Chapter 13 Flashcards
Adolescents do not generally develop serious psychological or social problems.
t
Important to distinguish between problems that are: 2 dimensions
- experimental vs. enduring
* transitory vs. persist into adulthood
which problems are more limited to during the adol period transitory
sub use, delinquency
which persist?
mood , anx dep. stating when younger but spans across life
Problems displayed during adolescence are caused by adol
f not necessarily caused by adolescence.
Just because a problem may be displayed during adolescence, it doesn’t mean that is a problem of adolescence.= can express existing vulnerability
practitioners distinguish between 3 broad categories of problems
Problems Related to Physical Health
Internalizing disorders
Externalizing disorders
Problems Related to Physical Health?
Substance abuse
eating disorders
ect
other physical health problems of childhood that persist into adol
chronic health, sleep disorders, elimination disorders
T: individuals problems turned inwards and manifested in emotional and cognitive distress
Internalizing disorders
T: problems turned outwards, e.g. behaviours
Externalizing disorders
how common is comorbidity across these 3 categories
Problems are likely comorbid.
e.g. dep anx com morbid with …
substance use
Comorbidity of Externalizing Problems: Delinquency associated with problems such as …
truancy, defiance, sexual promiscuity, academic difficulties, violence, substance
T: skipping school
truancy
T: assumes underlying cause os unconventionality in their personalty and social enviro (more tolerance of deviance in general) 4
Problem Behaviour Syndrome perspective
Problem Clusters perspective
Social Control Theory
Unconventional individuals and environments perspective on comorbidity
the people you hang out with
T: problems in one domain can create problems in another
Problem Clusters perspective
problems breed other problems = cascading effects, what perspective
Problem Clusters perspective
no common underlying trait but involved in problem activity leads to other problem behaviours
T: Clustering of problems may not stem from a problem in the person but from an underlying weakness in the attachment of the youth to society.
Social Control Theory
e.g. underlying problem outside of person e.g. school, family work what theory
Social Control Theory = explain low SES problems
Comorbidity of Internalizing Problems, One underlying factor appears to be …
negative emotionality.
T:subjective state of distress, how early they become distressed
Negative emotionality
Internalizing disorders are also more common among
those who are …
anhedonic especially depression
T: those low in positive emotions
anhedonic
comorbid internalizing symptoms
anxiety, panic, phobia, obsessional thinking, suicidal ideation, eating disorders, psychosomatic problems
psychosomatic problems?
physical symptoms with psychological cause
substance use: Society sends mixed messages to youth. how
some substances like alc are fine others not
portrays drinking TV Ads and comedies • “Having a good time is
impossible without alcohol.” TV programs “Just say NO”
…3are by far the most commonly used and abused substances.
Alcohol, tobacco, and marijuana
Canadian Student Tobacco, Alcohol and Drugs Survey (2018-2019): • how has smoking use changed
gradual decline= 3% regular cigarette users but 19% have used e-cigs? Vaping? in past month= increase
Canadian Student Tobacco, Alcohol and Drugs Survey (2018-2019): • …% alcohol
44
Canadian Student Tobacco, Alcohol and Drugs Survey (2018-2019): …% cannabis
18
of e cig users how many use frequently
40%
cannabis use over time
increased now plateaued
T: use substances before harder drugs
gateway drugs
e.g. of gateway drugs
tobacco, alcohol, and marijuana
Six different patterns of substance use, developmental trajectories based on…
when start and rate of use
Six different patterns of substance use: from most to least prev
Nonusers (33%) • Alcohol Experimenters (25%) Late Starters (20%) High Escalators (8%) Early Starters (6%) Low Escalators (5%)
T: began using early and slowly increasing
Low Escalators
T: high use early and gradual increased in HS
early starters
T: low use early but increased same as ES
late starters
T: high use early and rapid increase in HS
high escalators
T: alcohol early, occasional drinkers, no other substances
Alcohol Experimenters
what’s riskiest developmental trajectory
chronic and early use
Adolescents whose substance use begins early or escalates rapidly are most at risk for substance use problems as adults.
defining between …2 is important to understand the Causes and Consequences of Substance Use and Abuse
Occasional experimentation and problematic use
Youth who abuse substances are most at risk of what
less adjustment= school problems, mental health, more delinquency, relational problems ect
many classes and users of substance use why important
predict different problems
4 sets of risk factors are:
- Psychological
- Familial
- Social
- Contextual
• Psychological risk factor
impulsive, sensation seeking, inattentive, ect
• Familial risk factors?
hostile, distant conflict family enviro
permissive, uninvolved, neglectful parents
social risk factors?
peers and their drug use
contextual risk factors?
how available? community norms around use? how much is law against it enforced?
