ICL 2.2: Adolescent Development

Question 1

what are the major differences between 17 year olds and adults?

Answer 1

1. prone toward activities/things with short-term payoffs
2. downplay long-term consequences of what they do
3. prone to fail to consider alternative courses of action
4. impulsive
5. aggressive
6. emotionally volatile
7. likely to take risks
8. reactive to stress
9. vulnerable to peer pressure

Question 2

when does adolescence begin and end?

Answer 2

1. early adolescence starts with puberty

8-13 years for girls
10-14 years for boys

2. middle adolescence = 15-17 years old
3. late adolescence = 18-20+ years old!!

Question 3

what is puberty?

Answer 3

development of secondary sex characteristics and increase in body size

most observable changes occur over an average time span of 4 years

puberty begins and ends approximately 12 to 18 months earlier for girls than for boys

Question 4

what is precocious puberty?

Answer 4

a condition that occurs when sexual maturity begins earlier than normal so before age 8 for girls and before age 9 for boys = early puberty!

experts are really worried about this…for girls it looks like it’s a particularly negative experience

Question 5

what trend is happening with the start of puberty in women?

Answer 5

it has been beginning earlier since last century, for example menarch is starting almost 3-4 months earlier each decade!!

we think it’s because of nutrition, health, obesity, etc.

in fact, by age 8, 48% of African-American girls show clear signs of puberty, while only 15% of white girls do; we don’t know why this is happening!

Question 6

what are the effects of advancing puberty in boys vs. girls?

Answer 6

boys have improved moods

decreased feelings of attractiveness for girls

Question 7

what are the effects of early puberty on boys vs. girls?

Answer 7

boys have improved academic and social functioning like being more popular, relaxed and poised

girls have poor body image, increased risk for eating disorders, and behavioral problems like substance use, truancy (especially if they identify with an older peer group)

Question 8

what is adolescent turmoil?

Answer 8

reflects adolescent’s attempt to separate psychologically from parents and identify self as an individual and this is important!!

this is basically identity vs. role confusion so it’s important that a teen develop their own identity which is really important and necessary

they will sometimes go to extremes like drugs, hair music, etc. to do so

Question 9

what happens during adolescent turmoil?

Answer 9

1. identity exploration in social, psychological, biological, and sexual changes happen and the teenage needs to find out what’s important to them

most people have “identity confusion” – perhaps not a “crisis” per se

2. most young people attain identity achievement in college/early adulthood, earlier than Erikson thought
3. typically, family and social functioning technically unimpaired (functional impairment = can/do not carry out certain key functions in their daily lives)
4. small % of youth who suffer from more serious or preexisting psychiatric disturbances or who experience extraordinary stressors around this period
5. prevalence/incidence of some disorders (e.g., depression at adolescence, schizophrenia) is higher

overall rate of MI increases 2% from childhood to adolescence/early adulthood then remains steady

Question 10

what is self-concept?

Answer 10

“how do i describe myself? who am i?”

there’s increasing multidimensionality – judging adequacy in multiple domains

adolescence begin to define themselves in increasingly abstract terms like honest and compassionate vs. good at math and tall like they would as kids

Question 11

what are the positive changes seen by the end of adolescence?

Answer 11

1. more realistically consider future educational and vocation/career goals
2. give more consideration to the thoughts and feelings of others
3. spend time with fewer close friends (less so with large peer group)
4. have less of a sense of invulnerability
5. have a more stabilized identity/self-concept

Question 12

what % of teens are sexual active?

Answer 12

46% of 15-19 year olds have had sex

average age of sexual behavior is 16 years old

sexually active teens who do not use contraceptives have 90% chance of becoming pregnant within a year

Question 13

what are the issues seen with teen pregnancy?

Answer 13

1. teen pregnancy is a public health problem in the US
2. teen mothers are more likely to drop out of highschool
3. children of teen mothers have lower school achievement, higher rates of school drop out, more health problems.
4. they are more likely than other children to be incarcerated during adolescence, give birth as a teen, and be unemployed as a young adult*

the rate of teen pregnancy in the US is substantially higher than in other western industrialized nations*

the birth rate and abortion rate in US teenagers have been declining. Thought to be due to both more abstinence and higher use of contraceptives*

Question 14

what factors predispose teen girls to pregnancy?

Answer 14

1. depression
2. poor school achievement
3. parental divorce

Question 15

what is empathy?

Answer 15

responsiveness to the emotional experiences of another

it develops significantly during adolescence!! this is what helps adolescence develop and maintain important quality relationships

Question 16

at what age is the brain fully developed?

Answer 16

20s!!

by the end of the 20s, the # of cell-to-cell connections reaches a plateau that persists until old age

that means adolescence is a time of profound brain growth and change and the connections between and among neurons increases

Question 17

what NT increases during adolescence in the brain?

Answer 17

dopamine

dopamine inputs in prefrontal cortex grow markedly during adolescence

this leads to improvements in planning, decision-making, judgment and impulse control

Question 18

what is the function of the socioemotional network in the brain of an adolescence?

Answer 18

the socioemotional network is in the limbic and paralympic areas of the brain

it’s highly sensitive to social and emotional stimuli and important for reward processing

it develops/changes in early adolescence due to hormonal changes during puberty

Question 19

what is the function of the cognitive-control network in the brain of an adolescence?

