Normal Development Flashcards
What are the features of a mental disorder according to the DSM (there are no definitions of normality / mental health)?
A behavioral, emotional, or cognitive syndrome that reflects dysfunction in psychological, biological, or developmental processes. It is usually associated with distress, is not an expected / approved response, and is not simply socially deviant behavior.
What is attachment and its significance of attachment to infancy? What are the possible effects if it is not there?
Emotional connection that develops between infant and primary caregiver
Effects of deprivation longterm:
- Anaclitic depression
- Social / emotional deficits - poor socialization / language / trust in others
- Physical effects - failure to thrive, even death
What is anaclitic depression?
Children become susceptible to physical illness and are depressed when separated from primary caregiver
What are the four primary infant reflexes?
- Babinski
- Moro
- Rooting
- Palmar
Disappears like the ocular nerve numbers, 3, 4, 6 months
What is the Babinski reflex and when does it disappear by?
Big toe dorsiflexes with plantar stimulation (toes fan out)
Disappears at end of infancy / beginning of toddlerhood (1 year)
What is the Moro reflex and when does it disappear by?
Limbs extend when baby is startled
-Disappears by 3 months (first reflex to go)
What is the Rooting reflex and when does it disappear by?
Infant puckers lips and turns head upon perioral stimulation for breastfeeding
Disappears by 4 months (second reflex to go)
What is the Palmar reflex and when does it disappear by?
When an object is placed in infant’s palm, they will grasp
Disappears by 6 months
What is a transitional object? When does attachment develop?
Can develop in infancy, its an object which young child becomes attached to and uses as a halfway step between attachment to parent and herself
When does stranger anxiety develop and what does it mean?
Develops normally around 6 months (when palmar reflex disappears) -> infant can distinguish caregivers, will cry / cling to parent when strangers approach
When does separation anxiety develop and what is it?
Occurs by 9 months, separation from primary caregiver gives normal anxiety
What is the order of postural developments in infancy? From lying down to walking.
Lifts head to prone by 1 month Rolls over by 4-5 months Sits and rolls by 6 months Crawls by 8 months Stands by 10 months Walks by 12-18 months
What are the toy playing milestones in infancy?
6 months - passes toys hand to hand
10 months - Pincer grab (thumb to finger)
At what age can an infant drink from a cup and point to objects?
12 months
What is first aid mnemonic for developmental milestones?
Parents Start Observing, (0-12 months, infant)
Child Rearing Working, (12-36 months, toddler)
Don’t Forget, they’re still Learning! (3-5 yrs, preschool)
What are the three 3 S’s of infancy?
Social Smile (2 months) Stranger Anxiety (6 months) Separation Anxiety (9 months)
What are the 3 O’s of infancy and their associated times?
Orients to voice - 4 months, then name at 9 months
Object permanence - 9 months, develops at same time as separation anxiety
Oratory - says mama / dada at 10 months, but actually means mama / dada by 12 months
What is the mnemonic for 6 month milestones?
6 - sits alone
6abbles
6 (funny face nose) - laughs
What is Piaget’s first stage and what is the timetable?
Birth - 24 months
Sensorimotor stage -> gain control of motor functions and interact with world through sensory observation
What are Freud’s and Erikson’s theories of Infancy? What happens if you can’t fulfill Erikson’s
Both 0-1 year
Freud: Oral - urges focused on feeding, source of all satisfaction and frustration
Erikson: Trust vs Mistrust
- > Trust - when attached to a parent providing consistent care
- > Mistrust - can’t rely on parents, leads to emptiness / despair
When does gender identity set in and when is it fixed? Is it innate?
Begins at 18 months - you feel male or female
Fixed by 24-30 months.
Yes, majority of it is innate
What are the three R’s of toddlerhood (child Rearing working)?
Recreation - parallel play by 2 years
Rapproachment - by 2 years
Realization - of core gender identity
What are parallel play and rapprochement?
Parallel play - playing next to another child, but not with eachother
Rapprochement - Child wants independence but fears abandonment, will leave caregiver, return briefly, then go out to explore again
What are the four C’s of toddlership (Child rearing working)?
