Perkembangan mental dewasa & usia lanjut
Adnil EdwinNurdin
BEHAVIORAL GROWTH AND DEVELOPMENT
Erik Erikson Epigenetic Principle
• Development occurs in sequential, clearly defined stages
• Specific issue in each stage
• Issues in each stage must be resolved
Development can proceed smoothly
• Successful resolution failed in a particular stage
All subsequent stages reflect that failure
• Maladjustment of:
Physical growth
Cognitive development
Social development
Emotional development
Stages
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1.Basic Trust versus Mistrust (birth-1 year)
Need for instant satisfaction, TRUE LOVE
Resolved-----Strong Basic trust, believe in others, hopeful attitude, self
confidence, trustful personality
Unresolved-------suspicious, can’t control urge
2.Autonomy versus Shame and Doubt (1-3 years)
learning to walk, feed it self, talk, TOILET TRAINING
need for firm outer control, first discipline, in love----autonomy
to much outer control------shame
to much punishment, harsh discipline----self doubt
3.Initiative versus Guilt (3-5 years)
initiative arises in relation to tasks for the sake of activity
guilt arises on contemplated goal
mimic adult world
sibling rivalry
resolution through social role identification
I am a boy, she is a girl. I play with a toy gun, she plays with a doll
Stages (cont)
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6.Intimacy versus Isolation (21-40 years)
to love, to work, to nurture others, to be responsible for others
resolved-----intimacy, loyalty, responsible, loving
unresolved---isolation, view that others are dangerous
7.Generativity versus Stagnation (40-65 years)
work for the future generation, productive, creativity, concern and responsibility
for others, striving to left some thing good for future generation after death--GENERATIVITY
Unresolved-----self concern, isolated
8.Integrity versus Despair (more than 65 years)
Integrity---sense of satisfaction that life has been productive and worthwhile-----I
WILL SLEEP IN PEACE, AND IF THE TIME CAME, I HAVE LEFT SOMETHING USEFUL
FOR POSTERITY. THANK’S GOD FOR THIS LIFE
Despair----what have I done in the past---FEARFUL OF DEATH
Conclusion
1.Growth and development occur in stages
2.Each stage has it’s own specific issues which must be resolved
3.Unresolved issues in certain stage will hamper the next stages
4.Growth and development failure
• POST POWER SYNDROME ?
PERSONALITY MEMANG SUDAH TERGANGGU
WHAT ARE THE BIOLOGICAL BASE OF AGING?
• Memory in normal aging vs Alzheimer
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memory loss, hallmark Alzheimer's disease.
memory loss normal aging diff. Alzheimer's
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Mild cognitive impairment (MCI)
transitional state
cognitive changes of normal aging  Alzheimer's disease
MCI risk factor Alzheimer’s disease.
55% MCI  Alzheimer dalam 4.5 tahun
HIPOKAMPUS
Memory decline in normal aging
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ability to encode new memories of events or facts
working memory
episodic memory
impairments in the ability to refresh recently processed information
remembering the source of information
declines in the ability to bind information together
Domains of memory mostly spared in normal aging
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procedural memory
short-term memory
semantic knowledge, such as vocabulary, improves with age
enhancement in memory for emotional events
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Retrospective versus prospective memory
prospective memory naturalistic contexts >
retrospective <
Qualitative changes
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brain imaging use both hemispheres when completing memory tasksstrategi
berubah
positivity effect when remembering information
increased focus on regulating emotion
preferential looking toward happy and away from sad
ALZHEIMER
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neurodegenerative disease 
Progressive cognitive deterioration 
Declining activities of daily living
Neuropsychiatric symptoms or behavioral changes
Most common type of dementia
Gradual symptoms
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1 st.loss of short term memory (amnesia)
minor forgetfulness
steadily more pronounced
relative preservation of older memories.
cognitive (intellectual) impairment
language (aphasia)
skilled movements (apraxia),
recognition (agnosia),
decision-making and planning closely related to the frontal and temporal lobes
disconnected from the limbic system,
disease where the victims suffer the loss of qualities that define human
existence.
Patobiologi
• neuronal loss/atrophy, in the temporoparietal and frontal cortex
• inflammatory response to amyloid plaques and neurofibrillary tangles.
• Mutasi 3 gen  familial, early-onset AD.
• mutasi ApoE4 late onset AD
Neuropathology
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Anatomigross diffuse atrophy of the brain
loss of neurons, dendrit dan synap di cerebral cortex
subcortical regions.
gross atrophy
degenerasi temporal lobe, parietal lobe,frontal cortex ,cingulate gyrus.
acetylcholine, serotonin, norepinephrine, somatostatin me<
Glutamate me>
Risk reducers
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Intellectual stimulation, catur, bridge, crossword
Regular physical exercise
Regular social interaction
A generally healthy diet low in saturated fat, supplemented in
particular with:
– B vitamins
– Omega-3 fatty acids, especially Docosahexaenoic acid
– Fruit and vegetable juice
DETEKSI KLINIS AWAL
• MMS