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Perception The process of organizing and interpreting sensory information to give meaning to our environment. Bottom-up processing An approach where perception starts with sensory input and works up to the brain's integration of this information. Top-down processing Information processing guided by higher-level mental processes, drawing on experience and expectations to construct perceptions. Schema A concept or framework that organizes and interprets information. Perceptual set A mental predisposition to perceive one thing and not another. Gestalt psychology Emphasizes that we often perceive the whole rather than the sum of the parts. Closure The perceptual tendency to mentally fill in gaps in a visual image to perceive objects as wholes. Figure and ground The organization of the visual field into objects (figures) that stand out from their surroundings (ground). Proximity The perceptual tendency to group together visual and auditory events that are near each other. Similarity The perceptual tendency to group together elements that seem alike. Attention The focusing of mental resources on select information. Selective attention The focusing of conscious awareness on a particular stimulus. Cocktail party effect The ability to focus auditory attention on a particular stimulus while filtering out other stimuli. Inattentional blindness Failing to see visible objects when attention is directed elsewhere. Change Blindness Failing to notice changes in the environment. Binocular depth cues Depth cues, such as retinal disparity, that depend on the use of two eyes. Retinal disparity A binocular cue for perceiving depth by comparing images from the retinas in the two eyes. Convergence A binocular cue for perceiving depth by the extent to which the eyes converge inward when looking at an object. Monocular depth cues Depth cues, such as interposition and linear perspective, available to either eye alone. Relative clarity A monocular cue for perceiving depth; hazy objects are seen as farther away than sharp, clear objects. Relative size A cue that allows determining the closeness of objects to an object of known size. Texture gradient A gradual change from coarse to fine texture signaling increasing distance. Linear perspective Parallel lines appear to converge with distance. Aptitude tests Tests designed to predict a person's future performance; aptitude is the capacity to learn. Fixed mindset The idea that we have a set amount of an ability that cannot change. Growth mindset The belief that one's skills and qualities can change and improve through effort and dedication. Explicit memory Memory of facts and experiences that one can consciously know and 'declare.' Episodic memory The collection of past personal experiences that occurred at a particular time and place. Semantic memory Memory for factual information. Implicit memory Retention independent of conscious recollection. Procedural memory A type of long-term memory of how to perform different actions and skills. Prospective memory Remembering to perform a planned action or recall a planned intention at some future point in time. Long-term potentiation An increase in a cell's firing potential after brief, rapid stimulation. Believed to be a neural basis for learning and memory. Working memory model A model that suggests that memory involves a series of active, temporary memory stores that manipulate information. Working memory A newer understanding of short-term memory that involves conscious, active processing of incoming auditory and visual-spatial information, and of information retrieved from long-term memory. Central executive The part of working memory that directs attention and processing. Phonological loop The part of working memory that holds and processes verbal and auditory information. Visuospatial sketchpad The part of working memory that holds visual and spatial information. Multi-store model A model of memory that suggests information passes through three stages: sensory memory, short-term memory, and long-term memory. Sensory memory The immediate, very brief recording of sensory information in the memory system. Iconic memory A momentary sensory memory of visual stimuli; a photographic or picture-image memory lasting no more than a few tenths of a second. Echoic memory A momentary sensory memory of auditory stimuli; if attention is elsewhere, sounds and words can still be recalled within 3 or 4 seconds. Short-Term Memory Activated memory that holds a few items briefly before the information is stored or forgotten. Long-Term Memory The relatively permanent and limitless storehouse of the memory system. Includes knowledge, skills, and experiences. Automatic processing Unconscious encoding of incidental information, such as space, time, and frequency, and of well-learned information. Effortful processing Encoding that requires attention and conscious effort. Encoding The processing of information into the memory system—for example, by extracting meaning. Storage The retention of encoded information over time. Retrieval The process of getting information out of memory storage. Levels of processing model The theory that deeper levels of processing result in longer-lasting memory codes. Shallow encoding Processing information based on its surface characteristics. Deep encoding Processing information based on its meaning and the significance of the information. Mnemonic devices Memory aids, especially those techniques that use vivid imagery and organizational devices. Method of loci A mnemonic device that involves imagining placing items around a room or along a route. Chunking-Grouping Organizing items into familiar, manageable units; often occurs automatically. Categories-Grouping Grouping information into categories that share common attributes. Hierarchies-Grouping Organizing items into a hierarchy, starting with general categories and working down to specific examples. Spacing effect The tendency for distributed study or practice to yield better long-term retention than is achieved through massed study or practice. Massed practice Cramming information all at once. It is less effective than spaced practice. Distributed practice Spacing the study of material to be remembered by including breaks between study periods. Serial position effect Our tendency to recall best the last and first items in a list. Primacy effect The tendency to remember information at the beginning of a body of information better than the information that follows. Recency effect The tendency to remember information that is presented last. Maintenance rehearsal Repeating information over and over to keep it active in short-term memory. Elaborative rehearsal A method of transferring information from short-term to long-term memory by making that information meaningful in some way. Memory retention The ability to retain information over time through the storage and retrieval of information. Autobiographical memory The memory for events and facts related to one's personal life story. Retrograde amnesia An inability to retrieve information from one's past. Anterograde amnesia An inability to form new memories. Alzheimer's disease A progressive and irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and, finally, physical functioning. Infantile amnesia The inability to retrieve memories from much before age 3. Recall A measure of memory in which the person must retrieve information learned earlier, as on a fill-in-the-blank test. Recognition A measure of memory in which the person need only identify items previously learned, as on a multiple-choice test. Retrieval cues Stimuli that aid the recall or recognition of information stored in memory. Context-dependent memory The theory that information learned in a particular situation or place is better remembered when in that same situation or place. Mood-congruent memory The tendency to recall experiences that are consistent with one's current good or bad mood. State-dependent memory The theory that information learned in a particular state of mind (e.g., drunk, sober) is more easily recalled when in that same state of mind. The forgetting curve A graph showing retention and forgetting over time. Encoding failure The failure to process information into memory. Proactive interference The disruptive effect of prior learning on the recall of new information. Retroactive interference The disruptive effect of new learning on the recall of old information. Tip-of-the-tongue phenomenon The temporary inability to remember something you know, accompanied by a feeling that it's just out of reach. Repression The basic defense mechanism that banishes from consciousness anxiety-arousing thoughts, feelings, and memories. Misinformation effect Incorporating misleading information into one's memory of an event. Source amnesia Attributing to the wrong source an event we have experienced, heard about, read about, or imagined. Constructive memory The process by which memories are influenced by the meaning we give to events. Memory consolidation The neural storage of a long-term memory. Imagination inflation The increased confidence in a false memory of an event following repeated imagination of the event. Health Psychology A branch of psychology that focuses on how physical activities, psychological traits, and social relationships affect overall health and illness. Stress The process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging. Hypertension High blood pressure, often associated with stress, which can increase the risk of heart and kidney diseases and stroke. Immune Suppression Reduction in the effectiveness of the immune system, which can be caused by various forms of stress. Stressors Events or conditions in your surroundings that may trigger stress. Daily Hassles Everyday minor events that cause stress, such as traffic jams or overwhelming chores. Significant Life Changes Major life transitions like moving, leaving a job, or divorcing, which can be stressful. Catastrophes Unpredictable, large-scale events that cause significant stress and alter the lives of many people. Eustress (motivating) Positive stress which results from striving toward a challenging goal. Distress (debilitating) Negative stress that can make a person sick or keep a person from reaching a goal. Adverse Childhood Experiences (ACEs) Potentially traumatic events that occur in childhood and can have negative, lasting effects on health and well-being. General Adaptation Syndrome (GAS) The three-stage process (alarm, resistance, exhaustion) that describes the physiological changes the body goes through when under stress. Alarm Reaction Phase The initial reaction to a stressor, activating the body's defense systems. Resistance Phase The body's response after the initial shock of a stressful event, where the body attempts to return to normal functioning. Flight-Fight-Freeze Response A physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. Exhaustion Phase The third stage of the GAS, during which the body depletes its resources in responding to a prolonged stressor. Tend-and-Befriend Theory A theory that suggests people seek social support and tend to others in times of stress. Problem-focused Coping Strategies aimed at tackling the cause of stress in practical ways which directly tackle the problem causing the stress. Emotion-focused Coping Strategies aimed at relieving or managing the emotional distress associated with stress. Positive Psychology The scientific study of human strengths and virtues that enable individuals and communities to thrive. Subjective Well-being An individual's own assessment of their happiness and satisfaction with life. Resilience The ability to mentally or emotionally cope with a crisis or to return to pre-crisis status quickly. Posttraumatic Growth Positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning. Positive Emotions Feelings that engage us, elevate us, and promote growth and well-being. Gratitude A feeling of thankfulness and appreciation, especially in response to someone doing something kind or helpful. Signature Strengths & Virtues Character strengths and virtues that are personally fulfilling, intrinsic to one's identity, and contribute to the collective well-being. Categories of Virtues Broad categories that encompass character strengths, such as wisdom, courage, humanity, justice, temperance, and transcendence. Abnormal Psychology The study of psychological disorders, including their symptoms, etiology (i.e., their causes), and treatment. Clinical Psychology A branch of psychology that studies, assesses, and treats people with psychological disorders. Psychology Student Syndrome A phenomenon where psychology students begin to believe they have the disorders they are studying. