Adolesence Flashcards Preview

Y2 RDA (LCRS1) > Adolesence > Flashcards

Flashcards in Adolesence Deck (37)
Loading flashcards...

What is adolescence?

  • Adolescence – phase between childhood & adulthood
  • Pubertal development may be start of adolescence


When does adolesence usually start in males and females?


What is adrenarche and when does it start?

  • Precursor to puberty - stimulation of adrenal glands
  • Females: 6-9 years
  • Males: 7-10 years


What happens in adrenarche?

  • Rise in adrenal 19- carbon steroid production, dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS).
  • These are the precursors of sex steroids
  • Manifests clinically as the appearance of axillary and pubic hair, usually about age 8.


How is body fat related to periods?

  • Leptin stimulates the release of GnRH from the hypothalamus
  • No body fat = periods stop


What is menarche?

  • The 1st period
  • Usually, periods aren't considered to be established until 3 cycles are complete 
  • So although menarche is a single event, it can only be defined in retrospect


What is the endocrine axis of adrenarche?

  • Hypothalamus produces CRH
  • Anterior pituitary produces ACTH
  • Adrenal cortex produced Androstenedione and DHEA
  • These feedback on the pituitary and hypothalamus
  • They also initiate the development of:
    • pubic hair
    • armpit hair
    • acne


What is the endocrine axis of male puberty?

  • Hypothalamus produces GnRH
  • Anterior pituitary gonadotrophs produce LH&FSH
  • Act on gonads to initiate sperm production
  • Also act on gonads to produce androgens which initiate the development of:
    • Penis
    • Pubic hair
    • Testes


What is the endocrine axis of female puberty?

  • Hypothalamus produces GnRH
  • Anterior pituitary gonadotrophs produce LH&FSH
  • Act on gonads to initiate ovarian production and menarche
  • Also acts on gonads to produce estrogen - initiating the development of:
    • breasts 
    • ovaries
    • uterus


What are the phases of puberty?

  • Phase 1: Pre puberty
  • Phase 2-4: Puberty
  • Phase 5: Fully developed


What are the 3 measured stages of puberty?

  • Axillary hair growth
  • Pubic hair growth
  • Breast/penis growth


Why is puberty starting earlier than it used to?

Improvements in diet


What are the psychological changes of adolescence?

  • Cognition e.g. morality
  • Identity
  • Increased self-awareness
  • Affect expression and regulation


What are the social changes of adolescence?

  • Family - parental surveillance, confiding 
  • Peers
    • Increased importance
    • More complex & hierarchical
    • More sensitive to acceptance & rejection
    • Romantic relationships •
  • Social role – education, occupation, etc


How does the brain change during adolescence?

  • Increases in cortical thickness
  • Peaks at aprox 10 years old
  • Then begins synaptic pruning - removing unused synapses


What is the developmental mismatch hypothesis?

  • Increase in cognitive control throughout adolescence - increasing integration of affect (understanding your feelings)
  • Dopaminergic activity also increases up to 18 years which is associated with increased sensation seeking
  • This period where sensation seeking is higher than cognitive control is the risk period


What is the definition of anorexia nervosa?

  • Persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical health)

Old definition:

  • Body weight at least 15% below expected
  • With endocrine disturbance and wt loss behaviours.


What are the predisposing factors of anorexia nervosa?

Pre-morbid weight






What are the precipitating factors of anorexia nervosa?

Social exclusion 


What are the maintaining factors of anorexia nervosa?


Social media



Starvation-induced reward feeling


What factors can be used to predict development of anorexia?

  • Earlier pubertal maturation, & higher body fat
  •  Concurrent psychological problem e.g. depression
  •  Poor body image
  •  Specific cognitive phenotypes


How does anorexia cause change in neuropsychology?

  • Loose the ability to see the bigger picture - global processing difficulties
  • Association with autism



How is the assessment for anorexia made?

  • Family interview
  • Individual interview with child/adolescent
  • Physical examination
  • Data on growth
  • Physical examination & investigations


What are the other differential diagnoses of anorexia?


  • Gastro-intestinal disorder eg. crohns disease
  • Metabolic eg diabetes
  • Pituitary


  • Other feeding or eating disorder
  • Depression
  • Psychosis
  • Obsessive compulsive disorder


How is conduct disorder defined?

  • Repetitive & persistent (> 6 months) pattern of dis-social, aggressive or defiant behaviour
  •  Frequency & severity beyond age appropriate norms.


What are some behaviours associated with conduct disorders?

  • Oppositional behaviour, defiance
  • Tantrums
  • Excessive levels of fighting or bullying, assault
  • Running away from home
  • Truancy
  • Cruelty to animals
  • Stealing
  • Destructiveness to property
  • Fire-setting


What are the types of conduct disorder?

  • Unsocialized CD
  • Socialized CD
  • Oppositional CD
  • Depressive CD
  • Hyperkinetic CD


What is the difference between:

Antisocial behaviour


Conduct disorder

  • Antisocial behaviour - defined by society

  • Delinquency/offending - defined by the law

  • Conduct disorder - defined by psychiatry


What are the aetological factors for conduct disorders?

  • Environmental factors e.g. inner city, school 
    • This is the main target for therapy
  • Family factors e.g. inadequate parenting
    • This is the 2nd target for therapy
  • Child factors e.g. ADHD, depression
    • this is the last target for therapy


What is the prognosis of conduct disorders?

Predictor of:

  • Antisocial PD in adulthood 
  • Alcoholism & drug dependence
  • Unemployment and relationship difficulties


  • 40% of 7 and 8 year olds with CD became recidivist delinquents as teenagers.
  •  Over 90% of recidivist juvenile delinquents had conduct disorder as children.