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Semester 5 FSNM Exam 8 > Abnormal Adolescence > Flashcards

Abnormal Adolescence Flashcards

(65 cards)

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1
Q

The primary task of adolescence

A

identity development

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2
Q

By the time you are 5.. where is brain development

A

90% of its size BUT cerebral cortex and frontal lobes are immature through early adulthood

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3
Q

Prefrontal cortex

A

Regulating thought, feelings, actions
Capacity to inhibit impulse
White matter inc through early adulthood
Gray matter inc in early puberty and then dec (pruning)

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4
Q

Limbic System

A

Emotions
Undergoes myelination and then pruning (to lesser degree)
Sensation seeking, novelty seeking, risk taking

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5
Q

Risk taking in early adulthood

A

Risk taking declines by early adulthood

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6
Q

Psychosocial development - Adolescent development ___ from person to person

A

Varies dramatically
Development often occurs in spurts
Stages can vary from person to person (different rates per person)

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7
Q

Psychosocial development - Lasting difficulties

A

80% cope well with process and do not have any lasting difficulties

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8
Q

Psychosocial development - Sensation seeking peaks when

A

Early adolescence

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9
Q

Psychosocial development - Intensity of emotions and mood swings

A

Less frequent from early to late adolescence

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10
Q

Psychosocial development - Capacity to inhibit

A

Increases across adolescence

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11
Q

Psychosocial development - happiness

A

declines from early to late adolescence

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12
Q

Psychosocial development - conflict with parents

A

Constant major conflict btw adolescent and parents is not developmentally normal - intermittent conflicts in the context of a generally functional relationship is normal

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13
Q

Relationships with peers

A

Tend to select friends based on similarity in personality, values, and activities

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14
Q

Relationships with peers - Deviancy training

A

If an adolescent’s close friends engage in deviant bx, over time that adolescent is more likely to do so as well

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15
Q

Relationships with peers - presence of same age peers increases what

A

risk taking

and even more so if same sex

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16
Q

Typical characteristics of adolescent patients

A 
They aren't the ones making the appt 
Landscape of injury is unfamiliar and may provoke anxiety 
Strong desire for autonomy 
Prone to shame, feel vulnerable 
Sensitive to criticism 
Anger masking fear or sadness
Time perspective is short 
See problems as arising from outside the self
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17
Q

Bx challenges of adolescence

A

Often feel misunderstood, alienated
Opposition to authority is normal
Tend to focuse more on immediate and short term rather than vague distant future

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18
Q

Bx challenges of adolescence - Noncompliance

A

Can serve important developmental tasks - individuation from families, avoidance of activities that might decrease peer acceptance or peer conformity

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19
Q

Helpful qualities for treating adolescents

A 
Tact (be honest without seeming critical)
Flexibility
Sense of humor
Honesty
Playfulness
Tough of rebellion 
Relaxed, matter of fact
Genuine interest in the pt
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20
Q

Qualities adolescents desire in health care provider

A 
Caring
Not rushed
Trustworthy, honest, open
Non judgmental
Knowledgeable, experienced
Careful
Respectful
Willing to assure confidentiality
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21
Q

Common adolescent responses to injury

A

First few days - anxiety, fearful, distress
Irritability and uncooperative
Maybe feeling of emptiness or numbness after serious injury
Physical sx (HA, upset stomach)
Trouble sleeping
Might get extra clingy
Fear of disfigurement or disability

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22
Q

Common adolescent responses to injury - when to worry

A

More concerning if the symptoms are constant or if they interfere with the adolescent’s ability to function

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23
Q

Helping adolescent cope with injuries - strategy based on

A

Approaching and addressing the problem directly, rather than avoiding it

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24
Q

Helping adolescent cope with injuries

A

Good social support leads to better outcomes
Listen carefully
Elicit feeling and accept them
Address needs of the family
Ensure pain is managed
Normalize their feelings
Ask specifically about their fears and address them

