DIFFERENTIAL DIAGNOSIS

The dictionary meaning of Differential Diagnosis is the process of differentiating between two or more conditions which share similar signs or symptoms.
Common abbreviations of the term “differential diagnosis” include DDx, ddx, DD, D/Dx, ΔΔ.

Differential diagnosis is the distinguishing of a particular disease or condition from others that present similar clinical features. Differential diagnostic procedures are used by physicians to diagnose the specific disease in a patient, or, at least, to eliminate any imminently life-threatening conditions. Often, each individual option of a possible disease is called a differential diagnosis (e.g. acute bronchitis could be a differential diagnosis in the evaluation of a cough, even if the final diagnosis is common cold).

Definition:
• It is a process of distinguishing one disorder from other which have similar signs and symptoms.
• It refers to the process of weighing the probability of one disorder versus that of other disorder possibly accounting for a patient’s clinical picture and preventing symptoms.
• It is a systematic method of diagnosing a disorder that lacks unique signs and symptoms.
• Differential Diagnosis involves distinguishing between disease of similar character by comparing their signs and symptoms.

Differential Diagnosis (DDx,ddx,DD,D/Dx,∆∆):
This method of DD was first introduced by Emile Kraepline for diagnosis of mental disorders. It is a systematic method of diagnosis where the person(clinician) use to identify the presence of entity where multiple alternatives are possible. This procedure is largely used by physicians, psychiatrists and other trained professionals to eliminate any imminently life threatening conditions.
This diagnosis can be regarded as implementing aspects of hypothetical deductive method which means that potential presence of candidate disease or conditions can be viewed as hypo which are further processed as being true or false.

Generating a differential diagnosis — that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.
The list might be prioritized by likelihood and urgency.

Steps of Differential Diagnosis:
1. Psychiatrist should gather all information about the patient and create a list of symptoms. The list can be in writing or in psychiatrist’s head.
2. Psychiatrist should make a list of all possible causes of symptoms again this be in writing or in psychiatrist’s head but it must be done.
3. Psychiatrist should prioritize the list by placing the most urgently dangerous possible cause of symptoms at top of the list.
4. Psychiatrist should rule out (excluded) or treat possible causes beginning with the most urgently dangerous condition and working his/her own way down the list. (The cause that does not match hypothesis is ruled out)
5. Therefore, DD reveals following-
• It is a process of distinguishing disorder, having similar signs and symptoms.
• It is a systematic method of determining the most probable disorder that can best account for total symptomatic picture of patient. It involves the comparison of symptoms and ruling out the possibilities of all other factors or disorders except the one that can best account for presenting clinical picture/feature.

The core process of Differential Diagnosis:
1. There are several methods for performing DD e.g. the potential present with symptom A and B.
2. The diagnostician creates a list of diseases, disorders, symptoms and syndromes that include symptom A and B.
3. Consider there are only three disease process that features both these symptoms. Let then say it can be condition 1, 2 and 3.
• Condition 1 – A, B, C
• Condition 2 – A, B, C
• Condition 3 – A, B, E
4. The diagnostician test for presence of symptoms of C. A positive result would support diagnosis of condition 1 or 2 and would rule out the possibility of condition 3.
5. If the client tested positive for E, a test for D could be used to differentiate between condition 1 and condition 2.
Note: One of the most confusing task in psychiatric DD is to determine the presence of personality disorder.

Common Coping Strategies

Coping refers to efforts to master reduce or tolerate the demands created by stress”.

Appraisal focused coping.
Appraisal-focused coping is directed towards challenging our own assumptions and modifying the way we think.
Ellis’s rational thinking- Ellis’s insight about stress appraisal are the foundation for his widely used system of therapy. Ellis’s maintains that you feel the way you think. He argues that problematic emotional reactions are caused by negative self talk which he calls catastrophic thinking.
Catastrophic thinking involves unrealistic appraisals of stress that exaggerate the magnitude of one’s problems.

Ellis’s A-B-C Model-

Activating event. The A stands for activating event that produces the stress. For example – automobile accident, the cancellation of a date, a delay while waiting in a line at the bank.

Belief system. The B stands for your belief about the event for example- ‘How this is’ ‘I can’t stand it!’

Consequence. The C stands for the consequence of your negative thinking as a result of which you feel angry, outraged, anxious, panic-stricken, disgusted or dejected.

The roots of the catastrophic thinking.

Ellis (1994,1995) theorizes that and realistic operation of stress are derived from the rational assumption that people hold.


Some common irrational assumptions-
• I must have love and affection from certain people.
• I must perform well in all Endeavour.
• Other people should always behave competently and be considerate of me.
• Events should always go the way I like.


Catastrophic thinking can be reduced by-
• Learning the detect it whether it occurs
• Learning to dispute is rational assumptions.
• Defusing stressful situations with humour.
• Reinterpreting stressful situations in a more positive light.