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) The updated manual that describes and categorizes mental disorders in order to improve diagnoses, treatment, and research. International Classification of Mental Disorders (ICD) A standard diagnostic tool for epidemiology, health management, and clinical purposes. It is maintained by the World Health Organization (WHO) and covers a broad range of health conditions, including psychological conditions. Deviation In psychology, typically refers to departing from the norm, which can either be statistical, social, or functional in nature. Distress Negative stress that can lead to anxiety, depression, and potentially to physical problems. Dysfunction Abnormal functioning, as opposed to normal functioning, often used to refer to individual behaviors or the functioning of social systems. Eclectic Approach An approach to clinical practice that involves selecting the best treatment techniques from various disciplines based on the client's unique problems, strengths, and preferences. Behavioral Perspective Focuses on how we learn observable responses and how the environment impacts those responses. Psychodynamic Perspective Emphasizes the influence of the unconscious mind on behavior and the importance of childhood experiences. Humanistic Perspective Focuses on the importance of being your true self in order to lead the most fulfilling life. Cognitive Perspective Focuses on how we encode, process, store, and retrieve information. Evolutionary Perspective How the natural selection of traits promotes the perpetuation of one's genes. Sociocultural Perspective Examines how the social environments and cultural upbringing influence an individual's behavior and thoughts. Biological Perspective Explores the links between brain and mind, and how the body and brain enable emotions, memories, and sensory experiences. Biopsychosocial Model An integrated approach that incorporates biological, psychological, and social-cultural levels of analysis to better understand health and illness. Diathesis-Stress Model Suggests that a person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress. Stigma Disapproval or discrimination against a person based on perceivable social characteristics that serve to distinguish them from other members of society. Anxiety Disorders Mental health disorders characterized by significant feelings of anxiety and fear. Specific Phobia An anxiety disorder characterized by irrational and persistent fear of a specific object, situation, or activity. Acrophobia Fear of heights. Arachnophobia Fear of spiders. Agoraphobia Fear of open or crowded spaces. Panic Disorder An anxiety disorder that consists of sudden, overwhelming attacks of terror. Ataque de nervios A cultural syndrome primarily seen in Latin Americans, involving symptoms of intense emotional upset, acute anxiety, fear, or anger. Social Anxiety Disorder A chronic mental health condition in which social interactions cause irrational anxiety. Taijin Kyofusho A Japanese culture-specific syndrome characterized by an intense fear that one's body, body parts, or bodily functions give others a negative impression. Generalized Anxiety Disorder An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. Obsessive-Compulsive Disorders Disorders involving intrusive obsessions and compulsions which impede daily life. Obsessions Persistent ideas, thoughts, or impulses that are unwanted and inappropriate and cause marked distress. Compulsions Repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession. Hoarding Disorder A disorder characterized by the persistent difficulty discarding or parting with possessions, regardless of their actual value. Trauma and Stressor-Related Disorders Disorders related to the exposure to a traumatic or stressful event. Posttraumatic Stress Disorder A disorder characterized by failure to recover after experiencing or witnessing a terrifying event. Depressive Disorders Disorders that involve the presence of sad, empty, or irritable mood, accompanied by physical and cognitive changes that significantly affect the individual's capacity to function. Major Depressive Disorder A mood disorder causing a persistent feeling of sadness and loss of interest. Persistent Depressive Disorder A form of depression that is less severe than major depressive disorder but more chronic. Bipolar Disorder A disorder associated with episodes of mood swings ranging from depressive lows to manic highs. Bipolar Cycling The process of cycling through episodes of mania and depression in bipolar disorder. Bipolar I Disorder A type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode. Bipolar II Disorder A type of bipolar disorder marked by milder episodes of hypomania that alternate with periods of severe depression. Neurodevelopmental Disorders A group of conditions with onset in the developmental period, often before school age, that are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning. Attention-Deficit/Hyperactivity Disorder (ADHD) A chronic condition including attention difficulty, hyperactivity, and impulsiveness. Autism Spectrum Disorder (ASD) A disorder that affects communication and behavior. Feeding and Eating Disorders Disorders characterized by abnormal or disturbed eating habits, which negatively affect a person's health. Anorexia Nervosa An eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of body weight. Bulimia Nervosa An eating disorder characterized by binge eating followed by purging. Schizophrenic Spectrum Disorders A range of disorders that involve psychosis, including schizophrenia. Delusions False beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Delusions of Persecution The belief that others are out to get one. Delusions of Grandeur A false belief that one is more important or influential than they really are. Hallucinations False sensory experiences, such as seeing something in the absence of an external visual stimulus. Disorganized Thinking A symptom of psychosis, manifested as illogical or incoherent thought and speech. Disorganized Speech A style of talking involving incoherence and a lack of typical logical patterns. Word Salad A confused or unintelligible mixture of seemingly random words and phrases. Disorganized Motor Behavior Includes a variety of unusual behaviors including problems with goal-directed behavior leading to difficulties performing activities of daily living. Catatonia A state of unresponsiveness to one's outside environment, usually including muscle rigidity, staring, and inability to communicate. Flat Affect A lack of emotional responsiveness. Dopamine Hypothesis The theory that schizophrenia results from an excess of dopamine activity. Positive Symptoms Symptoms of schizophrenia that are excesses of behavior or occur in addition to normal behavior; hallucinations, delusions, and disorganized speech. Negative Symptoms Symptoms of schizophrenia that are marked by deficits in functioning, such as apathy, lack of emotion, and slowed speech and movement. Dissociative Disorders Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Dissociative Amnesia A disorder characterized by the sudden and extensive inability to recall important personal information, usually of a traumatic or stressful nature. Dissociative Fugue A rare dissociative disorder in which a person loses awareness of their identity or other important autobiographical information and also engages in some form of unexpected travel. Dissociative Identity Disorder A disorder characterized by the presence of two or more distinct personality states. Personality Disorders Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning. Cluster A Personality Disorders Odd, eccentric thinking or behavior (including paranoid, schizoid, and schizotypal personality disorders). Paranoid Personality Disorder Type of personality disorder characterized by extreme distrust and suspicion of others. Schizoid Personality Disorder A personality disorder characterized by persistent avoidance of social relationships and little expression of emotion. Schizotypal Personality Disorder A personality disorder characterized by severe social anxiety, thought disorder, paranoid ideation, derealization, transient psychosis, and often unconventional beliefs. Cluster B Personality Disorders Dramatic, overly emotional or unpredictable thinking or behavior (including antisocial, borderline, histrionic, and narcissistic personality disorders). Antisocial Personality Disorder A personality disorder characterized by a lack of conscience for wrongdoing, even toward friends and family. Histrionic Personality Disorder A personality disorder characterized by excessive emotionality and attention seeking. Narcissistic Personality Disorder A disorder in which a person has an inflated sense of self-importance. Borderline Personality Disorder A personality disorder characterized by severe instability in emotions and self-image, along with impulsive and reckless behavior. Cluster C Personality Disorders Anxious, fearful thinking or behavior, including avoidant, dependent, and obsessive-compulsive personality disorders. Avoidant Personality Disorder A personality disorder characterized by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Dependent Personality Disorder A personality disorder characterized by psychological dependence on other people. Obsessive-Compulsive Personality Disorder A personality disorder characterized by preoccupation with orderliness, perfection, and control. Deinstitutionalization The release of institutionalized individuals from institutional care to community-based care. Evidence-Based Interventions Treatments based on scientific evidence. Cultural Humility An approach to engagement across cultures emphasizing openness and self-awareness of one's own cultural identities. Therapeutic Alliance The relationship between a healthcare professional and a client. Conformity Adjusting one's behavior or thinking to coincide with a group standard. Normative Social Influence Influence resulting from a person's desire to gain approval or avoid disapproval. Social Norms Expected standards of conduct, which influence behavior. Social Comparison Evaluating one's abilities and opinions by comparing oneself to others. Relative Deprivation The perception that one is worse off relative to those with whom one compares oneself. Upward Social Comparison Comparing oneself with others who are better off. Downward Social Comparison Comparing oneself with others who are worse off. Informational Social Influence Influence resulting from one's willingness to accept others' opinions about reality. Obedience Following the directives of authority. Social Facilitation Improved performance on simple or well-learned tasks in the presence of others. Group Polarization The enhancement of a group's prevailing inclinations through discussion within the group. Groupthink The mode of thinking that occurs when the desire for harmony in a decision-making group overrides a realistic appraisal of alternatives. Bystander Effect The tendency for any given bystander to be less likely to give aid if other bystanders are present. Diffusion of Responsibility Diminished sense of responsibility among group members to act because others are seen as equally responsible. Social Loafing The tendency for people in a group to exert less effort when pooling their efforts toward attaining a common goal than when individually accountable. Deindividuation The loss of self-awareness and self-restraint occurring in group situations that foster arousal and anonymity. Attribution Theory The theory that we explain someone's behavior by crediting either the situation or the person's disposition. Dispositional Attributions Attributing behavior to the person's disposition and traits. Situational Attributions Attributing behavior to the environment. Explanatory Style A person's habitual way of explaining events, typically assessed along three dimensions: internal/external, stable/unstable, and global/specific. Optimistic Explanatory Style Explaining bad events as results of temporary, external causes. Pessimistic Explanatory Style Explaining bad events as results of stable, internal causes. Fundamental Attribution Error The tendency for observers, when analyzing others' behavior, to underestimate the impact of the situation and to overestimate the impact of personal disposition. Actor-Observer Bias The tendency to attribute one's own actions to external causes while attributing other people's behaviors to internal causes. Self-Serving Bias A readiness to perceive oneself favorably. Internal Locus of Control The perception that one controls one's own fate. External Locus of Control The perception that chance or outside forces beyond one's personal control determine one's fate. Altruism Unselfish regard for the welfare of others. Social Responsibility Norm An expectation that people will help those needing their help. Stereotype A generalized belief about a group of people. Confirmation Bias The tendency to interpret new evidence as confirmation of one's existing beliefs or theories. Belief Perseverance Clinging to one's initial conceptions after the basis on which they were formed has been discredited. Self-Fulfilling Prophecy A belief that leads to its own fulfillment. Prejudice An unjustifiable and usually negative attitude toward a group and its members. Discrimination Unjustifiable negative behavior toward a group and its members. Implicit Attitudes Attitudes that influence a person's feelings and behavior at an unconscious level. Just-World Phenomenon The tendency for people to believe the world is just and that people therefore get what they deserve. Out-Group Homogeneity Bias Perception of out-group members as more similar to one another than are in-group members. In-Group Bias The tendency to favor one's own group. Mere Exposure Effect The phenomenon that repeated exposure to novel stimuli increases liking of them. Ethnocentrism Evaluating other cultures according to the standards and