinvention of the wheel or, to adapt another met-
aphor, simply (and misleadingly) placing old wine in shiny new bottles. While

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 639

research practice within the discipline requires defined empirical-analytical
methodology (both qualitative and quantitative), study of the structure and
nature of the discipline requires extended contemplation, analysis, and critical
thinking, especially about its past as embedded in the present and future. (Below
we address the central question of how, where, and by whom such analysis and
thinking are best conducted.)

5. Concluding discussion

The fact that Kessen referred to the child as a ‘cultural invention’ might be taken
to mean he was suggesting that children are not (also) biological beings. We
should realize, however, that, via his title and related analysis, Kessen sought
to provoke self-critical reflection. In effect, he wanted to wake up those he saw
as mainstream and misguided ‘positivistic dreamers’. The child is also a cultural
invention, a product of the ‘Zeitgeist’. Kessen challenges developmental psy-
chologists to be critically aware of their (normative) concepts of the child, con-
cepts which they absorb, reinforce, and reify in their own theories and methods,
influenced by the socio-cultural zeitgeist, and which they are inclined to regard
and present as empirically established, universal, value-free laws of nature.

Consider the example of the decisive role of early experience, an assumption
often adhered to in the nineteenth century, consistent with the sentimentalized
child image of that century. It is at least debatable how decisive early experi-
ences are; but it is comforting to adhere to this view, in part because, as Kagan
(1984) asserted, it dovetails with and reinforces the convictions of the wider
public. He argued that developmental psychologists find it hard to consider
contra-indications seriously and prefer to keep adhering to the notion of early
determinism. For him, defending this absolute early determinism is as intelligent
as Ptolemy ‘proving’ that the earth is the stable center of the universe (Kagan,
1984, p. XI). Of course, in light of many findings since 1984, early experience and
education are undoubtedly important. But Kagan objected, in our view appro-
priately, to overgeneralizing and overvaluing early development as uniquely
causal in determining life course outcomes. In essence, Kagan wanted research-
ers to refrain from uncritically adopting general culturally-shaped assumptions,
concluding that ‘We celebrate empirical science because it corrects pleasing,
but not always accurate, intuitions.’ (l.c., p. X).

It is important that the celebration of empirical science does not lapse into
a positivistic tendency in the sense that we have described here. So, although
this may be a primarily rhetorical point, why is it that it has recently become de
rigueur to emphasize that we are engaged in developmental science? For one
thing, what does that imply about the (ir)relevance of multi-dimensional disci-
plines such as anthropology and history for shedding light on the complexities
of human development in rich and diverse socio-cultural contexts? And on the
same theme: When child developmental inquiry was institutionalized (in North

640 W. KOOPS AND F. KESSEL

America) in the 1920s. It was explicitly seen as a multi- or even inter-disciplinary
endeavor. Only later (primarily in the post-World-War II era) did it come to be
regarded and practiced as developmental psychology; moreover, one specific
conception and form of the discipline, viz., ‘experimental’ and, in essence, posi-
tivistic (Kessel, 2009). Is there now meaningful movement away from that restric-
tive, uni-disciplinary perspective? Perhaps. (See our concluding comments.)

Our view of what empirical-analytical research should be seems to dovetail
with what Kagan proposed when he wrote that ‘The Vienna philosophers went
too far in their accommodation to the new discoveries in physics . . .’ (l.c., p. XIII).
Consistent with what we suggested earlier about the Wiener Kreis, Kagan serves
to illustrate that Kessen’s critical, post-positivist chords are being echoed and
amplified by many (developmental) psychologists. (See Bronfenbrenner, Kessel,
Kessen, & White, 1986; Brown & Cole, 2001; Kessel, 1983) And that includes the
authors of the papers in this issue (as we hope will be evident).

An important closing question is whether Kessen’s critique and the contribu-
tions in this special issue are unduly oriented towards the West, or global North.
While these papers, for practical reasons of manageability, are primarily focused
on trends in Europe and the United States, we suggest that the analyses and
understanding emerging from the study of the history of childhood – exem-
plified by the contributions here – can be generalized to other continents and
regions.

Stearns’ book about Childhood in World History (2006) is an instructive
example. Because, however reluctant and careful he is in generalizing Western
developments to the rest of the world, Stearns nevertheless makes it clear that
contemporary globalization reflects general trends regarding the changing
contexts of child and family life. In particular, the transition from agricultural to
modern societies – such as first occurred after the Enlightenment in Europe and
North America – offers a number of discernible general patterns. For example,
children who no longer contribute to the workforce but go to school to learn
what is now considered relevant for their future functioning in the community
or society; also, children who have fewer siblings and will die at an early age
much less frequently than previously. And while the order and causal relation-
ships between these dynamic changes may differ at different locations in the
world and at different points in time, such patterns do indeed occur worldwide.

As another example, Stearns believes that the emphasis on the striving
for children’s happiness has also become a global tendency which is subtly
interlinked with these other patterns. Thus, the decrease of child mortality and
increase in health care, as well as increased welfare, allows more room for con-
cerns about ‘happiness’ (Stearns, 2010, 2011).

Thus, while the majority of the papers of this special issue are primarily
focused on elements of Western culture, we should emphasize that this is not an
unintended expression of a form of ethnocentrism but, rather, because historical
trends in the West are also unfolding in other parts of the world as a function

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 641

of modernization processes (Koops & de Winter, 2011). Moreover, as powerfully
illustrated by the Keller and Vicedo papers in this issue, a reciprocal process is
underway, where both historical and culturally-informed scholarship prompt a
critical perspective on core, deeply-entrenched mainstream assumptions and
theories. In their case, the focus is on attachment theory and research; a parallel
process is now underway regarding the presumed ‘word gap’, i.e., supposed con-
sequential deficiencies in the verbal environments of poor children, including
those in contexts outside the North America and Europe, compared to their
more affluent peers. (See Avineri & Johnson, 2015; Miller & Sperry, 2012)

The articles collected in this special issue will, we hope, encourage fur-
ther (self-)critical historical research, further contributions to what might
be called Historical Developmental Psychology (Koops & Elder, 1996). That,
in turn, reflects two related and fundamental features of what a generative
post-positivist paradigm entails: First, affirmative recognition that (develop-
mental) psychology is, at root, a ‘moral science’ (White, 1983a), where normative
assumptions are embedded, more or less explicitly, in both theory and practice,
and most fundamentally in the very notion(s) of ‘development’ itself (White,
1983b). And second:

