Puberty & Adolescence Flashcards
What is adolescence?
The transitional phase of growth and development between childhood and adulthood
What are the 3 phases of adolescence?
- Early: 11-13yrs
- Middle: 14-17yrs
- Late: 18-21yrs
What is puberty?
The biological changes of adolescence that tends to occur at 11.2 years in girls and 11.6 years in boys and is often completed within 3-5 years
What weight triggers pubertal hormonal changes in girls?
47kg
What instigates puberty?
Pulsed release of gonadotrophin-releasing hormone (GnRH) from specialised nerve cells in the hypothalamus which travel in the blood to the pituitary where production of FSH/LH is stimulated which control the levels of hormones produced by the testes/ovaries (testosterone, oestrogen + progesterone)
What is the average age for the adolescent growth spurt?
Girls: 10-18/19yrs
Boys: 12-20/22yrs
What is the adolescent growth spurt?
Rapid increase in the rate of height and weight noted in virtually all of the long bones of the body EXCEPT the female pelvis which follows a smooth and continuous growth until adulthood
How does bone grow during puberty and adolescence?
Mineral mass is the same in girls and boys until the onset of sexual maturation and then bone mass (size but not density) increases more in boys than girls due to a prolonged period of growth in males where bone building speed in the spine and hip increases by 5x so skeletal mass approx. doubles at the end of adolescence
Why is girls diet important between the ages of 11 and 13 years?
They accumulate bone tissue at this age that equates to the amount lost during the 30 years following menopause
What occurs physically in female puberty?
- Breasts develop and enlarge
- Pubic/axillary hair grows
- Growth spurt and pelvis widens
- Increases fat deposited in subcutaneous tissue esp. around hips and breasts
What are the important Tanner stages of puberty in females?
- Pre-pubertal so nothing
- Areolar enlargement with breast bud and few darker hairs along labia
- Enlargement of breast and areola as single mound and curly pigmented hairs across pubes
- Projection of areola above breast as double mound and small adult configuration of pubic hair
- Mature adult genitalia
What is the menstrual cycle?
Cyclical series of events every 26-20 days where the hypothalamus secretes luteinizing releasing hormone (LHRH) to stimulate pituitary to produce FSH and LH
What is the function of Follicle-Stimulating Hormone (FSH)?
Females: Aids maturation of ovarian follicles and stimulates oestrogen release leading to ovulation
Males: Stimulates spermatogenesis directly
What is the function of Luteinizing Hormone (LH)?
Females: Stimulation of ovulation, development of corpus luteum and progesterone secretion
Males: Stimulates Leydig cells to secrete testosterone
What are the 5 phases of the menstrual cycle?
- Menstrual (1-5 days): ovum not fertilised so the corpus luteum degenerates due to LH decline, progesterone/oestrogen levels fall so endometrium cells die due to blood vessel spasming so it is shed
- Menstruation (4-6 days)
- Proliferation (6-14 days): ovarian follicle stimulated by FSH, matures and produces oestrogen which stimulates endometrium to thicken in prep. to receive the Graafian follicle
- Ovulation (day 14)
- Secretory (15-28 days): rising progesterone produced by corpus luteum in ovary, endometrium becomes oedematous and secretory gland produces watery mucus to help spermatozoa passage through tubes to uterus
What is the earliest sign of male puberty?
Growth of the testicles - can be measured with an orchidometer
What is the average adult testicle volume?
20ml
What are the physical changes that occur in male puberty?
- Increase in height, weight, muscle and bone
- Larynx enlarges and voice deepens/breaks
- Hair grows on face, axillae, chest, abdomen and pubis
- Scrotum, penis and prostate gland enlarge
- Seminiferous tubules mature and spermatozoa produced
What is Spermarche?
Onset of sperm emissions
Where are sperm formed and how much are formed?
In the seminiferous tubule of the testes at the rate of 300 million a day from puberty and throughout life
What are the important Tanner’s stages of male puberty?
- Prepubertal so nothing
- Enlargement of testes > 4ml, reddening of scrotum and few darker hairs at base of penis
- Lengthening of penis, further enlargement of testes to 6-10ml and curly pigmented hairs across pubes
- Broadening of glands penis, growth of testes to 10-15ml and small adult configuration with thighs spared
- Mature adult genitalia
What problems can occur with puberty?
- Precocious puberty before 8 in girls or 9.5 in boys (5x more common in girls)
- Delayed puberty where there is lack of 2ndary sexual characteristics by 13 in girls and 14 in boys (more common in boys)
- Lack of progression through Tanners within 4.5-5 years of onset
When and why does sexual orientation become apparent?
