Development: a dynamic process that begins with conception und ends with death. Developmental psychology deals with the changes that occur during the course of a human life. In this article, we are going to illuminate developmental processes, primary/secondary socialization and present the psychosexual theories of Freud and Erikson. With this, you will be optimally prepared for tricky questions about developmental psychology in your medical exams.
Child with mother

Image: “children's view of the world” by Petr Dosek. License: CC BY 2.0

Important Terms in Developmental Psychology

  • Development: Changes in the organism. Ontogenesis describes the development of an individual from a germ to a fully grown human being. Phylogenesis refers to the evolution of an entire group, such as a species.
  • Socialization: Our socialization develops and changes permanently under the influence of social experiences. Learning processes, norms, moral concepts of a particular culture – they all leave a lasting imprint on us and make us grow into a mature personality that is capable of social interaction.
  • Primary socialization: At the age of 0–3, primary socialization takes place inside the family.
  • Secondary socialization: At the age of 3, secondary socialization begins via the institutions of friends, school, job, etc.
  • Maturation and learning: The developmental process is influenced by genetic, social and mental factors. The genetic factors are responsible for the process of maturation. Some processes of maturation occur spontaneously, on one hand, or in the context of learning processes, on the other.
Learning = Stimulation from the environment and training
  • Maturing and learning: When behavioral changes occur across different cultures at a certain moment in the lifespan, this is called maturation. Learned behavior is more variable with respect to point in time and requirements. Deprivation experiments also show that newborns undergo certain behavioral changes even without specific environmental stimuli.
  • Critical/sensitive period: In these maturational stages, the organism is especially sensitive for learning certain ways of behavior. If stimuli that are essential for this behavior do not occur in this time frame, the learning process is only partly possible and usually very difficult (for example, language acquisition, formation of emotional relationships).

Intrauterine Development

Note: Pregnancy (mother) = time of gestation (child) = 40 weeks.


development fetus

Pregnancy can be divided in more or less three stages. In the 1st stage (month: 0-3, terminology: embryo), the organs develop; in the 2nd stage (month: 3-6, terminology: from the 4th month, fetus), the organs undergo a functional differentiation; and in the 3rd stage (month: 6-9), mainly physical growth occurs. Intense mental stress in regard to family and/or job can lead to miscarriages. Premature births often happen to unmarried and divorced women and to women from lower social classes.

Prenatal Development

The following chart gives you an overview about the cornerstones of prenatal developmental steps:

Week 4
Movements of the embryo can be seen on a sonograph
Week 8
Development of movement patterns
Week 6-20
Fetal movements

Maturation and Learning

Sensory functions

  • Vision: Newborns are shortsighted and spend a lot of time looking around and fixating objects. Visual behavior of an adult is not reached until 2 years of age!
  • Hearing: Newborns can easily distinguish sounds. Different aspects of the human language can be identified.
  • Tasting: Newborns can distinguish sweet, sour, salty and bitter and particularly prefer sweet things.
  • Smelling: Newborns recognize the scent and smell of the breast milk of their own mother.

Motor functions

‘Practice makes perfect’ is a well-known phrase; however, it does not apply to motoric development! The process of motoric maturation follows its own internal rules. Exercise can only help to achieve safety and agility. Two trends can be distinguished in motoric development:

  • Cephalocaudal trend: Muscle control develops from the head to caudal.
  • Proximodistal trend: Muscles of the torso can be controlled earlier than proximal ones.

Stranger anxiety

Stranger anxiety begins at about 8 months old and is attributed to the child’s developing ability to distinguish between familiar and unfamiliar persons. The child’s inner question is: “Who is trustworthy and ensures my mental and physical well-being?” Stranger anxiety decreases continually from the third year of life.

Separation anxiety

Between 6 and 9 months of age, the child dares to go on first “discovery tours”. Separation anxiety can be considered as limit to this instinct. Between 2–3 years of age, separation anxiety peaks, afterwards continually decreasing.

Potty training

Conscious urination and defecation begins at the age of 2 years with the help of parents and instructive assistance.

Emotions and Bonding

Note: Mother-child relationship = bonding

The process of bonding develops and is aided by a lot of body contact, breast feeding and permanence of persons. Ainsworth designed the Strange Situation Procedure and observed 3 fundamental attachment styles.

