Cultural Specificity?

The idea behind cultural specificity is compelling, to say the least. For example, Asians seem to be generally more pessimistic than Caucasians (Chang, 1996). Even how and what we fear has a cultural basis: examining amygdala responsivity showed differences across cultures - greater fear (amygdala responsivity) was shown culture wide to specific images (Chiao et al., 2008). My take away from this is that we learn culturally to respond in general ways to specific stimuli. I find it compelling to see how deep our cultural roots are in ways that are below the level of conscious awareness. For counselors, the implication of this is tremendous. In essence, we have to become aware of any cultural tendencies that provoke stereotype and bias.

Chang, E. (1996). Evidence for the cultural specificity of pessimism in Asians vs Caucasians: A test of a general negativity hypothesis. Personality and Individual Differences, 21(5), 819-822. doi: 10.1016/0191-8869(96)00110-9

Chiao, J. Y., Iidaka, T., Gordon, H. L., Nogawa, J., Bar, M., Aminoff, E., ... Ambady, N. (2008). Cultural Specificity in Amygdala Response to Fear Faces. Journal of Cognitive Neuroscience, 20(12), 2167-2174. doi: 10.1162/jocn.2008.20151

Intelligence

                                                Defining Intelligence
I would define intelligence as a range of cognitive abilities that contribute to adaptability as well as the capacity to contribute to and alter the environment, specifically to make it more functional, enjoyable, comfortable, and understandable. Conventional wisdom tells us that necessity is the mother of invention. Throughout history, when the environment was challenging, uncomfortable, or mysterious, people sought to alter, augment, and understand it.

                                   Environmental Effects on Intelligence
Considering the effects of the environment in a different way, culture has a tremendous effect on intelligence as well. Howard Gardner might say that culture influences which type of intelligence becomes salient to individuals within the culture (Gardner & Hatch, 1989). For example, family has traditionally been one of the most salient aspects of Hawaiian culture. So, when Europeans and Americans were prioritizing science and formal education in the early 19th century, generally speaking, the Hawaiians were not. It was not because one group was more intelligent than the other, but because of the importance placed on different goals. In families, too, ideas or goals that are important to the parents may become salient for the children. Consider families in which one of the parents is a doctor and then 3 of the 4 children become doctors. Becoming a doctor was likely not a genetic predisposition, but because of the importance placed on medicine, the children became doctors.

Heredity influences intelligence, although the jury still seems to be out regarding just how much it does. Adoption studies on the heritability of intelligence have been inconclusive (Santrock, 2008). I found it particularly interesting that some research indicates as people grow older, intelligence is driven more by personal choices than by the effects of the others (Santrock, 2008). It was disturbing to read that underprivileged children may experience long-term effects from living in poverty and neglect (Bigelow, 2006). Even when these issues were addressed when the children entered school, it was too late even when special interventions were implemented.

Although some evidence is mounting for genes as they influence executive and other cognitive functions, research regarding particular genes and how and what they affect to create individual differences in intelligence is unclear (Dreary, Spinath, & Bates, 2006). There have been, however, chromosomal regions associated with learning abilities, although this does not imply a genetic link (Kovis & Plomin, 2008).

It may be appropriate, at least at this time, to acknowledge the apparently powerful influence the environment wields on individual intelligence as well as intelligence of whole peoples. I found it interesting that g (general intelligence) seems to have an overall influence, or perhaps an underlying influence on the results of cognitive domains, such as measured by the Wechsler Adult Intelligence Scale III (Dreary, Spinath, & Bates, 2006). So, in other words, if a person is basically intelligent, they will show similar intelligence across those specific cognitive domains.

As far as the effects of intelligence on physical, cognitive, and socio-emotional development, during childhood and adolescence, peer relationships have a significant impact on the overall development of the individual (Estell et al., 2006). For example, children with learning abilities seemed to be more isolated (because of less social acceptance) than average students. Isolation alone would affect cognitive and socio-emotional development, and using the same example, if the child did not want to engage in physical play because of the isolation, it might delay physical development as well. When children are excluded from peer relationships, it may set them up for a life-long social deficiency, although no definitive longitudinal research exists to clarify the long-term effects of such isolation (Estell et al., 2006). Estell et al. (2006) found no such effects.

