07 normal development

Upload: krysdana22

Post on 29-May-2018

216 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/9/2019 07 Normal Development

    1/22

  • 8/9/2019 07 Normal Development

    2/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org2

    CHAPTER 7 Topic Headings

    TOWARD AN INTEGRATED THEORETICAL MODEL

    OF MENTAL DEVELOPMENT

    Biopsychosocial StimuliObject Relationships and Experiential Mental

    Structural Representations

    Cognition and Memory

    Developmental Change

    Mental Organizing Principles

    Zone of Proximal Development

    Developmental Tasks

    INFANCY PHASE OF MENTAL DEVELOPMENT

    (BIRTH TO AGE 18 MONTHS)

    Major Developmental Tasks of InfancyFunctions of the Social Environment

    Providing Truthful Information About the Infants Body

    and Surrounding World

    Providing Stimulus Modulation and Protection

    Providing Encouragement, Support, and Admiration

    Providing Truthful Information About Achieving

    Gratification of Innate Needs

    Providing Adaptive Solutions to Emotionally

    Displeasurable Life Events

    The Organizational Mental Structures of the Id,Ego, Superego, and Self

    Maturation and Development of Innate Needs:

    The Oral Phase

    Innate Physiological NeedsNeed to Assertively Explore the Social Environment

    Human Motivation: The Central Role of Emotions

    Maturation and Development of Physical Capabilities

    Reflexive Abilities

    Perceptual Abilities

    Maturation and Development of Cognitive Capabilities

    Acquiring Knowledge in the Sensorimotor Phase

    Discrepant Events

    Maturation and Development of Temperamental

    CharacteristicsMaturation and Development of Emotions

    Role of Emotions

    Parents Interpretations of Infants Emotions

    Infants Ability to Perceive Others Emotions

    Development of the Self and Object Relationships

    Developing Self-Value While Engaging in Transactional

    Relationships With Others

    Developing a Sense of Separateness

    The Attachment Relationship

    The Triadic Attachment RelationshipPhases in the Attachment Relationship

    Maturation and Development of Adaptational Capabilities

    (continued)

  • 8/9/2019 07 Normal Development

    3/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org3

    CHAPTER 7 Topic Headings (continued)

    TODDLERHOOD PHASE OF MENTAL DEVELOPMENT

    (AGES 18 MONTHS3 YEARS)

    Major Developmental Tasks of ToddlerhoodFunctions of the Social Environment

    Maturation and Development of Innate Needs:

    The Anal Phase

    Maturation and Development of Physical

    Capabilities

    Maturation and Development of Cognitive

    Capabilities

    Emergence of Objective Self-Awareness

    Continued Development of Conceptual Thinking

    Maturation and Development of TemperamentalCharacteristics

    Maturation and Development of Emotions

    Maturation and Development of Verbal Language

    Abilities

    Development of Verbal Language

    Speech as Facilitator of an Autonomous Identity

    Maturation and Development of the Preexisting

    Representational World

    Development of the Self and Object Relationships

    Development of Autonomous and Gender IdentitiesFormation of a Gender Identity

    Mastery Over Bodily Functions: Toilet Training

    Advances and Regressions in Achievement of

    Autonomy

    The Rapprochement Subphase of Separation

    Individuation

    Development of the Superego

    Development of Adaptational Capabilities

    Development of New Defense MechanismsEffect of Parents Use of Defense Mechanisms on Their

    Toddlers Use of Defense Mechanisms

    EARLY CHILDHOOD PHASE OF MENTAL DEVELOPMENT

    (AGES 36 YEARS)Major Developmental Tasks of Early Childhood

    Functions of the Social Environment

    Fostering Childrens Healthy Narcissism in Conjunction With

    Their Developing Reciprocal Relationships With Others

    Development of a True Self

    Healthy and Unhealthy NarcissismMaturation and Development of Innate Needs:

    The Early Genital Phase

    Maturation and Development of Physical Capabilities

    Maturation and Development of Cognitive Capabilities

    Ways Self-Reflective/Mentalizing Parents Help Their

    Children Develop Reality-Based Thinking

    Maturing of the Minds Executive Functions

    Maturation and Development of Temperamental

    Characteristics

    Maturation and Development of EmotionsConstruction of Rules for Emotional Display

