OT121: Lifep Development and Occupation II University of the Philippines Manila | College of Allied Medical Professions Department of Occupational Therapy | Block 21 – Occupational Therapy SS 2012 – 2013 Young Adulthood Ms. Faith Deanne Mari B.
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Integrity ? Compassion o Maturity is the psychological ability to work and to love (Freud). PHYSICAL CHANGES ? Physical status o Peak of vitality, health, strength, energy, and endurance ? 25 years old is the prime in terms of strength. All motor systems are at peak during this age. ? Dispatch the young to do battle. OT 121: Lifep Development and Occupation II Young Adulthood ? ? ? Peak of sensorimotor skills ? 25 – 30: peak of physical conditioning, strength, motor skills, organ functioning ? 20 -40: peak of visual acuity ? 20 -45: peak of taste, smell, temperature, and pain sensation ?
Gradual hearing loss (more apparent after 25; particularly with high pitched sounds) o Most physical decline occurs after 30s (10% loss until 60s) Fitness and health o Generally healthy age period o Health patterns established in young adulthood are generally resistant to change ? Adolescence is a storming period of change but when one enters young adulthood, it is expected that one? s biological systems are already stabilized. Common Illnesses due to occupational hazards o Chronic back pain – by overworking selves and the effect of stress o Respiratory illnesses o Premenstrual syndrome o Sexually transmitted diseases ?
Highest among young adults and adolescence ? Due to poverty, drug use and risky sexual activity o HIV - 40 million people infected worldwide, 95% from developing world ? Males - lead cause of death ? Females - 4th cause of death Common Causes of Death o 3 causes that account for 72% in the early 20s and 51% among 25 - 34 year olds ? Accidents ? Homicide ? Suicide o AIDS - single leading cause of death in males aged 25-44 o YA has the lowest death rate among adult groups However, in the entire adult lifep, young adults have the lowest death rate. o
MORBIDITY o Defined as the occurrence of illness o Symptoms often appear in YA ? Genetically-determined diseases (diabetes, sickle cell anemia) (hypertension, ulcers, ? Stress-linked depression) Page 1 BLANCO | MARIANO | QUEMADO | VILLON ? Factors Linked to Health Status o Genetic factors ? However, if purely genetics, it should be seen early (right after birth) ? Multi-factorial diseases (genetics and environmental) ? Diabetes ? Atherosclerosis (narrowing of vessels due to fat planks) ? Obesity ? Cancer health conditions ? Mental predisposed to come out during YA such as schizophrenia o Health threatening behaviors ?
Nutrition and cholesterol ? You are what you eat ? Carotenoid-rich diet - lesser chance of heart disease ? Plant-based diet - reduction of cancer risk ? High-fat diet ? Colon and prostate cancer ? Increased cardiovascular risks ? Obesity ? Measured using body mass index 2 ? BMI: Kg/m If BMI >25, overweight If BMI>30, obese ? World-wide epidemic (WHO, 2001) ? Why? - Fast food culture - Labor saving technology - Genetic tendency: leptin response insufficiency - Leptin tells the brain that one is already full - Some clinically obese may not respond to leptin anymore ?
May lead to emotional problems and other diseases ? Physical activity ? Sedentary lifestyle is one of world's 10 leading causes of death and disability ? Smoking ? Leading preventable cause of death in US ? Smoking and cancer ? Alcohol ? College is prime time and place for drinking (Papalia, et al. , 2004) cause poor academic ? Can performance ? Can increase other risks for other diseases ? Alcohol in moderation can decrease the risk of heart diseases in the long run (i. e. red wine). ? Drug use ? Peak at 18 to 20 years old ?
Decreases as adults increase in maturity, settle down and take responsibility o Marijuana and cocaine use can lead to memory loss, attention deficits, cognitive deficits, and in some cases death Indirect influences on health status ? Socioeconomic status ? Income ? Education ? Higher socio-economic status and education generally lead to less exposure to health hazards ? Gender ? Relationship ? Social ties ? Emotional support ? Marriage ? Strong social environment leads to less risks in psychological illnesses. ? ? ?
