Session Three (Adolescence) Flashcards

1
Q

Broadly, what are the 4 most significant areas of development in adolescence?

A
  • Movement towards independence
  • Career interests
  • Sexuality
  • Ethics and self-direction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What notable changes occur as a person transitions from childhood into adolescence?

A
  • Puberty, and the hormonal changes that come with it
  • Increase in peer pressure
  • Increase in academic pressure
  • Begin to explore their sexuality
  • Begin to form an identity of their own
  • Change in their role within the family unit
  • Emergence of drug and alcohol behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why might it be difficult for a parent to communicate with their child in 2019?

A

Significantly different experiences with adolescence. Main changes = the rise of social media and the greater expectation to go to perform academically and go to university

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can we define adolescence, in terms of how it relates to a person’s development?

A
  • “Prelude to and preparation for adulthood”
  • Marked by physiological changes
  • Begins around 12 and ends around 19, with the end of basic education and the beginning of adulthood, and the rights and duties that entails.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How has adolescence changed in recent years?

A
  • Lengthened; starts earlier and ends later. Is therefore a much more significant part of a person’s life.
  • Greater uncertainty about navigating the route to adulthood (failing job and housing markets)
  • The gap between rich and poor is wider than ever, and this gap is felt especially strongly in adolescence

(as mentioned elsewhere, social media and university create their own sources of stress).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What effect do the physical changes seen in adolescence have on teenagers?

A
  • Begin to see significant changes due to puberty.
  • These changes must be dealt with and interpreted by the individual
  • Puberty will begin to affect their identity, how they feel about themselves and others
  • Puberty might begin to affect their gender identity
  • Teenagers go into puberty with idealised norms of physical attractiveness, feel inadequate if they don’t match these unrealistic criteria they force on themselves.
  • (this is especially impactful on girls than boys, as with puberty comes a growth spurt. most boys see this as a good thing, girls as a bad)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What effect do the physical changes of puberty have on girls?

A
  • Menarche: now at aged 12.5 but historically more like 17 (change caused by better nutrition). This can be a distressing time and must be dealt with by the girl.
  • Early developing girls tend to have poorer self image, as they feel self conscious about their size.
  • This puts them at greater risk of delinquency, depression and addiction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What effects do the physical changes of puberty have on boys?

A
  • Peak growth spurt around age 14
  • Development of beard and lowering of voice
  • Earlier developers have more positive body image (in contrast to girls) as they associate size with strength and view it as a good thing.
  • Later developers more at risk of body images
  • This male to female distinction is largely driven by the different idealised bodies boys and girls have (boys want to be big, girls want to be small)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe how the brain develops during adolescence?

A
  • 2 major brain growth spurts in teenage years; 13-15 and again 17-20
  • Proportion of grey matter decreases, but white matter increases as we transition from childhood to young adulthood.
  • 13-15 sees the cerebral cortex becoming thicker and neural pathways become more efficient. Enables abstract thinking and reflection on cognitive processes to develop.
  • 17-20 sees the frontal lobes of cerebral cortex develop, which control logic and planning (link to risk behaviours in teens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What significant change in circadian rhythms is seen in adolescence?

A

Sleep-wake cycle gets pushed back several hours, so teenagers don’t feel sleepy until later at night and don’t wake naturally till late in the morning. This has a supposedly evolutionary basis, to keep someone awake into the later hours of the night to guard against predators.

It has been suggested schools should start at 10 to combat this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What processes in the developing brain predispose teenagers to do risky, stupid things.

A
  • Early and rapid changes in affective systems linked to pubertal maturation cause a heightened desire to seek novelty.
  • But, cognitive skills and competence in self-control develop gradually and continue to mature long after puberty.
  • This causes an imbalance between the relative influence of MOTIVATIONAL and CONTROL systems
  • Dahl (2008) describes the adolescent brain as the tempted brain. As long as the development of executive functions like planning, reasoning and inhibition remains unfinished, the teenager is constantly tempted into greater risk-taking and novelty-seeking
  • This effect is confounded by the fact the environment teenagers grow up in is now more demanding of them, pushing them towards these behaviours.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some of the major social and societal changes that have occurred in recent times and have had an effect on adolescence?

A
  • Change in family structure/role within the family
  • Changes in labour and housing markets
  • Changes in education, now compulsory until 16 and most people stay until 18
  • Recession
  • Climate change
  • Rise of Social Media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What parenting style is associated with most positive outcome and describe it?

