PSYCHOLOGY

It originated from two Greek words

1. PSCHE – meaning mind, soul or spirit
2. LOGOS – meaning study
Psychology is therefore the scientific study of the mind and behaviour.

MIND:
Is the ability to think and feel emotions

Parts of the mind:

1. Conscious mind: Store of thoughts, memories and feeling that one is aware of.
2. Unconscious: Part of the mind which contains thoughts, memories and feelings that
cannot easily be brought to the conscious.
3. Preconscious: Store of memories, thoughts and feeling that can easily be brought to the
conscious.

SCIENCE
Is a science because it involves use of scientific methods in studying minds of people and
their behaviour for example
i. Observation
ii. Experiments
iii. Research
iv. Recording etc.

Psychology broke away from philosophy and physiology and emerged as a separate
discipline.
The first psychological laboratory was established by a German Philosopher and Psychologist
Wilhelm Wundt (Father of psychology).
Schools of thought or psychology at that time were: -
1. Structuralism:
This was established with a goal to find units or elements which make up the mind.

2. Gestalt:
According to this school, mind could be thought of as resulting from the whole pattern of
sensory activity.

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 3. Functionalism:
This emphasized that psychology should do what mind and behaviour do.

4. Behaviourism:
Psychology should be restricted on behaviour of people and animals.

SCOPE OF PSYCHOLOGY

OPERATION
i. It describes all types of life activities
ii. It studies and describes behaviour of living organisms
iii. It employs to all living creatures
iv. It studies not only human behaviour

APPLICATION

Human relationship and

self-development

Education
Medicine

Military

APPLICATION OF
PSYCHOLOGY

Business
and
industry
Guidance and
counselling

Politics Criminology

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PSYCHOLOGY AND HEALTH:
Wellness and illness are as result of several different interrelated factors affecting a person’s
life of which psychological factors carry the biggest percentage i.e.
i. Stress and anxiety levels
ii. Attitudes
iii. Life styles
iv. Poor coping mechanisms
v. Beliefs
vi. Cultural practice .

BRANCHES OF PSYCHOLOGY
1. Social psychology:
Is scientific study of how individuals think, feel and behave in regard to other people and
how individual’s thoughts, feelings and behaviours are affected by other people.

2. Sociology:
Is scientific study of social relationships.

3. Development psychology:
Focuses on human development from birth to death. It tries to study mental, physical and
social growth from prenatal periods through to childhood, adolescence, adulthood to old
age.

4. Abnormal psychology:
Is the study and treatment of abnormal behaviours e.g. drug abuse, alcoholism,
personality disorders.

5. Cognitive psychology:
Branch concerned with the study of mental processes e.g. thinking, learning,
remembering memory, feelings.

6. Behavioural psychology:
Branch concerned with the study of observable actions.

7. Physiological psychology:
Branch concerned with the genetic and physical roots of psychological disorders e.g. now
brains change due to drug abuse.

8. Clinical psychology:
Deals with treatment of people with mental or emotional disorders e.g. stress, anxiety,
depression.

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9. Community psychology:
Specialise in human behaviour at home, school and in neighbourhood.

10. Organizational psychology/industrial:

Concerned with behaviour or people at work place e.g. career counselling, retirement
planning, matching people the right jobs e.tc.

11. Educational psychology:

Focuses on how people learn. They identify and assist children who have problems with
learning, measurement of intelligence, and focus on instructional methods.

12. Geriatric psychology:

Focuses on the health and wellbeing of old people

RELEVANCE OF PSYCHOLOGY:
i. It helps us to understand ourselves and build self confidence for self improvement,
thus helps to develop our abilities to carry on our responsibilities and perform our
duties effectively and efficiently.

ii. It helps health workers to understand the attitudes, psychological problems, beliefs,
needs, values, personality characteristics of patients in a better way and attend to
them. This will help the patient to attain quick relief and cure.

iii. Helps to understand abnormal behaviours and help the nurse in management of
mental illnesses.

iv. Helps to enrich careers and understand other people by providing knowledge and
skills on how to correctly and rightfully deal with other people around us.

v. Provides knowledge and skills that help patients adjust to situations that occur
unexpectedly.

vi. Provides knowledge and skills to health workers to adjust to their professions for
success in their career.

vii. It provides communication skills that enable health workers to effectively

communicate with patients of different beliefs and values.

viii. Helps us to identify ourselves in distinctive cultural groups thus respecting each
persons culture.

ix. Helps strengthening/building a cooperative relationship between a patient and health

care team.

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 x. Provides knowledge to identify social psychological aspects of diseases in terms of
society, culture and ethnical influence.

xi. Provides us with knowledge to understand and determine how the body and the mind
work.

TERMINOLOGIES USED IN SOCIO PSYCHOLOGY

Norms:
Are social rules which specify how people should behave in specific situations e.g.
i. Obedience to authority
ii. A woman hiding the fact that she has conceived

Values:
Anything considered to be of importance to a given group of people in the society e.g.
i. In U.S.A culture democracy is prominent value
ii. Value in freedom
iii. Relationships

Belief:
Are convictions held by a person or persons about something. Convictions reflect truth of
something even if it may not be the case e.g. belief in witchcraft.

Importance of belief and values:

i. Helps to shape personal goals and motives
ii. Promotes harmony in the society
iii. Promotes discipline and good manner in the society

Relevance of belief and values in clinical practice:

i. Relevant in the healing process
ii. Relevant in decision making regarding health matter
iii. Relevant in counselling and guidance
iv. Relevant in health education

Importance of norms:
i. Promotes good behaviour in society
ii. They maintain good interpersonal relationship among members
iii. They promote harmony in society
iv. They provide structure and balance to the activities of group members
v. Help s group members to retain their membership and strengthen their association
with the group
vi. Serve as rules of conduct (Do’s and don’ts)

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vii. They help to maintain order in society

Custom: Are the usual ways of doing things.

CULTURE:
Way of life of a particular group of people or members of the society. It includes norms,
values, beliefs, customs, knowledge, patient care, forms of entertainment, dressing, and ways
of eating, marriage practices, religion, ceremonies and level of technology.

Cultural universal:
Are values or modes of behaviour shared by all human cultures e.g.
 Language – no culture without marriage
 Family systems – all cultures have recognizable form of family systems
 Marriage – all cultures have religions or religious rituals

Cultural diversity:
Cultural differences which distinguish societies from one another

Cultural relativism:
Is the idea that something can be understood and judged only in relationship to the cultural
context in which it appears.

Ethnocentrism:
Is the attitude that one’s culture is superior to others, one’s own beliefs and values.
Behaviours are more correct than others so that other people and cultures can be evaluated in
terms of one’ own culture.

Prejudice:
Negative feeling towards members of a particular group. Group can be defined by their
gender, racial, ethnic, religion, occupation, level of education, place of residence, appearance,
and stereotype.
Generalised beliefs about a group of people.

