Adolescence Flashcards
Define Adolescence?
Adolescence is a transitional stage ofphysicalandpsychological developmentthat generally occurs during the period frompuberty to legal adulthood
Stages of Adolescence?
Early - 11-14
Middle - 14-17
Late - 18-21
Physical changes in Females?
Breast budding Pubic hair growth Growth spurt (peak) 1st period (Menarche) Underarm Hair Change in body shape Adult breast size
What Marks the start of puberty in females?
Breast budding - 8 years old
Physical changes in Males?
Growth of scrotum and testes Change in voice Increased dick size Pubic hair growth Growth spurt (peak) Change in body shape Facial and underarm hair
Peak and start of puberty in girls v.s boys?
Girls start (8 years - with breast budding) Boys start (10.5)
Peak for girls (11-13.5)
Peak for boys (13-15)
Define puberty?
Process of physical changes through which a child’s body matures into an adult body capable of sexual reproduction
What is puberty initiated by?
Initiated by the various hormones in the brain signaling to the tests/ovaries
define Adrenarche?
- what does it cause
-
Adrenarche: increase in adrenal androgen production between 6-10yrs old in girls
Adrenarche occurs before puberty starts and = early sexual maturation stage (e.g axillary and pubic hair).
Define Menarche?
Onset of first menstrual cycle
Endocrinology of puberty?
- talk about GnRH axis switch on
- main male and female sex steroids
- Growth spurt mediator
Neurokinin B (NKB) + Kisspeptin = critical switch on of GnRH system
GnRH = stimulates gonadotrophin release from pit
LH stimulates Leydig (testes) and thecal cells (in ovary follicle) = androgens.
FSH = stimulates ovarian follicles, Sertoli cells [respond to FSH+ androgen - support development of spermatogonia]
Testosterone is the primary androgen from Leydig cells.
Oestradiol main female steroid hormone (androgens produced from thecal; cells converted to Oestradiol by nearby granulosa cells that contain aromatase).
IGF-1 rises due to GH – growth spurt mediator.
Role of leptin in initiating puberty?
- hence effect of childhood obesity
Increased leptin stimulates kisspeptin and thus stimulates GnRH. [leptin = a permissive factor for puberty to occur]
Thus childhood obesity = early puberty.
What change is seen in hypothalamus that allows the testosterone and oestrogen levels to rise in the body?
The hypothalamus and puberty become less sensitive to negative feedback so levels rise higher = development of secondary sexual characteristics.
Summarise 2 theories about onset of puberty?
- Maturation of CNS neurones = increased release of GnRH
2. Altered set-point of gonadal steroid feedback.
Piaget’s cognitive development
Kohlberg’s theory of moral development
Birth → 2 = sensorimotor
2-7yrs = preoperational, uses symbols to represent the world
7-11yrs = concrete operational stage = logical reasoning
11-15 = formal operational stage = think in abstract, hypothetical and idealistic manner.
Kohlberg’s theory of moral development?
Level 1+2 pre-conventional (desire to avoid punishment)
Level 3+4 Conventional - to illicit validation from others
Level 5+6 Internal moral code and independant of others
Emotional development: self-concept - Harter’s 8 dimensional model of self-concept?
Scholastic (concerned about education), job, athletic, physical appearance, social acceptance, close friends, romantic appeal and conduct of self – Some Jobs Are Pretty Shit, Can’t Really Complain.
• Self-concepts have clinical implications – 20-30% adolescents have low self-esteem which can lead to depression, anxiety, poor academia, social isolation, etc. However, people with good self-esteem can also be disposed to this!
Self-concepts have clinical implications?
•Self-concepts have clinical implications – 20-30% adolescents have low self-esteem which can lead to depression, anxiety, poor academia, social isolation, etc. However, people with good self-esteem can also be disposed to this!
Emotional development: Identity formation – Erikson’s 8-life-span stages?
Don’t need to know the stages but one stage is in age’s 10-20 which is “Identity vs. confusion”.