As far as the effects of influence and genetics on intelligence, I found it particularly interesting that "shared environmental influences were stronger for adolescents from poorer homes, while genetic influences were stronger for adolescents from more affluent homes" (Harden, Turkheimer, & Loehlin, 2007, p. 273). Perhaps this says that when the environment is optimal, the individual's unique ability to learn is more easily expressed. For example, in a household of higher economic status, abundant resources, parental guidance, less stress, and good nutrition may all contribute to individual success.

References

Bigelow, B. J. (2006). There’s an elephant in the room: The impact of early poverty and neglect on intelligence and common learning disorders in children, adolescents and their parents. Developmental Disabilities Bulletin, 34(1/2), 177–215.

Deary, I. J., Spinath, F. M., & Bates, T. C. (2006). Genetics of intelligence. European Journal of Human Genetics, 14(6), 690-700. doi: 10.1038/sj.ejhg.5201588

Estell, D. B., Jones, M. H., Pearl, R., Van Acker, R., Farmer, T. W., & Rodkin, P. C. (2008). Peer Groups, Popularity, and Social Preference: Trajectories of Social Functioning Among Students With and Without Learning Disabilities. Journal of Learning Disabilities, 41(1), 5-14. doi: 10.1177/0022219407310993

Gardner, H., & Hatch, T. (1989). Multiple intelligences go to school: educational implications of the theory of multiple intelligences. Educational Researcher, 18(8), 4. doi: 10.2307/1176460 [Note: since the ERIC database has limited availability at this time, please see the following website for this article: http://classes.jessicairish.com/ltd/readings/gardner_multiple_intelligences.pdf]

Harden, K. P., Turkheimer, E., & Loehlin, J. C. (2007). Genotype by Environment Interaction in Adolescents’ Cognitive Aptitude. Behavior Genetics, 37(2), 273-283. doi: 10.1007/s10519-006-9113-4

Kovas, Y., & Plomin, R. (2007). Learning abilities and disabilities: Generalist genes, specialist environments. Current Directions in Psychological Science, 16(5), 284–288. doi: 10.1111/j.1467-8721.2007.00521.x

Purpose and Technical Considerations for Assessment Instruments

The BDI-FastScreen for Medical Patients
                                    Purpose and Nature of the BDI FastScreen

Effects of Age, Gender, and Culture on Memory and Attention

                              Effects of Age on Memory and Attention

Children's memory increases because of the effects of rehearsal, speed of processing information, experience, and overall brain development, although the accuracy of memory may not be developed until much later in middle and late childhood (Santrock, 2008). Children are prone to the power of suggestion, wherein an adult can plant memories in the child by describing or discussing an event (Santrock, 2008).

Attention develops with age as well. Infants and young children may fixate on novel experiences and objects, although attention develops later in childhood and throughout adolescence (and further). The cognitive capacity to attend to tasks decreases with age (late adulthood), however, especially as complexity increases (Santrock, 2008). In effect, as adults age, it becomes more difficult to effectively multi-task - age effects the ability to attend to a variety of tasks simultaneously. Although older adults may function adequately when performing tasks with undivided attention, when attention is divided, they perform less effectively (Santrock, 2008).

Aging also effects memory. As brain structures shrink, older adults have a slightly limited capacity to remember. Santrock (2008), however, found that although the speed of semantic memory declines, the ability to ultimately retrieve the memory does not. Furthermore, implicit memory is not usually affected by age (Santrock, 2008). Working memory, processing speed, and episodic memory tends to suffer the greatest deficits in late adulthood (Santrock, 2008).

                           The Effects of Culture on Attention and Memory
For the most part, humans are selective with their attention and memory, and culture affects the selection process (Chentsova-Dutton & Tsai, 2010; Grossmann, Ellsworth, & Hong, 2012). For example, Grossmann, Ellsworth and Hong (2012) studied members of Russian culture who typically display overtly melancholy behavior. The Russians were more inclined to focus on the negative aspects of circumstances than might ordinarily be expected (Grossmann, Ellsworth, & Hong, 2012). These authors suggest cultural differences, as they affect attention, may have to do with how cultures manage impressions and stereotypes in general as well as what is of consequence in the particular culture. Grossmann, Ellsworth, & Hong (2012) discussed Americans' proclivity toward seeming happy and content. Because being happy and content is valued in American culture, people develop an intrinsic mechanism that helps them feel as if they are successful members of the culture (Grossmann, Ellsworth & Hong, 2012).