Discrimination:
Overt, unequal or unfair treatment of people based on their group membership e.g.
i. Denial of services to patients
ii. Financial discrimination
iii. Giving substandard treatment
iv. Disregarding patients for the right to informed consent

Stigma:
Sign of being socially unacceptable resulting in isolation, rejection, blame, shame etc.

Racism:
Any attitude, action or institutional structure which subordinates a person or group because of
race.

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Social change:
Transformation of culture and social institutions over time.

Social control:
Attempts by society to regulate thoughts and behaviour of individuals.

Bureaucracy:
An organization with an executive hierarchy and division of labour governed by explicit
rules.

Folkways:
Norms regarded as useful but not very essential for society. violation of some norms brings
about mild punishments – men wearing parts, greeting.

Role:
Is the expected behaviour others have for a person.

Status:
Position or rank in society

Achieved statuses:
Are occupied form the moment a person is born

Master status:
Dominant status:
Social role:

Sick role:
Behaviour expected and required of an ill person

Components of sick role:

i. Exemption from some social responsibilities
ii. The right to expect help from others
iii. An obligation to seek treatment
iv. Expectation of a wish of recover

Illness behaviour:
Any behaviour undertaken by an individual who feels ill, to relieve that experience, it
includes;
i. Seeking help
ii. Consulting doctors
iii. Taking medicines
iv. Giving up responsibilities
v. Health behaviours

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FACTORS INFLUENCING HEALTH SEEKING BEHAVIOUR
i. The extent to which symptoms are perceived as serious i.e. person’s estimate of the
present and future probabilities of danger.
ii. The extent to which symptoms disrupt family, household tasks and work
iii. Frequency of the appearance of signs or symptoms, their persistence and recurrence
iv. Peoples’ perception of health
v. Lack of information and knowledge about danger signs
vi. Basic needs that lead to denial
vii. Competing possible interpretations that can be assigned to the symptoms once they
are recognised
viii. Low decision making powers among patients
ix. Availability of treatment resources, physical proximity and monetary costs.
x. Feelings of stigma and humiliation upon certain illnesses like epilepsy, HIV
xi. Cultural beliefs that people hold about diseases.

CHARACTERISTICS OF CULTURE
i. Culture is shared, it is social not individual
ii. Culture is learned, culture beliefs and practices are usually so well learned through
experience, imitation and communication.
iii. Culture is symbolic, symbols are things or behaviours to which people give meaning
iv. Culture is transmitted vertically or horizontally.
 Vertical – generation to generation
 Horizontal – from group to group/society to society
v. Culture varies from society to society
vi. Culture is dynamic
vii. Culture is continuous and cumulative

FUNCTIONS OF CULTURE
i. It regulates conduct and prepares human beings for group life through the process of
socialization
ii. It defines values attitudes and goals
iii. It provides behaviour patterns and relationship with others
iv. It creates new needs and interest in individuals
v. It provides solutions to complicated things as it provides traditional ………………

CULTURE AND HEALTH

FACTORS INFLUENCING THE HEALTH OF AN INDIVIDUAL
Belief:
Different cultures have different beliefs regarding the cause of diseases. For example
sickness in some culture is thought of as produced by evil spirits such belief may reduce
importance that people attach to drug therapy and this in turn may create an impact on ones
health.

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Cultural practices:
Different cultures have different cultural practices that can have either positive or negative
effects, mutilation may cause scars leading to complications during child birth.

Diet:
Culture influence a person diet and food preparation which has an effect on one’s health

Preferences and decisions:

Culture may have an influence on the patient’s preferences and decisions regarding health
matters.

Individual’s perception of symptoms:

Culture has an influence on the extent to which symptoms are perceived as either serious or
not.

Communication:
Culture has an influence on the way we communicate and adhere to treatment

Perception of health and illness:

Culture has an influence on people’s feeling upon illness.

Attitudes:
Culture has an influence on people’s attitudes within their lives on sensitive matters regarding
their health

SOCIAL ASPECTS OF DISEASES

Poverty:
This usually causes a lot of unsatisfactory conditions that are stressful thus leading to mental
and physical illness.

Lack of social support:

Lack of social support is associated with higher level of anxiety, depression and low levels of
coping mechanism.

Unemployment:
Loss or lack of job leads to loss of self-esteem and failure to satisfy ones needs. This is
closely linked with mental, physical and social problems.

Poor working conditions:

Poor working conditions where employees are exposed to carcinogens, microorganisms,
accidents, and stress are both associated with both mental and physical illnesses.

Lack of education:
Low levels of education are associated with low income, job insecurity, poor sanitation
practices, poor methods of diseases prevention and lack of information on matters regarding
health.

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Crowded housing:
Is linked to increased levels of infectious diseases, injuries and noise thereby affecting one’s
health
i. Urbanisation
ii. Social exclusion
iii. Poor parenting
iv. Physical
v. Environment

BEHAVIOURAL FACTORS AFFECTING HEALTH

Smoking:
It increases the risk of having lung cancer of bronchitis predisposing factor for heart diseases

Alcohol:
Causes liver cirrhosis, high blood pressure, degeneration of brain cells, sexual dysfunction
and social problems.

Lack of exercise:
Mainly by people of higher social class, it is associated with heart diseases.

Poor diet:
Diet high in saturated fatty acids (meat, eggs, oil) may cause heart diseases and stroke.
Food high in refined sugars contribute to obesity and dental caries.

Prostitution:
Associated with sexually transmitted diseases.

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 MOTIVATION

Need satisfying behaviour/goal directed behaviour e.g.

Need Behaviour Satisfaction
Need – lack/deficit for an organism, wants desires.
Drive / motive – energetic force within an individual that compels or inspire him to act for
the satisfaction of his basic needs.

ASPECTS OF MOTIVATION
Motivation has three (3) major aspects
1. Driving state within an organism
2. Behaviour directed by this state
3. Goal towards which the behaviour is directed

Concepts of motivation
i. Motivation is generated through basic needs or drives
ii. It compels an individual to respond by creating a kind of tension or argue to act
iii. It is a goal directed activity pursued till the attainment of the goal
iv. Attainment of a goal helps in the release of tension aroused by a specific motive
v. Is an inner state or an aroused feeling
vi. Motive can be a learned response or innate

CLASSIFICATION OF NEEDS (broadly classified)

1. Biological needs / physiological:
Survival needs, must be satisfied in order for a creature to live e.g.
 Food
 Water
 Constant temperature
 Sleep
 Oxygen
 Rest
 Sex

2. Psychosocial needs (acquired through social learning and contact which others)

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  Freedom
 Security
 Love and belonging
 Recognition and social approval
 Social company
 Self-assertion
 Self actualisation

MOTIVES
Types (two main categories)
a) Innate or unlearned
b) Acquired or learned

Motives can also be classified as

a) Physiological / primary motives
b) Social or secondary motives
c) Personal motives
d) Unconscious motives

THEORIES OF MOTIVATION
These try to provide general sets of principles to guide our understanding of the urgues,
wants, needs, desires and goals.