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25
Establishing Rapport
Introduce yourself and shake hand Start off with casual chatting Connect with them - let them teach you something about their interests Let them talk Listen closely - be slow to give advice unless asked Offer reassurance Explain what is wrong and what you are doing step by step and why it is going to help!
26
Interviewing adolescents
Helpful to meet with them and their parents but sensitive measures alone
27
Insights from motivational interviewing
Explore with the adolescent in a way that does not presuppose the correct answer - Looking together with them at what might happen and explore those options with them
28
Encourage autonomy
Avoid pressuring them to change or problem solving for them | Goal is to support the pt in their process of exploring outcomes
29
Collaborate
See yourself as a partner of theirs with resources Balance guiding and supporting and allowing them room to explore and fail Explore their thoughts
30
Evoking intrinsic motivation
Help them to discover their own values and desires You want to be in the position where the adolescent is arguing for change, not you as PT - this requires you to remain neutral and honor the reason for not changing
31
Adolescent mental health
Mood swings, intense emotions are common and normal | Usually last a short time and do not impair overall functioning
32
Adolescent mental health - red flags
``` Consistent high levels of distress that last for more than a few days or do not improve with positive life events Suicidality Lack of positive relationships Hx of abuse or neglect Difficulty functioning ```
33
Adolescent mental health - internalizing problems involves what
Disturbances in how the person feels
34
Adolescent mental health - internalizing problems - more common with who
Girls
35
Adolescent mental health - internalizing problems - Marked increase in depression and anxiety in adolescence
Can be genetic, environmental, or cultural factors that may impact risk of depression
36
Adolescent mental health - internalizing problems - eating disorders
Risk for eating disorders increases (esp in girls) as puberty causes increases in body fat and change in shape (addition of weight comes before addition of height)
37
Adolescent mental health - externalizing problems involves what
Disturbances in how the person acts
38
Adolescent mental health - externalizing problems - more common with
Boys
39
Adolescent mental health - externalizing problems - delinquent bx does what as we get older
Markedly increases between early and middle adolescence, then declines
40
Adverse childhood experiences (ACES)
Accidents, injuries, and intentional violence are all more common in context of psychosocial dysfunction
41
Adverse childhood experiences (ACES) - Specifically childhood experiences of abuse, neglect, parental substance abuse, parental mental illness, parental loss, parental imprisonment, or domestic violence lead to elevated rates of
``` Depression Substance abuse More than 50 sexual partners Early intercourse Teen pregnancy Likelihood of being raped Likelihood of perpetrating domestic violence Work abstenation Financial problems Number of medically unexplained sx Shortened lifespan ```
42
Protective factors (ACES)
``` Stable, non reactive temperament Good physical and mental health Normal to high intelligence High self esteem Social competent Good social support Secure attachment style Competent parents Adequate socioeconomic resources Close with family Access to community resources ```
43
Eating disorders - Anorexia
Severe restriction of calories leading to body weight less than 85% of expected Often physical sx of malnutrition, including amenorrhea, dizziness, cold intolerance
44
Eating disorders - Bulimia
Recurrent binges with excess eating and a sense of lack of control Inappropriate compensatory bx Self eval is unduly influenced by weight
45
Mood disorder - after puberty
Twice as many females as males meet criteria
46
Mood disorder - how many don't receive tx
70-80% | Bad because they can develop this depressive mood as part of their personality and part of who they are
47
Mood disorder - Sx of depression
Last for two weeks and need to have depressed mood most days or diminished interest in most activities AND four of the seven things for at least two weeks
48
Mood disorder - Sx of depression - need 4 of the 7
``` Change in appetite or weight change Change in sleep Visibly restless or agitated Fatigue Worthlessness/guilt Inability to concentrate/make a decision Suicidality or recurrent thoughts about death ```
49
Treating an adolescent with depression
Refer for tx if not already in it Remain encouraging Adjust your style to be calmer Encourage activity but don't be judgemental if they don't follow through Very gently dispute cognitive distortions (I will never be able to handle this)
50
Suicidality - If you are concerned
Ask them about it
51
Suicidality - what do you ask about
Ideation Plan Means Intent
52
Suicidality - is ideation an emergency
No - but it does mean they need treatment | Ideation, with plan, means and intent is an emergency
53
Anxiety disorders
Most common psychiatric disorder experienced by adolescents | Similar prevalence in M and F
54
Anxiety disorders - social phobia
Worried about social situations or interacting with others or of performance situations Fear of criticism or humiliation
55
Anxiety disorders - generalized anxiety disorders
Chronic, unmanageable worry
56
Anxiety disorders - Obsessive compulsive disorder
Recurrent, intrusive thoughts (obsessions) | Recurrent, ritualized bx (compulsive) - spend at least an hour on it a day
57
Anxiety disorders - PTSD
Numbing/Increased arousal, avoidant, re-experience symptoms | Dissociation - seem detached or don't remember aspects of the trauma
58
Anxiety disorders - Panic Disorder
All of a sudden gets physical symptoms (intense) and lasts 15 min to an hour - spiral upward of F/F response
59
Tx an adolescent with anxiety
``` Refer for tx if not already being done Discourage avoidance of feared activities Remain calm and reassuring Empower them Identify and utilize resources ```
60
Attention deficit/Hyperactivity disoders
Highly heritable More common in males - F tend to be more inattentive than hyperactive so is more likely to be missed More impulsive
61
Symptoms of ADHD
``` Has to impair functions Careless mistakes, forgetful Easily distracted Inability to follow through Lose things Fidgety Difficulty waiting turn Interrupts people ```
62
Substance Abuse
Most significant public health issue in adolescents
63
Substance abuse - risk factors
``` Availability of drugs and norms favoring their use Extreme poverty Hx of abuse or parental abuse High levels of life stressors Sensation seeking ```
64
Substance abuse - protective factors
Stable environment, close, positive relationships with parents High motivation for achievement, affiliation with pro social groups and friends
65
Alcohol
Most commonly abused drug by adolescents

Semester 5 FSNM Exam 8 (5 decks)

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