Healthy Habits o Sleeping regularly for 7-8 hours each night o Eating regular meals o Not snacking o Eating and exercising moderately o Not smoking o Drinking in moderation Preventive Measures o Regular screening test o Self examination o Proper body mechanics o Ergonomics SOCIAL AND EMOTIONAL CHANGES ? Theories on Social and Emotional Issues of Young Adults o Normative-stage model Erikson: personality changes ? Erik throughout life ? Development follows basic sequence of age-related social and emotional changes ? Normative events - happens to all people of certain age ?
Changes are attributed to age/biology alone o Timing of events model ? Development depends on the occurrence of certain events ? Events that happens off-time (losing a job, unplanned pregnancy) ? Events that do not occur (singlehood, inability to have a child) ? If on time - smooth development ? If not - stress would occur ? Factors affecting response on events ? Anticipation and preparation ? Cognitive understanding ? Health ? Personality ? Life history ? Support systems ? Personality, support system and understanding play a big role on how one deals with unexpected events o Erik Erikson's Stages th ?
Intimacy versus Isolation: 6 stage Page 2 BLANCO | MARIANO | QUEMADO | VILLON OT 121: Lifep Development and Occupation II Young Adulthood o o Deep personal commitments to others ? If one does not reach intimacy, one may become selfabsorbed. ? Isolation for self-reflection ? Sacrifice and compromise are needed in a relationship ? YA with strong sense of self are: ? Ready to fuse their identity with another ? "True Genitality" - mutual orgasm in a loving heterosexual relationship ? Resolution of this stage = LOVE ? The perils of not fulfilling the natural procreative urge. The notion that singles are dysfunctional. George Vaillant's Adaptation Theory ? Persons change and develop through their lives ? Persons? lives are influenced by quality of relationships with others and not by isolated traumatic events ? The level of mental health influences adaptation to life situations ? Typical pattern ? Men in 20s - dominated by parents ? Men in 20s and 30s - age of establishment; autonomy, marriage, children, deepened friendship ? Men in 23-35s- age of consolidation; doing what needs to be done ? Men in 40s - age of transition, questioning commitments, soulsearching or midlife crisis ?
Four Adaptive Mechanisms ? Mature - humor, helping others, being altruistic psyschosomatic ? Immature symptoms (i. e. no physical reason but feels pain) ? Psychotic - distorting or denying reality ? Neurotic - developing irrational fears (i. e. developing anxiety) Daniel Levinson? s Life Structure Theory ? Evolving life structure ? Underlying pattern or design of a person at a given time ? Phases with tasks and accomplishments ? Has transitional phases for reflection in between ? 17-33: Entry Phase of YA ? Build first provisional life structure and emotional ? Financial independence ?
Dream of future achievement ? Age 30 Transition ? Reevaluate entry life structure ? 30 onwards : Culminating Phase ? Settles down ? Set goals that are time bound ? ? ? Anchors life Transition ? Period of preparation to enter the adult world ? Disequilibrium comes due to many choices an adult has to make ? Periods of stability and instability ? Response depends on self-definition ? Awareness of strengths and weaknesses ? Purpose ? From adolescent to adult ? Taking responsibility for one's self ? Making own decisions ? Redefining relationships with parents negotiation of ? Complete autonomy ?
Independence ? Emotional Independence free from parental dependence, one can make decisions on their own ? Attitudinal Independence hold own beliefs, depends on strength of personality ? Functional Independence support self ? Conflictual Independence guiltless feeling about separation with parents ? From student to worker ? Works defines daily schedule, social contacts and opportunities for personal development ? During YA, work defines who you are. relationship ? Reciprocal between substantive complexity of work to a person's flexibility in coping with cognitive demands ?
