Chapter 6 Growing and Developing

The Zygote

Within several hours, half of the 23 chromosomes from the egg and half of the 23 chromosomes from the sperm fuse together, creating a zygoteThe product of an egg and sperm that merge together during conception.—a fertilized ovum. The zygote continues to travel down the fallopian tube to the uterus. Although the uterus is only about 4 inches away in the woman’s body, this is nevertheless a substantial journey for a microscopic organism, and fewer than half of zygotes survive beyond this earliest stage of life. If the zygote is still viable when it completes the journey, it will attach itself to the wall of the uterus, but if it is not, it will be flushed out in the woman’s menstrual flow. During this time, the cells in the zygote continue to divide: The original two cells become four, those four become eight, and so on, until there are thousands (and eventually trillions) of cells. Soon the cells begin to differentiate, each taking on a separate function. The earliest differentiation is between the cells on the inside of the zygote, which will begin to form the developing human being, and the cells on the outside, which will form the protective environment that will provide support for the new life throughout the pregnancy.

The Embryo

Once the zygote attaches to the wall of the uterus, it is known as the embryoThe status of a zygote once it is implanted in the uterine wall.. During the embryonic phase, which will last for the next 6 weeks, the major internal and external organs are formed, each beginning at the microscopic level, with only a few cells. The changes in the embryo’s appearance will continue rapidly from this point until birth.

While the inner layer of embryonic cells is busy forming the embryo itself, the outer layer is forming the surrounding protective environment that will help the embryo survive the pregnancy. This environment consists of three major structures: The amniotic sacActing as a cushion as well as a temperature regulator, it is the fluid-filled reservoir in which the fetus lives until birth. is the fluid-filled reservoir in which the embryo (soon to be known as a fetus) will live until birth, and which acts as both a cushion against outside pressure and as a temperature regulator. The placentaThe organ that allows the exchange of nutrients between the fetus and the mother, while at the same time filtering out harmful material. is an organ that allows the exchange of nutrients between the embryo and the mother, while at the same time filtering out harmful material. The filtering occurs through a thin membrane that separates the mother’s blood from the blood of the fetus, allowing them to share only the material that is able to pass through the filter. Finally, the umbilical cordA cord that links the embryo directly to the placenta and transfers all material to the embryo from the mother. links the embryo directly to the placenta and transfers all material to the fetus. Thus the placenta and the umbilical cord protect the fetus from many foreign agents in the mother’s system that might otherwise pose a threat.

The Fetus

Beginning in the 9th week after conception, the embryo becomes a fetusThe stage of the embryo from 9 weeks after conception to birth. The defining aspect of the fetal stage is growth.. The defining characteristic of the fetal stage is growth. All the major aspects of the growing organism have been formed in the embryonic phase, and now the fetus has approximately six months to go from weighing less than an ounce to weighing an average of 6 to 8 pounds. That’s quite a growth spurt.

The fetus begins to take on many of the characteristics of a human being, including moving (by the 3rd month the fetus is able to curl and open its fingers, form fists, and wiggle its toes), sleeping, as well as early forms of swallowing and breathing. The fetus begins to develop its senses, becoming able to distinguish tastes and respond to sounds. Research has found that the fetus even develops some initial preferences. A newborn prefers the mother’s voice to that of a stranger, the languages heard in the womb over other languages (DeCasper & Fifer, 1980; Moon, Cooper, & Fifer, 1993),DeCasper, A. J., & Fifer, W. P. (1980). Of human bonding: Newborns prefer their mothers’ voices. Science, 208, 1174–1176; Moon, C., Cooper, R. P., & Fifer, W. P. (1993). Two-day-olds prefer their native language. Infant Behavior & Development, 16, 495–500. and even the kinds of foods that the mother ate during the pregnancy (Mennella, Jagnow, & Beauchamp, 2001).Mennella, J. A., Jagnow, C. P., & Beauchamp, G. K. (2001). Prenatal and postnatal flavor learning by human infants. Pediatrics, 107(6), e88. By the end of the 3rd month of pregnancy, the sexual organs are visible.

How the Environment Can Affect the Vulnerable Fetus

Prenatal development is a complicated process and may not always go as planned. About 45% of pregnancies result in a miscarriage, often without the mother ever being aware it has occurred (Moore & Persaud, 1993).Moore, K., & Persaud, T. (1993). The developing human: Clinically oriented embryology (5th ed.). Philadelphia, PA: Saunders. Although the amniotic sac and the placenta are designed to protect the embryo, substances that can harm the fetus, known as teratogensAny harmful material that can bypass the filter in the placenta and pass from the mother to the fetus., may nevertheless cause problems. Teratogens include general environmental factors, such as air pollution and radiation, but also the cigarettes, alcohol, and drugs that the mother may use. Teratogens do not always harm the fetus, but they are more likely to do so when they occur in larger amounts, for longer time periods, and during the more sensitive phases, as when the fetus is growing most rapidly. The most vulnerable period for many of the fetal organs is very early in the pregnancy—before the mother even knows she is pregnant.

Harmful substances that the mother ingests may harm the child. Cigarette smoking, for example, reduces the blood oxygen for both the mother and child and can cause a fetus to be born severely underweight. Another serious threat is fetal alcohol syndrome (FAS)The detrimental effect of large amounts of maternal alcohol consumption on fetal development., a condition caused by maternal alcohol drinking that can lead to numerous detrimental developmental effects, including limb and facial abnormalities, genital anomalies, and mental retardation. One in about every 500 babies in the United States is born with fetal alcohol syndrome, and it is considered one of the leading causes of retardation in the world today (Niccols, 1994).Niccols, G. A. (1994). Fetal alcohol syndrome: Implications for psychologists. Clinical Psychology Review, 14, 91–111. Because there is no known safe level of alcohol consumption for a pregnant woman, the U.S. Centers for Disease Control and Prevention indicates that “a pregnant woman should not drink alcohol” (Centers for Disease Control and Prevention, 2005).Centers for Disease Control and Prevention (2005). Alcohol use and pregnancy. Retrieved from http://www.cdc.gov/ncbddd/factsheets/FAS_alcoholuse.pdf Therefore, the best approach for expectant mothers is to avoid alcohol completely. Maternal drug abuse is also of major concern and is considered one of the greatest risk factors facing unborn children.

The environment in which the mother is living also has a major impact on infant development (Duncan & Brooks-Gunn, 2000; Haber & Toro, 2004).Duncan, G., & Brooks-Gunn, J. (2000). Family poverty, welfare reform, and child development. Child Development, 71(1), 188–196; Haber, M., & Toro, P. (2004). Homelessness among families, children, and adolescents: An ecological–developmental perspective. Clinical Child and Family Psychology Review, 7(3), 123–164. Children born into homelessness or poverty are more likely to have mothers who are malnourished, who suffer from domestic violence, stress, and other psychological problems, and who smoke or abuse drugs. And children born into poverty are also more likely to be exposed to teratogens. Poverty’s impact may also amplify other issues, creating substantial problems for healthy child development (Evans & English, 2002; Gunnar & Quevedo, 2007).Evans, G. W., & English, K. (2002). The environment of poverty: Multiple stressor exposure, psychophysiological stress, and socio-emotional adjustment. Child Development, 73(4), 1238–1248; Gunnar, M., & Quevedo, K. (2007). The neurobiology of stress and development. Annual Review of Psychology, 58, 145–173.

Mothers normally receive genetic and blood tests during the first months of pregnancy to determine the health of the embryo or fetus. They may undergo sonogram, ultrasound, amniocentesis, or other testing. The screenings detect potential birth defects, including neural tube defects, chromosomal abnormalities (such as Down syndrome), genetic diseases, and other potentially dangerous conditions. Early diagnosis of prenatal problems can allow medical treatment to improve the health of the fetus.

The Newborn Arrives With Many Behaviors Intact

Newborns are already prepared to face the new world they are about to experience. As you can see in Table 6.2 "Survival Reflexes in Newborns", babies are equipped with a variety of reflexes, each providing an ability that will help them survive their first few months of life as they continue to learn new routines to help them survive in and manipulate their environments.

In addition to reflexes, newborns have preferences—they like sweet tasting foods at first, while becoming more open to salty items by 4 months of age (Beauchamp, Cowart, Menellia, & Marsh, 1994; Blass & Smith, 1992).Beauchamp, D. K., Cowart, B. J., Menellia, J. A., & Marsh, R. R. (1994). Infant salt taste: Developmental, methodological, and contextual factors. Developmental Psychology, 27, 353–365; Blass, E. M., & Smith, B. A. (1992). Differential effects of sucrose, fructose, glucose, and lactose on crying in 1- to 3-day-old human infants: Qualitative and quantitative considerations. Developmental Psychology, 28, 804–810. Newborns also prefer the smell of their mothers. An infant only 6 days old is significantly more likely to turn toward its own mother’s breast pad than to the breast pad of another baby’s mother (Porter, Makin, Davis, & Christensen, 1992),Porter, R. H., Makin, J. W., Davis, L. B., & Christensen, K. M. (1992). Breast-fed infants respond to olfactory cues from their own mother and unfamiliar lactating females. Infant Behavior & Development, 15(1), 85–93. and a newborn also shows a preference for the face of its own mother (Bushnell, Sai, & Mullin, 1989).Bushnell, I. W. R., Sai, F., & Mullin, J. T. (1989). Neonatal recognition of the mother’s face. British Journal of developmental psychology, 7, 3–15.

