lifespan development psychology 2012 – fall 2004

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Lifespan Lifespan Development Development Psychology 2012 – Fall 2004

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Lifespan DevelopmentLifespan Development

Psychology 2012 – Fall 2004

Introduction: Your Life Story

Developmental Psychology – branch of psychology that studies how people change mentally, physically, and socially throughout the lifespan– For every age and stage of life, developmental

psychologists investigate the influence of multiple factors on development,

• including biological, environmental, social, cultural, and behavioral factors

– Along with studying common patterns of growth and change, developmental psychologists look at ways in which people differ in their development

– Developmental psychologists often conceptualize the lifespan in terms of basic stages of development

Introduction: Your Life Story

– Traditionally, the stages of the lifespan are defined by age, which implies relatively sudden, age-related changes as we move from one stage to the next

• Some aspects of development, such as prenatal development and language development, are closely tied to critical periods

– Most of our physical, mental, and social changes, however, occur gradually,

• And the theme of gradually unfolding changes throughout the ages and stages of life will become more evident as we trace the typical course of human development in this chapter

– Another important theme is the interaction between heredity and environment,

• Traditionally called the nature-nurture issue

Genetic Contributions to Your Life Story

A chromosome is a long, threadlike structure composed of twisted parallel strands of deoxyribonucleic acid (DNA), – which is the chemical basis of all heredity

DNA contains the chemical genetic code that directs the growth and development of many of your unique characteristics – Each gene is a unit of DNA instructions pertaining to

some characteristic, • such as eye or hair color, or handedness

Genetic Contributions to Your Life Story

At conception, the genes carried on the 23 chromosomes contributed by your biological mother’s ovum were paired with– The genes carried on the 23 chromosomes

contributed by your biological father’s sperm

Multiple gene pairs are involved in directing many complex features of development

Genetic Contributions to Your Life Story

Dominant and Recessive Characteristics– Genotype – the underlying genetic makeup of a particular

individual– Phenotype – the actual displayed traits

When a genotype combines conflicting genetic information:– the dominant gene will influence the trait actually

displayed• Traits like freckles, dark eyes, dark hair, and dimples are referred

to as dominant characteristics– Because they require only one member of a gene pair to be dominant

for the trait to be displayed

Genetic Contributions to Your Life Story

A recessive gene is a gene whose instructions are not expressed if combined with a dominant gene– Only expressed if paired with another recessive gene

• Recessive characteristics – traits whose expression requires two identical recessive genes

– Like straight hair, attached earlobes, and flat feet

We inherit from our biological parents a genetic potential:– the expression of which can be influenced by

environmental conditions

Genetic Contributions to Your Life Story

The sex chromosomes and sex-linked recessive characteristics– The sex chromosomes (the 23rd pair of

chromosomes) determine biological sex• The large X chromosome carries more genes than

does the smaller Y chromosome, including genes for traits unrelated to sex

– In females, the 23rd pair of chromosomes is made up of two large X chromosomes

– In males, a large X chromosome and a smaller Y chromosome make up the 23rd pair of chromosomes

Genetic Contributions to Your Life Story

The sex chromosomes and sex-linked recessive characteristics– For males, the smaller Y chromosome often does not

contain a corresponding gene segment to match the one on the X chromosome.

• This means that a male can display certain recessive characteristics as the result of having only one recessive gene carried on the X chromosome

– Like red-green color blindness and hemophilia

• Sex-linked recessive characteristics – traits determined by recessive genes on the X chromosomes

Prenatal Development

At conception, chromosomes from the biological mother and father combine to form a single cell – the fertilized egg (zygote)

Prenatal stage – made up of three distinct phases:

1. Germinal (first two weeks), 2. Embryonic (weeks 3-8), and 3. Fetal (week 9-birth) periods

Prenatal Development

Germinal (zygotic) period – represents the first two weeks of prenatal development– The zygote undergoes rapid cell division

before becoming implanted on the mother’s uterine wall

– By the end of the two-week germinal period, the single-celled zygote has developed into a cluster of cells called the embryo

The Zygote

First Division

Second Division

Prenatal Development

The embryonic period – from weeks 3 to 8– During this time of rapid growth and intensive cell differentiation, the

organs and major systems of the body form.• Genes on the sex chromosomes and hormonal influences trigger the initial

development of the sex organs

– Protectively housed in the fluid-filled amniotic sac, the embryo’s lifeline is the umbilical cord