The effects of culture produce varied responsiveness to "objects, events, and strategies, which in turn can influence the nature of memory" (Santrock, 2008, p. 260). In basic terms, it states that cultural experiences have a significant impact in thought processes, specifically in determining significance in an individual's life, consequently influencing what the individual will remember. For example, In the USA, holidays such as Christmas (or other similar religious celebrations) are significant. Families create tradition that is carried through generations. Many people recall the events surrounding this holiday because such importance is placed thereon. Ishii, Reyes, and Kitayama, (2003) gave primacy to culture over language, however, they pointed out that it is through language socialization that cultures transfer meaning to children and in this way preferences and responses are transferred and perpetuated. So, not only culture, but language itself contributes to how individuals respond and remember (Ishii, Reyes, & Kitayama, 2003).

The Effects of Gender on Memory and Attention
Gender affects memory as well, evidenced by observing females perform less effectively on visuo-spacial tasks compared to their male counterparts. Females do however, perform similarly on passive tasks that include less higher level thought processes such as complex mental images (Cattaneo, Postma, & Vecchi, 2006). For the most part, the differences did not appear significant enough to unequivocally state the difference (Cattaneo, Postma, & Vecchi, 2006). There is not enough research to state significant differences in either direction (Silverman & Eals, 1992). It may be safe to say that gender does, in fact affect memory, although exactly how it affects it needs further research. Cattaneo, Postma, and Vecchi (2006) formulated their findings on adults between the ages of 20-37, so they cannot be applied to all age groups. Regarding gender and attention, although boys seem to have higher levels of ADHD symptoms, generalizations about the effects of gender on attention cannot be inferred from Thorell and Rydell (2008).

References

Cattaneo, Z., Postma, A., & Vecchi, T. (2006). Gender differences in memory for object and word locations. The Quarterly Journal of Experimental Psychology, 59(5), 904–919.

Chentsova-Dutton, Y. E., & Tsai, J. L. (2010). Self-focused attention and emotional reactivity: The role of culture. Journal of Personality and Social Psychology, 98(3), 507-519. doi: 10.1037/a0018534

Grossman, I., Ellsworth, P. C., & Hong, Y. Y. (2012). Culture, attention, and emotion. Journal of Experimental Psychology: General, 141(1), 31-36.

Ishii, K., Reyes, J. A., & Kitayama, S. (2003). Spontaneous attention to word content versus emotional tone: Differences among three cultures. Psychological Science, 14(1), 39-46. doi: 10.1111/1467-9280.01416

Silverman, I., & Eals, M. (1992). Sex differences in spatial abilities: Evolutionary theory and data. In J. Barkow, I. Cosmides, & J. Tooby (Eds.), The adaptive mind: Evolutionary psychology and the generation of culture (pp. 533–549). New York: Oxford University Press.

Thorell, L. B., & Rydell, A-M. (2008). Behaviour problems and social competence deficits associated with symptoms of attention-deficit/hyperactivity disorder: Effects of age and gender. Child: Care, Health and Development, 34(5), 584– 595. 

A Synthesis of Vygotsky's and Piaget's Theories

One might naturally see the antithetic relationship of Vygotsky's and Piaget's theories; the former believed language drives thought, the latter that thought drives language (Santrock, 2008). This, only one difference in a long list of perceptions and beliefs that vary widely. In comparing the two, one does begin to see how they perceived the cognitive nature of the learning environment, and that children, in most situations, learn.

                                            Two Theories: A Synthesis

Cognitive development takes place because of biological maturation as well as through the level of stimulation in children's environments (Santrock, 2008). The pace of development aligns with Piaget's notion of the child's ability to assimilate information and with the quality of interaction surrounding the developing individual (described by Vygotsky). As children grow and develop, they contrive Piaget's schemes that help them organize, interpret, and learn; in effect, making meaning from information gathered from interacting as in Vygotsky's theory of the effects of the sociocultural environment (Santrock, 2008). The interplay of the child's intrinsic capacity for learning, as Piaget believed, influences how deeply and to what extent, the social environment will affect and advance cognition as in Vygotsky's theory. Piaget's idea of the intrinsic cognitive framework depends upon Vygotsky's notion of social interaction to give expression to the intrinsic capability (Santrock, 2008).

