True: It has long been known that preference for and tracking of face shapes is present at 4 days. More recently preference for face shapes has been demonstrated in neonates as young as 43 minutes of age. However, neonates cannot discriminate a static face from an equally complex pattern (Gross 2001, p. 235).

False: Age of onset of puberty in boys is between 10 and 14 years (mean = 13).

Girls enter puberty on average 12–18 months earlier than boys, i.e. between 8 and 13 years (mean = 11). Thus, the mean difference is only 2 years (Gross 2001, p. 534; Sadock & Sadock 2005, p. 3038).

False: Peer group friendships provide important support, feedback and companionship to adolescents. They become important points of reference in their social development and provide social contexts for shaping day-to-day values. However, parents continue to have a strong influence on their children’s identities and values. Adolescents tend to choose peers who share their own values and have similar identities. Thus, peer and friendship groups work in concert with, rather than in opposition to, adult values, attitudes, goals and achievements (Gross 2001, p. 540; Sadock & Sadock 2005, p. 3040).

True: Bonding refers to the mother’s feelings for and relationship to her infant. Bonding is different from attachment, which concerns the infant’s relationship with the mother. Bonding consists of feelings aroused by the neonate that result in affectionate, nurturing and protective behaviour. Ambivalence about pregnancy can affect bonding (Gelder et al 2000, p. 1203; Sadock & Sadock 2005, p. 145).

False: Infants show indiscriminate attachment behaviour to any friendly person until age 7–8 months. At around 4–6 months infants start showing increasing differential preference for their mother. Stranger distress and strange place distress develop by 7–9 months. Moreover, at 6 months the infant is too young to have attachment problems (Atkinson et al 2000, p. 89; Sadock & Sadock 2002, p. 141).

False: The Strange Situation procedure is a test designed by Mary Ainsworth. It examines the behaviour of children (aged 1 year) and aims to provide information on attachment. The essential steps of the procedure are as follows. Firstly a mother and baby enter a room and the baby is encouraged to play with some toys. Then a stranger enters and plays with the baby. Next, the mother leaves, and the stranger attempts to soothe any distress. The mother returns and the stranger leaves. Then the mother leaves the baby alone before the stranger and then the mother return.

Using this procedure Ainsworth described three attachment styles, anxious-avoidant, anxious-resistant and securely attached. An insecure-disorganized category is often also added. Securely attached children show distress when the mother leaves, seek her out on return and are quickly calmed when they do so. Around 65% of children fall into this category. The exact responses of the different attachment styles to different stages of the test appear in the exam and thus it is an area worth studying in more detail (Atkinson et al 2000, p. 90; Fear 2004, p. 509; Gross 2001, p. 465; Sadock & Sadock 2002, p. 141; Wright et al 2005, p. 58).

False: Insecure attachment is evidenced by either ignoring/avoiding the mother on her return (the anxious–avoidant child) or by seeking contact whilst simultaneously showing anger and resisting contact (the anxious–resistant child), or by contradictory approach–avoidance and disorganized behaviour (the disorganized/disoriented child) (Atkinson et al 2000, p. 90; Fear 2004, p. 509; Gelder et al 2000, p. 265; Gross 2001, p. 465).

False: Following psychological trauma, children may show weaker attachments to others. However, children show increased attachment behaviour when under threat (Fear 2004, p. 510; Gross 2001, p. 466).

True: Abused children often maintain their attachments to their abusive parents and show increased attachment behaviour. When children are hungry, sick, in pain or when rejected by their parents, they show increased attachment behaviour. Whilst there is a positive relationship between child abuse and attachment behaviour, child abuse is also associated with an insecure attachment style (Sadock & Sadock 2005, p. 3251).

False: Attachment behaviour depends mainly on parental sensitivity. A sensitive mother is responsive to the child’s needs, accepting, cooperative and accessible and promotes secure attachment in the child. By contrast, the insensitive mother interacts according to her own wishes, moods and activities and promotes insecure attachments (Gelder et al 2000, p. 351; Gross 2001, p. 465).

True: Attachment behaviour peaks at 18 months. Although a secure child will tolerate a stranger, s/he would not be happy. An insecure avoidant child can play as happily with a stranger as with a mother. An insecure resistant–ambivalent child would resist a stranger’s efforts to make contact (Atkinson et al 2000, p. 92; Gelder et al 2000, p. 265; Gross 2001, p. 465).

True: Disorganized–disoriented attachment is associated with maternal psychopathology, child maltreatment, family violence and poor parental sensitivity to infant cues. Non-accidental injuries indicate abusive care. Physically abused children tend to have insecure and atypical attachment patterns (Sadock & Sadock 2005, pp. 3249, 3415).

True: Children who have been adopted often develop secure attachments, albeit later. Institutionalized children are much less likely than adopted children to recover from deprivation and to develop secure attachments (Gross 2001, p. 467).

True: Separation is likely to cause most distress between age 7 months when attachments are beginning to develop and 36 months when most children are secure enough to interact comfortably with other children and adults in the absence of their parents. The maximum distress would be at 12–18 months. This is related to the child’s inability to maintain a mental picture of the mother when she is absent; inability to remember that mother did come back previously after brief periods of separation; limited ability to understand explanations such as ‘mother will come back soon’ and ‘grandmother will look after you until then’ (Atkinson et al 2000, p. 89; Gelder et al 2000, p. 1692; Gross 2001, p. 468).