During adolescence as a result of complex interactions between genetics, environment, emotional, hormonal and biological factors
What occurs in the adolescent brain?
Just before puberty there is exuberant synaptogenesis and then the weaker connections are selectively pruned in several areas of the brain mostly in the frontal lobes inc. the prefrontal cortex where the adolescent loses ~3% of grey matter
What is the prefrontal cortex responsible for?
Advanced reasoning Understanding cause and effect Impulse management Executive functioning Personality Reward Decision making Social decision making
What area of the brain kicks into high gear in early adolescence and what does this explain?
The limbic system BUT the frontal lobe that controls impulses and engages longer-term perspectives matures later which explains why teens in mid-adolescence take more risks than older adolescents
What are the components of cognitive ignition?
Advanced reasoning
Meta-cognition
Logical thought processes
Abstract thinking
What are Piagets stages of cognitive development?
- Sensorimotor (0-2yrs): Infant explores world through direct sensory and motor contact - object permanence and separation anxiety develop
- Pre-operational (2-6yrs): Child uses symbols (words and images) to represent objects but does not reason logically and child has ability to pretend - child is egocentric
- Concrete operational (6-12yrs): Child can think logically about concrete objects and can add/subtract also understanding conversation
- Formal operational (12yrs-adult): Adolescent can reason abstractly and think in hypothetical terms
What forms the foundation of social relationships?
Social recognition which the amygdala of the limbic system is responsible for
What is social recognition?
Recognising faces but also interactions in a social context by gaging ques
What are the social developmental tasks that we have to go through?
- Emotional separation from parents
- Peer identity where you develop social autonomy (late adolescence)
- Exploratory behaviours e.g. smoking, drinking, drugs
- Development of intimate relationships
- Development of vocational capabilities and financial independence e.g. 1st job
How do we form an identity?
- Become independent
- Achieve mastery/sense of competence e.g. hobbies
- Establish social status i.e. what we look like
- Experience intimacy
- Determine sexual identity
- Develop autonomy physically and psychologically
What is the key stage of Erickson’s psychosocial theory?
Identity vs Role Confusion: adolescents need to develop a strong personal identity where failure leads to role confusion and a weak sense of self
What stage of Kohlberg’s moral theory are most adolescents at?
Conventional:
- Interpersonal concordance: being good is what pleases others so child adopts a conformist attitude to morality where right and wrong determined by majority
- Law and order: being good means doing duty to society so we obey laws w/o question and show respect for authority
Most adults and people do not progress to the post-conventional stage
How does alcohol effect the adolescent brain?
The hippocampus is more vulnerable to the negative effects of alcohol which regulates working memory and learning but the brain is less sensitive to the sedative qualities of alcohol
How does tobacco affect the adolescent brain?
There is worst cell damage in the hippocampus than in adults
How does adolescent brain development affect sleep?
The circadian rhythm shifts forward so melatonin secretions that trigger sleepiness start later at night and turn off later in the morning thus, adolescents need more sleep (~9-10 hours) and most are sleep deprived
What is emotional intelligence?
A trait that allows you to develop the skills necessary for managing emotions and successful relationships BUT emotional/social development is not an inevitable biological process during adolescence
What different aspects are involved in emotional and social development?
- Self-awareness: what do I feel?
- Social awareness: what do others feel?
- Self-management: how can I control my emotions?
How do drugs affect the adolescent brain?
Drugs such as cocaine and amphetamines target the DA receptor neurons in the brain which may affect brain development in areas of impulse control and ability to experience reward
What does the quality of care-giving in the first 42 months give you an indication of?
Quality of romantic relationships in early adulthood
When does psychopathology occur in adolescence?
1/2 of all mental health problems in children have been established by 14 years of age
What is the best predictor of serious psychopathology in adolescence?
Disorganised attachment
What are the steps of Bibace and Walsh’s children’s explanation of illness?
Phenomenism (2-4yrs): particular objects are blamed but no sense of mechanism
Contagion (4-7): illness is caused by proximity to ill people/particular objects
Contamination (7-9yrs): illness is caused by physical contact with an ill person and may be viewed as punishment for misbehaviour
Internalisation (9-11yrs): illness located within body but may be caused by external factors e.g. people get colds from being cold
PHYSIOLOGICAL (11-16yrs): illness caused by malfunctions in organs or systems which may be due to infection
Psychophysiological (16+yrs): psychological factors e.g. stress/fatigue can affect physiological processes rather than being an outcome
What is STEP approach to adolescent development in clinical settings?
S: Sexual maturation and growth (Tanner’s staging and height/weight)
T: Thinking (establish by asking questions about life)
E: Education/employment (ask about school/work)
P: Peers/parents (have they got friends and a good relationship with parents?)
