Adolescent Development and Implications on Health Care Flashcards
Define adolescence?
Definition includes PHYSICAL and PSYCHOLOGICAL factors.
The period between childhood and adulthood which is age 12-21.
It is the period between onset of physical changes of puberty until adoption of “adult role”
Storm and Stress
Not the norm for adolescents
Most adolescents navigate this interval with minimal functional difficulties
But, empiric evidence for:
Increased conflict with parents
Mood volatility (and increased negative mood)
A higher percentage of adolescents have symptoms, mostly of depression or anxiety, but not sufficient to mildly impair their functioning
Increased risk behavior, recklessness, and sensation-seeking.
About 20% of adolescents with moderate or severe symptomatology that impairs functioning In fact, in recent years, there has been lowered rates of sexual activity, pregnancy and STDs
What is the difference between primary vs secondary sex characteristics?
Primary sex characteristics
The body organs and reproductive structures and functions that differ between women and men.
Gonads (testes and ovaries) things that you are born with.
Secondary sex characteristics
Characteristics of the body that are caused by HORMONAL changes DURING PUBERTY and last through adult life. I.E
Changes in genitals/breasts/voice
Pubic/body/facial hair
What are the physical changes that take place in adolescence?
Gain 25% of final height
Doubling of body mass
Major increase in genital system and secondary sex characteristics
Changes in shoulder width, pelvic width
Change in facial structure and appearance
Timing of pubertal changes?
For women breast development begins at 10 and ends around 14.5. The growth spurt begins at 10 and ends around 13. Pubic hair begins around 10.5. Menarche happens between the age of 12-13.
For men testes and scrotum development at 11.5 and ends around 14.5. Pubic hair begins at 12 and ends around 15.5. The growth spurt begins at 12.5 and ends around 15.5. The first ejaculation is at 13. The last thing to happen is the deepen voice which takes place at age 14ish.
What can happen with poor adaptation?
Poor adaptation can slow puberty
When an adolescence undergoes physical changes what do they need?
Physical changes demand accommodation (understanding, acceptance, coping)- it is a normative stress
Rate of Maturation
Rate of maturation may have significant consequences for adolescents.
Early maturation usually benefits boys, but not girls.
Early maturing girls had more negative feelings about their physical development, while boys tend to have more positive feelings.
Late maturing boys have lower self esteem and more difficulties with independence
Puberty-related behavioral and psychological domains
Adolescent period marked by: -Increased biological driven intensity of emotions -Greater inclination to seek experiences that create high--intensity feelings -Emotion Motivation Arousal Appetite Drives Peer affiliation Romantic motivation Sexual interest Emotional intensity Changes in fear regulation Risk for mood disorders (females) Increase risk-taking, novelty seeking, sensation seeking
Adolescent cognitive development
refers to how a person perceives, thinks, and gains an understanding of his or her world through the interaction and influence of genetic and learned factors.
Adolescent thinking from Concrete to Formal
Concrete: Here and Now (5 senses)
Formal
extends from about age 12 through adulthood
adolescents and adults develop the abilities to think about abstract or hypothetical concepts
consider an issue from another’s viewpoint, and solve cognitive problems in a logical way
What does Formal thinking includes
Includes: Abstraction Hypothesizing Combinatorial logic Future considerations
Personal Fable
“Personal Fable” is a belief held by many adolescents telling them that they are special and unique, so much so that none of life’s difficulties or problems will affect them regardless of their behavior
Imaginary Audience
“Imaginary Audience” is a belief, often exhibited in young adolescents, that multitudes of people are enthusiastically listening to or watching him or her.
Adolescent Egocentrism
phenomenon of adolescents’ inability to distinguish between their perception of what others think about them and what people actually think in reality.
Identity Crises
Identity crisis – uncertainty and discomfort adolescents experience when searching for an individual and societal “role”
Identity diffusion
- Is the adolescent committed to an identity?
- Is the individual searching for their identity?
When searching is absent and commitment is absent
James Marcia- Identity Statuses
have not thought about or resolved identity issues
have failed to chart future life course
Example “I really haven’t thought about whether I’ll go to college or not. I guess I’ve just been thinking about other things.”
