PSYCHOSOCIAL

PERSPECTIVES ACROSS
LIFESPAN
LECTURE 3(MEDICAL PSYCHOLOGY PHAS 229)
Ms GIFTY AMENYA, SCHOOL OF MEDICAL SCIENCES,
CENTRAL UNIVERSITY
• Growth- the measurable physical changes that occur throughout a
person’s life. examples: height, weight, body shape, dental structure
(teeth).

• Development – Refers to the changes in intellectual, mental and

emotional skills that occur over time. Think, maturation.
Nature and Nurture
• How do heredity and environment affect development? Which is
important?
• Heredity and environment also affect us throughout life.
• While heredity gives each of us a variety of potentials and limitations,
these are, in turn, affected by environmental influences, such as
learning, nutrition, disease, and culture.
• Ultimately, the person you are today reflects a continuous interaction,
or interplay, between the forces of nature and nurture (Kalat, 2007)
Nature/heredity
• Heredity refers to the genetic transmission of physical and
psychological characteristics from parents to their children.
• The nucleus of every human cell contains DNA. The DNA in each cell
contains a record of all the instructions needed to make a human
• Human DNA is organized into 46 chromosomes
• The sperm cells and ova contain 23 chromosomes each. Thus, a baby
receives 23 chromosomes from each parent summing up to 46
• Genes are small areas of DNA that affect a particular process or
personal characteristic.
Nature cont’d
• A gene can be dominant or recessive. Eg Brown-eyed child
• Also, genes can switch on (or off ) at certain ages or developmental
stages. In this way, heredity continues to exert a powerful influence
throughout maturation, the physical growth and development of the
body, brain, and nervous system.
• Genetic disorders are inherited from parents. Examples are sickle-cell
anemia, hemophilia, cystic fibrosis, muscular dystrophy, albinism, and
some types of mental retardation.
Nurture/environment
• Environment (“nurture”) refers to the sum of all external conditions that
affect a person
• The brain of a newborn baby has fewer dendrites (nerve cell branches) and
synapses (connections between nerve cells) than an adult brain. However,
the newborn brain is highly plastic (capable of being altered by experience).
• These factors actually start influencing development before birth. Although
the intrauterine environment is highly protected, environmental conditions
can affect the developing child.
• Prenatal Influences like maternal poor health or nutrition, like German
measles, syphilis, or HIV; or used drugs; or was exposed to X-rays or
radiation, can harm baby’s growth sequence.
Environmental Factors con’t
• In such cases babies can suffer from congenital problems, or “birth
defects”.
• Anything capable of directly causing birth defects is called a teratogen
• Early experiences can have particularly lasting effects. For example,
children who are abused may suffer lifelong emotional problems
• At the same time, extra care can sometimes reverse the effects of a
poor start in life
• Sensitive periods are times when children are more susceptible to
particular types of environmental influences. Events that occur during
a sensitive period can permanently alter the course of development
Life Stages
• Prenatal Period: The stage before taking birth
• Infancy: BIRTH TO ONE (1) Year
• Baby Hood
• Early Childhood: 1-6 years
• Late childhood: 6-12 years
• Puberty or preadolescence Adolescence: 12-18 years
• Early Adulthood: 19-40 Years
• Middle Adulthood: 40-65 Years
• Old age: After 65 Years
FOUR MAIN TYPES OF GROWTH AND
DEVELOPMENT
• Physical – body growth that includes height and weight changes.
• Mental/Cognitive/Perceptual – intellectual development, problem
solving and perception.
• Emotional – refers to feelings and includes dealing with love, hate,
joy, fear, excitement, and other similar feelings.
• Social – refers to interactions and relationships with other people.
Prenatal Period
• The development from conception till birth of a baby constitute the prenatal
stage. The approximate period of prenatal development is taken to be 9
calendar months, although babies are not born exactly after 280 days of
conception.
• Biologically it takes about 266 days from conception for a fetus to become
ready for the birth process. Actual birth of normal full-term baby may take
place any time after that. Prenatal stage is further divided into three phases.
• The first phase - the germinal period – is the period from conception until
implantation. Conception occurs when a sperm penetrates the wall of a
ripened ovum forming a zygote. In about 8-14 days, the zygote gets firmly
attached to the wall of the mother’s uterus. This is called implantation which
brings the germinal period to end.
• The second phase of prenatal development is the period of the embryo
which lasts from the beginning of the third week to the end of the
eighth week. During this time, all major organs are formed and the
heart begins to beat.
• The third phase is the period of the fetus. It lasts from the third
prenatal month until the baby is born. The major organ systems begin
to function and the growth of the organism is quite rapid.
INFANCY BIRTH TO 1 YEAR
• The term "infant" is typically applied to young children under one year of
age
• Physical: The most dramatic and rapid changes in growth and
development happen during the first year of life.
• Mental: Infants make their needs known by crying. They cannot speak
yet, but are able to understand some words by six months old. By one
year, they understand many words and use single words in their
vocabulary.
• Needs: Infants are dependent on others for all their needs. Love and
security are essential for emotional and social growth. Stimulation is
essential for mental growth.
Reflex Stimulation Response Duration
Babinski Sole of feet stroked Fans out toes and twists foot in Disappears at 9-12 months