• Via the umbilical cord, the embryo receives nutrients, oxygen, and water and gets rid of carbon monoxide and other wastes

• The umbilical cord attaches the embryo to the placenta, a disk-shaped tissue on the mother’s uterine wall

– The placenta prevents the mother’s blood from mingling with that of the developing embryo,

• acting as a filter to prevent some, but not all, harmful substances that might be present in the mother’s blood from reaching the embryo

Prenatal Development

The embryonic period – from weeks 3 to 8– Teratogens – harmful agents or substances that can

cause malformations or defects in an embryo or a fetus;

• Known teratogens include:1. Exposure to radiation

2. Toxic industrial chemicals, such as mercury and PCBs

3. Diseases, such as rubella, syphilis, genital herpes, and AIDS

4. Drugs taken by the mother, such as alcohol, cocaine, and heroin

The Embryo

1 month old Embryo

Teratogens

Cocaine and Heroin: Miscarriage, prematurity, birth defects

Alcohol: Fetal alcohol syndrome, motor development problems

Smoking: Reduces oxygen flow, increases CO2, increases odds of prematurity, low birthweight, and miscarriage

Prenatal Development

The third month is the beginning of the fetal period, the final and longest stage of prenatal development– By the end of the third month, the fetus can move its arms, legs,

mouth, and head– During the fourth month, the mother experiences quickening – she

can feel the fetus moving– By the fifth month, the fetus has distinct sleep-wake cycles and

periods of activity– During the sixth month, the fetus’s brain activity becomes similar

to that of a newborn baby– During the final two months, the fetus will double in weight,

gaining an additional three to four pounds

Fetal Development

3 month old male Fetus

Development During Infancy and Childhood

Initially, the newborn’s behavior is mostly limited to reflexes that enhance his chances for survival.

– Some major newborn reflexes:1. The rooting reflex – the infant turns toward the source of the touch

and opens the mouth2. The sucking reflex – just touching the newborn’s lips evokes this

reflex3. The grasping reflex – the baby will grip your fingers so tightly that

he or she can be lifted upright

In addition, the newborn’s senses – vision, hearing, smell, and touch – are keenly attuned to people,

– helping the infant quickly learn to differentiate between the mother and other humans

Development During Infancy and Childhood

Vision is the least developed sense at birth– Optimal viewing distance for the newborn is

about 6-12 inches• The perfect distance for a nursing baby to easily

focus on his mother’s face and make eye contact

Newborns respond with increased alertness to the sound of human voices

Development During Infancy and Childhood

Physical development

– At birth, the newborn’s brain is 25% of its adult weight• Body weight is only 5% of its adult weight

– Newborns enter the world with an estimated 100 billion neurons

• After birth, the brain continues to develop rapidly– The number of dendrites increases dramatically during the first

two years of life– The axons of many neurons acquire myelin:

• the white, fatty covering that increases a neuron’s communication speed

Development During Infancy and Childhood

Physical development – The basic sequence of motor skill

development during infancy is universal, but average ages can be a little deceptive

• Each infant has his or her own:1. genetically programmed timetable of physical

maturation and

2. developmental readiness to master different motor skills

• Like rolling over, sitting up, and standing

Development During Infancy and Childhood

Social and personality development

– Forming close social and emotional relationships with caregivers is essential to the infant’s physical and psychological well-being

– Temperamental qualities: Babies are different• Inborn predispositions to consistently behave and react in a certain

way define temperament• Most researchers agree that temperament has a genetic and biological

basis:– although environment can modify a child’s basic temperament

• In the 1950’s Chess & Thomas rated young infants on a variety of characteristics:

– such as activity level, mood, regularity, and attention span

Development During Infancy and Childhood

About 2/3 of the babies could be classified into one of three broad temperamental patterns: easy, difficult, and slow-to-warm-up

a. Easy babies – readily adapt to new experiences, generally display positive moods and emotions, and have regular sleeping and eating patterns

b. Difficult babies – tend to be intensely emotional, are irritable and fussy, cry a lot, and tend to have irregular sleeping and eating patterns

c. Slow-to-warm-up babies – have a low activity level, withdraw from new situations and people, and adapt to new experiences very gradually

About 1/3 of the infants were characterized as average babies because they did not fit neatly into one of these three categories

TemperamentCharacteristic ways of responding to the environment that vary from infant to infant