Marijuana use among Canadian youth aged 15 to 24 is different from adults how
more than double the prevalence in adults aged 25 and over
Youth have higher rates of crashes associated with …
marijuana use.
Heterogeneity in use patterns across adolescence and young adulthood what does this tell us
not everyone who uses has problems just 2 groups = Different associations with driving risk behaviours
Prevention of … risks and disorders is needed.
dependency
why drugs impact on brain in adol
Because brain is still malleable during adolescent
T: NT for pleasure
dopamine
Certain drugs increase the release of …
dopamine.
Frequent drug use interferes with the normal maturation of the brain’s dopamine system. what brain system
limbic = effects dopamine receptors = downregulation of normal pleasure response
Exposure to drugs during adolescence is more likely to lead to addiction than is exposure during adulthood. why
may need to use more to experience pleasure bcs of influence on NT
studies show repeated exposure to drugs in adol more likely to lead to addiction than if exposed in adulthood
t
adol are less likely to feel … and more likely to feel … of substance use
negative consequences of substance use and more likely to feel positive effects
chronic alc abuse Lasting effects of alcohol abuse on brain functioning (in the …2 areas) are worse in adolescence.
hippocampus and prefrontal cortex (more vulnerable to negative impact)
what use worse outcomes
chronic and heavy use= cog deficits
Criteria for substance abuse involve … harmful and repeated negative consequences of substance use over the last 12 months and be …
two or more
impairing functionings
… in adolescence include substance dependence and substance abuse
Adolescent Substance Use Disorders (SUDs)
9 diagnostic SUDs criteria?
- larger amount over time
- interpersonal problems
- stop doing enjoyable things
- increase risky behaviour
- cant cut down
- tolerance and withdrawal
- time spent with SUDs
- cant fulfil obligations
- cravings
Efforts to prevent abuse target focus on 3 factors
- the supply of drugs
- the enviro
- the characteristics of user themselves
raising the price of cig and alc doesn’t influence use
f does so does changing legal age
problem with prevention programs
don’t distinguish between drug use and abuse
problems with not distinguish between drug use and abuse
won’t succeed
Prevention efforts may need to target harms (e.g., harms associated with binge drinking, impaired driving).
Most encouraging programs target what
individual and enviro
combine some sort of social …(individual) with a … (aimed at the adolescents’ social environments such as peers, parents, and teachers).
competence training
community-wide intervention
what treatment: Modify negative interactions between family members, improve communication, and develop effective problem-solving skills to address areas of conflict
• Family-based approaches
most common treatment for SUDs
• Family-based approaches (individual and context family most immediate context)
T: treatment: • A patient-centered and directive approach
• Engage intrinsic motivation within individual to change behaviour
Motivational interviewing (MI) more individual but use their intrinsic motivation
Motivational interviewing (MI) assumes…
assumes they know they have a problem and want to change
MI Addresses ambivalence and discrepancies between a person’s … and ..
.current values and behaviors and their future goals
Adolescents with more severe levels of abuse, unstable living conditions, or comorbid psychopathology require an …2
inpatient or residential setting
substance treatment Effective approaches address multiple influences (e.g. …) on the individual
peer, family, school, and community
why adol time of self image difficulty
constantly evaluating due to puberty changes
during adol … drop = weight gain
basal metabolism
Feelings of body dissatisfaction can contributed to disordered eating. is it categorical?
f • A continuum:
• Dieting that may be perfectly sensible and healthy,
Disordered eating can be unhealthy but not at a level requiring treatment
t Symptoms meet clinical criteria.
where does body distal come from
cultural ideal of thinness
why more in westerner cultures
Linked to Western culture, where food is plentiful and physical appearance is highly valued
disordered eating bolstered by Sociocultural values like…
and preoccupation with weight and dieting- may be internalized (eg. parents attitudes, peer conformity pressure)
mens health ideal?