Humor as a stress reducer.
Humor can lessen the negative impact of stress on mood for many reasons- it creates a more positive appraisal, increases positive emotions and facilitates positive social interaction.

Positive reinterpretation. Making positive comparisons with others is a common coping mechanism that can result in improved mood and self-esteem (Wilson & Sandy,2001).

Problem- Focused Coping.
Problem-focused coping is that kind of coping aimed at resolving the stressful situation or event or altering the source of the stress.

Using systematic problem solving
Evidence suggest that problem solving skills can be enhanced through training (Heppner&Lee,2002) and by using these steps-
• Clarify the problem
• Generate alternative courses of action.
• Evaluate your alternative and select a course of action.
• Take action while maintaining flexibility.

Seeking help.
Social support can be powerful force that helps buffer effects of stress and that has positive effects of its own (Wills & Fegan,2001). People have more support because they have personal characteristics and attracts more support seeking aid from friends family co-workers and neighbours.

Using time more effectively.
One can make his life less stressful by learning sound time management strategies. The causes of wasted time involves-
• Inability to set or stick to priorities.
• Inability to say no
• Inability to delegate responsibilities
• Inability to throw things away.
• Inability to accept anything less than perfection
• The problem of procrastination

Time management techniques.
• Monitor your use of time.
• Clarify your goals.
• Plan your activities using a schedule.
• Protect your time time.
• Increase your efficiency.

Emotional Focused coping.
Emotion-focused coping is a type of stress management that attempts to reduce negative emotional responses that occur due to exposure to stressors. It is helpful to be able to recognise and modulate one’s emotion.

Enhancing emotional intelligence.
Emotional intelligence consists of the ability to perceive and express emotion, assimilate emotion and thought, understand and reason with emotion, and regulate emotion.

There are four essential components of emotional intelligence-
• To be able to accurately perceive emotions
• To express one’s own emotions.
• Awareness of how emotions shape the thinking, decision making and, coping with stress.
• To be able to understand and analyse their emotions.
• To be able to regulate their emotion.

Releasing pent-up emotions.
Efforts to actively suppressed emotions specially anger, tend to increase stress and physiological arousal. In contrast emotional disclosure is associated with better mood more positive cells perceptions that a physical and mental health.

Managing hostility and forgiving others.
Hostility is related to increased risk for heart attacks and other types of illness. Hostility can be managed by increased efforts to empathize and tolerate as can forgiveness which is an effective emotion-focused coping strategy that is associated with better adjustment and well being.

Meditating.
Meditation claim that it can improve learning, energy level, work productivity, physical health, mental health and general happiness for reducing tension and anxiety caused by stress.

Using relaxation procedures.
Systematic relaxation procedures can soothe the emotional turmoil and reduce stress induced physiological arousal.

The Subconscious Mind

Knowing it is one thing and understanding it is completely different. You know there’s subconscious mind and you may even know how it works but do you really understand it? Do you really understand how does your subconscious mind works? Here’s the content for you to understand How does Your Subconscious Mind works.

The Conscious and Subconscious are the two spheres of your one mind. The conscious mind is the reasoning mind. You make your decisions using conscious mind whereas the subconscious mind does not reason it rather forms impressions of what your conscious mind holds. It does not bother what is good or bad. If you give it wrong information, it will accept it as true and will work accordingly to make it correct by bringing you suggestions. But a suggestion cannot impose itself on your subconscious mind against the will of the conscious mind. Your conscious mind has the power to resist the suggestion.

Many of you are not aware of your own potential because you don’t know about the infinity within yourself. Whatever you want, you can draw from it. The infinity is your subconscious which is – huge – than you think it is. The Law of your mind is the law of belief. This means to believe in the way your mind works, to believe in belief itself. The Law of your mind is – the reaction of your subconscious mind is determined by what you hold in your conscious mind. Psychologists and psychiatrists point out that when thoughts are conveyed to your subconscious mind, impressions are made in the brain. As soon as your subconscious accepts any idea, it proceeds to put it in effect immediately.

Albert Ellis’s A-B-C model can also be taken into consideration in order to understand the relationship between your conscious and subconscious mind. According to him, Consequences(C) are based on what you believe(B) i.e. your belief cause the consequences and not any activating event(A). So what happens to you is what you believe will happen.

Your subconscious mind does not argue with you. It accepts what your conscious mind decrees. Your subconscious mind works to make true what you hold in your conscious mind. So select your thoughts wisely. You have the power to choose so why not choose health and happiness. You can choose to be happy or not by choosing what you say and what thought you hold in conscious mind.

YOU ARE THE CAPTAIN OF YOUR SOUL AND MASTER OF YOUR FATE. BELIEVE IT IN YOUR BONES AND NOTICE THE CONSEQUENCES.

