Human behavior: concepts and applications

Sociology/Social Work Questions

Explain why children in the early-school-aged period may be especially vulnerable to fluctuations in self-esteem and feelings of "worthlessness."

Young children, in the early school aged years are in a developmental stage that is focused on feelings of identity and self-esteem (Nutbrown & Clough, 2009, p 191). It is during the early years of school that children begin to form concepts of identity through a sense of belonging as well as through the demonstration that they are needed by others in their community, and especially those they hold in high regard, peers and teachers. They seek to demonstrate for themselves that they play an important role in their own lives and communities to help them establish a sense of self. In other words they seek almost above all else to establish that they are valuable and have purpose in their community and especially in school as this is often their first intense experience of exposure to peers and socialization on a large scale and everything up to this point has supported in them the feeling that doing well in school is essential to being a "good" child and therefore valuable. Nutbrown & Clough seek through research to demonstrate that including children's voices in the change and development of their own learning environment, in a sense giving then a job that demonstrates real change positively affects levels of self-esteem and a sense of belonging for young school aged children, stemming of the potential for feelings of worthlessness and their vulnerability to it (2009). Children also experience serious vulnerabilities to fluctuations in these two opposing feelings, high self-esteem and worthlessness as a result of the concrete learning stage, "if I am not uniquely needed then I must not be a valuable person or member of my community." Simple or what might seem small social and/or academic problems can in fact seriously affect a child's daily sense of value and therefore high self-esteem. This could be something as seemingly unimportant as being excluded in games by peers, doing poorly on a single assignment or task or feeling socially excluded because of appearance. In Hesketh, Wake & Waters longitudinal research on classifgications of overweight and how it affects the self-esteem of 5- to 10-year-old a common link was found between overweight and low self-esteem. According to Hesketh, Wake & Waters this low level of self-esteem (corresponding with feelings of worthlessness) was greater in those who were classified as overweight (2004). "Childhood obesity, now one of the most common chronic conditions of childhood, is believed to be strongly associated with psychosocial morbidity. For individual children, the immediate psychosocial effects of social isolation, discrimination, and peer problems can accompany childhood obesity," (Hesketh, Wake & Waters, 2004, p. 1233) this then follows many to early adolescence and adulthood as a pervasively lower sense of self-esteem and self value. Though overweight and the potential social implications of it are simply a single example of a factor that can poorly effect children in this early school aged group the social isolation aspect (no matter the cause) is a recognized factor in childhood development that indicates limitations in the development of positive self-identity and can without change, such as change of school environment or adoption by a positive peer group become a pervasive aspect of one's core identity. Though some intervention by adults, such as parents or teachers can mitigate some of the stronger feelings of exclusion, really at this stage peer rejection becomes a problem with pervasive effects, causing the individual to possibly begin to exhibit signs of stress which in young children can play out in behaviors, either self-isolating behaviors, aggressive behaviors or even limitations in achievement attempt behaviors. For example: "They have not included me in the past so why risk the rejected feelings?," Or bullying behaviors, "They don't deserve to have me as a friend so I will be cruel to them.) or even lack of effort for achievement, "Nothing is going well at school so why should I try?" To children at this developmental level it is logical to have concrete ideation about how pervasive a problem is, it is all or nothing or global in perspective which is clearly at the root of the susceptibility to fluctuations in self-esteem and feelings of worthlessness.

2. Describe what is meant by the concept of "a good death." How do hospice care and euthanasia help a person who is suffering a slow, painful death trajectory affect the effort to achieve a good death?

The line of reasoning or definition of a "good death" for many includes the idea that as a living person he or she has a great deal of personal control and is able to make decisions about what will or will not be a part of their life, including vocational, educational, procreativity and so on, but that in the end of life many of these choices are taken away. The definition then of a "good death" to many is one where they are in ultimate control over the decisions of their life in the end. There is also a sense of a good death being one that limits pain and allows the individual to spend as much time as possible in a setting that is comfortable to them (i.e. home) and with loved ones. Though euthanasia and the hospice ideology are almost completely incompatible, i.e. hospice denounces active euthanasia and stresses the need for pain management, comfort and social interaction in palliative care or passive euthanasia (allowing one to die as a natural course of his or her disease state) they still both seek to offer the individual a "good death." According to expert opinion the ideation of a "good death" should be a goal of healthcare and society, as a result of the last 30 years of progress with regard to understanding the impact of death and grief on individuals as well as the development of palliative care and other relatively new medical trends. The commentators describe a "good death" by stating; "While the hours or days before death are important, the focus should be the weeks and months before death when symptoms and needs increase, and interventions can have a significant impact on the well-being of patients and families. Thus, a good death should mean making the last weeks -- not minutes -- of life valuable and meaningful," (Emanuel & Emanuel, 1998, p. SII21)

When comprehensive palliative care is provided by an experienced team of specialists, most symptoms of end-of-life suffering can be effectively managed. However, clinicians note that a persistent proportion of dying patients (5% -- 35%) continue to suffer intolerably in the last weeks of life despite the best palliative care.1,2 A small percentage of these patients will ask their health care providers for assistance in dying in order to escape their suffering. (Schwarz, 2007, p. 1288)

For some individuals the concepts of a "good" death is simply one that they themselves determine, in other words they have up to this point had little if any control over the disease process and have hence been unsuccessful at avoiding death and would like to die a dignified death at a time that they rather than their disease chooses (Schwarz, 2007) Some will go as far as asking for physician-assisted suicide while others will succumb to the disease naturally and even others will do less active but still choice centered and voluntary things to hasten death, such as voluntarily stopping eating and drinking. "Some commentators suggest that the option of voluntarily stopping eating and drinking (VSED) may be a preferable alternative to physician-assisted dying as a means to hasten dying for suffering, terminally ill patients," (Schwarz, 2007, p. 1288) Though the legal ramifications of this act have yet to be explored the main and essential aspect of the definition of achievement of a "good" death is subjective and yet the most common thread for most people, and especially those experiencing terminal illness of self or a loved one is a death that reflects independent choice and is as free of suffering as possible. Additionally, the idea of a "good" death as one that is well thought and decisive may include active and/or passive euthanasia supported by a palliative care team the individual and the individual's family and/or hospice or other such care.