(Data from Thomas, et al., 1970)

Development During Infancy and Childhood

Attachment: forming emotional bonds

– Attachment – the emotional bond that forms between infant and caregivers, especially the mother

• According to attachment theory, an infant’s ability to thrive physically and psychologically depends in part on the quality of attachment

• In all cultures, the emotional bond between between infants and caregivers is an important relationship:

– although there are cultural differences in how the attachment relationship is conceptualized and encouraged

• Infants can form multiple attachments

Development During Infancy and Childhood

Depending on the parents, infants can form secure or insecure attachments

– Secure attachment – occurs when parents are consistently warm, responsive, and sensitive to their infant’s needs

– Insecure attachment – may develop when an infant’s parents are neglectful, inconsistent, or insensitive to the infant’s moods or behaviors

VIDEO – Attachment – The Human Experience, segment 21

Development During Infancy and Childhood

The most commonly used procedure to measure attachment, called the “Strange Situation”, was developed by Ainsworth

– And is typically used with infants between 1-2 years old1. The mother stays with the child for a few moments, 2. She then departs, leaving the child with the stranger3. After a few minutes, mother returns, spends a few minutes in the

room, 4. She then leaves, and returns again

– Psychologists assess attachment by observing the infant’s behavior toward the mother during the Strange Situation procedure

Development During Infancy and Childhood

The securely attached infant will use the mother as a “secure” base from which to explore the new environment, periodically returning to her side;

– Will show distress when mother leaves and will greet her warmly when she returns.

– The mothers easily soothe securely attached babies

An insecurely attached infant is less likely to explore the environment, even when the mother is present and may appear either very anxious or completely indifferent

– Such infants tend to ignore or avoid their mothers when they are present• Some become extremely distressed when the mother leaves the room

and, when reunited, – they are hard to soothe and: – may resist their mothers’ attempt to comfort them

Development During Infancy and Childhood

Language development– By the time children reach three years of age, they

have learned:a. approximately 3,000 words and:b. the complex rules of their language

– According to linguist Noam Chomsky, every child is born with a biological predisposition to learn language – any language• That is, they possess what he calls a “universal grammar”:

– a basic understanding of the common principles of language organization

Development During Infancy and Childhood

At birth, infants can distinguish among the speech sounds of all the world’s languages

By 10 months, they distinguish only the speech sounds that are present in the language to which they have been exposed

Development During Infancy and Childhood

Motherese: encouraging language development– People in every culture use a style of speech called

motherese, or infant directed speech, with babies• Motherese is characterized by:

a. Distinct pronunciation,

b. A simplified vocabulary,

c. Short sentences,

d. A high pitch, and

e. Exaggerated intonation and expression

Development During Infancy and Childhood

The cooing and babbling stage of language development

– In virtually every culture, infants follow the same sequence of language development, and at roughly similar ages

1. Around 3 months – infant begins to “coo”

1. Around 5 months – infant begins to “babble”– Infants all over the world use the same sounds when they babble,

• including sounds that do not occur in the language of their parents and other caregivers

1. Around 9 months – infant begins to babble more in the sounds specific to their language– Babbling seems to be a biologically programmed stage of language

development

Development During Infancy and Childhood

The one-word stage of language development

– Long before babies become accomplished talkers, they understand much of what is said to them.

• Thus, they have a comprehension vocabulary (words they understand) that is much larger than:

• their production vocabulary (the words they can say)

– Around their first birthday, infants produce their first real words• Usually referring to concrete objects or people that are important to

the child– Such as mama, dada, or ba-ba (bottle)

• During the one-word stage, babies use a single word and vocal intonation to stand for an entire sentence

– “ba-ba = “I want my bottle”

Development During Infancy and Childhood

The two word stage of language development

– Around their second birthday, infants begin putting words together to construct a simple “sentence”

• Such as “Mama go,” & “Where kitty,”

– These utterances include only the most essential words, • but basically follow a grammatically correct sequence

– Children move beyond the two-word stage at around 2½ years of age

• Language production and comprehension increase dramatically thereafter

Development During Infancy and Childhood

Gender-role development– Gender – refers to the cultural and social

meanings that are associated with maleness or femaleness

a. Gender roles – behaviors, attitudes, and personality traits that a given culture designates as either masculine or feminine

b. Gender identity – a person’s psychological sense of being male or female

Development During Infancy and Childhood

Between the ages of 2 and 3, children can identify themselves and other children as boys or girls, – although the details are still a bit fuzzy for them