Answer 19

primarily located in the prefrontal cortex and parietal cortex

it exercised regulatory control over impulsive and risky behavior

Question 20

do young adolescents have difficulty inhibiting inappropriate impulses or stopping risky behavior? Why?

Answer 20

research has failed to identify clear age differences between older adolescents’ and adults’ evaluations/understanding of the risks related to activities such as drunk driving and unprotected sex, as well as the costs, benefits and consequences related to risky behavior

so adolescent’s greater involvement in risk-taking behaviors does NOT result from lack of knowledge or ignorance!!

it’s because the cognitive control network, particularly in the prefrontal and frontal cortex, is NOT fully mature in early adolescence

AND

in the presence of peers or during emotional arousal, the socioemotional network* becomes highly activated and diminishes the effectiveness of the still-developing cognitive-control network

so basically the emotional centers of the brain are very active but the prefrontal cortex which is responsible for planning, setting priorities, good judgement, anticipating consequences, controlling impulses ex. is not yet mature!!!

Question 21

what is an imaginary audience?

Answer 21

brain development allows them to recognize that others think and have feelings different than their own, BUT early and middle adolescence are primarily egocentric and believe that others are focused on them and that they’re being observed and judged by others

so this self focus + rapid bodily changes seen in puberty lead adolescence to question “am i normal?”

so that’s why coming to accept and understand their adult body aka body image during adolescence is a very important task in this stage

Question 22

how much sleep to adolescence need?

Answer 22

9.2 hours

but in reality they get 7 hours on weekdays and 8.5 hours on the weekends which means a lot are sleep deprived during the week –> this leads to poor performance on cognitive tasks in the morning, depressed moods and high risk behaviors

Question 23

what percent of individuals under the age of 18 suffer from developmental, emotional, or behavioral difficulties?

Answer 23

20%

during adolescence specifically:
1. substance abuse increases

2. incidence of psychotic disorders increases
3. eating disorders

Question 24

what are the signs of depression in adolescence?

Answer 24

1. irritable mood
2. anhedonia = inability to experience pleasure from activities usually found enjoyable
3. persistent thoughts of death
4. social impairment like academic failure, poor family or peer relationships, isolation
5. somatic symptoms = insomnia, loss of appetite, psychomotor retard/agit

Question 25

what is the 2nd leading cause of death for ages 10-34?

Answer 25

suicide

10-13% of adolescents have a lifetime history of suicidal ideation

Question 26

what are the youth suicide risk factors?

Answer 26

1. history of previous suicide attempts
2. family history of suicide
3. history of depression or other mental illness
4. alcohol or drug abuse
5. stressful life event or loss
6. easy access to lethal methods
7. exposure to the suicidal behavior of others

Question 27

what % of adolescents partake in self-mutilation?

Answer 27

13-25%

many studies indicate that the rate of self-mutilation is increasing among teens

Question 28

how have substance use rates changed in adolescence in the past few years?

Answer 28

the increase in teen vaping from 2017 to 2018 was the largest increase since 1975 for any adolescent substance use outcome in the U.S.!!!

the 30 day prevalence of vaping nicotine double from 2017-2019 to 25.5% of 12 graders

the 30 day prevalence of vaping marajuana increased from 2018-2019 to 14% of 12th graders

however use of most other drugs remains steady and other tobacco use continues to decline

alcohol remains the substance most widely used: 60% have used by end of high school. Use remains steady

Question 29

what is the role of PCPs in the detection and treatment of adolescent mental health problems?

Answer 29

70% of youths visit a primary care physician in an average year so PCPs are CRITICAL to obtaining specialist care, including mental health services

however, only 48% of physicians always ask their patients about their mental health

Question 30

what is the best approach to health and behavioral health education with teens?

Answer 30

1. talk with teen about these topics without a parent present: abuse, risky behaviors, sexuality, substance use/abuse, physical appearance /obesity
2. educate about short-term benefits of health behavior changes

warnings about long-term consequences are much less likely to change teens’ behavior

ex. teeth will get stained from smoking or other teens find smoking disgusting

Question 31

what does a youth’s understanding of and reaction to illness depend on?

Answer 31

developmental stage

1. toddlers 15 months-2 years: hospitalized children fear separation from the parent more than they fear bodily harm or pain
2. preschoolers 3-6 years: hospitalized children’s greatest fear is bodily harm
3. school aged children 7-11 years often cope relatively well with hospitalization
4. teens may challenge the authority of doctors and nurses and resist being different from peers –> both can result in poor or no adherence to medical advice

Question 32

what is an infants/toddlers concept of death?

Answer 32

no understanding of death

just maintain routines, nurturing behavior

Question 33

what is a preschooler’s concept of death?

Answer 33

they do not understand that death is a permanent state

magical thinking/ view death as deliberately caused, may blame self

recommendations: maintain routines, nurturing behavior, use play to help process and express feelings, reassure death is not their doing/fault

Question 34

what is an elementary school kid’s concept of death?

Answer 34

can understand that death is permanent

recommendations: maintain routines, talk about feelings, use play to help express emotions, inform/remind that death is permanent, do not misinform or indicate dead loved one will return

Question 35

what is a pre-adolescence and adolescence concept of death?

Answer 35

adult awareness of death, especially by mid to late adolescence

anger and withdrawal are common

fecommendations: set the tone for (but do not force) open, honest communication, allow control in own life, decision/making