Drive reduction theory / Homestatic / push theory

States that when an internal drive state is aroused, the individual is pushed to engage in
behaviour which will lead to a goal, reducing the intensity of the drive state.
Motivation consists of:
i. Drive state
ii. Goal – directed behaviour initiated by the drive state
iii. Attainment of the drive state and subjective satisfaction and relief when the goal is
reached.
The sequence of events is called motivational cycle
Relief

Achievement of goal Driving state

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 Goal directed behaviour
Arousal theory / optimum arousal theory:
It suggests that people take certain actions to either increase or decrease levels of arousal.
According to this theory, we are motivated to maintain an optimal level of arousal.

Instinct theory:
This emphasises inborn and unlearned fixed pattern of behaviours (William James) e.g. fear,
anger, play, attachment, love, shy, sucking e.tc.

Incentive theory of motivation (Pull theory):

It suggests that people are motivated to do things because of external rewards e.g. one is
motivated to go to work each day for the monetary reward of being paid.

Humanistic theory / Maslow’s hierarchy of needs:

Abraham Maslow (1960 – 1970) proposed a hierarchy of motives ascending from the basic
biological needs present at birth to more complex psychological motives.
According to Maslow, needs at the lowest level of hierarchy must be satisfied before people
can be motivated by higher – level goals.
i. Physiological needs:
Physical requirements for human survival if not met, body can’t function properly
and will ultimately fail.

ii. Safety and security:

 Needs that protect us from danger
 If safety needs are not satisfied in children, may become fearful, insecure,
adults who are unable to cope with the ordinary demands of the environment.

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 iii. Love and belonging:
 It includes interpersonal relationship and feelings of belongings
 Hospitalisation, neglect, can impact individual’s ability to form and maintain
emotionally significant relationship.

iv. Esteem:
Need to feel respected
Satisfaction of esteem needs generates feelings of self confidence, self worth and
sense of being useful and necessary in the world.

Dissatisfaction in contrast, generates feelings or inferiority, weakness, dependency

and passivity.

v. Self-actualisation:
Realisation of one’s potential to the fullest

Maslow’s self-actualisation characteristics

a) Keen sense of reality – aware of real situations – objective judgement, rather than
subjective.
b) See problems in terms of challenges and situations requiring solutions, rather than see
problems as personal complaints or excuses.
c) Need for privacy and comfortable .
d) Reliant on own experiences and judgement – independent – not reliant on culture and
environment to form opinions and views.
e) Not susceptible to social pressures – non – conformist
f) Democratic, fair and non-discriminating – embracing and enjoying all cultures, races
and individual styles.
g) Socially compassionate – possessing humanity
h) Accepting others as they are and not trying to change people
i) Comfortable with oneself – despite any unconventional tendencies
j) A few close intimate friends rather than many surface relationships
k) Sense of humour directed at oneself or the human condition, rather than at the
expense of others
l) Spontaneous and natural – true to oneself, rather than being to others others want
m) Excited and interested in everything, even ordinary things
n) Creative, inventive and original
o) Seek peak experiences that leave a lasting impression
See the Maslow interviews DVDs – especially Maslow and

Maslow’s hierarchy provides a framework for nursing assessment and for understanding the
needs of the patient at all levels so that interventions to meet the needs become part of the
care team.

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Note:
According to Maslow
 Motivation affects the person as a whole rather than just a part
 People are motivated to seek personal goals, which make their lives rewarding and
meaningful
 Five basic classes of needs / motives influence human behaviour

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 EMOTIONS
Refer to display of feelings in response to events in the environment.

Functions of emotions
i. Can cause us to move and take actions
ii. Prepare and motivate us to respond adaptively to a variety of situations.
iii. Enable us to communicate our feelings and intentions more likely that others will
respond to us.

COMPONENTS OF EMOTIONS
i. Cognitive component:
Is responsible for the interpretation of a situation which determines the specific
emotions we feel.

ii. Physical component:

Is the physiological arousal that accompanies an emotion.

iii. Behavioural component:

Is the outward expression of the emotions

Cognition

Expression
Emotion

Physiology

PRIMARY AND SECONDARY EMOTIONS

Primary emotions:
Are those we feel first as a response to a situation e.g.
 Fear
 Sadness
 Anger
 Joy
 Surprise
 Relief
 Disgust

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Secondary emotions:
Appear after primary emotions e.g. a man feeling ashamed as a result of becoming anxious
or a woman becoming embarrassed when she express anger.

CHARACTERISTICS OF EMOTIONS
1. Every emotion is followed by physiological change
2. Emotion is accompanied by a feeling of pleasantness and unpleasantness, following
physiological changes
3. Emotions are subjective and purely individual
4. Emotion is a tripolar response
5. Emotions have wide range and are not restricted to a particular age
6. Emotions rise abruptly
7. Emotions have swings
8. An emotion mostly raises when the organism faces a difficult situation or when the
basic need is challenged or is not satisfied.

THEORIES OF EMOTIONS
1. James Lange theory (1920s)
Event/stimulus cause physiological arousal without any interpretation or conscious
thought and you experience the resulting emotion only after you interpret the physical
response.

Stimulus Body response Subjective experience (fear) I am afraid

because my heart is pounding.

2. Canon – Bard theory (1930s)

Stimulus causes both physiological and emotional response simultaneously and
neither one cause the other.
Stimulus Body response (arousal) The dog makes me feel afraid and my
heart pounds subjective experience (fear)

3. Schechter – Ginger Theory (cognitive theory of emotion, 1960s)

Event causes physiological arousal, but you must then identify a reason for the arousal
before you label the emotion.
Stimulus Body response interpretation subjective feeling
my pounding heart means I am afraid because I interpret the situation as dangerous.

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PHYSIOLOGICAL BASIS OF EMOTIONS:
When we experience an intense emotion e.g. fear or anger, the hypothalamus is activated and
sends impulses to the sympathetic nervous system which in turn stimulates the adrenal gland
to release adrenaline and noradrenaline.
These are associated with the following changes:
i. Increased blood sugar level
ii. Increased heart rate and blood pressure
iii. Stimulation of conversion of fats and proteins to sugar
iv. Increased blood flow to the muscles
v. Suppression of activities of digestion
vi. Hair on the skin become erect

EMOTIONS IN HEALTH AND ILLNESS

Our bodies function well when we are happy. Joy is the best medicine.
Intense and unpleasant emotions disturb the whole individual; if they persist they may cause
illness or worsen the condition of one already ill.

