Kaplan + Sadock's Synopsis of Psychiatry, 11e

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31.1 Introduction: Infant, Child, and Adolescent Development

Table 31.1-5 Emotional Development

Stages First Seen

Emotional Skills

Emotional Behavior

Gestational–Infancy: 0–2 yrs 0–2 mos onward

Love, evoked by touching Fear, evoked by loud noise

Social smile and joy shown Responds to emotions of others

Rage, evoked by body restrictions Brain pathways for emotion forming Self-regulation of emotions starts; brain pathways of emotion growing Self-regulation of emotion grows Increased intensity of basic three

All emotions there

3–4 mos onward

Laughter possible and more control over smiles; anger shown

7–12 mos

Able to elicit more responsiveness

Denies to cope with stress

1–2 yrs

Shame and pride appear; envy, embarrassment appear Displaces onto other children

Some indications of empathy starting; expressions of feeling: “I like you, Daddy” “I’m sorry” Likes attention and approval; enjoys play alone or next to peers Empathy increases with understanding More response and less reaction; self-regulation: “Use your words to say that you are angry with him” Aggression becomes competition By age 5, shows sensitivity to criticism and cares about feelings of others Empathy becomes altruism: “I feel so bad about their fire, I’m going to give them some of my things” Superego dominates but some temperamental traits did not persist. This finding was attributed to genetic and environmental effects on personality. A complex interplay exists among the initial characteristics of infants, the mode of parental interactions, and children’s subse- quent behavior. Observations of the stability and plasticity of certain temperamental traits support the importance of interac- tions between genetic endowment (nature) and environmental experience (nurture) in behavior. Attachment Bonding is the term used to describe the intense emotional and psychological relationship a mother develops for her baby. Attachment is the relationship the baby develops with its care- givers. Infants in the first months after birth become attuned to social and interpersonal interaction. They show a rapidly increasing responsivity to the external environment and an ability to form a special relationship with significant primary caregivers—that is, to form an attachment. Table 31.1-7 lists the commonly observed attachment styles. Harry Harlow.  Harry Harlow studied social learning and the effects of social isolation in monkeys. Harlow placed new- born rhesus monkeys with two types of surrogate mothers— one a wire-mesh surrogate with a feeding bottle and the other a wire-mesh surrogate covered with terry cloth. The monkeys preferred the terry-cloth surrogates, which provided contact and comfort, to the feeding surrogate. (When hungry, the infant monkeys would go to the feeding bottle but then would quickly return to the terry-cloth surrogate.) When frightened, monkeys Ego rules until age 6

Early Childhood: 2–5 yrs 3–6 yrs

Can understand causes of many emotions Can begin to find ways for regulating emotions and for expressing them Identifies with adult to cope

Middle Childhood: 5–11 yrs

7–11 yrs

Can react to the feelings of others More aware of other’s feelings

(or other primary caregiver) during the second 6 months of life can lead to depression that may persist into adulthood as part of an individual’s character. Temperamental Differences There are strong suggestions of inborn differences and wide variability in autonomic reactivity and temperament among individual infants. Chess and Thomas identified nine behavioral dimensions, in which reliable differences among infants can be observed (Table 31.1-6). Most temperamental dimensions of individual children showed considerable stability over a 25-year follow-up period,

Table 31.1-6 Temperament—Newborn to 6 Years

Dimension

Description

Activity level Distractibility

Percent of time spent in activities Degree to which stimuli are allowed to alter behavior

Adaptability Attention span

Ease moving into change Amount of time spent on attending

Intensity Energy level Threshold of responsiveness Intensity required for response Quality of mood Amount positive compared to amount negative behavior Rhythmicity Regulation of functions Approach/withdrawal Response to new situations