Ordinal Position Shapes Your Personality

First born, Middle Born or Last Born? How you feel, behave and what you become is not because of only one factor but it is because of mixture of many aspects of your life. There are some characteristics associated with your ordinal position which have some sort of effect on how you feel, behave and what you become.

Firstborns.

If you are the eldest one -the first born- you would relate to the points mentioned below

  • You behave in a matured way because of association with adults and because you are expected to assume responsibility.
  • You resent having to serve as model for your younger siblings and having to assume some of their.
  • You tend to conform to group wishes and pressures.
  • You have feeling of insecurity and resentment as a result of having being displaced as the center of attention by a second born sibling.
  • You lack dominance and aggressiveness as a result of parental over protection.
  • You develop leadership abilities as a result of having to assume responsibilities in home.
  • First borns are usually high achievers or over achievers because of parental pressure and expectation.
  • You are often unhappy because of insecurity arising from displacement by younger siblings.

Middle-borns.

Are you middle born? Because if you are, you might just tick (✓) every point mentioned here.

  • You have learnt to be independent and adventuresome as a result of greater freedom.
  • You might feel that you’ve become resentful or try to emulate the other’s behavior when compared unfavorably with an older sibling.
  • You resent privileges older siblings are granted.
  • You act up and break rules to attract parental attention to themselves.
  • You might develop a tendency to ‘boss,’ ridicule, tease, or even attack younger siblings who get more parental attention.
  • You have fewer responsibilities than firstborns- which they interpret as meaning they are inferior.
  • You are plagued by feeling of parental neglect.
  • You turn to outsider for peer companionship- but this often leads to better social adjustments than firstborns.

Last-borns.

So the last one then? Said to be the most loved and spoilt one among all.

  • You tend to willful and demanding as a result of less strict discipline and ‘spoiling’ by family members.
  • You have fewer resentments and greater feelings of security as a result of never being displaced by younger siblings.
  • You are usually protected by parents from physical or verbal attacks by older siblings and this encourages dependency and responsibility.
  • You tend to be underachiever because of fewer parental expectations and demands.
  • You experience good social relationship outside the home and are generally popular but frequently leaders because of lack of willingness to assume responsibilities.
  • You tend to be happy because of attention and ‘spoiling’ from family members during early childhood.

Note from author. You may not relate to every statement mentioned here because there are individual differences along with many other aspects like your environment of upbringing, your peer group etc. If you’ve anything else you see most people relate to just let me know in the comment box.

Schools Of Thought Psychology

The school of Structuralism.

Structuralism seeks to understand the structure (configuration of elements) of the mind and its perceptions by analyzing those perceptions into their constituent components (affection, attention, memory, sensation, etc). Structuralist sought to deconstruct the mind into its elementary components; they were also interested in how those elementary components work together to create the mind. 9c1162

Wilhelm Wundt (1832-1920). German Psychologist; Father of structuralism. Founder of experimental Psychology and first experimental lab was established by him in 1879.

Introspection Method. It is deliberate looking inward at pieces of information passing through consciousness. The aim of introspection is to look at the elementary components of an object or process. Involving introspection, individuals reported on their thoughts as they were working on reported on their thoughts as they were working on given task called introspection report.

Challenges associated with introspection.

  • People may not always be able to say exactly what goes through their mind.
  • What they say may not be accurate.
  • The fact that people are asked to pay attention to their thoughts while they’re working on a task may itself alter the processes that are going on.

Edward Titchener (1867-1927)- First full-fledged structuralist. His experiments relied solely on the use of introspection. He focused on structure of brain and context of perception.

Criticism- Cognition does not necessarily register in consciousness.

The school of Functionalism.

Functionalism emerged as a criticism of structuralism. Functionalism seeks to understand what people do and why they do it. It suggest that psychologist should focus on the process of thought rather than on its content. To understand human mind and behaviour functionalists studied the process of how and why the mind works as it does. They were particularly interested in the practical applications of their research. Functionalism led to pragmatism – which believes that knowledge is validated by its usefulness. “What can you do with it?” Pragmatist focus on learning and memory because it has application and is useful in daily life.

William James (1842-1910). ” Principles of Psychology” became basis of psychology specially in cognitive psychology.

John Dewey (1859-1952). Early pragmatist who profoundly influenced contemporary thinking in cognitive psychology.

Criticism. Functionalists did not really specify a mechanism by which learning takes place.

The school of Associationism.

It examines how elements of Mind, like events or ideas, can become associated with one another in the mind to result in a form of learning. For example- associationism may result from:

  • Contiguity. Associating things that tend to occur together at about the same time.
  • Similarity. Associated things with similar features.
  • Contrast. Associating things that shows polarities such as Hot-cold, light-dark.