An historical [developmental] psychology involves, … in the first place, an aware-
ness of the historicity of the very norms that are dominant in a given culture or
within a given science at a given time. In the second place, an historical [develop-
mental] psychology takes seriously the variety of culturally and socially operative
factors that go into the very constitution of such norms, whether of childhood,
or of cognitive development [or of social development], and at the same time
an historical [developmental] psychology is aware or critically self-aware of the
status of its own operative norms and methods of inquiry … An historical [devel-
opmental] psychology is thus, necessarily, a normative psychology, not only in
the descriptive sense of studying prevalent or historical norms, but also in the
critical sense of rejecting and proposing norms. (Wartofsky, 1983, p. 189; see also,
Bronfenbrenner et al., 1986, p. 1227)

And this follow-up passage powerfully underlines our overall theme (on the
critical role of historical developmental psychology, and psychologists):

[None of this means] we can’t get started until we all agree on the norms. But it
puts the determination and critique of norms right in the ballpark as a concern
of actual psychological theory and psycho logical practice. [This] doesn’t mean
every psychologist has to do so every day or say it as a little prayer every morning.
But it means that it [the determination and critique of norms becomes an integral
part of the field … and not some after-hours, cracker-barrel stuff you do when the
real psychologists aren’t around … which is its usual status. That is, consideration
of norms has to become integral to the field such that those who are doing it are
in touch with those who aren’t, making them aware of it and so percolating the
field. (op cit., p. 219)

All of which, we believe, both reinforces and honors Bill Kessen’s plea for a cul-
tural-historical approach to the study of child and human development (Kessel,
1991).

642 W. KOOPS AND F. KESSEL

6. Brief overview of the papers in this issue

We are pleased to record that this special issue originated in Ann Arbor,
Michigan on 12–14 May 2016 in a symposium on ‘Historical Perspectives on
Child Development: Implications for Future Research’ organized by then-still-
in-place History Committee of the Society for Research in Child Development
(SRCD). In essence the following papers are the written, final versions of the
symposium presentations by members of the Committee and other guests.
Appreciative of the Society’s support for that event, we conclude this introduc-
tion with the following Socratically-intended comments.

At least in its current stated strategic goals (Sherrod, 2016), SRCD – perhaps
the most influential organization of its kind – is signaling commitments to some
of the suggestions we have made here. As a noteworthy example, it has declared
the goal of returning to its, and the field’s, multi/inter-disciplinary roots. Similarly,
there is announced emphasis on seeking understanding of the cultural and con-
textual dimensions of human development, with a presumed greater receptivity
to qualitative forms of inquiry still more widely practiced in disciplines such
as cultural and linguistic anthropology and history; also, a recent, loosely-re-
lated focus on ‘social justice’. And there are some signs of a recognition that
relationships, both institutional and intellectual, between the global north and
south need to become more reciprocal, where theories, methods and findings
are open to critique and fundamental revision from outside–the-mainstream
perspectives. (See, e.g., Dawes, 2016; Kessel & Lukowski, 2016; Verma, 2016)

How will these commitments be institutionally enacted, most notably in the
planning and review processes for both SRCD’s highly sought-after biennial
meetings and its visible, high-impact journals? For a range of reasons, including
the understandable inertial dynamics of large professional-scientific organi-
zations, our view is that only time will tell how deep and consequential such
projected philosophical and substantive shifts will be.

In particular, and again for a combination of reasons, we are skeptical –
though hopeful – that the Society and the field as a widespread whole will create
significant space for the kind of critical historical-developmental scholarship that
these papers so persuasively represent. Such space would signal recognition, for
example, that twenty-first Century ‘history’ is far from being a single, stand-alone
‘discipline’ but, instead, variously engages issues at the intersection of culture,
society, politics and both epistemology and moral philosophy.

So will we get to the stage when, in Wartofsky’s perennially challenging
words, ‘[the determination and critique] of norms [are] integral to the field such
that those who are doing it are in touch with those who aren’t, making them
aware of it and so percolating the field’? Seeing such self-critical engagement
with normative and moral (and political) questions as akin to a final post-pos-
itivist frontier for developmental inquiry (at least in our professional lifetimes),
and inspired by these papers, we will strive to keep hope alive!

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 643

Consistent with the main theme of this collection, Steven Mintz (Why history
matters: Placing infant and child development in historical perspective) under-
scores the importance of systematic knowledge about how conceptions of
childhood vary across social time and space. In the process, he demonstrates
how such understanding helps rebut myths, undercuts linear views of progress
(and thus ‘development’), and sheds light on often misunderstood long-term
trends and processes.

With a focus on changing social views and standards regarding children and
emotions, Peter Stearns (Children and emotions history) provides a detailed case
study of the overall themes underlined by Mintz. He examines, in socio-cul-
tural context, two major changes in American approaches (around 1800 and
in the 1920s), as well as possible explanations for shifts in specific emotions
(e.g., happiness and shame). In a more ‘meta’ mode, he considers complexities
in discussing changes or continuities in children’s emotions, and reflects on the
possibilities for connections between historical and psychological approaches.

As a complement to Stearns’ paper, Paul Harris (Emotion, imagination and
the world’s furniture) considers how a particular conception of emotions that
emerged in the late nineteenth century was uncritically embedded in the
work of subsequent generations of psychologists (at least in Europe and North
America). Highlighting that conception’s heavily evolutionary-biological under-
pinnings, he then examines two species-specific qualities of human emotions,
where culture and imagination are central. Finally, he suggests that such a frame-
work would be generative in considering connections between the history of
emotions and their development in children.

Focusing on how John Bowlby’s and Mary Ainsworth’s ethological theory of
attachment was received in different disciplinary communities, Marga Vicedo
(Putting attachment in its place: Disciplinary and cultural contexts) makes two essen-
tial points: From Margaret Mead’s 1950s anthropological-critique onwards, cultural
challenges to the theory’s central assumptions (e.g., of universality) have been
essentially ignored. And second, that such a (dys)functional dynamic can be best
explained in terms of different disciplinary paradigms – philosophical and meth-
odological, positivist and not. She thus provides an insightful illustration of some of
the themes presented above, not least how fine-grained historical-archival research
can shed illuminating light on major areas of ‘mainstream developmental science’.

Heidi Keller (Cultural and historical diversity in early relationship formation)
complements both Vicedo’s paper and, again, parts of the ‘post-positivist’ view
presented above. Drawing on the work of cultural psychologists and anthropolo-
gists, as well as context-attuned developmental psychologists (herself included),
she reviews how caregiving/socialization beliefs and patterns vary, consequen-
tially, across changing sociocultural environments and historical time. She
concludes with reflections on how the often-assumed contradiction between
cultural-historical specificity and universality, e.g., in the realm of attachment
and overall early relationship formation, can be overcome. As a corollary, she

644 W. KOOPS AND F. KESSEL

too illustrates how historical and developmental analysis can and should be
two sides of the same analytic coin.

