Module 5.2

Question 1

Defining adolescence

Answer 1

13 until the person legally becomes an adult

“A period of life that begins with puberty and extends for 8 – 10 years or longer until the person is physically and psychologically mature, and ready to assume adult responsibilities”.

Question 2

Puberty

Answer 2

• the age at or period during which the body of a male or female matures and becomes capable of reproducing.
• the process typically takes about 4 – 6 years. Onset is generally about 2 years earlier for females. There is a significant range of variability amongst individuals.
• Puberty is considered early (precocious) if it occurs before the age of 8 years in females and 9 years in males.
• Puberty is considered late or delayed if it has not begun prior to the age of 13 years for girls and 14 years for boys.
• Voice change occurs about the same time as penis growth in males. The first seminal emissions can occur at about 1 year following the start of penile growth, with nocturnal emissions beginning on average at 14
• Increased output of oil and sweat-producing glands occurs at about the same time as underarm hair
• Estrogen and progesterone, in combination are responsible for development of mature female characteristics and reproductive cycle.

Question 3

Puberty Onset

Answer 3

• affected by both genetic factors (account for about 46% of timing) and by environmental factors such as nutritional state and social circumstances.
• obesity may be associated with early onset puberty for females and late onset for males

Question 4

Puberty Characteristics at different ages

Answer 4

Females:
-Height spurt		8-17 yrs
-Menarche	      	10 – 16 
-Breast Dev	     	  8 – 18
-Pubic &  Underarm Hair   	11 – 14

Males:
Height Spurt          10 – 20 yrs
Penile Dev	     	  10 – 16
Testicular Dev    	 9 – 17
Pubic, Facial, Underarm
    And Chest Hair  	  12 – 16

Question 5

Menarche

Answer 5

-In every decade from 1840 to 1950 there was a drop of four months in the average age of menarche (use to be at 17)
-The average age in North America 11.75 years.
-A viable ovum is often not produced during the first 12-24 months following menarche.
-About 80% of cycles in postmenarchial girls are anovulatory (they don’t involve release of an oocyte [egg]). Even in the 3rd year, about 50% are anovulatory.
-onset of puberty may be associated with the percentage of body fat. a level of at least 17% body fat is critical to menarche
>low BMI bad because it means insuffient estrogen production which protects against osteoporosis

Question 6

Hypothalamus

Answer 6

A portion of the brain that carries out a number of functions: regulates body temperature; regulates body fluid balance; influences sleep and wakefulness; influences reactions to pain and pleasure.

**It also regulates the release of certain Pituitary gland hormones that have a direct influence on the development of primary and secondary sex characteristics and reproductive capabilities.

Question 7

Primary/Secondary sex characteristics

Answer 7

Primary sex characteristics are the sex organs that are involved with reproduction.

Secondary sex characteristics are any of the external physical characteristics of sexual maturity secondary to hormonal stimulation that develop in the maturing individual. Secondary sex characteristics do not play a direct role in reproduction but contribute to differentiating the sexes. Examples are facial hair in males and breast development in females.

Question 8

Pituitary Gland

Answer 8

• A pea-shaped gland at the base of the brain that is also connected to the Hypothalamus
• Divided into 2 lobes: anterior and posterior
• Secretes growth hormone responsible for overall skeletal and tissue growth, as well gonadotropins that are important to obtaining sexual maturity.
• also stimulates the adrenal glands (on top of kidneys) of both sexes to produce androgens (substances that produce male characteristics): testosterone and androsterone.

Question 9

Define:

Gonadotropins

Follicle Stimulating Hormone (FSH)

Leutinizing Hormone (LH)

ICSH

Answer 9

Gonadotropins (hormones that stimulate the gonads to produce specific substances)

Follicle Stimulating Hormone (FSH): Influences the production of estrogen in females and the formation of sperm in males.

Leutinizing Hormone (LH): Along with FSH, acts to influence the production of progesterone in females. Influences testes in males to produce testosterone [called ICSH in males]

The gonads are: testes in males and ovaries in females.

ICSH stands for: Interstitial Cell Stimulating Hormone

Question 10

Feedback loop that regulates hormone release

Answer 10

When hormonal activity is called for, the hypothalamus stimulates the pituitary gland with GnRH (gonadotropin releasing hormone)

When sufficient hormones exist, the hypothalamus releases gonadotropin inhibiting hormones to signal the pituitary gland to stop releasing its gonadotropins .

