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Fundamentals · chapter 40 · Young and Middle-Aged Adults

Theories Related to Growth and Development

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. Development is lifelong

    The theories form a framework for understanding the range of social and physical developments across the life span. Development does not stop at a certain age; it is a continuous lifelong process.

  2. Individual development differences

    There are many individual and group differences in patterns of development, with the influences of gender, cohort/generation, race, ethnicity, culture, socioeconomic status, education level, and time in history all influencing these patterns.

  3. Nursing developmental perspective

    Life span developmental theories give nurses a comprehensive perspective of individual developmental journeys. Nurses with a strong understanding of the psychosocial theories of aging have a unique ability to individualize care for patients in various clinical settings.

  4. Erikson’s sense of self

    He described the idea that an individual’s sense of self is affected by how they interact with others. Erikson believed that humans are motivated by a need to achieve competence during the eight stages of development.

  5. Erikson’s developmental tasks

    Competence at any stage is achieved by resolving a specific developmental task or conflict, which leads to a healthy personality. Conversely, failure to master the developmental tasks in each stage may produce an internal sense of inadequacy.

  6. Early adulthood task

    People in early adulthood are concerned with intimacy versus isolation. After developing a sense of self in adolescence, individuals are ready to share their lives with others.

  7. Middle adulthood task

    During middle adulthood, the social task is generativity versus stagnation. Generativity involves finding one’s life’s work and contributing to the development of others through productive activities.

  8. Erikson in nursing care

    For nurses, understanding the highly variable aspects of human development allows them to create individualized care plans regardless of the age or stage of the individual.

  9. Levinson’s developmental transitions

    However, unlike Erikson’s psychological theory, Levinson believed that life structure changes occurred due to changes in an individual’s physiology, psychology, and societal roles (Agronin, 2014). He believed that transitions between these five stages include significant disturbance, which leads individuals to modify, build, or change their internal character or external life structure over several years.

  10. Levinson in nursing care

    For nurses, Levinson’s theory gives insight into the many struggles experienced by young and middle-aged adults. Nurses can express compassion for individuals struggling in these stages by acknowledging the universality of change during this developmental period.

  11. Vaillant’s health focus

    Vaillant’s theory of adult development is based on educational and physical health measures, proposing that higher education levels directly affect self-care and health monitoring over the adult life stage.

  12. Vaillant in nursing care

    In caring for young and middle-aged adults, nurses should remember the importance of developing a sense of contentment and competence during these life stages.

  13. Neugarten’s societal expectations

    Neugarten’s theory emphasizes how individuals’ adherence to, or deviation from, these societal expectations can shape their developmental trajectory and psychological well-being. She suggested that individuals may experience stress or satisfaction depending on how closely their personal life timelines align with societal norms (Ferraro, 2014).

  14. Kegan’s cognitive development

    Kegan’s constructive developmental theory explains that individuals change their thought processes over time as their cognitive development progresses. The tiered structure of the CDT theory implies that individuals progress through various levels of cognitive development, with each stage representing a greater understanding of oneself and others.

Terms to know

developmental theories
These developmental theories explain the progression of human needs, physical abilities, and psychosocial dynamics throughout an individual’s life span.
Generativity
Generativity involves finding one’s life’s work and contributing to the development of others through productive activities.
Life structure
Life structure is how individuals interact with their social and cultural environment as well as how they see themselves within this structure throughout their lives.
Career consolidation
Career consolidation involves the task of finding contentment and satisfaction in career aspirations.
social clock
Neugarten’s theory of adult development defines the “social clock” theory as a culturally determined timeline prescribing when individuals should achieve certain milestones and life events, such as marriage, parenthood, career advancement, and retirement.
constructive developmental theory
Kegan’s constructive developmental theory explains that individuals change their thought processes over time as their cognitive development progresses.
subject–object shift
He also described a subject–object shift in which individuals move from simply understanding their character traits and interactions with the world (subject) to acquiring the ability to reflect on their traits and interactions and engage with themselves and others (object).

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

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Every question here, with the answer

  1. A young adult who recently moved away from the family home tells the nurse, “I feel lonely and I’m not sure how to build close relationships.” Which nursing intervention best supports this developmental need?

    1. Explain that developmental tasks end after adolescence and should no longer affect care.
    2. Focus the plan of care only on retirement and late-adult transition issues.
    3. Encourage the patient to connect with an in-person social support group related to personal interests.
    4. Advise the patient to avoid close relationships until all career goals are completed.

    Answer: Encourage the patient to connect with an in-person social support group related to personal interests.

