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Psychiatry > Normal Development > Flashcards

Normal Development Flashcards

1
Q

What are the features of a mental disorder according to the DSM (there are no definitions of normality / mental health)?

A

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.

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2
Q

What is attachment and its significance of attachment to infancy? What are the possible effects if it is not there?

A

Emotional connection that develops between infant and primary caregiver

Effects of deprivation longterm:

  1. Anaclitic depression
  2. Social / emotional deficits - poor socialization / language / trust in others
  3. Physical effects - failure to thrive, even death
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3
Q

What is anaclitic depression?

A

Children become susceptible to physical illness and are depressed when separated from primary caregiver

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4
Q

What are the four primary infant reflexes?

A
  1. Babinski
  2. Moro
  3. Rooting
  4. Palmar

Disappears like the ocular nerve numbers, 3, 4, 6 months

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5
Q

What is the Babinski reflex and when does it disappear by?

A

Big toe dorsiflexes with plantar stimulation (toes fan out)

Disappears at end of infancy / beginning of toddlerhood (1 year)

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6
Q

What is the Moro reflex and when does it disappear by?

A

Limbs extend when baby is startled

-Disappears by 3 months (first reflex to go)

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7
Q

What is the Rooting reflex and when does it disappear by?

A

Infant puckers lips and turns head upon perioral stimulation for breastfeeding

Disappears by 4 months (second reflex to go)

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8
Q

What is the Palmar reflex and when does it disappear by?

A

When an object is placed in infant’s palm, they will grasp

Disappears by 6 months

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9
Q

What is a transitional object? When does attachment develop?

A

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

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10
Q

When does stranger anxiety develop and what does it mean?

A

Develops normally around 6 months (when palmar reflex disappears) -> infant can distinguish caregivers, will cry / cling to parent when strangers approach

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11
Q

When does separation anxiety develop and what is it?

A

Occurs by 9 months, separation from primary caregiver gives normal anxiety

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12
Q

What is the order of postural developments in infancy? From lying down to walking.

A 
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
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13
Q

What are the toy playing milestones in infancy?

A

6 months - passes toys hand to hand

10 months - Pincer grab (thumb to finger)

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14
Q

At what age can an infant drink from a cup and point to objects?

A

12 months

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15
Q

What is first aid mnemonic for developmental milestones?

A

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)

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16
Q

What are the three 3 S’s of infancy?

A 
Social Smile (2 months)
Stranger Anxiety (6 months)
Separation Anxiety (9 months)
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17
Q

What are the 3 O’s of infancy and their associated times?

A

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

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18
Q

What is the mnemonic for 6 month milestones?

A

6 - sits alone
6abbles
6 (funny face nose) - laughs

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19
Q

What is Piaget’s first stage and what is the timetable?

A

Birth - 24 months

Sensorimotor stage -> gain control of motor functions and interact with world through sensory observation

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20
Q

What are Freud’s and Erikson’s theories of Infancy? What happens if you can’t fulfill Erikson’s

A

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
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21
Q

When does gender identity set in and when is it fixed? Is it innate?

A

Begins at 18 months - you feel male or female
Fixed by 24-30 months.

Yes, majority of it is innate

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22
Q

What are the three R’s of toddlerhood (child Rearing working)?

A

Recreation - parallel play by 2 years
Rapproachment - by 2 years
Realization - of core gender identity

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23
Q

What are parallel play and rapprochement?

A

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

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24
Q

What are the four C’s of toddlership (Child rearing working)?

A

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

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25
Q

When does a child imitate housework?

A

by 18 months, get a play kitchen / grill / lawnmower

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26
Q

What is the W of child rearing Working?

A

W = words, knows 200 words by age 2 (two zeros)

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27
Q

When is object permanence fully matured? Is peek-a-boo still fun at this point?

A

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

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28
Q

What is Piaget’s second stage and how long does it last? How is their thinking?

A

Preoperational stage 2-7 years
Child uses symbols and language
-> Thinking and reasoning are intuitive, not logical / deductive.
-> cannot understand metaphors

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29
Q

What are Freud’s and Erikson’s second stage and their timing?

A

Both 1-3 years (toddlerhood)

Freud - Anal phase - urges centered on controlling bowel functions / body functions (potty training)

Erikson - Autonomy vs Shame and Doubt

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30
Q

What is the central conflict of Erikson’s second stage?

