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Flashcards in Adolescence and puberty Deck (71)
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1

What is growth due to




What is adolescence

Gonadal steroids (in particular androgens)

+ other hormones such as GH (somatotrophin) from anterior pit.


Adolescence: Adolescence refers to the period of development that occurs between ages 12-18 years.

2

How does the onset of puberty occur

Theories

1. Maturation of the CNS affecting GnRH neurones (increased pulsatile release)

2. Altered set point to gonadal steroid negative feedback

3

What might trigger maturation of CNS

Unclear....

BUT THERE IS EARLIER PUBERTY NOW:

Improved health care

Improved socio-economic factors (photoperiod and nutrition)

4

Outline Altered set point to gonadal steroid negative feedback

Initially:
-Low gonadal steroids
-But high sensitivity to these in negative feedback on pituitary/hypothalamus
-So low gonadotrophins

THEN, the sensitivity of the hypothalamus/pituitary to the gonadal secretions reduces, so
-Unchanged gonadal steroids results in
-Increased gonadotrophins (because the same amount of gonadal hormone has a lower negative feedback action because of the reduced sensitivity of the hypothalamus and pituitary)
-Gonadal hormones therefore increase (because of the increased GnRH and gonadotrophins)

The feedback further decreases until there are adult levels, whihc involve much higher hormone leves

5

What is menarche

the first occurrence of menstruation.

6

What has happened to age at menarche

Evidence that age at menarche has decreased over the last 150 years. Over the last 3-4 decades it seems to have levelled off – or it could even be increasing again.

7

How has body weight at menarche changed?

body weight at menarche has remained relatively constant at approximately 47kg.

8

What is adrenarche and what is it due to

Role: It's like the precurosr to puberty

Rise in adrenal 19- carbon steroid production,
dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS)

9

When is adrenarche in males and females

• Females: 6-9 years
• Males: 7-10 years

10

T/F adrenarche marks the beginning of puberty

F... it's the precursor to it.

11

What does adrenarche manifest as

• Manifests clinically as the appearance of axillary and pubic hair,
usually about age 8

12

Outline endocrinology of adrenarche

HPA axis

CNS and Hypothalamus stimulated leading to CRH

CRH leads to adenohypophysis ACTH release.

ACTH causes DHEA and DHEAS release from the zona reticularis

Leads to axillary, groin hair and acne

13

Outline endocrinology of puberty

HPG (not HPA like adrenarche)

CNS and hypothalamus releasing GnRH, pituitary releases LH/FSH. Menarche/sperm production and release of androgen and estrogen

14

What do oestrogen and androgen cause development of

ANDROGEN:
-penis, pubic hair and testes
-Also pubic, armpit hair and acne

ESTROGEN:
-breasts, ovaries, uterus

15

Why can extremely skinny women have periods stopping

Because leptin stimulates release of GnRH from the hypothalamus VIA increased kisspeptin release (which stimulates the GnRH neurones)

So if low leptin due to low body fat, then periods stop

16

Is menarche a single event

It is defined as such,

however periods take 3 cycles to be classed as fully established, so not clear cut

17

When do girls and boys have their growth spurts

Is this reflective of the rest of their development

Girls around age 12/13

Boys arund 15

Yes- girls are around 2 years ahead developmentally!

The boy growth spurt is also larger than the girls

18

What is the tanner scale

Scale to assess how advanced puberty is.

Based on:
i. Penile development
ii Breast development
iii. Growth of pubic hair

Each of these is rated 1-5 for development. 1 is pre-pubertyal and 5 is fully developed

19

What has the earlier age of puberty been down to


What is the normal age of puberty commencing for boys and girls

Improvement of diet

However obesity and overweight can lead to early onset of puberty


The average age for girls to begin puberty is 11, while for boys the average age is 12

20

Psychological changes in puberty

Cognition e.g. morality

Identity

Increased self-awareness

Affect expression and regulation (i.e. can you speak about how you feel, and then turn off those feelings)

21

T/F the psychological and biological development are not interlinked

F they are highly interrelated

Some hormones are required for proper cognition (oxytocin)

22

T/F menarche is early in the developmental process

F it's quite late (the child is quite developed at this point)

23

Social changes in puberty

• Family - parental surveillance, confiding

Peers
• Increased importance
• More complex & hierarchical
• More sensitive to acceptance & rejection
• Romantic relationships

Social role- education, occupation etc.

24

What changes in terms of importance of reationships in puberty

Changes from importance of parents to peers.

This is why some autism traits are only realised in puberty, when it is important to develop relationships with those outside of family when peers become primary relationships

25

Why is onset of mental health conditions often in pubery

Again because of this change in primary relationship from parents to support

And social support strognly associated with metnal health

And more sensitive to acceptance and rejection (because of infreased self awareness)

26

What are the wider cultural influences on puberty

• School
• Work
• Culture (“teen” subculture; migration/culture)
• Social influences eg unemployment, poverty/affluence, housing,
neighbourhood effects

27

What happens with brain during development

Grey matter volume = decreases from 6 yrs to adolescence & there is a linear increase in white matter at about 20 years

28

Outline developmental mismatch

Adolescence is a time of risk taking

Yes because of increased Regulatory/ Cognitive
control
Integration of affect

But Sensation seeking activity sharpy increases up to 17 years old and then decreases again

The area between these two lines is the risk taking activity

29

Examples of risk in adolescence

Sex
Delinquency
Violence
Self-harm
Disease control

30

When do mental health problems start

3/4 by the age of 24

1/2 by the age of 14