customs of one's own culture. Collectivism Giving priority to the goals of one's group and defining one's identity accordingly. Multiculturalism The practice of valuing and respecting differences in culture. Superordinate Goals Shared goals that override differences among people and require their cooperation. Social Traps A situation in which conflicting parties, by each rationally pursuing their self-interest, become caught in mutually destructive behavior. Persuasion The process of creating, reinforcing, or changing people's beliefs or actions. Elaboration Likelihood Model A theory of how persuasive messages lead to attitude changes. Central Route of Persuasion Attitude change path in which interested people focus on the arguments and respond with favorable thoughts. Peripheral Route of Persuasion Attitude change path in which people are influenced by incidental cues, such as a speaker's attractiveness. Halo Effect The tendency to draw a general impression about an individual on the basis of a single characteristic. Foot-in-the-Door Technique The tendency for people who have first agreed to a small request to comply later with a larger request. Door-in-the-Face Technique The strategy of getting someone to agree to a modest request by first asking them to agree to a much larger request that they will likely turn down. False Consensus Effect The tendency to overestimate the extent to which others share our beliefs and behaviors. Cognitive Dissonance The theory that we act to reduce the discomfort we feel when two of our thoughts are inconsistent. Industrial-Organizational (I/O) Psychologists Psychologists who apply psychology's principles to the workplace. Instincts A complex behavior that is rigidly patterned throughout a species and is unlearned. Drive-Reduction Theory The idea that a physiological need creates an aroused tension state (a drive) that motivates an organism to satisfy the need. Homeostasis The tendency to maintain a balanced or constant internal state; the regulation of any aspect of body chemistry, such as blood glucose, around a particular level. Ghrelin Hormone secreted by an empty stomach; sends 'I'm hungry' signals to the brain. Leptin Hormone secreted by fat cells; when abundant, causes brain to increase metabolism and decrease hunger. Hypothalamus A neural structure lying below the thalamus; directs several maintenance activities (eating, drinking, body temperature), helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward. Pituitary Gland The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands. Belongingness The human emotional need to be an accepted member of a group. Arousal Theory The theory that people are motivated to maintain an optimal level of alertness and physical and mental activation. Yerkes-Dodson Law The principle that performance increases with arousal only up to a point, beyond which performance decreases. Sensation-Seeking Theory The search for experiences and feelings that are varied, novel, complex, and intense. Thrill Seeking Pursuing activities that provide a rush of adrenaline. Adventure Seeking Engaging in unusual and exciting activities. Disinhibition Acting impulsively, without considering the consequences. Boredom Susceptibility Tendency to experience boredom and frustration when not engaged in stimulating activities. Incentive Theory A theory that states that behavior is motivated by a desire for reinforcement or incentives. Extrinsic Motivation A desire to perform a behavior to receive promised rewards or avoid threatened punishment. Self-Determination Theory A theory of motivation that is concerned with the beneficial effects of intrinsic motivation and the harmful effects of extrinsic motivation. Intrinsic Motivation A desire to perform a behavior effectively for its own sake. Lewin's Motivational Conflicts Theory A theory that describes situations in which conflicting motivations produce indecision and difficulty. Approach-Approach Conflicts Conflict that results from having to choose between two attractive alternatives. Avoidance-Avoidance Conflicts Conflict that results from having to choose between two distasteful alternatives. Approach-Avoidance Conflicts Conflict that results when a single action or event has both attractive and unattractive features. Emotion A response of the whole organism, involving (1) physiological arousal, (2) expressive behaviors, and (3) conscious experience. Affect A broad range of feelings that people experience. Facial-Feedback Hypothesis The idea that facial expressions can influence emotions as well as reflect them. Display Rules Culturally determined rules about which nonverbal behaviors are appropriate to display. Elicitors Stimuli that trigger emotional responses. Broaden-and-Build Theory of Emotion Theory proposing that happiness predisposes us to think more openly. Universal Emotions Basic emotions that are expressed by all cultures around the world such as happiness, sadness, fear, disgust, anger, and surprise. Psychodynamic Theory A view that explains personality in terms of conscious and unconscious forces, such as unconscious desires and beliefs. Preconscious Mind The level of consciousness that is not currently in focal awareness. Unconscious Mind A reservoir of mostly unacceptable thoughts, wishes, feelings, and memories. Denial Psychoanalytic defense mechanism by which people refuse to believe or even to perceive painful realities. Displacement Defense mechanism that shifts sexual or aggressive impulses toward a more acceptable or less threatening object or person. Projection Defense mechanism by which people disguise their own threatening impulses by attributing them to others. Rationalization Defense mechanism that offers self-justifying explanations in place of the real, more threatening, unconscious reasons for one's actions. Reaction Formation Defense mechanism by which the ego unconsciously switches unacceptable impulses into their opposites. Regression Defense mechanism in which an individual faced with anxiety retreats to a more infantile psychosexual stage. Repression Defense mechanism by which anxiety-provoking thoughts and feelings are forced to the unconscious. Sublimation Defense mechanism by which people re-channel their unacceptable impulses into socially approved activities. Humanistic Psychology A historically significant perspective that emphasized the growth potential of healthy people. Unconditional Regard An attitude of total acceptance toward another person. Self-Actualizing Tendency The human motive toward realizing our inner potential. Social-Cognitive Theory Views behavior as influenced by the interaction between people's traits (including their thinking) and their social context. Reciprocal Determinism The interacting influences of behavior, internal cognition, and environment. Self-Concept All our thoughts and feelings about ourselves, in answer to the question, 'Who am I?' Self-Efficacy One's sense of competence and effectiveness. Self-Esteem One's feelings of high or low self-worth. Trait Theories Theories that endeavor to describe the characteristics that make up human personality in an effort to predict future behavior. Big Five Theory The theory that there are five basic personality traits: openness, conscientiousness, extraversion, agreeableness, and neuroticism (emotional stability). Personality Inventories A questionnaire (often with true-false or agree-disagree items) on which people respond to items designed to gauge a wide range of feelings and behaviors; used to assess selected personality traits. Factor Analysis A statistical procedure that identifies clusters of related items (called factors) on a test; used to identify different dimensions of performance that underlie one's total score. Openness to Experience One of the five factors; willingness to try new things and be open to new experiences. Conscientiousness One of the five factors; a tendency to show self-discipline, act dutifully, and aim for achievement. Extraversion One of the five factors; energy, positive emotions, and the tendency to seek stimulation and the company of others. Agreeableness One of the five factors; a tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others. Behavioral Perspective Emphasizes learning and behavior in explaining thoughts, feelings, and actions. Associative Learning Making connections between events to learn. Habituation Becoming less responsive to a repeated stimulus. Classical Conditioning Pairing two stimuli to elicit a response. Unconditioned Stimulus (UCS) Naturally triggers a response without learning. Conditioned Stimulus (CS) Initially neutral, triggers a conditioned response. Acquisition Initial learning stage where a response is established. Extinction Diminishing of a conditioned response. Spontaneous Recovery Reappearance of an extinguished response after a pause. Stimulus Discrimination Ability to differentiate between stimuli. Stimulus Generalization Conditioned stimulus evokes similar responses. Higher-Order Conditioning Pairing a conditioned stimulus with a new one. Counterconditioning Uses conditioning to change responses to triggers. Taste Aversion Avoidance of food associated with discomfort. One-Trial Conditioning Learning with only one pairing of stimulus and response. Biological Preparedness Inclination to form associations between stimuli and responses. Operant Conditioning Learning through rewards and punishments. The Law of Effect Behaviors with favorable consequences are repeated. Reinforcement Strengthens behavior it follows. Primary Reinforcers Innately reinforcing stimuli satisfying biological needs. Secondary Reinforcers Gains reinforcing power through association. Punishment Event decreasing behavior it follows. Shaping Positive reinforcement of behavior patterns. Instinctive Drift Tendency to revert to instinctive behaviors. Fine Motor Coordination The ability to make small, precise movements, typically involving the coordination of the hands and fingers with the eyes. Gross Motor Coordination The ability to make large, general movements, such as crawling and walking. Maturation Biological growth processes that enable orderly changes in behavior, relatively uninfluenced by experience. Reflexes Automatic responses to sensory stimuli, like grasping a finger tightly with the hands. Rooting Reflex A baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple. Visual Cliff A laboratory device for testing depth perception in infants and young animals. Critical Periods Specific time periods during which an organism must experience stimuli in order to develop normally. Sensitive Periods Times in development when a person is particularly open to certain kinds of experiences. Imprinting The process by which certain animals form strong attachments during early life. Growth Spurt A rapid increase in growth during puberty. Puberty The period of sexual maturation, during which a person becomes capable of reproducing. Primary Sex Characteristics The body structures (ovaries, testes, and external genitalia) that make sexual reproduction possible. Secondary Sex Characteristics Nonreproductive sexual traits, such as female breasts and hips, male voice quality, and body hair. Menarche The first menstrual period. Spermarche The first ejaculation. Menopause The time of natural cessation of menstruation; also refers to the biological changes a woman experiences as her ability to reproduce declines. Sex The biologically influenced characteristics by which people define males and females. Gender The socially influenced characteristics by which people define men and women. Socialization The process by which people learn the norms, rules, and information of a culture or society. Jean Piaget A psychologist known for his study of cognitive development in children. Sensorimotor Stage The first stage in Piaget's theory of cognitive development, from birth to about 2 years of age, during which infants know the world mostly in terms of their sensory impressions and motor activities. Object Permanence The awareness that things continue to exist even when not perceived. Preoperational Stage The second stage in Piaget's theory, from about 2 to 7 years of age, during which a child learns to use language but does not yet comprehend the mental operations of concrete logic. Mental Symbols Internal depictions of information that the mind can manipulate. Chronosystem In Bronfenbrenner's theory, this system encompasses changes over time in child development. Authoritarian Parenting A parenting style characterized by high demands and low responsiveness. Parents with this style have very high expectations of their children, yet provide very little in the way of feedback and nurturance. Authoritative Parenting A parenting style characterized by high demands and high responsiveness. Parents with this style set limits and enforce rules but also listen to their children. Permissive Parenting A parenting style characterized by low demands with high responsiveness. These parents tend to be very loving, yet provide few guidelines and rules. Attachment Styles Patterns of attachment, defined by different ways of interacting and behaving in relationships. Secure Attachment An attachment style characterized by trust, a lack of concern with being abandoned, and the view that one is worthy and well liked. Insecure Attachment Attachment styles characterized by fear of abandonment and the feeling that