Psychosexual development

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PSYCHOSEXUAL DEVELOPMENT (FREUD)

• Oral Stage (birth to 1 year): Characterized by infant-seeking pleasure via oral activities such as biting, sucking, chewing, and vocalizing.

• Anal Stage (1 to 3 years): Characterized by interest in the anal region and sphincter muscles (child is able to withhold or expel feces); toilet training is a major milestone (method of parent discipline, may have lasting effects on child's personality development).

• Phallic State (3 to 6 years): Characterized by interest and recognition in differences between the sexes and becomes very curious about these differences; often described as interest by females as penis envy and by males as castration anxiety.

• Latency period (6 to 12 years): Characterized by gaining increased skill on newly acquired traits and skills; interested in acquiring knowledge and vigorous play. Sexuality lies dormant while energy is focused elsewhere.

• Genital stage (12 years and over): Characterized by maturation of the reproductive system and production of sex hormones; genital organs become a source of tension and pleasure; interested in forming friendships and preparation for marriage as an adult.

INTERPERSONAL DEVELOPMENT (SULLIVAN)

• Infant (0 to 1 year): Receive gratification and comfort from loving, tender care; develops trust and ability to count on others.

• Childhood (2 to 5 years): Engage in peer, family, neighborhood activities; need adult participation; learn to delay gratification and accept interference with wishes: gradually seek attention and approval from peers.

• Juvenile (5 to 12 years): Engage in socialization, competition, cooperation, and compromise; develop shared interests and genuine friendships with peers of same sex, and later with opposite sex; give more allegiance to peers than to family; promote personal identity

COGNITIVE DEVELOPMENT (PIAGET)

• Sensorimotor (birth to 2 years): Characterized by progression from reflex activity through simple repetitive behaviors to imitative behaviors; information is gained through the senses and developing motor abilities; develop a sense of "cause and effect"; problem-solving is by trial and error; high level of curiosity, experimentation, and enjoyment in novelty; begin to separate self from others; develop sense of "object permanence"; begin language development.

• Preoperational (2 to 7 years): Characterized by egocentrism (inability to put oneself in the place of others); interpret objects and events in terms of their relationships or use of them; cannot see another's point of view; thinking is concrete, tangible; inability to make deductions or

generalizations; display high level of imagination and questioning; reasoning is intuitive.

• Concrete Operations (7 to 11 years): Characterized by thoughts; become increasingly logical and coherent; able to classify, sort, organize facts, and begin to problem-solve; develop conservation (realize volume, weight, and number remain the same even though outward appearances are changed); solve problems in a concrete, systematic fashion, based on visual perceptions.

• Formal Operations (11 to 13 years): Characterized by thoughts which are adaptable and flexible; possess abstract thinking; able to make logical conclusions; able to make hypotheses and test them; can consider abstract, theoretical, philosophical issues.

MORAL DEVELOPMENT (KOHLBERG)

Based on cognitive development theory and consists of 3 major levels.

• Preconventional Level (2 to 7 years): Parallels Piaget's preoperational level of cognitive development and intuitive thinking. Characterized by development of: cultural values; sense of right and wrong; integrate things in terms of physical or pleasurable consequences of their actions. Initially, determines goodness or badness in terms of its consequences (attempt to avoid punishment). Later, determines right behavior consists of what satisfies own needs (and sometimes those of others).

• Conventional Level (7 to 11 years): Parallels Piaget's stage of concrete operations of cognitive development. Characterized by a concern with conformity and loyalty; value a specific group (i.e., the family, group, or national expectations); behavior that conforms to specific group considered good and earns approval. Values such as fairness, give and take, and sharing interpreted in a practical manner without loyalty, gratitude, or justice.

• Postconventional, Autonomous, or Principled Level (11 to 15 years): Parallels Piaget's stage of formal operations. Characterized by tendency/desire to display correct behavior in terms of individual rights and standards; begins to question possibility of changing existing laws/rules

in terms of societal needs.

SPIRITUAL DEVELOPMENT (FOWLER)

Five stages of development of faith; four are closely associated with parallel cognitive (Piaget) and psychosocial (Erickson) development in

childhood.

• Stage 0, (Undifferentiated): Characterized by infant period of development, in which the infant is unable to determine concept of right or wrong. Development of basic trust lays the foundation for beginning faith.

• Stage 1, (Intuitive-projectile): Characterized by toddler period of development, in which the primary behavior is referred to as imitating religious gestures and behaviors of others. Unable to comprehend meaning or significance of religious practices; begin to assimilate religious values

and beliefs held by parents; do not attempt to understand basic concepts of religion.

• Stage 2, (Mythical-literal): Characterized by school-age period of development, in which the child's spiritual development parallels cognitive development. Belief that spiritual development is associated with previous experiences and societal interactions. Newly-acquired conscience

influences actions (good vs. bad; bad actions create guilt); petitions to an omnipotent being important; able to articulate their faith.

• Stage 3, (Synthetic-convention): Characterized by early phase of adolescent period of development, in which become aware of spiritual disappointments (i.e., prayers are not always answered); may begin to abandon or modify previous religious practices and those established by their parents.

• Stage 4, (Individuating-reflexive): Characterized by middle phase of adolescent period of development, in which the adolescent may become skeptical and begin to compare religious standards of their parents and significant others. The adolescent will begin to compare religious beliefs with scientific facts, described as a period of searching for answers; and to be uncertain about their religious ideas.

Growth and Devt

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GROWTH AND DEVELOPMENT OF CHILDREN

Understanding the growth and development is an essential virtue in planning care to infants and children. The child's ability to cope with stress, illness, hospitalization, or terminal illness is related to physical, cognitive, and psychosocial growth and development. Nursing care is designed to foster the individual child's growth and support his or her developmental needs.

DEVELOPMENTAL THEORIES

PSYCHOSOCIAL DEVELOPMENT (ERICKSON)

• Trust Versus Mistrust, Infant (birth to 1 year): Characterized by taking in through all the senses; loving care of a mothering person is essential to develop trust; must have basic needs met; attachment to primary caretaker.

The favorable outcome is faith and optimism.

• Autonomy Versus Shame and Doubt, Toddler (1 to 3 years): Characterized by increasing ability to control bodies, themselves, and their environment; seek independence, negativism, threatened by changes in routine, curious explorer.

The favorable outcome is self-control and will power.

• Initiative Versus Guilt, Preschool (3 to 6 years): Characterized by enterprise and a strong imagination; develop conscience; feelings of being punished; egocentric, inquisitive, rich fantasy life, and magical thinking.

The favorable outcome is direction and purpose.

• Industry Versus Inferiority, School-Age (6 to 12 years): Active learners, well-developed language skills and concept of time, concerns about body image, understands concept of death. Enjoy sorting and ordering, making collections, and super heroes. Exhibit cognitive conceit. Can assist with own care and appreciates rewards. Physically graceful and skilled; sports and clubs of same-sex peers are important.

The favorable outcome is competence.

• Identity Versus Role Confusion, Adolescent (13 to 18 years): Characterized by ability to deal with reality and abstractions, mood swings, changing body image; preoccupied with the way they appear in the eyes of others as compared to their own self-concept. Peers of both same and opposite-sex are very important to identity formation.

The favorable outcome is devotion and fidelity to others and to values and ideologists.

Nursing Mom

Psychosexual development

Growth and Devt