Piaget's idea of assimilation occurs because of increased biological capability compounded by the ability to take social experiences and extricate new learning as Vygotsky believed (Santrock, 2008). As children's logic develops because of the increased ability to reason, as discussed by Piaget, they are more able to perceive and use cultural tools and understandings that help create the parameters for more complex learning as presented by Vygotsky (Meyer, 2009). Vygotsky's emphasis on the role of history in human development is vitally expressed through Piaget's stages when an increase in individual accomplishment offers a deeper capacity to assimilate broader and more complex knowledge (Vianna, 2005). This is based, at least in part, on Vygotsky's notion of scaffolding, wherein knowledge grows exponentially based on previous knowledge (Santrock, 2008).

                                 Comparing and Contrasting the Two Theories
A primary difference between Piaget and Vygotsky was that Piaget's roots were in biology and the evolutionary adaptation of humans, and Vygotsky's in Marxist theory as it explains how people transform their world rather than adapt to it (Vianna, 2006). An obvious difference in their theories is the primacy of the individual versus society; Piaget emphasized individual cognitive development, whereas Vygotsky placed importance on the psychosocial roots of development (Erdener, 2009). Piaget believed learning was a product of individual accomplishment, and perceived cognitive development from a biological perspective wherein the maturation of the child predisposed the child to learning (Mayer, 2009). Vygotsky, however, perceived learning from a collectivist and social perspective - learning was only as prevalent and powerful as the community surrounding the child (Santrock, 2008). Rather than individual maturation, Vygotsky believed humans have innate elementary functions that must be expressed in social circumstances (Van Geert, 1998). Piaget's stages were hierarchical in nature, and one must be completed prior to forward movement, whereas Vygotsky's perception of development had little dependence on time, but on social interactions (Santiago-Delefosse & Delefosse, 2002). Both theorists agreed that everyone is different and learning is a cognitive adventure, and both believed that social interaction is mechanistic in human learning and development (Kim & Baylor, 2006; Santiago-Delefosse & Delefosse, 2002).

                                    Strengths and Weaknesses of the Theories

Vygotsky's Theory

The most obvious shortcoming in Vygotsky's theory is his failure to account for any developmental stages in children, and, more importantly, how such cognitive stages effect the ability to integrate and assimilate the inherent value in socialization (Vianna, 2006). Vygotsky's description of the boundaries between the self and society as part of the relationship between cognitive development and learning remains important in education (Miller, 1983). His theories consider cultural differences, which supports usability across cultures (Miller, 1983).

Piaget's Theory

Development does not always occur as neatly as Piaget's theory predicts (Santrock, 2008). Some children have the capacity to learn material in advanced stages and some may not automatically develop formal operational functioning (Vianna, 2006). Furthermore, Piaget drastically underestimates social factors in cognitive development (Erdener, 2009). His theory does, however, provide a useful approximation of childhood development and some guidelines for education (Beilin, 1992).

                                                              Conclusion

There exists an extraordinary amount of developmental theory from Piaget and Vygotsky. In some cases, the strengths and weaknesses of one complement those of the other. Indeed, the theories may be more appropriately categorized as different rather than conflicting. Many of Vygotsky's conceptual understandings of development have no definitive counterpart in Piaget's theory and vice versa. Perhaps a synthesis presents a more effective and comprehensive overall perspective of human development than does a contrast or comparison, and is far more inclusive than one theory on its own.

References

Beilin, H. (1992). Piaget's enduring contribution to developmental psychology. Developmental Psychology, 28(2), 191-204. doi: 10.1037/0012-1649.28.2.191

Erdener, E. (2009). The arguments of Vygotsky on thought and language: A critical view to Piaget. Journal of Turkish Educational Sciences, 7(1), 85-103.

Kim, Y., & Baylor, A. L. (2006). A social-cognitive framework for pedagogical agents as learning companions. Educational Technology Research and Development, 54(6), 569- 596. doi: 10.1007/s11423-006-0637-3

Mayer, S. J. (2009). Dewey's dynamic integration of Vygotsky and Piaget. Education and Culture, 24(2), 6-24. doi: 10.1353/eac.0.0026

Miller, P. H. (1983). Theories of developmental psychology. San Francisco: W.H. Freeman.

Santiago-Delefosse, M. J., & Delefosse, J. O. (2002). Spielrein, Piaget and Vygotsky: Three positions on child thought and language. Theory & Psychology, 12(6), 723-747. doi: 10.1177/0959354302126001

Santrock, J. W. (2008). A topical approach to life-span development (3rd ed.). New York, NY: McGraw-Hill.

