Autism as a Model of Abnormal Emotional Development

The compilation of a multilevel picture of impairments secondary to anomalies in mental development requires differentiation of all pathological structures from the standpoint of the mechanisms underlying their genesis. Vygotsky (1983) criticized a linear model of organization of pathological syndromes such as that characteristic of the clinical descriptive method. He proposed instead a hierarchical model that required identification of the primary defect directly responsible for the disorder in the morphophysiological substrate and of secondary and tertiary structures, some of which are a consequence of the primary defect, others are formed indirectly, and still others are a response of the personality to the defect. The advantage of this approach is that it enables one to establish cause-and-effect relations among pathological symptoms of varying complexity and to focus psychotherapeutic and remedial interventions on the appropriate level of the disorder.