one's needs might not be met. Avoidant Attachment An attachment style characterized by difficulty in learning to trust others. Anxious Attachment An attachment style where individuals are often anxious about the stability of their relationships. Disorganized Attachment An attachment style characterized by a lack of clear attachment behavior. Temperament A person's characteristic emotional reactivity and intensity. Separation Anxiety Emotional distress seen in many infants when they are separated from people with whom they have formed an attachment. Contact Comfort The physical and emotional comfort that an infant receives from being in physical contact with its mother. Parallel Play Activity in which children play side by side without interacting. Pretend Play Play involving imaginary people and situations; also called fantasy play, dramatic play, or imaginative play. Egocentrism The inability to differentiate between self and other. More specifically, it is the inability to understand that others have different feelings, desires, and perspectives from one's own. Imaginary Audience A concept in adolescent psychology where an individual believes that his or her behavior is the main focus of others' attention and concern. Personal Fable An adolescent's belief that they are unique and protected from harm. Social Clock The culturally preferred timing of social events such as marriage, parenthood, and retirement. Emerging Adulthood A phase of the life span between adolescence and full-fledged adulthood which encompasses late adolescence and early adulthood, generally ages 18 to 25. Stage Theory of Psychosocial Development (Erikson) Erik Erikson's theory that identifies eight stages through which a healthily developing human should pass from infancy to late adulthood. Trust vs. Mistrust The first stage of Erik Erikson's theory of psychosocial development. This stage occurs between birth and approximately 18 months of age. During this stage, the infant learns if they can trust the world to fulfill their needs. Autonomy vs. Shame and Doubt The second stage of Erik Erikson's stages of psychosocial development. This stage occurs between the ages of 18 months to approximately 3 years. The child learns to be independent and confident or experiences shame and doubt about their abilities. Initiative vs. Guilt The third stage of Erik Erikson's stages of psychosocial development. This stage occurs during the preschool years, between the ages of 3 to 5 years. Children begin to assert control and power over their environment. Industry vs. Inferiority The fourth stage of Erik Erikson's stages of psychosocial development. This stage occurs between the ages of 5 and 12 years. Children learn to cope with new social and academic demands, success leads to a sense of competence, while failure results in feelings of inferiority. Identity vs. Role Confusion The fifth stage of Erik Erikson's stages of psychosocial development. This stage occurs during adolescence, from about 12-18 years. During this stage, adolescents explore their independence and develop a sense of self. Intimacy vs. Isolation The sixth stage of Erik Erikson's theory of psychosocial development. This stage occurs during young adulthood between the ages of approximately 19 and 40 years. Young adults need to form intimate, loving relationships with other people. Generativity vs. Stagnation The seventh stage of Erik Erikson's theory of psychosocial development. This stage takes place during middle adulthood between the ages of approximately 40 and 65. Individuals establish careers, settle down within relationships, begin families, and develop a sense of being a part of the bigger picture. Integrity vs. Despair The eighth and final stage of Erik Erikson's stages of psychosocial development. This stage occurs during old age and is focused on reflecting back on life. Adverse Childhood Experiences (ACEs) Potentially traumatic events that occur in childhood (0-17 years), such as experiencing violence, abuse, or neglect, witnessing violence in the home or community, and having a family member attempt or die by suicide. Achievement (adolescent development) In the context of identity development, this term refers to the successful integration of various aspects of self-concept, based on explorations of roles, values, and beliefs. Diffusion (adolescent development) A status of identity development where an individual has not yet experienced a crisis or made any commitments. They are undecided and uninterested in occupational and ideological choices. Foreclosure (adolescent development) A status of identity development where an individual has made a commitment without experiencing a crisis. This occurs when people commit to roles or values without exploring alternatives. Moratorium (adolescent development) A status of identity development where an individual is in the midst of a crisis but whose commitments are either absent or are only vaguely defined. Racial/Ethnic Identity An individual's awareness and experience of being a member of a racial or ethnic group, including the degree to which one's cultural, historical, and social aspects of identity are embraced. Sexual Orientation An inherent or immutable enduring emotional, romantic, or sexual attraction to other people. Religious Identity An individual's sense of belonging to a religious group, along with the importance of this group membership as it pertains to one's sense of self. Occupational Identity How a person identifies themselves based on their job or career choices and how they feel those roles impact their personal identity. Familial Identity The part of an individual's identity that is formed by the relationships they have with their family members. Possible Selves The aspect of oneself that includes all the ideas of what one might become, what one hopes to become, and what one is afraid of becoming. Evolutionary Perspective A way of looking at human behavior that emphasizes the role of natural selection and survival of the fittest in shaping our actions. Natural Selection A process where organisms better adapted to their environment tend to survive and produce more offspring. Nature Refers to the genetic or hereditary influences on behavior and traits. Nurture Refers to the environmental influences that shape behavior and traits after conception. Twin Studies Research that compares the similarities between identical and fraternal twins to understand the influence of genetics versus environment. Adoption Studies Studies that compare adopted children to their adoptive and biological parents to understand genetic and environmental influences. Family Studies Research that examines behavioral patterns or genetic markers across generations within families. Heredity The passing on of physical or mental traits genetically from one generation to another. Genetic Predisposition The increased likelihood of developing a particular disease or behavior based on a person's genetic makeup. Eugenics A controversial historical movement aimed at improving the genetic composition of the human race. Cerebral Cortex The outermost layer of the brain involved in high-level functions such as thought, language, and memory. Association Areas Parts of the brain that integrate different types of information from the senses and link it with stored memories. Lobes of the Brain Regions of the brain differentiated by their functions, including frontal, parietal, occipital, and temporal lobes. Frontal Lobes Areas of the brain involved in complex processes like reasoning, planning, and emotion. Prefrontal Cortex The part of the frontal lobes directly behind the forehead, involved in decision-making and self-control. Executive Functioning Higher-level cognitive processes including thinking, planning, and problem-solving. Motor Cortex The part of the brain that controls voluntary movements. Parietal Lobes Areas of the brain that process sensory information such as touch, temperature, and pain. Somatosensory Cortex A part of the parietal lobes that processes sensory input from various body areas. Occipital Lobes The part of the brain that processes visual information. Temporal Lobes Areas of the brain involved in processing auditory information and encoding memory. Corpus Callosum A large band of neural fibers that connects the left and right cerebral hemispheres and allows communication between them. Brainstem The central trunk of the brain continuing downward to form the spinal cord. Medulla The base of the brainstem that controls vital life-sustaining functions like heartbeat and breathing. Reticular Activating System A network of neurons in the brainstem that plays a role in waking and sleep. Cerebellum A part of the brain at the back of the skull that coordinates and regulates muscular activity. Limbic System A complex system of nerves and networks in the brain, controlling basic emotions and drives. Reward Center Brain regions that regulate the experience of pleasure, particularly related to survival and reward. Thalamus A structure deep within the brain that relays sensory signals to the cerebral cortex. Hypothalamus A small region at the base of the brain that directs several functions, including temperature regulation and energy maintenance. Pituitary Gland A gland at the base of the brain that controls growth and development. Hippocampus A part of the limbic system involved in learning and memory. Amygdala A structure in the limbic system involved in emotion, particularly fear and aggression. Nervous System The network of nerve cells and fibers that transmits nerve impulses between parts of the body. Central Nervous System The part of the nervous system consisting of the brain and spinal cord. Peripheral Nervous System All the nerves that lie outside the brain and spinal cord. Autonomic Nervous System The part of the nervous system responsible for control of the bodily functions not consciously directed, like breathing and the heartbeat. Sympathetic Nervous System The part of the autonomic nervous system that prepares the body for rapid action in emergencies. Parasympathetic Nervous System The part of the autonomic nervous system that calms the body and conserves energy. Somatic Nervous System The part of the peripheral nervous system associated with voluntary control of body movements via skeletal muscles. Neurons The basic working units of the brain, specialized cells that transmit information to other nerve cells, muscle, or gland cells. Glial Cells Cells in the nervous system that support, nourish, and protect neurons. Motor Neurons Neurons that carry outgoing information from the brain and spinal cord to the muscles and glands. Sensory Neurons Neurons that carry incoming information from the sensory receptors to the brain and spinal cord. Interneurons Neurons within the brain and spinal cord that communicate internally and intervene between the sensory inputs and motor outputs. Reflex Arc A neural pathway that controls a reflex action. Neural Transmission The process by which neurons communicate with each other by sending electrical or chemical signals. Threshold The level of stimulation required to trigger a neural impulse. Action Potential A neural impulse; a brief electrical charge that travels down an axon. All-or-Nothing Principle The rule that neurons are either on or off. Depolarization A change in a cell's membrane potential, making it more positive. Refractory Period A period immediately following stimulation during which a nerve or muscle is unresponsive to further stimulation. Resting Potential The state of the neuron when not firing a neural impulse. Reuptake A neurotransmitter's reabsorption by the sending neuron. Multiple Sclerosis (MS) A disease in which the immune system eats away at the protective covering of nerves. Myasthenia Gravis A chronic autoimmune disease that affects the neuromuscular junction and produces serious weakness of voluntary muscles. Neurotransmitters Chemicals transmitting information across synapses to dendrites of receiving neurons. Excitatory Neurotransmitters Chemical messengers increasing the likelihood of neuron firing an action potential. Glutamate An excitatory neurotransmitter strengthening synaptic connections between neurons. Inhibitory Neurotransmitters Chemical messengers decreasing the likelihood of neuron firing an action potential. GABA A major inhibitory neurotransmitter in the brain. Dopamine A neurotransmitter influencing movement, learning, attention, and emotion. Serotonin A neurotransmitter affecting mood, hunger, sleep, and arousal. Endorphins Neurotransmitters influencing the perception of pain or pleasure. Substance P A neurotransmitter involved in transmitting pain messages to the brain. Acetylcholine A neurotransmitter enabling learning, memory, and triggering muscle contraction. Hormones Chemicals produced by glands regulating activities of different body cells. Ghrelin A hormone stimulating appetite, increasing food intake, and promoting fat storage. Leptin A hormone helping regulate energy balance by inhibiting hunger. Melatonin A hormone regulating sleep-wake cycles. Oxytocin A hormone acting as a neurotransmitter, influencing social behavior and emotion. Adrenaline A hormone released in response to physical or mental stress. Norepinephrine A hormone and neurotransmitter involved in arousal and fight-or-flight response. Plasticity The brain's ability to change and adapt due to