Although infants are born ready to engage in some activities, they also contribute to their own development through their own behaviors. The child’s knowledge and abilities increase as it babbles, talks, crawls, tastes, grasps, plays, and interacts with the objects in the environment (Gibson, Rosenzweig, & Porter, 1988; Gibson & Pick, 2000; Smith & Thelen, 2003).Gibson, E. J., Rosenzweig, M. R., & Porter, L. W. (1988). Exploratory behavior in the development of perceiving, acting, and the acquiring of knowledge. In Annual review of psychology (Vol. 39, pp. 1–41). Palo Alto, CA: Annual Reviews; Gibson, E. J., & Pick, A. D. (2000). An ecological approach to perceptual learning and development. New York, NY: Oxford University Press; Smith, L. B., & Thelen, E. (2003). Development as a dynamic system. Trends in Cognitive Sciences, 7(8), 343–348. Parents may help in this process by providing a variety of activities and experiences for the child. Research has found that animals raised in environments with more novel objects and that engage in a variety of stimulating activities have more brain synapses and larger cerebral cortexes, and they perform better on a variety of learning tasks compared with animals raised in more impoverished environments (Juraska, Henderson, & Müller, 1984).Juraska, J. M., Henderson, C., & Müller, J. (1984). Differential rearing experience, gender, and radial maze performance. Developmental Psychobiology, 17(3), 209–215. Similar effects are likely occurring in children who have opportunities to play, explore, and interact with their environments (Soska, Adolph, & Johnson, 2010).Soska, K. C., Adolph, K. E., & Johnson, S. P. (2010). Systems in development: Motor skill acquisition facilitates three-dimensional object completion. Developmental Psychology, 46(1), 129–138.

Research Focus: Using the Habituation Technique to Study What Infants Know

It may seem to you that babies have little ability to view, hear, understand, or remember the world around them. Indeed, the famous psychologist William James presumed that the newborn experiences a “blooming, buzzing confusion” (James, 1890, p. 462).James, W. (1890). The principles of psychology. New York, NY: Dover. And you may think that, even if babies do know more than James gave them credit for, it might not be possible to find out what they know. After all, infants can’t talk or respond to questions, so how would we ever find out? But over the past two decades, developmental psychologists have created new ways to determine what babies know, and they have found that they know much more than you, or William James, might have expected.

One way that we can learn about the cognitive development of babies is by measuring their behavior in response to the stimuli around them. For instance, some researchers have given babies the chance to control which shapes they get to see or which sounds they get to hear according to how hard they suck on a pacifier (Trehub & Rabinovitch, 1972).Trehub, S., & Rabinovitch, M. (1972). Auditory-linguistic sensitivity in early infancy. Developmental Psychology, 6(1), 74–77. The sucking behavior is used as a measure of the infants’ interest in the stimuli—the sounds or images they suck hardest in response to are the ones we can assume they prefer.

Another approach to understanding cognitive development by observing the behavior of infants is through the use of the habituation technique. HabituationDecreased responsiveness toward a stimulus after it has been presented numerous times in succession. refers to the decreased responsiveness toward a stimulus after it has been presented numerous times in succession. Organisms, including infants, tend to be more interested in things the first few times they experience them and become less interested in them with more frequent exposure. Developmental psychologists have used this general principle to help them understand what babies remember and understand.

In the habituation procedureA procedure that uses the principles of habituation to allow researchers to infer the cognitive processes of newborns., a baby is placed in a high chair and presented with visual stimuli while a video camera records the infant’s eye and face movements. When the experiment begins, a stimulus (e.g., the face of an adult) appears in the baby’s field of view, and the amount of time the baby looks at the face is recorded by the camera. Then the stimulus is removed for a few seconds before it appears again and the gaze is again measured. Over time, the baby starts to habituate to the face, such that each presentation elicits less gazing at the stimulus. Then, a new stimulus (e.g., the face of a different adult or the same face looking in a different direction) is presented, and the researchers observe whether the gaze time significantly increases. You can see that, if the infant’s gaze time increases when a new stimulus is presented, this indicates that the baby can differentiate the two stimuli.

Figure 6.2

The habituation procedure is used to assess the cognitive abilities of infants.

Source: Photo courtesy of Infant Studies Centre, Department of Psychology, University of British Columbia, http://infantstudies.psych.ubc.ca/research/publications/visual_lang_disc.

Although this procedure is very simple, it allows researchers to create variations that reveal a great deal about a newborn’s cognitive ability. The trick is simply to change the stimulus in controlled ways to see if the baby “notices the difference.” Research using the habituation procedure has found that babies can notice changes in colors, sounds, and even principles of numbers and physics. For instance, in one experiment reported by Karen Wynn (1995),Wynn, K. (1995). Infants possess a system of numerical knowledge. Current Directions in Psychological Science, 4, 172–176. 6-month-old babies were shown a presentation of a puppet that repeatedly jumped up and down either two or three times, resting for a couple of seconds between sequences (the length of time and the speed of the jumping were controlled). After the infants habituated to this display, the presentation was changed such that the puppet jumped a different number of times. As you can see in Figure 6.3 "Can Infants Do Math?", the infants’ gaze time increased when Wynn changed the presentation, suggesting that the infants could tell the difference between the number of jumps.

Figure 6.3 Can Infants Do Math?

Karen Wynn found that babies that had habituated to a puppet jumping either two or three times significantly increased their gaze when the puppet began to jump a different number of times.

Source: Adapted from Wynn, K. (1995). Infants possess a system of numerical knowledge. Current Directions in Psychological Science, 4, 172–176.

Cognitive Development During Childhood

Childhood is a time in which changes occur quickly. The child is growing physically, and cognitive abilities are also developing. During this time the child learns to actively manipulate and control the environment, and is first exposed to the requirements of society, particularly the need to control the bladder and bowels. According to Erik Erikson, the challenges that the child must attain in childhood relate to the development of initiative, competence, and independence. Children need to learn to explore the world, to become self-reliant, and to make their own way in the environment.

Figure 6.4

Jean Piaget developed his theories of child development by observing the behaviors of children.

Source: Photo courtesy of mirjoran, http://www.flickr.com/photos/mirjoran/455878802.

These skills do not come overnight. Neurological changes during childhood provide children the ability to do some things at certain ages, and yet make it impossible for them to do other things. This fact was made apparent through the groundbreaking work of the Swiss psychologist Jean Piaget. During the 1920s, Piaget was administering intelligence tests to children in an attempt to determine the kinds of logical thinking that children were capable of. In the process of testing the children, Piaget became intrigued, not so much by the answers that the children got right, but more by the answers they got wrong. Piaget believed that the incorrect answers that the children gave were not mere shots in the dark but rather represented specific ways of thinking unique to the children’s developmental stage. Just as almost all babies learn to roll over before they learn to sit up by themselves, and learn to crawl before they learn to walk, Piaget believed that children gain their cognitive ability in a developmental order. These insights—that children at different ages think in fundamentally different ways—led to Piaget’s stage model of cognitive development.

Piaget argued that children do not just passively learn but also actively try to make sense of their worlds. He argued that, as they learn and mature, children develop schemasA pattern of knowledge in long-term memory that helps us organize information.—patterns of knowledge in long-term memory—that help them remember, organize, and respond to information. Furthermore, Piaget thought that when children experience new things, they attempt to reconcile the new knowledge with existing schemas. Piaget believed that the children use two distinct methods in doing so, methods that he called assimilation and accommodation (see Figure 6.5 "Assimilation and Accommodation").

Figure 6.5 Assimilation and Accommodation

When children employ assimilationThe use of an already developed schema to understand new information., they use already developed schemas to understand new information. If children have learned a schema for horses, then they may call the striped animal they see at the zoo a horse rather than a zebra. In this case, children fit the existing schema to the new information and label the new information with the existing knowledge. AccommodationThe change of an existing schema on the basis of new information., on the other hand, involves learning new information, and thus changing the schema. When a mother says, “No, honey, that’s a zebra, not a horse,” the child may adapt the schema to fit the new stimulus, learning that there are different types of four-legged animals, only one of which is a horse.

Piaget’s most important contribution to understanding cognitive development, and the fundamental aspect of his theory, was the idea that development occurs in unique and distinct stages, with each stage occurring at a specific time, in a sequential manner, and in a way that allows the child to think about the world using new capacities. Piaget’s stages of cognitive development are summarized in Table 6.3 "Piaget’s Stages of Cognitive Development".

The first developmental stage for Piaget was the sensorimotor stageA stage of Piaget’s model of cognitive development, lasting from birth to age 2, in which the baby perceives the environment through the senses and motor skills., the cognitive stage that begins at birth and lasts until around the age of 2. It is defined by the direct physical interactions that babies have with the objects around them. During this stage, babies form their first schemas by using their primary senses—they stare at, listen to, reach for, hold, shake, and taste the things in their environments.

During the sensorimotor stage, babies’ use of their senses to perceive the world is so central to their understanding that whenever babies do not directly perceive objects, as far as they are concerned, the objects do not exist. Piaget found, for instance, that if he first interested babies in a toy and then covered the toy with a blanket, children who were younger than 6 months of age would act as if the toy had disappeared completely—they never tried to find it under the blanket but would nevertheless smile and reach for it when the blanket was removed. Piaget found that it was not until about 8 months that the children realized that the object was merely covered and not gone. Piaget used the term object permanenceThe ability to be aware of an object’s existence even when it is not visible. to refer to the child’s ability to know that an object exists even when the object cannot be perceived.