Van Geert, P. (1998). A dynamic systems model of basic developmental mechanisms: Piaget, Vygotsky, and beyond. Psychological Review, 105(4), 634-677. doi: 10.1037/0033- 295X.105.4.634-677

Vianna, E. (2006). Embracing history through transforming It: Contrasting Piagetian versus Vygotskian (activity) theories of learning and development to expand constructivism within a dialectical view of history. Theory & Psychology, 16(1), 81-108. doi: 10.1177/0959354306060108

Evaluating Assessment Instruments

This paper reviews three instruments that assess depression: The BDI-FastScreen for Medical Patients, the Clinical Assessment of Depression, and the Postpartum Depression Screening Scale. These instruments assess depression in various populations including postpartum women, medical patients, children, and adults.

                                      BDI-FastScreen for Medical Patients

A. Title: BDI-FastScreen for Medical Patients (Beck, Steer, & Brown, 2003).

B. Author: Aaron T. Beck, Robert A. Steer, and Gregory K. Brown (Beck, Steer, & Brown, 2003).

C. Publisher: PsychCorp, A brand of Harcourt Assessment, Inc., 19500 Bulverde Road, San Antonio, TX (Beck, Steer, & Brown, 2003).

D. Forms, groups to which applicable: Previously called the Beck Depression Inventory for Primary and based on the Beck Depression Inventory-II. Designed for population ages 12 - 82 (Beck, Steer, & Brown, 2003).

E. Practical features: The BDI-FastScreen for Medical Patients is a self-report questionnaire containing seven psychological depression symptoms (Scheinthal, Steer, Giffin, & Beck, 2001). It is used by physicians assessing somatic and behavioral symptoms that may be associated with medical, biological or substance abuse problems. The seven items are rated on a 4-point scale (0-3) and assess frequency, over the past 2 weeks, of feelings of sadness, pessimism (hopelessness), sense of failure, loss of a sense of pleasure, loss of self-confidence, self-blame, and suicidal ideation. Corresponds to the DSM-IV-TR (Beck, Steer, & Brown, 2003).

F. General type: Serves as an indicator of depression as a result of medical, biological, or substance abuse problems (Beck, Steer, & Brown, 2003).

G. Date of publication: 2002 (Beck, Steer, & Brown, 2003).

H. Costs, booklets, answer sheets, scoring: 2003 price data: $67 per complete kit including manual and 50 score forms; $39 per manual; $39 per 50 record forms; $43 per 50 scannable record forms; quantity discounts available. Scoring is easily accomplished by summing the point values from the seven items, and interpreting total scores (Beck, Steer, & Brown, 2003).

I. Time required to administer: 5 minutes (Beck, Steer, & Brown, 2003).

J. Purpose for which evaluated: Designed to screen patients for depression that may be related to medical illness, chronic condition, or substance abuse (Beck, Steer, & Brown, 2003).

                                      Clinical Assessment of Depression

A. Title: Clinical Assessment of Depression (CAD)

B. Author: Bruce A. Bracken and Karen Howell (Bracken, & Howell, 2003).

C. Publisher: Psychological Assessment Resources, Inc., 16204 N. Florida Avenue, Lutz, FL 33549-8119 (Bracken, & Howell, 2003).

D. Forms, groups to which applicable: One version for children and adults age 8-79 (Bracken, & Howell, 2003).

E. Practical features: 14 scores: 5 Symptom-Based Scale Scores (Depressed Mood, Anxiety/Worry, Diminished Interest, Cognitive and Physical Fatigue, Total), 3 Validity Scale Scores (Inconsistency, Negative Impression, Infrequency), 6 Critical Item Cluster Scores (Hopelessness, Self-Devaluation, Sleep/Fatigue, Failure, Worry, Nervous). The CAD is closely linked to the DSM-IV-TR criteria (Bracken, & Howell, 2003).

F. General type: The CAD is an easily administered and scored instrument for depression that can be utilized with children and adults (Bracken, & Howell, 2003).

G. Date of publication: 1994-2004 (Bracken, & Howell, 2003).

H. Costs, booklets, answer sheets, scoring: 2007 price data: $130 per introductory kit including professional manual, 25 rating forms, and 25 score summary/profile forms; $185 per scoring program (CD-ROM) including unlimited scoring and reports. The test authors recommend that properly trained or licensed examiners use a five-step process that considers the total scores, the symptom scales, individual items, as well as interview data and other pertinent information. They also suggest when examiners interpret total scores, they consider the instrument's validity and symptom scales, and critical item clusters (Bracken, & Howell, 2003).