Lassonde’s focus (Authority, disciplinary intimacy & parenting in middle-class
America) is on historical shifts, from the mid-19th-century through to the pres-
ent, in beliefs and childcare advice regarding appropriate styles of parenting.
Examining such topics as views regarding corporal punishment and its pre-
sumed link to authoritarianism, his analysis emphasizes the importance of
understanding changing dynamics in wider socio-cultural-political contexts,
not least for critically locating the contingent views of developmental ‘experts’
(during various periods). And although the patterns he discerns are based in
the United States, that sort of analytic principle and goal is no less important for
work elsewhere, i.e., historical-developmental research (on ‘parenting’) that can
yield a picture of differences and similarities across time and space(s).

As a broad complement to Lassonde’s paper, Sandin (The parent: A cultural
invention. The politics of parenting) explores how – in Sweden in the twentieth
century – beliefs, practices, and policies regarding the relative roles of parents
and social institutions in fostering and protecting children were significantly
shaped by the philosophy of the wider welfare state. He analyzes how govern-
ment policies and (interventionist) practices both reflected and reified assump-
tions, for example, about limited parental responsibility, especially in relation
to children seen as competent, individual agents with adult-like rights; such
assumptions were, in turn, tied to certain notions of ‘developmental well-being’
and reinforced by certain international conventions.

In the end, then, the harmonious sounding of some distinctly Bill Kessen-like
themes!

Disclosure statement

No potential conflict of interest was reported by the authors.

References

Adorno, T. W., Albert, H., & Dahrendorf, R. (1993). Der Positivismusstreit in der deutschen
Soziologie. München: DTV.

Avineri, N., & Johnson, E. (2015). Introduction to “Bridging the Word Gap”. Linguistic
Anthropology, 25, 67–68.

Bevan, W., & Kessel, F. S. (1994). Plain truths and home cooking: Notes on the making and
remaking of psychology. American Psychologist, 49, 505–509.

Blumenthal, A. L. (1977). Wilhelm Wundt and early American psychology” A clash of two
cultures. Annals of the New York Academy of Sciences, 291, 13–20.

Boring, E. G. (1950). A history of experimental psychology. New York, NY: Appleton.
Bourdeau, M. (2011). Auguste comte. In E. N. Zalta (Ed.), The Stanford encyclopedia of

philosophy. Stanford: Stanford University.
Bronfenbrenner, U., Kessel, F., Kessen, W., & White, S. (1986). Toward a critical social history

of developmental psychology: A propaedeutic discussion. American Psychologist, 41,
1218–1230.

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 645

Brown, K., & Cole, M. (2001). A Utopian methodology as a tool for cultural and critical
psychologies: Toward a positive critical theory. In M. J. Packer, & M. B. Tappan (Eds.),
Cultural and critical perspectives on human development (pp. 41–66). New York, NY:
SUNY Press.

Busato, V. (2014). A.D. de Groot(1914-2006): Meester in de psychologie. In V. Busato, M.
van Essen, & W. Koops (Red.), Van fenomenologie naar empirisch analytische psychologie
(249–314). Amsterdam: Bert Bakker.

Cole, M. (1996). Cultural psychology: A once and future discipline. Cambridge: Harvard
University Press.

Comte, A. (1844). Discours sur l’esprit positif. Paris: Pain et Thunot.
Dahms, H.-J. (1994). Positivismusstreit. Die Auseinandersetzungen der Frankfurter Schule

mit dem logischen Positivismus, dem amerikanischen Pragmatismus und dem Kritíschen
Rationalismus. Frankfurt am Main: Suhrkamp.

Danziger, K. (1979). The positivist repudiation of Wundt. Journal of the History of the
Behavioral Sciences, 15, 205–230.

Dawes, A. (2016). The interface of rights and knowledge? Developments (SRCD Newsletter).,
59, 4–5.

Delanty, G., & Strydom, P. (2003). Philosophies of social science: The classic and contemporary
readings. London: Open University.

Finkelman, D., & Kessel, F. S. (Eds.). (1999). Sigmund Koch: Psychology in human context
– Essays in dissidence and reconstruction. Chicago, IL: The University of Chicago Press.

Goodnow, J., Miller, P., & Kessel, F. S. (Eds.). (1995). Cultural practices as contexts for
development. New directions in child development, No. 67. San Francisco, CA: Jossey Bass.

de Groot, A. D. (1961). Methodologie. Grondslagen van onderoek en denken in de
gedragswetenschappen. Amsterdam: Noordhollandse Uitgeversmaatschappij.

de Groot, A. D. (1969). Methodology. Foundations of inference and research in the behavioral
sciences. Den Haag: Mouton.

Jessor, R., Colby, A., & Shweder, R. A. (Eds.). (1996). Ethnography and human development:
Context and meaning in social inquiry. Chicago, IL: The University of Chicago Press.

Josselson, R. (2017). Editorial. Qualitative Psychology, 4(1), 1.
Kagan, J. (1984). The nature of the child. New York, NY: Basic Books.
Kessel, F. S. (1969). The philosophy of science as proclaimed and science as practiced:

“Identity” or “dualism”? American Psychologist, 24, 999–1005.
Kessel, F. S. (1983). On cultural construction and reconstruction in psychology: Voices in

conversation. In F. S. Kessel & A. W. Siegel (Eds.), The child and other cultural inventions.
New York, NY: Praeger.

Kessel, F. S. (1991). Vision, scholarship, and the child. In F. S. Kessel, M. H. Bornstein, & A.
J. Sameroff (Eds.), Contemporary constructions of the child: Essays in honor of William
Kessen. Hillsdale, NJ: Erlbaum.

Kessel, F. S. (2009). Research on child development: Historical perspectives. In R. A.
Shweder, et al. (Eds.), The child: An encyclopedic companion. Chicago, IL: The University
of Chicago Press.

Kessel, F. S. (2013). On the qualities, and quality, of qualitative (developmental) research:
Some semi-random reflections. ISSBD Bulletin, Serial No., 64, 6–8.

Kessel, F. S., & Lukowski, A. (2016). Global perspectives. Developments (SRCD Newsletter).,
59(1), 1.