At about 2 years of age, and until about 7 years of age, children move into the preoperational stageA stage of Piaget’s cognitive development model, lasting from 2 to 7 years of age, in which children become capable of forming mental images.. During this stage, children begin to use language and to think more abstractly about objects, but their understanding is more intuitive and without much ability to deduce or reason. The thinking is preoperational, meaning that the child lacks the ability to operate on or transform objects mentally. In one study that showed the extent of this inability, Judy DeLoache (1987)DeLoache, J. S. (1987). Rapid change in the symbolic functioning of very young children. Science, 238(4833), 1556–1556. showed children a room within a small dollhouse. Inside the room, a small toy was visible behind a small couch. The researchers took the children to another lab room, which was an exact replica of the dollhouse room, but full-sized. When children who were 2.5 years old were asked to find the toy, they did not know where to look—they were simply unable to make the transition across the changes in room size. Three-year-old children, on the other hand, immediately looked for the toy behind the couch, demonstrating that they were improving their operational skills.

The inability of young children to view transitions also leads them to be egocentric—unable to readily see and understand other people’s viewpoints. Developmental psychologists define the theory of mindThe ability to take another person’s viewpoint. as the ability to take another person’s viewpoint, and the ability to do so increases rapidly during the preoperational stage. In one demonstration of the development of theory of mind, a researcher shows a child a video of another child (let’s call her Anna) putting a ball in a red box. Then Anna leaves the room, and the video shows that while she is gone, a researcher moves the ball from the red box into a blue box. As the video continues, Anna comes back into the room. The child is then asked to point to the box where Anna will probably look to find her ball. Children who are younger than 4 years of age typically are unable to understand that Anna does not know that the ball has been moved, and they predict that she will look for it in the blue box. After 4 years of age, however, children have developed a theory of mind—they realize that different people can have different viewpoints, and that (although she will be wrong) Anna will nevertheless think that the ball is still in the red box.

After about 7 years of age, the child moves into the concrete operational stageA stage of Piaget’s cognitive development model, between ages 7 to 11 years, in which children begin to use concepts of time, space, and numbers more accurately, and are able to use deductive or reversible reasoning., which is marked by more frequent and more accurate use of transitions, operations, and abstract concepts, including those of time, space, and numbers. An important milestone during the concrete operational stage is the development of conservationThe understanding that changes in the form of an object do not necessarily mean changes in the quantity of the object.—the understanding that changes in the form of an object do not necessarily mean changes in the quantity of the object. Children younger than 7 years generally think that a glass of milk that is tall holds more milk than a glass of milk that is shorter and wider, and they continue to believe this even when they see the same milk poured back and forth between the glasses. It appears that these children focus only on one dimension (in this case, the height of the glass) and ignore the other dimension (width). However, when children reach the concrete operational stage, their abilities to understand such transformations make them aware that, although the milk looks different in the different glasses, the amount must be the same.

At about 11 years of age, children enter the formal operational stageA stage of Piaget’s cognitive development model, reached by children 11 years and older, in which they begin to think in abstract terms., which is marked by the ability to think in abstract terms and to use scientific and philosophical lines of thought. Children in the formal operational stage are better able to systematically test alternative ideas to determine their influences on outcomes. For instance, rather than haphazardly changing different aspects of a situation that allows no clear conclusions to be drawn, they systematically make changes in one thing at a time and observe what difference that particular change makes. They learn to use deductive reasoning, such as “if this, then that,” and they become capable of imagining situations that “might be,” rather than just those that actually exist.

Piaget’s theories have made a substantial and lasting contribution to developmental psychology. His contributions include the idea that children are not merely passive receptacles of information but rather actively engage in acquiring new knowledge and making sense of the world around them. This general idea has generated many other theories of cognitive development, each designed to help us better understand the development of the child’s information-processing skills (Klahr & McWinney, 1998; Shrager & Siegler, 1998).Klahr, D., & McWhinney, B. (1998). Information Processing. In D. Kuhn & R. S. Siegler (Eds.), Handbook of child psychology: Cognition, perception, & language (5th ed., Vol. 2, pp. 631–678). New York, NY: John Wiley & Sons; Shrager, J., & Siegler, R. S. (1998). SCADS: A model of children’s strategy choices and strategy discoveries. Psychological Science, 9, 405–422. Furthermore, the extensive research that Piaget’s theory has stimulated has generally supported his beliefs about the order in which cognition develops. Piaget’s work has also been applied in many domains—for instance, many teachers make use of Piaget’s stages to develop educational approaches aimed at the level children are developmentally prepared for (Driscoll, 1994; Levin, Siegler, & Druyan, 1990).Driscoll, M. P. (1994). Psychology of learning for instruction. Boston, MA: Allyn & Bacon; Levin, I., Siegler, S. R., & Druyan, S. (1990). Misconceptions on motion: Development and training effects. Child Development, 61, 1544–1556.

Over the years, Piagetian ideas have been refined. For instance, it is now believed that object permanence develops gradually, rather than more immediately, as a true stage model would predict, and that it can sometimes develop much earlier than Piaget expected. Renée Baillargeon and her colleagues (Baillargeon, 2004; Wang, Baillargeon, & Brueckner, 2004)Baillargeon, R. (2004). Infants’ physical world. Current Directions in Psychological Science, 13(3), 89–94; Wang, S. H., Baillargeon, R., & Brueckner, L. (2004). Young infants’ reasoning about hidden objects: Evidence from violation-of-expectation tasks with test trials only. Cognition, 93, 167–198. placed babies in a habituation setup, having them watch as an object was placed behind a screen, entirely hidden from view. The researchers then arranged for the object to reappear from behind another screen in a different place. Babies who saw this pattern of events looked longer at the display than did babies who witnessed the same object physically being moved between the screens. These data suggest that the babies were aware that the object still existed even though it was hidden behind the screen, and thus that they were displaying object permanence as early as 3 months of age, rather than the 8 months that Piaget predicted.

Another factor that might have surprised Piaget is the extent to which a child’s social surroundings influence learning. In some cases, children progress to new ways of thinking and retreat to old ones depending on the type of task they are performing, the circumstances they find themselves in, and the nature of the language used to instruct them (Courage & Howe, 2002).Courage, M. L., & Howe, M. L. (2002). From infant to child: The dynamics of cognitive change in the second year of life. Psychological Bulletin, 128(2), 250–276. And children in different cultures show somewhat different patterns of cognitive development. Dasen (1972)Dasen, P. R. (1972). Cross-cultural Piagetian research: A summary. Journal of Cross-Cultural Psychology, 3, 23–39. found that children in non-Western cultures moved to the next developmental stage about a year later than did children from Western cultures, and that level of schooling also influenced cognitive development. In short, Piaget’s theory probably understated the contribution of environmental factors to social development.

More recent theories (Cole, 1996; Rogoff, 1990; Tomasello, 1999),Cole, M. (1996). Culture in mind. Cambridge, MA: Harvard University Press; Rogoff, B. (1990). Apprenticeship in thinking: Cognitive development in social context. New York, NY: Oxford University Press; Tomasello, M. (1999). The cultural origins of human cognition. Cambridge, MA: Harvard University Press. based in large part on the sociocultural theory of the Russian scholar Lev Vygotsky (1962, 1978),Vygotsky, L. S. (1962). Thought and language. Cambridge, MA: MIT Press; Vygotsky, L. S. (1978). Mind in society. Cambridge, MA: Harvard University Press. argue that cognitive development is not isolated entirely within the child but occurs at least in part through social interactions. These scholars argue that children’s thinking develops through constant interactions with more competent others, including parents, peers, and teachers.

An extension of Vygotsky’s sociocultural theory is the idea of community learning, in which children serve as both teachers and learners. This approach is frequently used in classrooms to improve learning as well as to increase responsibility and respect for others. When children work cooperatively together in groups to learn material, they can help and support each other’s learning as well as learn about each other as individuals, thereby reducing prejudice (Aronson, Blaney, Stephan, Sikes, & Snapp, 1978; Brown, 1997).Aronson, E., Blaney, N., Stephan, C., Sikes, J., & Snapp, M. (1978). The jigsaw classroom. Beverly Hills, CA: Sage; Brown, A. L. (1997). Transforming schools into communities of thinking and learning about serious matters. American Psychologist, 52(4), 399–413.

Social Development During Childhood

It is through the remarkable increases in cognitive ability that children learn to interact with and understand their environments. But these cognitive skills are only part of the changes that are occurring during childhood. Equally crucial is the development of the child’s social skills—the ability to understand, predict, and create bonds with the other people in their environments.

Successfully Relating to Others: Attachment

One of the most important behaviors a child must learn is how to be accepted by others—the development of close and meaningful social relationships. The emotional bonds that we develop with those with whom we feel closest, and particularly the bonds that an infant develops with the mother or primary caregiver, are referred to as attachmentThe strong need of an infant to be close to the primary caregiver. (Cassidy & Shaver, 1999).Cassidy, J. E., & Shaver, P. R. E. (1999). Handbook of attachment: Theory, research, and clinical applications. New York, NY: Guilford Press.

As late as the 1930s, psychologists believed that children who were raised in institutions such as orphanages, and who received good physical care and proper nourishment, would develop normally, even if they had little interaction with their caretakers. But studies by the developmental psychologist John Bowlby (1953)Bowlby, J. (1953). Some pathological processes set in train by early mother-child separation. Journal of Mental Science, 99, 265–272. and others showed that these children did not develop normally—they were usually sickly, emotionally slow, and generally unmotivated. These observations helped make it clear that normal infant development requires successful attachment with a caretaker.

In one classic study showing the importance of attachment, Wisconsin University psychologists Harry and Margaret Harlow investigated the responses of young monkeys, separated from their biological mothers, to two surrogate mothers introduced to their cages. One—the wire mother—consisted of a round wooden head, a mesh of cold metal wires, and a bottle of milk from which the baby monkey could drink. The second mother was a foam-rubber form wrapped in a heated terry-cloth blanket. The Harlows found that, although the infant monkeys went to the wire mother for food, they overwhelmingly preferred and spent significantly more time with the warm terry-cloth mother that provided no food but did provide comfort (Harlow, 1958).Harlow, H. (1958). The nature of love. American Psychologist, 13, 573–685.

