II.

Mental
Health
Psychiatr
ic
A. Personality theories and determinants of
psychopathology: implications of mental health-
psychiatric nursing practice

1. PSYCHOANALYTIC
- Sigmund Freud
is the founder of the
psychoanalytic model
- Key Freudian
concept include levels
of consciousness,
structure of personality
and psychosexual
development.
 Three Levels of Consciousness

 First Level
- conscious mind, the part of the mind
that is aware of the present and
functions only when the person is
awake.
- It represents the smallest part of the
mind and directs an individual’s
rational, thoughtful behavior.
 Second Level
-preconscious (or subconscious), is the
part of the mind in which thoughts, feelings,
and sensations are stored.

 Third Level
-unconscious, represents the largest part
of the mind and is the storehouse for all of
the thoughts, feelings, and sensations
experienced during the individual’s lifetime.
 Structure of the
Personality
-second major concept developed by
Freud.

-Freud believed that the personality

consists of three aspects: ID, EGO,
SUPEREGO
 ID
-Is part and is derived from the unconscious
-It is unlearned, primitive and selfish.
-Does not have sense of right and wrong.

 EGO
-Develops as a result of the infant’s interaction
with its environment.
-It establishes an acceptable compromise
between the crude ,pleasure-seeking strivings of
the id and the inhibitions of the superego through
reality testing.
 SUPEREGO

-Acts as a moral judge of the individual based

on what the person has learned from significant
others, such as parents and teachers.
-It operates mostly at the unconscious level and
controls the id.
Two aspects of superego:
-Conscience – which punishes individual
through guilt and anxiety
-Ego ideal – which rewards individuals with
feelings of well-being
Psychosexual Development.
 Freud claimed that personality is a dynamic ,
evolving process that develops from birth
through young adulthood.

 Freud’s Stages of Psychosexual

development are oral (birth to 18mos.),anal
(18mos to 3 yrs.), phallic (3 to 6 yrs.), and
genital (13 yrs. to adulthood).
2. INTERPERSONAL
 First developed by Harry Stack Sullivan (1892-
1949)
 He believed that all human behavior is goal-
directed toward the fulfillment of two needs, the
need for satisfaction and the need for security.
need for satisfaction - derives from the person’s
biologic need for air, food, sex, shelter and so on.
need for security - derives from the person’s
emotional needs for feeling states such as
interpersonal intimacy, status and self-esteem.
 Stages of development
 Sullivan explained six developmental stages
called "epochs" or heuristic Stages in
Development.
 Stages (Epochs)
Characteristics

1 Infancy (Birth-18 months) Gratification of needs

2 Childhood (18 mo-6 yrs) Delayed gratification

3 Juvenile era(6-9 yrs) Formation of peer group

Developing relationships
4 Preadolescence (9-12 yrs)
within same gender

Early Adolescence (12-14

5 Identity
yrs)

Forming lasting, intimate

6 Late Adolescence (14-21 yrs)
relationships
 Sullivan explained about three types of
self:

The ‘good me’ versus the ‘bad me’ based on

social appraisal and the anxiety that results
from negative feedback
The ‘not me’ refers to the unknown,
repressed component of the self.
 Sullivan's theory explains about anxiety,
self system and self-esteem:

Security operations –those measures that

the individual employs to reduce anxiety and
enhance security.
Self system – all of the security operations
an individual uses to defend against anxiety
and ensure self esteem
4. BEHAVIORAL
Ivan Pavlov Classical
Conditioning Theory
- a form of conditioning and
learning that was first
demonstrated by Russian
physiologist Ivan Pavlov
(1927). In classical
conditioning two stimuli are
presented in close
succession repeatedly, until
the response given to one
becomes associated with the
other.
3. COGNITIVE

 Jean Piaget's theory of cognitive

development suggests that children move
through four different stages of mental
development. His theory focuses not only
on understanding how children acquire
knowledge, but also on understanding the
nature of intelligence.
 There Are Three Basic Components To
Piaget's Cognitive Theory:
 Schemas
(building blocks of knowledge)
 Processes that enable the transition from one
stage to another (
equilibrium, assimilation and accommodation)

Stages of Development:
 sensorimotor,
 preoperational,
 concrete operational,
 formal operational
Stage Age Characteristics Developmental Changes
Sensorimotor Stage Birth to 2 Years The infant knows the world Infants learn that things continue
through their movements and to exist even though they cannot
sensations. be seen (object permanence).

