Adolescence and puberty Flashcards
what is adolescence?
phase between childhood and adulthood.
pubertal development may be the start of adolescence
what is adulthood?
legally and cultural variability by usually above 18 years old.
capacity is at the age of 16 but can be over-ridden by an adult.
what are the main changes in adolescence?
cognitive/emotional changes- identity, awareness of the world, emotional change.
peers -sexual relationships, confinding, social/anti-social behaviour
biology - endocrine changes and physical growth
family- challenging rules + less intimacy in parents
what is adrenarche?
the stimulation of the adrenals to form DHEA and DHEAs which are metabolic intermediates in the formation of sex steroids.
girls occurs before boys - girls developmentally 2 years ahead.
girls start at 12/13 and boys at 15/16
what are similarities and differences in andrenarche?
both stimulated by the hypothalamus.
in andrenarchy this is the release of CRH to the pituitary which releases ACTH to the adrenal cortex to release DHEA.
in puberty - this is GnRH to the pituitary releasing FSH and LH to the gonads to release either oestrogen or androgens + inhibin.
—> leptin triggers the releases of GnRH.
what is menarche?
the first period - after three periods so defined in retrospect.
happens late in puberty
how many stages are there in puberty?
5
1- everything before puberty
2-4 puberty
5- fully developed
they fall into three domains:
- pubic hair
- axillary hair
- changes in breast or gonad size
what is the secular trends in puberty and why?
there is a decrease in the beginning age of puberty.
this is due to improvements in diet.
what are the psychological changes in adolescence?
cognition - mortality (ability to think –> concrete to formal during puberty (abstract reasoning)
identity- do i like who i am etc
increased self-awareness - how i feel?
affect expression and regulation - no language for feelings and how to regulate your feelings.
what are the social changes in adolescence?
family- parental surveillance and confining in parents
peers - increased importance, more complex and hierarchical. more sensitive to acceptance and rejection and romantic relationships
social role - education and occupation.
what are the wider social influences on adolescence?
school
work
culture - racial culture
social health
what are the brain changes in adolescence years?
there is a change in the cortical thickness.
then begins to narrow due to synaptic pruning - removing the redundant parts
why is there behavioural problems during adolescence?
there is a mismatch between the different parts of the brain.
one part there is greater feelings and integrate and understand it.
the dopaminergic activity is behind this and this leads to the behavioural issues.
what are risks in adolescence?
sex
delinquency
violence
self-harm
disease control
when do mental health problems start?
1/2 before 14 and so is more evident at adolescence.
what are mental health disorders divided into?
emotional
behavioural
hyperactivity
etc
what is anorexia nervosa?
low body weight –> 15% below average or less tha 17/5 BMI
avoidance of fattening foods.
psychopathogy-morbid dread of fatness
endocrine disturbance
may use appetite suppressants
may be induce vomiting
what are the causes of anorexia?
Genetic predisposition
perfectionist temperament
specific subcultures
childhood abuse and adversities
perhaps higher social class.
what are the treatments of anorexia?
Family intervention
For abnormal eating attitudes and depression: cognitive behavioural therapy.
Small % need admission for weight restoration
what are the symptoms of depression?
Affective – sadness, loss of enjoyment, irritability
Cognitive – self-blame, hopelessness, guilt
Biological – disturbed sleep, reduced appetite
May reach threshold for disorder
what are the causes of depression?
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
Familial aggregation; genetic factors known
Effects of family interaction e.g. criticism
Life events, adversities
which has a better prognosis pre or post pubertal depression?
pre-pubertal
what are interventions for depression?
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 conduct disorder?
Persistent failure to control behaviour appropriately within socially defined rules.
what are the symptoms of conduct disorder?
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 causes of conduct disorder?
- 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 for conduct disorder?
Poorer outcome with more problems in child, and family
Risk of antisocial personality disorder in males
Range of emotional and personality disorders in females
what are the interventions in conduct disorder?
For child – problem solving skills.
Parent training
Family intervention
Address problems across contexts e.g. in school