A

Authoritative. Marked by high control (strict boundaries, clear expectations) but also high acceptance and love. One without the other is associated with worse outcomes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the positive effects of a strong attachment between the adolescent and the parent?

A
  • Greater sense of wellbeing (WB more strongly correlated to parent attachment than to peer attachment)
  • Strong attachment associated with positive short and long term outcomes
  • Strong attachment associated with academic success and good peer relations, as well as less risk for drug use and antisocial behaviour later in life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What changes occur in our peer relations as we enter adolescence?

A
  • Dependence on friends increases markedly
  • And friendships become increasingly intimate
  • Friendships and peer groups become more stable, choices influenced by shared values and interests
  • Moves from same sex groups to heterosexual relationships and groups as we mature.
  • Friendships in adolescents are good preparation for the skills needed in relationships.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At what point do relationships begin to become important to teenagers?

A
  • Teens as young as 12/13 have a concept of “love”, be it an inaccurate one
  • However significant gender and income differences within this
  • Awareness of same sex attraction starts around 11 or 12 in all cultures, but acceptance of this attraction varies massively
  • Sexual activity is also happening much earlier, possibly in large parts due to the increased sexualisation of society, possibly due to greater availability of contraception.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Briefly outline Stanley Hall’s theories on adolescence?

A

Hall suggested that adolescents experience an evolutionarily shaped, biological process of storm and stress
(agrees with Freud)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Briefly outline Sigmund Freud’s theories on adolescence?

A

Freud suggested adolescence centres around the task of balancing biological urges with cultural expectations. Development ends here (now thought to be wrong).
(agrees with Stanley Hall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Briefly outline Margaret Mead’s theories on adolescence?

A

Mead identified the role of culture in minimising adolescent disturbances. Compared teenagers in Samoa and the US.
(disagrees with Hall and Freud’s views that stress of adolescence is a biological necessity).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Briefly outline Erikson’s theories on adolescence?

A
  • Wrote about fidelity, the confusion between identity and role.
  • The primary development task of adolescence is to develop a sense of self and personal identity
  • Success leads to an ability to stay true to yourself
  • Failure leads to role confusion and a weak sense of the self
  • Closely linked to the development of a self identity is the capacity for intimacy.

In short, this theory states that main objective of adolescence is to develop a personal identity that allows us to to be confident and intimate with others moving forward.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Briefly outline James Marcia’s theory of identity achievement?

A
  • Essentially states that identity formation (in adolescence) forms in two key parts;
  • CRISIS, a period of decision making when old values and choices are re-examined
  • COMMITMENT; following some specific role, value, goal or ideology
  • Spoke about 4 stages of identity achievement (diffusion, foreclosure, moratorium, and achieved)
  • And 4 statuses identity (based on wether they are Committed and/or/nor Exploring an aspect of their identity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe Marcia’s 4 STAGES of identity achievement?

A
  • Identity diffusion; not yet experienced the identity crisis, nor made any commitments
  • Foreclosure; not experienced crisis but has made commitments
  • Moratorium; in state of crisis, exploring and actively searching for their identity and any alternatives to it
  • Achievement; Experienced crises but have resolved them on their own terms

(also stated that the quest for personal identity continues across the lifespan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe Marcia’s 4 STATUSES of identity?

A
  • Both Exploration and Commitment are present (I have weighed up the options and decided on X)
  • Only Exploration (I am weighing up the options but have not committed)
  • Only Commitment (I am down X because its expected of me, I haven’t really considered it)
  • Neither (I don’t know what to do and aren’t giving it much thought, I believe things will work themselves out)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Briefly outline Coleman’s Focal theory of adolescence?

A
  • Centres around the idea that teenagers can cope with changes and challenges, but only really one at a time.
  • Most people come through adolescence unscathed because of this, however some get overwhelmed and struggle.
  • When single problems occur, they can be coped with, adjusted to and maturity can increase without undue pressure.
  • Too many changes at one time can be damaging.
    (vs Baltes who viewed development as very multi-directional)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Briefly outline Baltes’ theories on adolescence?