Modern medicine shows that uncontrolled emotionality plays a vital role in the causation of
many physical disorders;
i. Peptic ulcers
ii. Heart diseases
iii. Increased blood pressure
iv. Insomnia, chronic constipation
v. Susceptible to infections
vi. Epilepsy
vii. Diabetics and tuberculosis are made worse

Health worker has to reduce the intensity of emotional disturbance as much as it possible.
Note:
When an emotion recurs against and again and remains for a long time, troubles may start,
affecting the physical health.

EMOTIONAL RESPONSES TO ILLNESSES

a) Shock:
Sudden upset of mental or emotional balance

b) Fear:
Emotional response to an expectation of danger, harm or unpleasantness.

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 c) Sadness:
Feelings of despair, helplessness and isolation.

d) Guilt:
May arise from the belief that excessive demands are being placed on relatives or
friends.

e) Anger:
Patients become irritable and aggressive.

IMPORTANCE OF STUDYING EMOTIONS

i. Knowledge of emotions help us to identify emotions that patients are feeling
ii. Helps us to show respect for the patient’s feelings
iii. Helps us to identify the causes of emotional reactions among patients
iv. Helps us to identify and address the emotional needs of patients
v. Helps us to show acceptance of the patient’s behaviour due to emotional reactions
vi. Equips us with knowledge of understanding emotional changes during illnesses
and particular conditions like pregnancy and thus helping patients to have a
positive experience

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 STRESS

Is a state that occurs when people encounter events that they perceive as endangering their
physical or psychological well-being.

CAUSE
i. Natural disasters e.g. landslides, earth quake, floods
ii. Manmade disasters – wars, major fires, serious transport accidents, serious assaults
like rape
iii. Changes in life – death of spouse or loss family member or relative, divorce, fired
from job, retirement, change in financial state, pregnancy, illnesses, and disabilities
etc.
iv. Conflicts – conflict between employer and employee
v. Events like examinations
vi. Personality – people with type A personality are more prone to stress than type B
personality.
vii. Failure to relate well with others
viii. Concerns about one’s weight

CHARACTERISTICS OF PEOPLE WITH STRESS

i. Insomnia
ii. Fatigue
iii. Loss of weight
iv. Poor concentration
v. Loss of appetite
vi. Forgetfulness
vii. Anxiety
viii. Anger – leads to aggressive
ix. Isolation

CONCEPTS OF STRESS
i. Stress is a universal phenomenon
ii. Stress can have both positive and negative effects
iii. Stress is produced by change in the environment that is perceived as a challenge,
threat or danger
iv. Stress affects the whole person in all the human dimensions
v. Perception of stress and the response to it are highly individualised
vi. When a person faces a stressor, responses are referred to as coping strategies, coping
responses or coping mechanisms.

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Stress – Non specific response of the body to any kind of demand made upon it (Selye –
1956)
Stress – is the arousal of mind and body in response to demands made upon them.

EFFECTS OF STRESS
Excessive levels of stress are harmful
Direct physiological effects Harmful behaviours Indirect health related
behaviours
Heart diseases Increased smoking and Decreased compliance with
alcohol use medical advise
Peptic ulcers Decreased nutrition Increased delays in seeking
medical care
Hypertension Decreased sleep Decreased likelihood of seeking
medical advice
Decreased immune system Increased drug abuse
Damage of blood vessels Prostitution
Damage of body organs
Vaginal infection
Sexual dysfunction

GENERAL ADAPTATION SYNDROME (GAS) (HANS SELYE, 1945)

Hans Selye, a pioneering stress theorist developed “GAS” model that suggests that a person’s
response to stress consists of three stages.
1. Alarm
2. Resistance
3. Exhaustion
Alarm reaction or fight – flight response
Alarm reaction is the body’s initial reaction to a stressor. It is a set of reactions initiated
when the hypothalamus stimulates the sympathetic division and the adrenal medulla.
Alarm r x n meant to counteract a danger by mobilising the body’s resources for immediate
physical activity.

Resistance reaction
Helps the body to cope with a stressful situation by the help of regulating hormones secreted
by the hypothalamus. It’s a long-term reaction.
If the stress is severe, the GAS moves into the stage of exhaustion

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EXHAUSTION STAGE
At this stage the cells start to die and the organs weaken
Stage 1 Stage 2

Resistance
Alarm:
Stressor Attempts are made to
Body prepares cope with stressor
for action.
Increased
arousal

Stage 3

Exhaustion
Body can no longer
resist stressor

COPING WITH STRESS

Coping
Refers to the thoughts and behaviour we use to handle stress.

COPING STRATEGIES
1. Emotion – focused coping
People focus on alleviating the emotions associated with the stressful situation.
According to (Moos, 1988), EFC strategies are divided into

i. Behavioural strategies:
 Emotional support seeking from friends, relatives, health workers
and be able to talk to them about the stressful experience.
 Physical / relaxation activities to get our minds off a problem
 Using alcohol and other drugs
 Exposure therapy encourage the patient to repeatedly talk
about his trauma with a therapist or health workers. Patient will
learn to get control of his thoughts and feelings about the trauma.
 Group therapy – patient is encouraged to talk about a stressful event
with others who have had similar experiences.

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 ii. Cognitive strategies:
 Encourage patient to identify thought about the world and himself that
make him feel afraid or upset.
 Encourage positive thoughts and avoid negative thoughts.

2. Problem – focused coping

Person focuses on a specific problem or situation that has arisen. Easier for those less
depression.

Problem counselling:
Five stages of problem counselling include
i. Define the problem
ii. Generate alternative solutions
iii. Weighing the alternatives in terms of cost and benefits
iv. Choosing one among them
v. Implementing the selected alternatives

EGO DEFENCE MECHANISMS / DEFENCE MECHANISM

(Sigmund Freud and Anna Freud)
Unconscious ways that people use to deal with stress or negative emotions.

Purpose
 Reduce / eliminate anxiety
 Resolve mental conflict
 Protect one’s esteem / sense of security
Can be healthy if used in small doses and on short term basis.
Can be unhealthy if overused because can lead to breakdown of the personality.

Commonly used defence mechanisms

1. Repression:
Blocking a painful memory, emotion, idea from consciousness e.g. a widow blocking
memories about her husband’s suicide out of awareness.

2. Suppression:
Dealing with stress by intentionally or voluntarily thinking about disturbing problems,
feelings, experiences. Consciously hiding a fact, unacceptable feeling e.g. student
who failed in an examination, states he is not ready to talk about his grade.

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 3. Regression:
Engaging in behaviour appropriate to an earlier stage of development e.g. wife going
to her mother every time she has a problem with her husband.

4. Denial:
Refusing to acknowledge certain aspects of reality e.g. refusing to accept that you
have a serious illness.

5. Displacement:
Transfer of feelings or thoughts from its actual source to a soft target or threatening
object e.g.
i. A man blaming the doctor for the death of his wife instead of blaming himself
for not having taken her to the hospital early enough.
ii. A husband comes after a bad day and yells at his wife.