In the 1800s, associationist Herman Ebbinghaus (1850-1909) was the first experimenter to apply Association is Principal systematically. Specifically Ebbinghaus studied his own mental process. He counted his errors and response time. He studied how people learn and remember material through rehearsal.

Edward Lee thorndike (1874-1949). Held that the role of ‘satisfaction’ is the key to forming Association is he term this principle the ‘law of effect (1905): A stimulus will tend to produce produce a certain response overtime if an organism is rewarded for that response.’

The school of Behaviorism.

Behaviourism emerged in the late 19th and early 20th century. It focuses only on the relation between observable behavior and environmental event or stimuli. Throndike and other associationists studied responses that were voluntary.

Ivan Pavlov (1849-1936). Studied involuntary learning behavior. He told that there is involuntary learning through classical conditioning by establishing relation between stimulus and response.

  • Classical conditioning involves more than just an association based on temporal contiguity.
  • Effective conditioning required condition contingency.

Behaviourism focuses entirely on association between the environment and an observable behaviour. According to radical behaviorist, any hypothesis about internal thoughts and ways of thinking are nothing more than speculation contingencies in the form of reward and punishment are still used today.

John B. Watson (1878-1958). ‘Father of Observable behavior’, in 1913, launched behaviorism through his paper: Psychology as the behaviorist views it. He had no use for internal mental mechanism according to Watson, thinking is nothing more than sub vocalized speech.

B. F. Skinner (1904-1990). A radical behaviorist believed that virtually all forms of human behavior, not just learning could be explained by behavior admitted in reaction to the environment.

Criticism. Behaviorism did not account as well for Complex mental activities such as language learning and problem solving.

Edward Tolman (1886-1959). ‘Forefather of Modern Cognitive Psychology’, believed that all behavior is directed towards goal. To understand behavior, the purpose of and the planning for behavior is required to take into action.

Bandura (1977b)- He mentioned that learning is through observation know as ‘social learning’.

Gestalt Psychology.

It states rhat we must understand psychological phenomena when we view them as organised, structured wholes. We cannot fully understand behaviour when we only break phenomena down into smaller parts. Gestaltists, in contrast, studied insight, seeking to understand the observable mental event by which someone goes from having no idea about how to solve a problem to understanding it fully in what sense a mere moment of time.

The maxim “The whole is more than the sum of its part” aptly sum up the Gestalt perspective.

Note from Author. Here’s another blog to all Psychology student out there. Hope you are benefited from the content. Stay connected to get more of Psychological stuff. If you would like to know anything specific feel free to contact.

How Mental Health and Physical Health are Connected

Have you ever been in a condition where you were physically sick; went to different doctors; took all sort of check-ups and your report shows no worries yet you were sick. Have you ever thought of getting your mental health checked? Do you know How Important Your Mental Health Is?

A clear distinction is often made between ‘mind’ and ‘body’. But when considering mental health and physical health, the two should not be thought of as separate. In fact, the World Health Organization defines health as a state of complete physical, mental and social well-being.

Poor physical health can lead to an increased risk of developing mental health problems. Similarly, poor mental health can negatively impact on physical health, leading to an increased risk of some conditions. But have you ever wondered why?

This is because people with mental health conditions are less likely to receive the physical healthcare they’re entitled to which increases in respiratory disease, heart disease and cancer risk, along with other risks in them. The Mental Health Foundation reported that those who take part in mental health services are statistically less likely to receive many routine checks, such as weight, cholesterol and blood pressure, that might detect symptoms of these physical health conditions.

Connecting Mind and Body-

Isn’t it amazing to think that your physical health can have a direct impact on your mental health, and vice versa? Researchers have been studying the effects of mental health conditions on patients’ physical and mental health for decades.

Unfortunately, the link between physical and mental health is not always clear. However, researchers have found that there are intrinsic links between the two.

For example, patients with severe coronary artery obstructions often present with some form of depression. Studies also show that patients with chronic physical illness are three times as likely to have depression. You might be thinking; Well, they have a chronic illness, for goodness sake, wouldn’t it be normal to be depressed over your disease? Researchers have taken this into consideration as well. And what they’ve found is that, while chronic illness can contribute to depression, depression can also precede the physical illness. But it isn’t just depression that can lead to physical symptoms.