    Emotions as Energy Mobilizers

    Traumatic Emotional Memories as Unconscious Energy

    Mobilizers

    Emotions as Self-Regulators

    Emotions as Facilitators of Social Adaptation

    (continued)

  • 8/9/2019 07 Normal Development

    4/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org4

    CHAPTER 7 Topic Headings (continued)

    Maturation and Development of Verbal Language

    Abilities

    Maturation and Development of the PreexistingRepresentational World

    Development of the Self and Object Relationships

    Development of a Sexual Identity: Emergence

    of the Early Genital Phase

    Development of a Peer Identity

    Development of the Superego

    Development of Adaptational Capabilities

    LATE CHILDHOOD PHASE OF MENTAL

    DEVELOPMENT (AGES 612 YEARS)

    Major Developmental Tasks of Late ChildhoodFurther Development of a Peer Identity

    Development of a Social Identity

    Functions of the Social Environment

    Maturation and Development of Innate Needs

    Need for Fulfillment of Physiological Needs Related

    to Bodily Regulation and Physical Survival

    Need to Assertively Explore the Social Environment

    Need for Human Attachment in Emotionally

    Pleasurable Interactions

    Need for Emotionally Pleasurable SensorySexualStimulation and Gratification

    Need to Signal Distress When Experiencing Emotionally

    Displeasurable Over- or Understimulation and

    to Initiate Other Fight-or-Flight Behavioral and

    Mental Responses

    Maturation and Development of Physical Capabilities

    Maturation and Development of Cognitive Capabilities

    Emergence of More Complex Mental OperationsDifferentiation of Primary and Secondary Process Thinking:

    Development of Masking and Latent Symbols

    Maturation and Development of Temperamental

    Characteristics

    Maturation and Development of Emotions

    Maturation and Development of Verbal Language Abilities

    Maturation and Development of the Preexisting

    Representational World

    Development of the Self and Object Relationships

    Continued Development of Gender and Sexual IdentitiesDevelopment of Gender Identity

    Development of Sexual Identity

    Development of the Superego

    Development of Adaptational Capabilities: Evolution of New

    Defense Mechanisms

    ADOLESCENCE PHASE OF MENTAL DEVELOPMENT

    (AGES 1219 YEARS)

    Major Developmental Tasks of Adolescence

    Maturation and Development of Physical Capabilities

    Maturation and Development of Cognitive CapabilitiesEmergence of Hypothetical Thinking

    Construction of the Concept of an Unconscious Mental

    Domain

    (continued)

  • 8/9/2019 07 Normal Development

    5/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org5

    CHAPTER 7 Topic Headings (continued)

    Maturation and Development of Emotions:

    Development of Emotional Self-Awareness

    Emotions as Energy MobilizersEmotions as a Means of Self-Regulation

    Emotions as an Aid in Achieving Social Adaptation

    Maturation and Development of Verbal Language

    Abilities

    Development of the Self-Representation and

    of Object Representations

    Constructing an Emancipated Identity While

    Maintaining Transactional Relationships With

    Important Others

    Object Relations Conflicts and Structural ConflictsGenerational Conflicts

    Adoption of a False Identity

    Parents Role in Facilitating Formation of

    Emancipated Identity

    Further Development of Sexual and Social Identities

    Pubertal Changes

    Reemergence of the Early Triangular PhaseInitiation of Sexual Activity

    Development of the Superego

    Construction of Realistic Ambitions and Reasonable Ideals

    A Confused Conscience

    Attainment of an Integrated Conscience

    Development of Adaptational Capabilities: Emergence

    of More Socially Mature Mechanisms of Defense

    Transitioning From Adolescence to Young Adulthood:

    Criteria for Adulthood

    Establishment of Autonomy From Parents (Self-Autonomy)Establishment of Realistic Goals (Realistic Self-Image)

    Establishment of a Stable Sexual Identity

    Establishment of a Sense of Continuity Between Past Life

    Experiences and Current Motivations and Beliefs

    CONCLUSION

  • 8/9/2019 07 Normal Development

    6/22

  • 8/9/2019 07 Normal Development

    7/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org7

    TABLE 71. Components of each

    developmental phase

    Each aspect of normal development can be envisioned not as a unique characteristic that appears at a

    specific age but rather as a capacity that emerges during a certain period and then continues to evolve

    from one developmental phase to the next. The developmental process is continuous, in that each phase

    of development builds upon the previous phase and leads to the next. Table 71 lists the mastery areas

    for each developmental phase.