From living with parents to living alone (culture bound) ? Moving from family of origin to family of procreation ? Taking over day to day problems and financial support ? Relationships ? Seek emotional and physical intimacy ? Erikson: crucial task of adulthood ? Important to do Self-disclosure - revealing important information about oneself to another ? Skills needed: ? Self-awareness ? Empathy ? Ability to communicate emotions ? Sexual decision-making ? Conflict resolution ? Ability to sustain commitments OT 121: Lifep Development and Occupation II Young Adulthood Page 3 BLANCO | MARIANO | QUEMADO | VILLON The nature of intimacy ? May not include sexual contact ? Invokes a sense of belonging, emotional connection ? The need to form strong, stable, close caring relationship is a powerful motivator of human behavior (Papalia, et al. , 2004) ? The strongest emotions are invoked by intimate relationships. (Both good and bad: you bring out the best [and worst] in me) ? Need responsiveness to each other's needs, mutual acceptance, and respect ? Sternberg's Triangular Theory of Love ? INTIMACY, PASSION, COMMITMENT - these 3 elements need to be present to form a real consummate relationship ?
When you a love someone, you have to keep a PIC ? INTIMACY - Emotional element - Self disclosure --> connection, warmth and trust ? PASSION - Motivational element - Inner drive ? physiological arousal into desire. Cannot be controlled as it is a response of sensory physiological functions ? COMMITMENT - Cognitive element - Decision to love and to stay with the beloved ¦ Patterns of Loving TYPE I P C Nonlove (interpersonal relationships) Liking ¦ Infatuation („love at first ¦ sight”) Empty Love (long term ¦ relationship that lost intimacy and passion/arranged marriages)
Romantic Love ¦ ¦ Companionate Love (long ¦ ¦ term, committed friendship in marriage with diminished physical attraction) Fatuous Love (whirlwind ¦ ¦ courtship) Consumate Love ¦ ¦ ¦ ? ? ? ? ? ? ? Dating Practices of Filipino YA o Can start as early as 12 years of age (Medina, 1991) o Non-traditional practices: ? Speed dating ? Females paying for own share ? Open relationships ? Internet/other virtual context Gay relationship o Seeking love, companionship and sexual fulfillment through a relationship with a person of same sex Lesbians are more likely to have stable monoganous relationships than gay men. Gay and lesbian partners living together tend to be committed as married couples o Issues with custody, adoption, taxation, insurance and societal acceptance still exist Filipinos and Gay Relationship o Christian values and social norms view it as a "sin" (unnatural or immoral) to engage in a gay relationship o Greater scorn in low-middle classes o May never have complete “coming out” due to pressure from society and family Marriage o 'best way" to ensure orderly raising a children o Provides intimacy, commitment, friendship, affection sexual fulfillment, companionship, emotional growth, and new sources of identity and self-esteem Adjusting to Becoming a Spouse or Partner o Making joint decisions o Pooling of income o Living together ? Tests the relationships as the little that may annoy the partner are revealed. o Adjusting to each other's families o Taking on roles as husband and wife o Meeting each other's expectations Role of Extended Family among Married Filipino YAs o Serve as support systems o Older relatives as advisers o Younger relatives as companions (if couples are not yet going to have children) Divorce and Separation o In the Philippines, annulment -> legal separation, but one is not allowed to get married in the church again. It takes a long time before annulment is granted. Cohabitation before marriage, having divorced parents, bearing a child before marriage, having no child or having stepchildren are predictive whether a couple will end up separated or not o Reasons for divorce ? Incompatibility ? Lack of emotional support ? lack of career support ? Spousal abuse ? Mismatch of expectations o Effects of Divorce ? Income (no support, source of stress) ? Problems with identity and loneliness ? Anger and hostility ? Depression, alcoholism, sleep disorders, breakdown of immune system ? For the father, divorce can mean fewer rights to children, decline of income (support), less emotional support, negative impact on career o Divorce and Children ? Effects of divorce depend on ? Age ? Sex ? Nature of relationship with custodial parent Page 4 BLANCO | MARIANO | QUEMADO | VILLON o
OT 121: Lifep Development and Occupation II Young Adulthood ? ? ? ? Divorce in the Philippines ? Divorce is not acknowledged in the Philippines ? Cultural and religious influences affect acceptance of the practice ? Legal separation and annulment legal (Family Code of the Philippines, Executive Order 209) but costly and frowned upon ? House bill 1799, "An Act Introducing Divorce in the Philippines” filed July 27, 2010 The single life o Social pressure to marry o More freedom to take risks in life and make choices o Haven? t found the „right one? o Advantages ? Decisions about self o Disadvantages ? Loneliness and solitude ? Social risks ? Economic risks - no work, no money ?
