26.7 - Adolescent Psychopathology Flashcards
Define adolescence.
- WHO definition of adolescence: from 10–19 years
- But there have rececntyl been calls to extend this to 10–24 years, noting delays in the transition age to adult roles (eg, marriage and parenthood) in many societies
What are some factors that may explain changes in emotional processing during adolescence?
- Environmental (changes in the social context) -> Especially a change from family as the primary interaction to close friends
- Biological -> Puberty and maturation
(Blakemore, 2008) explains that there is an interaction between biological risk factors and a changing environment.
What are some social changes that occur during adolescence?
- Heightened self-consciousness
- Increased importance and complexity of peer relationships
- Improved understanding of others
- Adolescents are more sociable than children, form more complex and hierarchical peer relationships and are more sensitive to acceptance and rejection by their peers
(Steinberg & Morris, 2001)
Give some experimental evidence for the social changes that occur in adolescence.
[EXTRA]
(Benenson & Schinazi, 2004):
- Used a questionnaire approach
- Found that adolescent girls were more sensitive and negative than adolescent boys about outperforming friends of the same gender
(Sebastian, 2010):
- Used a ball-throwing simulator to simulate conditions of being included and excluded from a game
- Adolescents reported feeling more included than adults in the inclusion condition and more excluded in the exclusion condition
(Gardner & Steinberg, 2007):
- Used a game involving driving to simulate risk-taking
- Adolescents’ risk taking was more influenced by the presence of peers than adults’ risk taking
(Steinberg & Monahan, 2005):
- Adolescent girls are on average more resistant to peer influence than adolescent boys of the same age
- In both genders, there is an increase in this resistance during adolescence, but in girls it tends to happen at an earlier age
Describe the changes in brain volume that occur during adolescence.
- Total brain volume increases to a peak, then slowly decreases
- Grey matter volume increases to an early peak, then slowly decreases -> This is consistent with the idea of synaptic proliferation followed by pruning
- White matter volume increases gradually -> This is consistent with the idea of increased myelination
Compare the development of limbic and pre-frontal areas of the brain in adolescence. What is the significance of this?
[IMPORTANT]
(Somerville, 2010):
- Subcortical areas, such as the limbic system, develop earlier than the pre-frontal areas (responsible for risk taking and executive functions)
- This may explain heightened sensitivity to emotional responses during adolescence
Give some experimental evidence for comparing how adults and adolescents process emotions.
[EXTRA]
(Monk, 2003):
- Adolescents had higher activation of the anterior cingulate cortex (ACC), left orbitofrontal cortex (OFC) and amygdala than adults when passively viewing fearful faces and in ACC when attending to emotion was not needed.
- Adults had higher activation of OFC more than adolescents when attention was needed.
- This shows that adults can show greater modulation of relevant brain structures based on attention, while adolescents are more dictated by emotion.
(Lau, 2011):
- Conditioned adults and adolescents to associate a fearful face as a threat cue and a neutral face as a safety cue
- Adolescents showed much greater amygdala response to the threat cue more than adults, but not to the safety cue.
(Hare, 2008):
- Used a “gonogo” task featuring fearful faces to assess the activation of the amygdala upon seeing these faces
- There is a much wider range in activation and a higher average activation in adolescents than in children or adults
- However, interestingly, these changes are not linear, showing that changes in emotion processing are not linear from childhood to adolescence to adulthood
Summarise why adolescence is a period that is vulnerable to psychopathology, such as anxiety and depression.
[IMPORTANT]
Neurobiological differences between adolescents and adults underlies differences in emotional processing:
- Subcortical areas (e.g. the limbic system) develop earlier than prefrontal areas of the brain -> This can explain heightened sensitivity to emotional responses
- Adults show greater modulation of relevant brain structures based on attention, while adolescents are more dictated by emotion.
- Adolescents showed much greater amygdala response to the threat cues.
Environmental factors can also explain why adolescence is a difficult time for psychopathology.
Give some clinical relevance for adolescent psychopathology.
[EXTRA]
- Male criminal offending peaks at around the age of 17
- Deliberate self-harm is particularly prevalent in adolescent women
- There is a steep rise in depression diagnosis between the ages of 15 and 18, particularly in women (Hankin, 1998)
- Of people with an anxiety disorder at the age of 32, around 1/3rd are diagnosed at the age of 11-15 (Gregory, 2007)
Give a summary of the changes that take place during adolescence.
- A changing social environment
* Family to peer shift in focus
* Peer sensitivity and resistance to peers - Neural and genetic factors
* Increased activation of emotional circuits
* Slower development of control-related circuits
* Gene x environment interact in risk - Clinical implications
* A period of high risk
* Opportunity for intervention?
What neurodevelopmental changes take place during adolescence?
Adolescence is period where dramatic neurodevelopmental changes in brain
occurs - affects neurocognitive performance
- Shown by Giedd et al (1999) in longitudinal MRI study - found linear increase
in volume of white matter reflecting increasing myelination but non-linear and
regional changes in volume of cortical grey matter with initial increase, peaking
around 11-12, followed by decline - reflects synaptic proliferation and pruning
- Changes in grey matter regionally specific - provides support for
heterochronous development of cerebral cortex - frontal and parietal
lobes peaked first - temporal and then occipital
Describe the heterochronus cortical changes in adolescence.
Heterochronous cortical changes supported by further study by Gogtay et al (2004)
- suggested individual subregions follow distinct maturation patterns in which
lower-order sensorimotor regions occur before maturation of higher-order
association areas.
- Frontal lobe maturation began in primary motor cortex + primary sensory
area - occurs anteriorly and laterally - PFC and lateral temporal lobes develop
last.
- Corresponds with functional development - parts of brain associated with more
basic functions matures earlier, with areas involved in executive function,
attention and coordination matured later
when is treatment most effective?
Generally, adolescence is most amiable period.
Bath uni 2022 showed structural changes take place in EDs. They stressed the importance of early treatment to prevent the long-tern, structural brain changes. Perhaps related to why adolescence most amiable period?