Strange Situation Procedure by Ainsworth

1) anxious-avoidant Mother shows little care Child shows little emotion after the mother returns, seeks little closeness
2) secure Sense of the mother: reliable, open, friendly, sensitive, caring Child shows distress when the mother is absent, seeks closeness and contact after her return
3) anxious-ambivalent Ambivalent behavior of the mother Child is obviously distressed, sometimes angry during the mother’s absence, ambivalent behavior after her return

Cognitive Development

Piaget’s theory of cognitive development

The Swiss developmental psychologist Jean Piaget paved the way for most of what is known today about the development of cognition, thinking, imagination and problem solving. Piaget was of the opinion that especially active interaction is important for the child’s development. In his theory, children act in accordance with organic schemata of knowledge and behavior. But the constant new input from the environment require adaption. Two processes of adaption can be classified:

  • Assimilation: Already existing schemata are used to encompass new experiences and information.
  • Accommodation: New experiences and information alter the existing schemata.

These two mechanisms are supposed to maintain balance (equilibration).

Overview of the stages of cognitive development by Piaget

Age of life Stage Typical attributes
Birth – 2 years Sensorimotor Fundamental forms of perceiving the environment are being developed; coordination of functions (e.g., vision and grasping);
object permanence (objects still exist even if they can no longer be seen)
2 – 6/7 years Preoperational Naïve realism: development of imagination/comprehension of symbols/use of symbols (e.g., language acquisition)
2 – 4 years Preconceptual-symbolic Animism, generalization of concepts
4 – 7 years Eidetic thinking Development of bigger-smaller relations and place-time dimensions
12 – 15 years Formal operational Transition to conceptual thinking, ability of thought experiments (theory forming and testing)

References: M. Schön (2007): GK1 Medizinische Psychologie und Soziologie, p. 55, chart 1.10. Springer press.

Language and thinking

Month Parameters of the language stage
1 “cooing” sounds, many vowels
3 “singing sounds”, imitation of the parents
6 First words are comprehended conceptually, crying ↓, “chattering” ↑
7-8 Direct sound imitation
8-10 Sound chains (pa-pa, ma-ma, la-la)
9 Following conversations of others, social gestures can be understood and performed
12 Persons and objects of daily life can be recognized
12-18 Earliest speaking of first words

Language is absolutely necessary to achieve social cognitions.

Ego consciousness, for example, is expressed verbally at the end of the 2nd year of life in the“defiant phase”: “Me! I want!” This phase is an important step in developing the ability to understand other perspectives and develop empathy.

Moral development (Kohlberg, 1958)

Moral: System of belief and value systems that we use to decide about right and wrong behavior. The American psychologist Lawrence Kohlberg created a stage model about moral development with each stage subdivided into two substages. It represents an extension of Piaget’s model of cognitive development.

Preconventional (2-10 years)
Stage 1: 2 – 6 years: Obedience and punishment orientation Stage 2: 6 – 10 years: Instrumental relativistic exchange, recognizing individual interests
Conventional (10-12 years)
Stage 3: 10 – 12 years: Good personal relations, approval orientation Stage 4: 12 – 20 years: Authority and social order orientation
Postconventional (> 20 years)
Stage 5: 20 – 30 years: Orientation with socially acceptable principles Stage 6: > 30 years: Orientation with universal ethic principles

Educational Styles: The Cycle of Parents and Children

Education is always a reciprocal (bilateral) process. This means that parents as well as the child are always involved. 4 fundamental educational styles can be distinguished:

  • Authoritative: Precise rules and demands, open communication, warm behavior, regarding of mutual interests
  • Authoritarian: Rejection, control, brittle behavior, demanding obedience, and possibly punishment
  • Permissive: little to no limits and rules, high forbearance, interests of the child are heavily respected
  • Neglecting: Showing little interest in the child, little control, distance, rejection
Note: The authoritative educational style seems to be the most appropriate one for the child’s development.

Social determinants like changes in familiy structures (single parenting, patchwork families,…) and the media significantly influence the child’s development und socialization. Children often do not accept their parents as models anymore and rather choose characters from cinema and TV. Beside psychological impacts, “babysitter TV” is a cause of physical inactivity and secondary diseases.

Psychodynamic Developmental Models: Freud and Erikson

Phases of psychosexual development (Freud)

Sigmund Freud’s approach assumes that a person’s personality is formed by experiences. He especially emphasized the importance of early childhood psychosexual development. Every human makes experiences in the different stages, thereby forming his character by satisfying certain drives. If this satisfaction of drives cannot be achieved, conflicts emerge and thereby a fixation on this particular stage.

