3. Adolescent Medecine

Question 1

What’s the acronym for Adolescent History?

Answer 1

Adolescent Psychosocial Assessment HEEADSSS

• Home
• Education/Employment
• Eating
• Activities
• Drugs
• Sexuality
• Suicide and depression
• Safety/violence

Question 2

Describe: Adolescent Psychosocial Assessment HEEADSSS

Answer 2

• Home: Who do you live with? What kind of place do you live in? Do you get along with your parents and/or siblings?
• Education/Employment: What grade are you in? What are your favourite subjects? What was your average on your last report card (ask for changes)? How much school have you missed this past year? Do you work (if so, how much)? Do you get along with teachers/employers?
• Eating: Tell me about your meals/snacks in a typical day. Have you ever gone on a diet? What are your favourite and least favourite foods?
• Activities: What do you do after school? On the weekends? How much time do you spend on the com- puter/watching TV every day? Do you use social media (i.e. Facebook, Twitter, Instagram, etc.)? What do you do with your friends outside of school?
• Drugs: Which seems to be more popular at your school, alcohol or drugs? How often do you drink/ smoke marijuana or cigarettes/take other drugs? Have you ever passed out or not been able to remember what happened? Has anything bad ever happened to you while you were drunk or stoned?
  
  • can organize as a CRAFFT screen
    • Part A: during the last 12 mo, did you:
      
      • Drink alcohol?
      • Smoke any marijuana or hashish?
      • Use anything else to get high?
    • Part B:
      
      • Have you ever ridden in a car driven by someone (including yourself) who was high or had been using drugs/alcohol?
      • Do you ever use drugs/alcohol to relax, feel better about yourself, or fit in?
      • Do you ever use drugs/alcohol when you are alone?
      • Do you ever forget things you did while using drugs/alcohol?
      • Do your family/friends ever tell you that you should cut down on your drinking or drug use?
      • Have you ever gotten into trouble while you were using drugs/alcohol?
• Sexuality: Are you romantically interested in anyone? When you think about having sex with someone, do you think about females, males, or both? Have you ever had sex with anyone? Whether the answer is yes or no, the next question is: What activities would you include in the term ‘having sex’? What do you do to prevent getting a STI/getting pregnant/getting someone pregnant? Has anyone ever given you money, drugs, or other stuff in exchange for sex?
• Safety/Violence: Do you ever get into a car with a driver who has been drinking? Do you always wear a seatbelt/bicycle helmet? Are you being bullied at school? Has anyone ever touched you in an unwanted way?

Question 3

Rates of drug use in high school students who have used in the past year: alcohol (__%), cannabis (__%), tobacco (__%)

Answer 3

Rates of drug use in high school students who have used in the past year: alcohol (58.2%), cannabis (25.6%), tobacco (11.7%)

Question 4

Describe: Consent and Close Age Exceptions (4)

Answer 4

• The age of consent is 16
• A youth 16 or 17 cannot consent if: the partner is in a position of trust/authority (e.g. coach, teacher), young person is dependent on the partner (e.g. for care or support), the relationship is exploitative (e.g. prostitution or pornography)
• A 14 or 15-year old can consent as long as the partner is less than 5 years older and as long as there is no relationship of trust, authority, dependency, or exploitation
• A 12 or 13-year old can consent as long as the partner is less than 2 years older and as long as there is no relationship of trust, authority, dependency, or explo tation

Question 5

Date rape comprises __% of sexual assault in teenagers

Answer 5

Date rape comprises 80% of sexual assault in teenagers

Question 6

Prevalence of depression: ___% in pre- pubertal children and ___% in adolescents

Answer 6

Prevalence of depression: 1-2% in pre- pubertal children and 6-8% in adolescents

Question 7

Describe: Early Adolescence (10-13 yr)

• Cognitive and moral
• Self-concept/identity formation
• Family
• Peers
• Sexual

Answer 7

• Cognitive and moral:
  
  • Concrete
  • Unable to perceive long-term outcome of current decision-making
• Self-concept/identity formation:
  
  • Preoccupied with changing body
  • Self-consciousness about appearance and attractiveness
• Family: Increased need for privacy
• Peers: Seeks same-sex peer affiliation to counter instability
• Sexual:
  
  • Increased interest in sexual anatomy
  • Anxieties and questions about genital changes, size
  • Limited dating and intimacy

Question 8

Describe: Middle Adolescence (14-16 yr)

• Cognitive and moral
• Self-concept/identity formation
• Family
• Peers
• Sexual

Answer 8

• Cognitive and moral:
  
  • Emergence of abstract thought
  • Questioning mores
• Self-concept/identity formation:
  
  • Concern with attractiveness
  • “Stereotypical adolescent”
• Family:
  
  • Conflicts over control and independence
  • Struggle for acceptance of greater autonomy
• Peers:
  
  • Intense peer group involvement
  • Preoccupation with peer
• Sexual:
  
  • Testing ability to attract partner
  • Initiation of relationships and sexual activity
  • Questions of sexual orientation

Question 9

Describe: Late Adolescence (17-19 yr)

• Cognitive and moral
• Self-concept/identity formation
• Family
• Peers
• Sexual

Answer 9

• Cognitive and moral:
  
  • Future oriented with sense of perspective
  • Idealism
  • Ability to think things through independently
• Self-concept/identity formation:
  
  • More stable body image
  • Attractiveness may still be of concern
  • Firmer identity
• Family:
  
  • Emotional and physical separation from family
  • Increased autonomy
• Peers:
  
  • Peer group and values recede in importance
  • Intimacy/possible commitment takes precedence
• Sexual:
  
  • Consolidation of sexual identity
  • Focus on intimacy and formation of stable relationships