Concepts of Personality Development Chapter 2 Concepts of Personality Development

Introduction Personality is defined by the DSM-IV-TR as “enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts”

Introduction (cont.) Life-cycle developmentalists believe that people continue to develop and change throughout life, thereby suggesting the possibility for renewal and growth in adults

Introduction (cont.) Stages are identified by age; however, personality is influenced by temperament (inborn personality characteristics) and the environment *It is possible for behaviors from an unsuccessfully completed stage to be modified and corrected in a later stage

Introduction (cont.) Stages overlap, and individuals may be working on tasks from more than one stage at a time Individuals may become fixed in a certain stage and remain developmentally delayed

Introduction (cont.) The DSM-IV-TR states that personality disorders occur when personality traits become inflexible and maladaptive, causing either significant functional impairment or subjective distress

Psychoanalytic Theory: Freud Freud believed basic character was formed by age 5 years He organized the structure of the personality into three major components Id Ego Superego

Psychoanalytic Theory: Freud (cont.) Topography of the mind The conscious The preconscious The unconscious

Psychoanalytic Theory: Freud (cont.) Dynamics of the personality Psychic energy Cathexis Anticathexis

Psychoanalytic Theory: Freud (cont.) Development of the personality Oral stage (birth to 18 months) Anal stage (18 months to 3 years) Phallic stage (3 to 6 years) Latency stage (6 to 12 years) Genital stage (13 to 20 years)

Psychoanalytic Theory: Freud (cont.) Relevance to nursing practice Being able to recognize behaviors associated with the id, ego, and superego will assist in the assessment of a client’s developmental level Understanding the use of ego-defense mechanisms is important in making determinations about maladaptive behaviors and in planning care for clients to assist in creating change

Interpersonal Theory: Sullivan Based on the belief that individual behavior and personality development are the direct result of interpersonal relationships Major concepts of this theory Anxiety Satisfaction of needs Interpersonal security Self-system

Interpersonal Theory: Sullivan (cont.) Infancy (birth to 18 months) Childhood (18 months to 6 years) Juvenile (6 to 9 years) Preadolescence (9 to 12 years) Early adolescence (12 to 14 years) Late adolescence (14 to 21 years)

Interpersonal Theory: Sullivan (cont.) Relevance to nursing practice Relationship development is a major psychiatric nursing intervention Knowledge about the behaviors associated with all levels of anxiety and methods for alleviating anxiety help nurses assist clients in achieving interpersonal security and a sense of well-being

*Theory of Psychosocial Development: Erikson Based on the influence of social processes on the development of the personality Erikson identified eight stages of development and the major tasks associated with each

Theory of Psychosocial Development: Erikson (cont.) Trust vs. Mistrust (birth to 18 months) Autonomy vs. Shame and Doubt (18 months to 3 years) Initiative vs. Guilt (3 to 6 years) Industry vs. Inferiority (6 to 12 years) Identity vs. Role Confusion (12 to 20 years) Intimacy vs. Isolation (20 to 30 years) Generativity vs. Stagnation (30 to 65 years) Ego Integrity vs. Despair (65 years to death)

Theory of Psychosocial Development: Erikson (cont.) Relevance to nursing practice Many individuals with mental health problems are still struggling to achieve tasks from a number of developmental stages Nurses can plan care to assist these individuals to fulfill the tasks and move on to a higher developmental level

Theory of Object Relations: Mahler Based on the separation–individuation process of the infant from the maternal figure (primary caregiver) Stages of development Phase I: The Autistic Phase Phase II: The Symbiotic Phase Phase III: Separation–Individuation

Theory of Object Relations: Mahler (cont.) Phase III—four subphases Differentiation (5 to 10 months) Practicing (10 to 16 months) Rapprochement (16 to 24 months) Consolidation (24 to 36 months)

Theory of Object Relations: Mahler (cont.) Relevance to nursing practice Understanding the concepts of Mahler’s Theory of Object Relations assists the nurse in assessing clients’ level of individuation from primary caregivers The emotional problems of many individuals can be traced to lack of fulfillment of the tasks of separation–individuation

A Nursing Model: Peplau Applies interpersonal theory to nurse–client relationship development Correlates the stages of personality development in childhood to stages through which clients advance during the progression of an illness Sees interpersonal experiences as learning situations for nurses to facilitate forward movement in the development of personality

A Nursing Model: Peplau (cont.) Peplau identified six nursing roles in which nurses function to assist individuals in need of health services Resource person Counselor Teacher Leader Technical expert Surrogate

A Nursing Model: Peplau (cont.) Four stages of personality development Stage 1: Learning to count on others Stage 2: Learning to delay satisfaction Stage 3: Identifying oneself Stage 4: Developing skills in participation

A Nursing Model: Peplau (cont.) Relevance to nursing practice Peplau’s model provides nurses with a framework to interact with clients, many of whom are fixed in, or because of illness have regressed to, an earlier level of development Using nursing roles suggested by Peplau, nurses may facilitate client learning that was not achieved in earlier experiences.