What is necessary for identity development?
Only moratorium necessary for identity development.
moratorium (crisis, actively searching for identity)
Integration
Assimilation
Separation
Marginalisation
Integration – retain base culture, develop and maintain with mainstream culture as well. ++
Assimilation – lose base culture, develop and maintain into mainstream culture. -+
Separation – retain base culture, no development into mainstream culture. +-
Marginalisation – lose base culture, no development into mainstream culture. –
Impact of Social domains?
o Social domains – adolescents and parents may have different views about who has the final say depending upon the social “domains” – friendships, clothes, etc. – mid-adolescence is most intense negotiations
Social development- Family? :
Conflict with parents – most adolescents have good relationships, high confiding in mothers.
Family connectedness is associated with – reduced risk behaviours and increased self-esteem.
Social development -Peer development:
Primary school (7-11) – goal to be accepted by peers, prefer same gender and gain loyalty.
11-13 – expect genuineness, intimacy, common interests, emergence of cliques.
13-16 – friendship goals, cross-gender relationships and develop larger groups.
16-18 – emotional support expected and increase dyadic (between 2 people) romantic ties.
Social development - Gender differences?
Boys – less intimate, disclosing and friendships embedded in larger circles.
Girls – close and confiding relationships but are more brittle.
Social development - influence?
Peers influence – interpersonal style, fashion/entertainment.
Parents influence – academic choice, career choice and future aspirations
Main features of anorexia nervosa?
Deliberate weight loss, induced and sustained by the patient.
Usually in adolescent girls and young women, but boys and young men also.
Dread of fatness persisting as an intrusive overvalued idea, with self-imposition of threshold (of what fat threshold)
Endocrine abnormalities - amenorrhoea, delayed growth (in younger people).
BMI <17.5
Anorexia Causes?
genetics, perfectionism, temperament, abuse and adversity, high social class.
ANOREXIA TRETAMENT?
Treatment – family intervention, cognitive behavioural therapy, NGT feeding tube.
Summarise the range of mood disorders accompanying adolescent development?
Depression [pre-pubertal/adolescent depressive disorder]
Bipolar Affective Disorder
Mixed Anxiety and Depression
Psychotic depression
Depression presentation?
Can be single symptom / Can be part of cluster
Adolescent depressive disorder?
Irritability instead of sadness (especially in boys), social withdrawal.
Outcome with high recurrence and impairment in later adult relationships.
Symptoms and classification of depression?
1) Persistent sadness or low mood and/or;
o (2) Loss of interest or pleasure – anhedonia.
o (3) Fatigue/low-energy – anergia.
At least 1 of the above, most of the time for at least 2 weeks and some associated symptoms:
- loss of apatite
- comncentration/sleep e.t.c [total of 10]
Total 10 symptoms then classify level of depression - <4 (not), 4 (mild depression), 5-6 (moderate), 7> (severe).
causes of depression in adolescence?
Developmental consideration – as you develop, these happen which may predispose to depression (e.g more rejection and conflict, endocrine esp females)
Causes – genetics, family interactions (i.e. criticism), life events.
Prognosis of depression in adolescence?
Prognosis – major depression has a high risk of reoccurrence and pre-pubertal onset has a better prognosis.
Interventions for depression in adolescence?
o Cognitive behaviour therapy.
o Interpersonal psychotherapy.
o Family intervention.
o Anti-depressants – SSRIs (for mod severe depression).
Define Conduct disorder?
Conduct disorder – persistent (>6 months) failure to control behaviour appropriately within socially defined rules.
Developmental considerations - as you develop, these happen which may predispose to conduct disorders
o Family changes – less direct surveillance and physical closeness.
o Peer changes – increased involvement with peers may amplify Anti-social-behaviours.
o Experimentation and risk taking – rule violation, drugs and alcohol exposure.
Conduct disorder Males v.s females
some causes
3M:1F, associated with lower socioeconomical status and large family size, week genretic.
