5. Adolescence Flashcards
What is adolescence?
Phase between childhood and adulthood
What is adrenarche?
What are its manifestations?
Precursor event before puberty (earlier in females)
Rise in adrenal 19-carbon steroid production, DHEA, DHEA sulfate
Manifests clinically as appearance of axillary and pubic hair, usually around age 8
How does obesity lead to early puberty?
Leptin stimulates hypothalamus to produce GnRH
Why are adolescents vulnerable to risk taking?
Developmental mismatch hypothesis
Mismatch between regulatory/ cognitive control, (integration of affect) & Dopaminergic activity (higher)
What is the ICD10 diagnostic criteria for anorexia nervosa?
Body weight at least 15% below expected
Avoidance of fattening foods
Endocrine disturbance
Psychopathology-morbid dread of fatness
What are some neuropsychology effects of Anorexia nervosa?
Executive function deficits
Weak central coherence in eating disorders
Due to global processing difficulties
What is the ICD-10 diagnosis criteria for Conduct Disorder?
Repetitive and persistent (>6 months) pattern
Frequency and severity beyond age appropriate norms
Oppositional behaviour, defiance Tantrums Excessive violence, bullying Running away from home Truancy Animal cruelty Stealing Destructiveness to property Fire-setting
List the symptoms of depression?
- Anhedonia (loss of enjoyment)
- Low mood/ sadness
- Loss of energy
Present for at least 2 weeks
Describe the 2 types of pre-pubertal depression?
Type 1. More common
Co-morbid behavioural problems, parental criminality etc.
Resembles children with conduct disorder
No increased risk of recurrence in adult life
Type 2. Less common
Highly familial with multigenerational loading for depression
High rates of anxiety and bipolar disorder
Recurrence of depression in adolescence and adulthood
What is the treatment for mild depression?
- Cognitive behavioural therapy
- Interpersonal psychotherapy
What is the treatment for moderate/severe depression?
- Anti-depressants (SSRI, fluoxetine)
- SSRI+ Cognitive behavioural therapy
What is menarche?
First occurence of menstruation
What social factors are conduct disorder usually associated with?
- Larger family size
- Lower socio-economic status (poor schools and neighbourhood)
What is CD a predictor of?
- Antisocial PD in adulthood
- Alcoholism and drug dependence
- Unemployment and relationship difficulties
What problems is depression associated with?
Increased risk of self-harm
Anxiety disorders, eating disorders
Conduct problems, substance misuse
Familial aggregation (genetic and learning)
