1. Theoretical Models of Personality Development
Chapter 3
Theoretical Models of Personality
Development

2. Introduction Personality is defined as
“the characteristic way in which a person thinks, feels, and behaves; the ingrained pattern of behavior that each person evolves, both consciously and unconsciously, as his or her style of life or way of being.”
(Black and Andreasen 2011)

3. 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.

4. 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.

5. 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.

6. Introduction (cont.)
Personality disorders occur when personality traits become inflexible and personality functioning becomes individually and interpersonally impaired.

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

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

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

10. 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)

11. 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 developmental level in clients.
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.

12. Psychoanalytic Theory: Freud (cont.)
A college student is hospitalized after suicide attempt. During an interview, the father reveals that his ex-wife was punitive and scolded his daughter during toilet training. Freud would describe this student as fixated in which stage of psychosexual development?
A. Oral
B. Anal
C. Phallic
D. Latency

13. Psychoanalytic Theory: Freud (cont.)
Correct answer: B
The developmental task of the anal stage is learning independence and control with focus on the excretory function. Freud believed that the manner in which children are toilet trained has far-reaching effects on the child's personality. Children who had harsh and rigid training utilize those same approaches internally when evaluating their adult actions. The current situation reflects an alteration in fulfilling the child’s need for independence and control during the anal stage.

14. 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 include:
Anxiety
Satisfaction of needs
Interpersonal security
Self-system

15. Interpersonal Theory: Sullivan (cont.)
Stages of Development
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)

16. 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 to assist clients achieve interpersonal security and a sense of well-being.

17. 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.

18. Theory of Psychosocial Development: Erikson (cont.)
Stages of Development
Trust versus mistrust (birth to 18 months)
Autonomy versus shame and doubt (18 months to 3 years)
Initiative versus guilt (3 to 6 years)
Industry versus inferiority (6 to 12 years)
Identity versus role confusion (12 to 20 years)
Intimacy versus isolation (20 to 30 years)
Generativity versus stagnation (30 to 65 years)
Ego integrity versus despair (65 years to death)

19. Theory of Psychosocial Development: Erikson (cont.)
A 40-year-old man is estranged from his children and states, “I’m the only one I can count on to meet my needs. The kids just want my money.” Using Erikson’s theory, with which developmental conflict is this client struggling?
A. Industry versus inferiority
B. Intimacy versus isolation
C. Ego integrity versus despair
D. Generativity versus stagnation

20. Theory of Psychosocial Development: Erikson (cont.)
Correct answer: D
Generativity versus stagnation occurs in middle adulthood (30 to 65), which are primarily the working years. The major task is to achieve life goals established for oneself while also considering the welfare of future generations. This situation presents a client who is self-absorbed and unable to consider the welfare of his children. This situation is reflective of the developmental conflict of generativity versus stagnation.

21. 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 these tasks and move on to a higher developmental level.

22. 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: Autism (birth to 1 month)
Phase II: Symbiosis (1 to 5 months)
Phase III: Separation-Individuation (5 to 36 months)

23. Theory of Object Relations: Mahler (cont.)
Phase III. There Are Four Subphases:
Differentiation ( 5 to 10 months)
Practicing (10 to 16 months)
Rapprochement (16 to 24 months)
Consolidation (24 to 36 months)

24. Theory of Object Relations: Mahler (cont.)
Relevance to Nursing Practice
Understanding the concepts of Mahler’s theory of object relations assists the nurse to assess the client’s 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.

25. Cognitive Development: Piaget
Based on the premise that human intelligence is an extension of biological adaptation or one’s ability for psychological adaptation to the environment

26. Cognitive Development: Piaget (cont.)
Stages of Development
Piaget identified four stages of development that are related to age, demonstrating at each successive stage a higher level of logical organization than at the previous stage:
Sensorimotor ( birth to 2 years)
Preoperational (2 to 6 years)
Concrete operations ( 6 to 12 years)
Formal operations (12 to 15+ years)

27. Cognitive Development: Piaget (cont.)
Relevance to Nursing Practice
Nurses who work in psychiatry may use
techniques of cognitive therapy to help clients. Cognitive therapy focuses on changing “autonomic thoughts” that occur spontaneously and contribute to negative thinking. Nurses must have knowledge of cognitive development to help clients identify the distorted thought patterns and make the changes required for improvement in affective functioning.

28. Theory of Moral Development: Kohlberg
Stages of moral development are not closely tied to specific age groups; they are more accurately determined by the individual’s motivation behind the behavior.

29. Theory of Moral Development: Kohlberg (cont.)
Three Major Levels of Moral Development
Preconventional level (4 to 10 years)
Conventional level (10 to 13 years and into adulthood)
Postconventional level (from adolescence on)

30. Theory of Moral Development: Kohlberg (cont.)
Relevance to Nursing Practice
Moral development has relevance to psychiatric nursing in that it affects critical thinking about how individuals ought to behave and treat others. Psychiatric nurses must be able to assess the level of moral development of their clients to be able to help them in their efforts to advance toward a higher level of developmental maturity.

31. A Nursing Model of Interpersonal Development: 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
Views interpersonal experiences as learning situations for nurses to facilitate forward movement in the development of personality

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

33. A Nursing Model of Interpersonal Development: Peplau (cont.)
Four Stages of Personality Development
Stage 1: Learning to count on others
Stage 2: Learning to delay gratification
Stage 3: Identifying oneself
Stage 4: Developing skills in participation

34. A Nursing Model of Interpersonal Development: 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 of what has not been learned in earlier experiences.