A
  • Puberty occurs across a broad range of domains (focuses on the multidimensional components of development)
  • Multidirectional, individual domains both improve and decline in effectiveness e.g. risky behaviour and development of self-regulation.
  • Adolescence is not one transition, but many
  • This is shown in the research that shows as kids age they stop defining themselves by their appearance (decline) and start doing so by their beliefs (increase)
    (vs Coleman who viewed teenage development as highly focal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What has research told us about how the way in which people think of themselves changes over adolescence?

A

As they grow children and adolescents define themselves less and less by what they look like and more and more by how they feel and the ideologies and beliefs they subscribe to.

27
Q

What is meant by Identity and Agency in regards to adolescence? What are some modern aids and hinderances to them?

A
  • The idea that we need to work out who we are, what our values are, and what sort of a person we want to be in adolescence.
  • Aids; Digital technologies provide opportunities for access to information and options previously not available.
  • Hinderances; Bullying, cyberbullying, invasions of privacy
28
Q

What is delinquency?

A

Adolescent behaviour that violates the law

29
Q

What is Adolescent Onset Conduct Disorder?

A
  • A milder, more transitory form of conduct disorder
  • May be a reflection of peer-group pressure or the teen testing limits
  • Lag of behavioural impulses between moral reasoning, inability to look at own or assess hypothetical offences from the victim’s perspective
  • Likely accompanied by a cluster of other problem behaviours.
30
Q

What differences exist in terms of bullying behaviour between the genders?

A
  • Boys tend to be more physical

- Girls more psychological, commonly use exclusion as a form of bullying

31
Q

What has been the effect of technology on adolescent mental health?

A

Worsened. Most studies suggest teenagers have become steadily more unhappy since the advent of technology.

Cyberbullying is especially a big issue. Since it puts distance between the perpetrator and the victim it allows for nastier behaviour to occur. Linked to poor mental health down the line.

32
Q

Gives some examples of “normal” vs “problematic” difficult adolescent behaviour?

A

NORMAL:
Moodiness, Less affection towards parents, Preoccupation with sex, Masturbation, Occasional experimentation with cigarettes and alcohol, Self-conscious, Clique involvement

CRIES FOR HELP:
Regular use of alcohol and drugs, Sexual promiscuity, Lying, Stealing, Destructive behaviour, Poor school attendance, Self-harm

33
Q

Define self-esteem? How does it change throughout adolescence?

A
  • Sense of global; self-worth
  • Overall, falls then rises throughout adolescence. Boys more likely to have better self esteem throughout adolescence
  • This pattern is seen across socio-economic status and cultures, universal
  • High self-esteem associated with positive developmental outcomes e.g. good grades
34
Q

What are the 3 sorts of stress described in adolescence?

A
  • Normative: Those experienced by all young people e.g. puberty, changing schools, peer pressure
  • Non-normative: Those of greater concern e.g. illness, injury, parental conflict
  • Daily hassle: Daily events that while seemingly minor can build up and cause significant stress. e.g. losing something, doing poorly on a test.
35
Q

What determines a teenagers’ ability to cope with some stress?

A
  • Nature of stressor, mainly how predictable it was
  • Internal resources and perceived personal control
  • Social support
  • Appraisal and coping process

N.B. Not all stress is detrimental, some can be beneficial

36
Q

Outline the three broad coping strategies?

A
  • Problem focused (actions taken to modify stress at its source)
    VS
  • Emotion focused (actions taken to alter feelings engendered by stressor)
  • Withdrawal (dysfunctional coping)

Cognitive and social ability may restrict stress appraisal system

37
Q

What differences are seen between how the genders cope with stress during adolescence?

A

Boys: Active coping or deny problem
Girls: Use social support and emotion focused coping

Older adolescents show generally more dysfunctional coping, more self-blame and drugs and alcohol.

38
Q

What happens to gender identity in adolescence?

A
  • Gender role is the gender related aspects of the psychological self
  • Adolescents continue to understand sex roles as social conventions
  • Their gender role is something they continue to discover throughout adolescence.
  • This is in part shaped by paternal attitudes and beliefs.
  • In adolescence, people begin to view gender role as more flexible and masculine and feminine not as diametric opposites but dimensions along a continuum.
39
Q

What are the main health care issues we must bare in mind when it comes to teenagers?

A
  • Heightened level of sensation seeking e.g. desire to experience increased levels of arousal puts them at risk of reckless health risk behaviour.
  • While teenagers get ill less often, they can develop physical symptoms in response to perceived parental or peer rejection quite easily.
40
Q

How do young people view health differently from adults?