From about 18 months to the age of 2 years, sex differences in behavior begin to emerge– Toddler girls play more with soft toys and dolls,

• and ask for help from adults more than toddler boys do

– Toddler boys play more with blocks and transportation toys (trucks and wagons),

• and play more roughly

Development During Infancy and Childhood

Explaining gender roles: Two contemporary theories

1. Social learning theory – gender roles are learned through reinforcement, punishment, and modeling

2. Gender schema theory – children actively develop mental categories/schemas (mental representations) for masculinity and femininity • Gender schemas:

– Influence how people pay attention to, perceive, interpret, and remember gender-relevant behavior

– Seem to lead children to perceive members of their own sex more favorably than members of the opposite sex

– Help children to readily assimilate new information

Piaget’s Stages

According to Piaget, children progress through four distinct cognitive stage

1. Sensorimotor (0-2 years)

2. Preoperations (2-7 years)

3. Concrete Operations (7-12 years)

4. Formal Operations (12 and up)

– As a child progresses to a new stage, his/her thinking is qualitatively different

Piaget’s Stages

Sensorimotor

Understand the world through senses and motor actions

Develop object permanence – the idea that an object still exists even if it can’t be seen

CD ROM: Obj. Perm. (#15)

Piaget’s Stages

Preoperative (“before logic”)

Symbolic thought – ability to use words, images, and symbols to represent the world

Thinking is egocentric (the inability to take another person’s perspective)

Piaget’s Stages

Concrete Operations Can do logical operations

Understand reversibility

Can do conservation – two equal quantities remain equal even if the appearance of one has changed

Piaget’s Stages

Formal Operations:

Can do abstract & hypothetical reasoning

Development During Infancy and Childhood

CD ROM: Piaget’s Conservation Task (#18)

Studying Piaget’s theory– Generally, scientific research has supported Piaget’s

most fundamental idea: • That infants, young children, and older children use distinct

cognitive abilities to construct their understanding of the world

– Other aspects of Piaget’s theory have been criticized

Development During Infancy and Childhood

Three criticisms of Piaget’s theory

I. Inaccurate assessment of object permanence

II. Piaget’s stages are not as universal as he believed

III. Underestimation of the impact of the social and cultural environment on cognitive development

Development During Infancy and Childhood

Criticisms of Piaget’s theory

I. Today, many researchers believe that in assessing object permanence during infancy, Piaget confused:

• motor skill limitations with:• cognitive limitations

• Bailargeon – used visual tasks, rather than manual tasks to challenge Piaget’s belief regarding the age at which infants acquire object permanence– 3 ½ month-old infants looked longer at a carrot that cannot

be seen through a window• Showing object permanence much earlier than Piaget

thought

Development During Infancy and Childhood

Criticisms of Piaget’s theory

II. Piaget’s stages are not as universal as he believed• Researchers have found that many adults display abstract-

hypothetical thinking only in limited areas of knowledge, – And some adults never display formal operational thought

processes

• Some developmental psychologists emphasize the information-processing model of cognitive development – Focuses on the development of fundamental mental

processes like attention, memory, and problem solving– Cognitive development is viewed as continuously changing

over the lifespan

Development During Infancy and Childhood

Criticisms of Piaget’s theory

III. Piaget underestimated the impact of the social and cultural environment on cognitive development

• Russian psychologist Vygotsky believed that cognitive development is strongly influenced by social and cultural factors– Such as the support and guidance that children receive from

parents, other adults, and older children

• Cross-cultural studies show that cognitive development is strongly influenced by: – the skills that are valued and encouraged in a particular

environment

Vygotsky’s View

Cognitive ability falls in the "Zone of Proximal Development"

Kid’s performance without help

Kid’s performance with help

Zone of Proximal Development

Adolescence

A transitional stage between late childhood and the beginning of adulthood, during which:

1. sexual maturity is reached2. identity is explored

– Physical and sexual development• Puberty – tends to follow a predictable sequence for each sex

1. Internally, puberty involves the development of the primary sex characteristics

• The sexual organs that are directly involved in reproduction, such as the female’s uterus and the male’s testes

2. Externally, puberty involves the development of the secondary sex characteristics

• Characteristics not directly involved in reproduction, but still signal sexual maturity

