Lifespan development, health and wellbeing (year two)

Question 1

1. Define and explain lifespan development

Answer 1

• consistent feature of developmental psychology has beeen study of stability and change across life
• HIstorically, developmental psychology has been focused on childhood/old age
• Development is a lifelong process:
• we cannot understand adult experiences without appreciating what came before in childhood/adolescence
• Transitions define and shape the life course of each person (Miller, 2010).

Question 2

1. Define and explain lifespan development

Answer 2

• consistent feature of developmental psychology has beeen study of stability and change across life
• HIstorically, developmental psychology has been focused on childhood/old age
• Development is a lifelong process:
• we cannot understand adult experiences without appreciating what came before in childhood/adolescence
• Transitions define and shape the life course of each person (Miller, 2010).
• Skinner et al., 2019: Everything is developmental
• lifespan psychology is an orientation, rather than a theory

Question 3

Describe what thee life-span perspective aims to understand

Answer 3

• How individuals change and development throughout their lives
• The factors influencing changee (biological, social etc)

Question 4

Describe how the life-span perspective divides human development

Answer 4

• Early phase (Child and adolescence)
• Characterised by rapid age-reelated changes in perople’s size and abilities
• Later phase (young adulthood, middle age and old age)
• Characterised by slower chanes, but abilties continue to develop as people adapt to environment

Question 5

Define lifespan transitions and give Zittoun’s four forms (2006)

Answer 5

• Lifespan transitions represent a range of psychological processes and movements.
• Four forms (Zittoun, 2006):
1. Change in the cultural context (e.g. religiosity, faith)
2. Change of, or within, a person’s sphere of experience (e.g. having a baby)
3. Change in the relationships and interactions with objects and others (e.g. new romantic partner)
4. Change from within a person (e.g. chronic pain or illness)
• These different forms are not mutually exclusive.
• Some theorists view lifespan transitions as stressful; so called ‘life stressors’ (Miller, 2010), but pathologising lifespan overlooks positive change.

Question 6

Give Baltes’ (1987) key propositions of lifespan perspectives

Answer 6

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Question 7

Briefly describe the relationship between age and health

Answer 7

• Life-span transitions elicit individual differences in health and wellbeing
• Psychology was slow to adopt a lifespan framework for studying health and illness (Whitman et al., 1999)
• Historically, health psychology viewed age as a static variable and took cross-sectional snapshots of health rather than a videotape that captuers the ‘rich dynamics of cahnge’ (Peterson, 1996)
• Both health and age are dynamic:
• Ageing brings profound biological, cognitive, socioemotional, behavioural and environmental changes.
• A growing body of research examines how these changes, both normatively and abnormally, influence patterns of health and wellbeing.

Question 8

Describe the influence of individual differences on health

Answer 8

• When health and wellbeing are examined from a lifespan perspective, a myriad of questions are generated:
• How do patterns of health and wellbeing vary across the lifespan?
• Why do I eat and drink more at Christmas than at other times of year?
• Why do some new mothers develop postnatal depression whereas others don’t?
• To understand health and wellbeing both in and across age groups, individual differences in biological, psychological and social characteristics must be considered= DIRECT RELATIONSHIP.
• Factors that determine health status across the lifespan, although sometimes similar, can also differ considerably depending on a person’s developmental status= INDIRECT RELATIONSHIP.
• Mediating relationship between multidimensional risk factors, health status and age.

Question 9

Give the forces of the multidimensional approach

Answer 9

• Biological forces
• genetic and health-related factors
• Psychological forces
• internal perceptual, cognitivee, emotional and personality factors
• Sociocultural forces
• Interpersonal, societal, cultural and ethnic factors provide context
• Life-cycle factors
• Past experiences determine biological, psychological and sociocultural factors

Question 10

describe the biopsychosocial framework

Answer 10

• One way to organise the interactive forces is to adopt a biopsychosocial framework.
• Each of us is the product of a unique combination of these forces.
• Expands our theoretical understanding of lifespan development from a purely psychological context to a model in which many different factors contribute to health and wellbeing (Miller, 2009).