6. Reaction formation:
Behaviour that is completely the opposite of what one feels or wants e.g. a mother
who feels guilty about not liking her child, may over protect the child.

7. Projection:
Attributing your own difficulties or unacceptable behaviour onto someone else e.g. a
surgeon blaming a nurse who helped him for the death of the patient.

8. Rationalisation:
Person justifies his failures and socially unacceptable behaviour by giving socially
approved reasons. e.g. a husband who feels guilty about leaving his wife because he
does not enjoy her company may falsely say that she is shy and would not enjoy going
out.

9. Sublimation:
Is the unconscious diversion of impulse into more acceptable outlets e.g. playing
sports to re-channel aggressive impulses.

10. Intellectualisation:
Gain detachment from an emotionally threatening situation by dealing with it in
abstract intellectual terms e.g. doctor detaching himself from the suffering of the
patients.

11. Compensation – (conscious):

Covering up a weakness by over emphasizing strength in other areas e.g. a student
who fails in his studies may compensate by becoming the college champion in
athletics.

12. Identification:
is the unconscious adoption of the characteristics or activities of another person,

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IMPLICATIONS OF DEFENCE MECHANISMS
i. Persistent use is harmful and makes us unable to face problems
ii. Enable a person to resolve conflicts
iii. Many are a means of compromising with forbidden desires, feelings of guilty
iv. Relevance practice
v. Helps to recognise and understand maladaptive defence mechanisms that patients use
vi. Helps to appreciate what patients go through
vii. Helps to work with patients to encourage adaptive behaviours and discourage
maladaptive ones

25
 ATTITUDE

The tendency to behave or think in a certain way.

COMPONENTS OF ATTITUDES
1. Cognitive component – your thoughts and beliefs about a topic.
2. Emotional / affective – how the object; person or issue make you feel.
3. Behavioural component – the way you act or react.
Example
Cognitive emotional

Musoga Feeling of Act

dirty patient dislike unfriendly

Functions of attitudes
 Organise information
 Express beliefs and values
 Justify our actions

Good attitudes in health care service delivery

 Empathetic
 Love
 Non judgemental
 Respect
 Support

Importance of good attitudes in health service delivery

i. Mortality rate reduced
ii. Morbidity rate reduced
iii. Increased utilization of health services
iv. Reduced complications
v. Promotes positive relationship between health workers and patients

CHARACTERISTICS OF ATTITUDES

26
 i. Attitudes are formed and learnt by the individual
ii. Attitudes are endured
iii. Imply a subject – object relationship
iv. Guide the behaviour of the individual in one particular direction
v. Are related to the person’s needs and problems
vi. Are related to images, thoughts and external objects
vii. May be unconsciously created
viii. Are attached to one’s experiences

FORMATIONS AND DEVELOPMENT OF ATTITUDES

i. Attitudes are formed in the context of the individual’s wants. The individual in trying
to satisfy his wants, develops attitude.

ii. Families help in the formation of attitudes. They control rewards and punishment,
their approval and disapproval of certain activities lays the foundation for the
formation of favourable and unfavourable attitudes towards that activity in the child.

iii. Group affiliations help in the formation of individual’s attitudes. Peer group is a very
important source of attitude formation.

iv. Mass media e.g. newspapers, journals, books, movies etc. help in the formation of
attitudes.

v. Attitudes can be formed due to outcome of some experience if you have had an
unhappy experience in a hospital, your attitude towards hospitals in general will be
negative.

vi. Attitudes may be formed through imitation. This is done by imitating ready – made
attitudes or prejudiced attitudes towards things e.g. Racism is an attitude that some
people imitate from others.

ATTITUDE CHANGE
It is difficult to change the attitude that has been established, but it is necessary to modify
unhealthy or irrational attitudes for learning new things.
i. Provide information to the person concerned; provide information that contradicts the
attitude without any suggestion and persuasion e.g. giving information about cancer
and smoking.
ii. Providing positive models – setting ideal persons or examples in the society e.g.
teachers, nurses, doctors.
iii. Rewarding the correct attitudes or reacting back negatively for the incorrect attitudes
iv. Inducing individuals to state publicly an opinion or attitude that runs counter to their
own private attitudes.
v. Encouraging self perception of one’s own attitudes and behaviour
vi. The group support for the change should be obtained

27
vii. Provide an opportunity for much closer contact with the object / person concerned, let
the person learn through it and modify his own attitude.

viii. By adding a new belief or changing the old one he/she is holding so as to reduce
cognitive dissonance.

ix. Taking decision

ATTITUDE AND BEHAVIOUR

i. Attitudes are our expressions of the likes and dislikes towards the people and the
objects. They determine or guide our behaviour in social situations.

ii. Attitudes determine our life styles e.g. feeding habits, smoking, drug abuse,
prostitution

iii. Attitudes determine which social group to join (religious groups, peer groups,
political groups etc.) and all these exert powerful influence on our behaviour and
health.

iv. Attitudes determine the way one thinks about himself and his personal behaviour

v. Attitudes determine the way we think about members of a particular group which in
turn influence our behaviour and health.

Attitudes have been found to predict behaviour best when:

i. They are strong and consistent. Strong and consistent attitudes predict behaviour
better than the weak or ambivalent ones.
ii. They are specifically related to the behaviour being predicted
iii. They are based on the person’s direct experience
iv. Individual is aware of his or her attitude
v. They are reflected on one’s basic values

IMPLICATIONS OF ATTITUDES
i. Helps the health workers to recognise his attitudes and prevent them from interfering
with health care service delivery.
ii. Helps health workers to understand patient’s attitudes about themselves, their
illnesses and future life so that effective care can be provided.

iii. Helps health workers to try find out the causes of unfavourable attitudes and change
them into favourable ones as they help in treatment and recovery.

iv. Helps health workers to develop and cultivate professional attitude which will
contribute to his success in the work.

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 INTELLIGENCE
Is global capacity of the individual to think rationally, to act purposefully and to deal
effectively with the environment (Wechsler - 1944)

INTELLIGENCE BEHAVIOUR
Refers to doing what is right to get the right things done.

CLASSIFICATION OF INTELLIGENCE
1. Concrete intelligence – Related to concrete materials
2. Social intelligence – Ability of an individual to understand people and act wisely in
human relationship.
3. Abstract or general intelligence – Ability to respond to words, numbers and letters etc.

TYPES OF INTELLIGENCE BY HOWARD GARNER

1. Musical intelligence (“musical smart”):
Skills in tasks involving music e.g. musicians.

2. Bodily – Kinesthetic intelligence (“Body smart”):

Skills in using the whole body or various portions of it e.g. Dancers, Athletics, craft
people, Actors, Surgeons etc.