• Such as changes in height, weight, and body shape, appearance of body hair, voice changes, and in girls, breast development

Adolescence Some statistics:

1. Females are typically about two years ahead of males in terms of physical and sexual maturation

2. The adolescent growth spurt – the period of marked acceleration in weight and height gains• Occurs about two years earlier in females than in males

3. Menarche – a female’s first menstrual period, typically occurring around age 12 or 13• May take place as early as 9-10 or as late as 16-17

4. During early and middle adolescence, the physical changes of puberty:• Drive much of the adolescent’s interest in sexuality,

– although social and cultural factors also have an influence

5. Age is a good predictor of when teenagers typically begin various sexual behaviors

Adolescence

Social development

– As a general rule, when parent-child relationships have been good before adolescence,

• they continue to be relatively smooth during adolescence

• However:– Relationships with friends and peers become increasingly more

important

• Peer relationships tend to reinforce the traits and goals that parents fostered during childhood

The Adolescent’s Peers

Give feedback on social behavior

Provide an objective standard for self-comparison

Teach social skills

Adolescence

Identity formation: Erik Erikson’s theory of psychosocial development

– Identity – a person’s definition or description of himself or herself• Including values, beliefs, and ideals that guide the individual’s

behavior

• Erikson’s theory of psychosocial development – consists of eight stages throughout the lifespan– Believed that the key psychosocial conflict facing the adolescent is

identity versus identity diffusion1. The adolescent’s path to successful identity development

begins with identity diffusion2. This is followed by a moratorium period3. Gradually, the adolescent arrives at an integrated identity

Erickson’s Stages of Psychosocial Development

Stage Age

1. Trust vs. Mistrust 0-1

2. Autonomy vs. Shame & Doubt 1-3

3. Initiative vs. Guilt 3-6

4. Industry vs. Inferiority 6-Puberty

5. Identity vs. Role Confusion Adolescence

6. Intimacy vs. Isolation Young Adult

7. Generativity vs. Stagnation Middle-Age

8. Integrity vs. Despair Old Age

Adolescence

The development of Moral Reasoning

– The aspect of cognitive development that has to do with the way an individual reasons about moral decisions

– The most influential theory of moral reasoning was proposed by Kohlberg, • whose theory proposed three distinct levels of moral reasoning:

1. Preconventional - avoiding punishment/maximizing gain2. Conventional - social roles, rules, and obligations3. Postconventional - internalized legal and moral principles

• Each level is based on the degree to which a person conforms to conventional standards of society

• Each level has two stages that represent different degrees of sophistication in moral reasoning

Adolescence

1. The responses to children under 10 reflect preconventional moral reasoning

– Based on self-interest – avoiding punishment and maximizing personal gain

2. Beginning in late childhood and continuing through adolescence and adulthood, responses typically reflect conventional moral reasoning

– Emphasizes social roles, rules, and obligations

3. Postconventional moral reasoning is guided by internalized legal and moral principles:

– that protect the rights of all member of society

Kohlberg’s Theory

Preconventional Level:– Stage 1 -- Punishment avoidance is

"right"– Stage 2 -- Whatever benefits the

individual is "right"

Conventional Level:– Stage 3 -- Behavior that pleases

others is "right”– Stage 4 -- Authorities & rules

determines what's "right"

Post-Conventional Level:– Stage 5 -- Protecting both society

and individual is "right”– Stage 6 -- Universal principles

determine "right"

% Moral Statements

(Data from Kohlberg, 1963)

Adolescence

Criticisms of Kohlberg’s theory

1. Research was done on all males, but theory was applied to males and females• Gilligan – model is based on an ethic of individual rights

and justice, which is a more common perspective for males– She developed a model of women’s moral development that

is based on an ethic of care and responsibility

2. Some cross-cultural psychologists argue that Kohlberg’s stories and scoring system reflect:• a Western emphasis on individual rights, harm, and justice

that is not shared in many cultures

Adult Development

Physical changes– Our unique genetic blueprint greatly influences the unfolding of certain

physical changes during adulthood• Such changes vary significantly from one person to another

– For example, menopause (the cessation of menstruation that signals the end of reproductive capacity in women) may occur anywhere from the late thirties to the early fifties

– Staying mentally and physically active and eating a proper diet can both slow and minimize the degree of physical decline associated with aging