Kessel, F. S., & Siegel, A. W. (Eds.). (1983). The child and other cultural inventions. New York,
NY: Praeger.

Kessen, W. (1965). The child. New York, NY: Wiley.
Kessen, W. (1979). The American child and other cultural inventions. American Psychologist,

34, 815–820.

646 W. KOOPS AND F. KESSEL

Kessen, W. (1983). The child and other cultural inventions. In F. S. Kessel, & A. W. Siegel
(Eds.), The child and other cultural inventions (pp. 26–39). New York, NY: Praeger.

Koops, W. (2016). Een beeld van een kind. Amsterdam: Boom (Images of children).
Koops, W., & de Winter, M. (Red.). (2011). Wereldwijd opvoeden (Global education).

Amsterdam: SWP.
Koops, W., & Elder, G. H., Jr. (1996). Historical developmental psychology: some

introductory remarks. International Journal of Behavioral Development, 19, 369–371.
Leary, D. E. (1979). Wundt and after: Psychology’s shifting relations with the natural

sciences, social sciences, and philosophy. Journal of the History of the Behavioral
Sciences, 15, 231–241.

Leary, D. E. (2001). One big idea, one ultimate concern: Sigmund Koch’s critique of
psychology and hope for the future. American Psychologist, 56, 425–432.

Linschoten, J. (1964). Idolen van de psycholoog (Idols of Psychologists). Utrecht: Bijleveld.
Miller, P. J., & Sperry, D. E. (2012). Déjà vu: The continuing misrecognition of low-income

children’s verbal abilities. In H. R. Markus, & S. Fiske (Eds.), Facing social class: How
societal rank influences interaction. New York, NY: Russell Sage Foundation.

Packer, M. (2004). Editorial. Qualitative Research in Psychology, 1, 265.
Popper, K. (1935). Logik der Forschung. Wenen: Julius Springer Verlag.
Popper, K. (1959). The logic of scientific discovery. London: Hutchinson.
Popper, K. (1963). Conjectures and refutations: The growth of scientific knowledge. London:

Routledge.
Rogoff, B. (2003). The cultural. Nature of human development. New York, NY: Oxford

University Press.
Sherrod, L. (2016). SRCD in the 21st century. Developments (SRCD Newsletter)., 59(3), 1–2.
Shweder, R. A. (1994). Thinking through cultures: Expeditions in cultural psychology.

Cambridge: Harvard University Press.
Stassijns, K., & van Strijten, J. (Red.). (2004). De mooiste van William Wordsworth [The most

beautiful poems of William Wordsworth]. Amsterdam: Lannoo en Atlas.
Stearns, P. N. (2006). Childhood in world history. New York, NY: Routledge.
Stearns, P. N. (2010). Defining happy childhoods: Assessing a recent change. The Journal

of the History of Childhood and Youth, 3, 165–186.
Steel, C. (1989). Historische inleiding tot de Wijsbegeerte [Historical introduction to

Philosophy]. Leuven: Universitaire Pers Leuven.
Verma, S. (2016). A coalition with a truly international agenda. Developments (SRCD

Newsletter)., 59, 2–3.
Wartofsky, M. (1983). The child’s construction of the world and the world’s construction

of the child: From historical epistemology to historical psychology. In F. S. Kessel, & A.
W. Siegel (Eds.). (1983). The child and other cultural inventions. New York, NY: Praeger.

Weisner, T. S. (Ed.). (2005). Discovering successful pathways in children’s development: Mixed
methods in the study of childhood and family life. Chicago, IL: The University of Chicago
Press.

White, S. H. (1983a). Psychology as a moral science. In F. S. Kessel, & A. W. Siegel (Eds.),
The child and other cultural inventions. New York, NY: Praeger.

White, S. H. (1983b). The idea of development in developmental psychology. In R. M.
Lerner (Ed.), Developmental psychology: Historical and philosophical perspectives.
Hillsdale, NJ: Erlbaum.

Willig, C., & Rogers, W. S. (2008). Handbook of qualitative methods in psychology. Thousand
Oaks, CA: Sage.

Wundt, W. M. (1900-1920). Völkerpsychologie. Bnd. 1-2: Die Sprache(1900); Bnd 3: Die Kunst
(1908); Bnd. 4-5-6: Mythos und Religion (1910-1914); Bnd. 7-8: Die Gesellschaft (1917);
Bnd. 9: Das Recht (1918); Bnd. 10: Kultur in der Geschichte (1920). Leipzig: Engelmann.

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Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a
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  • Abstract
  • 1. Introduction
  • 2. Kessen’s plea
  • 3. Positivistic and empirical-analytical approaches
    • 3.1. The positivist approach
    • 3.2. The empirical-analytical approach
  • 4. Principles and history
  • 5. Concluding discussion
  • 6. Brief overview of the papers in this issue
  • Disclosure statement
  • References

Scholarship of Teaching and Learning
in Psychology
Sometimes a Demo Is Not Just a Demo: When
Demonstrating Cognitive Psychology Means Confronting
Assumptions
Marianne E. Lloyd
Online First Publication, April 16, 2020. http://dx.doi.org/10.1037/stl0000192

CITATION
Lloyd, M. E. (2020, April 16). Sometimes a Demo Is Not Just a Demo: When Demonstrating
Cognitive Psychology Means Confronting Assumptions. Scholarship of Teaching and Learning in
Psychology. Advance online publication. http://dx.doi.org/10.1037/stl0000192

PEDAGOGICAL POINTS TO PONDER

Sometimes a Demo Is Not Just a Demo: When Demonstrating
Cognitive Psychology Means Confronting Assumptions

Marianne E. Lloyd
Seton Hall University

Recent cross talk between cognitive psychology and education has yielded an onslaught
of articles, books, and demonstrations to improve application of basic cognitive
principles to educational settings. This essay will describe an example of how one of
these demonstrations can also illustrate potentially incorrect assumptions about stu-
dents. Specifically, a highly effective demonstration on the negative effects of task
switching on performance also revealed assumptions about language automaticity and
neurotypicality. Rather than avoiding these concerns, such demonstrations, in addition
to highlighting cognitive phenomena, can also be a springboard to explicit discussions
of issues of assumptions that may have implications for inclusion.