A

Autonomy - child is able to explore & briefly separate from parent (rapprochement)

Shame and Doubt - child loses confidence when parents expect too much

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31
Q

What are the three D’s of preschool years (Don’t forget they’re still learning)?

A

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)

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32
Q

What are the Drawing ages?

A

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

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33
Q

What are the two F’s of preschool years (don’t Forget they’re still learning)?

A

Freedom - spends part of day away from parents

Friends - cooperative play by age 4

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34
Q

What are the two L’s of preschool years (don’t forget they’re still Learning)?

A

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.

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35
Q

What what age can you read, tie shoelaces, and ride a bike?

A

Age 6 (First grade)

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36
Q

What are three thought patterns central to Piaget’s preoperational stage?

A

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

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37
Q

What are Freud’s and Erikson’s third stage and their timing? What are the feature’s of Freud’s phase?

A

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

38
Q

What are the features of Erikson’s third stage?

A

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)

39
Q

What is considered the latency period of Freud, and what does this mean?

A

Ages 6-11 years (4th stage)
Libido is repressed / latent as child develops same-sex friendships and participates in school / sports (becomes more skilled)

40
Q

At what age is death understood as final?

A

Age 8

41
Q

What is Piaget’s third stage and what characteristics underlie it?

A

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

42
Q

What are conservation and reversibility? These both develop in concrete operations.

A

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

43
Q

What is Erikson’s fourth stage? Years?

A

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

44
Q

In my opinion, what are the stages of development all about?

A

Infancy - senses / motor
Toddler - potty training
Preschool - punishment
Middle school - social development and complex thinking
Adolescence - identity, abstract thinking, sexuality

45
Q

What is the age of onset of puberty for girls / boys and what is the trigger?

A

Girls - 11 years
Boys - 13 years

Trigger: maturation of hypothalamic-pituitary-adrenal-gonadal axes

46
Q

What is the psychological development in adolescence?

A

Thinking becomes abstract, conceptual, and future oriented
Morality develops
Creativity increases
Identity forms - separate from parents and from many sources

47
Q

What is negativism which occurs in adolescence?

A

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

48
Q

What typically destroys self esteem in adolescence?

A

Any deviation from the norm which can result in them not belong in their peer group
-> social identity relies on peer group

49
Q

What are the reasons behind risky behavior in adolescence?

A
  1. Omnipotent fantasies - feeling they are invincible and know everything
  2. Fear of inadequacy - overcompensation
  3. Group dynamics - i.e. peer pressure
50
Q

What is Piaget’s theory of development in the adolescent years?

A 
Formal operations (11-18 years)
Can think abstractly, reason deductively, and define abstract concepts
-> highly variable
51
Q

What is Erikson’s adolescent development theory?

A

Age 13-21:
Identity vs Role Confusion

Identity = form cohesive self
Role confusion = confusion about his / her place in the world

52
Q

What is Freud’s adolescent development theory?

A

Genital phase (vs Phallic phase is 3-5 years) -> genital sexuality develops and proceeds to adulthood

53
Q

When does adolescence technically end?

A

When persons begin to assume actual tasks of adulthood

  • > assumption of new social roles
  • > socialization in these roles
  • > assumption of adult self / life structure
54
Q

What are the leading causes of death in people under 1 year?

A
  1. Congenital malformations
  2. Preterm birth
  3. Sudden infant death syndrome (SIDS)
55
Q

What are the leading causes of death in people 1-14 years?

A
  1. Accidents
  2. Cancer
  3. Congenital malformations
56
Q

What are the leading causes of death in people 15-35 years?

A
  1. Accidents
  2. Suicide
  3. Homicide
57
Q

What is the time tables of early, middle, and late adulthood?

A 
Early: 21-40
Middle: 40-65
Late: 65+
65-74 = young-old
75+ = old-old
58
Q

What is Erikson’s developmental stage of early adulthood?

A

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

59
Q

What is meant by assuming the role of a “psychological parent” in young adulthood?

A

Not only must you become a biological parent, but you must assume the role of raising your child in development

60
Q

As well as your changing relationship with your parents, how does your attitude towards time change as a young adult?

A

You start to realize time is more finite

61
Q

What is the idea behind “task theories” of the human lifecycle?

A

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

62
Q

How did Carl Jung describe age 40 and why?

A

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

63
Q

What is Erik Erikson’s stage following Intimacy vs Isolation?

