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Y2 LCRS 1 - RDA > Adolescence and puberty > Flashcards

Adolescence and puberty Flashcards

1
Q

Define adolescence

A

Period following the onset of puberty during which a young person develops from a child into an adult

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2
Q

What is the normal age of adolescence?

A

10-19 years

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3
Q

What are the main physical changes associated with adolescence?

A

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

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4
Q

Define puberty

A

Process of physical changes through which a child’s body matures into an adult body capable of sexual reproduction

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5
Q

What is menarche?

A

Onset of first menstrual cycle

(linked to adiposity - leptin)

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6
Q

What is adrenarche?

A
  • Precedes puberty
  • Development of the new zone in the adrenal cortex (zona reticularis)
    • Increase in adrenal androgen production
    • NOTE: glomerulosa = aldosterone; fasciculata = cortisol
  • Occurs between ages 6-10
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7
Q

How does puberty start?

A
  1. Beginning at approximately age 8, the hypothalamus increases its production of:-
    • new pathway discovered → KISS gene encodes kisspeptin → switches on GnRH
    • GnRH pulsatile release - marks the start of puberty
  2. GnRH triggers anterior pituitary to release LH and FSH - marks the start of puberty
  3. LH and FSH trigger testosterone production in testes and oestrogen production in ovaries
  4. Sex hormone release has effects: spermatogenesis, folliculogenesis, development of secondary sex characteristics
  5. Before puberty, the hypothalamus and pituitary are very sensitive to -ve fb signals from testosterone + oestrogen
  6. During puberty, sensitivity decreases to levels typically seen in adults
  7. This change allows an increase in production of testosterone and oestrogen that stimulates development of secondary sex characteristics
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8
Q

What are the major hormones involved in puberty?

A
  1. Neurokinin B + kisspeptin - present in same hypothalamic neurones; critical parts of control system that switches on GnRH
  2. GnRH - stimulates gonadotrope calles of ant pit
  3. LH - targets Leydig cells + thecal cells
  4. FSH - targets ovarian follicles, Sertoli cells + spermatogenic tissue
  5. Testosterone - from Leydig cells, primary androgen
  6. Oestradiol - acts of ERs
  7. IGF1 - rises in response to GH, possible principle mediator of growth spurt
  8. Leptin - from adipose tissue, primary target hypothalamus
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9
Q

What is the normal age of onset of puberty in girls?

A

10

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10
Q

What is the normal age of onset of puberty in boys?

A

12

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11
Q

How has the onset of puberty changed since the mid-19th century?

A
  • Age of onset consistently lowering - Every decade from 1840-1950 drop of 4 months in Western European girls - Multifactorial - Cultural variation
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12
Q

What are the main areas of psychological development in adolescence?

A
  • Cognitive development e.g. Moral development
  • Identity
  • Increased self awareness - Body weight issues
  • Affect expression and regulation
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13
Q

What are the main areas of normal social development in adolescence?

A
  • Friendships
  • Group formation + peer relationships
  • Parental conflict - adolescence strive for autonomy
  • Social role - education, occupation
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14
Q

What are the neurological changes during adolescence and what are the implications?

A
  1. Increase in cortical thickness and the rate of increase changes over age
    • peaks at 9, decreases afterthat this is due to synaptic pruning
    • process by which extra neurons and synaptic connections are eliminated in order to increase the efficiency of neuronal transmissions
  2. Developmental mismatch hypothesis - grey, white and dopaminergic pathway changes - increase vulnerability to risk taking
  • proposes that, in humans, subcortical structures involved in processing affect and reward develop earlier than cortical structures involved in cognitive control, and that this mismatch in maturational timing is most exaggerated during adolescence.
  • Furthermore, the mismatch in maturational timing between these two systems has been proposed to underlie stereotypical adolescent behaviors such as risk taking, sensation seeking and heightened emotional reactivity.
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15
Q

What are the risk factors for anorexia nervosa?

A
  1. Psychological - Low self-esteem - Depression/anxiety - Perfectionism - Temperament
  2. Social - Cultural variations - Media - Certain professions - Higher social class
  3. Biological - Genetic predisposition - Hormonal changes
  4. External - Dieting - Life events - Childhood abuse
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16
Q

Which mood disorders accompany adolescent development?

A
  1. Depression
  2. Bioplar affective disorder
  3. Psychotic depression
  4. Mixed anxiety and depression
17
Q

What are the aetiological and maintaining factors of depression?

A
  1. Familial link - Depressed children more likely to have depressed parents/siblings and vice versa
  2. Moderate heritability - twin studies
  3. Genetic loading - Increase young person’s vulnerability to life events
  4. Effects of family interaction, e.g. criticism
  5. Life events, adversities, grief
18
Q

What are the psychotherapeutic interventions that may ameliorate the problems linked to psychological disorders during development?

A
  1. Cognitive behavioural therapy
  2. Interpersonal psychotherapy
  3. Family therapy
19
Q

What are the pharmacological interventions that may ameliorate the problems linked to psychological disorders during development?

A
  1. Antidepressants (SSRIs)
  2. Stimulants (ADHD)
  3. Melatonin
  4. Antipsychotics
  5. Short-term medications
20
Q

What are the 2 theories for the onset of puberty?

A
  1. Maturation of CNS affecting GnRH neurones (increased pulsatile release)
  2. Altered set point to gonadal steroid -ve fb
21
Q

What is anorexia nervosa?

A

Disorder characterised by deliberate weight loss, induced and sustained by the patient

  • Body weight at least 15% below expected
  • Avoidance of fattening foods
  • Or persistent behaviour that interfere with weight gain
  • Psycholpathology morbid dread of fatness, aims for weight lower than premorbid or healthy
  • Endocrine disturbance
  • May also be other weight loss behavior
  • Persistent restrction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical healthy)
  • BOLD = new additions
22
Q

What are the neuropsychology of anorexia nervosa?

A

Executive function deficits

23
Q

What is conduct disorder?

A

Definition by law

Definition by society

Definition by psychiatry

Persistent failure to control behaviour appropriately within socially defined rules

Persistive and persistent (> 9 months)

24
Q

What are the main features of anti-social behaviour, conduct disorder and offending?

A

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
25
Q

What are the signs of developmental delay?

A

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

Y2 LCRS 1 - RDA (11 decks)

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