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The American Psychiatric Publishing Textbook of Psychiatry, Fifth Edition. Edited by Hales RE, Yudofsky SC,
Gabbard GO. 2008 American Psychiatric Publishing, Inc. All rights reserved. www.appi.org2
CHAPTER 7 Topic Headings
TOWARD AN INTEGRATED THEORETICAL MODEL
OF MENTAL DEVELOPMENT
Biopsychosocial StimuliObject Relationships and Experiential Mental
Structural Representations
Cognition and Memory
Developmental Change
Mental Organizing Principles
Zone of Proximal Development
Developmental Tasks
INFANCY PHASE OF MENTAL DEVELOPMENT
(BIRTH TO AGE 18 MONTHS)
Major Developmental Tasks of InfancyFunctions of the Social Environment
Providing Truthful Information About the Infants Body
and Surrounding World
Providing Stimulus Modulation and Protection
Providing Encouragement, Support, and Admiration
Providing Truthful Information About Achieving
Gratification of Innate Needs
Providing Adaptive Solutions to Emotionally
Displeasurable Life Events
The Organizational Mental Structures of the Id,Ego, Superego, and Self
Maturation and Development of Innate Needs:
The Oral Phase
Innate Physiological NeedsNeed to Assertively Explore the Social Environment
Human Motivation: The Central Role of Emotions
Maturation and Development of Physical Capabilities
Reflexive Abilities
Perceptual Abilities
Maturation and Development of Cognitive Capabilities
Acquiring Knowledge in the Sensorimotor Phase
Discrepant Events
Maturation and Development of Temperamental
CharacteristicsMaturation and Development of Emotions
Role of Emotions
Parents Interpretations of Infants Emotions
Infants Ability to Perceive Others Emotions
Development of the Self and Object Relationships
Developing Self-Value While Engaging in Transactional
Relationships With Others
Developing a Sense of Separateness
The Attachment Relationship
The Triadic Attachment RelationshipPhases in the Attachment Relationship
Maturation and Development of Adaptational Capabilities
(continued)
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CHAPTER 7 Topic Headings (continued)
TODDLERHOOD PHASE OF MENTAL DEVELOPMENT
(AGES 18 MONTHS3 YEARS)
Major Developmental Tasks of ToddlerhoodFunctions of the Social Environment
Maturation and Development of Innate Needs:
The Anal Phase
Maturation and Development of Physical
Capabilities
Maturation and Development of Cognitive
Capabilities
Emergence of Objective Self-Awareness
Continued Development of Conceptual Thinking
Maturation and Development of TemperamentalCharacteristics
Maturation and Development of Emotions
Maturation and Development of Verbal Language
Abilities
Development of Verbal Language
Speech as Facilitator of an Autonomous Identity
Maturation and Development of the Preexisting
Representational World
Development of the Self and Object Relationships
Development of Autonomous and Gender IdentitiesFormation of a Gender Identity
Mastery Over Bodily Functions: Toilet Training
Advances and Regressions in Achievement of
Autonomy
The Rapprochement Subphase of Separation
Individuation
Development of the Superego
Development of Adaptational Capabilities
Development of New Defense MechanismsEffect of Parents Use of Defense Mechanisms on Their
Toddlers Use of Defense Mechanisms
EARLY CHILDHOOD PHASE OF MENTAL DEVELOPMENT
(AGES 36 YEARS)Major Developmental Tasks of Early Childhood
Functions of the Social Environment
Fostering Childrens Healthy Narcissism in Conjunction With
Their Developing Reciprocal Relationships With Others
Development of a True Self
Healthy and Unhealthy NarcissismMaturation and Development of Innate Needs:
The Early Genital Phase
Maturation and Development of Physical Capabilities
Maturation and Development of Cognitive Capabilities
Ways Self-Reflective/Mentalizing Parents Help Their
Children Develop Reality-Based Thinking
Maturing of the Minds Executive Functions
Maturation and Development of Temperamental
Characteristics
Maturation and Development of EmotionsConstruction of Rules for Emotional Display
Emotions as Energy Mobilizers
Traumatic Emotional Memories as Unconscious Energy
Mobilizers
Emotions as Self-Regulators
Emotions as Facilitators of Social Adaptation
(continued)
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CHAPTER 7 Topic Headings (continued)
Maturation and Development of Verbal Language
Abilities
Maturation and Development of the PreexistingRepresentational World
Development of the Self and Object Relationships
Development of a Sexual Identity: Emergence
of the Early Genital Phase
Development of a Peer Identity
Development of the Superego
Development of Adaptational Capabilities
LATE CHILDHOOD PHASE OF MENTAL
DEVELOPMENT (AGES 612 YEARS)
Major Developmental Tasks of Late ChildhoodFurther Development of a Peer Identity
Development of a Social Identity
Functions of the Social Environment
Maturation and Development of Innate Needs
Need for Fulfillment of Physiological Needs Related
to Bodily Regulation and Physical Survival
Need to Assertively Explore the Social Environment
Need for Human Attachment in Emotionally
Pleasurable Interactions
Need for Emotionally Pleasurable SensorySexualStimulation and Gratification
Need to Signal Distress When Experiencing Emotionally
Displeasurable Over- or Understimulation and
to Initiate Other Fight-or-Flight Behavioral and
Mental Responses
Maturation and Development of Physical Capabilities
Maturation and Development of Cognitive Capabilities