Video Clip: The Harlows’ Monkeys

(click to see video)

The studies by the Harlows showed that young monkeys preferred the warm mother that provided a secure base to the cold mother that provided food.

The Harlows’ studies confirmed that babies have social as well as physical needs. Both monkeys and human babies need a secure base that allows them to feel safe. From this base, they can gain the confidence they need to venture out and explore their worlds. Erikson (Table 6.1 "Challenges of Development as Proposed by Erik Erikson") was in agreement on the importance of a secure base, arguing that the most important goal of infancy was the development of a basic sense of trust in one’s caregivers.

Developmental psychologist Mary Ainsworth, a student of John Bowlby, was interested in studying the development of attachment in infants. Ainsworth created a laboratory test that measured an infant’s attachment to his or her parent. The test is called the strange situationA measure of attachment in young children in which the child’s behaviors are assessed in a situation in which the caregiver and a stranger move in and out of the environment. because it is conducted in a context that is unfamiliar to the child and therefore likely to heighten the child’s need for his or her parent (Ainsworth, Blehar, Waters, & Wall, 1978).Ainsworth, M. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum Associates. During the procedure, which lasts about 20 minutes, the parent and the infant are first left alone, while the infant explores the room full of toys. Then a strange adult enters the room and talks for a minute to the parent, after which the parent leaves the room. The stranger stays with the infant for a few minutes, and then the parent again enters and the stranger leaves the room. During the entire session, a video camera records the child’s behaviors, which are later coded by trained coders.

Video Clip: The Strange Situation

(click to see video)

In the strange situation, children are observed responding to the comings and goings of parents and unfamiliar adults in their environments.

On the basis of their behaviors, the children are categorized into one of four groups, where each group reflects a different kind of attachment relationship with the caregiver. A child with a secure attachment style usually explores freely while the mother is present and engages with the stranger. The child may be upset when the mother departs but is also happy to see the mother return. A child with an ambivalent (sometimes called insecure-resistant) attachment style is wary about the situation in general, particularly the stranger, and stays close or even clings to the mother rather than exploring the toys. When the mother leaves, the child is extremely distressed and is ambivalent when she returns. The child may rush to the mother but then fail to cling to her when she picks up the child. A child with an avoidant (sometimes called insecure-avoidant) attachment style will avoid or ignore the mother, showing little emotion when the mother departs or returns. The child may run away from the mother when she approaches. The child will not explore very much, regardless of who is there, and the stranger will not be treated much differently from the mother.

Finally, a child with a disorganized attachment style seems to have no consistent way of coping with the stress of the strange situation—the child may cry during the separation but avoid the mother when she returns, or the child may approach the mother but then freeze or fall to the floor. Although some cultural differences in attachment styles have been found (Rothbaum, Weisz, Pott, Miyake, & Morelli, 2000),Rothbaum, F., Weisz, J., Pott, M., Miyake, K., & Morelli, G. (2000). Attachment and culture: Security in the United States and Japan. American Psychologist, 55(10), 1093–1104. research has also found that the proportion of children who fall into each of the attachment categories is relatively constant across cultures (see Figure 6.8 "Proportion of Children With Different Attachment Styles").

Figure 6.8 Proportion of Children With Different Attachment Styles

The graph shows the approximate proportion of children who have each of the four attachment styles. These proportions are fairly constant across cultures.

You might wonder whether differences in attachment style are determined more by the child (nature) or more by the parents (nurture). Most developmental psychologists believe that socialization is primary, arguing that a child becomes securely attached when the mother is available and able to meet the needs of the child in a responsive and appropriate manner, but that the insecure styles occur when the mother is insensitive and responds inconsistently to the child’s needs. In a direct test of this idea, Dutch researcher Dymphna van den Boom (1994)van den Boom, D. C. (1994). The influence of temperament and mothering on attachment and exploration: An experimental manipulation of sensitive responsiveness among lower-class mothers with irritable infants. Child Development, 65(5), 1457–1476. randomly assigned some babies’ mothers to a training session in which they learned to better respond to their children’s needs. The research found that these mothers’ babies were more likely to show a secure attachment style in comparison to the mothers in a control group that did not receive training.

But the attachment behavior of the child is also likely influenced, at least in part, by temperamentThe innate personality characteristics of an infant., the innate personality characteristics of the infant. Some children are warm, friendly, and responsive, whereas others tend to be more irritable, less manageable, and difficult to console. These differences may also play a role in attachment (Gillath, Shaver, Baek, & Chun, 2008; Seifer, Schiller, Sameroff, Resnick, & Riordan, 1996).Gillath, O., Shaver, P. R., Baek, J.-M., & Chun, D. S. (2008). Genetic correlates of adult attachment style. Personality and Social Psychology Bulletin, 34(10), 1396–1405; Seifer, R., Schiller, M., Sameroff, A. J., Resnick, S., & Riordan, K. (1996). Attachment, maternal sensitivity, and infant temperament during the first year of life. Developmental Psychology, 32(1), 12–25. Taken together, it seems safe to say that attachment, like most other developmental processes, is affected by an interplay of genetic and socialization influences.

Research Focus: Using a Longitudinal Research Design to Assess the Stability of Attachment

You might wonder whether the attachment style displayed by infants has much influence later in life. In fact, research has found that the attachment styles of children predict their emotions and their behaviors many years later (Cassidy & Shaver, 1999).Cassidy, J. E., & Shaver, P. R. E. (1999). Handbook of attachment: Theory, research, and clinical applications. New York, NY: Guilford Press. Psychologists have studied the persistence of attachment styles over time using longitudinal research designsResearch in which individuals are studied over an extended period of time, often over multiple developmental stages.—research designs in which individuals in the sample are followed and contacted over an extended period of time, often over multiple developmental stages.

In one such study, Waters, Merrick, Treboux, Crowell, and Albersheim (2000)Waters, E., Merrick, S., Treboux, D., Crowell, J., & Albersheim, L. (2000). Attachment security in infancy and early adulthood: A twenty-year longitudinal study. Child Development, 71(3), 684–689. examined the extent of stability and change in attachment patterns from infancy to early adulthood. In their research, 60 middle-class infants who had been tested in the strange situation at 1 year of age were recontacted 20 years later and interviewed using a measure of adult attachment. Waters and colleagues found that 72% of the infants received the same secure versus insecure attachment classification in early adulthood as they had received as infants. The adults who changed categorization (usually from secure to insecure) were primarily those who had experienced traumatic events, such as the death or divorce of parents, severe illnesses (contracted by the parents or the children themselves), or physical or sexual abuse by a family member.

In addition to finding that people generally display the same attachment style over time, longitudinal studies have also found that the attachment classification received in infancy (as assessed using the strange situation or other measures) predicts many childhood and adult behaviors. Securely attached infants have closer, more harmonious relationship with peers, are less anxious and aggressive, and are better able to understand others’ emotions than are those who were categorized as insecure as infants (Lucas-Thompson & Clarke-Stewart, (2007).Lucas-Thompson, R., & Clarke-Stewart, K. A. (2007). Forecasting friendship: How marital quality, maternal mood, and attachment security are linked to children’s peer relationships. Journal of Applied Developmental Psychology, 28(5–6), 499–514. And securely attached adolescents also have more positive peer and romantic relationships than their less securely attached counterparts (Carlson, Sroufe, & Egeland, 2004).Carlson, E. A., Sroufe, L. A., & Egeland, B. (2004). The construction of experience: A longitudinal study of representation and behavior. Child Development, 75(1), 66–83.

Conducting longitudinal research is a very difficult task, but one that has substantial rewards. When the sample is large enough and the time frame long enough, the potential findings of such a study can provide rich and important information about how people change over time and the causes of those changes. The drawbacks of longitudinal studies include the cost and the difficulty of finding a large sample that can be tracked accurately over time and the time (many years) that it takes to get the data. In addition, because the results are delayed over an extended period, the research questions posed at the beginning of the study may become less relevant over time as the research continues.

Cross-sectional research designs represent an alternative to longitudinal designs. In a cross-sectional research designA research design in which comparisons are made between samples of people at different ages., age comparisons are made between samples of different people at different ages at one time. In one example, Jang, Livesley, and Vernon (1996)Jang, K. L., Livesley, W. A., & Vernon, P. A. (1996). The genetic basis of personality at different ages: A cross-sectional twin study. Personality and Individual Differences, 21, 299–301. studied two groups of identical and nonidentical (fraternal) twins, one group in their 20s and the other group in their 50s, to determine the influence of genetics on personality. They found that genetics played a more significant role in the older group of twins, suggesting that genetics became more significant for personality in later adulthood.

Cross-sectional studies have a major advantage in that the scientist does not have to wait for years to pass to get results. On the other hand, the interpretation of the results in a cross-sectional study is not as clear as those from a longitudinal study, in which the same individuals are studied over time. Most important, the interpretations drawn from cross-sectional studies may be confounded by cohort effects. Cohort effectsRefers to the possibility that differences in cognition or behavior at two points in time may be caused by differences that are unrelated to the changes in age. The differences might instead be due to environmental factors that affect an entire age group. refer to the possibility that differences in cognition or behavior at two points in time may be caused by differences that are unrelated to the changes in age. The differences might instead be due to environmental factors that affect an entire age group. For instance, in the study by Jang, Livesley, and Vernon (1996)Jang, K. L., Livesley, W. A., & Vernon, P. A. (1996). The genetic basis of personality at different ages: A cross-sectional twin study. Personality and Individual Differences, 21, 299–301. that compared younger and older twins, cohort effects might be a problem. The two groups of adults necessarily grew up in different time periods, and they may have been differentially influenced by societal experiences, such as economic hardship, the presence of wars, or the introduction of new technology. As a result, it is difficult in cross-sectional studies such as this one to determine whether the differences between the groups (e.g., in terms of the relative roles of environment and genetics) are due to age or to other factors.

