The Life Cycle Flashcards
what are biological and environmental factors present during prenatal period?
physical: infections, exposure to drugs
behavior: patterns in-utero can presage those that occur in birth
birth: 32% now by C-section
what is premature VS very premature birth? what may cause it?
premature < 37 weeks
very premature < 32 weeks
delayed childbearing or increased maternal age, low SES
what is an APGAR score?
Appearance (color) Pulse Grimace (reflex irritability) Activity (muscle tone) Respiration
used to predict likelihood of immediate survival
what are some postpartum reactions?
- baby blues - exaggerated emotionally and tearfulness lasting a few days after birth
- due to oxytocin-dopamine interactions associated with maternal-infant bond
- social and psychological factors - major depression - occurs in ~10% of new mothers within one month of childbirth
- can persist for up to 1 year - postpartum psychosis - 0.1%
how do spheres of development occur?
- cephalad to caudad
- central to peripheral
- from self to others, and from understanding to expressing
what is the Chess and Thomas theory?
temperament (birth endogenous differences)
-activity level, reactivity to stimuli, cyclic behavior patterns, reactions to people, mood, distratibility, attention span
what is the Erik Erikson theory?
critical periods of social goals
what is the Jean Piaget theory?
cognitive or learning capabilities
what is the Margaret Mahler theory?
separation-individuation
what is the Freud theory?
parts of body in which pleasure is derived
what occurs in infancy to 18 mo?
- human need for seeking presence of others
- attachment
- social smile at 12 weeks
- stranger anxiety at 9 months
- separation anxiety in first year, but object permanence comes first
how much will a stranger understand if a 1, 2, 3, and 4 year old speak to them?
1 yo: 25%
2 yo: 50%
3 yo: 75%
4 yo: 100%
what are reflexes and instincts infants have?
necessary for survival
- rooting reflex: touch cheek –> turn to nipple
- palmar grasp reflex: grip any object put in palm
- Moro reflex: limbs extend when child is startled
- Babinski reflex: dorsiflexion of toes when sole of foot is stroked (disappears at 1 year)
what occurs in the toddler years (18 mo to 3 years)?
Rapprochment: moves away (separation), but quickly returns for comfort
- at age 2, show autonomy (“No!”) as “Terrible Twos”
- parallel play next to, but not with, other children
- at 3 yo: spend a few hours away from mother in care of another adult, gender identify
- at 4 yo: bowel function
- at 5 yo: bladder function
what is solitary, parallel, associative, and cooperative play?
solitary: alone
parallel: play next to another child, but not reciprocal
associative: play together, but different “goals”
cooperative: play together with same goal
what occurs in preschool years (3 to 6 years)?
- sibling rivalry
- regression (to get attention)
- between 2 to 4 yo: vocabulary increases dramatically (repeats bathroom words)
- active fantasy life (imaginary friends), but knows they’re not real
- at 4 yo: cooperative play
- strong fear of bodily injury (not good for elective procedures
- curiosity about bodies (play doctor)
what are milestones at 6 yo?
- development of child’s conscious (superego)
- sense of morality (right VS wrong)
- empathy
- learns that lying is wrong
- understanding finality of death (associated fears of losing loved ones)
what occurs in school age and adolescence (7 to 11 years)?
- psychosexual issues are dormant/latent
- industry VS inferiority (compare selves to others)
- lifelong sense of competence
- formal schooling starts, thus capacity for logical thought (reason and mathematics)
- concrete operations (more than one property, concept of conversion)
- learning problems identified
what are play and peer relationships for school age kids?
- relationships with adults who are not primary caregiver
- peer relationships with same sex
- not fitting in may cause them to get bossy or aggressive, depressed, anxious, or low self-esteem
- sexuality: latent, identify with parent of same sex
- morality: rule conscious (“play fair”) but by 12 they are more flexible
- more complex motor tasks (team sports for gross motor skills)
- illness: deal better with hospitalization
- by age 9: universality of death (know they can die too)
- acting out as defense mechanism
what are changes in the brain that occur in adolescence?
- myelination (increased white matter to gray matter volume)
- frontal and parietal lobes still developing
- pruning of up to 50% of synaptic connections, decline in glucose and O2 metabolism
what occurs in early adolescence (11-14 years)?
puberty is physical indicator (girls at 10.5 yo VS boys at 11.5 yo)
- first menstruation 11-14 yo
- first ejaculation 12-15 yo
- complete by 13.5 to 15 years (Tanner staging)
- usually more obedient (older would oppose)
what occurs in middle adolescence (15-17 years)?