Identity achievement
- Is the adolescent committed to an identity?
- Is the individual searching for their identity?
When searching is present and commitment is present
James Marcia- Identity Statuses
have resolved identity issues by personally choosing particular goals, beliefs, and values
Example “I changed my major twice before hitting on something that really feels good to me. I kept thinking I didn’t want to become a teacher because that’s what everyone in my family does and I didn’t want to just follow along, but then I surprised myself with how much I like working with the kids. I can really imagine myself doing this forever and never getting tired of it!”
Identity foreclosure
- Is the adolescent committed to an identity?
- Is the individual searching for their identity?
When searching is absent and commitment is present
James Marcia- Identity Statuses
“Have chosen” an identity without experiencing crisis or deciding what they want for themselves
Example “My parents went to college, so I probably will too. I guess I’ll be a teacher – everybody in my family does that.”
Moratorium (a temporary prohibition of an activity)
- Is the adolescent committed to an identity?
- Is the individual searching for their identity?
When searching is present and commitment is absent
James Marcia- Identity Statuses
Experiencing identity crisis and actively questioning life choices and commitments
Example “I’ve been thinking a lot about my future. I used to think I’d be a teacher since I have so many relatives who teach, but I’m not really sure that I have the patience for that. I’ve always really liked sports and ACTION….so I’m thinking about some kind of physical education degree….but I want to see how other courses seem before I decide.”
Moratorium
- Is the adolescent committed to an identity?
- Is the individual searching for their identity?
When searching is present and commitment is absent
mneumonic for Phsychosocial screening
Home- environment, relationships
Education- academic performance, grade level, career aspirations
Eating- nutrition, attitudes
Activities- interests, work, participation
Affect/Anxiety
Drugs- smoking, drinking, drugs
Sexuality- behavior, orientation, attitudes
Safety- driving behavior, violence screen, abuse
Developmental tasks of Adolescence
Win acceptance of peers Achieve independence from the family (individuation) Develop the capacity to love a person and be intimate Achieve a comfortable sense of self Body image Self-image (self-esteem, self-efficacy) Sexual identity Vocational identity Achieve an effective value/moral system
Adolescence Developmental Obsessions
Body image Identity Separation/Individuation Socialization/Peers Sexuality Future orientation
Development and High Risk Behavior
Some of the behaviors are normal in teens because:
Experimenting is part of growing up. This includes testing limits (in self and authority figures)
Peer affiliation is a strong need and teens perceive that others are doing behaviors
Behaviors are sometimes an attempt to cope, a reaction to stress, a way to “get away”
Teens are not consequential thinkers yet
Inexperienced in the world causes miscalculation
Common behavioral problems
tobacco and substance use /abuse nutrition/eating patterns exercise accidents/injury emotional liability/depression/coping school performance sexual behavior and orientation rape/abuse body image problems and eating disorders non-compliance with treatment regimens in chronic disease
Goal of Primary Care in Adolescence
Screen for illness and risk of illness
Educate patient regarding health areas
Promote healthy behavior
Help develop healthy self-awareness and self-regulation
Help parents learn how to support healthy maturation
How are adolescence underserved by the government?
Barriers identified:
Lack of age appropriate sites for care
Lack of confidential sites for care
Lack of provider training in adolescent medical problems, especially gynecologic and mental health related
Belief that adolescents are “generally healthy” and don’t need services
Less compelled to come in for services. Less preventive medicine visits
Care is time consuming
Unfavorable reimbursement for providers
How are adolescence underserved by the government?
Barriers identified
Lack of age appropriate sites for care
Lack of confidential sites for care
Lack of provider training in adolescent medical problems, especially gynecologic and mental health related
Belief that adolescents are “generally healthy” and don’t need services
Less compelled to come in for services. Less preventive medicine visits
Care is time consuming
Unfavorable reimbursement for providers
What are some behaviors that adolescent takes part in that lead to preventable deaths?
Smoking
Alcohol and other drug use
Diet and exercise habits leading to obesity
Conflict resolution and coping
What are some behaviors that adolescent takes part in that lead to preventable deaths/
Smoking
Alcohol and other drug use
Diet and exercise habits leading to obesity
Conflict resolution and coping