3. Logical – mathematical intelligence:

Ability to solve problems and think scientifically e.g. scientists

4. Natural intelligence:
Ability to identify and classify patterns in nature

5. Linguistic intelligence (“word smart”):

Ability to produce and use language to express complex meanings e.g. Journalists,
Novelists, Poets.

6. Spatial intelligence (picture smart):

Skills involving spatial configurations e.g. Sailors, pilots, architects, Sculptors.

7. Interpersonal intelligence (“people smart”):

Ability to understand and interact effectively with others e.g. Teachers, Social
Workers, Politicians, Actors.

8. Intrapersonal intelligence (“self smart”):

Capacity to understand oneself and one’s thoughts and feelings

29
 9. Existential intelligence:
Sensitivity and capacity to tackle deep questions about human existence such as the
meaning of life, why do we die and how did we get here.

USES OF INTELLIGENCE
i. Helps the individual to adjust to changing situations quickly and correctly
ii. Helps to carry on the higher mental processes e.g. reasoning, judging and criticizing
iii. Helps to learn difficult tasks and solve problems
iv. Helps the individual to improve performance in any situation
v. Helps in quick understanding of things
vi. Helps the individual to apply the knowledge gained in various subjects/situtaions in
dealing with present situations

INTELLIGENCE QUOTIENTS (I Q)
The idea was first utilised in 1916 by Stanford – Binet tests
I Q is a measure of mental (MA) age Vs Chronological age (CA)
IQ MA X 100
CA
MA – is determined by intelligence tests
CA – is determined from the date of birth
Imagine a 10 year old boy score a mental age of 12. His I Q will be
IQ 12 X 100
10
120

CLASSIFICATION OF INDIVIDUAL ACCORDING TO I Q

i. Genius (Extra ordinary) 140 above
ii. Very high (superior) 100 – 140
iii. Average (normal) 80 – 100
iv. Mild retardation 50 – 70
v. Moderate retardation 35 – 50
vi. Severe mental retardation 20 – 35
vii. Profound mental retardation 0 – 20

30
ASSESSMENT OF INTELLIGENCE
Intelligence can be assessed through psychological tests.
Alfred Binet (1875 - 1911) was the first Psychologist to device an intelligence test.
Intelligence test – is one that predicts individual’s intellectual performance

CLASSIFICATION OF INTELLIGENCE TESTS

Can be classified into broad categories namely:
i. Individual test
ii. Group test

INTELLIGENCE TESTS

Individual tests Group tests

(Only one individual is (A group of
tested at a time) individuals tested at a
time)

Verbal tests Non-verbal

(These tests make Non-verbal
(Performance tests: Verbal
use of languages) (performance
These tests involve tests
tests)
such activities, in
which the use of
language is not
necessary)

31
Comparison between individual and group tests
Individual tests Group tests
1. Not economical in terms of labour, time Economical
and money
2. Applicable for children and adults Can’t be administered to young children
below 10 years
3. Bring tester and child closer and Personal contact between the two is not
establish a better relationship between possible
the two

THEORIES OF INTELLIGENCE
1. Factor theories of intelligence:
Charles Spearman, British Psychologist proposed that every individual possesses
general intelligence factor (G) in varying amount and specific intelligence factor (s)
which allows an individual to deal with particular problems.

2. Process – oriented theories of intelligence:

Focuses on the pattern of thinking that people use when they reason and solve
problems, focus on development of cognitive abilities.

3. Information – processing theory – Robert Sternberg – 1984:

Focussed on the information processing approach to cognition or problem solving –
i.e. How individuals gather information and make use of this information to complete
a task or solve problems in hand.

IMPLICATIONS OF INTELLIGENCE
i. Knowledge about the nature of intelligence and its measurement is useful to the
understanding herself, her colleagues as well as her patients.

ii. Health workers explanations or guidance to the patient would be according to the
patient’s intellectual level.

iii. Knowledge of intelligence helps in diagnosing a patient with mental sub normality or
superior intelligence.

iv. Assessment of intelligence is of great assistance in management of disorders like

epilepsy, psychiatric disorders and some of the endocrinal disorders.

v. Knowledge about abnormalities in new-borns and development of their intelligence

helps the health workers in providing suitable care.

vi. Aging patient though physically slow, retain their levels of intelligence, respect and
encouragement with combined health care delivery has to be ensured.

32
Learning

33
 PERSONALITY

DEVELOPMENT AND GROWTH

Development:
Qualitative gradual orderly and durable changes in people’s characteristics or functions.
Examples include intelligence, language etc.
Growth:
Is increase in actual biological components (tissue, organs), size, weight, height.
Personality:
Stable and personal behaviour characteristics of an individual.
Personality development:
Enhancing and grooming one’s outer and inner self to bring about a positive change in life.

Elements of personality:
 Element of stability
 Element of consistence
 Element of uniqueness

Why study personality:

 Helps us to know the origin of personality
 Helps us to assess personality and predict how patients will react or respond to illness
and treatment
 Helps us to deal with others
 Helps us to manage personalities that cause serious problems to patients or other
people

TYPES OF PERSONALITY:
HIPPOCRATES CLASSIFICATION
1. Saguine
i. Optimistic
ii. Happy
iii. Social
iv. Talkative
v. Easy going
vi. Lively

34
 2. Phlegmatic
i. Calm
ii. Even – tempered
iii. Passive
iv. Slow
v. Careful
vi. Reliable

3. Melancholic
i. Sad
ii. Quiet
iii. Pessimistic
iv. Anxious
v. Unsocial

4. Choleric
i. Active
ii. Restless
iii. Irritable
iv. Impulsive
v. Aggressive
vi. Excitable

KRETSCHMER’S CLASSIFICATION
Kretschmer classified all human beings into certain biological types according to their
physical structure.
1. Pyknic (Fat bodies):
 Sociable
 Jolly
 Easy going
 Good natured

2. Athletic (Balanced body):

 Optimistic
 Adjustable
 Energetic

3. Leptosomatic (Learn and thin):

 Unsociable
 Reserved
 Shy
 Sensitive
 Pessimistic

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SHELDON’S CLASSIFICATION
1. Endomorphic
(Have highly developed) Viscera, but weak somatic structure – fat, soft, round (like
pyknic type)

Characteristics
 Easy going
 Sociable
 Affectionate
 Fond of eating

2. Mesomorphic
(Balanced development of viscera) and strong somatic structure – muscular (like
athletic type)

Characteristics
 Self – assertive
 Loves risk and adventure
 Energetic
 Bold tempered
 Craving for muscular activity