Keywords: demonstrations, assumptions, task switching

Several years ago, I started using a classroom
demonstration from The Learning Scientists (Wein-
stein, 2018) to demonstrate the impact of task
switching on performance. In this demonstration,
participants pair up and then time themselves per-
forming three tasks. First, each person recites the
alphabet from A to Z. Then each counts from 1 to 26.
For the final task, the two previous tasks are com-
bined (i.e., 1-A, 2-B, 3-C . . . 26-Z). The single tasks
of reciting the alphabet and counting typically takes
less than 10 s, whereas combing counting and the
alphabet often takes 1–2 min. There is usually laugh-
ter at people’s ability to speak with lightning pace for
just letters or numbers, but there is often a very
different, much quieter tone to the room for the
interleaving task. During this third task, one can
usually see the students using a variety of strategies
to manage the difficulty of combining the two lists—
closing eyes, plugging ears, using fingers as spatial
markers, getting encouragement from their partner,
and sometimes even giving up. In this way, it is a

very successful demonstration of the difficulties of
task switching versus engaging in a single task.

I have implemented this demonstration in my
one-off lectures for first-year students on im-
proving college performance as an activity on
the first day of many of my other classes to
justify my no– cell phone policy and in faculty
development events to encourage bringing cog-
nitive psychology findings to pedagogy. It
works beautifully every time. Although the stu-
dents show some level of frustration, faculty
especially groan at the task switching condition,
and I remind them this can help build empathy
to the difference between how we feel about
material (crystal clear and fun) and a student’s
experience (muddy and bleak). Students are
readily able to understand that things that are
easy on their own because of automaticity be-
come difficult when combined. Overall, it was a
perfect demonstration as far as I was concerned
to show that easy is not always as such.

However, this summer, when I again pre-
sented the demonstration as part of a program
for boosting first-year student success in col-
lege, I realized that some of my assumptions
about it might not always be correct. First, I had
always assumed that the first two tasks are easy
because of their automaticity. As an English-

Correspondence concerning this article should be ad-
dressed to X Marianne E. Lloyd, Department of Psychol-
ogy, Seton Hall University, 400 South Orange Avenue,
South Orange, NJ 07079. E-mail: [email protected]

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Scholarship of Teaching and Learning in Psychology
© 2020 American Psychological Association 2020, Vol. 2, No. 999, 000
ISSN: 2332-2101 http://dx.doi.org/10.1037/stl0000192

1

speaking monolingual person from Ohio, yes,
this is true for me. However, it might not be true
for students who did not grow up learning the
same A-Z alphabet or counting from 1 to 26 in
English. Consequently, these might not be au-
tomatic tasks for all participants. Second, clas-
sifying these tasks as easy or difficult assumed
some level of neurotypicality among partici-
pants. Presumably, this task would not be as
easy for any of my students who have language
or numeracy difficulties or working memory
impairments. Lastly, I assumed the demo would
be easy because it was a low-stakes task (i.e.,
done in pairs instead of in front of the entire
class). However, performing for a partner could
add additional difficulty to the task for a student
with a lot of social anxiety or one with a speech
impairment who does not feel comfortable re-
citing the material under time pressure.

When the demonstration is finished and I
collect the data to present to the class, we typ-
ically start by discussing the main idea—that
even tasks that are usually accomplished
quickly can take more time when completing
multiple tasks at once. I use this as a plea for
keeping phones away during class. After all,
what is happening in class and on the phones are
both more complicated than reciting something
likely already memorized, so following both
lecture and one’s phone distractions at the same
time should be even more difficult than com-
bining numbers and letters. Once you add in
that the phone is pretty much guaranteed to be
of greater interest than what is happening in
class, this kind of multitasking becomes an even
bigger risk of becoming a barrier to learning. At
least for that day, the students seemed con-
vinced that task switching is not an ideal way to
spend class time.

Now when I included this demonstration in
my class, I follow the discussion on the main
idea that switching tasks is problematic with
pointing out all the assumptions that I had made
about the tasks they had just performed. I am
explicit that this failure to consider my own
assumptions was likely not limited to this dem-
onstration and asked the students to help me
realize when I am making incorrect assump-
tions. I also highlight that this does not, how-
ever, change the key point of the demonstration
that learning will be more effective with less
divided attention. Despite my potentially incor-
rect assumptions about the task being easy for

everyone, the demonstration does reliably yield
data in which the task-switching condition has a
higher total completion time by a significant
margin than the total completion time of the two
single tasks.

Being aware of the assumptions we make
about the students in our classes is perhaps a
regular part of teaching reflection for many pro-
fessors. However, I must be honest that I was
considering these assumptions for the first time.
When I revise my courses, I take many factors
into consideration—student feedback, test per-
formance, difficulty of material, and insights
from teaching conferences and journal articles.
However, I was not trained to contemplate in-
dividual differences may increase or decrease
the suitability of blanket statements I make
about how a demonstration works. This does
not mean these helpful demonstrations should
be discarded but rather that I need to be more
thoughtful about how I frame them. This spring,
I have continued to include the demonstration in
my courses. The students enjoy it and it gives
me to opportunity to nudge them toward better
classroom choices.

I expect that now that I have found these
assumptions inherent in this demonstration, I
am only just beginning to see the way that
assumptions about my students might influence
my teaching. I have also begun to recognize
other assumptions that I use in my lectures on
increasing academic success. The demonstra-
tion of the difficulty in picking out the correct
penny from a set of distractors (Nickerson &
Adams, 1979) and the Moses Illusion (“How
many animals of each type did Moses bring on
the ark?”; Erickson & Mattson, 1981) both also
come with assumptions. The former assumes
experience with American currency and the lat-
ter expects some familiarity with characters and
stories associated with Abrahamic faiths. These
are still acceptable choices to demonstrate key
teaching points in class, but now I try to balance
their use with some context about how they
work only when one has consistent background
experience and that for some students in my
classes this may not be the case.

As I work to improve the teaching of psy-
chology, I think we need to be aware of other
places in which assumptions such as these may
lurk. A quick review of the ancillary materials
for an introductory psychology textbook sug-
gests other potentially less inclusive demos, in-

2 LLOYD

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cluding those that relied on visual materials for
demonstrations of perceptual illusions or
schema memory examples that presumed a
level of familiarity with the stimuli. There has
been some progress toward acknowledging
these concerns with the recent distribution of a
manual for including issues of disability in in-
troductory psychology courses (Rosa, Bogart,
& Dunn, 2018). This resource contains demon-
strations such as a tactile version of Gestalt
principles, which would be suitable for vision-
impaired students in ways the more conven-
tional pictorial stimuli would not. A similar
resource would be a welcome addition for fac-
ulty wanting to consider additional factors re-
lated to diversity and inclusion. In the mean-
time, I am not going to try to find only those
demonstrations that are universally appropriate
because this would likely be impossible. In-
stead, I will model my willingness to learn by
continuing to share many kinds of demonstra-
tions while adding in discussions of the assump-
tions about the participants that are inherent in
each.

