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A framework for classification of childhood psychic disorders is provided. Psychopathology is linked genetically to traumatic experiences and the subsequent fixation points in relation to development of object relations. Ego development is stressed along with psychosexual development in providing a nosology of psychopathology.
Using Mahler's ego developmental phases the author stresses that the different types of psychic disorders result from trauma at different phases during the course of ego development and the ontogenesis of object relationships. Psychophysiologic disorders and psychosis tend to result when trauma has occurred in the autistic and symbiotic phases, whereas the psychoneuroses and neurotic character result when trauma has occurred during or after the prephallic phase. Likewise psychotic characters are similarly related to ego development.
Attention is drawn to Anna Freud's prediction of chances for recovery based on assessment of such criteria as the child's frustration tolerance, potential for sublimation, attitude toward anxiety, and the 'balance of his progressive versus regressive tendencies'.
The type of clinical disorder is determined by the timing of the traumatic experience as well as the severity of its impact on the child. The concepts of neurotic and psychotic character disorder can also be differentiated from neurosis and psychosis on the basis of the degree of impairment of object relationship, ego defects, and perceptual distortion influencing internal and external reality.