Question 11

5 Biological Stages of Puberty Female

Answer 11

Stage 1 –> 8-11:
there are no outside signs of development, but ovaries are enlarging and hormone production is beginning.

Stage 2 –> 11-12:
The first sign is typically the beginning of breast growth, including “breast buds.” A female may also grow considerable height and weight. The first signs of pubic hair start out fine and straight, rather than curly

Stage 3 –> 12-13:
Breast growth continues, and pubic hair coarsens and becomes darker, but there still isn’t a lot of it. The body is still growing, and vagina is enlarging and may begin to produce a clear or whitish discharge, which is a normal self-cleansing process. Some get their first menstrual periods late in this stage.

Stage 4 –> 13-14:
Pubic hair growth takes on the triangular shape of adulthood, but doesn’t quite cover the entire area. Underarm hair is likely to appear in this stage, as is menarche. Ovulation begins in some, but typically not in a regular monthly routine until Stage 5.

Stage 5 –> 15:
This is the final stage of development, when a girl is physically an adult. Breast and pubic hair growth are complete, and full height is usually attained by this point. Menstrual periods are well established, and ovulation occurs.

Question 12

5 Biological Stages of Puberty Male

Answer 12

Stage 1 –> 10:
Male hormones are becoming active, but there are hardly, if any, outside signs of development. Testicles are maturing, and some boys start a period of rapid growth late in this stage.

Stage 2 –> 12-13:
Testicles and scrotum begin to enlarge, but penis size doesn’t increase much. Very little, if any, pubic hair at the base of the penis. Increase in height and change in body shape.

Stage 3 –> 13-14:
Penis starts to grow in length, but not much in width. Testicles and scrotum still growing. Pubic hair starts to get darker and coarser and is spreading towards the legs. Height growth continues and body/face shape look more adult. Voice begins to deepen (and crack). Some hair around the anus grows.

Stage 4 –> 14-15:
Penis width increases, as well as length. Testicles and scrotum still growing. Pubic hair begins to take adult texture, although covers a smaller area. Most have first ejaculations. Underarm hair develops. Facial hair increases on chin and upper lip. Voice gets deeper and skin gets more oily.

Stage 5 –> 16:
Nearing full adult height and physique. Pubic hair and genitals have adult appearance. Facial hair grows more completely and shaving may begin now or soon.

Question 13

adolescent growth spurt

Answer 13

• When cartilage is replaced by bone [ossification, or hardening {bone replacement} occurs] at the ends of the long bones [epiphyseal fusion], growth in length can no longer occur.
• The growth plate (physis) is an area of developing tissue near the ends of long bones, between the widened part of the shaft of the bone (the metaphysis) and the end of the bone (the epiphysis). The growth plate regulates and helps determine the length and shape of the mature bone. The long bones of the body do not grow from the center outward. Instead, growth occurs at each end of the bone around the growth plate. The growth plate is the last portion of the bone to harden (ossify).

Question 14

Effects of early and late onset puberty

Answer 14

Early Onset
-have a better self-image, & in general, are comparatively more popular
-males are more likely to engage in delinquent & antisocial behaviour, and are more likely to use drugs/alcohol and take part in precocious sexual activity.
-females, in general, are comparatively more popular
-females experience:
>Less positive self-image
>Higher rates of depression, anxiety and disordered eating
>Greater likelihood of alcohol/drug use & early sexual intercourse

Late Onset

• have comparatively lower self-esteem & more prominent feelings of inadequacy
• Females who develop later have lower popularity and low self esteem

Question 15

Early Adolescence Stages

Answer 15

• Focus is on becoming comfortable with physical changes
• Often, increasing separation from parents, with less involvement in family activities
• More critical of parental, other authority & discipline
• Adolescent egocentricity often emerges
• The tendency to believe that one is being evaluated by an “imaginary audience”; that one is the centre of others’ attention and scrutiny
• The tendency to view one’s own experiences as entirely unique and not understood by others
• Hypersensitivity and self-consciousness are a function of this developmental period.