Physical risks - depression, breakdown of immune system Cohabitation o Unmarried couple in a sexual relationship in a consensual or informal union (living together) o Substitute for marriage/trial marriage o Partners may miss out on economic, psychological, and health benefits of marriage which has ? Long term commitment and security ? Greater sharing of resources ? Stronger community connection o Advantages ? Getting to know each other ? Understanding intimate relationships ? Clarifying what you want earlier o Disadvantages ? Social stigma ? Over involvement (isolation from friends) ? Sexual risks ? Perceived loss of identity ? Over dependence ? Discomfort on ambiguity of situation ? Distance from friends o Cohabitation in Philippines ? 2. million Filipinos cohabiting (NSO, 2000), 18% of which between 20-24 years old ? 35% agree that live in arrangements are acceptable for couples intending to marry, 20% for couples do not ? 36% decide to cohabit because of economic reasons, 23% because of pregnancy, 15% as a "dry run," 13% too young to marry, 3% not allowed to be married by parents, 2% lacking necessary documents Expression of sexuality o Decision to lead lifestyle o To marry and have a child o Engage in premarital sex o Showing who you are and how you relate to others in a manner of dress, roles fulfilled and preference for partner Sex, Homosexuality and Bisexuality in Philippines o Cultural and religious values still a major influence o ? ? ? ?
Increasing tolerance compared to previous years, though limited to certain groups o “Private” practices in order to avoid discrimination from society o Continued use of derogatory terms Parenthood o Change from traditional family in western industrial families o Trend to have less children and bear them later in life ? Increased maturity and commitment ? Decreased economic advantage of having large family ? Overpopulation and hunger in developing countries o Becoming parents ? Changes in identity and inner life ? Shifts in roles and relationships within marriage ? Changing roles and relationships outside of family (female and work) ? New parenting roles and relationships ? Shifting in previous mindset that fathers are breadwinners and mothers the primary caregivers ? Having a baby can affect marital satisfaction ?
Less satisfaction when pregnancy is planned involvement means ? Increased increased satisfaction ? Low self-rating as parents decreased satisfaction o Stages of Parenting ? Image-making Stage (conception to birth) – creating images of self as parents ? Nurturing Stage (birth to 2 years) ) attachment of baby, balancing needs of child with emotional commitment and time spent with significant others ? Authority Stage (2 to 5 years) – examining type of parent one has become and will be ? Interpretative Stage (6 to 11 years) – reexamining and testing long-held theories ? Interdependence Stage (12 to 18 years) – re-asserting self as authority, competing and comparing self with children ?
Departure Stage (leaving home) – taking stock of performance as a parent Having Children o marriage? s ultimate fulfillment (Papalia & Olds, 1995) o children give companionship, love and happiness o provide emotional and financial support in later years o psychological value for success to parents o give meaning to life Remaining Childless o Financial burden of raising a child o Fears if becoming less attractive or changing relationship with spouse o Enjoying freedom to travel and make decisions o Concentrating on careers or causes o Worries on being a parent Single parenthood o Exhausting, continual struggle Page 5 BLANCO | MARIANO | QUEMADO | VILLON o OT 121: Lifep Development and Occupation II Young Adulthood o o o o o
Only one of the two parents is present, may include spouses of OFWs Less financially secure than when with a partner Difficulty coping with demands and making decisions Balancing work and raising a child Extended families provide invaluable support ? ? Adult Friendships o Single young adults have more friends than of middle-aged and older adults o YA seek friendships for social stimulation and new info; later on in life will value friendships that are long-lasting and equitable o Socio-emotional selectivity theory ? Greater emphasis on fulfilling own emotional needs ? “Limited time left to live” o Center on work, parenting activities, and sharing of confidence and advice o Varying quality of friendships ? Intimate and supportive ? Frequent conlfict ? Common interests ? Lifelong or fleeting COGNITIVE CHANGES o Piaget's Cognitive Stage ? Formal operational thinking ? Introspection ?