Key Takeaways

• Babies are born with a variety of skills and abilities that contribute to their survival, and they also actively learn by engaging with their environments.
• The habituation technique is used to demonstrate the newborn’s ability to remember and learn from experience.
• Children use both assimilation and accommodation to develop functioning schemas of the world.
• Piaget’s theory of cognitive development proposes that children develop in a specific series of sequential stages: sensorimotor, preoperational, concrete operational, and formal operational.
• Piaget’s theories have had a major impact, but they have also been critiqued and expanded.
• Social development requires the development of a secure base from which children feel free to explore. Attachment styles refer to the security of this base and more generally to the type of relationship that people, and especially children, develop with those who are important to them.
• Longitudinal and cross-sectional studies are each used to test hypotheses about development, and each approach has advantages and disadvantages.

Exercises and Critical Thinking

1. Give an example of a situation in which you or someone else might show cognitive assimilation and cognitive accommodation. In what cases do you think each process is most likely to occur?
2. Consider some examples of how Piaget’s and Vygotsky’s theories of cognitive development might be used by teachers who are teaching young children.
3. Consider the attachment styles of some of your friends in terms of their relationships with their parents and other friends. Do you think their style is secure?

Physical Changes in Adolescence

Adolescence begins with the onset of pubertyA developmental stage in adolescence in which hormonal changes create rapid physical changes in the body., a developmental period in which hormonal changes cause rapid physical alterations in the body, culminating in sexual maturity. Although the timing varies to some degree across cultures, the average age range for reaching puberty is between 9 and 14 years for girls and between 10 and 17 years for boys (Marshall & Tanner, 1986).Marshall, W. A., & Tanner, J. M. (1986). Puberty. In F. Falkner & J. M. Tanner (Eds.), Human growth: A comprehensive treatise (2nd ed., pp. 171–209). New York, NY: Plenum Press.

Puberty begins when the pituitary gland begins to stimulate the production of the male sex hormone testosterone in boys and the female sex hormones estrogen and progesterone in girls. The release of these sex hormones triggers the development of the primary sex characteristicsThe organs concerned with reproduction, including the testicles and the penis in boys and the ovaries, uterus, and vagina in girls., the sex organs concerned with reproduction (Figure 6.9 "Sex Characteristics"). These changes include the enlargement of the testicles and the penis in boys and the development of the ovaries, uterus, and vagina in girls. In addition, secondary sex characteristicsPhysical features that distinguish the two sexes from each other but that are not involved in reproduction. (features that distinguish the two sexes from each other but are not involved in reproduction) are also developing, such as an enlarged Adam’s apple, a deeper voice, and pubic and underarm hair in boys and enlargement of the breasts, hips, and the appearance of pubic and underarm hair in girls (Figure 6.9 "Sex Characteristics"). The enlargement of breasts is usually the first sign of puberty in girls and, on average, occurs between ages 10 and 12 (Marshall & Tanner, 1986).Marshall, W. A., & Tanner, J. M. (1986). Puberty. In F. Falkner & J. M. Tanner (Eds.), Human growth: A comprehensive treatise (2nd ed., pp. 171–209). New York, NY: Plenum Press. Boys typically begin to grow facial hair between ages 14 and 16, and both boys and girls experience a rapid growth spurt during this stage. The growth spurt for girls usually occurs earlier than that for boys, with some boys continuing to grow into their 20s.

Figure 6.9 Sex Characteristics

Puberty brings dramatic changes in the body, including the development of primary and secondary sex characteristics.

A major milestone in puberty for girls is menarcheThe first menstrual period., the first menstrual period, typically experienced at around 12 or 13 years of age (Anderson, Dannal, & Must, 2003).Anderson, S. E., Dannal, G. E., & Must, A. (2003). Relative weight and race influence average age at menarche: Results from two nationally representative surveys of U.S. girls studied 25 years apart. Pediatrics, 111, 844–850. The age of menarche varies substantially and is determined by genetics, as well as by diet and lifestyle, since a certain amount of body fat is needed to attain menarche. Girls who are very slim, who engage in strenuous athletic activities, or who are malnourished may begin to menstruate later. Even after menstruation begins, girls whose level of body fat drops below the critical level may stop having their periods. The sequence of events for puberty is more predictable than the age at which they occur. Some girls may begin to grow pubic hair at age 10 but not attain menarche until age 15. In boys, facial hair may not appear until 10 years after the initial onset of puberty.

The timing of puberty in both boys and girls can have significant psychological consequences. Boys who mature earlier attain some social advantages because they are taller and stronger and, therefore, often more popular (Lynne, Graber, Nichols, Brooks-Gunn, & Botvin, 2007).Lynne, S. D., Graber, J. A., Nichols, T. R., Brooks-Gunn, J., & Botvin, G. J. (2007). Links between pubertal timing, peer influences, and externalizing behaviors among urban students followed through middle school. Journal of Adolescent Health, 40, 181.e7–181.e13 (p. 198). At the same time, however, early-maturing boys are at greater risk for delinquency and are more likely than their peers to engage in antisocial behaviors, including drug and alcohol use, truancy, and precocious sexual activity. Girls who mature early may find their maturity stressful, particularly if they experience teasing or sexual harassment (Mendle, Turkheimer, & Emery, 2007; Pescovitz & Walvoord, 2007).Mendle, J., Turkheimer, E., & Emery, R. E. (2007). Detrimental psychological outcomes associated with early pubertal timing in adolescent girls. Developmental Review, 27, 151–171; Pescovitz, O. H., & Walvoord, E. C. (2007). When puberty is precocious: Scientific and clinical aspects. Totowa, NJ: Humana Press. Early-maturing girls are also more likely to have emotional problems, a lower self-image, and higher rates of depression, anxiety, and disordered eating than their peers (Ge, Conger, & Elder, 1996).Ge, X., Conger, R. D., & Elder, G. H., Jr. (1996). Coming of age too early: Pubertal influences on girls’ vulnerability to psychological distress. Child Development, 67(6), 3386–3400.

Cognitive Development in Adolescence

Although the most rapid cognitive changes occur during childhood, the brain continues to develop throughout adolescence, and even into the 20s (Weinberger, Elvevåg, & Giedd, 2005).Weinberger, D. R., Elvevåg, B., & Giedd, J. N. (2005). The adolescent brain: A work in progress. National Campaign to Prevent Teen Pregnancy. Retrieved from http://www.thenationalcampaign.org/resources/pdf/BRAIN.pdf During adolescence, the brain continues to form new neural connections, but also casts off unused neurons and connections (Blakemore, 2008).Blakemore, S. J. (2008). Development of the social brain during adolescence. Quarterly Journal of Experimental Psychology, 61, 40–49. As teenagers mature, the prefrontal cortex, the area of the brain responsible for reasoning, planning, and problem solving, also continues to develop (Goldberg, 2001).Goldberg, E. (2001). The executive brain: Frontal lobes and the civilized mind. New York, NY: Oxford University Press. And myelin, the fatty tissue that forms around axons and neurons and helps speed transmissions between different regions of the brain, also continues to grow (Rapoport et al., 1999).Rapoport, J. L., Giedd, J. N., Blumenthal, J., Hamburger, S., Jeffries, N., Fernandez, T.,…Evans, A. (1999). Progressive cortical change during adolescence in childhood-onset schizophrenia: A longitudinal magnetic resonance imaging study. Archives of General Psychiatry, 56(7), 649–654.

Adolescents often seem to act impulsively, rather than thoughtfully, and this may be in part because the development of the prefrontal cortex is, in general, slower than the development of the emotional parts of the brain, including the limbic system (Blakemore, 2008).Blakemore, S. J. (2008). Development of the social brain during adolescence. Quarterly Journal of Experimental Psychology, 61, 40–49. Furthermore, the hormonal surge that is associated with puberty, which primarily influences emotional responses, may create strong emotions and lead to impulsive behavior. It has been hypothesized that adolescents may engage in risky behavior, such as smoking, drug use, dangerous driving, and unprotected sex in part because they have not yet fully acquired the mental ability to curb impulsive behavior or to make entirely rational judgments (Steinberg, 2007).Steinberg, L. (2007). Risk taking in adolescence: New perspectives from brain and behavioral science. Current Directions in Psychological Science, 16, 55–59.

The new cognitive abilities that are attained during adolescence may also give rise to new feelings of egocentrism, in which adolescents believe that they can do anything and that they know better than anyone else, including their parents (Elkind, 1978, p. 199).Elkind, D. (1978). The child’s reality: Three developmental themes. Hillsdale, NJ: Lawrence Erlbaum Associates. Teenagers are likely to be highly self-conscious, often creating an imaginary audience in which they feel that everyone is constantly watching them (Goossens, Beyers, Emmen, & van Aken, 2002).Goossens, L., Beyers, W., Emmen, M., & van Aken, M. (2002). The imaginary audience and personal fable: Factor analyses and concurrent validity of the “new look” measures. Journal of Research on Adolescence, 12(2), 193–215. Because teens think so much about themselves, they mistakenly believe that others must be thinking about them, too (Rycek, Stuhr, McDermott, Benker, & Swartz, 1998).Rycek, R. F., Stuhr, S. L., Mcdermott, J., Benker, J., & Swartz, M. D. (1998). Adolescent egocentrism and cognitive functioning during late adolescence. Adolescence, 33, 746–750. It is no wonder that everything a teen’s parents do suddenly feels embarrassing to them when they are in public.