Cruises - takes first steps by 12-18 months, runs by 24 months
Climbs stairs 18 months
Cubes stacked - 3 x age in years = 6 by two years
Cutlery - feeds self with fork and spoon
Kicks ball - not a C, but 24 months
When does a child imitate housework?
by 18 months, get a play kitchen / grill / lawnmower
What is the W of child rearing Working?
W = words, knows 200 words by age 2 (two zeros)
When is object permanence fully matured? Is peek-a-boo still fun at this point?
Fully matured at 24 months, (starts at 9 months with separation anxiety), peekaboo is still fun because child is excited to know that you are still there and they are able to find you
What is Piaget’s second stage and how long does it last? How is their thinking?
Preoperational stage 2-7 years
Child uses symbols and language
-> Thinking and reasoning are intuitive, not logical / deductive.
-> cannot understand metaphors
What are Freud’s and Erikson’s second stage and their timing?
Both 1-3 years (toddlerhood)
Freud - Anal phase - urges centered on controlling bowel functions / body functions (potty training)
Erikson - Autonomy vs Shame and Doubt
What is the central conflict of Erikson’s second stage?
Autonomy - child is able to explore & briefly separate from parent (rapprochement)
Shame and Doubt - child loses confidence when parents expect too much
What are the three D’s of preschool years (Don’t forget they’re still learning)?
Drive - can ride tricycle with 3 wheels (age 3 for three wheels)
Drawings
Dexterity - Hops on one foot by age 4, Uses buttons / grooms self by age 5, can use buttons or zippers by age 5 (full dressing of self by age 5)
What are the Drawing ages?
3 - fits in circle - can copy circle
4 - add a line to a plus - can copy a + (make stick figure now)
5 - fits in square with line on top of 5 - can copy square
6 - tip of 6 points to tip of triangle - can copy a triangle
What are the two F’s of preschool years (don’t Forget they’re still learning)?
Freedom - spends part of day away from parents
Friends - cooperative play by age 4
What are the two L’s of preschool years (don’t forget they’re still Learning)?
Language - 3 zeros for age 3 - knows 1000 words. Can also use complete sentences by age 4.
Legends - At age 4, when can use complete sentences, can also tell complete stories.
What what age can you read, tie shoelaces, and ride a bike?
Age 6 (First grade)
What are three thought patterns central to Piaget’s preoperational stage?
Imminent justice - punishment for bad deeds is unavoidable
Egocentrism - Child is the center of the universe, cannot see from other’s perspective
Animistic thinking - Physical events & objects have feelings
What are Freud’s and Erikson’s third stage and their timing? What are the feature’s of Freud’s phase?
3-5 years (preschool years)
Freud - Phallic Phase
-> preoccupation with illness / injury
-> Oedipal complex -> child competes with parent to focus on parent of opposite sex
Erikson - Initiative vs Guilt
What are the features of Erikson’s third stage?
Initiative - increasing mastery of skills, wishing to explore and conquer. Opposite of Freud: takes steps to establish relationship with parent of same sex
Guilt - Results from anxiety over anticipated punishment of exploring (think of Piaget’s imminent justice)
What is considered the latency period of Freud, and what does this mean?
Ages 6-11 years (4th stage)
Libido is repressed / latent as child develops same-sex friendships and participates in school / sports (becomes more skilled)
At what age is death understood as final?
Age 8
What is Piaget’s third stage and what characteristics underlie it?
Concrete operations, Ages 7-11 (preoperational was 2-7), ends the same year as Freud’s latency stage
Ability to understand other’s viewpoint (no longer egocentric), ability to organize / group according to characterstics of objects
What are conservation and reversibility? These both develop in concrete operations.
Conservation - Understanding that the same volume of water poured into container of two different dimensions is still the same volume
Reversibility - ice to water to ice again can occur
What is Erikson’s fourth stage? Years?
5-13 years: Industry vs Inferiority
Child must understand his family is part of a larger society, and focuses on learning and doing
Industry - develops a sense of mastery over environment / accompliashment
Inferiority - when a child cannot master tasks
In my opinion, what are the stages of development all about?
