Adolescence and puberty Flashcards
Define adolescence
Period following the onset of puberty during which a young person develops from a child into an adult
What is the normal age of adolescence?
10-19 years
What are the main physical changes associated with adolescence?
Girls:
- Breast budding
- Growth of pubic hair
- Growth spurt
- Menarche
- Growth of underarm hair
- Change in body shape
Boys:
- Growth of scrotum and testes
- Lengthening of penis
- Growth of pubic hair
- Growth spurt
- Change in body shape
- Growth of facial + underarm hair
Define puberty
Process of physical changes through which a child’s body matures into an adult body capable of sexual reproduction
How does puberty start?
- Beginning at approximately age 8, the hypothalamus increases its production of GnRH
- GnRH triggers anterior pituitary to release LH and FSH
- LH and FSH trigger testosterone production in testes and oestrogen production in ovaries
- Sex hormone release has effects: spermatogenesis, folliculogenesis, development of secondary sex characteristics
- Before puberty, the hypothalamus and pituitary are very sensitive to -ve fb signals from testosterone + oestrogen
- During puberty, sensitivity decreases to levels typically seen in adults
- This change allows an increase in production of testosterone and oestrogen that stimulates development of secondary sex characteristics
What is the normal age of onset of puberty in girls?
10
What is the normal age of onset of puberty in boys?
12
How has the onset of puberty changed since the mid-19th century?
- Age of onset consistently lowering
- Every decade from 1840-1950 drop of 4 months in Western European girls
- Multifactorial
- Cultural variation
What is menarche?
Onset of first menstrual cycle
What is adrenarche?
- Occurs prior to onset of puberty
- Increase in adrenal androgen production
- Occurs between ages 6-10
What are the main areas of psychological development in adolescence?
- Cognitive development
- Moral development
- Body weight issues
What are the main areas of normal social development in adolescence?
- Friendships
- Group formation + peer relationships
- Parental conflict - adolescence strive for autonomy
What are the risk factors for anorexia nervosa?
- Psychological
- Low self-esteem
- Depression/anxiety
- Perfectionism
- Temperament - Social
- Cultural variations
- Media
- Certain professions
- Higher social class - Biological
- Genetic predisposition
- Hormonal changes - External
- Dieting
- Life events
- Childhood abuse
Which mood disorders accompany adolescent development?
- Depression
- Bioplar affective disorder
- Psychotic depression
- Mixed anxiety and depression
What are the aetiological and maintaining factors of depression?
- Familial link
- Depressed children more likely to have depressed parents/siblings and vice versa - Moderate heritability - twin studies
- Genetic loading
- Increase young person’s vulnerability to life events - Effects of family interaction, e.g. criticism
- Life events, adversities, grief
What are the main features of anti-social behaviour, conduct disorder and offending?
Disturbance for 12 months involving at least 3 of the following:
- Often bullies, threatens or intimidates
- Often initiates physical fights
- Has used a weapon that can cause serious harm to others
- Has been physically cruel to people
- Has been physically cruel to animals
- Stealing with force
- Forced someone into a sexual act
- Fire-setting to cause damage
- Has destroyed others’ property
- Has broken into car or house
- Cons others
- Stealing without force
- Often out at night without permission
- Ran away from home overnight twice
- Often truants, beginning under 13 years
What are the psychotherapeutic interventions that may ameliorate the problems linked to psychological disorders during development?
- Cognitive behavioural therapy
- Interpersonal psychotherapy
- Family therapy
What are the pharmacological interventions that may ameliorate the problems linked to psychological disorders during development?
- Antidepressants (SSRIs)
- Stimulants (ADHD)
- Melatonin
- Antipsychotics
- Short-term medications
What are the 2 theories for the onset of puberty?
- Maturation of CNS affecting GnRH neurones (increased pulsatile release)
- Altered set point to gonadal steroid -ve fb
What are the major hormones involved in puberty?
- Neurokinin B + kisspeptin - present in same hypothalamic neurones; critical parts of control system that switches on GnRH
- GnRH - stimulates gonadotrope calles of ant pit
- LH - targets Leydig cells + thecal cells
- FSH - targets ovarian follicles, Sertoli cells + spermatogenic tissue
- Testosterone - from Leydig cells, primary androgen
- Oestradiol - acts of ERs
- IGF1 - rises in response to GH, possible principle mediator of growth spurt
- Leptin - from adipose tissue, primary target hypothalamus
What is anorexia nervosa?
Disorder characterised by deliberate weight loss, induced and sustained by the patient
What is conduct disorder?
Persistent failure to control behaviour appropriately within socially defined rules
What are the signs of developmental delay?
Children may present with developmental concerns either through
(i) identification of antenatal or postnatal risk factors
(ii) developmental screening
(iii) concerns raised by parents or other healthcare professionals
Thus, these children may present at any age