Social Development in Adolescence

Some of the most important changes that occur during adolescence involve the further development of the self-concept and the development of new attachments. Whereas young children are most strongly attached to their parents, the important attachments of adolescents move increasingly away from parents and increasingly toward peers (Harris, 1998).Harris, J. (1998), The nurture assumption—Why children turn out the way they do. New York, NY: Free Press. As a result, parents’ influence diminishes at this stage.

According to Erikson (Table 6.1 "Challenges of Development as Proposed by Erik Erikson"), the main social task of the adolescent is the search for a unique identity—the ability to answer the question, “Who am I?” In the search for identity, the adolescent may experience role confusion in which he or she is balancing or choosing among identities, taking on negative or undesirable identities, or temporarily giving up looking for an identity altogether if things are not going well.

One approach to assessing identity development was proposed by James Marcia (1980).Marcia, J. (1980). Identity in adolescence. Handbook of Adolescent Psychology, 5, 145–160. In his approach, adolescents are asked questions regarding their exploration of and commitment to issues related to occupation, politics, religion, and sexual behavior. The responses to the questions allow the researchers to classify the adolescent into one of four identity categories (see Table 6.4 "James Marcia’s Stages of Identity Development").

Studies assessing how teens pass through Marcia’s stages show that, although most teens eventually succeed in developing a stable identity, the path to it is not always easy and there are many routes that can be taken. Some teens may simply adopt the beliefs of their parents or the first role that is offered to them, perhaps at the expense of searching for other, more promising possibilities (foreclosure status). Other teens may spend years trying on different possible identities (moratorium status) before finally choosing one.

To help them work through the process of developing an identity, teenagers may well try out different identities in different social situations. They may maintain one identity at home and a different type of persona when they are with their peers. Eventually, most teenagers do integrate the different possibilities into a single self-concept and a comfortable sense of identity (identity-achievement status).

For teenagers, the peer group provides valuable information about the self-concept. For instance, in response to the question “What were you like as a teenager? (e.g., cool, nerdy, awkward?),” posed on the website Answerbag, one teenager replied in this way:

Responses like this one demonstrate the extent to which adolescents are developing their self-concepts and self-identities and how they rely on peers to help them do that. The writer here is trying out several (perhaps conflicting) identities, and the identities any teen experiments with are defined by the group the person chooses to be a part of. The friendship groups (cliques, crowds, or gangs) that are such an important part of the adolescent experience allow the young adult to try out different identities, and these groups provide a sense of belonging and acceptance (Rubin, Bukowski, & Parker, 2006).Rubin, K. H., Bukowski, W. M., & Parker, J. G. (2006). Peer interactions, relationships, and groups. In N. Eisenberg, W. Damon, & R. M. Lerner (Eds.), Handbook of child psychology: Social, emotional, and personality development (6th ed., Vol. 3, pp. 571–645). Hoboken, NJ: John Wiley & Sons. A big part of what the adolescent is learning is social identityThe part of the self-concept that is derived from one’s group memberships., the part of the self-concept that is derived from one’s group memberships. Adolescents define their social identities according to how they are similar to and differ from others, finding meaning in the sports, religious, school, gender, and ethnic categories they belong to.

Developing Moral Reasoning: Kohlberg’s Theory

The independence that comes with adolescence requires independent thinking as well as the development of morality—standards of behavior that are generally agreed on within a culture to be right or proper. Just as Piaget believed that children’s cognitive development follows specific patterns, Lawrence Kohlberg (1984)Kohlberg, L. (1984). The psychology of moral development: Essays on moral development (Vol. 2, p. 200). San Francisco, CA: Harper & Row. argued that children learn their moral values through active thinking and reasoning, and that moral development follows a series of stages. To study moral development, Kohlberg posed moral dilemmas to children, teenagers, and adults, such as the following:

As you can see in Table 6.5 "Lawrence Kohlberg’s Stages of Moral Reasoning", Kohlberg concluded, on the basis of their responses to the moral questions, that, as children develop intellectually, they pass through three stages of moral thinking: the preconventional level, the conventional level, and the postconventional level.

Although research has supported Kohlberg’s idea that moral reasoning changes from an early emphasis on punishment and social rules and regulations to an emphasis on more general ethical principles, as with Piaget’s approach, Kohlberg’s stage model is probably too simple. For one, children may use higher levels of reasoning for some types of problems, but revert to lower levels in situations where doing so is more consistent with their goals or beliefs (Rest, 1979).Rest, J. (1979). Development in judging moral issues. Minneapolis: University of Minnesota Press. Second, it has been argued that the stage model is particularly appropriate for Western, rather than non-Western, samples in which allegiance to social norms (such as respect for authority) may be particularly important (Haidt, 2001).Haidt, J. (2001). The emotional dog and its rational tail: A social intuitionist approach to moral judgment. Psychological Review, 108(4), 814–834. And there is frequently little correlation between how children score on the moral stages and how they behave in real life.

Perhaps the most important critique of Kohlberg’s theory is that it may describe the moral development of boys better than it describes that of girls. Carol Gilligan (1982)Gilligan, C. (1982). In a different voice: Psychological theory and women’s development. Cambridge, MA: Harvard University Press. has argued that, because of differences in their socialization, males tend to value principles of justice and rights, whereas females value caring for and helping others. Although there is little evidence that boys and girls score differently on Kohlberg’s stages of moral development (Turiel, 1998),Turiel, E. (1998). The development of morality. In W. Damon (Ed.), Handbook of child psychology: Socialization (5th ed., Vol. 3, pp. 863–932). New York, NY: John Wiley & Sons. it is true that girls and women tend to focus more on issues of caring, helping, and connecting with others than do boys and men (Jaffee & Hyde, 2000).Jaffee, S., & Hyde, J. S. (2000). Gender differences in moral orientation: A meta-analysis. Psychological Bulletin, 126(5), 703–726. If you don’t believe this, ask yourself when you last got a thank-you note from a man.

Physical and Cognitive Changes in Early and Middle Adulthood

Compared with the other stages, the physical and cognitive changes that occur in the stages of early and middle adulthood are less dramatic. As individuals pass into their 30s and 40s, their recovery from muscular strain becomes more prolonged, and their sensory abilities may become somewhat diminished, at least when compared with their prime years, during the teens and early 20s (Panno, 2004).Panno, J. (2004). Aging: Theories and potential therapies. New York, NY: Facts on File Publishers. Visual acuity diminishes somewhat, and many people in their late 30s and early 40s begin to notice that their eyes are changing and they need eyeglasses. Adults in their 30s and 40s may also begin to suffer some hearing loss because of damage to the hair cells (cilia) in the inner ear (Lacher-Fougëre & Demany, 2005).Lacher-Fougëre, S., & Demany, L. (2005). Consequences of cochlear damage for the detection of inter-aural phase differences. Journal of the Acoustical Society of America, 118, 2519–2526. And it is during middle adulthood that many people first begin to suffer from ailments such as high cholesterol and high blood pressure as well as low bone density (Shelton, 2006).Shelton, H. M. (2006). High blood pressure. Whitefish, MT: Kessinger Publishers. Corresponding to changes in our physical abilities, our cognitive and sensory abilities also seem to show some, but not dramatic, decline during this stage.

Menopause

The stages of both early and middle adulthood bring about a gradual decline in fertility, particularly for women. Eventually, women experience menopauseThe cessation of the menstrual cycle, which usually occurs at around age 50., the cessation of the menstrual cycle, which usually occurs at around age 50. Menopause occurs because of the gradual decrease in the production of the female sex hormones estrogen and progesterone, which slows the production and release of eggs into the uterus. Women whose menstrual cycles have stopped for 12 consecutive months are considered to have entered menopause (Minkin & Wright, 2004).Minkin, M. J., & Wright, C. V. (2004). A woman’s guide to menopause and perimenopause. New Haven, CT: Yale University Press.

Researchers have found that women’s responses to menopause are both social as well as physical, and that they vary substantially across both individuals and cultures. Within individuals, some women may react more negatively to menopause, worrying that they have lost their femininity and that their final chance to bear children is over, whereas other women may regard menopause more positively, focusing on the new freedom from menstrual discomfort and unwanted pregnancy. In Western cultures such as in the United States, women are likely to see menopause as a challenging and potentially negative event, whereas in India, where older women enjoy more social privileges than do younger ones, menopause is more positively regarded (Avis & Crawford, 2008).Avis, N. E., & Crawford, S. (2008). Cultural differences in symptoms and attitudes toward menopause. Menopause Management, 17(3), 8–13.

Menopause may have evolutionary benefits. Infants have better chances of survival when their mothers are younger and have more energy to care for them, and the presence of older women who do not have children of their own to care for (but who can help out with raising grandchildren) can be beneficial to the family group. Also consistent with the idea of an evolutionary benefit of menopause is that the decline in fertility occurs primarily for women, who do most of the child care and who need the energy of youth to accomplish it. If older women were able to have children they might not be as able to effectively care for them. Most men never completely lose their fertility, but they do experience a gradual decrease in testosterone levels, sperm count, and speed of erection and ejaculation.

Social Changes in Early and Middle Adulthood

Perhaps the major marker of adulthood is the ability to create an effective and independent life. Whereas children and adolescents are generally supported by parents, adults must make their own living and must start their own families. Furthermore, the needs of adults are different from those of younger persons.

