Behavioral Science: Development 1 & 2

Question 1

Definitions of premature birth, very premature birth

Answer 1

premature =

Question 2

APGAR score

Answer 2

A- appearance (color)
P- pulse
G- grimace
A- activity (muscle tone)
R- respiration

Used to predict likelihood of immediate survival

Question 3

US birth outcomes

Answer 3

High rate of premature births, so high infant mortality rate compared to other developed countries
Low income –> premature births + infant mortality

Question 4

Baby blues

Answer 4

exaggerated emotionality and tearfulness for a few days after birth

Question 5

post-partum depression

Answer 5

Major Depression that occurs in up to 10% of new mothers within 1 month of childbirth, can persist for up to 1 year

Question 6

What direction do babies develop?

Answer 6

Cephalad to caudad, central to peripheral

- self to others, understanding to expressing

Question 7

What happens from infancy to 18 mos?

Answer 7

• Humans need and seek the presence of others
• Attachment
• Social smile at 12 weeks
• Stranger anxiety at 9 months
• Separation anxiety late in first year, object permanence comes first

Question 8

Importance of attachment

Answer 8

• psychoimmunology

- resulted in the concept of foster families

Question 9

Infant reflexes

Answer 9

Rooting: touch cheek, turns toward nip
Palmar Grasp: grips any object put in palm
Moro: limbs extend when startles
Babinski: dorsiflexion of toes when sole of foot stroked (until 1 yr)

Question 10

Milestones from 18 months to age 5

Answer 10

Rapprochment: moves away but quickly returns for comfort
Age 2: “NO”
Age 3: can spend a few hours away from mom, gender identity
Age 4: Bowel function
Age 5: bladder function

Question 11

Preschool child (ages 3-6)

Answer 11

Sibling rivalry, regression.

• Between 2-4 vocabulary increases a shit ton
• Active fantasy life, knows that imaginary friends aren’t real
• Cooperative play at 4 years
• Strong fear of bodily injury
• Curiosity about bodies

Question 12

6 year old milestones

Answer 12

• development of conscience (superego)

- morality, empathy, right vs. wrong, finality of death

Question 13

Autism Spectrum Disorders

Answer 13

• don’t acquire verbal and social skills at expected age
• seen before age 3
• no finger pointing (theory of mind)
• 50% have intellectual impairment
• more common in boys
• larger head circumference
• genetic component (associated w/ tuberous sclerosis and Fragile X)

Question 14

Rett’s Disorder

Answer 14

4 years of normal functioning –>
hand wringing, breathing problems, intellectual impairment, ataxia, motor and social decline
- X linked

Question 15

Childhood Disintegrative Disorder age

Answer 15

2-10 years of normal development

Question 16

School age (7-11) and adolescence

Answer 16

• psychosexual issues dormant
• industry vs inferiority
• lifelong sense of competence
• concrete operations
• learning problems identified

Question 17

School age (7-11) peer relationships

Answer 17

• relationships with adults other than primary caregiver
• same sex peer relationships
• not fitting in
• sexual latency, identifying with same sex parent
• morality, rule conscious (by 12 more flexible)
• more complex tasks (team sports)
• better at dealing with illness and hospitalization
• acting out as defense mechanism
• age 9: universality of death

Question 18

Changes to brain during adolescence (11-20)

Answer 18

• myelination
• frontal and parietal lobes
• pruning of up to 50% of synaptic connections, decline in glucose and oxygen metabolism

Question 19

Puberty milestones

Answer 19

10. 5 in girls, 11.5 in boys
    - first menstruation 11-14
    - first ejaculation 12-15
    - complete by 13.5 in girls, 15 in males

Question 20

Factors the predispose to teen pregnancy

Answer 20

1. depression
2. poor school achievement
3. divorced parents

Question 21

Down syndrome

Answer 21

• single palmar transverse crease, protruding tongue, flat facies, hypotonia, epicanthal folds, small ears, thick neck, premature aging and Alzheimer’s disease

Question 22

Fragile X Syndrome

Answer 22

Affects males more severely
- delayed cognitive function, hyperactive, hand flapping, hyperextensible joints, large ears, elongated face, postpubertal enlargement of testes

Question 23

Phonological disorders

Answer 23

Leaves out or misplaces speech sounds, ie “ca” for cat, “top” for stop

Question 24

Articulation disorders

Answer 24

Unable to make necessary motor movements for accurate speech production, ie lisping

Question 25

Tourette’s disorder

Answer 25

Involuntary, before age 18

• OCD/ ADHD/ dopamine
• treat w/ dopamine blocking agents

Question 26

Factors that increase risk of divorce

Answer 26

• Short courtship, teenagers, premarital pregnancy, absence of family support, prior divorce in family, difference in religion/SES, couples w/ seriously ill children
• Risk higher when one spouse is physician (female, married prior to med school, psychiatry)

Question 27

Single Parent Family trends

Answer 27

highest to lowest: black, hispanic, white

• increased risk of physical and mental illness
• parent divorce: child at higher risk for school failure, depression, drug abuse, suicide, crime, divorce themselves

Question 28

Types of child custody

Answer 28

Sole custody: child lives with one parent who has legal responsibility for the child, other parent contributes to financial support

Joint custody: time split between both parents

Split custody: Each parent has custody of at least 1 child in the family

Question 29

Early adulthood (20-40)

Answer 29

age 30: role in society is defined, physical development at peak, individual is independent

• love and work/ intimacy vs isolation
• women often change paths in middle 30s
• adopt parental values after years of rebellion

Question 30

Middle adulthood (40-65)

Answer 30

Good health, money, power, authority

• “Sandwich generation” - responsibilities to older and younger relatives
• More life behind than ahead –> midlife crisis
• Climacterium: the physiological changes that occur during midlife

Question 31

Losses of aging

Answer 31

• Social status, death of spouses and friends, decline in health
• ego integrity vs despair, pride vs wasted life

Question 32

Cognitive function in the elderly

Answer 32

Dementia in less than 10% of elderly

- over age 85, 1/2 have cognitive impairment

Question 33

PHysical and neurological changes of aging

Answer 33

• decreased cerebral blood flow, brain weight, formation of amyloid plaques
• intelligence is same
• decreased neurotransmitter availability
• more sensitive to side effects, increased depression

Question 34

Psychosocial changes of aging

Answer 34

• reduced bladder control, loss of strength, vision and hearing loss, elder abuse

Question 35

Psychopathology in old people

Answer 35

• depression, suicide, anxiety, alcohol + substance abuse, delirium

Question 36

Stages of dying

Answer 36

Denial, Anger, Bargaining, Depression, Acceptance

not necessarily in that order

Question 37

Normal grief vs complicated bereavement

Answer 37

• both have initial shock and denial
• denial in abnormal grief can be days to weeks
• both include sadness, crying. normal grief can subside in 1-2 years
• anniversary rxns common
• abnormal grief –> symptoms intensify instead of lessening, suicidal thinking or hallucinations
• cultural differences

Question 38

Role of physician in death and dying

Answer 38

• make aware of dx and prognosis
• reassurance
• serve as resource to family
• medically follow bereaved family members
• resist emotional attachment