Critique: Freud’s theory lacks any empirical base; neither is the theory falsifiable.

Stage/Age Attributes Attitude/character due to fixation Associated disorder
Oral stage< 2 years Most important instinct is food intake Demanding, immature, sarcasm, tendency for dependence/addiction, optimism, generosity Early stage: Schizoid personality disorder; Late stage: Depression
Anal stage 2 – 3 years Satisfaction by release/retaining of feces, control over parents Compulsive, thrifty, meticulous, correct, controlling, stubborn, ambivalent towards superiors Anankastic personality disorder
Phallic stage 3 – 5 years = oedipal stage Child desires the opposite-sex parent; Boys: Oedipus complex and fear of castration
Girls: Electra complex and penis envy
>> solving the conflict by identification with the same sex parent
Rivalry/competition coercion, demonstration of potency (status symbols), high-mindedness, carefreeness Hysterical personality disorder
Latency stage 6 – 12 years Drive energy is channeled into cultural contents, the own intellectual skills are central  —-  —-
Genital stage > 12 years “rediscovery of the genitals”, search for a partner outside the family = mature form of the personality  —-

References: M. Schön (2007): GK1 Medizinische Psychologie und Soziologie, p. 38, chart 2.6. Springer press.

Stage model of psychosocial development by Erikson

The stage model by Erikson indeed builds on Freud’s theory in large part, but rates the human development as a life-long process. Erikson classified 8 stages in this process.

  • Trust vs. mistrust: 1st year of age. The child learns to show trust or distrust to its environment.
  • Autonomy vs. shame/doubt: 2 – 3 years. Curiosity and autonomous exploring drive. If this is suppressed, shame/doubt can occur.
  • Initiative vs. guilt: 4 – 5 years. Education and environmental conditions cause initiative or  guilt.
  • Industry vs. inferiority: 6–11 years. School, peer groups influence the individual.
  • Identity vs. role diffusion: 12 – 18 years. Development of own identity or negative world views with role diffusion (perhaps criminal career, dependence,…)
  • Intimacy vs. isolation: Young adulthood. Emotional, sexual bonds and social relationships are central, otherwise loneliness and isolation.
  • Generativity vs. stagnation: Middle adulthood. Family and job are central, or stagnation impends.
  • Ego integrity vs. despair: Maturity. Positive retrospect on the lived life (contentment) or resignation/discontent/despair about goals not being achieved.

Development in Early and Middle Adulthood

Young adults often have to orient themselves in different roles simultaneously: partnership, family, and job. Role conflicts bring along psychosocial stress. Two established models are the job demands-resources model and the gratification model.

Women have to battle climacteric between the 40th and 50th year of age before the menopause begins. Main complaints are: hot flashes, vertigo, sweating attacks, weight gain, and tiredness.

In contrast to that, men are more often affected by midlife crisis than women: Life is interpreted as a chain of disappointments and wrong decisions and common consequences are divorces and adulteries. Suicide threats should be taken very seriously. Life crises like divorce, the partner’s death or job loss are common reasons for suicidal thoughts.

Development in Old Age

There are two controversial theories with respect to psychosocial development in old age:

  • Disengagement theory: Old people retreat socially and orient inwards.
  • Theory of activity: Old people want to be socially active.

The social situation of old people is increasingly characterized by social isolation and loss of the partner, decrease of participation due to disability and uprooting due to referral to retirement homes. Because of constant cuts of pensions, high costs for medical treatments and devices, many people also suffer from pauperism in old age.

Popular Exam Questions on Developmental Psychology

Solutions can be found below the references.

1. Match the relevant constellation to the age group 6 – 10 years according to the model of psychosocial development by Erikson!

  1. Trust vs. mistrust
  2. Autonomy vs. shame and doubts
  3. Initiative vs. guilt
  4. Industry vs. inferiority
  5. Identity vs. diffusion of identity

2. In psychoanalysis, different character types can be described. One of these is characterized by rival and competitive behavior, wanting and demonstrating status symbols, high-mindedness and carefreeness. To which developmental stage does this character type belong?

  1. Oral stage
  2. Anal stage
  3. Phallic stage
  4. Latency stage
  5. Genital stage

3. Parents set clear rules in their education, a warm, understanding tone defines the reciprocal relationship between parents and children. The parents try to consider both their interests and the child’s ones equally. Which educational style is described?

  1. Anti-authoritarian
  2. Liberal
  3. Authoritative
  4. Authoritarian
  5. Permissive
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