3. Discuss the concept of intimacy. Why is it important in development? What skills may result from achieving intimacy? What are the difficulties in achieving a sense of intimacy? What effect may one's resolution of the crises of intimacy vs. isolation have on later development?

Intimacy is a concept associated with close personal ties with others, usually intimacy refers to the level of trust one has in a relationship with an adult in a primary love relationship but intimacy can also take place in relationships with close peers or even in relationships with siblings and to some degree parents. For the purpose of this work the idea of intimacy refers to the experience of early adulthood that is an aspect of creating independence for self and linking one's self emotionally and possibly physically to another adult for mutual gain. The development of intimacy is associated strongly with the development of individual independence, independence from structures and systems that have supported and aided a young person up to this point. Most believe that individuals who fail to develop positive intimate relationships are limited in the capacity to thrive as adults, in a myriad of ways, including but not limited to living on one's own, supporting his or her own social and emotional health and generally becoming a productive adult. The foundational development of intimacy with another adult develops empathy, social tolerance, a strong sense of self-identity, social caring, trust and trustworthiness and several other aspects of important social and human development (Lobel & Winch, 1988). According to Erikson the 6th stage of psychosocial development, intimacy vs. isolation is that which occurs from ages 20-35, namely the years when one is seeking to make intimate connections with others outside of family, possibly to begin their own family. The theory of psychosocial stages is based on the idea that during certain periods of one's life he or she experiences stages which are particularly high in both possibilities and vulnerabilities and therefore represent essential periods of individual growth and/or stagnation, where the effects of each stage is cumulative and any limitations or successes in achievement of the prior stages can affect the development of the later stages (Hamachek, 1990, pp. 677-678).

According to Lobel & Winch the stages of development are not discrete nor is any stage "completed" as an aspect of development, as they point out in a brief interpretation of Erickson's theory:

…it is important to recognize that the ego qualities associated with each stage are not "achieved" once and for all nor are they by forever overcoming challenges, The basic conflicts remain throughout the life cycle. In Erikson's words (1959), the human personality "to remain psychologically alive must resolve these conflicts unceasingly" (p. 51) Thus what a person acquires at each stage is what Erikson (1959) identified as; "a certain ratio between the positive and negative which, if the balance is toward the positive, will help him to meet later crises with a better chance for unimpaired total development" (p. 61) ( Lobel & Winch, 1988, p. 679)

What this basically means is that if the individual manages to achieve intimacy on a learning level during early adulthood and that intimacy is mostly positive in its ability to teach the individual the important aspects of the stage of development then he or she will be more able to achieve later stage learning. Without a positive leaning balance the individual may find difficulty in achieving success in lower level of intimacy relationships, such as those associated with the workplace and the next stage of psychosocial development (generativity vs. stagnation). The result of this negative leaning balance, i.e. A poorly developed level of intimacy and limited learning level intimate relationships between the ages of 20-35 may result in difficulty developing the successes associated with productive work and productive low level intimate relationships needed for success in this area. The individual might find it very difficult to trust others and act and live in a trustworthy manner and may have an excess of continual conflicts in their intimate and non-intimate relationships, causing further developmental challenges. It is also important to state that according to most developmental theory those who have success at normal development in any given stage from birth to adulthood will have an easier time with each, in other words intimacy may be hampered by a negative leaning balance in any of the first few stages of development. On the issue of trust, an individual who failed to elicit trust in infancy (with negative or sporadic caregivers) might also find it difficult to enter into the concepts of trust as an adult in relationships intimate or otherwise.

4. Discuss the relationship of gang membership to the psychosocial needs of early adolescence. Compare and contrast how gang membership is similar to and different from other types of group identification?

The relationship of gang membership to early adolescent psychosocial needs is relatively straight forward. The individual adolescent may see and experience the gang as an alternative to family, almost regardless of the positive or negative nature of the family relationship but more often when the family relationship is lacking. It is normal during this period to begin to see peers as more important in one's life than family, as this is the period of life when individuals begin to develop independence from family and learn to cope without direct family aid. Though the separation of the individual from the family is a normal stage of development, that can play out in extremely positive ways the fact that this is the stage that individuals experience this separation to autonomy that creates vulnerability to negative associations, such as gang involvement. This and other important reasons make gang membership particularly troubling during this age. That being said with the inclusion of other factors, i.e. The gang recognizes the power struggle a young adult has in the culture as well as stimulates a sense of expression of rebellion (rebellion from family and what is "right" in the way one is expected to act) and/or aggression that is often suppressed rather than given positive outlets in our society. According to one study both peers and teachers reported and perceived gang members between the ages of 11 and 14 as more aggressive and oppositional than nongang members in the same age bracket: