The Life Cycle Flashcards
Prentally, what are we worried about?
Physical (infections, exposure to drugs); behavior patterns in-utero can presage those that occur after birth;
prematurely: <32 weeks
AGPAR: What does it stand for and what is it used for?
Appearance (color), pulse, grimace (reflex irritability), activity (muscle tone), respiration; used to predict LIKELIHOOD OF IMMEDIATE SURVIVAL
Regarding birth, low income is associated with; prematurity is associated with
premature births and high infant mortality; delayed childbearing/increased maternal age;
ALSO: no free prenatal care and LOW INCOME associated with premature births and high infant mortality
Some postpartum reactions:
- baby blues (exaggerated emotionality and tearfulness lasting a few days after birth)
- oxytocin-dopamine interactions associated with maternal-infant bond
- social and psychological factors
- Major depression (can last up to 1 year)
- Postpartum psychosis
Spheres of development
Motor, social, verbal/cognitive, cephalad to caudad and central to peripheral
Infancy to 18 mos:
- Humans need and seek presence of others
- Attachment
- Social smile: 12 wks
- Stranger anxiety 9 mos
- Separation anxiety late in first year, with object permanence coming first
Importance of attachment slide:
- Psychoimmunology
- Want to encourage families to spend time with kids when hospitalized; also foster families
- If kid is separated from parents because they work all the time, no evidence of long-term consequences
Reflexes characteristic of infant
- Rooting reflex (touch cheek turn toward nipple)
- Palmar grasp reflex
- Moro reflex (limbs extend when child is startled)
- Babinski reflex (disappears at 1 year)
NECESSARY REFLEXES FOR SURVIVAL!!
Toddler years: 18 mos to 3 years
- Rapprochement (goes away but comes back for comfort)
- Parallel play; also begin to say NO!!
- at 3 years: spend a few hours away from mother in care of another adult
- Autonomy
- Bowel and bladder function (more at 4 and 5 years, respectively)
- Gender ID by 3 years
For 3-6 years:
- sibling rivalry
- regression
- b/w 2-4 years: old vocab increases dramatically; repeats bathroom words
- Active fantasy life (imaginary friends: know that they’re not real)
- Cooperative play at 4 years
- Strong fear of bodily injury
- Curiosity about bodies: e.g. play doctor
Milestone at 6 years:
- Child conscience develops (superego)
- Sense of morality
- Empathy
- Learns that lying is wrong
- Understand finality of death: get fear of losing loved ones
FLEMingoS
Disorders before age 6:
Think mostly autism spectrum disorders (seen before age 3, no finger pointing, more common in boys, larger head circumference, then genetic component);
also Rett’s disorder and Childhood Degen Disorder
School Age and Adolescence (7-11 yoa)
- Psychosexual issues are dormant
- Industry vs inferiority
- Lifelong sense of competence (in school kids comparing with each other and if they measure up to one another)
- Formal schooling starts (capable of logical thought, like reason and math)
- Concrete operations (more than one property, concept of conservation)
- Learning problems ID’d!!
Play and Peer Relationships
Let him talk about this slide;
focusing on peer relationships, morality and being RULE CONSCIOUS, and more complex motor tasks with team sports; ID with parent of same sex, also universality of death!!
For adolescence: 11 to 20 years
Early adolescence (11-14): puberty the physical indicator of adolescence, with girls earlier than boys, first menstruation at 11-14, first ejaculation at 12-15, and complete by 13.5 years in girls vs 15 in guys (Tanner Staging); here, more likely to be obedient to adults
Middle (15-17): at 15, body image and popularity, wanting to spend time with friends and not family; now risk-taking behavior because frontal lobe not FULLY DEVELOPED; want autonomy/need for privacy and need education about short-term benefits regarding physical appearance or popularity
Late adolescence (18-20): ID crisis, ROLE CONFUSION, maybe some developing abstraction (hypothetical and formal reasoning: calculus and formal operations)
Emotional and social factors predisposing to teen pregnancy:
- Depression
- Poor school achievement
- Divorced parents;
preggers rate among older women is increasing
Certain problems affecting development:
Mental Retardation (Down Syndrome and Fragile X syndrome most common genetic factors)
Challenges of Early and Middle Adulthood
- Transitional Periods
- Reappraisal of desires, goals and values
- Vulnerable to physical and emotional illness during periods of life change (midlife crises)
- Regression (maybe become more adolescent)
Early adulthood (20-40 years):
- age 30: one’s role in society is defined, physical development at peak, individual INDEPENDENT
- age 30 transition: love and work/intimacy vs isolation
- Women often change paths in middle 30s, either by returning to work or becoming homemakers
Middle Adulthood (40-65 years)
- Unique social responsibilities
- Sandwich generation (responsibilities to older and younger relatives)
- More life behind than ahead
- Climacterium
- Men decrease in muscle strength, endurance, sex performance; women have menopause but few significant physical/psychological changes; vasomotor instability: sleep and fatigue relied with ERT but increased risk of cancer for uterus
Losses of Aging:
65 yrs and older:
- Loss of social status
- Loss by death of spouses, family members and friends
- Decline in overall health and strength
- Most adjust well: freedom from work and childrearing
- Either pride in accomplishments or life feels wasted
(past 65, you are a senior citizen with social security and medicare eligibility); 85 and older is fastest growing segment of population
Physical and Neurological Changes of aging
- Neuro changes: decreased cerebral blood flow, decreased brain weight, amyloid plaques
- Intelligence remains the same
- Decreased NT availability (less secretion, increased MAO, less responsive receptors)
- More sens to SE’s (increased depression)
Pyschosocial changes of aging
- Reduced bladder control
- Loss of strength
- Vision and hearing loss
- Abuse of cognitive or physically impaired elderly by caretakers (elder abuse, adult protective services are not mandates)
Psychopath in elderly:
- depression (memory loss and cognitive problems called pseudodementia)
- Suicide rates increasing: social loss, physical illness or depression more common in elderly than general pop
- Anxiety
- Alcohol and substance abuse
- Delirium (illness or depression)
Theories on development:
Chess and Thomas: temperament (activity level, reactivity to stimuli, cyclic behavior patterns, reactions to people, mood, distractibility, attention span)
Erikson: critical periods of social goals
Piaget: cognitive stages
Mahler: separation-individuation
Freud: parts of body in which pleasure is derived
Other disorders with development (ie learning and comm)
- Phonological disorders (ca and not cat, top instead of stop)
- Articulation disorders (can’t make right motor movements, so lisping)
- Tourette’s (runs with OCD often; before 18, involuntary)
- Separation anxiety disorder (school phobia or school refusal; starts at 7 years)
- Selective mutism (start at age 6 usually)
Assisted repro and adoption:
- Fertility tends to decrease with age
- Can do IN VITRO
- Adoption: should ideally get them in infancy; also tell them at earliest possible age and all you know about biological parents
How do most of the elderly in America live?
Most live independently; otherwise, younger family members watch over them, they are in assisted living, or in nursing homes
Over age 85,
half have some degree of cognitive impairment; most common form of dementia is ALZHEIMER’S!!;
think MEMORY and LEARNING problems
Bereavement vs. Complicated bereavement: similarities and differences
- Both have initial shock and denial, but denial in abnormal can last over days or weeks
- Both with sadness, crying
- Anniversary reactions
- Abnormal grief has symptoms intensify or persist over time rather than lessen and has suicidal thinking or hallucinations
