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AMA 114 Basic Psychology Principles. Influences on Behavior. Needs – Basic needs; Maslow’s Hierarchy Interests – where attention is directed, activities pursued, decisions made, occupations chosen Values – beliefs, ideas, ethics, morals, standards of behavior
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Influences on Behavior • Needs – Basic needs; Maslow’s Hierarchy • Interests – where attention is directed, activities pursued, decisions made, occupations chosen • Values – beliefs, ideas, ethics, morals, standards of behavior • Culture – ethnicity, religion, neighborhood, role models • Heredity – genetic traits • Development – heredity + prenatal + environment: physical, intellectual, emotional and spiritual • Environment – physical and social • Health – illness and wellness
Heredity • Heredity – genetic traits • Genotype – unique set of inherited traits • Phenotype – result of all genes determining physical appearance • Expressed – individual will manifest trait • Unexpressed – predisposed to trait, manifested under certain conditions • Dominant trait – expressed • Recessive trait – manifested if both parents have gene • Genetics – study of heredity • Genetic disorder – results from genetic makeup of individual i.e. Down’s syndrome • Genetic testing – Human Genome Project; mapping of all DNA. A person can be tested for genetic traits for disease
Behaviorism • Pavlov – Classical Conditioning • Conditioned and unconditioned stimulus and response • Salivating Dog – famous experiment • Skinner – Operant Conditioning • Feelings affect behavior • Operant produces change • Stimulus and response • Positive and negative reinforcement
Sigmund Freud • Psychoanalysis: importance of the unconscious mind in understanding conscious thought and behavior • The psyche can be divided into three parts: Ego, super-ego, and id. • The id: child-like portion of the psyche; very impulsive and only takes into account what it wants and disregards all consequences. • The super-ego: moral code of the psyche; follows right and wrong and takes into account no special circumstances in which the morally right thing may not be right for that situation. • The ego: balance between the two; part of the psyche portrayed in the person's action, and after the super-ego and id are balanced, the ego acts in a way that takes both impulses and morality into consideration.
Erik Erikson Psychoanalyst: life-stage virtues/development, in the order of the stages in which they may be acquired, are: • hope - Basic Trust vs. Mistrust - Infant stage. Does the child believe its caregivers to be reliable? • will - Autonomy vs. Shame and Doubt - Toddler stage. Child needs to learn to explore the world. Bad if the parent is too smothering or completely neglectful. • purpose - Initiative vs. Guilt - Kindergarten - Can the child plan or do things on his own, such as dress him or herself. If "guilty" about making his or her own choices, the child will not function well. Erikson has a positive outlook on this stage, saying that most guilt is quickly compensated by a sense of accomplishment. • competence - Industry vs. Inferiority - Around age 6 to puberty. Child comparing self worth to others (such as in a classroom environment). Child can recognise major disparities in personal abilities relative to other children. Erikson places some emphasis on the teacher, who should ensure that children do not feel inferior. • fidelity - Identity vs. Role Confusion - Teenager. Questioning of self. Who am I, how do I fit in? Where am I going in life? Erikson believes that if the parents allow the child to explore, they will conclude their own identity. However, if the parents continually push him/her to conform to their views, the teen will face identity confusion. • love (in intimate relationships, work and family) - Intimacy vs. Isolation - Young adult. Who do I want to be with or date, what am I going to do with my life? Will I settle down? This stage has begun to last longer as young adults choose to stay in school and not settle. • caring - Generativity vs. Stagnation - the Mid-life crisis. Measure accomplishments/failures. Am I satisfied or not? The need to assist the younger generation. Stagnation is the feeling of not having done anything to help the next generation. • wisdom - Ego Integrity vs. Despair - old age. Some handle death well. Some can be bitter, unhappy, dissatisfied with what they accomplished or failed to accomplish within their life time. They reflect on the past, and either conclude at satisfaction or despair.
Myers-Briggs • The Myers-Briggs Type Indicator (MBTI) assessment is a psychometric questionnaire designed to identify certain psychological differences according to the typological theories of Carl Gustav Jung • The original developers of the personality inventory were Katharine Cook Briggs and her daughter, Isabel Briggs Myers. They initially created the indicator during World War II, believing that a knowledge of personality preferences would help women who were entering the industrial workforce for the first time identify the sort of war-time jobs where they would be "most comfortable and effective". • http://en.wikipedia.org/wiki/Myers-Briggs_Type_Indicator
Threats to Adjustment • Change – requires learning and acquiring new behaviors, coping skills • Life Stages – Erikson’s stages • Social and Cultural Stressors – peer pressure, dugs, discrimination, sexual activity, sexism, harassment • Major changes – new experiences, marriage, divorce, death, illness, injury, employment status • Chronic Stressors – financial problems, family difficulties, learning problems or disorders, mental problems, behavior issues • Good coping skills and resources will help with adjustment; resilience or bouncing back • Eat healthy and exercise • Get enough sleep • Have someone to talk to • Set goals and work towards them
Responding to Patient Behavior • Accept the patient – do not judge • Show interest and concern – give full attention, respond appropriately • Listen and observe – use therapeutic communication techniques • Recognize significant behavior – egocentrism, regression, unfriendly behavior, aggression both passive and physical, hostility, crying, non-cooperation, overly cheerful or friendliness • Use appropriate responses – reflecting, clarifying, validating, open-ended questions • Maintain confidentiality – HIPAA, respect • Be sensitive to feelings – encourage positivism • Identify patient needs – establish therapeutic relationship, help to access resources
Coping with Loss • Recognize loss involved in life event • Grant the right to grieve • Recognize emotions involved: anger, fear, guilt • Allow time to grieve • Acknowledge vulnerability to loss and pain • Acknowledge lack of total control • Accept grief as a process, work through feelings • Acknowledge your own mortality • Accept life involves change • Believe in your own coping ability • Be supportive of those who suffer loss
Caring for Dying Person • Kubler-Ross’ Stages of Dying/Grief: denial, anger, depression, bargaining, acceptance • Dying as growth process; healthy reaction includes free expression and sharing of feelings with loved ones and friends. Be aware of changes in lifestyle and self-concept that need emotional adjustment • Personal and family issues: where to die, what meds to use, healthcare directives, power of attorney, palliative care, informed consent, rights of dying person, psychological and physiological changes • Health Care Provider roles: substitute palliative goals for curative goals, compassion, therapeutic communication, acceptance, support for family, respect beliefs of patient