experience. Split Brain Research Studies on patients with severed corpus callosum to understand brain hemisphere functions. Contralateral Hemispheric Organization Arrangement where the brain's right hemisphere controls the left side of the body and vice versa. Hemispheric Specialization Control of distinct functions by the brain's right and left hemispheres. Linguistic Processing Brain functions involved in understanding and producing language. Broca's Area Frontal lobe area directing muscle movements involved in speech. Broca's Aphasia Condition from damage to Broca's area causing impaired speaking and writing. Opioids A class of drugs including heroin and prescription pain relievers. Heroin An opioid drug made from morphine, derived from opium poppy plants. Tolerance Diminishing drug effect with regular use, necessitating larger doses. Addiction Compulsive craving for drugs or behaviors despite adverse consequences. Withdrawal Symptoms post cessation of drug intake in addicted individuals. Sensation Reception and representation of stimulus energies by sensory receptors. Transduction Conversion of stimulus energies into neural impulses in sensation. Perception Organization and interpretation of sensory information for object recognition. Absolute Threshold Minimum stimulus energy to detect a stimulus 50% of the time. Just-noticeable Difference Smallest difference in stimulus intensity detectable by a sense. Sensory Adaptation Decrease in sensitivity to constant stimulation levels. Weber's Law Principle that stimuli must differ by a constant proportion for detection. Synesthesia Condition where one sense is perceived as if by additional senses. Retina Light-sensitive eye surface with rods, cones, and neural processing layers. Blind Spot Point where optic nerve exits the eye, lacking receptor cells. Visual Nerve Nerve transmitting neural impulses from the eye to the brain. Lens Transparent eye structure behind the pupil, aiding image focus. Accommodation Process of lens shape change for focusing on near or far objects. Nearsightedness Clear vision for close objects but blurry for distant ones. Farsightedness Clear vision for distant objects but blurry for close ones. Photoreceptors Rods and cones in the retina converting light into neural signals. Rods Photoreceptors detecting black, white, and gray for peripheral vision. Cones Photoreceptors concentrated for daylight vision, color, and detail. Trichromatic Theory Theory of three color receptors in the retina for color perception. Opponent-process Theory Theory of opposing processes in color vision enabling perception. Psychology the scientific study of mental processes and behavior. Mental Processes Thoughts, feelings, and motives that each of us experiences privately but that cannot be directly observed. Behavior Any action that people can observe or measure Confirmation Bias The tendency to favor information that confirms your existing beliefs. Hindsight Bias The feeling after something happens that you knew it was going to happen. Overconfidence Being more confident than correct; overestimating the accuracy of your beliefs. Empirical Evidence Information from experiments or observations rather than theories. Scientific Method A step-by-step method for conducting research. Hypothesis A prediction that you can test through study and experimentation. Falsifiable Something that can be proven wrong through tests. Peer Review The process of having other experts examine your work to check its validity. Replication Repeating a study to see if the same results are obtained. Reliability The consistency of a research study or measuring test. Validity The accuracy of a test or research to measure what it claims to measure. The American Psychological Association (APA) A major organization for psychologists in the United States. Research Design The plan for a research study, determining how to collect and analyze data. Methodology The specific procedures or techniques used to identify, select, process, and analyze information about a topic. Quantitative Data Data that can be counted or measured and given a numerical value. Qualitative Data Data that describes qualities or characteristics. Likert Scales A scale used to represent people's attitudes or feelings; respondents specify their level of agreement to a statement. Structured Interviews Interviews where everyone is asked the same questions in the same way. Survey Technique A method of gathering information by asking questions to people. Wording Effect How the way a question is phrased can influence the answers given. Social Desirability Bias: The tendency of respondents to answer questions in a manner that will be viewed favorably by others. Naturalistic Observation Watching behaviors occur naturally without interfering. Case Study A detailed examination of a single subject or group. Correlational Research A study that investigates the relationship between two variables to determine if they vary together. Third Variable Problem A situation where an unseen variable affects the results of a study. Scatterplot A graph in which the values of two variables are plotted along two axes, the pattern of the resulting points revealing any correlation present. Correlation Coefficient A number between -1 and 1 that describes the strength and direction of a relationship between variables. Positive Correlation A relationship where if one variable increases, the other does too. Negative Correlation A relationship where if one variable increases, the other decreases. Experimental Method: A method where the researcher manipulates one variable to see if it affects another. Independent Variable The variable that is changed or controlled in a scientific experiment. Dependent Variable The variable that is tested and measured in a scientific experiment. Confounding Variable An extra variable that wasn't accounted for that could affect the results of an experiment. Operational Definitions Clearly defining how you will measure your variables in research. Experimental Group The group in an experiment that receives the variable being tested. Control Group The group in an experiment that does not receive the test variable. Random Assignment Assigning participants to experimental and control groups by chance, which helps ensure that any differences observed after the treatment are due to the treatment and not a preexisting difference. Placebo Effect A change in a participant's illness or behavior that results from a belief that the treatment will have an effect, rather than the actual treatment. Experimenter Bias When a researcher's expectations influence the outcome of a study. Single-Blind Study When the participants do not know whether they are receiving the treatment or not. Double-Blind Study When neither the participants nor the researchers know who is receiving a particular treatment. Placebo Condition A condition in which participants receive a placebo instead of the actual treatment. Sample A group of subjects selected from a larger population for study. Representative Sample: A randomly chosen sample of subjects from a larger population that accurately reflects the characteristics of the larger population. Random Sample A sample that fairly represents a population because each member has an equal chance of being included. Sample Bias A sample that does not accurately represent the population from which it was drawn. Generalizability The extent to which research findings can be applied to larger populations. Statistics The science of collecting, analyzing, presenting, and interpreting data. Descriptive Statistics Statistics that summarize data, such as mean or standard deviation Inferential Statistics: Statistics used to infer the properties of a population, based on a sample of data. Measure of Central Tendency: A statistical measure that describes the center of a data set; includes mean, median, and mode. Mean The average of a set of numbers. Median The middle number in a set of numbers arranged in order. Mode The number that appears most frequently in a data set. Range The difference between the highest and lowest values in a data set. Normal Curve A bell-shaped curve that shows data distribution; most scores fall near the middle. Regression to the Mean The phenomenon that extreme values in data tend to be closer to the average on subsequent measurements. Positive Skew When more scores fall on the low side of the scale and tail on the high side. Negative Skew When more scores fall on the high side of the scale and tail on the low side. Standard Deviation A measure of how spread out numbers are around the mean. Percentile Rank The percentage of scores in a distribution that a specific score is greater than. Bimodal Distribution A distribution of data with two modes or peaks. Statistical Significance The likelihood that a result from data collected by an experiment is not due to chance. Effect Sizes A measure of the strength of the relationship between two variables. Meta Analysis A method of combining data from many different research studies. Institutional Review Boards (IRB) Groups of people responsible for reviewing proposed research to ensure that it is ethical. Informed Consent Permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. Informed Assent Agreement by a minor or other not able to give legal consent to participate in the activity. Confidentiality Keeping information given by participants in a research study private. Deception Misleading participants about the true purpose of a study or the events that will transpire. Confederates Actors who take part in a study pretending to be real participants. Debriefing Explaining to participants at the end of a study the true purpose of the study and exactly what transpired.
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Chapter 6: Adolescence Growth in Adolescence Puberty is a period of rapid growth and sexual maturation. These changes begin sometime l between eight and fourteen. Girls begin puberty at around ten years of age and boys begin approximately two years later. Pubertal changes take around three to four years to complete. Adolescents experience an overall physical growth spurt. The growth proceeds from the extremities toward the torso. This is referred to as distalproximal development. First the hands grow, then the arms, hand finally the torso. The overall physical growth spurt results in 10-11 inches of added height and 50 to 75 pounds of increased weight. The head begins to grow sometime after the feet have gone through their period of growth. Growth of the head is preceded by growth of the ears, nose, and lips. The difference in these patterns of growth result in adolescents appearing awkward and out-of-proportion. As the torso grows, so do the internal organs. The heart and lungs experience dramatic growth during this period. During childhood, boys and girls are quite similar in height and weight. However, gender differences become apparent during adolescence. From approximately age ten to fourteen, the average girl is taller, but not heavier, than the average boy. After that, the average boy becomes 223 both taller and heavier, although individual differences are certainly noted. As adolescents physically mature, weight differences are more noteworthy than height differences. At eighteen years of age, those that are heaviest weigh almost twice as much as the lightest, but the tallest teens are only about 10% taller than the shortest (Seifert, 2012). Both height and weight can certainly be sensitive issues for some teenagers. Most modern societies, and the teenagers in them, tend to favor relatively short women and tall men, as well as a somewhat thin body build, especially for girls and women. Yet, neither socially preferred height nor thinness is the destiny for many individuals. Being overweight, in particular, has become a common, serious problem in modern society due to the prevalence of diets high in fat and lifestyles low in activity (Tartamella et al., 2004). The educational system has, unfortunately, contributed to the problem as well by gradually restricting the number of physical education courses and classes in the past two decades. Average height and weight are also related somewhat to racial and ethnic background. In general, children of Asian background tend to be slightly shorter than children of European and North American background. The latter in turn tend to be shorter than children from African societies (Eveleth & Tanner, 1990). Body shape differs slightly as well, though the differences are not always visible until after puberty. Asian background youth tend to have arms and legs that are a bit short relative to their torsos, and African background youth tend to have relatively long arms and legs. The differences are only averages, as there are large individual differences as well. Sexual Development Typically, the growth spurt is followed by the development of sexual maturity. Sexual changes are divided into two categories: Primary sexual characteristics and secondary sexual characteristics. Primary sexual characteristics are changes in the reproductive organs. For males, this includes growth of the testes, penis, scrotum, and spermarche or first ejaculation of semen. This occurs between 11 and 15 years of age. For females, primary characteristics include growth of the uterus and menarche or the first menstrual period. The female gametes, which