Emergence of More Complex Mental OperationsDifferentiation of Primary and Secondary Process Thinking:
Development of Masking and Latent Symbols
Maturation and Development of Temperamental
Characteristics
Maturation and Development of Emotions
Maturation and Development of Verbal Language Abilities
Maturation and Development of the Preexisting
Representational World
Development of the Self and Object Relationships
Continued Development of Gender and Sexual IdentitiesDevelopment of Gender Identity
Development of Sexual Identity
Development of the Superego
Development of Adaptational Capabilities: Evolution of New
Defense Mechanisms
ADOLESCENCE PHASE OF MENTAL DEVELOPMENT
(AGES 1219 YEARS)
Major Developmental Tasks of Adolescence
Maturation and Development of Physical Capabilities
Maturation and Development of Cognitive CapabilitiesEmergence of Hypothetical Thinking
Construction of the Concept of an Unconscious Mental
Domain
(continued)
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CHAPTER 7 Topic Headings (continued)
Maturation and Development of Emotions:
Development of Emotional Self-Awareness
Emotions as Energy MobilizersEmotions as a Means of Self-Regulation
Emotions as an Aid in Achieving Social Adaptation
Maturation and Development of Verbal Language
Abilities
Development of the Self-Representation and
of Object Representations
Constructing an Emancipated Identity While
Maintaining Transactional Relationships With
Important Others
Object Relations Conflicts and Structural ConflictsGenerational Conflicts
Adoption of a False Identity
Parents Role in Facilitating Formation of
Emancipated Identity
Further Development of Sexual and Social Identities
Pubertal Changes
Reemergence of the Early Triangular PhaseInitiation of Sexual Activity
Development of the Superego
Construction of Realistic Ambitions and Reasonable Ideals
A Confused Conscience
Attainment of an Integrated Conscience
Development of Adaptational Capabilities: Emergence
of More Socially Mature Mechanisms of Defense
Transitioning From Adolescence to Young Adulthood:
Criteria for Adulthood
Establishment of Autonomy From Parents (Self-Autonomy)Establishment of Realistic Goals (Realistic Self-Image)
Establishment of a Stable Sexual Identity
Establishment of a Sense of Continuity Between Past Life
Experiences and Current Motivations and Beliefs
CONCLUSION
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TABLE 71. Components of each
developmental phase
Each aspect of normal development can be envisioned not as a unique characteristic that appears at a
specific age but rather as a capacity that emerges during a certain period and then continues to evolve
from one developmental phase to the next. The developmental process is continuous, in that each phase
of development builds upon the previous phase and leads to the next. Table 71 lists the mastery areas
for each developmental phase.
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TABLE 72. Developmental phases and key tasks
Developmental tasks generally can be defined for each phase of the life cycle from infancy through
adolescence (Table 72). These tasks determine what knowledge and behaviors the infant will be more
or less expected to acquire and master in order to become a productive member of society, and how
each child must adapt his or her innate and maturationally emerging needs, emotions, temperamental
characteristics, and cognitive capabilities to societys rules and guidelines concerning their proper
verbal and behavioral expression.
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TABLE 73.
Ego functions
The ego performs a variety ofego functions (Table 73). The ego operates silently and henceunconsciously. Infants and children will never directly experience their egos; they will experience them
only indirectly through observing the products of their egosnamely, their own mental and behavioral
abilities and surface and verbal behaviors.
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TABLE 74. Piagets phases of cognitive maturation and development
According to Piaget, there are four major phases of cognitive maturation and development, each of
which is qualitatively and quantitatively different from the preceding phase (Table 74). The age spans
listed for the phases are approximations of when most children can be expected to show the specific
cognitive developmental achievements characteristic of that particular phase.
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TABLE 75. Schema or mental representations
Infants continue to acquire knowledge and learn by acting on and reacting to their environment; in
this way, motor actions become the initial basic triggers for acquiring new knowledge. The repetition
of behaviors makes up a set of experiences that eventually become an internal mental representation
called a schema. This schema then becomes a new unit of knowledge for the infant (Table 75).
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TABLE 76. Phenomenological categories of infant temperament: action and reaction
patterns
Researchers have found evidence indicating that infants temperamental characteristics (Table 76)
undergo maturation. Both innate and maturationally emerging temperamental characteristics operate as
psychological stimuli that interact with the social environment and ultimately lead infants to construct
representations of each of their temperamental traits.
Source. Studies ofThomas and Chess (1977) and Chess and Thomas (1989).
