Adolescence and Puberty

Question 1

Define adolescence

Answer 1

a transitional stage ofphysicalandpsychological developmentbetween childhood and adulthood

Question 2

Define puberty

Answer 2

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

Question 3

Give the boundaries for early, middle and late adolescence

Answer 3

E = 11-14
M = 14-17
L = 18+

Question 4

What are the main physical changes that occur in adolescence for girls

Answer 4

Breast budding
Growth spurt 
First period
Growth of underarm and pubic hair 
Change in body shape

Question 5

What are the main physical changes that occur in adolescence for boys

Answer 5

Growth of scrotum and testes
Change in voice
Penis lengthening 
Pubic, facial and underarm hair growth
Change in body shape

Question 6

Compare the age of onset of growth spurts in girls and boys

Answer 6

Growth spurts have an earlier onset in girls than in boys (10-14 vs 11-17)

Question 7

When does puberty begin and what initiates it

Answer 7

Begins around 11 for girls, 12 for boys

Initiated by the various hormones in the brain signalling to the tests/ovaries

Question 8

What are the changes in brain development in adolescence

Answer 8

Brain development underpins cognitive changes in adolescence.
In the prefrontal cortex:
Up to puberty - increase in grey matter
After puberty - grey matter density decreases to early adulthood
From puberty onwards, there is an increase in cortical white matter.

Question 9

What is adrenarche

Answer 9

stimulation of adrenal androgen production (DHEA and DHEAS)

this occurs prior to onset of puberty (6-10yrs)

Question 10

What is menarche

Answer 10

onset of first menstrual cycle

Question 11

What are the overall changes in psychological development during adolescence

Answer 11

Cognition e.g. morality
Identity
Increased self-awareness
Affect expression and regulation
Formal operational (think in an abstract, hypothetical manner)

Question 12

Give examples of social changes that occur in adolescence

Answer 12

Parental surveillance, confiding and conflicts
Increased importance of peers
Peer groups become more complex and hierarchical
More sensitive to acceptance and rejection
Romantic relationships

Question 13

summarise the change in the onset of puberty since the mid-19th century and the adolescent attitudes to pubertal development

Answer 13

Age at menarche has decreased over the last 150 years and has levelled off over the last 3-4 decades.

Question 14

How is puberty associated with anorexia nervosa

Answer 14

For girls, puberty causes increased adiposity and body shape dissatisfaction

Question 15

What are the key features of anorexia nervosa

Answer 15

Self-induced weight loss

Body weight maintained 15% below expected weight, or BMI < 17.5.

Question 16

Describe the psychopathology of anorexia nervosa

Answer 16

The dread of fatness and flabbiness persisting as an intrusive overvalued idea

Question 17

What are the endocrine disturbances that occur in anorexia nervosa

Answer 17

amenorrhoea
delayed growth
puberty in younger sufferers.

Question 18

What are the risk factors for anorexia nervosa

Answer 18

Being female 
Low self esteem
Depression/anxiety
Cultural variation
Media 
Genetic predisposition
Dieting
Childhood abuse
Higher social class

Question 19

How is anorexia nervosa treated

Answer 19

psych interventions = family therapy, CBT

physical: admissions if extreme or NGT feeding tube

Question 20

Give examples of mood disorders that might arise in adolescence

Answer 20

Depression
Bipolar Affective Disorder
Mixed Anxiety and Depression
Psychotic depression

Question 21

What is depression

Answer 21

May refer to a single symptom, a symptom cluster or a disorder

Single: feeling miserable, differing severity, persistence and mood quality
Cluster: with various affective, cognitive and behavioural symptoms

Question 22

What are the symptom clusters of depression

Answer 22

Affective – sadness, loss of enjoyment, irritability

Cognitive – self-blame, hopelessness, guilt

Biological – disturbed sleep, reduced appetite

Question 23

Give examples of environmental factors that might contribute to the onset of depression in adolescence

Answer 23

Endocrine change
Changes in family relationships
Peers
Responsibilities and hassles

Question 24

What are the interventions for mood disorders

Answer 24

Mainly cognitive behavioural therapy
Family/Interpersonal therapy
Pharmacology

Question 25

What drugs can be used for mood disorders

Answer 25

SSRIs e.g. fluoxetine for moderate – severe depression
Antipsychotics
Melatonin (sleep)

Question 26

What is conduct disorder

Answer 26

Persistent failure to control behaviour appropriately within socially defined rules

Question 27

What are the features of conduct disorder

Answer 27

child that looses temper and argues
defies adult requests or rules
bullies
fights or intimidates
commits crimes and steals

Question 28

What are the contributing developmental factors to conduct disorder

Answer 28

changes in family relationships, peer pressure

Question 29

Describe the epidemiology of conduct disorder

Answer 29

4% at ages 5-10 years
6% at ages 10-15 years
overall 5% at ages 5-15 years
Higher in deprived inner-city areas
Boys: girls 3:1

Question 30

What interventions are used for conduct disorder

Answer 30

For child – problem solving skills,
Parent training, Family intervention
Address problems across contexts e.g. in school