Although the timing of the major life events that occur in early and middle adulthood vary substantially across individuals, they nevertheless tend to follow a general sequence, known as a social clockThe culturally preferred “right time” for major life events, such as moving out of the house, getting married, and having children.. The social clock refers to the culturally preferred “right time” for major life events, such as moving out of the childhood house, getting married, and having children. People who do not appear to be following the social clock (e.g., young adults who still live with their parents, individuals who never marry, and couples who choose not to have children) may be seen as unusual or deviant, and they may be stigmatized by others (DePaulo, 2006; Rook, Catalano, & Dooley, 1989).DePaulo, B. M. (2006). Singled out: How singles are stereotyped, stigmatized and ignored, and still live happily ever after. New York, NY: St. Martin’s Press; Rook, K. S., Catalano, R. C., & Dooley, D. (1989). The timing of major life events: Effects of departing from the social clock. American Journal of Community Psychology, 17, 223–258.

Although they are doing it later, on average, than they did even 20 or 30 years ago, most people do eventually marry. Marriage is beneficial to the partners, both in terms of mental health and physical health. People who are married report greater life satisfaction than those who are not married and also suffer fewer health problems (Gallagher & Waite, 2001; Liu & Umberson, 2008).Gallagher, M., & Waite, L. J. (2001). The case for marriage: Why married people are happier, healthier, and better off financially. New York, NY: Random House; Liu, H., & Umberson, D. (2008). The times they are a changin’: Marital status and health differentials from 1972 to 2003. Journal of Health and Social Behavior, 49, 239–253.

Divorce is more common now than it was 50 years ago. In 2003 almost half of marriages in the United States ended in divorce (Bureau of the Census, 2007),Bureau of the Census. (2007). Statistical abstract of the United States 2006 (p. 218). Washington, DC: U.S. Government Printing Office. although about three quarters of people who divorce will remarry. Most divorces occur for couples in their 20s, because younger people are frequently not mature enough to make good marriage choices or to make marriages last. Marriages are more successful for older adults and for those with more education (Goodwin, Mosher, & Chandra, 2010).Goodwin, P. Y., Mosher, W. D., Chandra A. (2010, February). Marriage and cohabitation in the United States: A statistical portrait based on Cycle 6 (2002) of the National Survey of Family Growth. Vital Health Statistics 23(28), 1–45. Retrieved from National Center for Health Statistics, Centers for Disease Control and Prevention, website: http://www.cdc.gov/nchs/data/series/sr_23/sr23_028.pdf

Parenthood also involves a major and long-lasting commitment, and one that can cause substantial stress on the parents. The time and finances invested in children create stress, which frequently results in decreased marital satisfaction (Twenge, Campbell, & Foster, 2003).Twenge, J., Campbell, W., & Foster, C. (2003). Parenthood and marital satisfaction: A meta-analytic review. Journal of Marriage and Family, 65(3), 574–583. This decline is especially true for women, who bear the larger part of the burden of raising the children and taking care of the house, despite the fact they increasingly also work and have careers.

Despite the challenges of early and middle adulthood, the majority of middle-aged adults are not unhappy. These years are often very satisfying, as families have been established, careers have been entered into, and some percentage of life goals has been realized (Eid & Larsen, 2008).Eid, M., & Larsen, R. J. (Eds.). (2008). The science of subjective well-being. New York, NY: Guilford Press.

Cognitive Changes During Aging

The changes associated with aging do not affect everyone in the same way, and they do not necessarily interfere with a healthy life. Former Beatles drummer Ringo Starr celebrated his 70th birthday in 2010 by playing at Radio City Music Hall, and Rolling Stones singer Mick Jagger (who once supposedly said, “I’d rather be dead than singing ‘Satisfaction’ at 45”) continues to perform as he pushes 70. The golfer Tom Watson almost won the 2010 British Open golf tournament at the age of 59, playing against competitors in their 20s and 30s. And people such as the financier Warren Buffet, U.S. Senator Frank Lautenberg, and actress Betty White, each in their 80s, all enjoy highly productive and energetic lives.

Figure 6.12

Aging does not affect everyone equally. All of these people—in their 60s, 70s, or 80s—still maintain active and productive lives.

Sources: Jagger photo courtesy of Gonzalo Andrés, http://commons.wikimedia.org/wiki/File:Mick_Jagger.jpg. Starr photo courtesy of Tina 63, http://commons.wikimedia.org/wiki/File:Ringo.jpg. Lautenberg-Pascrell photo courtesy of Tony, http://www.flickr.com/photos/tonythemisfit/2551278536. Buffet photo courtesy of Mohammad Bahareth, http://www.flickr.com/photos/mbahareth/3771184817. Watson photo courtesy of Ian Tilbrook, http://commons.wikimedia.org/wiki/File:2008_Open_Championship_-_Tom_Watson.jpg. White photo courtesy of Alan Light, http://www.flickr.com/photos/alan-light/211186811.

Researchers are beginning to better understand the factors that allow some people to age better than others. For one, research has found that the people who are best able to adjust well to changing situations early in life are also able to better adjust later in life (Rubin, 2007; Sroufe, Collins, Egeland, & Carlson, 2009).Rubin, L. (2007). 60 on up: The truth about aging in America. Boston, MA: Beacon Press; Sroufe, L. A., Collins, W. A., Egeland, B., & Carlson, E. A. (2009). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York, NY: Guilford Press. Perceptions also matter. People who believe that the elderly are sick, vulnerable, and grumpy often act according to such beliefs (Nemmers, 2005),Nemmers, T. M. (2005). The influence of ageism and ageist stereotypes on the elderly. Physical & Occupational Therapy in Geriatrics, 22(4), 11–20. and Levy, Slade, Kunkel, and Kasl (2002)Levy, B. R., Slade, M. D., Kunkel, S. R., & Kasl, S. V. (2002). Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology, 83, 261–270. found that the elderly who had more positive perceptions about aging also lived longer.

In one important study concerning the role of expectations on memory, Becca Levy and Ellen Langer (1994)Levy, B., & Langer, E. (1994). Aging free from negative stereotypes: Successful memory in China among the American deaf. Journal of Personality and Social Psychology, 66(6), 989–997. found that, although young American and Chinese students performed equally well on cognitive tasks, older Americans performed significantly more poorly on those tasks than did their Chinese counterparts. Furthermore, this difference was explained by beliefs about aging—in both cultures, the older adults who believed that memory declined with age also showed more actual memory declines than did the older adults who believed that memory did not decline with age. In addition, more older Americans than older Chinese believed that memory declined with age, and as you can see in Figure 6.13, older Americans performed more poorly on the memory tasks.

Figure 6.13

Is Memory Influenced by Cultural Stereotypes? Levy and Langer (1994) found that although younger samples did not differ, older Americans performed significantly more poorly on memory tasks than did older Chinese, and that these differences were due to different expectations about memory in the two cultures.

Source: Adapted from Levy, B., & Langer, E. (1994). Aging free from negative stereotypes: Successful memory in China among the American deaf. Journal of Personality and Social Psychology, 66(6), 989–997.

Whereas it was once believed that almost all older adults suffered from a generalized memory loss, research now indicates that healthy older adults actually experience only some particular types of memory deficits, while other types of memory remain relatively intact or may even improve with age. Older adults do seem to process information more slowly—it may take them longer to evaluate information and to understand language, and it takes them longer, on average, than it does younger people, to recall a word that they know, even though they are perfectly able to recognize the word once they see it (Burke, Shafto, Craik, & Salthouse, 2008).Burke, D. M., Shafto, M. A., Craik, F. I. M., & Salthouse, T. A. (2008). Language and aging. In The handbook of aging and cognition (3rd ed., pp. 373–443). New York, NY: Psychology Press. Older adults also have more difficulty inhibiting and controlling their attention (Persad, Abeles, Zacks, & Denburg, 2002),Persad, C. C., Abeles, N., Zacks, R. T., & Denburg, N. L. (2002). Inhibitory changes after age 60 and the relationship to measures of attention and memory. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 57B(3), P223–P232. making them, for example, more likely to talk about topics that are not relevant to the topic at hand when conversing (Pushkar et al., 2000).Pushkar, D., Basevitz, P., Arbuckle, T., Nohara-LeClair, M., Lapidus, S., & Peled, M. (2000). Social behavior and off-target verbosity in elderly people. Psychology and Aging, 15(2), 361–374.

But slower processing and less accurate executive control does not always mean worse memory, or even worse intelligence. Perhaps the elderly are slower in part because they simply have more knowledge. Indeed, older adults have more crystallized intelligenceA person’s accumulated general knowledge about the world, including semantic knowledge, vocabulary, and language.—that is, general knowledge about the world, as reflected in semantic knowledge, vocabulary, and language. As a result, adults generally outperform younger people on measures of history, geography, and even on crossword puzzles, where this information is useful (Salthouse, 2004).Salthouse, T. A. (2004). What and when of cognitive aging. Current Directions in Psychological Science, 13(4), 140–144. It is this superior knowledge combined with a slower and more complete processing style, along with a more sophisticated understanding of the workings of the world around them, that gives the elderly the advantage of “wisdom” over the advantages of fluid intelligenceThe ability to think and acquire information quickly and abstractly.—the ability to think and acquire information quickly and abstractly—which favor the young (Baltes, Staudinger, & Lindenberger, 1999; Scheibe, Kunzmann, & Baltes, 2009).Baltes, P. B., Staudinger, U. M., & Lindenberger, U. (1999). Life-span psychology: Theory and application to intellectual functioning. Annual Review of Psychology, 50, 471–506; Scheibe, S., Kunzmann, U., & Baltes, P. B. (2009). New territories of positive life-span development: Wisdom and life longings. In S. J. E. Lopez & C. R. E. Snyder (Eds.), Oxford handbook of positive psychology (2nd ed., pp. 171–183). New York, NY: Oxford University Press.