  • 8/9/2019 07 Normal Development

    8/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org8

    TABLE 72. Developmental phases and key tasks

    Developmental tasks generally can be defined for each phase of the life cycle from infancy through

    adolescence (Table 72). These tasks determine what knowledge and behaviors the infant will be more

    or less expected to acquire and master in order to become a productive member of society, and how

    each child must adapt his or her innate and maturationally emerging needs, emotions, temperamental

    characteristics, and cognitive capabilities to societys rules and guidelines concerning their proper

    verbal and behavioral expression.

  • 8/9/2019 07 Normal Development

    9/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org9

    TABLE 73.

    Ego functions

    The ego performs a variety ofego functions (Table 73). The ego operates silently and henceunconsciously. Infants and children will never directly experience their egos; they will experience them

    only indirectly through observing the products of their egosnamely, their own mental and behavioral

    abilities and surface and verbal behaviors.

  • 8/9/2019 07 Normal Development

    10/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,

    Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org10

    TABLE 74. Piagets phases of cognitive maturation and development

    According to Piaget, there are four major phases of cognitive maturation and development, each of

    which is qualitatively and quantitatively different from the preceding phase (Table 74). The age spans

    listed for the phases are approximations of when most children can be expected to show the specific

    cognitive developmental achievements characteristic of that particular phase.

  • 8/9/2019 07 Normal Development

    11/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    11

    TABLE 75. Schema or mental representations

    Infants continue to acquire knowledge and learn by acting on and reacting to their environment; in

    this way, motor actions become the initial basic triggers for acquiring new knowledge. The repetition

    of behaviors makes up a set of experiences that eventually become an internal mental representation

    called a schema. This schema then becomes a new unit of knowledge for the infant (Table 75).

  • 8/9/2019 07 Normal Development

    12/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    12

    TABLE 76. Phenomenological categories of infant temperament: action and reaction

    patterns

    Researchers have found evidence indicating that infants temperamental characteristics (Table 76)

    undergo maturation. Both innate and maturationally emerging temperamental characteristics operate as

    psychological stimuli that interact with the social environment and ultimately lead infants to construct

    representations of each of their temperamental traits.

    Source. Studies ofThomas and Chess (1977) and Chess and Thomas (1989).

  • 8/9/2019 07 Normal Development

    13/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    13

    TABLE 77. Characteristics of

    defense mechanisms

    Functioning as mental safety valves,

    defense mechanisms (Table 77) enable

    the child to regain a momentary state of

    emotional self-regulation and a sense of

    control when an intensely

    unpleasurable emotion threatens tobreak into consciousness. In all

    definitions of defense mechanisms, it is

    acknowledged that use of these

    mechanisms should be transient,

    because they are mental processes that

    suspend the childs necessary and

    healthy engagement in resolving

    external and internal developmental

    conflicts.

  • 8/9/2019 07 Normal Development

    14/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    14

    TABLE 78.

    Executive ego

    functions

    In recent years, developmentalists have identified many of the cognitive functions that mature during the

    first 4 years of life and continue to be used by children. These functions, named executive ego functions,are used by the childs self, the minds superordinate or executive organizational structure. The self

    functions unconsciously and exerts an overriding organizing and regulating control over the id, ego, and

    superego. These executive functions, as outlined by Brown (2006), mediate how the mind organizes tasks

    (Table 78).

    Source. Brown 2006.

  • 8/9/2019 07 Normal Development

    15/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    15

    TABLE 79. First resolution of triangular wishes (age 67 years)

    Triangular wishes in heterosexual children decrease when children begin to put aside (but do not

    completely give up) their wishes to have what the same-gender parent has and do what the same-gender

    parent does (Table 79).

  • 8/9/2019 07 Normal Development

    16/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    16

    TABLE 710. Preparations for beginning first grade (age 56 years)

    The dominant triggering social variable in the biopsychosocial model of mental development from 611

    years of age is the social requirement (in most countries, it is a law) for all children to attend school. In

    essence, going to school is the job of late childhood (Table 710).

