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Y2 LCRS Reproduction, Development and Ageing > adolescence > Flashcards

adolescence Flashcards

1
Q

define adolescence

A

phase between childhood and adulthood (expanding from 10-25 y/o)

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2
Q

what may be start of adolescence

A

pubertal development

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3
Q

4 key constructs that change significantly during adolescence

A

cognitive/emotional changes (hormonally driven, identitiy and self-awareness), peers (increase importance), family (challenge rules), biology (puberty, growth)

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4
Q

puberty, marriage and childbirth: 1950 vs now

A

now earlier puberty, later marriage and childbirth

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5
Q

what is adrenarche

A

before puberty and associated with appearance of axillary and pubic hair around 8 y/o

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6
Q

what drives adrenarche

A

adrenal glands to produce DHEA and DHEAS (not gonadal)

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7
Q

when does adrenarche happen

A

in females 6-9 y/o, in males 7-10 y/o

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8
Q

adrenal production pathway (adrenarche)

A

hypothalamus -> CRH -> pituitary -> ATCH -> adrenal cortex -> DHEA (development of pubic hair, armpit hair and acne in females, along with androgens)

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9
Q

gonadal production pathway (puberty)

A

hypothalamus -> GnRH -> pituitary -> LH/FSH -> gonads -> sperm/ovary production, androgen production (development of pubic hair, penis and testes in males) and oestrogen production (development of breasts, ovaries and uterus in females)

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10
Q

pattern of growth in puberty for boys and girls

A

girls do it 2 years earlier (12 vs 14), but wide variation; for girls, growth spurt is early pubertal event, but for boys it is a late pubertal event

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11
Q

why has age of puberty reduced over past centuries

A

improved nutrition

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12
Q

4 psychological changes in adolescence

A

cognition (morality), identity, increased self-awareness, affect expression and regulation

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13
Q

3 social changes in adolescence (deficits core to mental health)

A

family (parental surveillance, confiding), peers (increased importance, heirarchy, romantic), social role (education, occupation etc.)

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14
Q

4 wider social influences in adolescence

A

school, work, culture, social influences (e.g. unemployment, poverty, housing etc.)

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15
Q

describe what happens to cortex in brain development

A

thickens, then thins again

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16
Q

what does crossover from grey matter to white matter (pruning) account for and why

A

fail to calculate risks as mismatch between dopminergic pathways for reward and regulatory congnitive control

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17
Q

examples of risks in pruning

A

sex, delinquency, violence, self-harm, disease control

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18
Q

link of brain development with mental health

A

most in adolescence; 1/10 between 5-16 have diagnosable condition; 1/2 of all mental health problems established by 14; 3/4 all mental health problems established by 24

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19
Q

when do emotional orders emerge vs behavioural, hyperactivity and less common disorders

A

later on (between 17-19 y/o), vs younger

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20
Q

DSM-5 criteria for anorexia nervosa (no absolute normal low weight, but only mental health condition with weight; highest mortality of psychiatric disorders)

A

restriction of energy intake relative to requirements so significantly low body weight in context; intense fear of gaining weight/becoming fat; disturbance in experience of weight/shape, undue influence of weight/shape on self-evaluation, or persistent lack of recognition of seriousness of low body weight (not amenorrhoea as affects all)

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21
Q

2 subtypes of anorexia nervosa

A

restricting, binge-eating/purge

22
Q

formulation framework for mental health conditions

A

predisposing, precipitating, perpetuating, protective; focuses on individual, family and systemic, or biological, psychological and social

23
Q

what increases likelihood of suffering from anorexia nervosa

A

complex combination of psychiatric and somatic (genetic and hormonal) risk factors

24
Q

what are adolescent eating problems associated with

A

earlier pubertal maturation and higher body fat, concurrent psychological problem e.g. depression, poor body image, specific cognitive phenotypes