Question 16

Middle Adolescence Stages

Answer 16

-Peer group allegiance is generally at its peak
-Peer relationships provide a sense of belonging and help adolescent elaborate on his or her identity
-Having a supportive peer group has been linked with positive personal development, including positive self-concept, and achievement.
-Positive peer relationships enable adolescents to explore problems and issues together, without feeling threatened, as is often the case in “unequal” relationships with adults
-is also the time when individuals are more susceptible to expectations for peer group conformity.
-Individuals who are most susceptible to conformity demands are:
>Those who are self-conscious, insecure & don’t want to stand out as “different”
>Those who perceive themselves as less competent in relation to seemingly more competent peers
>Those who are perceived to be middle status adolescents

Question 17

Late Adolescence Stages

Answer 17

• Commonly, values are being clarified
• Peer group tends to be less influential as individual identity is more completely shaped
• Individuation, or the understanding of the individual as different from other family members, and others, is occurring
• More adult-like friendships
• Often, the first emotionally intimate relationship occurs during this time
• As a general construct, values are held when they’ve been: identified, claimed, acted upon.

Question 18

Adolescence and Mental Health

Answer 18

-The prevalence of 3 problems increases significantly during adolescence
Depression
Alcohol & drug dependency
Eating disorders

• These are more prominent during middle and late adolescence
• Paralleling these is an increase in attempted suicide
• Depression and negative self-worth tend to be featured in all three.
• Alcoholism and drug dependency are viewed by some as attempts to self-medicate or inoculate against the depression

Question 19

Sex Education

Answer 19

-An important issue is in the pressure that is felt to have sexual intercourse as a function of sexual capacity
-Some are not prepared because of
>Absence of information about contraception
>Not wanting to appear prepared because doesn’t conform to self-image
>Un-comfortability in discussing intimacy & own unpreparedness; not wanting to displease partner
>Macho male image
-How much sex education to provide youth, as well as how young to start, is a contentious social and political issue.
-The more education youth have the more safer sex they have and more likely to have a positive relationship with their sexuality

Question 20

Young Adulthood

Answer 20

-18-25 & ending at 45 years

Legal description
-In Manitoba, 18 year olds are considered to be fully capable and competent for their decisions. They may consume controlled substances, participate in legal processes as well as political processes (voting). They are fully legally accountable for their actions

Cultural and historical contexts

• In some cultures, individuals are initiated into adulthood at early ages, while in others, there is a comparatively long adolescence.
• In general, life expectancy will have an impact on what is considered young, middle or old adulthood.

Psychological and social contexts
-Person’s view of self, how others view person, and how that person behaves may be factors.

Question 21

Physical Development

Answer 21

• Body structures reach maximum capacity and efficiency in the teens and twenties (after 20’s features of senescence begin to appear).
• Overall, this is the healthiest age group
• Peak of strength, energy and endurance
• Senses are at their keenest
• Coordination, reaction time and fine motor skills are at maximum levels
• Sexual responsiveness is at its peak
• Additionally, both young men and women enjoy the benefits of society’s emphasis on youthful appearance.
• Senescence refers to the biological changes which take place in organisms as they age e.g. lens of eye begins to stiffen as do arterial walls, hair begins to thin, skin begins to lose elasticity, etc.

Question 22

Cognitive Development

Answer 22

Changes in the way young adults thinking differs from adolescents:
• Dualistic Thinking is used to describe an adolescent’s view of the world. Everything is seen in polar terms or opposites: good or bad, right or wrong.
• As youth mature, dualistic thinking is replaced by Multiple Thinking.
• They gradually become aware of the diversity of opinion in other people
• Young adults may come to understand that truth is relative, and knowledge is often constructed, contextual and not absolute.

Question 23

Emotional Development

Answer 23

• Increased clarity & consistency of personality
• Stabilization of self & identity
• Increased coping skills
• Decrease in youthful illusion, fantasy
• Expanded personal resources for development & maintenance of happiness, and…………….
•As a general rule, at the end of adolescence & during the young adult years, the body is at its peak……….
• If that’s the case, what accounts for this:
-Alcoholism & drug addiction are at their peaks between 18 & 40.
-Studies across countries show that the risk of emotional disturbance of almost any kind is highest between the ages of 25 & 44.
–>As people enter into an independent life, a lot more pressure start to pile up in life and this can be a lot, especially in a culture that stigmatizes asking for help

Question 24

Psychosocial Developmental Tasks

Answer 24

• Erikson says that the psychosocial “crisis” during this time is one of “intimacy vs isolation”: involving a commitment to another person, cause or creative effort.
• Developing a mature, intimate relationship with another person [married or otherwise]
• Getting started in an occupation
• Establishing independence from the parental home
• Establishing & maintaining a home that may or may not involve children

Question 25

What common reasons for conflict exist when young adults live within the original home?