Blinking Flush of light or puff of air Closes eyes Permanent

Grasping Palms touched Grasps tightly Weakens at 3 months,

disappears at 1 year
Moro Sudden move; loud noise Startles; throw out arms and legs Disappears at 3-4 months
and pulls them towards body

Rooting Cheek stroked or side of mouth touched Turns towards source, opens Disappears at 3-4 months
mouth and sucks

Stepping Infant held upright with feet touching ground Moves feet as if to walk Disappears at 3-4 months

Sucking Mouth touched by object Sucks an object Disappears at 3-4 months

Swimming Placed face down in water Makes coordinated swimming Disappears at 6-7 months
movement
Tonic neck Placed on back Makes fists and turns head to the Disappears at 2 months
right
 Early childhood 1-6
• It generally includes toddlerhood and some time afterwards.
• Physical: Muscle coordination allows the child to run, climb, and move freely. Children
learn how to write, draw and use a fork and knife. By 2-4 years, most children learn
bowel and bladder control.
• Mental: Develops rapidly. Vocabulary grows from using several words at age one to
1,500-2,500 words by age 6. By age 6 most children want to learn how to read and write.
• Emotional: “terrible twos”-children become frustrated when they cannot perform as
desired. They can become stubborn.
• Needs: Still include food, rest, shelter, love, and security. They must learn to be
responsible and to follow rules. This is accomplished by making reasonable demands
based on the child’s ability.
LATE CHILDHOOD
• It is a period from the age of 6 until the age of 12 years. Also known as
preadolescence.
• It is in late childhood that the first signs of puberty usually begin to appear.
• Physical: Most of the baby teeth are lost and permanent teeth erupt. During ages
10-12, secondary sexual characteristics may begin to develop in some children.
• Mental: Rapid because child is in school.
• Emotional: Fears surrounding starting school are brought under control. By
ages 10-12, sexual maturation and body changes can lead to periods of
depression followed by periods of joy.
• Needs: The same as infancy and early childhood but now peer acceptance is
added.
PUBERTY
• Phase/process of physical changes through which a child's body matures into
an adult body capable of sexual reproduction.
• It is initiated by hormonal signals from the brain to the gonads: the ovaries in
a girl, the testes in a boy.
• In response to the signals, the gonads produce hormones that stimulate libido
and the growth, function, and transformation of the brain, bones, muscle,
blood, skin, hair, breasts, and sex organs.
• Physical growth—height and weight—accelerates in the first half of puberty
and is completed when an adult body has been developed.
• Until the maturation of their reproductive capabilities, the pre-pubertal
physical differences between boys and girls are the external sex organs.
 ADOLESCENCE 12-18
• It is a transitional stage of physical and psychological development that generally occurs during the
period from puberty to legal adulthood (age of majority).

• Physical: physical changes are most dramatic in the early period.

• Mental: growth primarily involves increase in knowledge and sharpening of skills. Conflict occurs
when adolescents are treated both as children and adults or told to ‘grow up’ while being reminded
that they are ‘still children’.

• Emotional: Often stormy and in conflict. Trying to establish independence and identities.

• Social: Spending more time with friends than family. Seek security in groups of people their own age.
• Needs: In addition to basic needs, adolescents need reassurance, support and understanding. Eating
disorders and chemical abuse may occur if adolescents experience feelings of inadequacy or
insecurity.
 EARLY ADULTHOOD 19-40
• This is a stage of life between 18 and 25 years, when adolescents become more
independent and explore different life possibilities.
• Physical: Usually the most productive life stage. Physical development is basically
complete. This is the prime time for childbearing.

• Mental: formal education continues, young adults may choose to marry and start
families.

• Emotional: may experience stress related to careers, marriage, family.