Question 11

Give the two key aproaches to lifespan theories

Answer 11

• Lifespan theories can be grouped into two key approaches
• Person-centred approach
• Stage theories
• E.g Erikson (1958), Peck (1968)
• Function-centred approach
• e.g Bronfenbrenner (1979), Baltes (1987), Sameroff (2010)

Question 12

Describe Erikson (1958) psychosocial stages of development

Answer 12

• Erikson’s (1958) psychosocial stages of development
• Each stage of a person’s life requires the resolution of an ‘issue’ as part of that person’s ego development.
• Each stage consists of a crisis/conflict with alternative possibilities wherein the individual may move forward, backward or remain stuck.
• Successful development: sameness and continuity between the self and the outer world.
• Maladjustment: break in continuity of development, such as moving backward or becoming stuck,
• The way each person resolves these issues results in the acquisition of a ‘virtue’; an ego strength or special quality.
insert picturee

Question 13

evaluate Erikson’s theory of psychsocial development

Answer 13

Erikson’s (1958) theory was one of the first to explicitly recognise that psychological development continued throughout life.

Important emphasis on the relationship between the individual and society in affecting personal development.

Most developmental change is seen as occurring in early life.

Characterises later life in very narrow terms; a period of relative stability, where the primary concern is coming to terms with death and dying.

Latter two stages (40+) are supposed to represent all of the psychological crises and crisis resolutions of the last 40-45 years of life (Peck, 1968).

Question 14

Describe Peck’s stages of psychlogical development in teh second half of life

Answer 14

• Peck’s (1968) stages of psychological development in the second half of life
• Subdivided middle and old age into additional sub-stages to attempt to characterise the crises in more detail.
• Middle age – 4 crises
• Old age – 3 crises
• In doing this, Peck (1968) characterised later life more positively, as a time for growth.

Question 15

Evaluate stage theories

Answer 15

• The defining characteristics of stage theories suggest that development is:
• sequential
• unidirectional
• contains an end state
• irreversible
• structural in transformation
• universal
• Stage theories have been criticised on the following three grounds:
1. Normalising patterns of development
2. Age-related focus on development
3. Culture, context and history.
• Normalising patterns of development
• Stage theories are based on the premise that each stage is experienced universally, in the same way in all individuals.
• Human development shows relative plasticity, so there is no single or ideal developmental pathway for any one person.
• Presents problems to those who sit outside the parameters of what any given society considers ‘normal’.
• Age-related focus on development
• Stage theories view developmental change as related to chronological age.
• Individuals progress in very different ways; regression or stability is not always a bad thing!
• Culture, context and history
• Universal nature of change undermines the role of culture, context, person-environment interaction and individual, community and generational histories.

Question 16

define life course theories

Answer 16

• Life course theories acknowledge the full social context of the individual and thereby offer a more fully informed account of influences on development and reflect our global and culturally diverse society.

Question 17

define developmental contextualism

Answer 17

• Development doesn’t occur in isolation, it is affected by the context of a person’s life.
• Internal influences on development such as biology and psychology interact with external influences such as their cultural context and interpersonal relationships.

Question 18

define dynamic interactionism

Answer 18

• If one of the variables influencing development changes, this can cause changes in other variables at the same or a different level.
• It is not possible to separate biology and psychology of a person from the environment in which they live.

Question 19

Explain Bronfenbrenner’s ecological systems theory

Answer 19

• The developing individual is always in interaction with an evolving environment.
• The ecological environment is a ‘nest’ of interactive structures or settings placed within each other:
• Microsystem (innermost level)
• Where the individual is at a particular moment in time, e.g. at home, work.
• Mesosystem
• Interaction between different microsystems, e.g. success at work may be influenced by home situation.
• Exosystem
• An external environment that influences an individual even if they are not physically present within that environment, e.g. parent’s promotion at work may improve the quality of life for their child(ren).
• Macrosystem (outermost level)
• Beliefs, attitudes and traditions within a given culture that influence the individual, e.g. Western individualism vs. Eastern collectivism.

Question 20

Define microsystem

Answer 20

• Microsystem (innermost level)

* Where the individual is at a particular moment in time, e.g. at home, work.

Question 21

Define mesosysteem

Answer 21

• Mesosystem

* Interaction between different microsystems, e.g. success at work may be influenced by home situation.

Question 22

Define exosystem

Answer 22

• An external environment that influences an individual even if they are not physically present within that environment, e.g. parent’s promotion at work may improve the quality of life for their child(ren).