The differential changes in crystallized versus fluid intelligence help explain why the elderly do not necessarily show poorer performance on tasks that also require experience (i.e., crystallized intelligence), although they show poorer memory overall. A young chess player may think more quickly, for instance, but a more experienced chess player has more knowledge to draw on. Older adults are also more effective at understanding the nuances of social interactions than younger adults are, in part because they have more experience in relationships (Blanchard-Fields, Mienaltowski, & Seay, 2007).Blanchard-Fields, F., Mienaltowski, A., & Seay, R. B. (2007). Age differences in everyday problem-solving effectiveness: Older adults select more effective strategies for interpersonal problems. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 62B(1), P61–P64.

Dementia and Alzheimer’s Disease

Some older adults suffer from biologically based cognitive impairments in which the brain is so adversely affected by aging that it becomes very difficult for the person to continue to function effectively. DementiaA progressive neurological disease that includes loss of cognitive abilities, which affect social and occupational functioning. is defined as a progressive neurological disease that includes loss of cognitive abilities significant enough to interfere with everyday behaviors, and Alzheimer’s diseaseA form of dementia that originates in the cerebral cortex and is ultimately fatal. is a form of dementia that, over a period of years, leads to a loss of emotions, cognitions, and physical functioning, and which is ultimately fatal. Dementia and Alzheimer’s disease are most likely to be observed in individuals who are 65 and older, and the likelihood of developing Alzheimer’s doubles about every 5 years after age 65. After age 85, the risk reaches nearly 8% per year (Hebert et al., 1995).Hebert, L. E., Scherr, P. A., Beckett, L. A., Albert, M. S., Pilgrim, D. M., Chown, M. J.,…Evans, D. A. (1995). Age-specific incidence of Alzheimer’s disease in a community population. Journal of the American Medical Association, 273(17), 1354–1359. Dementia and Alzheimer’s disease both produce a gradual decline in functioning of the brain cells that produce the neurotransmitter acetylcholine. Without this neurotransmitter, the neurons are unable to communicate, leaving the brain less and less functional.

Figure 6.14 A Healthy Brain (Left) Versus a Brain With Advanced Alzheimer’s Disease (Right)

Dementia and Alzheimer’s are in part heritable, but there is increasing evidence that the environment also plays a role. And current research is helping us understand the things that older adults can do to help them slow down or prevent the negative cognitive outcomes of aging, including dementia and Alzheimer’s (Pushkar, Bukowski, Schwartzman, Stack, & White, 2007).Pushkar, D., Bukowski, W. M., Schwartzman, A. E., Stack, D. M., & White, D. R. (2007). Responding to the challenges of late life: Strategies for maintaining and enhancing competence. New York, NY: Springer Publishing. Older adults who continue to keep their minds active by engaging in cognitive activities, such as reading, playing musical instruments, attending lectures, or doing crossword puzzles, who maintain social interactions with others, and who keep themselves physically fit have a greater chance of maintaining their mental acuity than those who do not (Cherkas et al., 2008; Verghese et al., 2003).Cherkas, L. F., Hunkin, J. L., Kato, B. S., Richards, J. B., Gardner, J. P., Surdulescu, G. L.,…Aviv, A. (2008). The association between physical activity in leisure time and leukocyte telomere length. Archives of Internal Medicine, 168, 154–158; Verghese, J., Lipton, R., Katz, M. J., Hall, C. B., Derby, C. A.,…Buschke, M.D. (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine, 348, 2508–2516. In short, although physical illnesses may occur to anyone, the more people keep their brains active and the more they maintain a healthy and active lifestyle, the more healthy their brains will remain (Ertel, Glymour, & Berkman, 2008).Ertel, K. A., Glymour, M. M., & Berkman, L. F. (2008). Effects of social integration on preserving memory function in a nationally representative U.S. elderly population. American Journal of Public Health, 98, 1215–1220.

Social Changes During Aging: Retiring Effectively

Because of increased life expectancy in the 21st century, elderly people can expect to spend approximately a quarter of their lives in retirement. Leaving one’s career is a major life change and can be a time when people experience anxiety, depression, and other negative changes in the self-concept and in self-identity. On the other hand, retirement may also serve as an opportunity for a positive transition from work and career roles to stronger family and community member roles, and the latter may have a variety of positive outcomes for the individual. Retirement may be a relief for people who have worked in boring or physically demanding jobs, particularly if they have other outlets for stimulation and expressing self-identity.

Psychologist Mo Wang (2007)Wang, M. (2007). Profiling retirees in the retirement transition and adjustment process: Examining the longitudinal change patterns of retirees’ psychological well-being. Journal of Applied Psychology, 92(2), 455–474. observed the well-being of 2,060 people between the ages of 51 and 61 over an 8-year period, and made the following recommendations to make the retirement phase a positive one:

1. Continue to work part time past retirement, in order to ease into retirement status slowly.
2. Plan for retirement—this is a good idea financially, but also making plans to incorporate other kinds of work or hobbies into postemployment life makes sense.
3. Retire with someone—if the retiree is still married, it is a good idea to retire at the same time as a spouse, so that people can continue to work part time and follow a retirement plan together.
4. Have a happy marriage—people with marital problems tend to find retirement more stressful because they do not have a positive home life to return to and can no longer seek refuge in long working hours. Couples that work on their marriages can make their retirements a lot easier.
5. Take care of physical and financial health—a sound financial plan and good physical health can ensure a healthy, peaceful retirement.
6. Retire early from a stressful job—people who stay in stressful jobs for fear that they will lose their pensions or won’t be able to find work somewhere else feel trapped. Toxic environments can take a severe emotional toll on an employee. Leaving early from an unsatisfying job may make retirement a relief.
7. Retire “on time”—retiring too early or too late can cause people to feel “out of sync” or to feel they have not achieved their goals.

Whereas these seven tips are helpful for a smooth transition to retirement, Wang also notes that people tend to be adaptable, and that no matter how they do it, retirees will eventually adjust to their new lifestyles.

Death, Dying, and Bereavement

Living includes dealing with our own and our loved ones’ mortality. In her book, On Death and Dying (1997),Kübler-Ross, E. (1997). On death and dying. New York, NY: Scribner. Elizabeth Kübler-Ross describes five phases of grief through which people pass in grappling with the knowledge that they or someone close to them is dying:

1. Denial: “I feel fine.” “This can’t be happening; not to me.”
2. Anger: “Why me? It’s not fair!” “How can this happen to me?” “Who is to blame?”
3. Bargaining: “Just let me live to see my children graduate.” “I’d do anything for a few more years.” “I’d give my life savings if…”
4. Depression: “I’m so sad, why bother with anything?” “I’m going to die. What’s the point?” “I miss my loved ones—why go on?”
5. Acceptance: “I know my time has come; it’s almost my time.”

Despite Ross’s popularity, there are a growing number of critics of her theory who argue that her five-stage sequence is too constraining because attitudes toward death and dying have been found to vary greatly across cultures and religions, and these variations make the process of dying different according to culture (Bonanno, 2009).Bonanno, G. (2009). The other side of sadness: What the new science of bereavement tells us about life after a loss. New York, NY: Basic Books. As an example, Japanese Americans restrain their grief (Corr, Nabe, & Corr, 2009)Corr, C. A., Nabe, C. M., & Corr, D. M. (2009). Death and dying: Life and living (6th ed.). Belmont, CA: Wadsworth. so as not to burden other people with their pain. By contrast, Jews observe a 7-day, publicly announced mourning period. In some cultures the elderly are more likely to be living and coping alone, or perhaps only with their spouse, whereas in other cultures, such as the Hispanic culture, the elderly are more likely to be living with their sons and daughters and other relatives, and this social support may create a better quality of life for them (Diaz-Cabello, 2004).Diaz-Cabello, N. (2004). The Hispanic way of dying: Three families, three perspectives, three cultures. Illness, Crisis, & Loss, 12(3), 239–255.

Margaret Stroebe and her colleagues (2008)Stroebe, M. S., Hansson, R. O., Schut, H., & Stroebe, W. (2008). Bereavement research: Contemporary perspectives. In M. S. Stroebe, R. O. Hansson, H. Schut, & W. Stroebe (Eds.), Handbook of bereavement research and practice: Advances in theory and intervention (pp. 3–25). Washington, DC: American Psychological Association. found that although most people adjusted to the loss of a loved one without seeking professional treatment, many had an increased risk of mortality, particularly within the early weeks and months after the loss. These researchers also found that people going through the grieving process suffered more physical and psychological symptoms and illnesses and used more medical services.

The health of survivors during the end of life is influenced by factors such as circumstances surrounding the loved one’s death, individual personalities, and ways of coping. People serving as caretakers to partners or other family members who are ill frequently experience a great deal of stress themselves, making the dying process even more stressful. Despite the trauma of the loss of a loved one, people do recover and are able to continue with effective lives. Grief intervention programs can go a long way in helping people cope during the bereavement period (Neimeyer, Holland, Currier, & Mehta, 2008).Neimeyer, R. A., Holland, J. M., Currier, J. M., & Mehta, T. (2008). Meaning reconstruction in later life: Toward a cognitive-constructivist approach to grief therapy. In D. Gallagher-Thompson, A. Steffen, & L. Thompson (Eds.), Handbook of behavioral and cognitive therapies with older adults (pp. 264–277). New York, NY: Springer Verlag.