They are separate beings from

the people and objects around
them.

They realize that their actions

can cause things to happen in
the world around them.

Learning occurs through

assimilation and accommodation.

Preoperational Stage 2 to 7 Years Children begin to think Children at this stage tend to be
symbolically and learn to use egocentric and struggle to see
words and pictures to represent things from the perspective of
objects. They also tend to be very others.
egocentric, and see things only
from their point of view.
While they are getting better with
language and thinking, they still
tend to think about things in very
conrete terms.
Concrete Operational Stage 7 to 11 Years During this stage, children begin They begin to understand the
to thinking logically about concept of conservation; the the
concrete events. amount of liquid in a short, wide
cup is equal to that in a tall,
skinny glass.

Thinking becomes more logical

and organized, but still very
concrete.

Begin using inductive logic, or

reasoning from specific
information to a general
principle.

Formal Operational Stage 12 and Up At this stage, the adolescent or Abstract thought emerges.
young adult begins to think
abstractly and reason about
hypothetical problems.
Teens begin to think more about
moral, philosophical, ethical, social,
and political issues that require
theoretical and abstract reasoning.

Begin to use deductive logic, or

reasoning from a general principle
to specific information.
 B.F Skinner’s Theory of Operant
Conditioning

 is a form of learning
during which an
individual modifies the
occurrence and form of
its own behavior due to
the reinforcement of
consequences of the
behavior.
 4 types of Operant
Conditioning
a. Positive Reinforcement
- such as reward or
recognition strengthens
behavior
b. Negative Reinforcement
- such as punishment and extinction
weakens behavior.
c. Punishment

- weakens a particular
behavior through the
consequence of
experiencing a
negative condition.
d. Extinction
- weakens a particular behavior
through the consequence of not
experiencing either positive or negative
condition.
5. HUMANISTIC

- Abraham Maslow
- He described a hierarchy of needs that
occur in the following sequence: 1)
Physical needs, 2) needs for personal
safety, 3) the need to receive love 4) the
need for a healthy amount of self-esteem,
5) self-actualization and 6) self-
transcendence.
6. PSYCHOSOCIAL

 Erik Erikson described development that

occurs throughout the lifespan. Learn more in
this chart summarizing Erikson's stages of
psychosocial development.
 In each stage, the person confronts, and
hopefully masters, new challenges. Each
stage builds upon the successful
completion of earlier stages. The
challenges of stages not successfully
completed may be expected to reappear as
problems in the future
Stage Basic Conflict Important Events Outcome
Infancy (birth to 18 months) Trust vs. Mistrust Feeding Children develop a sense of trust
when caregivers provide
reliabilty, care, and affection. A
lack of this will lead to mistrust.

Early Childhood (2 to 3 years) Autonomy vs. Shame and Doub Toilet Training Children need to develop a
t sense of personal control over
physical skills and a sense of
independence. Success leads to
feelings of autonomy, failure
results in feelings of shame and
doubt.

Preschool (3 to 5 years) Initiative vs. Guilt Exploration Children need to begin asserting
control and power over the
environment. Success in this
stage leads to a sense of
purpose. Children who try to
exert too much power experience
disapproval, resulting in a sense
of guilt.

School Age (6 to 11 years) Industry vs. Inferiority School Children need to cope with new
social and academic demands.
Success leads to a sense of
competence, while failure results
in feelings of inferiority.
Adolescence (12 to 18 years) Identity vs. Role Confusion Social Relationships Teens need to develop a sense
of self and personal identity.
Success leads to an ability to
stay true to yourself, while
failure leads to role confusion
and a weak sense of self.

Young Adulthood (19 to 40 years) Intimacy vs. Isolation Relationships Young adults need to form
intimate, loving relationships with
other people. Success leads to
strong relationships, while failure
results in loneliness and
isolation.

Middle Adulthood (40 to 65 years) Generativity vs. Stagnation Work and Parenthood Adults need to create or nurture
things that will outlast them, often
by having children or creating a
positive change that benefits
other people. Success leads to
feelings of usefulness and
accomplishment, while failure
results in shallow involvement in
the world.

Maturity(65 to death) Ego Integrity vs. Despair Reflection on Life Older adults need to look back
on life and feel a sense of
fulfillment. Success at this stage
leads to feelings of wisdom,
while failure results in regret,
bitterness, and despair.
THANK YOU! :