exercise to be as muscley as possible
women health ideal?
how to be thinner
Adolescents with eating disorders have an extremely …
distorted body image. see self as overweight when underweight
T: extreme restriction of diet until starving
Anorexia
T: cycle of binging and compensatory purging strategy
bulimia
Clinically defined bulimia and anorexia preference differ for …
females than males.
which disorder more common for men and women
Binge eating disorder
T: consuming a lot followed by distress about this behaviour
Binge eating disorder
how do they develop? 2
- Dieting and weight concerns in adol
2. only small number of dieters go on to develop disorder
Anorexia and bulimia typically occur during ..
adolescence= give rise
Emphasis on self-perceptions of physical appearance gender dif
both struggle
.e.g drive for muscularity
drive for muscularity survey created by who
McCreary, D. R., & Sasse, D. K. (2000). An exploration of the drive for muscularity in adolescent boys and girls
what lead to dieting
drive to Achieving an ideal appearance
Dieting may lead to a vicious cycle describe
false hope cycle= unrealistic expectations = behaviours to achieve
3 main tenants of annor
Characterized by refusal to maintain minimally normal body weight; intense fear of gaining weight= anxiety; and significant disturbance in perception and experiences of body size= don’t see as unhealthy
DSM-5 subtypes of annor
Restricting type
Binge-eating/purging type
T: individual loses weight through diet, fasting, or
excessive exercise without binging or purging in the past 3 months annor
Restricting type
T: individual has engaged in the above methods in past 3 months. annor
Binge-eating/purging type (purge occasional)
in adol what prevalence
1% prevalence
bulimia more roles common
more 3% prevalence
bulimia Primary feature is …
recurrent binge eating
Binges are followed by compensatory behaviors (intended to prevent weight gain) in the form of two subtypes:
- Purging
* Non-purging
which dsm category more categories
bulimia
severity of bul depends on
the number of compensatory behaviours per week
T: Similar to bulimia without the compensatory behaviors
• Involves periods of eating more than other people would
Binge Eating Disorder
Binge Eating Disorder what feeling after binges
loss of control
problems with Binge Eating Disorder
health problems of obesity
Bulimia more common that anorexia what bul weight
close to normal weight within 10% normal= harder to identify
Anor how much below normal weight
15%
how common is Eating disorders among boys
more common than we thought
male vulnerability for eating dis ?
Sexual orientation and eating disorders
6 predisposing factors?
- neurobiological factors
- Mental health problems
- Social dimension
- Family influences
- Trauma (though general risk factor for psychopathology)
- Cognitive deficits
what neurobiological factors
imbalance of serotonin regulates appetite
OCD similarity
Mental health problems?
also report 90% symptoms of depression= commorbidty risk factor
Social dimension?
western cultures
Family influences?
families relationship with food and dieting
or to direct attention away from family conflict
self image
Trauma?
child sexual abuse especially bulimia but though general risk factor for psychopathology)
Cognitive deficits?
unrealistic expectations = faulty thinking processes
what treatment usually used
psychosocial interventions (CBT, interpersonal ect)
psychosocial interventions effective alone
f comprehensive treatment plans (e.g. also nutritionist, art therapist ect)
Comprehensive treatment plans often involve …
family = Resolution of family and interpersonal problems are crucial to recovery from an eating disorder (situational and personal issues)
all can be managed as out-patient
f most but • Hospitalization (usually brief) is necessary for more severe = physical or psychiatric risk, comorbidity ect
2…. oriented CBT works to change eating behaviors with rewards and modeling
Individual or family
CBT thinking processes as well
underlying interpersonal issues
3 main categories of externalizing problems
conduct disorders
aggression
delinquency
2 types of conduct disorders
CD
ODD
2 types of aggression
overt covert
2 types of delinquency
antisocial acts
juvenile offending
CD and ODD across lifespan?
f limited to childhood and adol
T: repetitive and persistant patterns of Antisocial behaviour
CD
one way to prevent adolescents from experimenting with more serious drugs might be to stop them from ..
drinking, smoking, and using marijuana.