I. Time required to administer: 10 minutes (Bracken, & Howell, 2003).

J. Purpose for which evaluated: Designed to help clinicians assess and diagnose depression for
ages 8 to 79 (Bracken, & Howell, 2003).

                                   Postpartum Depression Screening Scale

A. Title: Postpartum Depression Screening Scale (PDSS) (Beck, & Gable, 2003).

B. Authors: Cheryl Tatano Beck and Robert K. Gable (Beck, & Gable, 2003).

C. Publisher: Western Psychological Services, 12031 Wilshire Blvd., Los Angeles, CA 90025-1251 (Beck, & Gable, 2003).

D. Forms, groups to which applicable: One version for measuring postpartum depression in women ages 14-49 (Beck, & Gable, 2003). The first 7 items can be used as a short form (White, 2008). Designed for new mothers ages 14-49 (Beck & Gable, 2003)

E. Practical features: The PDSS is a 35-item paper-and-pencil, self-report that uses a 5-point Likert scale that varies between Strongly Disagree and Strongly Agree (Beck & Gable, 2003; White, 2008). It contains a validity scale composed of 10 item pairs to assess inconsistent responses and seven scales that measure symptom content: Sleeping/Eating Disturbances (5 items); Anxiety/Insecurity (5 items); Emotional Liability (5 items); Mental Confusion (5 items); Loss of Self (5 items); Guilt/Shame (5 items); and Suicidal Thoughts (5 items). May be orally administered (Beck, & Gable, 2003).

F. General type: The PDSS serves to identify women who are at risk for developing postpartum depression (Beck, & Gable, 2003). .

G. Date of publication: 2002 (Beck, & Gable, 2003).

H. Costs, booklets, answer sheets, scoring: 2005 price data: $72.50 per kit including manual (59 pages) and 25 AutoScore(tm) test forms; $32.50 per 25 AutoScore(tm) test forms; $45 per manual; $17.50 per 10 test forms in Spanish. Interpretation is straightforward using the scoring and summary sheets, which provide interpretive guidelines for the total score and for the symptom content scores (Beck, & Gable, 2003).

I. Time required to administer (5-10) minutes; (1-2) minutes for short form (Beck, & Gable, 2003).

J. Purpose for which evaluated: Designed to be a brief, easily administered, self-report inventory to assess the presence, severity, and type of postpartum depression in women ages 14 - 49 (Beck, & Gable, 2003).

References

Beck, C., T., & Gable, R. K. (2003). Review of the Postpartum Depression Screening Scale. In B.S. Plake, J.C. Impara, & R.A. Spies (Eds.), The sixteenth mental measurements yearbook. Lincoln, NE: Buros Institute of Mental Measurements. Retrieved from http://web.ebscohost.com.ezp.waldenulibrary.org/

Beck, A., Steer, R., A., & Brown, G., K. (2003). Review of the BDI-FastScreen for Medical Patients. In B.S. Plake, J.C. Impara, & R.A. Spies (Eds.), The seventeenth mental measurements yearbook. Lincoln, NE: Buros Institute of Mental Measurements. Retrieved from http://web.ebscohost.com.ezp.waldenulibrary.org/

Bracken, B. A., & Howell, K. (2003). Review of the Clinical Assessment of Depression. In B.S. Plake, J.C. Impara, & R.A. Spies (Eds.), The seventeenth mental measurements yearbook. Lincoln, NE: Buros Institute of Mental Measurements. Retrieved from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/search/advanced?sid=0d 1420e6-f12e-4d6a-9d32-60376b6edaa7%40sessionmgr14&vid=1&hid=25

Scheinthal, S. M., Steer, R. A., Giffin, L., & Beck, A. T. (2001). Evaluating geriatric medical outpatients with the Beck Depression Inventory-FastScreen for Medical Patients. Aging & Mental Health, 5(2), 143-148. doi: 10.1080/13607860120038320

White, G. (2008). A comparison of the Postpartum Depression Screening Scale (PDSS) with the Edinburgh Postnatal Depression Scale. New Zealand College of Midwives Journal, 39, 28-32.

Healthy Growth

From childhood throughout adulthood, people engage in "health-enhancing or health-compromising behavior" (Santrock, 2008, p. 142). Obstacles exist at every developmental stage that prevent or delay healthy growth. Health education, individualized therapy, and public programs seek to provide resources and awareness for health and well-being across the lifespan (Santrock, 2008; Sussman, Skara, & Ames, 2008; Wolfe, 1999).