Answer 25

• While adults are commonly expected to be independent from the parental home, what factors are responsible for remaining in or returning to the original home?
• approximately 11% of the population between 15 – 24 is unemployed
• Even when there are jobs available to young adults, many are minimal wage jobs making it very difficult to support one’s self.
• A post secondary education is important in today’s society. This means that many young adults are carrying heavy financial debts.
• Divorce/separation or other domestic issues may result in young adults returning to the parental home
• Parental needs: on occasion, young adults may remain in the home or return to provide support to parents. This may be for reasons of illness, finances, or for other forms of support, such as emotional support. In earlier agrarian times, the support of adult children may have been needed in order to maintain the family farm.
• Cultural variations exist, so that in some cultures, intergenerational living may be the expected norm, with grandparents assisting in the rearing of grandchildren, and adult children assisting with parental needs.
• When conflicts arise, they are often related to intergenerational differences in philosophies, lifestyles and expectations.

Question 26

HIV and AIDS

Answer 26

• Acquired Immune Deficiency Syndrome
• HIV (Human Immunodeficiency Virus) causes AIDS
• Being HIV-positive [evidence of HIV antibodies], or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don’t get sick for many years. As HIV disease continues, it slowly wears down the immune system [reduction in “T-cells”]. Viruses, parasites, fungi and bacteria that usually don’t cause any problems now do.
• AIDS is thought to have jumped from animals to humans during the 1940s.
• AIDS occurs five times more frequently in males, but the expectation is that gender distribution will even out.
• HIV is a condition that can compromise the immune system by seriously reducing the number of white blood cells (T cells), and when that occurs, the person is susceptible to fatal infections/encephalopathy/wasting that is associated with AIDS.
• HIV is found in other bodily fluids in low concentration that cannot lead to infection. These include sweat, tears and saliva (CDC). Additionally, HIV cannot be contracted through insect bites or from contact with fluid from sneezing or coughing.
• effective drug therapy has modified the status of the infection to that of a long-term chronic infection, rather than a short term death sentence. From 10 years to 76 years.
• HIV has riven from 8 million in 1990 to 34 million in 2013
• Africa has 11.6 million AIDS orphans.
• Antriretroviral treatment (ART) has been becoming more available in sub Saharan Africa

Question 27

How do you catch HIV

Answer 27

• Having unprotected sex with an infected person [passed through blood, semen, vaginal secretions] .
• Sharing a needle (shooting drugs) with someone who’s infected
• Being born when the mother is infected, or drinking the breast milk of an infected woman.

Question 28

Middle Years of Adulthood

Answer 28

Age Range: 45 – 60 or 70
• Definition depends on a number of factors
• Physical condition
• Psychological age [how old does the person feel & behave]

Many people in this age range report that this is a time of relative contentment
>Social and occupational roles may be well established & reasonably satisfying
>It may be a period of greater economic security; and can be a time of “liberation”, such that the person or couple is able to do things that he/she or they were previously not able to
>Relationships are often established, and couples are often quite comfortable with each other, & without the need to pretend or impress.

Changes can be prominent issues
>Loss of reproductive ability (Climacteric period)
>Loss of youthful appearance
>Loss of children from the home
>Loss of parents or dependency of parents
>Midlife re-evaluation

Question 29

Climacteric

Answer 29

a term describing the physiological period of decrease of reproductive capacity in men and women

Andropause: Gradual reduction in testosterone level associated with decreased libido, energy & muscle mass

Menopause: The gradual cessation of menstruation (along with production of mature ova) resulting in a loss of ability to reproduce. Menopause is preceded by a period of perimenopause. Menopause occurs after 12 months of no periods.

Question 30

Perimenopause

Answer 30

• Approximately 10% of females don’t experience any perceptible consequence of menopause, except for the cessation of their menstrual cycle.
• 70% - 80% of females report affects, but largely don’t describe them as problematic.
• For the remaining percentage, affects can be severe.
• In general, the most acute effects occur in the 2 years preceding and the 2 years following the last menstrual period.

