Adolescence and Early Adulthood Flashcards
Define adolescence and adulthood
Adolescence – phase between childhood & adulthood
(Pubertal development may be start of adolescence)
Adulthood – legally, culturally variable
UN definition of children - <18 yrs
What is adrenarche? When does it occur?
Adrenarche – Stimulation of adrenals to form DHEA and DHEAS. Pre-puberty may present will axillary and pubic hair (and aggression)
Females:6-9 yrs
Males:7-10 yrs
What are the HPA and HPG axes controlling growth in adolescence?
CRH – ACTH – Androstenedione and DHEA
GnRH – LH/FSH – Androgen and Oestrogen
Menarche – First period (Can only be defined in retrospect, early cycles irregular)
Leptin from adipose permissive to GnRH from hypothalamus
How do growth patterns in adolescence differ between sexes?
Boy and Girls different patterns
Female growth spurt – 11-13 yrs
Male growth spurt – 14-16 yrs
Describe Kohlberg’s theory of moral development
At birth all humans have no moral or ethical stance.
There are 6 developmental stages, split into 3
different levels:
The first level is about avoiding
punishment.
The second level is about trying to
please others, and make sure that they are happy with what you do.
The third level involves thinking about
ethical principles.
Describe Kohlberg’s theory of moral development
At birth all humans have no moral or ethical stance.
There are 6 developmental stages, split into 3
different levels:
Pre-conventional (1) about avoiding
punishment.
Conventional (2) about trying to
please others, and make sure that they are happy with what you do.
Post-conventional (3) involves thinking about ethical principles.
According to Erikson’s developmental stages what occurs during adolescence?
In adolescence, one of the issues is a conflict between identity and confusion.
Adolescents wonder what they are meant to be
doing with life - causes internal conflict
What is a theory regarding the formation of friendships in humans?
Friendships = reciprocal relationship mimicking attachments between children and their mothers. The type of friends that you develop is similar to the friendship you have with your mother.
What determines friendships for children of various ages?
When younger, friendships are geographically based and practical
As cognitive function further develops, friendships are based on values and beliefs
Adolescents seek friends with same interests
What are the Shaffer characteristics of friendship?
Interact on a regular basis
Sense of belonging
Share implicit or explicit norms in relation to
behaviours
Develop structure/social organization that enables
the group to work together for a shared goal
What drives conflict between adolescents and parents and how can it be resolved?
Adolescence strive for autonomy
Can upset previous family patterns of functioning
Family’s problem solving skills
Family’s communication patterns
Belief system of individuals within the family
How the family interacts on day-to-day level
General consensus that adolescent and parental values are similar
What are the observed pros and cons of increased social media use in young people?
Pros Increased connection Relationship development Obtain information Some increased wellbeing
Cons Cyber bullying Innapropriate content Dangerous contacts (e.g pro-ana groups) Some decreased wellbeing Not secure
Describe the prevalence of mental disorders in adolescents?
Many disorders occur frequently in adolescence: depression, anxiety, self-harm and suicidality
10% of children/young people (5-16 years) have a clinically diagnosable mental health problem
Yet 70% of children/adolescents who experience mental health problems have not had appropriate
interventions at a sufficiently early age
Increase in both self-harm and mental health disabilities in the UK
Eating disorders encompasses bulimia, anorexia, binge eating and other specified feeding disorders
What is anorexia nervosa?
Cardinal features
Body weight (self-induced) maintained 15% below expected wight, or BMI < 17.5.
Psychopathology – dread of fatness, and preoccupation with this.
Endocrine disturbance: amenorrhoea, or delayed growth and puberty in younger sufferers.
Outcome
Community sample: 50% recover after 5 years
Clinic samples: after 1 year 37% recover; 25% weight gain but not menstruating; 37% underweight, symptoms.
Treatment
Family intervention For abnormal eating attitudes and depression: cognitive behavioural therapy.
Small % need admission for weight restoration
What are the epidemiology and causes of anorexia?
Approx 0.5-1% adolescent females are anorexic. <10% anorexic patients are male.
Causes
Genetic predisposition, perfectionist temperament, specific subcultures, childhood abuse and adversities; perhaps higher social class.
What are the symptoms of depression in adolescents?
Affective – sadness, loss of enjoyment, irritability
Cognitive – self-blame, hopelessness, guilt
Biological – disturbed sleep, reduced appetite
May reach threshold for disorder
What factors may contribute towards depression in adolescents?
Endocrine change – especially female may increase risk low mood
Changes in family relationships –physical closeness, joint activities, family conflict
Peers – increased involvement with peers; peer rejection and conflict
Responsibilities and hassles: life events, exams, etc
What is depressive disorder?
2-5% adolescents experience depressive disorder
Causes
Familial aggregation; genetic factors known
Effects of family interaction e.g. criticism
Life events, adversities
Prognosis Major depression: Duration In specialist CAMHS settings: 6-9 months Primary care: 2-3 months High risk recurrence Prepubertal onset – better prognosis Small number in adolescence – bipolar (mania, hypomania)
Treatment
Cognitive behavioural therapy
Interpersonal psychotherapy
Family intervention for associated family problems
Antidepressants – selective serotonin reuptake inhibitors e.g. fluoxetine for moderate – severe depression.
What is depressive disorder?
2-5% adolescents experience depressive disorder
Causes
Familial aggregation; genetic factors known
Effects of family interaction e.g. criticism
Life events, adversities
Treatment
Cognitive behavioural therapy
Interpersonal psychotherapy
Family intervention for associated family problems
Antidepressants – selective serotonin reuptake inhibitors e.g. fluoxetine for moderate – severe depression.
What is the prognosis of depressive disorder?
Major depression: Duration In specialist CAMHS settings: 6-9 months Primary care: 2-3 months High risk recurrence Prepubertal onset – better prognosis Small number in adolescence – bipolar (mania, hypomania)
What is conduct disorder?
Persistent failure to control behaviour appropriately within socially defined rules.
Contributing factors
Changes in family relationships – less direct surveillance, physical closeness, joint activities
Peers – increased involvement with peers; may amplify antisocial behavior
Experimentation and risk taking – rule violation, drugs & alcohol, petty offending frequent.
How may conduct disorder present in an adolescent?
Looses temper and argues
Defies adult requests or rules
Bullies, fights or intimidates,
Stealing, breaking into cars or houses, destroys property running away, truanting
What are the epidemiology and associations of conduct disorder?
4% at ages 5-10 years; 6% at ages 10-15 years; overall 5% at ages 5-15 years.
Higher in deprived inner-city areas
Boys: girls 3:1
Age of onset may vary
Associated with
Larger family size
lower socio-economic status
Genetic – weak
Child – difficult temperament
Family – poor parenting, discord, lack warmth, inconsistent discipline, coercive interaction, aggression
Wider environment (poor schools, neighbourhoods)
What are the outcomes and interventions of conduct disorder?
Outcomes
Poorer outcome with more problems in child, and family
Risk of antisocial personality disorder in males
Range of emotional and personality disorders in females
Interventions For child – problem solving skills. Parent training Family intervention Address problems across contexts e.g. in school