    Early adulthood is associated with intimacy versus isolation, so helping the patient build supportive relationships is appropriate. The other options ignore the young adult’s current developmental task or contradict the section’s emphasis that development is lifelong and individualized.

  2. A middle-aged adult says, “I do not feel productive anymore, and I have very little connection with other people.” Which response by the nurse best reflects Erikson’s theory?

    1. Encourage the patient to withdraw from new responsibilities until the feeling passes.
    2. Teach that the main developmental task in middle adulthood is identity versus role confusion.
    3. Explain that only raising children can meet this developmental need.
    4. Explore opportunities such as mentoring, volunteering, or other productive activities that contribute to others.

    Answer: Explore opportunities such as mentoring, volunteering, or other productive activities that contribute to others.

    In Erikson’s theory, middle adulthood centers on generativity versus stagnation, and generativity includes contributing to others through productive activities. Withdrawal, focusing on an adolescent task, or limiting generativity to raising children does not match the section.

  3. A 43-year-old patient reports reassessing career goals, experiencing relationship strain, and feeling an intense desire for change. Which nursing actions are appropriate when applying Levinson’s theory? Select all that apply.

    1. Advise the patient to avoid reassessing family or career structure until late adulthood.
    2. Tell the patient that significant disturbance during transitions is abnormal.
    3. Normalize use of behavioral health services during the transition.
    4. Acknowledge that change during this developmental period is common.
    5. Encourage internal reflection and healthy psychological and physical practices.

    Answer: Normalize use of behavioral health services during the transition., Acknowledge that change during this developmental period is common., Encourage internal reflection and healthy psychological and physical practices.

    Levinson’s midlife transition includes deep reflection and possible alteration in life structure, so the nurse should normalize change, support reflection and healthy practices, and normalize behavioral health services. Calling disturbance abnormal or discouraging reassessment conflicts with the theory described in the section.

  4. A middle-aged adult recovering from an unexpected life change wants to improve health, feel more competent in self-care, and find greater satisfaction in work and life choices. Which nursing approaches are consistent with Vaillant’s career consolidation theory? Select all that apply.

    1. Frame unexpected change as an opportunity for compensation and growth.
    2. Tell the patient to abandon prior learning because adult developmental tasks are not sequential.
    3. Explore contentment in life choices or continued work toward better life choices.
    4. Encourage commitment to both mental and physical health.
    5. Support the patient in evaluating health and deciding on changes to implement.

    Answer: Frame unexpected change as an opportunity for compensation and growth., Explore contentment in life choices or continued work toward better life choices., Encourage commitment to both mental and physical health., Support the patient in evaluating health and deciding on changes to implement.

    The section applies Vaillant’s career consolidation to health by emphasizing commitment, compensation, contentment, and competence. Telling the patient to abandon prior learning is inconsistent with Vaillant’s sequential developmental tasks and with internalizing lifetime learning.

  5. An adult patient says, “I feel like I am failing because my life has not followed the timeline my community expects for marriage and career advancement.” Which nursing response best reflects Neugarten’s theory?

    1. Assign age-based roles to help the patient conform to the conventional social clock.
    2. Reinforce that following the expected social timeline is necessary for psychological well-being.
    3. Tell the patient that societal expectations do not influence adult development or stress.
    4. Explore how cultural age norms may be affecting the patient and support the patient in navigating an individual life path.

    Answer: Explore how cultural age norms may be affecting the patient and support the patient in navigating an individual life path.

    Neugarten’s theory focuses on the social clock and how alignment or deviation from societal expectations can affect well-being. The best response challenges rigid norms and empowers the patient, rather than reinforcing conformity or denying the influence of societal expectations.

  6. An adult patient facing a treatment decision says, “I need my family involved, and my spiritual values are important, but I feel conflicted about the options.” Which nursing actions align with Kegan’s socialized mind stage? Select all that apply.

    1. Maintain flexibility and respect for varied values and beliefs.
    2. Involve family and significant others in decision-making.
    3. Support the patient through internal struggles related to treatment options.
    4. Allow the patient to interpret and make decisions based on spiritual values.
    5. Use only a specific task-oriented treatment plan without patient input.

    Answer: Maintain flexibility and respect for varied values and beliefs., Involve family and significant others in decision-making., Support the patient through internal struggles related to treatment options., Allow the patient to interpret and make decisions based on spiritual values.

    For the socialized mind stage, nursing care includes family involvement, respect for spiritual values, flexibility, and support during internal struggles about treatment. A rigid task-oriented plan without patient input does not reflect the nursing care examples in the section.

Where every quote comes from

Section 40.2 Theories Related to Growth and Development of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.