Question 23

Define macrosystem

Answer 23

• Beliefs, attitudes and traditions within a given culture that influence the individual, e.g. Western individualism vs. Eastern collectivism.
- outermost level

Question 24

Describe Baltes’ selection, optimisation and compensation model (1987)

Answer 24

• Baltes’ (1987) Selection, Optimisation with Compensation model
• Lifespan development consists of dynamic interactions between growth (gains, e.g. new job) and decline (losses, e.g. health).
• A person’s internal and external resources are finite. As we age:
• We must devote more resources to maintain function and compensate for biological losses.
• Resources are replenished less often and drawn upon more exhaustively.
• The SOC model posits that the following three fundamental processes are essential for successful development:
1. Selection: Selecting functional domains on which to focus one’s limited resources
2. Optimization: Maximising gains
3. Compensation: Compensating for losses
• These processes ensure the maintenance of functioning and minimisation of losses throughout the life course.
• e.g. Carpentieri et al. (2017)
• Examined the way that older people talk about their use of selection, optimisation and compensation in the context of physical decline.
• The authors found that older people who engaged in high levels of SOC talk had high wellbeing despite low physical function. Those who engaged in little SOC talk had low wellbeing despite higher physical function.
1. Selection: “I don’t do ladder work now. I think there was a year when I felt my wrists weren’t strong enough to deal with the ladder, you know, and I just said, ‘Right, that’s it.’ I stopped”.
2. Optimization: Colin had recently begun “making myself go to the gymnasium every day” in an effort to improve his physical and mental fitness.
3. Compensation: “After the first [hip] operation I wasn’t allowed to bend, so I’d sweep the kitchen floor and then I’d have to get [HUSBAND] to come in and put it into a dustpan… And I got one of the long-handled dustpans and brushes…and it’s been fabulous”.

Question 25

Describe Sameroff’s integrative model of development (2010)

Answer 25

• Sameroff’s (2010) Integrative Model of Development
• The biopsychosocial ecological system.
• Based on Bronfenbrenner’s model of nested systems, but adds the biological and psychological ‘twin’ nature of the individual at the centre of the various social systems.
• The individual is a biopsychological self-regulating system composed of biological and psychological
• parts.
• The self-regulating individual is embedded in, and influenced by, social systems, including: parents; family; friends; community; and geopolitical environment.

Question 26

give critiques of the lifeespan approach

Answer 26

• There are two key critiques of the lifespan approach to health and wellbeing (Skinner et al., 2019):
• The notion that ‘everything is developmental’
• Lifespan approach has claimed the territory of all of psychology
• Could this be diluting our in-depth understanding of development, health and wellbeing?
• Emphasis on context
• Lifespan approach assumes that the individual is a passive agent
• What is the role of the individual in actively dictating what environments must provide?

Question 27

What is a long-term condition?

Answer 27

• “LONG TERM CONDITIONS are characterised by their on-
going duration and the fact that they are often managed
throughout the life span…changes the life of the
individual affected and generates a need to adapt and
develop an understanding of the relationship between the
demands of life and those of the condition” (Lambert &
Keogh, 2015

Question 28

GIve some of the 14 conditions identified by the PRISMS project

Answer 28

• Asthma, type 1 and type 2 diabetes, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders (Taylor et al, 2014)

Question 29

Give some commonalities between types of LTCs

Answer 29

• Commonalities:
• Related to other LCTs
• Linked to behavioural factors
• Linked to inequalities
• Live much of life with the condition
• Constant management
• Complex

Question 30

Give the stages of living with LTCs

Answer 30

1. Opportunity for prevention of LTC
2. Detection and diagnosis
3. Adjustment (new identity)
4. Learning to live with a LTC
5. Reducing additional risk (co-morbidity)
6. Self-management
7. Adapting and thriving

Question 31

describe the core aims of LTCs care

Answer 31

• Optimise quality of life
• Reduce impact on physical, social and emotional functioning
• Prevent multi-morbidity (other LTCs developing)
• Protect psychological wellbeing
• Diagnose early, help with adjusting to living with LTC, support self-management

Question 32

Describe the prevalence of LTCs

Answer 32

• 15 million people in England with LTCs
• Numbers of people with LTCs/multiple LTCs are growing
• 14% of people <40 years old
• 58% of people >60 years old
• Those in the poorest social class have a 60% higher chance of having a LTC, 30% more severe, than those in the richest social class

