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Semester 5 FSNM Exam 8 > Abnormal Adolescence > Flashcards

Abnormal Adolescence Flashcards

1
Q

The primary task of adolescence

A

identity development

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2
Q

By the time you are 5.. where is brain development

A

90% of its size BUT cerebral cortex and frontal lobes are immature through early adulthood

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3
Q

Prefrontal cortex

A

Regulating thought, feelings, actions
Capacity to inhibit impulse
White matter inc through early adulthood
Gray matter inc in early puberty and then dec (pruning)

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4
Q

Limbic System

A

Emotions
Undergoes myelination and then pruning (to lesser degree)
Sensation seeking, novelty seeking, risk taking

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5
Q

Risk taking in early adulthood

A

Risk taking declines by early adulthood

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6
Q

Psychosocial development - Adolescent development ___ from person to person

A

Varies dramatically
Development often occurs in spurts
Stages can vary from person to person (different rates per person)

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7
Q

Psychosocial development - Lasting difficulties

A

80% cope well with process and do not have any lasting difficulties

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8
Q

Psychosocial development - Sensation seeking peaks when

A

Early adolescence

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9
Q

Psychosocial development - Intensity of emotions and mood swings

A

Less frequent from early to late adolescence

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10
Q

Psychosocial development - Capacity to inhibit

A

Increases across adolescence

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11
Q

Psychosocial development - happiness

A

declines from early to late adolescence

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12
Q

Psychosocial development - conflict with parents

A

Constant major conflict btw adolescent and parents is not developmentally normal - intermittent conflicts in the context of a generally functional relationship is normal

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13
Q

Relationships with peers

A

Tend to select friends based on similarity in personality, values, and activities

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14
Q

Relationships with peers - Deviancy training

A

If an adolescent’s close friends engage in deviant bx, over time that adolescent is more likely to do so as well

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15
Q

Relationships with peers - presence of same age peers increases what

A

risk taking

and even more so if same sex

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16
Q

Typical characteristics of adolescent patients

A 
They aren't the ones making the appt 
Landscape of injury is unfamiliar and may provoke anxiety 
Strong desire for autonomy 
Prone to shame, feel vulnerable 
Sensitive to criticism 
Anger masking fear or sadness
Time perspective is short 
See problems as arising from outside the self
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17
Q

Bx challenges of adolescence

A

Often feel misunderstood, alienated
Opposition to authority is normal
Tend to focuse more on immediate and short term rather than vague distant future

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18
Q

Bx challenges of adolescence - Noncompliance

A

Can serve important developmental tasks - individuation from families, avoidance of activities that might decrease peer acceptance or peer conformity

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19
Q

Helpful qualities for treating adolescents

A 
Tact (be honest without seeming critical)
Flexibility
Sense of humor
Honesty
Playfulness
Tough of rebellion 
Relaxed, matter of fact
Genuine interest in the pt
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20
Q

Qualities adolescents desire in health care provider

A 
Caring
Not rushed
Trustworthy, honest, open
Non judgmental
Knowledgeable, experienced
Careful
Respectful
Willing to assure confidentiality
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21
Q

Common adolescent responses to injury

A

First few days - anxiety, fearful, distress
Irritability and uncooperative
Maybe feeling of emptiness or numbness after serious injury
Physical sx (HA, upset stomach)
Trouble sleeping
Might get extra clingy
Fear of disfigurement or disability

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22
Q

Common adolescent responses to injury - when to worry

A

More concerning if the symptoms are constant or if they interfere with the adolescent’s ability to function

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23
Q

Helping adolescent cope with injuries - strategy based on

A

Approaching and addressing the problem directly, rather than avoiding it

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24
Q

Helping adolescent cope with injuries

A

Good social support leads to better outcomes
Listen carefully
Elicit feeling and accept them
Address needs of the family
Ensure pain is managed
Normalize their feelings
Ask specifically about their fears and address them

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25
Q

Establishing Rapport

A

Introduce yourself and shake hand
Start off with casual chatting
Connect with them - let them teach you something about their interests
Let them talk
Listen closely - be slow to give advice unless asked
Offer reassurance
Explain what is wrong and what you are doing step by step and why it is going to help!

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26
Q

Interviewing adolescents

A

Helpful to meet with them and their parents but sensitive measures alone

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27
Q

Insights from motivational interviewing

A

Explore with the adolescent in a way that does not presuppose the correct answer - Looking together with them at what might happen and explore those options with them

28
Q

Encourage autonomy

A

Avoid pressuring them to change or problem solving for them

Goal is to support the pt in their process of exploring outcomes

29
Q

Collaborate

A

See yourself as a partner of theirs with resources
Balance guiding and supporting and allowing them room to explore and fail
Explore their thoughts

30
Q

Evoking intrinsic motivation

A

Help them to discover their own values and desires
You want to be in the position where the adolescent is arguing for change, not you as PT - this requires you to remain neutral and honor the reason for not changing

31
Q

Adolescent mental health

A

Mood swings, intense emotions are common and normal

Usually last a short time and do not impair overall functioning

32
Q

Adolescent mental health - red flags

A 
Consistent high levels of distress that last for more than a few days or do not improve with positive life events 
Suicidality 
Lack of positive relationships 
Hx of abuse or neglect
Difficulty functioning
33
Q