A

Young people view health behaviour as a here and now situation, less liable to think ahead.

Health decisions are a trade off between whats good for you + what the social situation demands.

41
Q

How do we distinguish between risk-taking and experimentation?

A

Very difficult, exists on a continuum.

42
Q

Is the health of young people improving or getting worse?

A
  • Some things getting worse e.g. obesity, mental health

- Some things getting better e.g. conception, alcohol use both down

43
Q

How has diet and eating changed amongst young people in the last generation?

A
  • We’ve seen an increase both in dietary choice making and slimming
  • As well as an increase in obesity
  • This is significant of the widening socioeconomic gap that exists amongst young people, and the health inequalities that come with them.
  • Contrary to popular belief eating disorders are NOT increasing. Still more common in young women though.
44
Q

Just how prevalent is obesity in kids?

A
  • 1/5 Reception age children are overweight or obese

- 1/3 year 6 children are overweight or obese

45
Q

50% of pregnant mothers are obese. How does this relate to the obesity epidemic?

A
  • Substantial link between obesity during pregnancy, childhood obesity for the offspring and later on adult obesity.
  • Furthermore, children in a home with even one obese parent are more likely to become obese themselves.
  • Poor diet and low levels of physical activity tend to be shared family traits and are the primary causal factors of obesity.
46
Q

How has drinking prevalence changed in adolescents over the last generation?

A

Summary is that its going down:

  • 62% of 15 year olds in England have never had an alcoholic drink
  • 6% were regular drinkers (1pw) and 8% were semi-regular drinkers (0.5pw)
  • Historically, the most prevalent reason people drank young was to seem cool to people their own age, however since 2003 kids have become far less tolerant of their peers drinking, possibly causing this decline.
47
Q

What is the link between early drug/substance use and development? What are some possible predictors for substance abuse?

A
  • Most drug use starts in adolescence
  • However there has been a notable decline in teenage drug use since 2001
  • Earlier start leads to a worse impact on the brain, as it interferes with normal development e.g. cannabis use.
  • Cognitive impulsivity is a possible predictor (e.g. Schilt study into first ecstasy use in young women)
  • Genes, environment and stress all interact to shape neurobiological vulnerability leading to excessive drug taking.
48
Q

Why can it be difficult to provide teenagers with good health services?

A
  • Teenagers respond best to community services, but where do you place these so they are accessible to a cohort who can’t drive/may not know about it/be embarrassed?
  • This is made even more difficult in the most vulnerable groups of teens; those in custody/care
  • Teenagers respond well to multi-disciplinary approaches, can be difficult to provide.
  • GPs sometimes find adolescents difficult to work with due to their personality traits.
  • Good health promotion depends on adults’ willingness to relate to young people.
49
Q

What does the CAMHS Care Quality Commission report tell us about adolescent mental health services?

A
  • Spike in mental health issues recently.
  • Has lead to children with mental health problems waiting up to 18 months to be treated.
  • These long delays can have a variety of negative effects, from, self harm to falling out of education, to relationship failure, to parents needing to drop out of work to care for their child.
  • Furthermore, children are often sent 100s of miles away from home in order to be treated.
50
Q

Baring in mind how overwhelmed current CAMHS services are, what cheap form of intervention has shown remarkable efficacy amongst teenagers?

A

Text messaging/mobile phone interventions.

  • Studies have (so far) targeted clinic attendance, contraceptive use, oral health, physical activity, weight management, sun protection, HPV, vaccination, smoking cessation, sexual health.
  • Studies reported high acceptability and satisfaction amongst participants, indicating good feasibility for clinical practice.
  • Demonstrated significant improvement in preventative behaviour.
51
Q

How should teenagers being hospitalised be treated?

A
  • Parents are legally responsible, however the teenagers opinion may be that they don’t want them there (although will be highly aware they may still need them)
  • Admission to a young person’s ward is ideal
  • Use of pre-admission questionnaires can help work out what the teenager wants.
  • Parent and teen involvement in day-to-day management is good also.
52
Q

What overlap exists between physical and psychological symptoms amongst teenagers?