A

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

64
Q

What is the arguably the most difficult change of middle adulthood?

A

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

65
Q

What is midlife transition vs midlife crisis?

A

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

66
Q

What are people with mental illness at greater risk for?

A

Medical problems, complications and poorer functioning in all facets of life

67
Q

What is the definition of maturity in adulthood? When does it happen?

A

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

68
Q

What is the strongest determinant about who is happy-well vs sad-sick among old people?

A

Subjective physical health at that age (how well they feel)

69
Q

What other factors can promote happiness in very happy old people?

A

Objectively good physical health, good mental health, social supports and overally life satisfaction

70
Q

Group the following factors into strong predictor of wellness vs poor predictor of wellness in our 70’s:

  1. Regular exercise + healthy weight
  2. Stable marriage
  3. Higher education
  4. All parental factors (social class, marriage, childhood death)
  5. No smoking / quitting by age 50
  6. IQ
  7. Ancestral longevity
  8. Mature defenses / adaptive coping
A
  1. Regular exercise + healthy weight - YES
  2. Stable marriage - YES
  3. Higher education - YES
  4. All parental factors (social class, marriage, childhood death) - NO
  5. No smoking / quitting by age 50 - YES
  6. IQ - NO
  7. Ancestral longevity - NO
  8. Mature defenses / adaptive coping - YES
71
Q

What is the best predictor of high income in the Harvard graduate / inner city people comparison?

A

Whether their mother made them feel loved

72
Q

What are two physiological factors which are generally unchanged in adulthood?

A

Intelligence and libido (may drop somewhat in women after menopause)

73
Q

What is presbycusis and where are these cells damaged?

A

High frequency hearing loss - destruction of hair cells at cochlear base (near source, at the oval window)

74
Q

What happens to sleep as we age?

A

Sleep latency and awakenings during the night increase

REM percentage and stages 3/4 sleep drop off (less deep and restorative sleep

75
Q

What can have a large effect on sexuality as age goes on?

A

Body image & ability to accept body changes

Men will have slower erection / ejaculation
Women will have vaginal shortening, thinning, and dryness

76
Q

What are the leading causes of death in 35-44 year olds?

A

Accidents
Cancer
Heart Disease

77
Q

What are the leading causes of death in 45-64 year olds?

A

Cancer
Heart Disease
Accidents

78
Q

What are the leading causes of death in 65+ years?

A

Heart Disease
Cancer
Chronic Respiratory Disease

79
Q

What are some of the negative possible consequences of polypharmacy?

A

Drug interactions, increased economic cost -> med discontinuation, inaccurate use

80
Q

What changes with age with regards to pharmacokinetics? How should this be handled?

A

Decreased volume of distribution
Increased elimination half-life

-> start low and go slow, change one medication at a time, check kidney and liver function

81
Q

Are most elderly people impaired on a day to day basis from doing tasks?

A

No, but they may need help from family and friends

82
Q

How can a doctor improve communication with an elderly patient?

A

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

83
Q

Who is typically admitted to a nursing home? Is it a large proportion of old people?

A

Widowed women

About 1/3 will be admitted to a long-term facility at some point in their lives

84
Q

What should you ask about when in a visit with an elderly patient?

A

Sources of social support, adjustment to role changes / aging, possible elder abuse

85
Q

Among healthy (free from chronic illness) elderly people, what is the overall prevalence of psychiatric diseases?

A

Lower than other life stages

86
Q

What is Erikson’s final stage of development?

A

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

87
Q

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?

A

Mental illness and chronic physical illness

88
Q

What are the five stages of grief?

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Despair / Depression
  5. Acceptance
89
Q

What are the types of denial? Define: magical thinking, excessive fantasy, regression, withdrawal/rejection

A
  1. Magical thinking - things will be different by magic
  2. Excessive fantasy - nothing is wrong, loss is imagined
  3. Regression - make others assure them nothing is wrong, child-like
  4. Withdrawal / rejection - avoiding and rejecting those who confront them with the truth
90
Q

What is a common feeling in the despair / depression phase of the stages of grief?

A

Guilt of responsibility - feeling that illness is for bad past deeds, or a punishment for sin

91
Q

When is ability to reason about treatment relating to the disease regained?

A

In the acceptance phase, when appropriate emotions and rational thinking have returned.

Psychiatry (23 decks)

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