Infancy - senses / motor
Toddler - potty training
Preschool - punishment
Middle school - social development and complex thinking
Adolescence - identity, abstract thinking, sexuality
What is the age of onset of puberty for girls / boys and what is the trigger?
Girls - 11 years
Boys - 13 years
Trigger: maturation of hypothalamic-pituitary-adrenal-gonadal axes
What is the psychological development in adolescence?
Thinking becomes abstract, conceptual, and future oriented
Morality develops
Creativity increases
Identity forms - separate from parents and from many sources
What is negativism which occurs in adolescence?
Active, verbal way of expressing emotions which tests parents and authority figures
-> attempt to tell world that young person has a mind of his/her own
What typically destroys self esteem in adolescence?
Any deviation from the norm which can result in them not belong in their peer group
-> social identity relies on peer group
What are the reasons behind risky behavior in adolescence?
- Omnipotent fantasies - feeling they are invincible and know everything
- Fear of inadequacy - overcompensation
- Group dynamics - i.e. peer pressure
What is Piaget’s theory of development in the adolescent years?
Formal operations (11-18 years) Can think abstractly, reason deductively, and define abstract concepts -> highly variable
What is Erikson’s adolescent development theory?
Age 13-21:
Identity vs Role Confusion
Identity = form cohesive self
Role confusion = confusion about his / her place in the world
What is Freud’s adolescent development theory?
Genital phase (vs Phallic phase is 3-5 years) -> genital sexuality develops and proceeds to adulthood
When does adolescence technically end?
When persons begin to assume actual tasks of adulthood
- > assumption of new social roles
- > socialization in these roles
- > assumption of adult self / life structure
What are the leading causes of death in people under 1 year?
- Congenital malformations
- Preterm birth
- Sudden infant death syndrome (SIDS)
What are the leading causes of death in people 1-14 years?
- Accidents
- Cancer
- Congenital malformations
What are the leading causes of death in people 15-35 years?
- Accidents
- Suicide
- Homicide
What is the time tables of early, middle, and late adulthood?
Early: 21-40 Middle: 40-65 Late: 65+ 65-74 = young-old 75+ = old-old
What is Erikson’s developmental stage of early adulthood?
Intimacy vs Isolation (21-40 years)
Intimacy - find a partner by making / honoring commitments, and sacrificing / compromising
Isolation - when you are unable to tolerate fear of abandonment, resulting in withdrawal and depression
What is meant by assuming the role of a “psychological parent” in young adulthood?
Not only must you become a biological parent, but you must assume the role of raising your child in development
As well as your changing relationship with your parents, how does your attitude towards time change as a young adult?
You start to realize time is more finite
What is the idea behind “task theories” of the human lifecycle?
In order to move to the next life stage, must finish the tasks of the previous stage (although there may be some overlapping)
For Erikson: you must resolve a conflict to meet the next one
How did Carl Jung describe age 40 and why?
The Noon of Life - beginning of middle adulthood
Because this is a transitional stage where you review where you’ve been, how things have gone, and what will the future hold
-> people may change roles many times in their life
What is Erik Erikson’s stage following Intimacy vs Isolation?
Generativity vs Stagnation - Ages 40-60
Generativity - Guiding the incoming generation or improving society.
Stagnation - Person stops developing -> no impulse to guide others, or producing children but not caring for them
What is the arguably the most difficult change of middle adulthood?
Each person must deal with the loss of their previously well-functioning body which may have been taken for granted
-> observing medical problems of friends can also lead to thoughts of mortality
What is midlife transition vs midlife crisis?
Transition - Viewing middle age as a chance to re-write the ending and taking new opportunities which may lead to productive change
Crisis - Emotional struggles which lead to serious maladaptive behavior
What are people with mental illness at greater risk for?
Medical problems, complications and poorer functioning in all facets of life
What is the definition of maturity in adulthood? When does it happen?