most with ODD go on to develop CD
t
those with CD might go on to have what diagnosis
Antisocial Personality Disorder (APSD)
T: disregard for legal and moral standards, don’t abide by rules or get along • A disorder of adulthood
Antisocial Personality Disorder (APSD)
T: antisocial and charming, impulsive, indifferent to others feelings
• Psychopathic or callous-unemotional traits (CU)
seen in APSD
Not all adolescents go on to become psychopaths
t just more likely for delinquency
people who begin in early adolescence (before age 14) are… times more likely to binge drink as teenagers and … times more likely to develop a substance abuse or dependence disorder at some point in life
seven
five
which subtype most predictive of antisocial PD in adulthood
callous lack of empathy
which subtype most predictive of antisocial PD in adulthood
callous lack of empathy in 2/3 of APD
most ODD in what range of severity
90% on moderate
adolescents who are mistakenly enrolled in treatment programs (because their parents have overreacted to the adolescent’s normative and probably harmless experimentation with drugs) may end up ..
.more alienated and more distressed—and more likely to become drug abusers
Children with childhood-onset CD display at least one symptom before age …
10
adol onset more likely in boys
f no gender dif- less violent offences and less persistence over time
temporal sequencing of OC and ODD?
• CD is most always preceded by ODD
But ODD does not always mean CD
relocation dropped violence
t
For most children, ODD is a strong risk factor for later ..
.ODD= stable trait
T: behavior that is done intentionally to hurt someone.
aggression
2 types of aggression
- Physical
* Relational
Can be ..(planned) or … (unplanned).
.instrumental
reactive
whose aggression are we worried about
• Relatively stable over time, but usually declines over the course of childhood and adolescence.
• “…” is legal term includes delinquency
Juvenile offending
• Although a large % of offenders have CD, not all adolescents with
CD are offenders
t (because depends if they broke law).
what are some juvenile offences
Violence (e.g., assault, rape, robbery, and murder) and property crimes (e.g., burglary, theft arson)
what are Status offences
only against law for minors
..% of all high school students feel so sad and hopeless so often that they stop engaging in their usual activities, and each year, …% of this age group seriously contemplate committing suicide
.30
18
juvenile offending Increases in frequency between the …
preadolescent and adolescent
years. peaks in highschool
increase in early adol peaks highschool declines again :T
Age-crime curve
The onset of serious delinquency when
highschool
Adolescents who attempt to kill themselves usually have made appeals for help and have tried but failed to get emotional support from family or friends
t
although one-third of all teenagers report having had an anxiety disorder by age 18, almost all of these individuals had developed an anxiety disorder before turning 12 what does this tell us
simply because a problem may be displayed during adolescence does not mean that it is a problem of adolescence.
…% of adolescents have a mental illness that will persist into adulthood
20
likely to have had a problematic childhood as well as a problematic adolescence.
When a young person exhibits a serious psychosocial problem, such as depression, the worst possible interpretation is that it is a normal part of ..
growing up
sign something wrong
individuals who have strong predispositions toward the disorder may become depressed in the face of .
.mildly stressful circumstances that most of us would consider to be normal.
Although alcohol and tobacco use among adolescents in most European countries is substantially higher than it is in the United States, twice as many American than European adolescents …
regularly use illicit drugs (mainly marijuana)
one way to prevent adolescents from experimenting with more serious drugs might be to stop them from ..
drinking, smoking, and using marijuana.
where do life course pathway come from
- Genetic or environmental
- E.g., fearlessness/stress reactivity (blunted response)
- Have histories of aggression identifiable early
Have histories of aggression identifiable as early as age
.
8.
Life-course-persistent (LCP) intel?
low scores poor school performance
Intelligence, cognitive deficits
hostile attribution bias
property crimes start with… behaviour
overt
agressive kids start as
difficult children
T: path begins early and persists into adulthood
life course persistent
background for life course persistent ?
• From disorganized families with hostile or inept parents.= more neglectful= don’t teach how control their behaviours and emotions
where do life course pathway come from
- Genetic or environmental
- E.g., fearlessness/stress reactivity
- Have histories of aggression identifiable early
Have histories of aggression identifiable as early as age
.
8.
Life-course-persistent (LCP) intel?
low scores poor school performance
Intelligence, cognitive deficits
hostile attribution bias
Intelligence, cognitive deficits how stable
very highly predictive of later success
Because …4 are relatively stable traits over childhood, there is a great deal of continuity in problem behaviors over time.
aggressiveness, impulsivity, hyperactivity, and intelligence
Life-Course Persistent Offenders • Have problems with self-regulation 2 pieces of evidence
- More likely than peers to suffer from ADHD.