When our emotions – like anger and sadness – are not dealt with, the body is adversely affected. For instance, when patients have excessive anger, stress hormones are released, including cortisol and adrenaline. These hormones increase a person’s blood pressure. Over time, uncontrolled anger can result in chronic high blood pressure, heart disease, anxiety, insomnia, headaches, and digestive issues. Depression alone can cause chronic fatigue, insomnia and increased sensitivity to aches and pains due to abnormal function of neurotransmitters in the brain whereas post-traumatic stress disorder causes back pain

How to Create A Healthy Body And Mind-

Now that you know mental condition have direct relation with physical conditions, what can you do about it? Here are some ways you can improve your mental and physical health:

  • Exercise regularly. Exercise can release endorphins and serotonin which are feel-good brain chemicals that can ease depression and anxiety. Choose a program or form of exercise that works for you. This may be cardio-intense interval training or a more mindful and intention-driven yoga practice or something in between. The key is that you stick to it.
  • Eat a healthy diet. High-calorie and low-nutrient foods have been linked with increased depression and anxiety. Skipping meals is a big NO because it leads to fatigue and unhealthy snacking. Including fruits, vegetables, nuts, whole grains, fish and healthy fats, like avocados, into your meals will be helpful for increased brain functioning.
  • Maintain a normal sleep schedule. Not getting enough sleep has been linked with depression, anxiety and stress. The recommendation for adults is seven or more hours of sleep per night. If you’re having trouble falling and staying asleep, try one of the following:
    • relaxing before bed,
    • lowering your caffeine intake, or
    • setting a stricter schedule for bedtime.
  • Get support. Your social circle is also a vital aspect to prevent a decline in mental health. But mental health can be a difficult topic to discuss with peers which often prevents people from seeking help. Don’t be afraid to reach out to friends and family for support.

Note from author-

You all know “Precaution is better than cure” but how many of you follow in regard of your mental health? Why do you seek out a mental health expert only after a crisis has occurred? Getting help earlier can prevent mental health conditions, like depression and anxiety, from developing.

If you are experiencing symptoms of any mental health condition, it is important to contact a professional who can help you ease up. Eating right and exercising can help some people improve their mental health. However, others may need medication or counseling to see changes. By partnering with an expert, you will be better able to find out what’s right for you.

Old Age

Old age is the closing period in life span which begins at approximately sixty years, is characterised by certain physical and psychological changes that are far more likely to lead to poor adjustments. It is a period when people “move away” from previous, more desirable periods- or times of “usefulness.” People often look back on their lives as they move away from the earlier periods of their lives, usually regretfully, and tend to live in the present, ignoring the future as much as possible.

The last stage in the life span is frequently subdivided into early old age, which extends from age sixty to age seventy, and advanced old age, which begins at seventy and extends to the end of life.

Characteristics of Old Age-

  • Old Age is a period of decline.
  • There are individual differences in the effect of aging.
  • Old age is judged by different criteria
  • There are many stereotypes of old people
  • Social attitudes towards Old age
  • The Elderly have a minority-group status
  • Aging requires role change
  • Poor adjustment is characteristic of old age
  • The desire for rejuvenation is widespread in old age

Developmental Tasks of Old Age-

  • Adjusting to decreasing physical strength and health.
  • Adjusting to retirement and reduce income.
  • Adjusting to death of spouse.
  • Establishing an explicit affiliation with members of one’s age group.
  • Establishing satisfactory physical living arrangements.
  • Adapting to social roles in a flexible way.

Adjustments during Old Age-

Personal Adjustment- During this period of life, old age people need to make some personal adjustment such as-

  • Physical health problems, various disease during old age
  • Changes in interests like Changes in appearance
  • Internal changes; bodily organs
  • Sensory changes
  • Changes in physical function like walking
  • Sexual changes; decrease in sexual capacity
  • Motor abilities decreases
  • Cognition deterioration

Vocational Adjustments- Older men are more interested in steady work than in advancement which they realize is not likely to be forthcoming. As a result, they’re usually more satisfied with there jobs than younger men.

  • Vocational opportunities for older workers are fewer
  • Appraisal of older workers
  • Adjustments to retirement which somewhat depends on the kind of retirement and attitude of individual towards retirement.

Family Adjustments- The pattern of family life, established in early adulthood, starts to change with the onset of middle age. These changes are made more pronounced by retirement, with the accompanying reduced income, or by the death of spouse in old age. Family adjustment during old age-

  • The first important adjustment centering around family relationships elderly people must make is establishing good relationships with their spouse.
  • Elderly people also need to make adjustment with changes is sexual behavior
  • Relationship with offspring
  • Parental dependency
  • Relationship with grandchildren
  • Adjustment to loss of a spouse in old age
  • Adjustment to singlehood in old age

Middle age

Middle age is generally considered to extend from age forty to age sixty. The onset is marked by physical and mental changes, as it end. At sixty, there is usually a decline in physical vigor, often accompanied by a lessening of mental alertness. Middle age is a long period in life span, it is subdivided into early middle age, which extends from age forty to age fifty, and advanced middle age, which extends from age fifty to age sixty.