Question 33

Describe the NHS house of care framework for LTC care

Answer 33

• 50% of all GP appointments, 64% of all outpatient appointments, 70% of all bed days
• Absorbs 70% of acute and primary care costs in the NHS
• ‘Multi-morbidity is now the norm’- current NHS care not set up to manage this
• Single-condition services
• Lack of care coordination
• Lack of attention to wellbeing and mental health
• Fragmented care (more than medicine provided elsewhere)
• Informational continuity– patient records, consistent care
• Reactive not predictive services
• Lack of emphasis on self-care

Question 34

Give the top 4 risk factors for health as identified by King’s fund (2018)

Answer 34

• Diet
• Alcohol
• Smoking
• Exercise

Question 35

Describe the NHS long-term plan

Answer 35

“Multiple risk should be taken as seriously as multi-morbidity”
• 7 in 10 people exhibit 2 or more of these ‘big 4’ risk factors
• More risk factors = higher mortality risk
• Risk linked to the 3 Ps…
• Prevention
• Personal responsibility
• Health inequalities

Question 36

Give some wider risk factors for LTCs

Answer 36

high blood pressure
Obesity
Biology
Social environment

Question 37

Describe the NHS long-term plan

Answer 37

“Multiple risk should be taken as seriously as multi-morbidity”
• 7 in 10 people exhibit 2 or more of these ‘big 4’ risk factors
• More risk factors = higher mortality risk
• Risk linked to the 3 Ps…
• Prevention
• Personal responsibility
• Health inequalities

Question 38

Describe te role of mental health in LTCs

Answer 38

• Having a LTC may increase the risk of developing a mental health problem (e.g. becoming depressed or anxious)
• Psychological impact of living with a LTC
• Reductions in quality of life
• Side effects of medications (e.g. sedation)
• Physiological changes due to illness (e.g. hormone imbalances)
• Side effects of psychotropic medications (e.g. obesity)
• Chronic stress leading to damage to cardiovascular / immune system
• Unhealthy coping strategies (e.g. alcohol / poor diet)
• Poor self-care / management of health condition

Question 39

describe integration of physical and mental health care

Answer 39

• High rates of mental health conditions among those with LTCs
• Reduced life-expectancy for people diagnosed with severe mental illness, largely due to poor physical health
• Little psychological support currently available for people adjusting to and living with LTCs

Question 40

Give some elements of self-management in medical settings

Answer 40

• Attending / organising health care appointments
• Information processing
• Health literacy
• Coordination of care

Question 41

Give some elements of self-management in the home environment

Answer 41

• Healthy lifestyle
• Medication adherence – taking medications, applying treatment regimes
• Psychological wellbeing
• Adapting to home, family, work environments
• Managing / detecting symptoms, relapses or flare ups

Question 42

Give some elements of self-management in the home environment

Answer 42

• Healthy lifestyle
• Medication adherence – taking medications, applying treatment regimes
• Psychological wellbeing
• Adapting to home, family, work environments
• Managing / detecting symptoms, relapses or flare ups

Question 43

What does effective self management look like?

Answer 43

Key characteristics: 
• Multi-faceted
• Tailored not generic 
• Culture/beliefs-specific
• Specific to disease trajectory
• Collaborative Dr-patient relationship
• Health care organisation that promotes self-care
*Evidence from RCTs shows that no single component here is any more important that another

Question 44

Describe intervention for chronic kidney disease

Answer 44

• 3 systematic reviews of interventions for Chronic Kidney Disease: Mason et al, 2008; Matteson et al, 2010; Strand et al, 2012
• What did it try to change? peer support to enhance motivation for self-care, also emphasis on autonomy and reducing anxiety
• What did it include? Education provision (e.g. disease features, required dietary changes), written resources, group problem-solving sessions, encouraging/prescribing exercise plans, hypnotherapy, coaching
• How was it delivered? Dieticians, psychologists, social workers, nurses, patient peers.

Question 45

Describe the FORT intervention for cancer

Answer 45

• 6 group sessions
• Theory-base:
• Self-regulatory model
• Uncertainty in illness model
• Cognitive model of worry
• Aims to reduce anxiety and improve quality of life

Question 46

Describe the ‘Meeting, Compliance, Responsibility, Autonomy’ Intervention for COPD

Answer 46

• guided meditation, education about disease, anatomical model of illness and illness perception drawings lead to understanding of disease + adhearence + QOL + autonomy