Adolescence and Puberty

Question 1

What is the mean age of onset of puberty in girls and boys?

Answer 1

Girls - 11.2 yrs

Boys - 11.6 yrs

Question 2

How is puberty instigated hormonally?

Answer 2

By pulsed release of GnRH from specialised nerve cells in the hypothalamus

Question 3

What bone/bones are the major EXCEPTION in the adolescent growth spurt?

Answer 3

Female pelvis - follows a smooth and continuous growth in size until adulthood

Question 4

When does the growth spurt start and finish in girls and boys?

Answer 4

Girls: 10 - 18/19 yrs
Boys: 12 - 20/22 yrs

Question 5

Describe the changes in mineral mass and bone mass in boys and girls during puberty and adolescence.

Answer 5

Mineral mass - same before maturation

Bone mass increases more in boys than girls due to prolonged period of growth in males

Question 6

For girls, how much bone mass is accumulated between 11-13 years compared to how much is lost after menopause?

Answer 6

EQUAL amount

Question 7

What are the 5 Tanner’s stages of puberty in girls? (Hint: breast and pubic hair)

Answer 7

1: None (Prepubertal)
2: Areolar enlargement with breast bud/ few darker hair along labia
3: Enlargement of breast and areolar as single mound/. curly pigmented hairs along pubes
4: Projection of areolar above breast as double mound/ small adult config
5: adult breast - single contour/ adult pubic hair

Question 8

What are the 5 Tanner’s stages of puberty in boys? (Hint: genital maturity and pubic hair)

Answer 8

1: None (testes - 2ml)
2: testes enlarge - 4ml and reddening of scrotum/ few dark hairs at base of penis
3: penis lengthens, testes enlarge - 6-10ml/ curly pigmented hairs across pubes
4: Broadening of glands of penis, testes - 10-15ml/ small adult config (thighs spared)
5: Adult testes - 15-25ml/ adult pubic hair

Question 9

What is precocious puberty and delayed puberty? Is it more common in girls or boys?

Answer 9

Precocious puberty - before 8yrs in girls and 9.5 yrs in boys (5x common in girls)
Delayed puberty - lack of secondary sexual characteristics by 13 yrs in girls and 14 yrs in boys (more common in boys)

Question 10

What determines sexual oritentation?

Answer 10

Environmental, emotional, hormonal and biological factors

Question 11

What happens in the adolescent brain (which part?) before puberty?

Answer 11

Exuberant synaptogenesis
Weaker connects are pruned (cutoff)
Happens mainly in prefrontal cortex

Question 12

What is synaptic pruning?

Answer 12

Selective pruning
Happens in adolescence
Loses approx 3% of the gray matter in the frontal lobes

Question 13

Why do teens in mid adolescence take more risks than older adolescents?

Answer 13

The limbic system perceives rewards from risks and kicks into high gear during early adolescence
The frontal lobe matures later - controls impulses and long-term perspectives

Question 14

Which region of the limibic system is most involved with social recognition?

Answer 14

Amygdala

Question 15

What are the social developmental tasks that adolescents might go through?

Answer 15

Emotional separation from parents
Peer identity - social autonomy 
Exploratory behaviours
Intimate relationships
Vocational capabilities/ financial independence

Question 16

What are the Kohlberg’s moral stages? (mention ages)

Answer 16

Preconventional (up to 9yrs)
Conventional (most adolescents and adults)
Postconventional (0-15% of over 20s)

Question 17

What are the effects of tobacco and alcohol on the developing of the adolescent brain?

Answer 17

On hippocampus (working memory and learning)
Less sensitive to sedative qualities of alcohol (drinks a lot before crashing)
Nicotine - cell damage worse in hippocampus

Question 18

What happens to the circadian rhythm and melatonin secretions in adolescence?

Answer 18

Circadian rhythm shifts forwards
Melatonin secretions (trigger sleep) start later at night and turn off later in the morning
Need more sleep (9-10 hrs)
Most are sleep deprived

Question 19

What does the quality of care-giving in the first 42 months of life affect?

Answer 19

Predicts the quality of romantic relationships in early adulthood

Question 20

What is the Bilbace and Walsh model?

Answer 20

Explains children’s explanation of illness
E.g. 11-16 yrs (adolescence) = physiological
ilness is caused by malfunctions in organs or systems which may be due to infection

Question 21

What is the STEP approach?

Answer 21

Simple approach to considering adolescent development in clinical settings
S - Sexual maturation and growth
T - Thinking
E - Education/Employment
P - Peers/Parents

Question 22

What are Tanner’s stages used to assess?

Answer 22

Development of secondary sexual characteristics