Abstract and Keywords
There is substantial evidence for symptoms of affective distrubances in high-risk infants and toddlers. Significant progress has been made in characterizing and validating clinical depression in the preschool period. Identification of affective disorders in the infancy and preschool periods may be critical to early and potentially more effective intervention. However, the accurate identification of affective disorders in this very young age group is complicated by several factors. A central issue was the basic developmental question of whether the emotional repertoire was itself sufficiently differentiated to encompass true “depressive” and/or “elated” affect during early life. However, empirical studies have shown that many of these emotional capacities are present in early childhood. Further, a significant limitation was the fact that many standard assessment tools failed to describe the developmentally specific manifestations of symptoms, an issue that measures described in this chapter now address. The fact that the symptoms of depressive disorders are internalizing, and therefore less apparent to caregivers, is an obstacle to appropriate referral. For these reasons, an assessment for the symptoms of affective disorders in infants and toddlers should include direct observational play assessment, parental interview that probes for developmental manifestation of affective symptoms and consideration of normative variations in affect that must be distinguished from clinical symptoms.This chapter will discuss strategies useful for the assessment of affective symptoms and disorders in infants and toddlers. Data supporting major depressive disorder criteria for preschoolers will be reviewed. Case examples of preschool children with depression and a presumptive bipolar subsyndrome will be presented.
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