Abstract thinking ? Logical thinking ? Hypothetical thinking o Information Pocessing Skills ? Vocabulary: declines after 59; related more to educational level rather than age ? Sentence comprehension: deteriorates at 60 but may be attributed to hearing acuity ? Prose comprehension: young better than old ? Better at understanding short prose passages ? Better at remembering short prose passages ? Indication of capacity of working memory Memory ? ? Primary (short term/working memory) ? Secondary) ? Episodic (events, how things happened) ? Semantic (facts) (left when amnesia strikes in) ? Procedural (how-to) Creativity ? ? Break from procedural thinking ?
Problem solving that produces novel solutions ? Increase steeply from 20s to late 30s to early 40s before gradually declining ? Historians/scholars: peak in the 60s and decline after ? Scientists: peak in 40s, decline in 70s ? Artists: peak in 30s to 40s and decline steeply after ? Differences within fields: poets before novelists, mathematicians before scientists o Trends in cognitive capacities ? Information processing at its peak OT 121: Lifep Development and Occupation II Young Adulthood o o Better education suggests better chance of further increasing IQ in adulthood ? Type of course/interest/expertise can affect which skills are honed ? Skills frequently used are maintained ?
Judgment and reasoning continue to develop throughout life Beyond Formal Operation Thought Draws on intuition and emotion and logic Experience and nuanced thinking Capacity to deal with uncertainty, inconsistency, contradiction, and compromise Born of experience and years of dealing with different situations Postformal thought Problem Finding Stage ? Raising questions from problems ? Involves dialectical thinking (accepting contradictions, exposure to both sides of problem) and wisdom (pragmatic knowledge acquired through time) ? Seeing shades of gray ? Transcend a single logical system ? Reconcile conflicting ideas Post Formal Thought ? ? Shifting gears – “this might work on paper but not in real life” ? Multiple causality, multiple solutions – “let? s try it your way; if it doesn? t work, let? s try it my way” ? Compromise, there are more than 1 solution most of the time ? Pragmatism – “if you want the most practical solution, do this; the fastest, do that” ?
Awareness of paradox – “doing this will give him what he wants, but it will only make him unhappy in the end” ? Know the consequences of the actions and the eventual implications that may be opposite to what was expected would happen Schaie's Stages of Adult Cognitive Development Achieving stage (late teens to early 20s-30s) ? ? Knowledge for independence and competence ? Using what one knows to pursue goals (career, family) Responsible stage (late 30s to early 60s) ? ? Using what one knows to solve practical problems associated with responsibilities to others (family members, employees) ? For long-range goals Sternberg's Triarchich Theory of Intelligence o Componential (analytic) ? How efficiently one processes information ?
Knowledge on how to solve problems, monitor solutions, evaluate results o Experiential (insightful/creative) ? How people approach novel or familiar tasks ? Knowledge on how to compare new information with old and integrate this information in the palanner o Contextual /Practical ? How people deal with the environment Page 6 BLANCO | MARIANO | QUEMADO | VILLON ? ? ? Knowledge on how to look at a situation and decide how to look to move forward/get over with it. Involves tacit knowledge (inside information) Self-management Management of task Management of others Studies imply that componential intelligence grow until midlife. ? MORAL CHANGES Kohlberg's Stages of Moral Development ? o Postconventional Morality ?