- by age 15: body image and popularity
- prefer to spend time with friends over family
- risk taking behavior (frontal lobe breaking system still developing)
- education about obvious short-term benefits specifically (appearance, popularity)
- autonomy/need for privacy
- -less likely to comply with medical advice
what occurs in late adolescence (18 to 20 years)?
- identity crisis: define and refine place in world
- role confusion
- some but not all can develop abstraction (hypothetical and formal reasoning through calculus and formal operations)
explain teenage sexuality and pregnancy
- daily masturbation is normal
- homosexual experiences may or may not be initial expressions of orientation
- average first sexual intercourse at 16 yo, marriage at 23 yo (sex before marriage is norm)
- fewer than 1/2 of sexually active teens regularly use contraceptive
what are emotional and social factors that predispose to teen pregnancy?
- depression
- poor school achievement
- divorced parents
1/3 of American girls get pregnant before age 20
what are phonological disorders?
leaves out or misplaces speech sounds (ca = cat, top = stop)
what is articulation disorder?
unable to make necessary motor movements for accurate speec production (lisping)
what is selective mutism?
usually starts at age 6
what are 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 crisis)
- regression (may become more adolescent)
what are factors that increase divorce?
- short courtship
- teenage premarital pregnancy
- absence of family support
- prior divorce in family
- differences in religion or SES
- couples that experience serious illness in child
- ~20% higher when one spouse is physician (female, married prior to medical school, psychiatry)
what is there an increased risk for in single parent families?
physical and mental illness
what is there an increased risk for in parent divorces?
child is at higher risk for school failure, depression, drug abuse, suicide, criminal activity, divorce themselves
what does sole custody mean?
the parent who the child lives with has legal responsibility for the child and makes decisions about care
-other parent contributes to financial support and visits on scheduled basis
what does joint custody mean?
child spends part of the time living with each parent
what does split custody mean?
each parent has custody of at least one child in the family
when is the best time to tell a child he or she is adopted?
at earliest possible age
- told all that is known about biological parents
- decreases chances other people will tell
what occurs in early adulthood (20 to 40 years)?
- at 30: one’s role in society is defined, physical development at peak, and individual is independent
- -transition: love and work/intimacy VS isolation
- -Freud: love and gratifying work
- women often change paths in mid-30s, either by returning to work or becoming homemakers
- adopt parental values after years of rebellion and soul seeking
what occurs in middle adulthood (40 to 65 years)?
unique social responsibilities
- good health, more money, power, authority
- “Sandwich generation”: responsibilities to both older and younger relatives
- generativity VS stagnation: more life behind than ahead
- men: decrease in muscle strength, endurance, sexual performance
- women: menopause (ovaries stop functioning/menstruation stops)
- -most women have few significant physical/psychological changes
- -vasomotor instability: fatigue, sleep problems relieved by ERT (but long-term increases risk of cancer for uterus)
what are the losses that come with aging?
- loss of social status
- death of spouses, family members, and friends
- decline in overall health and strength
- most adjust well: freedom from responsibilities of work and childrearing
- ego integrity VS despair: pride in accomplishments or feels wasted life
what are the physical and neurological changes of aging?
neurological: decreased cerebral blood flow, decreased brain weight, amyloid plaques
- intelligence remains the same
- decreased nt availability (decreased secretion, increased monoamine oxidase, less responsive receptors)
- more sensitive to side effects, increased depression
what are psychosocial 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 (yet) as are child protective services
what is the psychopathology in elderly?
- depression: memory loss and cognitive problems called pseudodementia
- suicide rates increasing: social loss, physical illness or depression more common in elerly
- anxiety
- alcohol and substance abuse
- delirium (illness or depression)
what is bereavement VS complicated bereavement?
bereavement is normal grief
- both have initial shock and denial, but in CB, denial can last over days or weeks
- both have sadness, crying (normally subsides over 1-2 years), but if CB may intensify or persist over time
- -suicidal thinking, hallucinations (which may be okay in certain ways)
- anniversary reactions are common
- cultural differences (internal VS external expressions)
what is the role of physician in dying and death?
- make aware the diagnosis and prognosis
- reassurance that intense responses to news is expected
- serve as resource to family
- medically follow bereaved family members because of increased risk of morbidity and mortality
- resist emotional detachment