• Social: development frequently involves moving away from peers to association with
coworkers and mates.
 MIDDLE AGE 40-65
• Many changes may occur between young adulthood and this stage. The body may slow
down and the middle aged might become more sensitive to diet, substance abuse, stress,
and rest.
• Chronic health problems can become an issue along with disability or disease.
• Physical: Changes begin to occur. Hair begins to gray and thin, skin begins to wrinkle,
hearing loss starts, vision declines, and weight gain occurs.

• Mental: Mental ability can continue to increase. This is a period when individuals
understand life and have learned to cope with many of its stresses.

• Emotional: Can be a period of contentment or crisis. Emotional status varies depending

on life changes revolving around children growing up and leaving home, job
satisfaction, financial success, good health.
OLD AGE (65 YEARS TO DEATH)
• Old age refers to ages nearing or surpassing the life expectancy of
human beings and is thus the end of the human life cycle.
• Senescence: Is the organic process of ageing.
• Gerontology: Is the medical study of the aging process.

Physical: All body systems are affected. Skin becomes dry, wrinkled,
and thinner. Hair becomes thin and bones become brittle and more
likely to break. Muscle loses tone, nervous system can cause intolerance
to temperature changes.
• Mental: While some elderly people continue to learn, others have mental declines
that can affect short-term memory. Diseases such as Alzheimer's disease can lead
to irreversible loss of memory, Intellectual functions, speech, and disorientation.

• Emotional: Varies depending on individual's ability to cope. some remain happy

and enjoy life, while others may become lonely, frustrated, depressed and
withdrawn.

• Needs: In Addition to those of all other life stages, the elderly need a sense of
belonging, self-esteem, financial security, social acceptance and love
• Old people often have limited regenerative abilities and are more susceptible to
disease, syndromes, injuries and sickness than younger adults.
 Principles of Development
• Development is life long
• Development follows a specific sequence
I. Cephalo caudal development
II. Proximo distal development
• Development is irreversible
• Development proceeds from general to specific Child develops as whole
• Development is cumulative in nature
• Development varies from one child to another
• Biological and environmental contexts strongly influence development
• Development in multidimensional and multi directional
Developmental Theories
Jean Piaget’s Theory of Cognitive
Development
•Jean Piaget ( 1896 – 1980)
•Swiss Psychologist
•Known for work on child development
•Importance on education of children
•4 stages
•Intelligence changes as child grows
•Cognitive development occurs through interaction of innate capacities and environmental events
and not only knowledge.
• Piaget was convinced that intellect grows through processes he called assimilation and
accommodation
• Assimilation refers to using existing mental patterns in new situations.
• Accommodation; existing ideas are modified to fit new requirements.
Stage 1: Sensorimotor ( Birth to 18-24
months)
•Learns about the world through their senses and their actions
•Object permanence: knowing that an object still exist, even if it is
hidden.
•Egocentrism ( perceiving the world from their own point of view).
•Language starts to develop: Realize words can be used to represent
objects and feelings.
•The child begins to be able to store information that he/she knows
about the world, recall it and label it.
The Preoperational Stage ( 2 to 7 years)
• Symbolic Thought
• Can think about things symbolically.
• Emergence of language takes place.
• Children becomes more skilled at pretend play.
• There is no understanding or logic and take point of view of other
people.
• No Transformation (The ability to mentally change the shape or form
of a mental image or idea).
• They cannot engage in mental reversibility
The concrete operational Stage ( 7 to 11
years)
•Logical thought
•Thinking becomes more logical and organized
•Understanding improves, knowledge that thought and feelings are unique.
•Children become better at thinking and how people might view a situation.
•Children begin to think how other people might think and feel.
• Mastery of conservation (the concept that mass, weight, and volume
remain unchanged when the shape of objects changes)
The Formal Operational Stage (12 years and
above)
• Goal: Scientific reasoning
• Understanding of abstract ideas
• Think about moral, philosophical, ethical, social and political issues
• Increase in logic and reasoning
• Capable of seeing multiple potential solutions.
• Formation of theories, hypothesis and scientific thinking when faced
with a problem.
Piaget Guidelines for parent

Sensorimotor Stage (0–2 Years) The stage during which sensory Active play with a child is most effective at this stage.
input and motor responses become coordinated. Encourage explorations in touching, smelling, and manipulating
objects. Peekaboo is a good way to establish the permanence of
objects

Preoperational Stage (2–7 Years) The period of cognitive Specific examples and touching or seeing things continues to be
development when children begin to use language and think more useful than verbal explanations. Learning the concept of
symbolically, yet remain intuitive and egocentric. conservation may be aided by demonstrations with liquids,
beads, clay, and other substances.