  • 8/9/2019 07 Normal Development

    17/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    17

    TABLE 711. Components of an

    emancipated identity

    The attainment of an emancipated identityis the major developmental task of

    adolescence; as such, it is not fully

    achieved until the completion of

    adolescence, by age 18 or 19 years.

    Although Erikson did not use the termemancipated, his definition of identity in

    adolescence is the same as that

    delineated in Table 711.

  • 8/9/2019 07 Normal Development

    18/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    18

    TABLE 712.

    Adolescence phase:

    the function of

    superego as an

    internal regulator

    of behavior

    During adolescence as during childhood, the peer group rescues teenagers from feeling too disappointed

    and anxious about becoming emancipated, and they can eventually relinquish their view of their parents

    as all-protecting and all-admiring. In so doing, teenagers feel, for a while, a sense of loss in losing their

    parents as a source of admiration and positive self-esteem (Table 712).

  • 8/9/2019 07 Normal Development

    19/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    19

    CHAPTER 7 Key Points

    Accommodationtransformation principleThe principle that becomes

    activated when stimuli create perceptions or conceptions that cannot be

    assimilated into prior representations. When this occurs, the infant will either

    change a preexisting representation to include the new perception or

    conception or add a new representation to his or her mental world.

    Attachment relationshipThe specific relationship that develops between

    infants and their parents.

    BeliefA type of conception that, as a representational mental structure,

    establishes the relationship between two or more inanimate objects, aspects

    of natures laws, or people (e.g., the child and his or her mother).

    Child protective factorA characteristic within the child, the parents, the

    childparent relationship, and/or the society in which the child is living that

    helps the child and the parents achieve developmental adaptations and

    maintain their goodness-of-fit transactions.

    Developmental continuityThe term used to address the fact that a greatpart, but not all, of psychological development is dependent on what took

    place in the past.

    (continued)

  • 8/9/2019 07 Normal Development

    20/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    20

    Developmental discontinuityAn event in a persons life that is

    unexpected and not predictable from what has occurred in the persons past. Developmentally enhancing adaptationsAdaptations by the child that

    enhance the childs feelings of competency, pleasure in mastering a task, and

    feelings of joyful pride.

    Disintegration anxietyThe internally generated fear that if anyone knew

    how imperfect or impotent the child believes himself or herself to be, others

    would totally reject him or her. Experiential mental structuresThe emotions (e.g., shame, guilt), thoughts

    (perceptions and conceptions), and memories (short- and long-term) that are

    the result of the minds processing of transactions between biopsychosocial

    stimuli.

    Hierarchical restructuring principleThe principle that states that as a

    childs cognitive abilities continue to mature and his or her mind continues toreconstruct prior representations to reflect a more advanced level of cognitive

    integration and comprehension, the childs mind will reorganize its

    representations into a hierarchy that reflects the childs unique preferences.

    CHAPTER 7 Key Points (continued)

    (continued)

  • 8/9/2019 07 Normal Development

    21/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    21

    CHAPTER 7 Key Points (continued)

    Inner mental world or representational worldThe inner world we refer to

    as an individuals mind, which is in contrast to the outer world of people andthings.

    Mentalizing functionThe capacity to use self-reflection to become aware

    of the existence of possessing a mind and to gradually understand ones

    mind and the minds of others as being complex, with different emotions,

    beliefs, and conflicts.

    Normal developmental external conflictAn aspect of normaldevelopment that occurs when there is a disparity between the childs current

    need, wish, and/or impulse and the desires of the parents or others with

    whom the child is relating.

    Normal developmental internal conflictAn aspect of normal development

    that occurs when there is a disparity between what the child desires to do,

    fantasizes about, or believes and an inner voice that prohibits or warns the

    child that a developmental calamity will occur if the child acts upon his or her

    impulse, desire, and/or fantasy.

    (continued)

  • 8/9/2019 07 Normal Development

    22/22

    The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org

    22

    CHAPTER 7 Key Points (continued)

    Normogenic beliefA belief, developed by the child, that enhances the

    childs psychological development. Such a belief enables the child togenerate positive expectancies about new life events and people.

    Pathogenic beliefA belief, developed by the child, that interferes with the

    childs psychological development. Such a belief functions as an internal

    inhibiting factor in that it causes the child to generate negative expectancies

    about new life events and people.