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YR2: Reproduction, Ageing and Development > 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 in boys?

A 
Growth of scrotum + 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

How does puberty start?

A
  1. At ~ age 8, hypothalamus increases production of GnRH
  2. GnRH triggers anterior pituitary to release LH + FSH
  3. LH + FSH trigger testosterone production in testes + oestrogen production in ovaries
  4. Sex hormone release has effects: spermatogenesis, folliculogenesis, development of secondary sex characteristics
  5. Before puberty, the hypothalamus + 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 + oestrogen that stimulates development of secondary sex characteristics
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6
Q

What is the normal age of onset of puberty?

A

Girls: 10
Boys: 12

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7
Q

How has the onset of puberty changed since the mid-19th century? What may be the reasons for this?

A

Age of onset consistently lowering
improved health care
improved socio-economic factors

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8
Q

What is menarche?

A

Onset of 1st menstrual cycle

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9
Q

What is adrenarche? How does adrenarche manifest clinically?

A

Occurs prior to onset of puberty
Increase in adrenal androgen production
Between ages 6-10
Appearance of axillary + pubic hair

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10
Q

What are the main areas of psychological development in adolescence?

A

Cognitive development e.g. abstract thinking
Identity e.g. own values
Increased self-awareness
Emotional expression + regulation

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11
Q

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

A

Friendships
Group formation + peer relationships
Parental conflict: adolescence strive for autonomy

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12
Q

What are the risk factors for anorexia nervosa?

A

Earlier pubertal maturation + higher body fat
Concurrent psychological problems e.g. Depression
Poor body image
Specific cognitive phenotypes

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13
Q

Which mood disorders accompany adolescent development?

A

Depression
Bioplar affective disorder
Psychotic depression
Mixed anxiety + depression

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14
Q

What are the aetiological and maintaining factors of depression?

A

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

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15
Q

What are the main features of conduct disorder?

A 
Bullies, threatens or intimidates
Initiates physical fights
Loses temper + argues
Stealing, breaking into cars/ houses
Running away/ truanting
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16
Q

What are the psychotherapeutic interventions for psychological disorders during development?

A

Cognitive behavioural therapy
Interpersonal psychotherapy
Family therapy
Psychosocial intervention

17
Q

What are the pharmacological interventions for psychological disorders during development?

A

Antidepressants (SSRIs)
Stimulants (ADHD)
Antipsychotics

18
Q

What are the 2 theories for the onset of puberty?

A

Maturation of CNS affecting GnRH neurones (increased pulsatile release)
Altered set point to gonadal steroid -ve fb

19
Q

What are the major hormones involved in puberty?

A

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

20
Q

What is anorexia nervosa?

A

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

21
Q

What is conduct disorder?

A

Persistent failure to control behaviour appropriately within socially defined rules

22
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

23
Q

What are the main physical changes associated with adolescence in girls?

A 
Breast budding
Growth of pubic hair
Growth spurt
Menarche
Growth of underarm hair
Change in body shape
24
Q

What hypothalamic hormones are involved in adrenarche and menarche?

A

A: CRH
M: GnRH

25
Q

When does the growth spurt occur in boys and girls?

A

B: Late pubertal event
G: Early pubertal event

26
Q

What is the developmental mismatch hypothesis?

A

Reward driven activities are ahead of cognitive + emotional ability to respond rationally to, cope with + think through risky activity, tends to result in miscalculated risks

27
Q

List 3 predisposing factors of anorexia nervosa

A

Genetics
Perfectionism
Culture

28
Q

List 3 precipitating factors of anorexia nervosa

A

Bullying
Severe food reaction
Friend with ED

29
Q

List 3 perpetuating factors of anorexia nervosa

A

Feelings of control
Positive reactions to ED
Behavioural habit

30
Q

List 5 symptoms of depression

A 
Low mood
Loss of enjoyment
Loss of energy
Appetite change
Sleep change
31
Q

What criteria need to accompany the symptoms of depression?

A

Pervasive nature of symptoms
Impairing daily life
Present for > 2 weeks

32
Q

What are the associated problems of depression?

A

Increased risk of self harm
Anxiety + eating disorders
Substance misuse
Familial aggregation

33
Q

What are the 2 main types of pre-pubertal depression?

A
  1. Presents with co-morbid behavioural problems, similar to CD, no increased risk of recurrence
  2. Familial, high rates of anxiety + BPD, recurrences as adult
34
Q

How may adolescent depressive disorder present?

A

Irritability
Somatic complaints
Social withdrawal

35
Q

What interventions are useful in treatment of conduct disorder?

A

Parenting programmes
Interventions at school
Managing underlying hyperactivity

36
Q

What causes are associated with conduct disorder?

A

Child has difficult temperament e.g. inconsistent discipline
Genetic
Environment e.g. neighbourhood

YR2: Reproduction, Ageing and Development (9 decks)

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