Adolescence and puberty

Question 1

what is adolescence?

Answer 1

phase between childhood and adulthood.

pubertal development may be the start of adolescence

Question 2

what is adulthood?

Answer 2

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.

Question 3

what are the main changes in adolescence?

Answer 3

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

Question 4

what is adrenarche?

Answer 4

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

Question 5

what are similarities and differences in andrenarche?

Answer 5

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.

Question 6

what is menarche?

Answer 6

the first period - after three periods so defined in retrospect.

happens late in puberty

Question 7

how many stages are there in puberty?

Answer 7

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

Question 8

what is the secular trends in puberty and why?

Answer 8

there is a decrease in the beginning age of puberty.

this is due to improvements in diet.

Question 9

what are the psychological changes in adolescence?

Answer 9

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.

Question 10

what are the social changes in adolescence?

Answer 10

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.

Question 11

what are the wider social influences on adolescence?

Answer 11

school

work

culture - racial culture

social health

Question 12

what are the brain changes in adolescence years?

Answer 12

there is a change in the cortical thickness.

then begins to narrow due to synaptic pruning - removing the redundant parts

Question 13

why is there behavioural problems during adolescence?

Answer 13

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.

Question 14

what are risks in adolescence?

Answer 14

sex

delinquency

violence

self-harm

disease control

Question 15

when do mental health problems start?

Answer 15

1/2 before 14 and so is more evident at adolescence.

Question 16

what are mental health disorders divided into?

Answer 16

emotional

behavioural

hyperactivity

etc

Question 17

what is anorexia nervosa?

Answer 17

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

Question 18

what are the causes of anorexia?

Answer 18

Genetic predisposition

perfectionist temperament

specific subcultures

childhood abuse and adversities

perhaps higher social class.

Question 19

what are the treatments of anorexia?

Answer 19

Family intervention

For abnormal eating attitudes and depression: cognitive behavioural therapy.

Small % need admission for weight restoration

Question 20

what are the symptoms of depression?

Answer 20

Affective – sadness, loss of enjoyment, irritability

Cognitive – self-blame, hopelessness, guilt

Biological – disturbed sleep, reduced appetite

May reach threshold for disorder

Question 21

what are the causes of depression?

Answer 21

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

Question 22

which has a better prognosis pre or post pubertal depression?

Answer 22

pre-pubertal

Question 23

what are interventions for depression?

Answer 23

Cognitive behavioural therapy

Interpersonal psychotherapy

Family intervention for associated family problems

Antidepressants – selective serotonin reuptake inhibitors e.g. fluoxetine for moderate – severe depression.

Question 24

what is conduct disorder?

Answer 24

Persistent failure to control behaviour appropriately within socially defined rules.

Question 25

what are the symptoms of conduct disorder?

Answer 25

looses temper and argues

defies adult requests or rules

bullies, fights or intimidates, stealing, breaking into cars or houses, destroys property running away, truanting

Question 26

what are causes of conduct disorder?

Answer 26

1. Genetic – weak
2. Child – difficult temperament
   Family – poor parenting, discord, lack warmth, inconsistent discipline, coercive
   interaction, aggression.
3. Wider environment poor schools + neighbourhoods

Question 27

what are the outcomes for conduct disorder?

Answer 27

Poorer outcome with more problems in child, and family

Risk of antisocial personality disorder in males

Range of emotional and personality disorders in females

Question 28

what are the interventions in conduct disorder?

Answer 28

For child – problem solving skills.

Parent training

Family intervention

Address problems across contexts e.g. in school