* Hostile attribution bias
• Other…underpinnings (esp. callous/unemotional may have inherited tendency towards fearlessness, low hr, and less stress reactivity to painful/emotional stimuli).
biological
• Score lower on standardized tests of intelligence and neuropsychological functioning.=
• Perform poorly in school.
T: path begins at puberty and ends in young adulthood and tend to be more temporary, don’t commit serious crimes
Adolescent-limited (AL) offenders
background of Adolescent-limited (AL)
• Do not usually show signs of psychological problems or family pathology, less likely to drop out
While fewer youth are detained, those who are represent the most troubled youth committing the most serious crimes.
t
main Risk factor for AL
poor parenting practices and affiliation with antisocial peers
gender dif in risk factors for AL
similar across gender and ethnic groups
T: youth who have been subject to law Apprehension and court contact;
Juvenile delinquency
Juvenile delinquency excludes antisocial behaviours at
…
home or school
how are rates of Juvenile delinquency changing in Canada
declining due to youth criminal justice act= less incarceration focus on reintegration
BC lowest rate of incarceration
t = closing cutlery centres, those who are detained very bad
While fewer youth are detained, those who are represent the most troubled youth committing the most serious crimes.
t
Profile of At-Risk BC Youth in Custody… youth remain overrepresented within the justice system.
Indigenous
peer factors as risk?
process of selection or socialization e.g. gangs
Indigenous youth in custody Most had a history of involvement with youth justice
system (before age of …).
14 = early onset
3 most common adol offences
assault
breach admin
robbery
BC Data, McCreary Centre, 2014 report found what about conditions
about half (biggest predictor of being in the system)= behaviour problem e.g. conduct disorder, problems with anger
Risk Factors – individual & social
• Interaction of genetic factors and events e.g. ?
genetic= self control events= trauma
low … levels in boys = conduct problems in boys
cortisol = less stress
cognitive deficits?
hostile at bias
Adolescence-limited what 4 strategies?
parent management training PMT
problem solving skills training PSST
multisystemic therapy MST
family risk factors ?
(stress, poverty – capital) e.g social capital
Adolescence-limited what 4 strategies?
- teaching youth to defend against peer pressure and resist agression
- involve parents, help parents monitor child more closer and effectively and increase communication
- altering context- classroom school context to discourage antisocial and promote prosocial behaviours
- treating the delinquent act more seriously when it occurs but within the school context not authorities
prevention and treatment same for adol and chronic life course
f different challenges and treatment and severity
Chronic antisocial behavior prevention 3
combo
• Prevent disruption in early family relationships. • Head off early academic problems.
• Improve transition from school to work roles.
Some treatments are not very effective which
- Group treatments can worsen the problem
* Restrictive approaches (residential treatment, inpatient hospitalization, incarceration)
which treatment effective
individual psychotherapy and family interventions
Adolescence-limited what 4 strategies?
parent management training PMT
problem solving skills training PSST
multisystemic therapy MST
Adolescence-limited are easier to treat why
they agree with moral standards and treatment already =age out
Adolescence-limited what 4 strategies?
- teaching youth to defend against peer pressure and resist agression
- involve parents, help parents monitor child more closer and effectively and increase communication
- altering context- classroom school context to discourage antisocial and promote prosocial behaviours
- treating the delinquent act more seriously when it occurs but within the school context not authorities
which therapy most comprehensive
multisystemic therapy MST
adolescents who experiment with alcohol and marijuana are no worse adjusted than their peers who abstain from them
t
Experimentation with substances, as long as it takes place later in adolescence, is associated with better adjustment in young adulthood than is abstaining, abusing, or using drugs problematically
t
heavy cigarette smoking during adolescence can exacerbate feelings of emotional distress and lead to …
depression and anxiety disorders
One explanation for especially high rates of substance use among affluent suburban teenagers is that their parents often are …
tolerant of this behavior
Adolescent marijuana use is not higher in states that have legalized the drug for medical use
t
people who begin in early adolescence (before age 14) are… times more likely to binge drink as teenagers and … times more likely to develop a substance abuse or dependence disorder at some point in life
seven
five
Similarly, juvenile rodents are more likely to experience the rewarding aspects of nicotine exposure, including …, than are older animals
enhanced learning
effects of weed use on brain
Both early and heavy marijuana use are associated with worse outcomes than later or less frequent use, including cognitive deficits and diminished educational attainment
brain abnormalities in many of the same areas that are also affected by drinking, including the hippocampus and prefrontal cortex, regions that play an important role in memory, advanced thinking abilities, and emotion regulation
One reason that substance use is more common among teenagers from lower socioeconomic backgrounds is that they have fewer opportunities
to …
engage in pleasurable activities that don’t involve drugs
raise SE
adolescents who are mistakenly enrolled in treatment programs (because their parents have overreacted to the adolescent’s normative and probably harmless experimentation with drugs) may end up ..
