Behavioral Science: Development 1 & 2 Flashcards
Definitions of premature birth, very premature birth
premature =
APGAR score
A- appearance (color) P- pulse G- grimace A- activity (muscle tone) R- respiration
Used to predict likelihood of immediate survival
US birth outcomes
High rate of premature births, so high infant mortality rate compared to other developed countries
Low income –> premature births + infant mortality
Baby blues
exaggerated emotionality and tearfulness for a few days after birth
post-partum depression
Major Depression that occurs in up to 10% of new mothers within 1 month of childbirth, can persist for up to 1 year
What direction do babies develop?
Cephalad to caudad, central to peripheral
- self to others, understanding to expressing
What happens from infancy to 18 mos?
- Humans need and seek the presence of others
- Attachment
- Social smile at 12 weeks
- Stranger anxiety at 9 months
- Separation anxiety late in first year, object permanence comes first
Importance of attachment
- psychoimmunology
- resulted in the concept of foster families
Infant reflexes
Rooting: touch cheek, turns toward nip
Palmar Grasp: grips any object put in palm
Moro: limbs extend when startles
Babinski: dorsiflexion of toes when sole of foot stroked (until 1 yr)
Milestones from 18 months to age 5
Rapprochment: moves away but quickly returns for comfort
Age 2: “NO”
Age 3: can spend a few hours away from mom, gender identity
Age 4: Bowel function
Age 5: bladder function
Preschool child (ages 3-6)
Sibling rivalry, regression.
- Between 2-4 vocabulary increases a shit ton
- Active fantasy life, knows that imaginary friends aren’t real
- Cooperative play at 4 years
- Strong fear of bodily injury
- Curiosity about bodies
6 year old milestones
- development of conscience (superego)
- morality, empathy, right vs. wrong, finality of death
Autism Spectrum Disorders
- don’t acquire verbal and social skills at expected age
- seen before age 3
- no finger pointing (theory of mind)
- 50% have intellectual impairment
- more common in boys
- larger head circumference
- genetic component (associated w/ tuberous sclerosis and Fragile X)
Rett’s Disorder
4 years of normal functioning –>
hand wringing, breathing problems, intellectual impairment, ataxia, motor and social decline
- X linked
Childhood Disintegrative Disorder age
2-10 years of normal development
School age (7-11) and adolescence
- psychosexual issues dormant
- industry vs inferiority
- lifelong sense of competence
- concrete operations
- learning problems identified
School age (7-11) peer relationships
- relationships with adults other than primary caregiver
- same sex peer relationships
- not fitting in
- sexual latency, identifying with same sex parent
- morality, rule conscious (by 12 more flexible)
- more complex tasks (team sports)
- better at dealing with illness and hospitalization
- acting out as defense mechanism
- age 9: universality of death
Changes to brain during adolescence (11-20)
- myelination
- frontal and parietal lobes
- pruning of up to 50% of synaptic connections, decline in glucose and oxygen metabolism
Puberty milestones
- 5 in girls, 11.5 in boys
- first menstruation 11-14
- first ejaculation 12-15
- complete by 13.5 in girls, 15 in males
Factors the predispose to teen pregnancy
- depression
- poor school achievement
- divorced parents
Down syndrome
- single palmar transverse crease, protruding tongue, flat facies, hypotonia, epicanthal folds, small ears, thick neck, premature aging and Alzheimer’s disease
Fragile X Syndrome
Affects males more severely
- delayed cognitive function, hyperactive, hand flapping, hyperextensible joints, large ears, elongated face, postpubertal enlargement of testes
Phonological disorders
Leaves out or misplaces speech sounds, ie “ca” for cat, “top” for stop
Articulation disorders
Unable to make necessary motor movements for accurate speech production, ie lisping
Tourette’s disorder
Involuntary, before age 18
- OCD/ ADHD/ dopamine
- treat w/ dopamine blocking agents
Factors that increase risk of divorce
- Short courtship, teenagers, premarital pregnancy, absence of family support, prior divorce in family, difference in religion/SES, couples w/ seriously ill children
- Risk higher when one spouse is physician (female, married prior to med school, psychiatry)
Single Parent Family trends
highest to lowest: black, hispanic, white
- increased risk of physical and mental illness
- parent divorce: child at higher risk for school failure, depression, drug abuse, suicide, crime, divorce themselves
Types of child custody
Sole custody: child lives with one parent who has legal responsibility for the child, other parent contributes to financial support
Joint custody: time split between both parents
Split custody: Each parent has custody of at least 1 child in the family
Early adulthood (20-40)
age 30: role in society is defined, physical development at peak, individual is independent
- love and work/ intimacy vs isolation
- women often change paths in middle 30s
- adopt parental values after years of rebellion
Middle adulthood (40-65)
Good health, money, power, authority
- “Sandwich generation” - responsibilities to older and younger relatives
- More life behind than ahead –> midlife crisis
- Climacterium: the physiological changes that occur during midlife
Losses of aging
- Social status, death of spouses and friends, decline in health
- ego integrity vs despair, pride vs wasted life
Cognitive function in the elderly
Dementia in less than 10% of elderly
- over age 85, 1/2 have cognitive impairment
PHysical and neurological changes of aging
- decreased cerebral blood flow, brain weight, formation of amyloid plaques
- intelligence is same
- decreased neurotransmitter availability
- more sensitive to side effects, increased depression
Psychosocial changes of aging
- reduced bladder control, loss of strength, vision and hearing loss, elder abuse
Psychopathology in old people
- depression, suicide, anxiety, alcohol + substance abuse, delirium
Stages of dying
Denial, Anger, Bargaining, Depression, Acceptance
not necessarily in that order
Normal grief vs complicated bereavement
- both have initial shock and denial
- denial in abnormal grief can be days to weeks
- both include sadness, crying. normal grief can subside in 1-2 years
- anniversary rxns common
- abnormal grief –> symptoms intensify instead of lessening, suicidal thinking or hallucinations
- cultural differences
Role of physician in death and dying
- make aware of dx and prognosis
- reassurance
- serve as resource to family
- medically follow bereaved family members
- resist emotional attachment