25
Q

why are anorexia nervosa and autistic spectrum disorder associated

A

when starved, become more narrow-minded (don’t see bigger picture), so difficult to separate effects of starvation from predisposing phenotype

26
Q

2 main drivers for eating disorders and obesity

A

dieting and body image satisfaction

27
Q

treatment for young people with eating disorders if they have parental/carer support

A

focussed family therapy in conjoint, separated or multifamily format (as outpatient; if too sick, as day patient following brief admission for medical stabilisation)

28
Q

prognostic factor for anorexia nervosa

A

duration of illness (earlier the better)

29
Q

concepts of depression: dimension

A

more symptoms you have, more impaired you’re likely to be (continuum)

30
Q

concepts of depression: category

A

either depressed or not

31
Q

3 core symptoms of depression

A

low mood/sadness, loss of enjoyment (anhedonia), loss of energy

32
Q

what can depression manifest as

A

changes to appetite, sleep, concentration, pessimistic thoughts, self-esteem, libido, psychomotor agitation, self harm

33
Q

diagnostic threshold for depression

A

symptoms pervasive (behave differently but feel same in different contexts), impairing and for >2 weeks

34
Q

subcategories of depression based on severity

A

mild, moderate, severe

35
Q

subcategories of depression based on course

A

depressive episodes, recurrent depression, dysthymia, bipolar, pyschotic, atypical, seasonal affective disorder, inflammatory

36
Q

what is depression associated with

A

increased risk of self-harm; association with anxiety disorders, eating disorders, substance misuse etc.; familial aggregation

37
Q

2 main types of pre-pubertal depression

A

brought on by low mood with co-morbid behavioural problems (associated with family circumstances and other types of anti-social behaviour, with no recurrence in adulthood), and pure depressive (highly familial with recurrence in adulthood)

38
Q

what can adolescent depressive disorder look like

A

irritability instead of sadness, somatic complaints and social withdrawal (psychotic symptoms rate before mid-adolescence)

39
Q

adolescent depressive disorder: short term outcome

A

high rates of persistence and recurrence

40
Q

adolescent depressive disorder: long term outcomes

A

significant continuity adolescence into adulthood, with impaired relationships and education

41
Q

what influences vulnerability to depression

A

biological changes, social changes, life events (e.g. losses), psychological and cognitive emotional changes

42
Q

3 treatments for mild depression

A

cognitive behavioural therapy, interpersonal psychotherapy for adolescents, brief psychosocial intervention

43
Q

2 treatments for moderate-severe depression

A

antidepressants e.g. SSRIs, cognitive behavoural therapy and antidepressant

44
Q

what is anti-social behaviour defined by

A

society

45
Q

what is delinquency/offending defined by

A

law

46
Q

what is conduct disorder defined by

A

psychiatry

47
Q

what is conduct disorder (commonest psychiatric disorder of childhood that increases with age and is more common in urban areas)

A

repetitive and persistent (>6 months) pattern of behaviour, with frequency and severity beyond age appropriate norms; usually adolescent-limited

48
Q

examples of conduct disorder behaviours

A

oppositional behaviour, tantrums, excessive fighting, running away from home, truancy, cruelty to animals, stealing, destroying, arson

49
Q

types of conduct disorder

A

socialised (with peer group), unsocialised (alone - worse prognosis feature)

50
Q

3 factors affecting conduct disorder

A

child factors e.g. ADHD, family factors e.g. inadequate parenting, environmental factors e.g. inner city

51
Q

describe intervention of conduct disorder

A

target at major modifiable risk factors, early, manage underlying hyperactivity, parenting programmes, cognitive problem-solving skills training, interventions at school, multi-systemic therapy

52
Q

what is conduct disorder a predictor of (importance of prevention)

A

antisocial personality disorder in adulthood, alcoholism and drug dependence, unemployment and relationship difficulties

Y2 LCRS Reproduction, Development and Ageing (10 decks)

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