.more alienated and more distressed—and more likely to become drug abusers
The onset of serious delinquency generally begins between the ages of …
13 and 16
This is not to say that all bullies grow up to be violent criminals or that all stubborn preschoolers run away from home as teenagers. But …
the reverse is almost always true.
mong American 15- to 19-year-olds, homicide accounts for ..% of all deaths among Blacks and 17% of all deaths among Hispanics, but about 8% of deaths among Native Americans, 5% among Asian Americans, and 4% among Whites
.43
relocation dropped violence
t
because minority youth are overrepresented among the poor, they are also overrepresented among those who commit crimes does this mean limited
One-third of adolescents in affluent neighborhoods report involvement in violent and serious delinquency
between …%, depending on the study—account for most serious criminal activity
5% and 10
Although studies indicate that most adolescents—regardless of their social backgrounds—do something that violates the law at one time or another
virtually everybody desists from crime by midlife, so that there really is no such thing as “…” offending
life-course-persistent
it is extremely difficult to predict which antisocial adolescents will persist in their bad behavior solely on the basis of their behavior during adolescence
t
the best predictor of continued offending in adulthood isn’t whether someone is antisocial in adolescence. It’s the presence of serious antisocial behavior in …
childhood.
There is some evidence that exposure to harsh parenting may adversely affect the developing child’s brain chemistry—in particular, the activity of ..receptors—which may increase the risk of antisocial behavior
.serotonin
All CU adolescents do not become delinquents, however; it also takes a willingness to engage in antisocial activity, sometimes referred to as “…”
moral disengagement
The identification of the biological underpinnings of problematic functioning does not necessarily mean that they are inborn or hard-wired.
t maltreatment can cause
abstaining from antisocial behavior leads to peer rejection
f
..% of all high school students feel so sad and hopeless so often that they stop engaging in their usual activities, and each year, …% of this age group seriously contemplate committing suicide
.30
18
increased reward seeking caused by this brain change with changes in the adolescent’s social world leads to an i..
.ntensification in adolescents’ desire for the rewards of intimate friendships and romantic relationships.
Before adolescence, depression sex dif?
boys are somewhat more likely to exhibit depressive symptoms than girls, but after puberty, the sex difference in prevalence of depression reverses.
It is well-known that rates of depression are about twice as high among adult women than men; it is less well-known that this sex difference is entirely due to the higher prevalence of depression among girls than boys, which persists into adulthood what does this mean
Sex differences in the appearance of depression for the first time after adolescence (which is rare in either gender) are very small.
Adolescents who attempt to kill themselves usually have made appeals for help and have tried but failed to get emotional support from family or friends
t
increased alarmingly between 1950 and 1990, fueled by the increased use …
of drugs and alcohol and the increased availability of firearms
The rate of adolescent suicide is especially high in …, where it has increased significantly in recent years
South America
suicide most common in black communities
f Attempted suicide is most common among Native American and Alaskan Native adolescents and least common among Black, Asian, and White adolescents; the rate among Hispanic adolescents falls between these extremes
individuals who have strong predispositions toward the disorder may become depressed in the face of .
.mildly stressful circumstances that most of us would consider to be normal.
the single most common trigger of the first episode of major depression in adolescence is ..