References

Erickson, T. D., & Mattson, M. E. (1981). From words to
meaning: A semantic illusion. Journal of Verbal Learn-
ing and Verbal Behavior, 20, 540–551. http://dx.doi
.org/10.1016/S0022-5371(81)90165-1

Nickerson, R. S., & Adams, M. J. (1979). Long-term
memory for a common object. Cognitive Psychol-
ogy, 11, 287–307. http://dx.doi.org/10.1016/0010-
0285(79)90013-6

Rosa, N. M., Bogart, K., & Dunn, D. S. (2018).
Increasing inclusiveness and awareness: Disability
in introductory psychology. Retrieved from http://
teachpsych.org/resources/Documents/otrp/resources/
Disability%20in%20Intro%20Psych%20Revision
%20042419%20-%20Google%20Docs.pdf

Weinstein, Y. (2018). The cost of task switching: A
simple yet very powerful demonstration. Retrieved
fromhttps://www.learningscientists.org/blog/2017/
7/28-1.

Received October 10, 2019
Revision received February 19, 2020

Accepted March 14, 2020 �

3SOMETIMES A DEMO

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  • Sometimes a Demo Is Not Just a Demo: When Demonstrating Cognitive Psychology Means Confronting A …
    • References

Revista Argentina de Clínica Psicológica
2020, Vol. XXIX, N°1, 1016-1021
DOI: 10.24205/03276716.2020.142

2020, Vol. XXIX, N°1,1016-1021

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ANALYSIS ON UNCERTAINTIES IN JUDICIAL DECISION BASED ON
COGNITIVE PSYCHOLOGY

Yongchao Li*

Abstract

A judicial decision is arrived at through fact reasoning, legal reasoning and decision reasoning. Due to the
difference between judges in cognitive psychology, the above reasoning process is affected by uncertainty
thought, resulting in uncertainties of the judicial decision. This paper explores deep into the uncertainties in
judicial decision from the perspective of cognitive psychology, and puts forward some countermeasures.
Specifically, the author analysed the cognition psychology of judges in the process of judicial decision,
examined the manifestation of uncertainties in judicial decision, and conducted a psychological analysis of
uncertainty thought. The results show that the cognitive psychology of law and justice is formed through long-
term integration of learning and work; in the process of judicial decisions, judges are limited by their own
cognition in the process of fact reasoning, legal reasoning and decision reasoning, resulting in an unfair
judgment against one party; the uncertainties of judicial decision should be reduced from aspects of legislation,
legal application procedures, the personal emotions and qualities of judges, as well as publicity and education.
The research findings lay the basis for the application of cognitive psychology in judicial decisions.

Key words: Judicial Decision, Reasoning, Uncertainty Thought, Cognitive Psychology.
Received: 19-02-19 | Accepted: 09-07-19

INTRODUCTION

The certainty of judicial decision is an
important manifestation of formal rationality,
mainly through the consistency of legal rules,
but in any judicial decision system, “certainty” is
the goal pursued (Foxall, 2014). At present, no
jurist or legal institution’s thought can occupy an
absolute dominant position; it is only based on a
certain angle, and absolute judicial uncertainty
or certainty is one-sided (Rand, 2015).
Moreover, the judicial decision process is a
passive right, initiated on the litigation of the
litigant, generally including th e identification of
legal facts, the search for relevant legal norms,
the subsumption according to the legal order,
and the final declaration of judicial decisions
(Vlek, 2010). In the entire judicial decision

Zhengzhou University School of Law, Zhengzhou 450001,
China.
E-Mail: [email protected]

process, the uncertainties of the judicial pro cess
include the identification of legal facts and
evidence collection and adoption, the timeliness
of evidence, the criteria for the identification of
evidence or facts, etc.; besides, considering the
extreme complicatedness of the cases, the
conflict of legal rules between judicial staffs is
also a factor of uncertainty (Brinkman, 2017).

The judicial process is related to people’s
cognitive psychological state. As a special social
psychological activity, judicial decisions formally
express people’s attitudes, concepts and
theories about legal uncertainty, as well as their
thoughts, perspectives, knowledge and
psychology, etc. on judicial phen omena (Stone,
2010; Emma & Mcnaught, 2016). People’s
internal psychological behaviours are only ones
that are no different from external behaviours
while cognitive psychology is a by -product of
behaviourism, in which people are active
information explorers and do not change their
thoughts and behaviours under the

YONGCHAO LI

2020, Vol. XXIX, N°1,1016-1021

REVISTA ARGENTINA

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1017

environmental stimuli (Cunliffe, 2014). The
psychological cognitive process of law is a
cognition collection of legal characteristics
formed in the individual consciousness after
long-term accumulation and integration,
including the subtle learning in daily life, work
and study (Bishop, 2017). It is the uncertainty in
the process of judicial decision that makes it
impossible to anticipate the legitimacy of one’s
actions and thus fail to correctly un derstand the
outcome of the decision (Davies, 2012). Based on
the theory of cognitive psychology, this paper
aims to explore the uncertainty of ideas in the
process of judicial decision and gives
corresponding countermeasures.

THE PROCESS OF JUDICIAL COGNITION

PSYCHOLOGY

Judicial decisions are based on legal ground,
which is generated in social consciousness. The
formation of legal consciousness is an important
part of people’s cognitive psychology. People’s
legal cognition process starts with sporadic le gal
phenomena (Shapiro, Mixon, Jackson et al., 2015).
One’s cognitive psychology begins from birth.
Table 1 lists the four stages of cognitive
development: at the sensorimotor stage, there
develops a sense of good and bad, and the
emotion will be more devoted to oneself; at the
pre-operational stage, social behavioural
activities begin to manifest, and there is no
intentional concept in the process of cognitive
psychology formation; at the concrete
operational stage, human will and autonomy are
mainly formed; at the formal operational,
people’s idealistic emotions appear and
personality begins to form. Figure 1 shows the
influencing factors of judicial cognition
psychology, mainly including social learning,
communication and mass communication,
popularization of law, legal education, and legal
research.

People’s cognitive psychology of the judiciary
needs to be taught and induced, e.g., in the
course of people’s growth or learning (Flanagan
& Ahern, 2011). The process of communication
is also an important channel for the formation of
cognitive psychology, allowing people to share
news, ideas and attitudes, and establish a
cognitive identity and ideological resonance
between people (Soboleva, 2013). The
popularization and publicity of judicial
knowledge has enabled people to directly

acquire judicial knowledge, gradually cultivated
their awareness of judicial cognition, and
continued to lay a solid legal foundation for the
formation of a society ruled by law. Judicial
lectures, seminars, reading clubs, and legal
columns have all become common popularized
forms of law so that people are always in contact
with the law and obey the law, which can also
greatly promote the cultivation of people’s
judicial cognition.

