HLCD WEEK 2 & 3→ DEVELOPMENTAL CONCEPTS AND CONTROVERSIES AND PSYCHOSOCIAL DEVELOPMENT Flashcards
Nursing Assessment
- Assessments often focus on a person’s vulnerabilities (elements that put person at risk) and protective factors- aspects of the person or social structure that increases or contributed to the likelihood of recovery
Holistic Assessment
- Biomedical: focus on physical
- Psychological: focus on human behaviour
- Sociological: focus on social environment
Nursing uses a holistic approach that incorporates all three aspects: the biopsychosocial model
Tanner’s Model of Clinical Judgement
- Noticing (confidence)
- Interpreting (communication)
- Responding (decision making)
- Reflecting (change in clinical practice)
Lifespan development
- Each phase of life span present new challenges, experiences and problems. E,g. Old age more prone to depression Stages - Infancy to early childhood (birth to five years) - Middle childhood (6-12) - Adolescence (13/18) - Early adulthood (19-29) - Adulthood (30-60) - Later maturity (60>)
Transitional periods
E.g. High school, puberty, leaving school, first job, middle age, empty nest
Critical periods
Period of special sensitivity to specific types of learning and sensory stimulation that shape the capacity for future development
Sensitive periods
Times that are more important to subsequent development than others
Why is it important to know someone’s lifespan
- Different stages have different risks. E.g. Elderly might be at risk of depression, falls
- How you will educate someone, how to provide info based on age, e.g. Different for a thirteen year old and a three year old
- Helps in terms of discharge planning, what support is available for them
- Might be stressed based on if they have kids, if they are doing HSC if they are elderly and have pets
Attachment Theory Overview
- Theory in development psychology. John Bowlby first person to talk about it
- Main underlining→ we form attachments in early stages of our life that are important to future development
- If attachments are secure much more likely to continue with the rest of our lives to make strong attachments
- If have ability to make attachments, it makes us feel supported
Historical roots of theory (Attachment Theory)
- Up until 1950s feeding was felt to be the critical element in early attachment
- Across the early 1950s, Bowlby was becoming more dissatisfied with earlier views and put forward the proposition that the infant’s tie to the mother was evolutionary
- Bowlby sought new understandings from animal studies, biology, developmental psychology
- Harry Harlow established the importance of ‘contact comfort’ and ‘perceived security’ as the critical elements in attachment through his studies in infant rhesus monkeys (cloth mother and wire mother, with robot it was scared, ran to cloth mother got confident from mother’s touch)
What is needed to support optimal psychosocial development in early childhood?
- Learning to share, playing with others
- Learning to grow up in a stable environment with morals and values as the norm
- Growing up in a happy home, loved environment
- Child taught right from wrong
- Knowing where you fit in society
Socialisation: To function as adults
- Children must learn the rules, beliefs, skills and attitudes and behaviour patterns of their society
- Children are active participants in their own socialisation, who must construct an understanding of social rules and gradually come to experience cultural beliefs and values as their own
- The way children behave, shapes the way their parents respond
- Children who are impulsive and poorly controlled elicit ineffective parenting, just as ineffective parenting can create troubled children
Socialisation is a lifelong process
- Individuals learn throughout their lives to play different roles (e.g. student, parent, friend, wage-earner or retiree) and roles change from one phase of life to the next
- Although deliberate teaching is important; much of socialisation is implicit (e.g. children learning about the importance of being on time by the regular sounding school bells between classes)
Role of parents
- Studies suggest that the family environment shared by siblings has little impact on personality, social or cognitive traits, particularly when compared with genetic influences and environmental influences not shared by siblings (e.g. experiences with peers)
- Peers play a substantial role in development and their influences can be seen in problems such as delinquency or substance abuse in adolescents→
- However adolescents choose their peers and both the peers they choose and their susceptibility to ‘bad company’ depend heavily on the social skills, expectations and capacities for intimacy they developed at home in their attachment relationships