Concrete Operational Stage (7–11 Years) The period of Children are beginning to use generalizations, but they still
cognitive development during which children begin to use require specific examples to grasp many ideas. Expect a degree
concepts of time, space, volume, and number, but in ways that of inconsistency in the child’s ability to apply concepts of time,
remain simplified and concrete. space, quantity, and volume to new situations.

Formal Operations Stage (11 Years and Up) The period of It is now more effective to explain things verbally or
intellectual development marked by a capacity for abstract, symbolically and to help children master general rules and
theoretical, and hypothetical thinking. principles. Encourage the child to create hypotheses and to
imagine how things could be
Erik Erikson Psychosocial theory
•Danish-German- American developmental psychologist and
psychoanalyst.
•8 Stages of man
•Each stages include:
• Significant relationship
• Psychosocial crisis
• Potential positive or negative outcome
The Eight Stages

• Trust vs Mistrust
• Autonomy vs Shame and Doubt
• Initiative vs Guilt
• Industry vs Inferiority
• Identity vs Role confusion
• Intimacy vs Isolation
• Generosity vs Self absorption
• Integrity vs Despair
Stage 1 : Trust vs. Mistrust - 0 to 1 ½ years
•Basic Virtue: HOPE
•Uncertain about the world they live
•Look towards primary care giver for stability and care
•If infant receives consistent and reliable care, they will develop a sense
of trust and feel secure
•If the needs are not met then mistrust, suspicion and anxiety may
develop.
•Failure to acquire virtue of hope will lead to development of fear.
Stage 2: Autonomy vs. Shame and Doubt – 1
to 3 years
• Basic virtue: WILL
• Children in this age should be encourages and supported in their
increased independence, they become more confident and secure in
their own ability to survive in the world.
• If children are continuously criticized, overly controlled and not given
opportunity they begin to feel inadequate, lack of self esteem and feel
a sense of shame or doubt in their abilities.
• Self control without a loss of self esteem
 Stage 3: Initiative vs. Guilt – 3 to 5 years
• Basic Virtue: PURPOSE
• Time of rapid development, very lively years in child’s life. Parent may
see the behaviors as aggressive.
• Primary feature is interacting with other.
• Central focus is play
• Begin to plan activities, make up games and initiate activities with others.
• Child asks a lot of questions
• Conversely, if this tendency is criticised, punished or controlled the child
develops a sense of guilt.
Stage 4: Industry vs. Inferiority- 5 to 12 years
• Basic virtue: COMPETENCY
• Learning to read, write, do sums and do things on their own.
• Teacher begin to take an important role
• Child now feels the need to win approval of peer by demonstrating
specific competencies.
• Child should be encouraged and reinforced for their initiative to feel
industrious
• If the child cannot develop specific skills, then may develop a sense of
Inferiority
Stage 5: Identity vs. Role confusion- 12 to 18
years
• Basic Virtue: FIDELITY
• Transition from childhood to adulthood
• More independent, looks for future career, relationships, families.
• During this stage the adolescent try to identify who he or she is.
• The sexual identity and the occupational identity are involved.
• When the individual is not being sure about themselves or their place
in society it leads to role confusion or identity crisis
Stage 6: Intimacy vs. Isolation- 18 to 40 years
• Basic Virtue: LOVE
• Major conflicts: Forming intimate, loving relationships with other
people.
• Explore relationships for longer-term commitments
• Successful completion of this stage can result in happy relationships
with sense of commitment, safety and care
• Avoiding intimacy, fearing commitment and relationships lead to
isolation, loneliness and sometimes depression.
Stage 7: Generativity vs Stagnation- 40 to 65
years
• Basic virtue: CARE
• Making your mark in the world through creating or nurturing things
that will outlive the individual.
• Giving back to society through raising our children, productive at
work and become involved on community activities and organizations.
• Failure to contribute leads to stagnation and feeling of unproductive.
Stage 8: Ego Integrity vs. Despair- >65 year

• Basic virtue: WISDOM

• Acceptance of one’s life cycle, contemplate our accomplishments and
develops integrity if we see ourselves leading a successful life.
• Explore life as a retired person.
• If we see ourselves as unproductive, feel guilty about our past or feel
we did not accomplish life goals.
• Then the individual feels despair
Freud’s Theory of Psychosexual
Development
•Sigmund Freud (1856- 1939)
•Austrian Neurologist
•Founder of psychoanalysis
•4 Stages
•During each stage sexual energy (libido) is expressed in different ways
through different body parts.
•Conflict resolution
•Id – Superego – Ego
Oral Stage Birth to 1 year

• Discovering world through oral senses – MOUTH

• Main pleasure: sucking mother’s breast or a bottle.
• Satisfaction from putting all sort of things in mouth Sucking, biting
and breastfeeding Weaning not proper or oral stimulations were
denied: addictions, chewing gums, smoking etc
Anal stage- 1 to 3 years

• Libido focus: Control of the bladder and bowel movements

• The child is aware that they are a person in their own right.
• Their wishes can bring them into conflict.
• Learning how to use the potty.
Phallic Stage 3 to 6 years

• Libido centres upon the child’s genitalia as the erogenous zone.