Table 1. Overview of each stage of cognitive
development

Phase Principal variation

Perception-
motion phase

The initial likes and dislikes
emerge, and emotions pour out on

the self

Preoperational
stage

For real social behavior to begin
with, there is no concept of
intention in moral reasoning

Concrete
operational stage

The formation of will and the
emergence of autonomy

Formal operation
stage

The emergence of idealistic
feelings, the formation of

personality began, began to adapt
to the adult world

Figure 1. Formation of judicial cognitive
psychology

Formation of judicial

cognitive psychology

Social learning

Communication and mass communication

Franco-prussian propaganda

Legal education

Legal research

PSYCHOLOGICAL ANALYSIS OF UNCERTAINTY IN

JUDICIAL DECISIONS

The manifestation of uncertainty in judicial
decisions

The uncertainty of judicial decisions is
generated by the coordination and balance
between the legality and rationality of the ruling.
When the legal norms of the adjudicated cases
are ambiguous or the facts are in conflict, the
judges will have an idea of uncertainty; even if
the legal norms of the judicial decisions are clear
and the facts are clearly defined, the judicial
officials may be subject to internal bias, the
trade-off between morality and law, and the
influence of public opinion, and also reveals the
idea of uncertainty. Figure 2 shows the main

ANALYSIS ON UNCERTAINTIES IN JUDICIAL DECISION BASED ON COGNITIVE PSYCHOLOGY

2020, Vol. XXIX, N°1,1016-1021

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manifestation of the uncertainty in terms of fact
reasoning, legal reasoning, and decision
reasoning in judicial decision. Among them, the
uncertainty of fact reasoning includes that of
causal connection and factual reasoni ng; the
uncertainty of legal reasoning includes that of
legal norms and legal interpretation; the
uncertainty of decision reasoning includes that
of statutory law and judge-made law, etc. Figure
3 shows the causes of uncertainty in judicial
decisions, including the uncertainty of natural
language, the limitations of legislation, the non –
self-sufficiency of the legal system, and the
subjective factors of judges.

Psychological analysis of uncertainty
thought

The psychological analysis of uncertainty
thought mainly includes the acquisition of
psychological knowledge, the establishment of

psychological ideals, the cultivation of
psychological emotions, the occurrence of
psychological will and the establishment o f
psychological beliefs. Due to the interaction of
life experience and sociality, people will
gradually integrate effective information into
their existing psychological cognition and
assimilate this information. The formation of
uncertainty thoughts is related to human
maturity, social activities and judicial activities.
Among them, social activities have a more
significant influence, because people’s judicial
psychological cognition depends on social
interaction. From the perspective of cognitive
psychology, the idea of uncertainty originates
from the process of people pursuing justice,
maintaining order and realizing the rule of law.
Through long-term judicial research, the
certainty of pursuing judicial decisions is mainly
to satisfy the rules of conduct of all parties.

Figure 2. The main manifestation of the thought of uncertainty in judicial decision

The main performance of

the uncertainty thought

of judicial decision

Uncertainty of fact

reasoning

Uncertainty of

legal reasoning

Uncertainty in

decision reasoning

Philosophical questioning of

uncertainty in fact reasoning

Judicial analysis of uncertainty

in fact reasoning

Uncertainty of legal norms

Uncertainty of legal

interpretation

Uncertainty of decision

reasoning in statutory law

Uncertainty of decision

reasoning in judgment method

Diversity of the meaning of facts

Causal probability

Non-reproducibility of objective facts

The tailorability of normative facts

Legal doubts

Legal loopholes

Creativity of legal interpretation

Openness of legal interpretation

Figure 3. The causes of uncertainty thought in judicial decision

The causes of

uncertainty thought in

judicial decision

Uncertainty of natural language

Limitations of legislation

Insufficiency of the legal system

Subjective factors of judicial officers

YONGCHAO LI

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SIGNIFICANCE AND COUNTERMEASURES OF

IDEOLOGICAL UNCERTAINTY IN JUDICIAL DECISION

Theoretical analysis of judicial decisions and
significance of ideological uncertainty

A complete judicial decision includes not only
statutory judicial interpretations, but also
interpretations given in the application of law
and of the judge’s authority. Current legislation
and judicature are independent systems, and
uncertainties arisen in the judicial process is
placed above the will of the legislator. Ta ble 2
lists the current choice and reasons for rural
dispute resolution; if people want to spend less
time, they will choose cadre mediation to solve
privately; if they want to spend the least, most
will choose cadre mediation; if they prefer a
more satisfactory solution, judicial decisions will
be more effective through lawsuits. The judicial
decision process must have clear objectives,
strong feasibility and legal interpretation
applicability. Figure 4 shows the logical diagram
of the judicial decision behaviour management
theory. If judicial decision -making behaviour
management needs to follow the deductive logic
from value to fact, the intrinsic logical
relationship between legal value research and
judicial form research cannot be ignored. Figure
5 shows the role of legal facts in judicial
decisions. The judicial decision process needs to
support facts by evidence; legal facts are formed
through legal evaluation and legal tailoring, and
then filed as the factual basis and premise of
judicial decision. A complete judicial decision
process also includes repetitive confirmation of
the case facts and the outcome of the ruling
based on legal normative logic, where repetitive
confirmation is the last link in the decision
reasoning.