- Children with maltreatment histories by their parents; tend to have poor peer relationships
Authoritarian
- Place high value on obedience and respect for authority
- Don’t encourage discussion of why particular behaviours are important, or listen to the child’s point of view
- Instead; impose set of standards to which they expect their children to adhere to and are likely to punish their children frequently and physically
- Authoritarian parents produce children who are→ Low independence, vulnerable to stress, low self esteem
Permissive
- Impose virtually no controls on their children; allow them to make their own decisions whenever possible
- Parents tend to accept their children’s impulsive behaviours, including angry r aggressive ones and rarely give punishments
- Permissive parents→ Children tend to be low in self reliance and impulse control and to have more trouble with substance abuse in adolescence
Authoritative
- Set standards for their children and firmly enforce them; but also encourage give and take and explain their views while showing respect for their children’s opinions
- Authoritative parents→ tend to produce the most self-controlled, independent, curious, academically competent and sociable children
Uninvolved
- Parents who consistently place their own needs above the needs of their child
- Uninvolved parenting leads to kids→ Display low self esteem and aggressive behaviour
The Role of Culture:
An authoritative parenting style is rare or nonexistent in many cultures and is probably not the most adaptive pattern everywhere
Agricultural societies usually value obedience far more than autonomy or independence
Parents from different cultures often have very different views and practices when it comes to child development (e.g. comparison between lebanese and australian mothers→ lebanese mothers expected their children to continue misbehaving at a considerably later age than all other mothers)
Socialisation of gender→ Overview
- Gender roles; specify the range of behaviours considered appropriate for males and females
- In general; sex refers to biological categorisation based on genetic and anatomic differences and gender refers to the psychological meaning of being male or female (influenced by learning)
- Sex typing→ process by which children acquire personality traits, emotional responses, skills, behaviours and preferences that are culturally considered appropriate to their sex
Socialisation: Girls
Girls receive more warmth, affection and trust, though they are kept under closer surveillance than boys
Girls are socialised to pursue careers (if they pursue them at all) in disciplines such as the humanities
Socialisation: Boys
Boys in Aus and other western countries→ receive more encouragement to compete, more pressure not to cry and more punishment
Boys have always been encouraged to pursue careers in construction, science, maths and engineering
Socialised towards stereotypical gender roles by peers beginning in early preschool; boys and girls rewarded and punished by their peers for engaging in gender appropriate and gender inappropriate behaviour (i.e. a boy playing with dolls is likely to be teased by members of the peer group)
Peer relationships
- Only children or the first borns are likely to invent imaginary friends to play with
- Children’s friendships are almost exclusively same-sex friendships
- Friendships marked by commitment and reciprocity (sharing and give and take) begin to emerge around age three
- Children develop reputations amongst their peers by the time they are in preschool and those reputations affect the way other children behave towards them
Sibling relationships
- Sibling relationships involve rivalry and conflict as well as warmth and companionship
- In childhood siblings compete for precious resources
- The birth of a sibling can be a difficult event even for children; parents report high range of responses such as increased dependency, anxiety, bed wetting and aggressiveness→ the younger the child’s age, the more issues they have with being ‘displaced’
Linking early healthy attachment with long term mental health
- Insecure attachment between mother and baby can have profound impact on child’s future mental health
- Bond with primary caregiver→ biological function to ensure security, survival and protection
- If separation occurs→ after initial grief and upset; can turn to indifference towards the mother
Attachment Theory
Ainsworth found→ Babies whose mothers responded to their cries quickly when they were 6 months old→ cried much less as one year olds and were more obedient in the first year, cooperating with necessary transitions, developed cognitive skills sooner than babes whose mothers had been less sensitive to their early stages