.the breakup of a romantic relationship
The use of antidepressant medications among adolescents has nearly doubled since the 1990s
t
stress causes dysfunction
f resilience impact
… is the most common internalizing disorder
among adolescents
• Depression
how many experience a prolonged sense of helplessness
Minority
Show significant impairment in daily functions give some examples
psychosomatic symptoms, impair relationships
on top of sadness 3 other symptoms
Disturbances in thinking, physical functioning, and social behavior (low self esteem, decrease of pleasure)
3 types of depression
symtoms, syndrome, disorder
T: common feelings of sadness
Depressed mood
T: symptoms of depression (cluster into single dimension of negative affect)
• Depressive
symptoms/syndromes
why become common in adol?
stressful events in adol, cognitive changes= rumination,
developmental course of dep
rise through adol late adol highest risk for dep
increase prev of dep in NA- why?
not sure
• DSM-5 divides mood disorders into two general categories
Depressive disorders excessive unhappiness (dysphoria) and loss of interest in activities (anhedonia)
• Bipolar disorder mood swings from deep sadness to high elation (euphoria) and expansive mood (mania)
another class of mood disorderSymptoms are less severe, but more chronic than MDD (Is characterized by symptoms of depressed mood that occur on most days, and persist for at least one year)
Persistent Depressive Disorder [P-DD] (Dysthymia Disorder)
often those with PDD have poor…
emotion regulation
why is PDD harder to treat
chronic
Youth with both MDD and P-DD are more severely impaired than youth with just one disorder
t
Sex differences may be attributed to:
social roles = gender roles – pressure to act passive, dependent, and fragile, heightened self-consciousness over physical appearance, poorer body image.
stress: greater levels of stress during early adolescence.
coping with stress: ruminating more – turning feelings inward. boys distract self or turn outwards
first and second leading cause of death for adol in Canada
In Canada, suicide is the second leading cause of death among young people (after accidents, unintentional deaths; Stats Can)
but increase in
risk for suicide for youth in Canada 3?
gender: men and boys more su girls more self harm
more attempts
First Nations
prevalence of Non-Suicidal Self-Injury compared to dep
Between 12-38% of Canadian HS and university students engage in NSSI much more than dep but risk factor for dep
Risks for Suicide? 6
• Having a psychiatric problem • Having a family history of suicide in the family • Being under intense stress (academic, social) • Experiencing extreme family conflict • Suicide contagion - attempts (more risks= more likely)
suicide contagion equally likely in adults
f adol more influenced by it
what model do we explain cause of depression with
diathesis stress
Depression occurs when people with a predisposition (a diathesis) toward internalizing problems are exposed to chronic or acute stressors (a stress).
those without the … are able to withstand a great deal of stress without developing psychological problems.
diathesis
the diathesis May be … in origin (neuroendocrine or genetically linked), or because of ….(tendencies toward hopelessness, pessimism, and self-blame).
biological
cognitive style
e.g. of biological diathesis
HPA axis activation during puberty so stress can prolong cortisol?
the stress: enviro influences of dep 3 components
family, social factors and adversity
Primarily from having a high-conflict and low-cohesion family, being unpopular, reporting more chronic and acute stressors, peer victimization what are these
family
social =stresses
trauma, loss, chronic health conditions and maltreatment what kind of stress
adversity
treatment of adol during adol similar to during other points in lifespan
t
3 types of treatment approaches for inter
- Biological therapies
- Psychotherapies (root of dep)
- Family therapy
what stressors do adol face
daily hassles, stressful situations, 1 more?
Range of stressors
Stress responses vary; some adolescents experience:
stressors can cause 3
- internalized disorders (anxiety, depression, headaches, indigestion, immune system problems).
- externalized disorders (behavior and conduct problems). • drug and alcohol abuse problems.
Stress does not always lead to negative outcomes. when does it not
• Resilience in the face of adversity
when are stressors worse
Multiple stressors have a much greater impact than single stressors (multiplicative)
• Adolescents who have internal and external resources are less likely to be affected by stress than their peers.
internal resource example?
emotional regulation, self esteem, mindfulness, IQ
external resources?
supportive parents, cultural capital, social support from friends
youth who have … are less distressed by stress
close family or peer relationships
2 mechanisms of coping with stress
Primary control strategies versus secondary control strategies
T: taking steps to change source of your stress, usually best strategy
Primary control
T: adapting to problem or stress, best when uncontrollable situation
secondary control strategies
adol who use which Primary control strategies versus secondary control strategies better adapted
both!