– Physical strength typically peaks in early adulthood (the 20’s and 30’s)• Strength and endurance gradually decline in middle adulthood (40’s

to mid 60’s)• Physical strength and stamina decline further and faster during late

adulthood (mid 60’s on)

Adult Development

Social development

– In his theory of psychosocial development, Erikson described two fundamental themes that dominate adulthood: love and work

• According to Erikson, the primary psychosocial task of early adulthood is to:

– form a committed, mutually enhancing, intimate relationship with another person

• During middle adulthood, the primary psychosocial task becomes one of generativity:

– The need to contribute to future generations through your children, your career, and other meaningful activities

Adult Development

The focus of adult friendships is somewhat different for men and women

– Female friends tend to:• confide in one another about their feelings, problems, and

interpersonal relationships

– Male friends typically:• minimize discussions about relationships or personal feelings

or problems; – Instead, male friends tend to do things together that they find

mutually interesting, • such as activities related to sports or hobbies

Adult Development

Establishing a committed relationship takes on a new urgency in adulthood: – getting married and starting a family are the traditional

tasks of early adulthood• Today, young adults are postponing marriage so they can

finish their education and establish a career

– As a general rule, we tend to be attracted to and marry people who are similar to us on a variety of dimensions,

• Including physical attractiveness, social and educational status, ethnic background, attitudes, values, and beliefs

Age of First Marriage

(Data from Census Bureau, 1994)

Adult Development

The transition to parenthood– Marital satisfaction tends to decline after the

birth of the first child• It tends to rise again after the children leave home

Adult Development

The nature of intimate relationships and family structures varies widely in the US– In the 1990’s well over 3 million unmarried couples

were living together– More than half of all first marriages end in divorce

• Thus, remarrying and starting a second family is not unusual

– It may be that any relationship that promotes the overall sense of happiness and well-being for the people involved is a successful relationship

U.S. Households

Reasons for Divorce

Adult Development

Careers in adulthood

1. Researchers have found that close to 1/3 of people in their late twenties and early thirties:• do not just change jobs within a particular field,

– but completely switch occupational fields

2. Dual-career families have become increasingly common• Multiple roles seem to provide both men and women with a

greater potential for:– increased feelings of self-esteem, happiness, and competence;

• The critical factor is not the number of roles that people take on, but the quality of experiences on the job, in the marriage, and as a parent

Late Adulthood and Aging

The average life expectancy:– for men is about 72 years old; – for women, it is about 79 years

The majority of older adults live healthy, active, and self-sufficient lives

The number of older adults in the US has been gradually increasing over the past several decades

Late Adulthood and Aging

Cognitive changes

– Psychologist Schaie and his colleagues have conducted longitudinal studies:

• following some 5,000 people as they have aged to learn what happens to intellectual abilities

– Schaie’s findings: general intellectual abilities gradually increase until the 40’s,

• Then become relatively stable until about 60, • When a small but steadily increasing percentage of older adults

experience slight declines on tests of general intellectual abilities

– Schaie found that those who were better educated and engaged in physical and mental activities throughout older adulthood:

• showed the smallest declines in mental abilities

Late Adulthood and Aging

Social Development– The activity theory of aging

• Psychosocial theory that life satisfaction in late adulthood is highest when:

– people maintain the level of activity they displayed earlier in life

– Along with satisfying social relationships, the prescription for psychological well-being in old age:

• includes achieving what Erikson called Ego Integrity – The feeling that one’s life has been meaningful, vs.

• Despair – feelings of regrets or bitterness about past mistakes, missed opportunities, or bad decisions; a sense of disappointment in life

– Often the themes of ego integrity or despair emerge as older adults engage in life review

• Thinking about or retelling their life story to others

Living Arrangements

Living Arrangements

The Final Chapter: Dying and Death

Attitudes toward dying and death are as diverse in late adulthood as they are throughout the lifespan– In general, anxiety about death tends to peak

in middle adulthood, • then decrease in late adulthood

The Final Chapter: Dying and Death

Elisabeth Kubler-Ross interviewed over 200 terminally ill patients and proposed that the dying go through five stages

1. Denial of death2. Anger at the notion of dying3. Bargaining – making a “deal” with doctors, relatives, or God4. Depression5. Acceptance

Further research indicates that individuals who are dying do not progress through a predictable sequence of stages

– Dying is as individual a process as is living• People cope with the prospect of dying much as they have

coped with other stresses involved in living