are stored in the ovaries, are present at birth, but are immature. Each ovary contains about 400,000 gametes, but only 500 will become mature eggs (Crooks & Baur, 2007). Beginning at puberty, one ovum ripens and is released about every 28 days during the menstrual cycle. Stress and higher percentage of body fat can bring menstruation at younger ages. Male Anatomy: Males have both internal and external genitalia that are responsible for procreation and sexual intercourse. Males produce their sperm on a cycle, and unlike the female's ovulation cycle, the male sperm production cycle is constantly producing millions of sperm daily. The main male sex organs are the penis and the testicles, the latter of which produce semen and sperm. The semen and sperm, as a result of sexual intercourse, can fertilize an ovum in the female's body; the fertilized ovum (zygote) develops into a fetus which is later born as a child. Female Anatomy: Female external genitalia is collectively known as the vulva, which includes the mons veneris, labia majora, labia minora, clitoris, vaginal opening, and urethral opening. Female internal reproductive organs consist of the vagina, uterus, fallopian tubes, and ovaries. The uterus hosts the developing fetus, produces vaginal and uterine secretions, and passes the male's sperm through to the fallopian tubes while the ovaries release the eggs. A female is born with all her eggs already produced. The vagina is attached to the uterus through the cervix, while the uterus is attached to the ovaries via the fallopian tubes. Females have a monthly reproductive cycle; at certain intervals the ovaries release an egg, which passes through the fallopian tube into the uterus. If, in this transit, it meets with sperm, the sperm might penetrate and merge with the egg, fertilizing it. If not fertilized, the egg is flushed out of the system through menstruation. Secondary sexual characteristics are visible physical changes not directly linked to reproduction but signal sexual maturity. For males this includes broader shoulders and a lower voice as the larynx grows. Hair becomes coarser and darker, and hair growth occurs in the pubic area, under the arms and on the face. For females, breast development occurs around age 10, although full development takes several years. Hips broaden, and pubic and underarm hair develops and also becomes darker and coarser. Acne: An unpleasant consequence of the hormonal changes in puberty is acne, defined as pimples on the skin due to overactive sebaceous (oil-producing) glands (Dolgin, 2011). These glands develop at a greater speed than the skin ducts that discharges the oil. Consequently, the ducts can become blocked with dead skin and acne will develop. According to the University of California at Los Angeles Medical Center (2000), approximately 85% of adolescents develop acne, and boys develop acne more than girls because of greater levels of testosterone in their systems (Dolgin, 2011). Experiencing acne can lead the adolescent to withdraw socially, especially if they are self-conscious about their skin or teased (Goodman, 2006). Effects of Pubertal Age: The age of puberty is getting younger for children throughout the world. According to Euling et al. (2008) data are sufficient to suggest a trend toward an earlier breast development onset and menarche in girls. A century ago the average age of a girl’s first period in the United States and Europe was 16, while today it is around 13. Because there is no clear marker of puberty for boys, it is harder to determine if boys are maturing earlier too. In addition to better nutrition, less positive reasons associated with early puberty for girls include increased stress, obesity, and endocrine disrupting chemicals. Cultural differences are noted with Asian-American girls, on average, developing last, while African American girls enter puberty the earliest. Hispanic girls start puberty the second earliest, while European-American girls rank third in their age of starting puberty. Although African American girls are typically the first to develop, they are less likely to experience negative consequences of early puberty when compared to European-American girls (Weir, 2016). Research has demonstrated mental health problems linked to children who begin puberty earlier than their peers. For girls, early puberty is associated with depression, substance use, eating disorders, disruptive behavior disorders, and early sexual behavior (Graber, 2013). Early maturing girls demonstrate more anxiety and less confidence in their relationships with family and friends, and they compare themselves more negatively to their peers (Weir, 2016). Problems with early puberty seem to be due to the mismatch between the child’s appearance and the way she acts and thinks. Adults especially may assume the child is more capable than she actually is, and parents might grant more freedom than the child’s age would indicate. For girls, the emphasis on physical attractiveness and sexuality is emphasized at puberty and they may lack effective coping strategies to deal with the attention they may receive. 226 Figure 6.4 Source Additionally, mental health problems are more likely to occur when the child is among the first in his or her peer group to develop. Because the preadolescent time is one of not wanting to appear different, early developing children stand out among their peer group and gravitate toward those who are older. For girls, this results in them interacting with older peers who engage in risky behaviors such as substance use and early sexual behavior (Weir, 2016). Boys also see changes in their emotional functioning at puberty. According to Mendle, Harden, Brooks-Gunn, and Graber (2010), while most boys experienced a decrease in depressive symptoms during puberty, boys who began puberty earlier and exhibited a rapid tempo, or a fast rate of change, actually increased in depressive symptoms. The effects of pubertal tempo were stronger than those of pubertal timing, suggesting that rapid pubertal change in boys may be a more important risk factor than the timing of development. In a further study to better analyze the reasons for this change, Mendle et al. (2012) found that both early maturing boys and rapidly maturing boys displayed decrements in the quality of their peer relationships as they moved into early adolescence, whereas boys with more typical timing and tempo development actually experienced improvements in peer relationships. The researchers concluded that the transition in peer relationships may be especially challenging for boys whose pubertal maturation differs significantly from those of others their age. Consequences for boys attaining early puberty were increased odds of cigarette, alcohol, or another drug use (Dudovitz, et al., 2015). Gender Role Intensification: At about the same time that puberty accentuates gender, role differences also accentuate for at least some teenagers. Some girls who excelled at math or science in elementary school, may curb their enthusiasm and displays of success at these subjects for fear of limiting their popularity or attractiveness as girls (Taylor et al/, 1995; Sadker, 2004). Some boys who were not especially interested in sports previously may begin dedicating themselves to athletics to affirm their masculinity in the eyes of others. Some boys and girls who once worked together successfully on class projects may no longer feel comfortable doing so, or alternatively may now seek to be working partners, but for social rather than academic reasons. Such changes do not affect all youngsters equally, nor affect any one youngster equally on all occasions. An individual may act like a young adult on one day, but more like a child the next. Adolescent Brain The brain undergoes dramatic changes during adolescence. Although it does not get larger, it matures by becoming more interconnected and specialized (Giedd, 2015). The myelination and 227 development of connections between neurons continues. This results in an increase in the white matter of the brain and allows the adolescent to make significant improvements in their thinking and processing skills. Different brain areas become myelinated at different times. For example, the brain’s language areas undergo myelination during the first 13 years. Completed insulation of the axons consolidates these language skills but makes it more difficult to learn a second language. With greater myelination, however, comes diminished plasticity as a myelin coating inhibits the growth of new connections (Dobbs, 2012). Even as the connections between neurons are strengthened, synaptic pruning occurs more than during childhood as the brain adapts to changes in the environment. This synaptic pruning causes the gray matter of the brain, or the cortex, to become thinner but more efficient (Dobbs, 2012). The corpus callosum, which connects the two hemispheres, continues to thicken allowing for stronger connections between brain areas. Additionally, the hippocampus becomes more strongly connected to the frontal lobes, allowing for greater integration of memory and experiences into our decision making. The limbic system, which regulates emotion and reward, is linked to the hormonal changes that occur at puberty. The limbic system is also related to novelty seeking and a shift toward interacting with peers. In contrast, the prefrontal cortex which is involved in the control of impulses, organization, planning, and making good decisions, does not fully develop until the mid-20s. According to Giedd (2015) the significant aspect of the later developing prefrontal cortex and early development of the limbic system is the “mismatch” in timing between the two. The approximately ten years that separates the development of these two brain areas can result in risky behavior, poor decision making, and weak emotional control for the adolescent. When puberty begins earlier, this mismatch extends even further. Teens often take more risks than adults and according to research it is because they weigh risks and rewards differently than adults do (Dobbs, 2012). For adolescents the brain’s sensitivity to the neurotransmitter dopamine peaks, and dopamine is involved in reward circuits, so the possible rewards outweighs the risks. Adolescents respond especially strongly to social rewards during activities, and they prefer the company of others their same age. Chein et al. (2011) found that peers sensitize brain regions associated with potential rewards. For example, adolescent drivers make risky driving decisions when with friends to impress them, and teens are much more likely to commit crimes together in comparison to adults (30 and older) who commit them alone (Steinberg et al., 2017). In addition to dopamine, the adolescent brain is affected by oxytocin which facilitates bonding and makes social connections more rewarding. With both dopamine and oxytocin engaged, it is no wonder that adolescents seek peers and excitement in their lives that could end up actually harming them. 228 Because of all the changes that occur in the adolescent brain, the chances for abnormal development can occur, including mental illness. In fact, 50% of the mental illness occurs by the age 14 and 75% occurs by age 24 (Giedd, 2015). Additionally, during this period of development the adolescent brain is especially vulnerable to damage from drug exposure. For example, repeated exposure to marijuana can affect cellular activity in the endocannabinoid system. Consequently, adolescents are more sensitive to the effects of repeated marijuana exposure (Weir, 2015). However, researchers have also focused on the highly adaptive qualities of the adolescent brain which allow the adolescent to move away from the family towards the outside world (Dobbs, 2012; Giedd, 2015). Novelty seeking and risk taking can generate positive outcomes including meeting new people and seeking out new situations. Separating from the family and moving into new relationships and different experiences are actually quite adaptive for society. Adolescent Sleep According to the National Sleep Foundation (NSF) (2016), adolescents need about 8 to 10 hours of sleep each night to function best. The most recent Sleep in America poll in 2006 indicated that adolescents between sixth and twelfth grade were not getting the recommended amount of sleep. On average adolescents only received 7 ½ hours of sleep per night on school nights with younger adolescents getting more than older ones (8.4 hours for sixth graders and only 6.9 hours for those in twelfth grade). For the older adolescents, only about one in ten (9%) get an optimal amount of sleep, and they are more likely to experience negative consequences the following day. These include feeling too tired or sleepy, being cranky or irritable, falling asleep in school, having a depressed mood, and drinking caffeinated beverages (NSF, 2016). Additionally, they are at risk for substance abuse, car crashes, poor academic performance, obesity, and a weakened immune system (Weintraub, 2016). Troxel et al. (2019) found that insufficient sleep in adolescents is a predictor of risky sexual behaviors. Reasons given for this include that those adolescents who stay out late, typically without parental supervision, are more likely to engage in a variety of risky behaviors, including risky sex, such as not using birth control or