True: Insecure attachment is associated with indiscriminate attachment and disinhibited behaviour. In Disinhibited Reactive Attachment Disorder the child participates in diffuse attachments and demonstrates indiscriminate sociability and excessive familiarity with strangers. The onset is before age 5 years. It is associated with ‘grossly pathological care’ in which there is a disregard for a child’s emotional and physical needs, abuse, or frequent changes in caregivers. Since the latter factors are also associated with insecure attachment, it is appropriate to conclude that children with insecure attachment may show disinhibited behaviour (DSM-IV 1994; Sadock & Sadock 2005, p. 1236).

True: The insecure anxious–avoidant child is indifferent towards the mother. Play is little affected by whether the mother is present or absent. The child shows little distress when the mother leaves, and avoids her on her return (Fear 2004, p. 509; Gross 2001, p. 465; Sadock & Sadock 2005, p. 3428).

True: There is continuity of an infant’s attachment styles through childhood and adulthood. The early attachment experiences are internalized in ‘internal working models’, i.e. a mental model of the relations between self and significant others. Childhood attachments become templates for future relationships. Those who had secure attachments expect others to be caring and trustworthy, while those who were neglected or rejected as children grow up expecting others to reject them. Securely attached infants become adults with better self-esteem and positive outlook and are more sociable and cooperative in their relationships (Gelder et al 2000, p. 1692; Gross 2001, p. 465).

True: The earliest normal attachment behaviours are the reflexes at birth, e.g. rooting, head turning, sucking, swallowing, hand–mouth grasp, digital extension, crying and responsiveness to mother’s voice.

Object constancy is Mahler’s 6th subphase and lasts from 2 to 5 years. Mahler’s subphases are:

False: Stranger anxiety occurs from 7 months till the end of the first year. Object constancy is Mahler’s 6th subphase and lasts from 2 to 5 years (Atkinson et al 2000, p. 89; Sadock & Sadock 2002, p. 141).

False: Object constancy is Mahler’s 6th subphase and lasts from 2 to 5 years. Separation anxiety, i.e. distress over separation from a parent, occurs between age 7 months when attachments are beginning to develop, and 36 months when most children are secure enough to interact comfortably with other children and adults in the absence of their parents. The maximum distress would be at 12–18 months (Atkinson et al 2000, p. 89; Gelder et al 2000, p. 1692; Gross 2001, p. 468; Sadock & Sadock 2005, p. 729).

True: Kohlberg’s and Piaget’s notions of moral development focus on a unified theory of cognitive maturation for both sexes. Others have found no gender differences in moral development in people aged 5–63 years. However, these theories have been criticized as being male biased because they emphasize a masculine style of abstract reasoning. Critics argue that emphasizing the social context of moral development reveals different patterns in moral development. The predominant features of moral reasoning in women are compassion, caring and concern for the integrity and continuation of relationships. Those in men are related to perceptions of justice, rationality and fairness (Atkinson et al 2000, p. 87; Fear 2004, p. 50; Gross 2001, p. 534; Sadock & Sadock 2005, p. 3040).

False: Piaget’s concept of conservation refers to the understanding that any quantity such as number, liquid quantity, length, weight, volume, time and substance remains the same despite physical changes in the arrangement of objects. Pre-operational children cannot conserve because their thinking is dominated by the perceptual nature (appearance) of the objects but can reverse when they reach the stage of concrete operations (Fear 2004, p. 48; Gross 2001, p. 494; Sadock & Sadock 2002, p. 136; Sadock & Sadock 2005, p. 530).

True: Piaget’s schemes or schemas are the basic units of intelligent behaviour. How the child takes in new sensory information depends on how it fits in with existing schemes. If new experiences can be fitted into what the child can already do, they are assimilated, keeping the child in a comfortable state of equilibrium. If the new information cannot be assimilated into an existing scheme, it leads the child to a less comfortable state of disequilibrium. Hence, s/he must accommodate a scheme to bring him/herself back to equilibrium. This balance of assimilation of and accommodation to new experiences is called adaptation (Gross 2001, p. 491; Sadock & Sadock 2005, p. 529).

False: According to Piaget’s theory of constructivism, individuals learn by actively discovering what the world is like. Schemes or schemas are the building blocks of intelligent behaviour. They are structures that organize past experience and provide a way of understanding future experiences. Schemes develop in complexity through the process of adaptation, assimilation and accommodation. In contrast, George Kelly’s personal construct theory defines personal constructs as the dimensions that individuals use to interpret themselves and their social worlds (Atkinson et al 2000, p. 475; Sadock & Sadock 2002, p. 136).

False: When a child is hospitalized, prolonged and complete separation from parents causes what René Spitz called hospitalism or anaclitic depression. They become depressed, withdrawn, non-responsive and vulnerable to physical illness, but recover when their mothers return. Hence, parents are usually allowed 24-hour visiting (Sadock & Sadock 2005, p. 2891).