Stage 5: Morality of Contract, Individual Rights, and Democratically Accepted Law ? Stage 6: Morality of Individual Principles of Conscience ? “What is right is what gives justice and is right for all individuals” Morality in YA ? o Cognitive awareness if principles comes in adolescence but commitment happens in adulthood o Growth influenced by: ? Encountering conflicting values away from home ? Being responsible for others Moral reasoning ? Stage 5 ? o Social contract where rules must be obtained through democratic consensus for will or majority and maximizing social welfare o Understanding of underlying purpose of law o Calls for change in a law that compromises basic rights Stage 6 ? Defines right and wrong on basis of selfgenerated principles that are broad and universal in application o Moral musical chairs as it depends on every situation, every context o Discovers through reflection Stage 7 ? o "Why be moral? " o Post-Kohlberg theorists o Equated to concept of self-transcendence o Achievement of cosmic perspective (i. e. nirvana) Sample Situation: There was a woman who had very bad cancer, and there was no treatment known to medicine that would save her. Her doctor, Dr. Jefferson knew that she only had 6 months to live. She was in terrible pain, but she was so weak that a good dose of pain killer like ether or morphine would make her die sooner. She was delirious and almost crazy with pain, and in her calm periods, she would ask Dr. Jefferson to give her ether to kill her.
She said she couldn? t stand the pain and she was going to die in a few months anyway. Although he knows mercy killing is against the law, the doctor thinks about granting her request. ? Stage 5: Yes, give her the drug o Although most of our laws have a sound basis in moral principle, laws against mercy killing do not. The doctor? s act is morally justified because it relieves the suffering of OT 121: Lifep Development and Occupation II Young Adulthood ? ? the woman without harming other people. Yet he still must be held legally accountable because society would be damaged if everyone simply ignored laws they do not agree with. Stage 5: No don? give her the drug o The laws against mercy killing protect citizens from harm at the hands of unscrupulous doctors and selfish relatives and should be upheld because they serve a positive function for society. If laws were to be changed through the democratic process, that might be another thing. But right now the doctor can do the most good for society by adhering to them. Stage 6: Yes, give her the drug o We must consider the effects of this act on everyone concerned – the doctor, the dying woman, other terminally ill people and all people everywhere. Basic moral principle dictates that all moral people have a right to dignity and self-determination as long as others are not harmed by their decisions. Assuming no one else will be hurt, she has a right to live or die as she chooses.
The doctor may be doing right if he respects her integrity as a person and saves her, her family, and all of society from needless suffering. Stage 6: No, don? t give her the drug o If we truly adhere to the principle that human life should be valued above all else and all lives should be valued equally, it is morally wrong to “play God” and decide that some lives are worth living and others are not. Before long, we would have a world in which life has no value. CAREER CHANGES Selection of career path ? o Depends on: ? Interests, abilities, and personality ? Responsibilities ? Educational level ? Gender ? Social class ? Proximity to workplace ? Luck ? Parental attitudes o Continues from an adolescent's search for vocal identity, influenced by increasing realism ?
YA gives you a perspective of what you can achieve, the only question is how to achieve it o Taking on increasing responsibilities o Entering college/getting specialized education o Getting work experience Entering the workforce ? o Reality shock ? Expectations clashing with reality ? Source of frustration and anger o Growth of competence and autonomy ? Positive role of mentors ? Independence and surpassing mentors o Growth of loyalty and commitment ? Maintaining excitement and commitment essential to mature satisfaction Page 7 BLANCO | MARIANO | QUEMADO | VILLON ? ? ? ? ? Identifying with occupation, employer, industry Gender-Based Adjustment o Males ? Roles they want to play ? Use of their abilities and training ?
Authority ? Pay raises ? Job transfers o Female ? Use of their abilities, expectation, training ? Feeling of being in a dead end job because more opportunities for promotion are given to males ? Being stereotyped Factors that Affect career decisions o Work options/types o Changes in work skill demands (technology) o Flexibility of working time (home responsibilities) o Preparation for a specific job o Sexual stereotypes o Labeling of occupations o Security (permanent vs seasonal jobs) o Career goals o Personal values and expectations Job Satisfaction o Intrinsic factors ? Work challenge (bored or challenged? ) ? Interest ? Work competence ? Achievement
Intrinsic factors are the concern of ? YA
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