Mothers who allowed babies to set the baby choose time and pace of the feeding→ had children who were less fussy later in the year
Caregiver→ serves as haven of safety and secure base→ basic premise of attachment theory
Babies securely attach to their mothers, tended to go to their mothers to be soothed before returning to play with toys
Babies with disorganised patterns→ higher risk for emotional and behavioural problems as they get older
People who have early secure attachments with their caregivers→ tend to have more stable adult love relationships
People with avoidant or ambivalent history→ tend to have trouble with later relationships
Development is a complex set of unfolding pathways with opportunities for different outcomes
A baby who has had a disorganized attachment due to mistreatment can return to a normalised pathway, e.g. parent overcomes addiction; pathways can change either later in life (e.g. with a partner)
People with relatively secure attachment→ can go off track by losing a secure attachment
Secure Base
Place from which the baby can explore. Feel secure and comfortable before the child goes off to explore
Haven of safety
Response to the stress. If child is scared or upset, the child needs soothing from here. Protection and security
4 types of attachment
Secure Attachment
Ambivalent/ Resistant Attachment
Avoidant Attachment
Disorganised Attachment
Secure Attachment
- Immense distress when mother left quickly, soothed when mother returned (responds appropriately to distress)
Stronger relationships in the future; going to be able to trust better and be more social as they are older; more optimistic and have more empathy - Cry more in the lab compared to the other babies
- Loss/ trauma in later life if they lose the secure attachment
- More likely to form stable adult relationships
Ambivalent/ Resistant Attachment
- Very distressed; even when mother came back in→ won’t let itself be calmed down→ kicking and arching its back
- When mother was there and exploring→ didn’t really explore, very anxious
- It doesn’t have that safe haven so it doesn’t feel secure to explore; not displaying normal behaviours
- Doesn’t feel reassured when she reenters
Trouble with later relationships
Avoidant Attachment
- Infant avoids aren’t; inconsistency in parenting
- Don’t express their upset; learn to be independent→ bit unresponsive
- Trouble with later relationships
- At return weren’t running up wanting to be picked up
- Prematurely independent
- Parent wasn’t picking up on cues
- Baby was actually distressed but had leant not to show it as that isn’t what the parents wanted to see
Disorganised Attachment
- Higher risk of emotional and behaviour issues when older, more difficulties with relationships earlier in life
- Unable to make an organised response to change when parent returns
- Child can overcome this once the caregiver deals with personal issues (i.e. overcoming addiction)
- Experienced maltreatment as a child, traumatic past etc
- Overwhelmed by whole experience; didn’t know how to react
- When the reunion occurred; weren’t sure whether to go up to caregiver or not; confused
- At home in the families→ trauma or maltreatment
- Weren’t really exploring; just overwhelmed by emotions
- These were the at risk patients in the nursing practice→ it’s a strange situation in the hospital ward so it would be easy to see these behaviours (nurses are mandatory reporters for child abuse)
- May be in cases of postnatal depression, if parent is at work all the time and there is no skin to skin contact
Erikson Stages of Psychosocial Development: Stage 1→ Trust vs Mistrust (0-1)
- Basic task is to learn to trust; negative counterpart is lack of trust
- Basic virtues that arise from this stage→ sense of hope and a drive to form relationships
- Erikson views 1st stage as foundation for all later psychosocial development. When the psychic crisis is successfully resolved the infant emerges with a ‘sense of hope’ which should permeate the entire life cycle
- The quality of the caregiver- infant interaction has direct impact
Erikson Stages of Psychosocial Development: Stage 2→ Autonomy vs shame and doubt (1-3)
- Basic task→ to learn to separate from mother and from 1st sense of autonomy
- Negative counterpart is sense of shame and doubt in oneself
- Basic virtues are self control and willpower
If the infant has developed basic trust→ now begins to discover they can predict and have some control over events - Autonomy contributes to a sense of identity in which the child has courage to choose and guide his or her own actions
- Erikson sees behaviours such as temper tantrums and refusal to cooperate, common at this stage as the child is developing independence
Erikson Stages of Psychosocial Development: Stage 3→ Initiative vs guilt (3-5)
