Developmentalism Principles physiological development drives psychosocial development time

Developmentalism Principles: • physiological development drives psychosocial development • time is a major determinant of personality development • “stages of development” exist; stages cannot be skipped, missed, or avoided

Developmental Tasks of Infancy • • • Motor Skills Emotive Skills Cognitive Skills Social Skills Integrative skills

I. Stages of Motor Development 1 month 2 months 3 months 4 months 6 -7 months 8 months 11 months 12 months 17 months Lifts head while lying on stomach Lifts chest while lying on stomach Rolls over Sits up with support Sits up alone Crawls, stands up with help Stands alone Walks up steps

II. Stages of Emotional Development • Attachment related to genetically based behaviours (crying, sucking, smiling, clinging and following) • Attachment is active and reciprocal • Separation anxiety caused by absence of the attachment figure

Attachment • Parents who respond to cries promptly • Appropriate responsiveness of parent more important than time of physical closeness • Categorization of infants: Secure Insecure Ambivalent-resistant Avoidant

III. Stages of Cognitive Development • Piaget • • Sensorimotor Pre-operational Concrete operational Formal Operational

Sensorimotor Stage • 0 -2 years of age • Use of senses and motor abilities to understand respond to the world • Object permanence • Cause-effect reasoning • The development of memory

Pre-operational Stage • • 2 -6 years of age Ability to hold mental representations Pretending, play are possible Ego-centric world-view (“I” vs “you”) Ability to think symbolically “The Explosion of Words” Consequential thinking

Concrete Operations • 7 -11 years of age • Progressive ego-decentering • Ability to classify, categorize, draw generalizations, stereotype • Ability to consequentialize and seriate (put things in order) • Able to use inductive and deductive logic

Formal Operations • • 12+ years of age Able to form and test mental hypothesis Able to deal with abstractions Able to understand (though not deal with) ambiguity

IV. Stages of Social Development • Belenky’s “Women’s Way of Knowing” • Culture Shock Model • Perry’s Development of College-Aged Students

Erikson’s Stages of Human Development

Erikson’s Stages of Human Development

Stage 1: Infancy (0 -1) • Crisis: Trust vs. Mistrust • Description: In early life, infants must rely entirely upon adults to meet basic physiological needs • Positive Outcome: If needs are met consistently and responsively, secure attachment will form

Stage 2: Toddler (1 -2) • Crisis: Autonomy vs. Doubt Independence vs. Shame • Description: Toddlers learn to walk, talk, use toilets, etc. which represents self-control • Positive Outcome: Confidence to cope with situations that require initiative, choices, control and independence

Stage 3: Early Childhood (2 -6) • Crisis: Initiative vs. Guilt • Description: Children discover their own power, and must learn to control impulses and childish fantasies • Positive Outcome: Children learn, with consistent discipline to accept without shame that certain things are not allowed

Stage 4: School Years (6 -12) • Crisis: Industry/Competence vs. Inferiority • Description: Transition from world of home to world of peers and others • Positive Outcome: Pleasure in intellectual stimulation, being productive and succeeding in competition

Stage 5: Adolescence (13 -20) • Crisis: Identify vs. Role Confusion • Description: With the onset of puberty, children struggle to determine their owh characters, independent of family • Positive Outcomes: Grounded acceptance and sense of self, and one’s own strengths and limitations

Stage 6: Early Adulthood (20 -35) • Crisis: Intimacy vs. Isolation • Description: Adults learn to share feelings with others and develop intense, mutual inter-dependent relationships with others • Positive Outcomes: The ability to relate and share emotions and thoughts with others and to learn and grow from this

Stage 7: Middle Adulthood (35 -55) • Crisis: Generativity vs. Stagnation • Description: At the peak of their working lives, adults need to contribute meaningfully to society • Positive Outcomes: Artefacts, creativity, insight, accomplishment, success

Stage 8: Late Adulthood (55+) • Crisis: Integrity vs. Despair • Description: Towards the end of life, adults must come to terms with their lives and accept all their dreams did not come true • Positive Outcome: Death with dignity

Developmental Explanation for Emotional Responses Rage: (anger due to frustrated desire) Guilt: (self-recrimination due to lack of control) Self-conciousness: (fear of negative evaluation by others) Embarrassment: (experiencing negative evaluation by others) Shame: (enduring state of embarrassment) Social Anxiety: (avoidant/withdrawal behaviours)

Behaviours that emerge as a result of emotional responses • • • Denial (distorting reality) Downward social comparison Self-handicapping Self-focus/narcissism Rule-boundedness Borderline

Summary of Developmental Perspective • Stages of development cannot be skipped • Personality formation is based on successful, age-appropriate negotiation of fundamental crises • Is there a fixed time in which personality or traits may be formed?

Application to Pharmacy Practice • People cannot understand issues which are developmentally beyond them • Need to meet patient at his/her developmental level, not yours • Observed behaviour is not the end-point; reason for emergence of behaviour is important