3. Ectomorphic
(Weak somatic structure as well as undeveloped viscera – thin, long, fragile (like
leptosomatic type)

Characteristics
 Pessimistic
 Unsociable
 Reserved

KARL .G. JUNG’S CLASSIFICATION OF PERSONALITY

Extrovert Introvert
1. Interested in the world around them Interested in themselves, own feelings and
(outgoing personality ) thoughts than in things outside them
2. Sociable Solitary life
3. Talkative Quiet and reserved
4. Optimistic Pessimistic
5. Easily excited by things Dislike excitement
6. Generally impulsive They look before they leap
7. Gregarious Fond of books
8. Socially active / dynamic Shy
9. Fond of practical jokes
10. Less reliable More reliable

36
Note:
There are very few people who are purely extrovert or introvert. Most of us have qualities of
both these types (ambiverts)

ALL PORT’S CLASSIFICATION OF PERSONALITY

Ascendant Descendant
1. Tendency to dominate a situation Submissive
2. Sociable Socially aloof
3. Optimistic Pessimistic

PERSONALITY TYPES AND HEART DISEASES

Two specific behaviour patterns types are known to be associated with increased or decreased
likelihood of coronary artery disease.
i. Type A personality
ii. Type B personality

Type A Type B
1. Hard driving and competitive Non competitive
2. Impatient Patient
3. Sense of time urgency Less hurried
4. Irritable Less angered
5. Talkative Reserved
6. Take on multiple activities with deadlines to meet Don’t
7. Perform tasks near their maximum capacity Work harder when given a
deadline
8. Don’t easily bear stress Bear stress easily

PERSONALITY THEORIES
A. PSYCHODYNAMIC THEORIES
1. PSYCHOANALYTIC THEORY – Sigmund Freud’s theory of psychosexual
development
a) Freud emphasised the unconscious factors as the basis for motivation and
behaviour.
b) Freud organised personality into three major structures, systems or components
ID
i. Present at birth and unconscious
ii. Contains all our inborn biological drives
iii. It seeks for immediate satisfaction of our needs
iv. It obeys the pleasure principle
v. Operates up to around the age of 4 years
vi. Behaviours are impulsive and irrational
37
 EGO
i. Operates on reality principle
ii. Modifies irrational demands of the ID
iii. Maintains harmony between ID, Superego and environment

SUPEREGO
i. Mature and moral part of individual’s personality
ii. Judges whether the actions are right or wrong (assists ego in the control
of ID impulses)
iii. It is the moral and judicial part of personality
iv. Obeys perfection principle

c) He believed that psychic energy influence mental functioning and personality and
originates in the ID
d) personality develops through five stages
e) Over or under satisfaction at a specific stage causes FIXATION

FREUD’S STAGES OF PERSONALITY DEVELOPMENT

Stage Characteristics Successful task Unsuccessful
completion completion
Oral stage (0 – 2) and Mouth is source of Oral gratification Mistrust, alcoholism,
(0 – 1 ) satisfaction, sucking, smoking,
suckling talkativeness, nail
biting, greed, drug
addiction

Anal stage (2 – 3 Pleasure around anus.  Bowel and  Constipation

years) and (1 – 3 Sensual pleasure in bladder  Toilet mal
years) muscle control in control behaviour,
bladder, rectum and  Good toilet excessive
anus habits concern for
cleanliness and
orderliness
 Obsessive
compulsive
disorder
 Perfectionism

Phallic 3 – 7 years and  Pleasure around Becomes aware of  Homosexuality

(3 – 5 years) genital organs sexuality  Promiscuity
 Learn sexual  Lust for sex
identity  sexual identity
 Oedipus complex problems
(romantic feelings  Difficult in

38
 towards mother) accepting
 Electra complex authority
girl develops
romantic feelings
– father

Latency 7- 11 years Absence of sexual Learn to socialize  Solitary life

and 5 – 13 years interest  Egocentrism
 inability to
conceptualise
 Lack of
motivation in
school or job

Genital 11 – adulthood Satisfactory Sexual maturity  Fear of those of

and 13 – Puberty relationships with the opposite sex
opposite sex  Premature
ejaculation
 Lust for sex
 Unsatisfactory
relationship

2. ERIKSON’S THEORY OF PSYCHOSOCIAL DEVELOPMENT

i. Erik Erikson (1902 – 1994) was a German Psychoanalyst who extended
Freud’s work.
ii. Described personality development throughout the entire life span while
focusing on social and psychological aspects in the life or cognitive life stages.
iii. Described formation of personality through eight stages.
iv. Each stage is dependent on completion of previous stage and life task

39
Stage Virtue Task Positive Consequence
resolution unsuccessful task
completion
INFANT Hope Viewing the Sense of  Suspiciousness
Trust Vs Mistrust world as safe security  Feeling of
0 – 1 year and reliable, frustration
relationships and  Withdrawal
nurturing, stable  Lack of
and dependable confidence
 Trouble with
personal
relationship

TODDLER Will Achieving a Sense of  Low self

Autonomy Vs sense of control independence esteem
shame and doubt and free will  dependency on
(2 – 4 years) substances or
people

PRESCHOOL Purpose Beginning Balance  Passive

Initiative Vs Guilt development of between personality
(4 – 5 years) conscience spontaneity  Feelings of
learning to and restraint guilt
manage conflict  Remain
followers, feel
nuisance to
others

SCHOOL AGE Competence Emerging  Sense of  Unmotivated

Industry Vs confidence in self  Unreliable
Inferiority own ability, confidence  Inferiority
(6 – 12 years) taking pleasure feelings
in
accomplishments

ADOLESCENCE Fidelity Formulating a Unified  Confusion

Identity Vs Role sense of self and  Rebellion
confusion belonging  Subst abuse
(13 – 19 years)  Difficulty
keeping
personal
relationship
 Regression –
child play
behaviours

YOUNG Love Formulating Form close  Emotional

ADULTHOOD adult loving personal immaturity
Intimacy Vs relationships and relationship  Deny need for
Isolation meaningful which is personal

40
20 – 24 years or attachments with comfortable relationship
20 – 40 years others  Isolation
 Depression
 Loneliness

MIDDLE Care Being creative Promote well-  Inability to

ADULT and productive being of show concern
Generativity Vs Focus is on others for anyone,
Stagnation family and but self
25 – 64 years or guiding the next  Feeling of
40 – 64 years generation stagnant
 Feeling of
dissatisfaction
with the
relative
 Lack of
productivity

MATURITY Wisdom Accepting Sense of  Feeling of

Ego Vs Despair responsibility for satisfaction hopelessness
late adulthood one’s self and with life; well  Depression
life lived  Despair
 Guilt

3. ALFRED ADLER
We strive to achieve superiority as a way to develop our personalities.

4. CARL JUNG
Believed that a successful person brings opposing parts of a person together –
pleasant and unpleasant qualities of personality.

B. HUMANISTIC THEORIES
When personality development focusses upon the development of self, it is called
HUMANISM.

Humanists like Carl Rogers and Abraham Maslow believe that each person is creative
and responsible, free to choose and each strives for fulfilment or self actualisation.