A
  • Physical symptoms can obviously lead to mental health issues such as depression and anxiety.
  • Diseases interfere with the process of becoming independent, a member of a peer group and the development of sexual relationships.
  • 30-40% of kids with a severe paediatric condition go on to have a psych co-morbidity (this is even more so in neuro diseases e.g. epilepsy)
  • But conversely, physical symptoms can arise with no somatic aetiology in teenagers, linked to their mental health.
  • These can include diarrhoea, palpitations, hyperventilation, chronic fatigue or even neurological symptoms such as pseudo-paralysis, pseudo-seizures, loss of visual acuity.
53
Q

What is the link between self-harm and adolescence? What way has SH behaviour been trending?

A
  • 90% of people who engage in self harm begin during their teen or pre-adolescent years
  • Females make up 60% of those who self harm
  • Linked to personality traits such as impulsivity, aggression, anger and anxiety.
  • Worth noting that self-injury behaviour exists on a continuum (up to self-poisoning)
  • Self-harm amongst girls rose by 68% between 2010 and 2014
54
Q

What does the data say about the severity of the mental health problems in young people in 2019?

A
  • 1/10 kids aged 5-16 suffer from a diagnosable MH condition
  • More than half of adults with MH problems were diagnosed in childhood, but less than half received aid in time
  • Half of those with life time mental illness first experience symptoms in childhood.
  • 72% of kids in care have a behavioural or emotional problem
  • 95% of imprisoned young offenders have a mental health disorder
  • Number of young people with depression has doubled since the 1980s.
  • Although the treatment available is definitely effective, only 25% seek it in time
55
Q

What did the Millennium Cohort Study do and what did it show?

A
  • Followed close to 20,000 children born in the UK in between 2000 and 2001.
  • Measured average levels of emotional symptoms (mainly D and A) year on year and looked for increased.
  • Found that up until age 11 boys and girls experience about the same amount of symptoms, after 11 girls experience them more.
  • At age 14, 24% of girls and 9% of boys suffer from high symptoms of depression.
  • People from a poorer socio-economic background experience greater symptoms.
56
Q

What factors affecting teens make them more susceptible to MHP?

A
  • Life stress (both normative and non-normative)
  • Being NEET (loss of status/purpose/financial independence)
  • Family breakdown
  • Peer influence, friendship groups, bullying
  • Physical or emotional neglect
57
Q

How common is depression in teenagers and what are its most obvious consequences?

A
  • 1/33 young people
  • Only 1/4 of these are detected and treated
  • Teenager girls more likely to report
  • Stress, low self-esteem and parental depression most strongly linked factors
  • Can lead to suicide, 3rd biggest killer in the 15-24 age group
  • Depression also effects memory and cognitive function (therefore school)
58
Q

What anxiety disorders are most commonly seen in young people?

A
  • Phobic anxiety (2%)
  • School refusal (treated as an anxiety disorder)
  • Social phobia (very commonly onsets in teenage years)
  • GAD
59
Q

Apart from depression and anxiety disorders, what are the other big adolescent psych disorders?

A
  • Tics and Tourette’s (onset between 2-15, affects 3-5 in 10,000 people)
  • Bulimia nervosa
  • Anorexia nervosa (10x more common in women than men)
  • Other eating disorders like obesity and binge eating
  • Suicide
60
Q

How do we define Anorexia, and what are it’s causes and consequences in adolescence?

A

Definition:

  • Extreme dieting and fear of weight gain
  • Weight less than 85% of normal
  • Distorted sense of body shape

Cause: Stress-diathesis model most likely

Consequences:

  • Amenorrhea
  • Low BP
  • CV symptoms
  • Hair loss
  • Very commonly co-morbid with depression or OCD
  • 70% recover, but 10-15% will die by it
61
Q

How do we define Bulimia and what are its consequences?

A

Definition:

  • Intense concern about weight and frequent binge eating and purging
  • Normal weight but intense shame and depression about normal eating behaviours

Consequences:

  • Tooth decay
  • Stomach irritation
  • Disturbances in body temperature and chemistry
  • Hair loss
62
Q

What screening tool do we use for teenagers with a suspected eating disorder?

A

The SCOFF questionnaire.

  • Do you make yourself sick if you feel uncomfortably full?
  • Do you worry about losing control over how much you eat
  • Would you say food dominates your life
  • Do you believe you are fat when others say you are thin etc…
63
Q

What factors. convey resilience to MHP?

A
  • Intelligence and problem solving abilities
  • External interests and attachments
  • Parental attachment and bonding (supportive, harmonious parents)
  • Easy temperament, good humour, social skills
  • Good peer relationships
  • High self-esteem
  • Successful school experiences