using substances before/during sex. An alternative explanation for risky sexual behavior is that the lack of sleep negatively affects impulsivity and decision-making processes. Figure 6.7 Source Why do adolescents not get adequate sleep? In addition to known environmental and social factors, including work, homework, media, technology, and socializing, the adolescent brain is also a factor. As adolescent go through puberty, their circadian rhythms change and push back their sleep time until later in the evening (Weintraub, 2016). This biological change not only keeps adolescents awake at night, it makes it difficult for them to wake up. When they are awake too early, their brains do not function optimally. Impairments are noted in attention, academic achievement, and behavior while increases in tardiness and absenteeism are also seen. 229 To support adolescents’ later sleeping schedule, the Centers for Disease Control and Prevention recommended that school not begin any earlier than 8:30 a.m. Unfortunately, over 80% of American schools begin their day earlier than 8:30 a.m. with an average start time of 8:03 a.m. (Weintraub, 2016). Psychologists and other professionals have been advocating for later school times, and they have produced research demonstrating better student outcomes for later start times. More middle and high schools have changed their start times to better reflect the sleep research. However, the logistics of changing start times and bus schedules are proving too difficult for some schools leaving many adolescent vulnerable to the negative consequences of sleep deprivation. Troxel et al. (2019) cautions that adolescents should find a middle ground between sleeping too little during the school week and too much during the weekends. Keeping consistent sleep schedules of too little sleep will result in sleep deprivation but oversleeping on weekends can affect the natural biological sleep cycle making it harder to sleep on weekdays. Adolescent Sexual Activity By about age ten or eleven, most children experience increased sexual attraction to others that affects social life, both in school and out (McClintock & Herdt, 1996). By the end of high school, more than half of boys and girls report having experienced sexual intercourse at least once, though it is hard to be certain of the proportion because of the sensitivity and privacy of the information. (Center for Disease Control, 2004; Rosenbaum, 2006). Adolescent Pregnancy: As can be seen in Figure 6.8, in 2018 females aged 15–19 years experienced a birth rate (live births) of 17.4 per 1,000 women. The birth rate for teenagers has declined by 58% since 2007 and 72% since 1991, the most recent peak (Hamilton, Joyce, Martin, & Osterman, 2019). It appears that adolescents seem to be less sexually active than in previous years, and those who are sexually active seem to be using birth control (CDC, 2016). Figure 6.8 Source Risk Factors for Adolescent Pregnancy: Miller et al. (2001) found that parent/child closeness, parental supervision, and parents' values against teen intercourse (or unprotected intercourse) decreased the risk of adolescent pregnancy. In contrast, residing in disorganized/dangerous neighborhoods, living in a lower SES family, living with a single parent, having older sexually 230 active siblings or pregnant/parenting teenage sisters, early puberty, and being a victim of sexual abuse place adolescents at an increased risk of adolescent pregnancy. Consequences of Adolescent Pregnancy: After the child is born life can be difficult for a teenage mother. Only 40% of teenagers who have children before age 18 graduate from high school. Without a high school degree her job prospects are limited, and economic independence is difficult. Teen mothers are more likely to live in poverty, and more than 75% of all unmarried teen mother receive public assistance within 5 years of the birth of their first child. Approximately, 64% of children born to an unmarried teenage high-school dropout live in poverty. Further, a child born to a teenage mother is 50% more likely to repeat a grade in school and is more likely to perform poorly on standardized tests and drop out before finishing high school (March of Dimes, 2012). Research analyzing the age that men father their first child and how far they complete their education have been summarized by the Pew Research Center (2015) and reflect the research for females. Among dads ages 22 to 44, 70% of those with less than a high school diploma say they fathered their first child before the age of 25. In comparison, less than half (45%) of fathers with some college experience became dads by that age. Additionally, becoming a young father occurs much less for those with a bachelor’s degree or higher as just 14% had their first child prior to age 25. Like men, women with more education are likely to be older when they become mothers. Eating Disorders Figure 6.9 According to the DSM-5-TR (American Psychiatric Association, 2022), eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning. Although eating disorders can occur in children and adults, they frequently appear during the teen years or young adulthood (National Institute of Mental Health (NIMH), 2016). Eating disorders affect both genders, although rates among women are 2½ times greater than among men. Similar to women who have eating disorders, men also have a distorted sense of body image, including muscle dysmorphia, which is an extreme desire to increase one’s muscularity (Bosson et al., 2019). The prevalence of eating disorders in the United States is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians, with the exception that anorexia nervosa is more common among Non-Hispanic Whites (Hudson et al., 2007; Wade et al., 2011). Source Risk Factors for Eating Disorders: Because of the high mortality rate, researchers are looking into the etiology of the disorder and associated risk factors. Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors (NIMH, 2016). Eating disorders appear to run in families, and researchers are working to identify DNA variations that are linked to the increased risk of developing eating 231 disorders. Researchers from King’s College London (2019) found that the genetic basis of anorexia overlaps with both metabolic and body measurement traits. The genetic factors also influence physical activity, which may explain the high activity level of those with anorexia. Further, the genetic basis of anorexia overlaps with other psychiatric disorders. Researchers have also found differences in patterns of brain activity in women with eating disorders in comparison with healthy women. The main criteria for the most common eating disorders: Anorexia nervosa, bulimia nervosa, and binge-eating disorder are described in the DSM-5-TR (American Psychiatric Association, 2022) and listed in Table 6.1. Table 6.1 DSM-5-TR Eating Disorders Anorexia Nervosa  Restriction of energy intake leading to a significantly low body weight  Intense fear of gaining weight  Disturbance in one’s self-evaluation regarding body weight Bulimia Nervosa Binge-Eating Disorder  Recurrent episodes of binge eating  Recurrent inappropriate compensatory behaviors to prevent weight gain, including purging, laxatives, fasting or excessive exercise  Self-evaluation is unduly affected by body shape and weight  Recurrent episodes of binge eating  Marked distress regarding binge eating  The binge eating is not associated with the recurrent use of inappropriate compensatory behavior Health Consequences of Eating Disorders: For those suffering from anorexia, health consequences include an abnormally slow heart rate and low blood pressure, which increases the risk for heart failure. Additionally, there is a reduction in bone density (osteoporosis), muscle loss and weakness, severe dehydration, fainting, fatigue, and overall weakness. Anorexia nervosa has the highest mortality rate of any psychiatric disorder (Arcelus et al., 2011). Individuals with this disorder may die from complications associated with starvation, while others die of suicide. In women, suicide is much more common in those with anorexia than with most other mental disorders. The binge and purging cycle of bulimia can affect the digestives system and lead to electrolyte and chemical imbalances that can affect the heart and other major organs. Frequent vomiting can cause inflammation and possible rupture of the esophagus, as well as tooth decay and staining from stomach acids. Lastly, binge eating disorder results in similar health risks to obesity, including high blood pressure, high cholesterol levels, heart disease, Type II diabetes, and gall bladder disease (National Eating Disorders Association, 2016). 232 Figure 6.10 Source Eating Disorders Treatment: To treat eating disorders, adequate nutrition and stopping inappropriate behaviors, such as purging, are the foundations of treatment. Treatment plans are tailored to individual needs and include medical care, nutritional counseling, medications (such as antidepressants), and individual, group, and/or family psychotherapy (NIMH, 2016). For example, the Maudsley Approach has parents of adolescents with anorexia nervosa be actively involved in their child’s treatment, such as assuming responsibility for feeding the child. To eliminate binge eating and purging behaviors, cognitive behavioral therapy (CBT) assists sufferers by identifying distorted thinking patterns and changing inaccurate beliefs
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CNS Stimulants ADHD Medications Amphetamine (Adderall, Dexedrine) Mechanism of Action: Stimulates excitatory neurons, increases dopamine & norepinephrine. Indications: ADHD, narcolepsy. Adverse Effects: Increased HR/BP, anxiety, tremor, insomnia, headache, decreased appetite, GI distress, dry mouth. Contraindications: Cardiac abnormalities, hypertension, anxiety, agitation, glaucoma, MAOI use (within 14 days). Nursing Implications: Administer 4-6 hours before bedtime. Take on an empty stomach. Monitor BP, pulse, weight, growth patterns in children. Avoid abrupt withdrawal. Methylphenidate (Ritalin, Concerta) Mechanism of Action: CNS stimulant affecting dopamine reuptake. Indications: ADHD, narcolepsy. Adverse Effects: Same as amphetamines. Nursing Implications: Same as amphetamines. Lisdexamfetamine (Vyvanse) Mechanism of Action: Converted into dextroamphetamine. Indications: ADHD, binge-eating disorder. Nursing Implications: Similar to amphetamines. Atomoxetine (Strattera) Mechanism of Action: Selective norepinephrine reuptake inhibitor. Indications: ADHD (children >6 and adults). Adverse Effects: Lower abuse potential, less insomnia, but Black Box Warning for suicidal thoughts. Nursing Implications: Monitor mental health for suicidal ideation. Narcolepsy Medications Modafinil (Provigil) Mechanism of Action: Low abuse potential stimulant. Indications: Narcolepsy, shift work sleep disorder. Nursing Implications: Monitor BP & mental health. Antimigraine Medications Rizatriptan (Maxalt), Sumatriptan (Imitrex) Mechanism of Action: Serotonin receptor agonist, causing vasoconstriction. Indications: Acute migraine treatment. Adverse Effects: Tingling, flushing, chest tightness, rebound headaches if overused. Contraindications: Cardiovascular disease, hypertension, glaucoma. Nursing Implications: Administer at first sign of migraine. Avoid triggers. Monitor cardiac history. Endocrine Medications Pituitary Medications Somatropin (Humotrope) Mechanism of Action: Growth hormone replacement. Indications: Growth failure (hypopituitarism, HIV wasting). Adverse Effects: Hyperglycemia, hypothyroidism, injection site reactions. Nursing Implications: Monitor growth, motor skills, thyroid, and glucose levels. Rotate injection sites. Octreotide (Sandostatin) Mechanism of Action: GH antagonist. Indications: Acromegaly, GH-producing tumors. Adverse Effects: GI distress, glucose changes, cardiac conduction issues. Nursing Implications: Monitor glucose, EKG, growth. ADH Medications Vasopressin (Pitressin) & Desmopressin (DDAVP) Mechanism of Action: Mimics ADH. Indications: Vasopressin: Hypotension, hemorrhage. Desmopressin: Diabetes insipidus, bedwetting. Adverse Effects: Increased BP, headache, GI distress. Nursing Implications: Monitor VS, urine output, cardiac status. Thyroid Medications Levothyroxine (Synthroid) Mechanism of Action: Synthetic T4. Indications: Hypothyroidism. Adverse Effects: Hyperthyroid symptoms. Nursing Implications: Administer before breakfast on an empty stomach. Monitor thyroid labs (TSH, T3, T4). Avoid iodine-rich foods, iron/calcium supplements. Propylthiouracil (PTU) Mechanism of Action: Inhibits thyroid hormone production. Indications: Hyperthyroidism, thyroid storm. Adverse Effects: GI distress, bone marrow suppression. Nursing Implications: Monitor thyroid levels & CBC. Avoid iodine-rich foods. Radioactive Iodine (I-131) Mechanism of Action: Destroys thyroid tissue. Indications: Hyperthyroidism, thyroid cancer. Adverse Effects: Radiation sickness, Pregnancy Category X. Nursing Implications: Radiation precautions: Avoid close contact, use separate utensils, increase fluids. Adrenal Medications Glucocorticoids Hydrocortisone (Solu-Cortef), Prednisone (Deltasone), Dexamethasone (Decadron), Methylprednisolone (Solu-Medrol) Mechanism of Action: Anti-inflammatory, immunosuppressant. Indications: Adrenal insufficiency, inflammatory/autoimmune