Characteristics of Middle Age-

  • Middle age is a dreaded period
  • Middle age is a time of transition
  • Middle age is a time of stress
  • Middle age is a “dangerous age”
  • Middle age is an “Awkward age”
  • Middle age is a time of achievement
  • Middle age is a time of evaluation
  • Middle age is evaluated by a double standard
  • Middle age is the time of empty nest
  • Middle age is a time of boredom

Developmental Task of Middle Age-

  • Achieving adult civic and social responsibility
  • Assisting teenage children to become responsible and happy adults
  • Developing adult leisure-time activities
  • Relating oneself to one’s spouse as a person
  • Accepting and adjusting to the physiological changes of middle age
  • Reaching and maintaining satisfactory performance in one’s occupational career
  • Adjusting to aging parents

Various Adjustments in Middle Age-

Adjustments to physical changes- One of the most difficult adjustments middle-aged men and women must make is to changed appearance.

  • Changes in Appearance- Middle-aged people rebel against threats to the status they fear they may lose as their appearance deteriorates.
  • Changes in Sensory Abilities- Gradual deterioration of sensory abilities begins in middle age.
  • Changes in Physiological Functioning- These Changes are, for the most part, the direct or indirect result of changes in the body tissues.
  • Changes in Health- Middle age is characterized by a general decline in physical fitness and some deterioration of health is common.
  • Sexual Changes- Women go through the menopause, or change of life, whereas men experience the male climacteric.

Adjustment To Mental Changes- There is a traditional belief that as physical abilities decline, so do mental abilities.

Terman and Oden in a study mentioned that mental abilities, such as problem solving and verbal ability, little or no decline was reported in middle age among those whose initial abilities were high.

Another report by Kangas and Bradway has indicated that intelligence may even increases slightly in middle age, especially among those of higher intellectual levels.

Adjustment to Changed Interest- While there are changes in interest during middle age, they are far less marked than the changes that occurred during the earlier years of life. Adjustment to changed interest includes-

  • Appearance and clothes- Interests in appearance, which begins to wane after marriage and especially during the early years of parenthood, intensifies when the external physical changes which accompany advancing age become noticeable.
  • Money- Regardless of how much or how little money they may have, middle-aged men and women are interested in money.
  • Status symbols- Because middle-aged people like to think of themselves as the “command generation” – the group that exercises that will proclaim their certain material possessions that will proclaim their status to others.
  • Community affairs- The middle-agee man is well established in his work, and the average woman’s home responsibilities have decreased. Thus they can devote more time to community affairs.
  • Recreations- One of the major tasks of middle age is learning how to use leisure time in a satisfying way.

Social Adjustments- Family responsibility of middle age people decrease and as their economic status improves, they’re better able to engage in social activities than they are better able to engage in social activities than they were during early adulthood.

People of this age enjoy entertaining friends at dinners or parties. These activities reach their peak in the late forties and early fifties and then begin to decline as individual approaches the sixties. A decrease in energy at this time puts a stop to a too active social life.

Vocational Adjustments- Vocational adjustments of middle-aged men and women are complicated by such factors as-

  • Unfavorable social attitudes
  • Hiring policies
  • Increased use of automation
  • Group work
  • Increasing importance of the role of wives
  • Compulsory retirement
  • Dominance of big business
  • Necessity for relocation

Adulthood

The term adult comes from the Latin word “adultus” meaning “grow to full size and strength” or matured. Adult are, therefore, individuals who have completed their growth and are ready to assume their status in society along with other adults.

Characteristics of Early Adulthood-

  • Early adulthood is the “settling-down age”
  • It is the “Reproductive age”
  • Early adulthood is a “Problem age”
  • Early adulthood is a period of emotional tension
  • Early adulthood is a period of social isolation
  • Early adulthood is a time of commitments
  • Early adulthood is often a period of dependency
  • It is a time of value change
  • It is the time of adjustment to new lifestyles
  • Early adulthood is a creative age

Developmental Task of Early Adulthood-

  • Getting started in an occupation
  • Selecting a mate
  • Learning to live with a marriage partner
  • starting a family
  • Rearing children
  • Managing a home
  • Taking on civic responsibility
  • Finding a congenial social group

Changes in Interest in Early Adulthood-

Adolescents carry over into the adult years many of their interests. Interests change during the adult years, however. Some of these carry-over interests are no longer appropriate to the adult role while others do not provide the satisfaction they did earlier.