Adolescent mental health - internalizing problems involves what

A

Disturbances in how the person feels

34
Q

Adolescent mental health - internalizing problems - more common with who

A

Girls

35
Q

Adolescent mental health - internalizing problems - Marked increase in depression and anxiety in adolescence

A

Can be genetic, environmental, or cultural factors that may impact risk of depression

36
Q

Adolescent mental health - internalizing problems - eating disorders

A

Risk for eating disorders increases (esp in girls) as puberty causes increases in body fat and change in shape (addition of weight comes before addition of height)

37
Q

Adolescent mental health - externalizing problems involves what

A

Disturbances in how the person acts

38
Q

Adolescent mental health - externalizing problems - more common with

A

Boys

39
Q

Adolescent mental health - externalizing problems - delinquent bx does what as we get older

A

Markedly increases between early and middle adolescence, then declines

40
Q

Adverse childhood experiences (ACES)

A

Accidents, injuries, and intentional violence are all more common in context of psychosocial dysfunction

41
Q

Adverse childhood experiences (ACES) - Specifically childhood experiences of abuse, neglect, parental substance abuse, parental mental illness, parental loss, parental imprisonment, or domestic violence lead to elevated rates of

A 
Depression
Substance abuse
More than 50 sexual partners
Early intercourse
Teen pregnancy
Likelihood of being raped
Likelihood of perpetrating domestic violence 
Work abstenation
Financial problems
Number of medically unexplained sx
Shortened lifespan
42
Q

Protective factors (ACES)

A 
Stable, non reactive temperament
Good physical and mental health
Normal to high intelligence
High self esteem
Social competent
Good social support
Secure attachment style
Competent parents
Adequate socioeconomic resources
Close with family
Access to community resources
43
Q

Eating disorders - Anorexia

A

Severe restriction of calories leading to body weight less than 85% of expected
Often physical sx of malnutrition, including amenorrhea, dizziness, cold intolerance

44
Q

Eating disorders - Bulimia

A

Recurrent binges with excess eating and a sense of lack of control
Inappropriate compensatory bx
Self eval is unduly influenced by weight

45
Q

Mood disorder - after puberty

A

Twice as many females as males meet criteria

46
Q

Mood disorder - how many don’t receive tx

A

70-80%

Bad because they can develop this depressive mood as part of their personality and part of who they are

47
Q

Mood disorder - Sx of depression

A

Last for two weeks and need to have depressed mood most days or diminished interest in most activities
AND four of the seven things for at least two weeks

48
Q

Mood disorder - Sx of depression - need 4 of the 7

A 
Change in appetite or weight change
Change in sleep 
Visibly restless or agitated
Fatigue 
Worthlessness/guilt
Inability to concentrate/make a decision
Suicidality or recurrent thoughts about death
49
Q

Treating an adolescent with depression

A

Refer for tx if not already in it
Remain encouraging
Adjust your style to be calmer
Encourage activity but don’t be judgemental if they don’t follow through
Very gently dispute cognitive distortions (I will never be able to handle this)

50
Q

Suicidality - If you are concerned

A

Ask them about it

51
Q

Suicidality - what do you ask about

A

Ideation
Plan
Means
Intent

52
Q

Suicidality - is ideation an emergency

A

No - but it does mean they need treatment

Ideation, with plan, means and intent is an emergency

53
Q

Anxiety disorders

A

Most common psychiatric disorder experienced by adolescents

Similar prevalence in M and F

54
Q

Anxiety disorders - social phobia

A

Worried about social situations or interacting with others or of performance situations
Fear of criticism or humiliation

55
Q

Anxiety disorders - generalized anxiety disorders

A

Chronic, unmanageable worry

56
Q

Anxiety disorders - Obsessive compulsive disorder

A

Recurrent, intrusive thoughts (obsessions)

Recurrent, ritualized bx (compulsive) - spend at least an hour on it a day

57
Q

Anxiety disorders - PTSD

A

Numbing/Increased arousal, avoidant, re-experience symptoms

Dissociation - seem detached or don’t remember aspects of the trauma

58
Q

Anxiety disorders - Panic Disorder

A

All of a sudden gets physical symptoms (intense) and lasts 15 min to an hour - spiral upward of F/F response

59
Q

Tx an adolescent with anxiety

A 
Refer for tx if not already being done 
Discourage avoidance of feared activities 
Remain calm and reassuring
Empower them 
Identify and utilize resources
60
Q

Attention deficit/Hyperactivity disoders

A

Highly heritable
More common in males - F tend to be more inattentive than hyperactive so is more likely to be missed
More impulsive

61
Q

Symptoms of ADHD

A 
Has to impair functions
Careless mistakes, forgetful
Easily distracted 
Inability to follow through
Lose things
Fidgety 
Difficulty waiting turn
Interrupts people
62
Q

Substance Abuse

A

Most significant public health issue in adolescents

63
Q

Substance abuse - risk factors

A 
Availability of drugs and norms favoring their use
Extreme poverty
Hx of abuse or parental abuse
High levels of life stressors 
Sensation seeking
64
Q

Substance abuse - protective factors

A

Stable environment, close, positive relationships with parents
High motivation for achievement, affiliation with pro social groups and friends

65
Q

Alcohol

A

Most commonly abused drug by adolescents

Semester 5 FSNM Exam 8 (5 decks)

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