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TABLE 77. Characteristics of
defense mechanisms
Functioning as mental safety valves,
defense mechanisms (Table 77) enable
the child to regain a momentary state of
emotional self-regulation and a sense of
control when an intensely
unpleasurable emotion threatens tobreak into consciousness. In all
definitions of defense mechanisms, it is
acknowledged that use of these
mechanisms should be transient,
because they are mental processes that
suspend the childs necessary and
healthy engagement in resolving
external and internal developmental
conflicts.
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TABLE 78.
Executive ego
functions
In recent years, developmentalists have identified many of the cognitive functions that mature during the
first 4 years of life and continue to be used by children. These functions, named executive ego functions,are used by the childs self, the minds superordinate or executive organizational structure. The self
functions unconsciously and exerts an overriding organizing and regulating control over the id, ego, and
superego. These executive functions, as outlined by Brown (2006), mediate how the mind organizes tasks
(Table 78).
Source. Brown 2006.
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TABLE 79. First resolution of triangular wishes (age 67 years)
Triangular wishes in heterosexual children decrease when children begin to put aside (but do not
completely give up) their wishes to have what the same-gender parent has and do what the same-gender
parent does (Table 79).
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TABLE 710. Preparations for beginning first grade (age 56 years)
The dominant triggering social variable in the biopsychosocial model of mental development from 611
years of age is the social requirement (in most countries, it is a law) for all children to attend school. In
essence, going to school is the job of late childhood (Table 710).
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TABLE 711. Components of an
emancipated identity
The attainment of an emancipated identityis the major developmental task of
adolescence; as such, it is not fully
achieved until the completion of
adolescence, by age 18 or 19 years.
Although Erikson did not use the termemancipated, his definition of identity in
adolescence is the same as that
delineated in Table 711.
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TABLE 712.
Adolescence phase:
the function of
superego as an
internal regulator
of behavior
During adolescence as during childhood, the peer group rescues teenagers from feeling too disappointed
and anxious about becoming emancipated, and they can eventually relinquish their view of their parents
as all-protecting and all-admiring. In so doing, teenagers feel, for a while, a sense of loss in losing their
parents as a source of admiration and positive self-esteem (Table 712).
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CHAPTER 7 Key Points
Accommodationtransformation principleThe principle that becomes
activated when stimuli create perceptions or conceptions that cannot be
assimilated into prior representations. When this occurs, the infant will either
change a preexisting representation to include the new perception or
conception or add a new representation to his or her mental world.
Attachment relationshipThe specific relationship that develops between
infants and their parents.
BeliefA type of conception that, as a representational mental structure,
establishes the relationship between two or more inanimate objects, aspects
of natures laws, or people (e.g., the child and his or her mother).
Child protective factorA characteristic within the child, the parents, the
childparent relationship, and/or the society in which the child is living that
helps the child and the parents achieve developmental adaptations and
maintain their goodness-of-fit transactions.
Developmental continuityThe term used to address the fact that a greatpart, but not all, of psychological development is dependent on what took
place in the past.
(continued)
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Developmental discontinuityAn event in a persons life that is
unexpected and not predictable from what has occurred in the persons past. Developmentally enhancing adaptationsAdaptations by the child that
enhance the childs feelings of competency, pleasure in mastering a task, and
feelings of joyful pride.
Disintegration anxietyThe internally generated fear that if anyone knew
how imperfect or impotent the child believes himself or herself to be, others
would totally reject him or her. Experiential mental structuresThe emotions (e.g., shame, guilt), thoughts
(perceptions and conceptions), and memories (short- and long-term) that are
the result of the minds processing of transactions between biopsychosocial
stimuli.
Hierarchical restructuring principleThe principle that states that as a
childs cognitive abilities continue to mature and his or her mind continues toreconstruct prior representations to reflect a more advanced level of cognitive
integration and comprehension, the childs mind will reorganize its
representations into a hierarchy that reflects the childs unique preferences.
CHAPTER 7 Key Points (continued)
(continued)
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CHAPTER 7 Key Points (continued)
Inner mental world or representational worldThe inner world we refer to
as an individuals mind, which is in contrast to the outer world of people andthings.
Mentalizing functionThe capacity to use self-reflection to become aware
of the existence of possessing a mind and to gradually understand ones
mind and the minds of others as being complex, with different emotions,
beliefs, and conflicts.
Normal developmental external conflictAn aspect of normaldevelopment that occurs when there is a disparity between the childs current
need, wish, and/or impulse and the desires of the parents or others with
whom the child is relating.
Normal developmental internal conflictAn aspect of normal development
that occurs when there is a disparity between what the child desires to do,
fantasizes about, or believes and an inner voice that prohibits or warns the
child that a developmental calamity will occur if the child acts upon his or her
impulse, desire, and/or fantasy.
(continued)
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CHAPTER 7 Key Points (continued)
Normogenic beliefA belief, developed by the child, that enhances the
childs psychological development. Such a belief enables the child togenerate positive expectancies about new life events and people.
Pathogenic beliefA belief, developed by the child, that interferes with the
childs psychological development. Such a belief functions as an internal
inhibiting factor in that it causes the child to generate negative expectancies
about new life events and people.