Table 2. Choice and reasons of dispute
resolution ways in rural areas

Lawsuit Cadre
mediation

Compounding
in private

Minimum
time-

consuming

9.39% 45.23% 45.23%

Spend least 9.12% 51.92% 37.06%
Successful

solution
48.29% 34.84% 17.97%

Figure 4. Schematic diagram of the
theoretical management of judicial
adjudication

Judicial

justice

Judicial

decision

behavior

Social needs

Judicial adjudication

Judging mechanism

Judge Motivation

Judge competence

Decision-making process

Influencing factor

Rule control

Conflict of responsibility

Judge experience

Social expectations

Judicial

management

measures

Compliance with applicable rules of law

Human resource management of judges

Judicial macro-management system

Court internal management system

Figure 5. The role of legal facts in judicial
adjudication

Influence and countermeasure of

uncertainty in judicial decisions
The judicial decision process is a logical

inference process, but this process is
incomplete, thereby resulting in uncertainty.
China’s legislative institutions and judicial
organs have different powers. The law can only
be interpreted by the legislature, which leads to
the fact that the judicial organs do not have
universal inevitability in legal norms. Moreover,
the facts of the case are probabilistic, so, for
many times there exists no reasoning of an
implication relationship between the
preconditions and conclusions, seriously
affecting the fairness and justice of the judiciary.
The uncertainty of judicial decisions is relative
and objective. Just because of the existence of

ANALYSIS ON UNCERTAINTIES IN JUDICIAL DECISION BASED ON COGNITIVE PSYCHOLOGY

2020, Vol. XXIX, N°1,1016-1021

REVISTA ARGENTINA

DE CLÍNICA PSICOLÓGICA

1020

relative situations or the amplification of
objective conditions, its negative impact on the
judicial system is very large, which will definitely
bring unreasonable and unacceptable judgment
to the parties, and make them suffer the loss of
material, spirit, and even life. Figure 6 shows the
legal normative process of judicial process. Clear
rules are selected through the legal norm system
and legal rules, and used to explain the rule of
legal interpretation in the broad sense and select
appropriate legal principles.

The uncertainty of judicial decisions should
be reduced from the aspects of legislation, legal
application procedures, judges’ personal
emotions and qualities, and publicity and
education. Legislation should be forward –
looking; laws and regulations should be
formulated and updated in a timely manner to
adapt to the changing realities of society.
Furthermore, legislation should be as specific
and operational as possible. The legal
procedures should be initiated to limit the will of
the judges and reduce their subjective
psychology in the judicial decision process. From
the perspective of subjective cognitive
psychology, the judicial decision is the discretion
of the judge; although the whole process is
based on law and facts, ultimately it depends on
the psychological role of the judges. Therefore,
more stringent reforms must be carried out in
the election and appointment system and
procedures of the judges, and external
supervision and institutional constraints on the
judges should be strengthened so that the
discretion of the judges is within the scope
permitted by law and procedures. Strengthening
the publicity of the legal and judicial process is
an important measure to improve the judicial
and legal cognition of the whole people. Only by
enabling the whole people to understand the law
and obey the law can the number of judicial
decisions be greatly reduced, thereby reducing
the uncertainty of judicial decisions.

Figure 6. The legal process of judicial
adjudication

Legal

norm

system

Legal

rule

Clear

rules

A broad

interpretation

of the law

after the rule

Legal

principles

Legal norm proposition

CONCLUSIONS

Based on the theory of cognitive psychology,
this paper explores the uncertainty in the
process of judicial decision and gives
corresponding countermeasures. The specific
conclusions are as follows:

(1) Judicial lectures, seminars, reading clubs,
and legal columns have all become widely used
forms of law so that people are always in contact
with the law and obey the law, which greatly
promotes the cultivation of people’s judicial
cognition;

(2) The uncertainty in judicial decision is
mainly reflected in the uncertainty of fact
reasoning, the uncertainty of legal reasoning and
the uncertainty of decision reasoning. Its causes
include the uncertainty of natural language, the
limitations of legislation, the non -self-sufficiency
of the legal system, and the subjective factors of
the judge;

(3) The idea of uncertainty arising in the
judicial process is placed above the will of the
legislator. The management of judicial decision –
making must follow the deductive logic from
value to fact, and the judicial decision process
needs to support the facts by evidence; through
legal evaluation and legal tailoring, legal facts
are formed and then filed a as the factual basis
and premise of judicial decisions;

(4) The uncertainty of judicial judgment is
relative and objective. Measures should be
formulated from the aspects of legislation, legal
application procedures, judges’ personal
emotions and qualities, publicity and education,
etc., to reduce the emergence of the uncertainty
in judicial decisions.

Acknowledgement

This paper is supported by the National Social
Science Fund of China: The theory of interior
administrative act’s exteriorization , No.
14CFX011.

REFERENCES

Bishop, P. (2017). Salmon fishing in the Severn:
judicial deference to regulatory judgments based
on scientific assessments. Environmental Law
Review, 19(3), 201-209.

Brinkman, J. T. (2017). “Thinking like a lawyer” in an
uncertain world: The politics of climate, law and

YONGCHAO LI

2020, Vol. XXIX, N°1,1016-1021

REVISTA ARGENTINA

DE CLÍNICA PSICOLÓGICA

1021

risk governance in the united states. Energy
Research & Social Science, 34, 104-121.

Cunliffe, E. (2014). Judging, fast and slow: using
decision-making theory to explore judicial fact
determination. The International Journal of
Evidence & Proof, 18(2), 139-180.

Davies, A. (2012). State liability for judicial decisions
in European union and international law.
International and Comparative Law Quarterly,
61(3), 585-611.

Emma, M. N. J., & Mcnaught, A. (2016). Exploring
decision making around therapist self-disclosure
in cognitive behavioural therapy. Australian
Psychologist, 53(1), 33-39.

Flanagan, B., & Ahern, S. (2011). Judicial decision-
making and transnational law: A survey of
common law supreme court judges.
International and Comparative Law Quarterly,
60(1), 1-28.

Foxall, G. R. (2004). What judges maximize: toward
an economic psychology of the judicial utility
function. Liverpool Law Review, 25(3), 177-194.

Rand, E. J. (2015). Fear the frill: Ruth Bader Ginsburg
and the uncertain futurity of feminist judicial
dissent. Quarterly Journal of Speech, 101(1), 72-
84.

Shapiro, D. L., Mixon, L. K., Jackson, M., & Shook, J.
(2015). Psychological expert witness testimony
and judicial decision making trends.
International Journal of Law and Psychiatry, 42-
43, 149-153.

Soboleva, A. (2013). Use and misuse of language in
judicial decision-making: Russian experience.
International Journal for the Semiotics of Law-
Revue internationale de Sémiotique juridique,
26(3), 673-692.

Stone, A. (2010). Democratic objections to structural
judicial review and the judicial role in
constitutional law. University of Toronto Law
Journal, 60(1), 109-135.

Vlek, C. (2010). Judicious management of uncertain
risks: ii. simple rules and more intricate models
for precautionary decision-making. Journal of
Risk Research,13(4), 545-569.

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Piaget’s Theory of Cognitive Development

Citation: Huitt, W., & Hummel, J. (2003). Piaget’s theory of cognitive development. Educational Psychology Interactive. Valdosta,
GA: Valdosta State University. Retrieved [date] from http://www.edpsycinteractive.org/topics/cognition/p