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 in boys?
Growth of scrotum + 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?
- At ~ age 8, hypothalamus increases production of GnRH
- GnRH triggers anterior pituitary to release LH + FSH
- LH + FSH trigger testosterone production in testes + oestrogen production in ovaries
- Sex hormone release has effects: spermatogenesis, folliculogenesis, development of secondary sex characteristics
- Before puberty, the hypothalamus + 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 + oestrogen that stimulates development of secondary sex characteristics
What is the normal age of onset of puberty?
Girls: 10
Boys: 12
How has the onset of puberty changed since the mid-19th century? What may be the reasons for this?
Age of onset consistently lowering
improved health care
improved socio-economic factors
What is menarche?
Onset of 1st menstrual cycle
What is adrenarche? How does adrenarche manifest clinically?
Occurs prior to onset of puberty
Increase in adrenal androgen production
Between ages 6-10
Appearance of axillary + pubic hair
What are the main areas of psychological development in adolescence?
Cognitive development e.g. abstract thinking
Identity e.g. own values
Increased self-awareness
Emotional expression + regulation
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?
Earlier pubertal maturation + higher body fat
Concurrent psychological problems e.g. Depression
Poor body image
Specific cognitive phenotypes
Which mood disorders accompany adolescent development?
Depression
Bioplar affective disorder
Psychotic depression
Mixed anxiety + depression
What are the aetiological and maintaining factors of depression?
Familial link: Depressed children more likely to have depressed parents/siblings + 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 conduct disorder?
Bullies, threatens or intimidates Initiates physical fights Loses temper + argues Stealing, breaking into cars/ houses Running away/ truanting
What are the psychotherapeutic interventions for psychological disorders during development?
Cognitive behavioural therapy
Interpersonal psychotherapy
Family therapy
Psychosocial intervention
What are the pharmacological interventions for psychological disorders during development?
Antidepressants (SSRIs)
Stimulants (ADHD)
Antipsychotics
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 cells 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 + 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
What are the main physical changes associated with adolescence in girls?
Breast budding Growth of pubic hair Growth spurt Menarche Growth of underarm hair Change in body shape
What hypothalamic hormones are involved in adrenarche and menarche?
A: CRH
M: GnRH
