Adolescence

Question 1

Early adolescence characteristics

Answer 1

10-13
less interest in home
puberty
same sex peers
increased cognition
increased fantasy world
idealistic
privacy
impulse control
concrete cognition

Question 2

Middle adolescence characteristics

Answer 2

14-16
peak of parental conflict
bodily experimentation
peak of peer involvement
sexual activity/experimentation
increased range emotions
increased intellectual ability
omnipotence
risk-taking

Question 3

Late adolescence characteristics

Answer 3

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

Question 4

Early adulthood characteristics

Answer 4

18-25
developing financial independence
transitions: school, employment, residence, foster care system
Ongoing brain development
medically underserved, high morbidity and mortality

Question 5

Neurological model of adolescent risk behaviours

Answer 5

Limbic regions develop faster than prefrontal regions

Question 6

5Cs of positive youth development

Answer 6

Competence
Confidence
Connection - provides the most protection
Character
Caring/compassion
Contribution

Question 7

HEADS assessment

Answer 7

Home
Education
Eating
Activities
Drugs
Depression
Sex
Suicide
Safety

Question 8

SHADES

Answer 8

Strengths
School
Home
Activities
Drugs
Emotions/depression
Sex
Safety

Question 9

Transition counselling

Answer 9

gradual: start at age 10-12 y
support developmentally appropriate autonomy
Anticipatory guidance to adult health care system

Question 10

Grey matter peaks

Answer 10

girls 11

boys at 12

Question 11

Teenage brain under renovation

Answer 11

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

Question 12

Ancient reward system

Answer 12

Tegmentum (brainstem) to accumbens (midbrain)

visceral, gut reaction

Question 13

Newer reward system

Answer 13

tegmentum –> accumbens –> prefrontal cortex

planned thoughtful reaction

Question 14

Dopamine function

Answer 14

reward
motivation
pleasure, euphoria
motor function (fine tuning)
compulsion
perseveration

Question 15

Serotnin functions

Answer 15

mood
memory processing
sleep
cognition

Question 16

Hypotheses of adolescent risk taking

Answer 16

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

Question 17

Dopamine downsides

Answer 17

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

Question 18

Romantic love and dopamine

Answer 18

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

Question 19

Age of onset of addiction

Answer 19

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

Question 20

Decision making in adolescence

Answer 20

attribute greater weight to positive outcomes rather than potential negatives

Question 21

Adolescent perspectives on marijuana

Answer 21

Understanding of harm and benefit
increased weighting of positives
indifference to harms

Question 22

Outcome of marijuana use as an adolescent

Answer 22

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

Question 23

Trends in substance use

Answer 23

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 =)

Question 24

Age of first use

Answer 24

~14 across the board

Question 25

Factors associated with early onset of use

Answer 25

LGBTW2S
history of abuse
limiting health condition or disability
government care
poverty
family/friend who attempted suicide
looking older than their peers

Question 26

Drug exposure opportunities

Answer 26

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

Question 27

Youth - motives for using cannabis

Answer 27

Social

Coping

Question 28

DSM 5 substance use disorder

Answer 28

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