Individual Determinants of Health

This article discusses the individual determinants of health, including learning principles, cognitive development, memory, and their impact on behavior. It also explores the impact of Anna's behavior on her mother and father. The article provides references to theories of cognitive development and psychosocial development.

Running head: INDIVIDUAL DETERMINANTS OF HEALTH
INDIVIDUAL DETERMINANTS OF HEALTH
Name of the Student:
Name of the University:
Author note:

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Question 1
As observed form the case study, Anna’s learning of certain behaviors are influence of a
number of learning principles, encompassing classical and operant conditioning, as well as social
learning. Classical conditioning, as formulated by Ivan Pavlov, encompasses learning of a
concerned response or behavior upon pairing of an unconditioned stimulus with a neutral
stimulus which results into a conditioned stimulus. Classical conditioning can be observed in
Anna when she displays agitation in the presence of the conditioned stimulus of ID tag of doctors
and the intake workers – acquired possibly from pairing of the doctors ‘taking away’ her father
(unconditioned stimulus) Chris at the hospital with their ID tags (neutral stimulus) (Zhang et al.,
2019). Operant conditioning, is a learning acquired through rewards and punishments. Anna can
be observed reducing her rude behavior to the worker after being hit by her mother (punishment)
followed by behaving politely after being offered toys or chocolates (reward) (Watson, Maurer &
Hundziak, 2017). Social learning, as noted by Albert Bandura, implies learning of behaviors in
children through observation. Anna can be observed to demonstrate social learning through her
enthusiasm of building and ‘driving’ a lego care, after noticing her mother drive her to Chris and
the child care center every day (Juffer et al., 2017).
Question 2
As per Jean Piaget’s theory of cognitive development, four and a half year old can be
identified to be in the preoperational stage. Anna’s development in this stage is impacted by
pretend playing – where her thoughts might be influenced by specific methods of thinking,
egocentrism – where she will be unable to understand other’s perspectives and centration –

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where she may show fixation upon particular characteristics (Barrouillet, 2015). As observed in
the case study, pretend playing influences Anna’s behaviors by increasing her eagerness to drive
(lego car building) and enhancing her fears of parental separation (preoccupied with her doll).
Anna’s behaviors are highly egocentric as observed in her concern of wanting to go home, meet
her father and get a chocolate while showing disregard to being polite towards health workers.
Anna’a behavior are centered as observed in her constant fixation in the doctor’s ID tag and
characteristic features of the patient resulting in her agitation.
As per Erik Erikson’s theory of psychosocial development, Anna can be identified to
belong to the stage of Childhood (Initiative vs. Guilt) where her behavior can will be impacted
by an eagerness to explore surroundings as well as feelings of guilt if her needs are not
responded to adequately (Knight, 2015). Hence, as observed in the case study, the characteristic
desire towards external play has influenced Anna’s behavior by compelling her to explore the
intake worker’s room, the toys as well as playing outside despite restrictions at the childcare
center. Her guilt can be observed in her sulking, crying and sleeping with her mother, upon being
scolded by her to being rude to her.
Question 3
Memory encompasses the processes outlining information acquisition, storage and
retrieval which further influences long term changes in behaviors and knowledge (D’Andrade,
2017). In this situation, episodic memory of specific events such as the doctor’s ID tag
associated with patient treatment and her father’s care, are impacting Anna’s behavior by making
her aggressive, frightening and mistrustful towards such health professionals, as observed during
her mother meeting with the intake worker (Moscovitch et al., 2016). Here memory plays an

