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
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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 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
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Sensorimotor
Pre-operational
Concrete operational
Formal Operational
Sensorimotor Stage
• 0-2 years of age
• Use of senses and motor abilities to
understand and respond to the world
• Object permanence
• Cause-effect reasoning
• The development of memory
Pre-operational Stage
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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
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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
Stage
Age
Crisis
1
0-1
2
1-2
3
2-6
4
6-12
Trust vs.
Mistrust
Autonomy vs.
Doubt
Initiative vs.
Guilt
Industry vs.
Inferiority
Erikson’s Stages of Human
Development
Age
Stage
Crisis
5
13-20
6
20-35
7
35-55
8
55+
Identity vs.
Role Confusion
Intimacy vs.
Isolation
Generativity vs.
Stagnation
Integrity vs.
Despair
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
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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