Signs/Symptopns:
>First indicator is often irregular periods
>Hot flashes experienced by 80%
>Sleep disturbance/fatigue/night sweats
>Itchy, burning skin
>Headaches
>Joint pain
>Breast tenderness
>Vaginal dryness & thinning of the walls
>Difficulty concentrating
>Numbness or tingling in hands and feet
>Depression/anxiety

Question 31

Menopause:

Answer 31

• Mean menopausal age is 51 (North America)
• Ovaries begin to slow estrogen production around the age of 40
• Affects may vary in number & severity from person to person, & may include:
>Relief on not having to be concerned with pregnancy, contraception, menstruation
>A greater sense of sexual freedom
>A sense of personal loss

Symptom Relief
• HRT
• Vitamin E may have an impact on hot flashes & vaginal dryness
• To mixed reviews, Black Cohosh has been used by some [this herb is thought to contain phyto-estrogens that are suggested to mimic estrogen and result in diminishment of the discomfort of menopause]
• Phyto-estrogens are also found in tofu, soybeans, chickpeas, red clover and other legumes; and in grains and seeds such as flax seed, and in beans, fruit and vegetables
•Some herbal remedies may contain substances that certain people should not have. For instance ephedra (should be off the market by now, but may still show up) is a vaso-constrictor and can cause elevated blood pressure, as can licorice.

Question 32

Hormone replacement therapy

Answer 32

• Until recently, HRT was widely prescribed for short term “symptom” relief of menopause, and for prevention of cardiovascular disease & osteoporosis
• Recent findings, however, show that though HRT remains effective for osteoporosis, risk for heart disease, stroke & breast cancer is increased with HRT use.
• More recent findings also suggested an increased risk for cognitive impairment in older women, & although a rare occurrence, with or without HRT, ovarian cancer.
• Even more recent studies, however, have shown that these risks are variable depending on dosage, timing and type of therapy.
• These conflicting results have led to some bad press for HRT, and a drastic decline in usage for a period as many decided the risks were not worth the benefit. That said, it has started to regain some popularity in recent years as scientists get a more nuanced understanding of the pros and cons of HRT.

Question 33

Atherosclerosis

Answer 33

• Atherosclerosis comes from the Greek words athero (meaning gruel or paste) and sclerosis (hardness).
• It’s the name of the process in whichdeposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque.

Question 34

Cholesterol

Answer 34

• Cholesterol is a soft, waxy substance found among the lipids (fats) in the bloodstream and in all your body’s cells.
• It’s an important part of a healthy body because it’s used to form cell membranes, some hormones and is needed for other functions.
• LDL-C [Low Density Lipoprotein]
A high level of LDL cholesterol creates increased risk of heart disease.
• HDL-C [High Density Lipoprotein]
A high HDL level seems to protect against heart attack.
• Lipoproteins are proteins that combine with fats to transport them throughout the bloodstream.
• Hydrogenation adds hydrogen to edible oils and converts them to saturated fats so that they maintain a solid form at room temperature.
• When too much LDL-C cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries
• HDL-C tends to carry cholesterol away from the arteries and back to the liver, where it’s passed from the body. Some experts believe that HDL-C removes excess cholesterolfromplaque in arteries, thus slowing the buildup

How to get Low Cholesterol:

• Keeping dietary intake of saturated fats low can significantly lower dietary cholesterol. Choose lean cuts of meat & lower fat dairy products.
• Foods containing polyunsaturated fats or monounsaturated fats are sources of HDL-C. Products like vegetable oils, non-hydrogenated margarine, fish: salmon, mackerel, trout, herring, sardines.

Question 35

Osteoporosis

Answer 35

• Refers to a condition in which bones become thin, brittle, fragile, and prone to fractures. Estimates are that 25% - 40% of postmenopausal women will develop osteoporosis.
• By age 70, both females and males experience osteoporosis to same extent. Osteoporosis is associated with diminishment in estrogen production.
• Caucasians and Asians, and people with smaller bone mass are more prone to osteoporosis.

Factors that promote bone mass are:
>Adequate dietary intake of calcium and vitamin D
>Physical exercise
>Estrogen replacement therapy (assess risk/benefit).

Question 36

Presbyopia

Answer 36

• Often begins around age 40
• Characterized by blurring of close vision.
• Occurs as a result of a stiffening of tissues in the eye’s lens, which makes it more difficult to focus on near objects.

Question 37

The Midlife Crisis

Answer 37

• A period of reflection & reappraisal
• A change in time perspective: people begin to think in terms of “time left” rather than “time since birth”
• May feel depressed/incomplete; regret about current lifestyle and unaccomplished or unmet goals/ideals. A sense of unfulfillment
• Research doesn’t show an increase in mental health disturbances during middle adulthood that can be accounted for by midlife crisis. It does not seem to be extraordinarily stressful, beyond experiences during other stages of development.
• Some suggest that midlife crisis occurs for about 1/3 of males, commonly emerging around 40-45 years of age.
• These tend to be middle class, western males.