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important part in influencing behavior since the memory of a specific event at the hospital has
made it very difficult to initiate a communication between Anna and the health worker. Anna’s
also seems to be influenced by the memory of being mistreated by other children at the care
center resulting in her aggression when the intake worker evokes memories of the same by
enquiring about her playing with others.
Question 4
It can be observed that Anna’s aggressive behavior towards the intake worker and other
children at the childcare center, along with her refusal to wear her eye patch, are problematic.
a) These behaviors are problematic towards the intake worker, her mother and children as
well as workers employed at the childcare centre.
b) Anna’s aggression and mistrust towards the intake worker makes communication with
her problematic since it becomes very difficult for the intake worker to build a rapport or
understand her needs. This behavior is also problematic towards her mother since often
she is unable to control Anna’s restlessness and often reverts to hitting her resulting in
further distress and agitation. This is also problematic at the childcare center since other
children are physically injured due to altercations with her and the workers are unable to
include her in the surroundings since she has now been isolated by these children. Her
refusal to wear her eye patch is problematic since it paves the way for infections.
Question 5
As observed in the case scenario, it can be observed that Anna’s father, Chris, is having
the greatest impact on her behavior.

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a) The incident of Chris’s accident is the reason for which Chris has resulted in the greatest
impact on Anna’s behavior. The
b) The impact can be observed mostly in the childcare center, at home as read from her
mother’s notes as well as in the community center during the meeting with the intake
worker.
c) The impact can be observed strongly in the childcare center where, after Chris’s accident
and his period of stay away from home at the hospital resulted in Anna being rude,
impolite, isolated and violent towards children in the childcare center. At home, from
Kat’s notes, it can be observed that Anna cries upon seeing her father’s unhappiness, is
significantly agitated in having nightmares of permanent separation from home and takes
active part in household activities on the day he arrives at home. During the visit with the
worker, Anna’s disinterest towards communication is immediately corrected after a stern
scolding from Chris.
Question 6
Anna’s behavior is having the greatest impact on her mother, Katrina.
a) Anna is the only child of the couple and was a result after several IVF attempts, hence
making her close to both parents. However, her mother is most impacted since upon
Chris’s accident, her life revolves majorly around Anna’s needs and hence, the burden of
her husband’s condition has further enhanced her attachment with her daughter.
b) The impact of Anna’s behavior on her mother can be observed at home and during
community center meetings with the intake worker.

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c) At home, Kat is significantly saddened whenever she gets into a scuffle with Anna
resulting in her not talking to her mother, as observed in the notes. The notes also reveal
that she cooks Anna’s favorite meal as and when she asks for and is significantly
depressed when her daughter expresses dislike of the sandwich she prepared. She is also
disturbed and quickly engages in giving Anna a chocolate, to silence her aggressive
behavior as observed in the meeting with the intake worker.

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References
Barrouillet, P. (2015). Theories of cognitive development: From Piaget to today. doi:
https://doi.org/10.1016/j.dr.2015.07.004.
D’Andrade, R. G. (2017). Memory and the assessment of behavior. In Measurement in the social
sciences (pp. 159-186). Routledge.
Juffer, F., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2017). Pairing attachment
theory and social learning theory in video-feedback intervention to promote positive
parenting. Current Opinion in Psychology, 15, 189-194. doi:
https://doi.org/10.1016/j.copsyc.2017.03.012.
Knight, Z. G. (2017). A proposed model of psychodynamic psychotherapy linked to Erik
Erikson's eight stages of psychosocial development. Clinical psychology &
psychotherapy, 24(5), 1047-1058. doi: https://doi.org/10.1002/cpp.2066.
Moscovitch, M., Cabeza, R., Winocur, G., & Nadel, L. (2016). Episodic memory and beyond:
the hippocampus and neocortex in transformation. Annual review of psychology, 67, 105-
134. doi: https://doi.org/10.1146/annurev-psych-113011-143733.
Watson, L. S., Maurer, R. A., & Hundziak, M. (2017). Operant Conditioning in Toilet Training
of Severely Retarded Boys. In Behavior Therapy with Children (pp. 96-101). Routledge.
Retrieved from:
https://www.taylorfrancis.com/books/e/9781351314435/chapters/10.4324/978135131444
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Zhang, L., Lu, X., Bi, Y., & Hu, L. (2019). Pavlov’s Pain: the Effect of Classical Conditioning
on Pain Perception and its Clinical Implications. Current Pain and Headache
Reports, 23(3), 19. doi: https://doi.org/10.1007/s11916-019-0766-0.