Carl Rogers believed that everyone should be given unconditioned positive regard.

C. TRAIT – TYPE OF THEORIES OR BIOLOGICAL THEORIES

Trait – relatively stable characteristics that cause an individual to behave in certain
ways.
Hans Eysenck’s theory (factor analytic trait theory)

41
 Emphasised the role of genetic factors and neurophysiological factors, in explaining
individual differences in behaviour (cerebral cortex, ANS, limbic system, reticular
system)

Defined two major dimensions of personality

 Introversion – extroversion
 stability – instability

Later he added a third type of dimension – psychoticism

i. He describes categories of people or personality
ii. Introvert
iii. Extrovert
iv. Stable
v. Psychoticism
Gordon Allport’s theory (1937) Raymond Cattell’s theory (1965)

D. LEARNING THEORIES OF PERSONALITY

Learning is through imitation (social learning theory).
i. According to Psychologist Albert Bandura and colleagues (1977) a major part
of human learning consists of observational learning.

According to Bandura, observational takes place in four steps

 Pay attention and observe another person’s behaviour
 Remember the behaviour
 Reproduce the action
 Being motivated to carry out the behaviour

Other theorists include:

ii. Dollard and Miller’s learning theory of personality

PERSONALITY ASSESSMENT METHODS

1. Interview
2. Observation
3. personality inventory
4. Projective technique

42
 MORAL DEVELOPMENT

Morality refers to standards of good behaviour.

LAWRENCE KOHLBERG’S DESCRIPTION OF MORAL DEVELOPMENT

Kohlberg decided that moral development consisted of six stages, in three levels.
LEVEL 1 Morality of punishment and obedience.
STAGE 1 Children blindly obey superior authority in
PRE – CONVENTIONAL order to avoid punishment.
MORALITY Morality of naïve instrumental hedonism or
STAGE 2 instrumental – relativist
Children obey in order to gain concrete
rewards.

LEVEL 2 Morality of maintaining good relations

STAGE 3 Morality evolves to a more conventional level
that cares for others. Good behaviour is
whatever pleases others.
CONVENTIONAL Morality of maintaining social order
MORALITY Laws and moral rules are seen as instruments
STAGE 4 for maintaining social order. Rules and laws
are upheld simply because they are rules and
laws.
LEVEL 3 STAGE 5 Morality of social contracts
Post conventional morality affirms people’s
agreed – upon rights, individual rights can
sometimes take precedence over laws.
POST CONVENTIONAL STAGE 6 Morality of universal ethical principles
Morality follows what one personally
perceives as basic ethical principles. Moral
action is determined by our inner conscience
and may not be in accordance with public
opinion or society’s laws.

COGNITIVE DEVELOPMENT (Jean Piaget)

(Intellectual development)
It is about the nature and development of human intelligence i.e. how young people think,
reason and understand and how they change overtime.

43
CONCEPTS

i. Schema:
Intellectual structures that classify events as they are seen by the organism into
groups according to common characteristics e.g. dog schema.

ii. Assimilation:
Is the cognitive process by which a person fits new events or stimuli into the
existing schemata.

iii. Equilibrium:
State of balance between assimilation and accommodation.

COGNITIVE DEVELOPMENT (intellectual development)

PIAGET’S THEORY OF COGNITIVE DEVELOPMENT
STAGES
i. Sensorimotor
 Infants acquire knowledge through sensory experience (0 – 2 years)
 Object permanency

ii. Preoperational (2 – 7 years)

 Symbolic learning
 Selfish
 perceptual beats their understanding

iii. Concrete operations (7 – 11 years)

 Logical thinking
 classify objects according to size, colour, shape, quantity

iv. Formal operations (adolescence through adulthood)

 Abstract thinking – moral, philosophic, ethical, social and political issues.

PERSONALITY DISORDERS
1. PARANOID PERSONALITY:
i. Suspicious
ii. Mistrust of other people
iii. Sensitive
iv. Argumentative
v. Self important
vi. Search for hidden meanings and hostile intentions in everything others say
and do
2. SCHIZOID:

44
 i. Detachment and social withdrawal
ii. Introspective
iii. Emotionally cold
iv. Prone to fantasy

3. HISTRIONIC:
i. Short lived enthusiasms and readily become bored and discontented
ii. Pervasive pattern of excessive emotionally
iii. Fleeting adventures – enjoy novelty, search restlessly for new experiences
iv. Lack of consideration for others and selfish preoccupation
v. May use emotional black mail and demonstrate suicide attempts to force other
people to comply with their wishes
vi. Remarkable capacity for self deception
vii. Attent seeking behaviour

4. ANTISOCIAL (DISSOCIAL) PERSONALITY DISORDER:

i. Violent
ii. Impulsive behaviour
iii. Low frustration tolerance
iv. Lack of feelings for others
v. Criminal behaviours – Repeated offences against the law
vi. Unable to maintain consistent, responsible functioning at work, school or as a
parent
vii. Failure to sustain loving relationship

5. NARCISSISTIC:
i. Grandiose of sense of self importance
ii. Self centred
iii. Takes advantages of people to achieve his own ends and uses them without
regard to their feelings
iv. Preoccupied with fantasies of success, power and intellectual brilliance

6. BORDERLINE PERSONALITY DISORDER:

i. Damaging behaviour – stealing, reckless spending
ii. Unwarranted outbursts of anger
iii. Recurrent suicidal threats or behaviour
iv. Inability to make stable relationships

7. ANXIOUS PERSONALITY DISORDER:

i. Extreme social anxiety
ii. Social withdrawal
iii. Hypersensitivity to others opinion
iv. Low self-esteem and poor self confidence
v. Timid and cautious about new experiences
vi. Fearful of disapproval or criticism
vii. They avoid social demands e.g. taking new responsibilities at work

45
 viii. They dwell on the negative and have difficult viewing situations and
interactions objectively

8. DEPENDENT:
i. Extreme need to be taken care of
ii. Compliant with wishes of others
iii. Lack vigour and self reliance
iv. Avoid responsibilities – some achieve their aims by persuading others to
assist them

FACTORS INFLUENCING PERSONALITY DEVELOPMENT

1. Genetics:
Behavioural characteristics may have hereditary origin thus causing personality
problems.

2. Emotional factors:
Lack of love or warmth due to parental separation, maternal death or divorce may
cause antisocial behaviour.

3. Parental child rearing practices:

Poor parental child rearing practices may cause personality problems like
dependency, aggressiveness, and good practices lead to positive behaviour – good
social skills, independence and assertiveness.

4. Child experiences of one’s body parts:

These influence one’s later personality according to Sigmund Freud.

5. Nature of the environment:

Rich environment promotes good behaviour like curiosity, self-confidence
independence and poor ones causes passiveness, quietness, unhappiness.

6. Culture:
Cultural norms are an important influence on one’s personality.

46