- Basic task to turn to act on the world and initiate
- Negative counterpart i sense of guilt
Basic virtue is direction and purpose - The child now recognises themselves as a person in their own right; allows further exploration
- As language and confidence grows, she/he will initiate interactions with others and begin to see themselves as ‘grown up’
- The child now understands right from wrong and has a developing conscience
- The child has a growing sense of identity but she/he can still be ‘shamed’ and made to doubt themselves by the coercive actions of significant others
- They may have fears unique to the age such as body and loss of control
Erikson Stages of Psychosocial Development: Stage 4→ Industry vs inferiority (6-11)
- Basic task is to learn to achieve with work and have a sense of being productive
- Negative counterpart is sense of inferiority
Basic virtue is method and competence - During this stage; child masters learning tools necessary to succeed in his culture and society
- As they adapt to the world, they develop distinctive personality and behaviors
- Success or mastery gives child a sense of accomplishment and good feelings→ builds self esteem and self concept
- Gains competence in social interactions
Erikson Stages of Psychosocial Development: Stage 5→ Identity vs isolation (Adolescence 12-18)
- Basic task is to form an identity that will carry into adulthood
- Negative counterpart is role confusion
- Basic virtue is fidelity and devotion
identity→ individuals attempt to define themselves as a unique person (primary task of adolescence)
Erikson Stages of Psychosocial Development: Stage 6→ Intimacy vs isolation (Young adulthood 19-40)
- Basic task is to form meaningful relationships
- Negative counterpart is lack of intimacy
- Basic virtue is love and affiliation
- Need for intimacy may be met at many levels
- Basic concept is the sharing of self, hether in friendships or in life partnerships
- Based on quality of the person’s ability to contribute
- Otherwise isolation occurs because the person is unable to truly give or contribute to a positive relationship
- If the sense of identity is insecure then a mature relationship can develop as the fusion with another becomes identity loss and plunges the self concept into confusion
Erikson Stages of Psychosocial Development: Stage 7→ Generativity vs self absorption (Middle adulthood 40-65)
- Basic task is to be content and productive in work and personal relationships
- Negative counterpart is total absorption with self and own needs
- Basic virtue is caring and production
- Generativity→ looking outward from self, such as concern for welfare of others; a time where people want to leave something of lasting value achieved through work or parenthood
Erikson Stages of Psychosocial Development: Stage 8→ Integrity vs despair (Maturity/old age 65+)
- Basic task is integrity that comes with the acceptance of the way one has thrived their life
- Negative counterpart is despair
- Basic virtues are wisdom and renunciation
- As person moves into old age, they may reflect on its meaning and pursue
- Erikson suggests that this life review is one way in which they may come to terms with the ending of life
- Where he still has unresolved psychological conflict, or regrets over they might have been this is experienced as psychic pain
- Dissatisfaction with their life course and regret for past actions leads to feelings of despair
What are Erikson’s stages of psychosocial development?
Stage 1→ Trust vs Mistrust (0-1)
Stage 2→ Autonomy vs shame and doubt (1-3)
Stage 3→ Initiative vs guilt (3-5)
Stage 4→ Industry vs inferiority (6-11)
Stage 5→ Identity vs isolation (Adolescence 12-18)
Stage 6→ Intimacy vs isolation (Young adulthood 19-40)
Stage 7→ Generativity vs self absorption (Middle adulthood 40-65)
Stage 8→ Integrity vs despair (Maturity/old age 65+)
Erik Erikson’s theory of psychosocial development
- Psychosocial→ as growth is a product of the person’s interaction with the environment, societal influences and their biological maturation
- Personality development is explained as the ability of the ego (psyche) to deal with developmental life crises
- Involves 8 innately determined, sequential stages
- Notion of ego strengths; each stage offers new opportunities to develop strengths or basic virtues
- Each stage has 2 opposing forces that are active on the psyche and the person must resolve the potential crisis
- Successful resolution: Person is able to integrate the psychosocial strengths of the age/stage into his/her life in a positive manner and so maintains emotional and psychological balance
- Unsuccessful resolution→ Inability to resolve the dilemmas of the age/stage delays, maturation of the ego and may fixate the person at that level