Personal Interests- Personal interests are those related to the individual. Most young adults carry over from their adolescent years a strong interest in self which results in egocentrism. Personal interest includes-

  • Appearance
  • Clothes and personal adornment
  • Symbols of maturity
  • Status symbols
  • Money
  • Religion

Recreational Interest- The term recreation means an activity that renews strength and refreshes spirits after toil or anxiety. Some recreational interests that adults are involved in-

  • Talking
  • Dancing
  • Sports and games
  • Entertaining
  • Hobbies
  • Amusement

Social Interest- Early adulthood, as Erickson has emphasized when he referred to it as the time of “isolation crisis,” is frequently a lonely time for both men and women. Havighurst has explained that loneliness during the early adult years occur because this is a”relatively unorganized period in life which marks the transition from an age-graded to a social-status-graded society” . There are various changes that includes-

  • Changes in social participation
  • Changes in friendship
  • Changes in social groupings
  • Change in value placed on popularity
  • Changes in Leadership status

Adjustments of Adulthood-

Vocational Adjustments- For most adult men, happiness depends to a large extent upon satisfactory vocational adjustments. The whole pattern of their lives is dependents. The whole pattern of their lives is dependent on on how much they earn and how they earn it. Vocational adjustment includes-

  • Selection of a vocation
  • Stability of vocational selection
  • Appraisal of vocational adjustment

Marital Adjustment- Just as the ever-increasing number of vocational opportunities make vocational selection and adjustment difficult, so does the ever-increasing number of family patterns makes marital adjustment difficult. Marital Adjustment includes-

  • Adjustment to a mate
  • Sexual adjustment
  • Financial adjustments
  • In-law adjustment

Adjustment to Parenthood- It has been said that parenthood is the most important criterion of the individual’s transition to maturity and adult responsibility. While parenthood, unquestionably, brings with it many gratifications, it can also be regarded as a “crisis” in life because it necessitates major changes in attitudes, values, and roles. Adjustment of parenthood-

  • Voluntary Childlessness
  • Single Parenthood
  • Variations in adjustment to Parenthood

Adolescence

The term “Adolescence” comes from the Latin word adolescence, meaning “to grow” or ” to grow to maturity”. The term adolescence has broader meaning as of today which includes mental, emotional, and social maturity as well as physical maturity. Psychologically, adolescence is the age when the individual becomes integrated into the society of adults, the age when child no longer feels that he is below the level of his elders but equal, at least in rights.

Characteristics of Adolescence-

  • Adolescence is one of the period when both the immediate and long-term effects are important.
  • Adolescence is a passage from one stage of development to another. This means what has happened before will leave its mark on what happens now and in future.
  • Adolescence is a period of change because the rate of change in attitude and behavior is parallels the rate of physical change.
  • Adolescence is a problem age because during earlier stage of life their problems were met and solved but now they’re on their own to solve problem to which they face difficulty to cope with.
  • Adolescence is a time of search for identity. Adolescents gradually begin to crave for identity and are no longer satisfied to be like their peers in every respect as they were earlier.
  • Adolescence is a dreaded stage. Popular stereotypes have also influenced the self-concepts and attitudes of adolescents toward themselves.
  • Adolescence is a time of unrealism. Adolescents have tendency to look at life through rose-tinted glasses.
  • Adolescence is the threshold of adulthood.

Developmental task of Adolescence-

  • Achieving new and more relation with age-mates of both sexes
  • Achieving a masculine or feminine social role
  • Accepting one’s physique and using one’s body effectively
  • Desiring, accepting, and achieving socially responsible behavior
  • Achieving emotional independence from parents and other adults
  • Preparing for a economic career
  • Preparing for marriage and family life
  • Acquiring a set of values and en ethical system as a guide to behavior- developing an ideology

Types of changes in Adolescence-

Physical changes-

  • Height- The average girl reaches her mature height between the ages of seventeen and eighteen and for boys, it is a year or later.
  • Weight- Weight changes follow a timetable similar to that for height changes.
  • Body proportion- The various parts of the body gradually come into proportion.
  • Sex Organs– Reaches to maturity in late adolescence along with Secondary Sex Characteristic.
  • Digestive System- The stomach becomes longer and less tubular the intestines grow in length and circumference, the muscles in the stomach and intestine walls becomes thicker and stronger.
  • Circulatory System- The heart grows rapidly during adolescence; by the age of seventeen and eighteen.
  • Respiratory System- The lung capacity of girls is almost at a mature level at age seventeen: boys reach this level several years later.
  • Endocrine System- The increased activity of gonad at puberty results in a temporary imbalance of the whole endocrine system. The sex glands develop rapidly and become functional.

Emotional Changes-

Storm and Stress- The term was coined by G. Stanley Hall in Adolescence, written in 1904. Hall used this term because he viewed adolescence as a period of inevitable turmoil that takes place during the transition from childhood to adulthood. ‘Storm‘ refers to a decreased level of self-control, and ‘stress‘ refers to an increased level of sensitivity. Three main categories of storm and stress described by Hall are:

  • Conflict with parents: Adolescents tend to rebel against authority figures as they seek greater independence and autonomy.
  • Mood disruption: Hormonal changes and the psychological stress of adolescence can cause uncontrollable shifts in emotions.
  • Risky behavior: The combination of a neurological need for stimulation and emotional immaturity lead to increased risk-taking behavior during adolescence.

