Adolescence Flashcards
Early adolescence characteristics
10-13 less interest in home puberty same sex peers increased cognition increased fantasy world idealistic privacy impulse control concrete cognition
Middle adolescence characteristics
14-16 peak of parental conflict bodily experimentation peak of peer involvement sexual activity/experimentation increased range emotions increased intellectual ability omnipotence risk-taking
Late adolescence characteristics
17-21 reacceptance of parental values decreased importance of peer group education and vocational goals reinforcement of moral, religious, sexual values increased ability to set limits abstract cognition
Early adulthood characteristics
18-25
developing financial independence
transitions: school, employment, residence, foster care system
Ongoing brain development
medically underserved, high morbidity and mortality
Neurological model of adolescent risk behaviours
Limbic regions develop faster than prefrontal regions
5Cs of positive youth development
Competence Confidence Connection - provides the most protection Character Caring/compassion Contribution
HEADS assessment
Home Education Eating Activities Drugs Depression Sex Suicide Safety
SHADES
Strengths School Home Activities Drugs Emotions/depression Sex Safety
Transition counselling
gradual: start at age 10-12 y
support developmentally appropriate autonomy
Anticipatory guidance to adult health care system
Grey matter peaks
girls 11
boys at 12
Teenage brain under renovation
differentiation via pruning of neurons
pathways more often used - less likely to be discarded
behaviour establishing machine - customization of brain and adaptability
myelination allows integration of neural circuits and increases processing speed
Ancient reward system
Tegmentum (brainstem) to accumbens (midbrain)
visceral, gut reaction
Newer reward system
tegmentum –> accumbens –> prefrontal cortex
planned thoughtful reaction
Dopamine function
reward motivation pleasure, euphoria motor function (fine tuning) compulsion perseveration
Serotnin functions
mood
memory processing
sleep
cognition
Hypotheses of adolescent risk taking
lower stimulation of childhood ancient reward pathway before new adult pathway established
lower basal dopamine levels and greater surge of dopamine release in response to risky activity drives greater novelty to seeking to attain pleasure
evolutionary mismatch in timing of brain development is purposefully built in to allow skill development in a relatively secure time
Dopamine downsides
dopamine release drives cravings to repeat pleasurable activity
repeated use of pathway strengthens it - increases association between activity and sense of pleasure
increased drive for reward –> impulsivity, susceptibility to addiction
Romantic love and dopamine
stimulates same dopamine pathway as risky behaviour, drive/craving quality
intensity similar across lifespan
response to breakups differ due to lack of life experience tempered with dopamine withdrawal
- girls: depression, sleep and appetite changes, tend to engage others for support
- boys: isolate, abuse substances, drive too fast, increased likelihood of self harm/aggression
Age of onset of addiction
1/10 all users of marijuana become addicted
1/6 all users that start in adolescence become addicted
18-20% develop cannabis use DO within 10 years for adolescents
15% those who use alcohol before 14 develop alcoholism
2% who start alcohol use >21 develop alcoholism
25% those who abuse Rx drugs by
Decision making in adolescence
attribute greater weight to positive outcomes rather than potential negatives
Adolescent perspectives on marijuana
Understanding of harm and benefit
increased weighting of positives
indifference to harms
Outcome of marijuana use as an adolescent
increased risk of schizophrenia
less likely to have completed college, decreased total household income
increased risk of anxiety
more likely to be unemployed
daily marijuana use started in adolescense associated with 8 pt loss in IQ over subsequent decades
higher risk of developing MDD, suicidal thoughts and behaviours
poor outcomes in life satisfaction/achievement measures
Trends in substance use
almost 70% high school students have tried alcohol
50% illegal drug
40% smoked a cigarette
>20% Rx for nonmedical purpose
40% smoked marijuana
Regular, heavy use of alcohol most common in 17-24
Polysubstance use common
most report being already intoxicated before trying a differnet drug
increased likelihood of hiding use
marijuana, alcohol and tobacco use in BC is trending DOWN =)
Age of first use
~14 across the board
Factors associated with early onset of use
LGBTW2S history of abuse limiting health condition or disability government care poverty family/friend who attempted suicide looking older than their peers
Drug exposure opportunities
Marijuana increases risk to use other illicit substances
1/2 marijuana users given opportunity to try hallucinogens (vs 1/16)
once given opportunity, marijuana users were 12x more likely to try hallucinogens than nonusers
marijuana users were 15x more likely to use cocaine given the opportunity
Youth - motives for using cannabis
Social
Coping
DSM 5 substance use disorder
within 12 mo, >2 out of 11:
HEP C WASTTED
Hazardous situations use
Evades major role obligations
resultant Personal/social problems
Cravings
Withdrawal
Amounts larger or over longer period than intended
Social/occupational/recreational activities given up or reduced
TOlerance
Time spent procuring, using or recovering
Efforts to cut down or control use
use Despite physical or psychological consequences