diseases. Adverse Effects: Metabolic: Hyperglycemia, weight gain, Cushing’s syndrome. Musculoskeletal: Osteoporosis, muscle wasting. CV: Hypertension, edema. Neuro: Mood swings, insomnia. Nursing Implications: Administer in the morning with food. Taper off slowly to prevent adrenal crisis. Monitor glucose levels with long-term use. Avoid sick contacts due to immune suppression. Mineralocorticoids Fludrocortisone (Florinef) Mechanism of Action: Mimics aldosterone (Na & water retention). Indications: Addison’s disease, adrenal insufficiency. Adverse Effects: Hypertension, hypokalemia, edema. Nursing Implications: Monitor BP, electrolytes (Na, K). Immunosuppressants Cyclosporine (Sandimmune), Tacrolimus (Prograf) Mechanism of Action: Suppresses immune response. Indications: Organ transplant, autoimmune diseases. Adverse Effects: Increased risk for infections, nephrotoxicity, diabetes. Nursing Implications: Strict dosing schedule (same time every day). Avoid grapefruit juice & styrofoam cups. No live vaccines (MMR, Varicella, Smallpox). Report any signs of infection immediately. Lifespan Considerations Pediatrics: Monitor growth in children using ADHD meds & growth hormones. Pregnancy: Avoid radioactive iodine (I-131) & immunosuppressants. Elderly: Caution with stimulants & corticosteroids (risk of cardiac issues, osteoporosis). Patient Teaching CNS Stimulants: Avoid abrupt withdrawal. Monitor growth (children). Thyroid Meds: Take levothyroxine on an empty stomach. Avoid iodine-rich foods if on PTU. Corticosteroids: Taper off gradually. Monitor glucose, avoid infections. Immunosuppressants: No live vaccines. Strict dosing schedule. Insulins Rapid-acting Insulins (Insulin lispro - Humalog, Insulin aspart - Novolog) Mechanism of Action: Fast-acting insulin that mimics natural insulin secretion in response to meals. Indications: Type 1 or Type 2 Diabetes. Adverse Effects: Hypoglycemia, weight gain, lipodystrophy at injection sites. Nursing Implications: Must eat a meal after injection. Administer subcutaneously (SQ) or via infusion pump. Clear, colorless solution. Short-acting Insulin (Regular insulin - Humulin R) Mechanism of Action: Provides short-term glucose control. Indications: Type 1 & Type 2 Diabetes. Adverse Effects: Hypoglycemia, weight gain. Nursing Implications: Onset: 30-60 min, Peak: 2.5 hr, Duration: 6-10 hr. Can be administered IV, IM, or SQ. Clear, colorless solution. Intermediate-acting Insulin (NPH - Isophane insulin suspension) Mechanism of Action: Delayed onset but prolonged glucose control. Indications: Often combined with regular insulin for Type 1 & Type 2 Diabetes. Adverse Effects: Hypoglycemia, weight gain. Nursing Implications: Onset: 1-2 hr, Peak: 4-8 hr, Duration: 10-18 hr. Cloudy suspension, administered SQ. Usually given twice daily before meals. Long-acting Insulins (Insulin glargine - Lantus, Insulin detemir - Levemir) Mechanism of Action: Provides basal insulin coverage with no peak effect. Indications: Type 1 & Type 2 Diabetes. Adverse Effects: Hypoglycemia (less risk), weight gain. Nursing Implications: Onset: 1-2 hr, No peak, Duration: 24 hr. DO NOT mix with other insulins. Clear, colorless solution. Oral Antidiabetics Biguanides (Metformin - Glucophage) Mechanism of Action: Decreases hepatic glucose production & increases insulin sensitivity. Indications: First-line treatment for Type 2 Diabetes. Adverse Effects: GI discomfort, diarrhea, metallic taste, reduced B12 levels. Black Box Warning: Risk of lactic acidosis (especially in renal failure). Nursing Implications: Administer 30 min before meals. Hold if contrast dye is used (renal failure risk). Sulfonylureas (Glipizide - Glucotrol) Mechanism of Action: Stimulates pancreatic insulin release. Indications: Type 2 Diabetes (early stages). Adverse Effects: Hypoglycemia, weight gain, nausea. Contraindications: Sulfa allergy. Nursing Implications: Give 30 min before meals. Monitor for hypoglycemia. Glinides (Repaglinide - Prandin) Mechanism of Action: Increases insulin secretion from beta cells. Indications: Type 2 Diabetes (postprandial glucose control). Adverse Effects: Hypoglycemia, weight gain. Black Box Warning: May exacerbate heart failure. Nursing Implications: Take with each meal, skip if meal is skipped. Glitazones (Pioglitazone - Actos) Mechanism of Action: Improves insulin sensitivity. Indications: Type 2 Diabetes (often combined with metformin or sulfonylureas). Adverse Effects: Fluid retention, weight gain, fractures. Black Box Warning: May exacerbate heart failure. Nursing Implications: Weigh daily. Monitor for heart failure signs. Alpha-glucosidase Inhibitors (Acarbose - Precose) Mechanism of Action: Delays carbohydrate absorption. Indications: Type 2 Diabetes (postprandial glucose control). Adverse Effects: GI issues (flatulence, diarrhea). Contraindications: GI disorders (IBD, malabsorption). Nursing Implications: Take with first bite of meal. DPP-4 Inhibitors (Gliptins) (Sitagliptin - Januvia) Mechanism of Action: Enhances incretin hormone function. Indications: Adjunct to diet/exercise in Type 2 Diabetes. Adverse Effects: URI, headache, diarrhea. Nursing Implications: Take once daily, with or without food. SGLT-2 Inhibitors (Canagliflozin - Invokana) Mechanism of Action: Inhibits glucose reabsorption in kidneys. Indications: Type 2 Diabetes (weight loss benefit). Adverse Effects: UTIs, yeast infections, dehydration, ketoacidosis. Nursing Implications: Take once daily before breakfast. Injectable Non-Insulin Medications Amylin Agonists (Pramlintide - Symlin) Mechanism of Action: Slows gastric emptying, suppresses glucagon. Indications: Type 1 & Type 2 Diabetes. Adverse Effects: Nausea, vomiting, anorexia. Contraindications: Gastroparesis. Nursing Implications: Inject before meals. Take at least 1 hr before oral meds. Incretin Mimetics (Exenatide - Byetta) Mechanism of Action: Enhances insulin secretion. Indications: Type 2 Diabetes (used when oral meds fail). Adverse Effects: GI symptoms, weight loss, thyroid tumors (Black Box Warning). Nursing Implications: Administer SQ 1 hr before meals. Glucose-Elevating Agents Glucagon Indications: Severe hypoglycemia. Adverse Effects: Vomiting (turn patient on side). Nursing Implications: Used when patient cannot take oral glucose. Dextrose 50% in Water (D50W) Indications: Emergency treatment of hypoglycemia. Nursing Implications: Administer IV. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Salicylates (Aspirin - ASA) Mechanism of Action: COX-1 & COX-2 inhibitor, antiplatelet. Indications: Pain, fever, inflammation, CV prevention. Adverse Effects: GI bleeding, Reye’s syndrome in children. Nursing Implications: Do not give to children with viral infections. Acetic Acid Derivative (Ketorolac - Toradol) Indications: Short-term pain management (up to 5 days). Adverse Effects: Renal impairment, GI distress. COX-2 Inhibitor (Celecoxib - Celebrex) Indications: Osteoarthritis, rheumatoid arthritis. Adverse Effects: CV risk (Black Box Warning). Contraindications: Sulfa allergy. Propionic Acid Derivatives (Ibuprofen, Naproxen) Indications: Pain, inflammation, fever. Adverse Effects: GI distress, bleeding risk. Antigout Medications Allopurinol (Zyloprim) Mechanism of Action: Reduces uric acid production. Indications: Chronic gout prevention. Adverse Effects: Stevens-Johnson syndrome. Nursing Implications: Take with food. Colchicine (Colcrys) Mechanism of Action: Reduces inflammatory response. Indications: Acute gout attack. Adverse Effects: GI distress, bleeding risk. Nursing Implications: Hydration (3L/day). Immunizations Active Immunizing Drugs Mechanism of Action: Stimulate the immune system to produce antibodies against specific pathogens, offering long-term immunity. Indications: Prevention of infectious diseases. Adverse Effects: Common: Soreness, fever, mild rash. Severe: Fever >103°F, encephalitis, convulsions, anaphylaxis. Contraindications: Immunocompromised patients, pregnancy (some vaccines), active infections. Nursing Implications: Assess medical history, immune status, and pregnancy. Administer vaccines at appropriate sites: Infants: Mid-lateral thigh. Older children/adults: Deltoid muscle. Use warm compresses, Tylenol for mild reactions. Report severe reactions to VAERS (Vaccine Adverse Event Reporting System). Examples of Active Immunizations: Diphtheria, tetanus toxoids, acellular pertussis (DTaP, Td): Prevents diphtheria, tetanus, and pertussis. Haemophilus influenzae type B (Hib): Prevents bacterial infections, especially in children. Hepatitis B vaccine: Prevents Hep B infection. Influenza vaccine: Annual vaccine for flu prevention. Measles, mumps, rubella (MMR): Prevents viral infections. Pneumococcal vaccine: Protects against pneumococcal infections (pneumonia, meningitis). Poliovirus vaccine (IPV): Prevents poliomyelitis. Rabies vaccine: Given for rabies exposure or pre-exposure prophylaxis. Human papillomavirus (HPV - Gardasil): Prevents HPV-related cancers. Herpes zoster (Zostavax, Shingrix): Protects against shingles. Varicella vaccine: Prevents chickenpox. Passive Immunizing Drugs Mechanism of Action: Provides preformed antibodies for immediate protection; temporary immunity. Indications: Post-exposure prophylaxis in high-risk patients. Examples: Hepatitis B immunoglobulin: Post-exposure protection for Hepatitis B. Immunoglobulin: General immune support. Rabies immunoglobulin: Post-exposure prophylaxis after animal bites. Tetanus immunoglobulin: Used in unvaccinated individuals exposed to tetanus. Dermatologic Medications Antibacterials Bacitracin Mechanism of Action: Inhibits bacterial cell wall synthesis. Indications: Minor skin infections. Adverse Effects: Burning, itching. Neomycin & Polymyxin B (Neosporin) Mechanism of Action: Broad-spectrum antibacterial. Indications: Minor wounds. Adverse Effects: Local irritation. Mupirocin (Bactroban) Indications: Topical: Treats impetigo (Staphylococcus, Streptococcus infections). Intranasal: Used for MRSA colonization. Adverse Effects: Burning, itching. Silver Sulfadiazine (Silvadene) Mechanism of Action: Acts on bacterial cell wall. Indications: Burn treatment (prevention of infection). Adverse Effects: Pain, burning, contraindicated in sulfa allergy. Antiacne Medications Benzoyl Peroxide Mechanism of Action: Releases oxygen, killing acne bacteria. Indications: Mild to moderate acne. Adverse Effects: Red, peeling skin, warmth. Tretinoin (Retin-A) Mechanism of Action: Vitamin A derivative, stimulates cell turnover. Indications: Acne, UV damage. Adverse Effects: Skin peeling, severe sunburn risk (use sunscreen). Isotretinoin (Accutane) Mechanism of Action: Sebaceous gland suppression. Indications: Severe cystic acne. Adverse Effects: Teratogenic (Pregnancy Category X), liver toxicity, mood changes. Black Box Warning: IPLEDGE Program (2 contraceptive methods required). Antifungals Clotrimazole (Lotrimin) Mechanism of Action: Inhibits fungal growth. Indications: Athlete’s foot, ringworm, yeast infections. Adverse Effects: Local irritation. Miconazole (Monistat) Mechanism of Action: Antifungal, some Gram-positive action. Indications: Yeast infections, jock itch, athlete’s foot. Adverse Effects: Burning, itching, pelvic cramps. Antivirals Acyclovir (Zovirax) Mechanism of Action: Inhibits viral DNA replication. Indications: Herpes simplex (HSV-1 & HSV-2), shingles. Adverse Effects: Stinging, rash. Miscellaneous Dermatologics Permethrin (Elimite) Mechanism of Action: Neurotoxic to lice/scabies. Indications: Head lice, scabies. Adverse Effects: Itching, burning. Ophthalmic Medications Cholinergic Drugs (Miotics) Acetylcholine (Miochol-E) Indications: Induces miosis (pupil constriction) during surgery. Adverse Effects: Eye discomfort, blurred vision. Pilocarpine (Pilocar) Mechanism of Action: Stimulates cholinergic receptors, reduces intraocular pressure. Indications: Glaucoma, ocular surgery. Adverse Effects: Blurred vision, tearing, reduced night vision. Beta-Adrenergic Blockers Timolol (Timoptic) Mechanism of Action: Reduces aqueous humor production & increases outflow. Indications: Glaucoma, ocular hypertension. Adverse Effects: Eye irritation, systemic effects possible (bradycardia, hypotension). Otic Medications Ofloxacin (Floxin Otic) Mechanism of Action: Fluoroquinolone antibiotic (bacterial DNA disruption). Indications: Otitis externa & media. Adverse Effects: Mild itching/pain. Carbamide Peroxide (Debrox) Mechanism of Action: Softens & breaks down earwax. Indications: Earwax removal. Adverse Effects: Ear irritation. Nursing Considerations Lifespan Considerations Pediatrics: Infants: Thigh for vaccines, avoid aspirin (Reye’s syndrome risk). Monitor growth with long-term corticosteroids. Pregnancy: Avoid live vaccines (MMR, varicella, HPV, Zoster). Avoid isotretinoin (teratogenic). Elderly: Caution with ophthalmic beta-blockers (can cause systemic effects). Monitor renal function with fluoroquinolones (ototoxicity risk). Patient Teaching Vaccines: Keep records, report reactions. Use Tylenol, not aspirin for fever. Dermatologics: Apply with gloves, wash hands before & after. Sunscreen required with tretinoin & isotretinoin. Ophthalmic/Otic: Apply pressure to inner canthus after eye drops (reduce systemic absorption). Hold ear up & back (adults), down & back (children) for otic drops
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Binge Eating
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