Sophisticated level of self-awareness based on an honest appraisal of one’s own experience + the ability to use this knowledge carefully in relation to one’s self / others
Happens in different ways and times for different people
What is the strongest determinant about who is happy-well vs sad-sick among old people?
Subjective physical health at that age (how well they feel)
What other factors can promote happiness in very happy old people?
Objectively good physical health, good mental health, social supports and overally life satisfaction
Group the following factors into strong predictor of wellness vs poor predictor of wellness in our 70’s:
- Regular exercise + healthy weight
- Stable marriage
- Higher education
- All parental factors (social class, marriage, childhood death)
- No smoking / quitting by age 50
- IQ
- Ancestral longevity
- Mature defenses / adaptive coping
- Regular exercise + healthy weight - YES
- Stable marriage - YES
- Higher education - YES
- All parental factors (social class, marriage, childhood death) - NO
- No smoking / quitting by age 50 - YES
- IQ - NO
- Ancestral longevity - NO
- Mature defenses / adaptive coping - YES
What is the best predictor of high income in the Harvard graduate / inner city people comparison?
Whether their mother made them feel loved
What are two physiological factors which are generally unchanged in adulthood?
Intelligence and libido (may drop somewhat in women after menopause)
What is presbycusis and where are these cells damaged?
High frequency hearing loss - destruction of hair cells at cochlear base (near source, at the oval window)
What happens to sleep as we age?
Sleep latency and awakenings during the night increase
REM percentage and stages 3/4 sleep drop off (less deep and restorative sleep
What can have a large effect on sexuality as age goes on?
Body image & ability to accept body changes
Men will have slower erection / ejaculation
Women will have vaginal shortening, thinning, and dryness
What are the leading causes of death in 35-44 year olds?
Accidents
Cancer
Heart Disease
What are the leading causes of death in 45-64 year olds?
Cancer
Heart Disease
Accidents
What are the leading causes of death in 65+ years?
Heart Disease
Cancer
Chronic Respiratory Disease
What are some of the negative possible consequences of polypharmacy?
Drug interactions, increased economic cost -> med discontinuation, inaccurate use
What changes with age with regards to pharmacokinetics? How should this be handled?
Decreased volume of distribution
Increased elimination half-life
-> start low and go slow, change one medication at a time, check kidney and liver function
Are most elderly people impaired on a day to day basis from doing tasks?
No, but they may need help from family and friends
How can a doctor improve communication with an elderly patient?
Explain medical care, asking patient to repeat back information and providing it in a written form. Leave time to answer questions, see patient alone for part of visit (for personal questions), and schedule a follow up for significant diagnoses
Who is typically admitted to a nursing home? Is it a large proportion of old people?
Widowed women
About 1/3 will be admitted to a long-term facility at some point in their lives
What should you ask about when in a visit with an elderly patient?
Sources of social support, adjustment to role changes / aging, possible elder abuse
Among healthy (free from chronic illness) elderly people, what is the overall prevalence of psychiatric diseases?
Lower than other life stages
What is Erikson’s final stage of development?
Integrity vs Despair (60)+
Integrity - Sense of peace and wisdom coming to terms with how’s one life is lived
Despair - Life was too short and one didn’t choose wisely
What two disease states have the same relative impact: increase in hospitalizations, meds, expenditures, loss of functioning, quality of life, ability to meet developmental tasks?
Mental illness and chronic physical illness
What are the five stages of grief?
- Denial
- Anger
- Bargaining
- Despair / Depression
- Acceptance
What are the types of denial? Define: magical thinking, excessive fantasy, regression, withdrawal/rejection
- Magical thinking - things will be different by magic
- Excessive fantasy - nothing is wrong, loss is imagined
- Regression - make others assure them nothing is wrong, child-like
- Withdrawal / rejection - avoiding and rejecting those who confront them with the truth
What is a common feeling in the despair / depression phase of the stages of grief?
Guilt of responsibility - feeling that illness is for bad past deeds, or a punishment for sin
When is ability to reason about treatment relating to the disease regained?
In the acceptance phase, when appropriate emotions and rational thinking have returned.