                                    Obstacles to Healthy Growth During Childhood

Malnutrition

Although nutritional deficiency is common in developing countries, it is also a concern in the United States (Drewnowski & Spector, 2004). Drewnowski and Spector (2004) discovered that the highest rates of obesity are found in populations with higher poverty rates and less education. Higher rates of malnutrition are found in this same group as well (Santrock, 2008). Healthier food is more expensive than sugary foods, sweets, and grain products, so the less expensive foods are a popular substitution in poor households (Drewnowski, 2010). Federal programs have helped eliminate malnutrition in pre-school children (Santrock, 2008) and similar community programs may help reconcile malnutrition in poor and rural areas.

Poverty and the Lack of Preventive Medicine

According to Simpson, Bloom, Cohen, and Parsons (1997), in 1993, over 7.3 million American children had at least one unmet health care need, or had medical care delayed, and another 4.2 million children did not have a source for regular medical care. For most of these children, their inadequate health care was the result of poverty (Simpson, Bloom, Cohen, & Parsons, 1997). Wolfe (1999) believed that providing health insurance to underinsured children should reduce the inequality of healthcare resources. Providing a health insurance package to all children may provide equal access to medical care, even for extremely poor households, and an increase in the number of families who take advantage of cost-free services (Wolfe, 1999).

                                    Obstacles to Healthy Growth During Adolescence

Substance Abuse

Approximately 5% of American teenagers fulfill the diagnostic criteria for substance abuse disorder, which is the most common cause of adolescent mortality in the United States (Sussman, Skara, & Ames, 2008; Tartar, 2002). Other related problems include "poor academic performance, job instability, teen pregnancy, and ...sexually transmitted diseases" (Sussman, Skara, & Ames, 2008, p. 1802) Brook, Saar, Zhang, and Brook (2009) found family therapy may help reduce substance abuse. Santrock (2008) found creating awareness before adolescence and programs such as Family Matters were successful for reducing teenage substance abuse.

Overweight and Obesity

American adolescents eat more junk food than teenagers in 28 other countries (Santrock, 2008). Overweight and obesity have become increasingly common and once established, they are far more difficult to treat (Caballero, 2004). Obesity can lead to cardiovascular disease, hypertension, diabetes, inflammation and oxidative stress (Raj, 2012). Raj (2012) believed neglecting current trends of overweight and obesity threatens cardiovascular health and may result in a public health crisis. Creating awareness, individualized therapy and mentorship, diet modification, and regular exercise have been successful with reducing overweight and obesity in teens (Santrock, 2008; Wengle et al., 2011)

                                    Obstacles to Healthy Growth During Adulthood

Smoking

"Smoking is linked to 30% of cancer deaths, 21% of heart disease deaths, and 82% of chronic pulmonary disease deaths in the United States" (Santrock, 2008, p. 168). Few doubt the diseases and general harm smoking causes. Children's exposure to second hand smoke caused long-term health effects, and smoking in the home was predictive for children's future smoking behavior (Wang, Ho, & Lam, 2011). The most useful and cost effective intervention is smoking cessation (Duaso & Duncan, 2012). Duaso and Duncan (2012) found the most effective therapies used a non-confrontational and non-judgmental approach.

Lack of exercise

Although overwhelming evidence suggests physical activity is related to mortality and overall health, most adults do not exercise regularly (Paluska & Schwenk, 2000). Exercise produces benefits throughout adulthood that include psychological well being and quality of life, not to mention longevity, cardiac, respiratory, and general physical health (Balkin, Tietjen-Smith, Caldwell, & Shen, 2007; Eriksson & Gard, 2011; Yohannes, Doherty, Bundy, & Yalfani, 2010). Larson and Bruce (1987) believed as the number of aging Americans increases, it will be important to find ways to disseminate information regarding age appropriate exercise. Santrock (2008) recommended people watch less television, stop making excuses, and learn about the effects of exercise versus sedentary lifestyles, so they become motivated to exercise regularly.

                                                                  Conclusion

Across developmental stages, challenging obstacles claim the health of children, adolescents, and adults. Healthy growth does not happen in a vacuum and it is undermined or strengthened by cultural, familial, and community systems. Taking into account the unique contexts as well as the larger systems of affected individuals may contribute to successful education and interventions that establish long-term health and well-being.

References

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