• Discovers difference between the female and male gender.
• Boys conflict in this phase as rivalry with their father called the Oedipus complex
• Girls conflict in this phase as desires the father more than mother and it is called
Electra Complex.
• Conflict resolves: imitating, copying
• If conflicts are not resolved: castration anxiety, Penis envy, aggressive towards
woman, constantly needs to compete with other man, inferiority complex towards
man
Latency Period- 6 years to Puberty

• Dormant stage of psychosexual development

• More interest in hobbies, schoolwork and friendships Much of child’s
energy is channeled into developing new skills and acquiring new
knowledge and play becomes very important.
Genital Stage: After Puberty

•Erogenous Zone: Maturing Sexual Interests

•Libido becomes active again
•More interest towards the opposite sex.
•One to one relationships outside the family
•Conflicts resolved: Succeed in building a strong ego, disciplined at
work, has a loving relationship and fulfilled sex life.
•Conflict not resolved: Suppression of desires, always sexual needs are
prioritized, becomes egoistic without guilt, breaks laws.
 Vygotsky’s Sociocultural Theory
• Vygotsky believed that children actively seek to discover new principles.

• Zone of proximal development: Refers to the range of tasks a child cannot yet master alone,
but that she or he can accomplish with the guidance of a more capable partner.
• That adults help children learn how to think by “scaffolding,” or supporting, their attempts to
solve problems or discover principles

• Emphasized a process he called scaffolding

• Scaffolding: is the process of adjusting instruction so that it is responsive to a beginner’s
behavior and supports the beginner’s efforts to understand a problem or gain a mental skill.
• During their collaborations with others, children learn important cultural beliefs and values
IMPLICATIONS
• Vygotsky saw that grown-ups play a crucial role in what children
know.
• As they try to decipher the world, children rely on adults to help them
understand how things work.
• Vygotsky further noticed that adults unconsciously adjust their
behavior to give children the information they need to solve problems
that interest the child.
• Children through adults to learn about their culture and society
Kohlberg’s Theory of Moral Development
• Three levels of Moral development
• Each level is split into two stages. (6 stages)
• Moral logic: seeking and maintaining justice
• By Lawrence Kohlberg an American Psychologist
Level 1 : Preconventional Morality (0 – 7 yrs)
Stage 1:
• Obedience and Punishment - Rules are fixed.
• Obeying the rules is important to avoid punishment

Stage 2:
• Individual interest- Child recognizes that there is not just one right
view. Different viewpoints are identified.
• Behavior is driven by self-interest and rewards.
Level 2 : Conventional Morality (7 – 12
years)
Stage 3:
• Good interpersonal relationships – Living up to social expectations
(Good boy/good girl)
• Behavior is driven by social approval

Stage 4:
• Behavior is driven by obeying authority and conforming to norms
• Maintaining Social Order by obeying rules to uphold the law,
performing one’s duty and respecting authority.
Level 3: Postconventional Morality
(Adolescents/ Adults)
Stage 5:
•Social Contract and Individual Rights
•Rules and regulations are good, but it can be against the interest of
some individuals

Stage 6:
• Universal Principles
• Behavior is driven by internal moral principles.
 Short Story
• Mr. H’s wife was dying from a particular type of cancer. Doctors said a new drug might
save her.
• The drug had been discovered by a local chemist, and Mr. H tried desperately to buy
some, but the chemist was charging ten times the money it cost to make the drug, and
this was much more than the Shyam could afford.
• Mr. H could only raise half the money, even after help from family and friends. He
explained to the chemist that his wife was dying and asked if he could have the drug
cheaper or pay the rest of the money later.
• The chemist refused, saying that he had discovered the drug and was going to make
money from it.
• The husband was desperate to save his wife, so later that night he broke into the
chemist’s and stole the drug.
What are your opinions?
Should Mr. H have stolen the drug?
Would it change anything if Mr. H did not love his wife?
What if the person dying was a stranger, would it make any difference?
Should the police arrest the chemist for murder if the woman died?