Apart from storm and stress which is seen in adolescents because of change in emotionality, nature of emotion, emotional expression also changes with increase in irritation along with emotional maturity and decrease in self control.

Social Changes-

  • Increased peer group influence- Because adolescents spend most of their time outside the home with members of the peer group, it is understandable that peers would have a greater influence on adolescent attitudes, speech, interest. appearance and behavior than the family has.
  • Changes in social behavior- Of all the changes that take place in social attitudes and behavior, the most pronounced is in the area of heterosexual relationships. In short period of time, adolescents make the radical shift from disliking members of the opposite sex to preferring their companionship to that of members of their own sex.
  • New social groupings- The gang of childhood gradually break up at puberty and during early adolescence as the individual’s interests shift from the strenuous play activities to less strenuous and more formal social activity of adolescence.
  • New values in selection of friends- Adolescents want as friends those whose interests and values are similar to theirs, who understand them and make them feel secure, and in whom they can confide problems.
  • New values in social acceptance- Adolescents have new values concerning social acceptable or unacceptable members of different peer groups, such as cliques, crowd, or gangs.
  • New values in selection of leaders- Adolescents want their leader of superior ability who is admired and respected by others because they feel that the leaders of their peer groups represent them in the eyes of society.

Changes in Interest- The interest of adolescents depend upon their sex, their intelligence, environment in which they live the opportunities they have for developing interests, what their peers are interested in, their status in the social group, their innate abilities, the interests of their families, and many more factors.

  • Recreational interests- Some recreational interests of adolescents are – games and sports, relaxing, traveling, dancing, reading, movies, radio and records, television, daydreaming etc.
  • Social Interests- Social interests like parties, drinking, drugs, conversations, helping others, world affairs, criticism and reform.
  • Personal interests- It includes interest in appearance, clothes, achievements, independence and interest in money.
  • Educational, vocational, religious, interest in status symbols are also seen in adolescents.

Changes in Morality-

  • The individual’s moral outlook becomes progressively more abstract and less concrete.
  • More convictions become more concerned with what is right and less concerned with what is wrong. Justice emerges as a dominant moral force.
  • Moral judgement becomes increasingly cognitive. This encourages the adolescent to analyze social and personal codes more vigorously than during childhood and to decide on moral issues.
  • Moral judgement becomes less egocentric.
  • Moral judgement becomes psychologically expensive in the sense that it takes an emotional toll and creates psychological tension.

Problems of Adolescence-

Adolescence also know as problem age because their problems were met during the earlier stage of life and solved but now they’re on their own to solve problem to which they face difficulty to cope with. Hence there are many problems with this stage of human life span.

  • Pre-adolescence- Negative attitude develops, shows critical behavior, lack social control, face tension and anxiety if they’re not allowed to do what they desire, instability in emotion and aimlessness is also observed.
  • Early-adolescence- During the early adolescence their is adjustment problem because a lot of changes occur around the adolescents.
  • Late-adolescence- The adolescent face difficulty with sexual interests, family, status, peers in addition to vocational and educational adjustment.

Types pf problems-

  • Independence
  • Pre- relationship
  • Opposite sex relationship
  • Vocational
  • Morality and religious
  • Emotional maturity
  • Social conformity
  • School problem
  • Health problem
  • Recreational problem
  • Family problem

Means of solving problem-

  • Guidance and counseling
  • Social support, appreciation, and training
  • Family environment
  • Techniques of discipline
  • Objective approach
  • Selecting alternative goal
  • Self-control

Self and Personal Identity-

Self is the combination of physical and psychological attributes that is unique to each individual.

Shaffer and Kipp

Self concept is all the information and belief individual have about their own characteristics and themselves.

Barron(2001)

Self depends on the knowledge and acceptance on one’s own self which is developed during adolescence because during this time period we’re aware of our characteristics. Self awareness is behavior modification; acting according to situation which decides our aspiration and achievement. If an individual has knowledge of self  based on reality it results in better adjustment. For self enhancement and self- defence, an individual cannot do it without awareness of his/her self.

Types of self-

  • Real Self
  • Social Self

Determinants of self Development-

  • Imitation
  • Identification
  • Role play
  • Language
  • Introjection
  • Interjection.

All characteristics which recognises of self is Personal Identity.

Identity refers to a sense who one is, where one is going in life and how one fixes into the society.

Shaffer and kipp (2007)

Determinants of Personal Identity-

  • Cognitive Factor
  • Family  effects
    • Diffusion
    • Fore closure
    • Moratorium
    • Identity achievement
  • School Effect
  • Socio-Culture Effect
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