Lecture 12- Depression and Hospitalism in Infants
Axis 1: primary diagnosis (stress disorder, sleep behavior disorder, etc.)
Axis II: Relationship Classification (overinvolved, abusive, angry etc)
Child Temperament: *genetic influence
– Activity level (verbal/nonverbal)
– Rhythmicity (regularity--sleeping, eating, bowel)
– Approaching/withdrawing (resist/accept--new
people/environments)
– Adaptability (adjust to change over time—goal directed or not)
– Responsiveness (intense or calm)
– Mood (happy/unhappy demeanor)
– Distractibility (do stimuli alter behavior)
– Attention span (persistence)
– Intensity (energy level—active/passive)
Anaclitic Depression: absence of mothering impaired physical, social and
intellectual development
 Spitz
 Can be reversed if reintroduced to mother
 Separated for 3 months or longer
 Ex.- Harlow Monkey experiment, babies in orphanage
Infant Stimulation: need skin contact, play, interaction, being held
Ex.- still face experiment (depressed moms can cause infants to be
depressed)
Failure to thrive- inability to grow from a disease or from improper care
Developmental Milestones:
2yo- copies line, “No” , points to body parts, two words
3yo- draws circle, 3 word sentence, gender identity, ride tricycle
4yo- draw a cross, hop on one foot, colors
5yo- draw a square, count #’s, skip
6yo- draw a triangle, draws person w/ 6 parts
7yo- draws a diamond
Attachment Theory: relationships b/t humans; infants need a primary giver to
attach to
-Continuous and warm care by one person
- vs. bonding is parents relationship w/ the child (mother needs to bond w/
child!)
 Autistic phase- infant is self absorbed
 Symbiosis- understands self and caregiver
 Rapprochement- return to mother for comfort (2yo- begin crawling and
walking): “secure base”
 Individuation- comfortable being separated from mother
1. Secure attachment- trust needs will be met (happy child, sensitive mother)
2. Avoidant attachment- subconsciously don’t think needs will be met (sad
child, distant mother)
3. Ambivalent attachment- don’t rely on needs being met (angry, anxious child;
inconsistent mother)
4. Disorganized attachment- confused with no strategy to have needs met
(depressed, nonresponsive child; erratic, frightening mother)
Winnicott- transitional object as comfort when mother is not around
Paiget:
Assimilation: objects put into experiences they have already encountered; simplify
everything into their head. Put what their perceive on the outside and fit it into their
internal world. Unrealistic perception
Accommodation: forms new ideas so info from outside world will make sense.
Change internal world to understand outside world. Forming a uniform reality
Stages:
Sensorimotor Stage (birth to 2 yrs)
- explore env
- stranger anxiety
- object permanence
Preoperational Stage (2-7yo)
- egocentric
- anticipate experiences with consequences
- imagination (magical thinking and animism)
Concrete Operational Stage (7-11yo)
-think logically
- conservation (#s, length, volume, weight)
- cause and effect
Formal Operations (11 and up)
-abstract thinking
- imaginary audience( think everyone is watching them)
- hypothetical-deductive reasoning (adolescent excuses)
Id: biological drive; no consequence, sexual and agressive
Ego: rational decisions (mediates superego and id)
Superego: rules, morals
Defense Mechanisms:
Repression - motivated forgetting of things that cause turmoil or conflict within
them
Regression - returning to an earlier state of functioning
Reaction Formation - presenting self as the opposite of what one really
is/feels/desires
Projection - attributing one's desires, attitudes, motivations to another person
Rationalization - coming up with reasons why the behavior occurred, making up
excuses
Displacement - diverting behavior to a less threatening target
Denial - refusal to believe in whatever it is that causes the anxiety
Undoing - doing things to "undo" or make up for other actions that produce anxiety
Sublimation - shift unacceptable energies into acceptable, productive, behaviors
Intellectualization - thinking about threatening things in logical and rational ways
to keep them from generating anxiety
Freud’s Psychosexual Stages:
Oral- birth to 1
Anal- 1 to 3 (potty training)
Phallic- 3 to 6 (genital stimulation); Oedipus and Electra conflict; superego formed
Latency- 6 to 11
Genital- adolescence (puberty and phallic drives reappear)
Erikson’s Psychosocial Stages:
-if one not successfully completed, may reappear as a problem in the future
Kohleber’s Moral Dilemma/ Dev:
When responding to a moral dilemma not important what they should do but the
form of the response
Touch: Elkiss and Jerome 2012
- Communicates reciprocity, empathy, intent to help
- Patient knows they are being examined comprehensively; sense of trust
- Brain releases oxytocin when touched (limbic system)
- Puts patient at ease