Lecture 8.16.16 - Adolescent Development

Question 1

Adolescence involves a confusing mix of ___ and ___.

Answer 1

Privilege; constraint

Question 2

What is adolescence?

Answer 2

Period between onset of physical changes of puberty until adoption of the “adult role”

Question 3

What is the defined age range of adolescence?

Answer 3

12-21

Question 4

What is emerging adulthood?

Answer 4

The period between adolescence and adulthood

Question 5

What is the progression from the way a child thinks to the way an adult thinks?

Answer 5

Cognitive development

Question 6

What type of development involves the formation of the social, emotional, and moral selves?

Answer 6

Psychosocial development

Question 7

What are some of the developmental tasks and challenges for adolescents?

Answer 7

1. Achievement of biological and sexual maturation
2. Development of personal identity
3. Achieve a comfortable sense of self (body image, self-image, sexual identity)
4. Vocational identity
5. Win acceptance of peers
6. Establishment of independence and autonomy in the context of the sociocultural environment
7. Develop the capacity to love a person and be intimate
8. Achieve an effective value/moral system

Question 8

What is physical development during the adolescent period?

Answer 8

Puberty

Question 9

What is the period at the beginning of adolescence when the sex glands become functional and the secondary sexual characteristics emerge?

Answer 9

Puberty

Question 10

What are the Sexual Maturity or Tanner Stages?

Answer 10

Stage 1: Genitalia and associated structures are the same as childhood
Stage 2: Scant, straight pubic hair, testes enlarge, scrotum develops texture, slight elevation of breast tissue in girls
Stage 3: Pubic hair spreads over the pubis and becomes curly, penis increases in length and testes enlarge, breasts enlarge
Stage 4: Penis increases in width, glans develop, scrotal skin darkens, and areola rises above the rest of the breast in girls
Stage 5: Male and female genitalia are like adults, pubic hair spreads to thighs, areola is no longer elevated above the breast in girls

Question 11

What are the primary sex characteristics?

Answer 11

Body organs and reproductive structures and functions that differ between men and women

Question 12

What are the secondary sex characteristics?

Answer 12

Characteristics of the body that are caused by hormonal changes during puberty and last through adult life (changes in genitals, breast, voice, hair)

Question 13

The physical and psychological aspects of adolescent development are ___.

Answer 13

Interdependent

Question 14

Physical changes demand ___; it is a normative stress.

Answer 14

Accommodation

Question 15

True or false - there are variable rates of maturation and they are all normal.

Answer 15

True

Question 16

___ development refers to changes in how people think.

Answer 16

Cognitive

Question 17

Adolescence marks the beginning development of ___ thinking processes, moving away from ___ thinking.

Answer 17

Abstract; concrete

Question 18

What are the two types of adolescent egocentrism?

Answer 18

Personal fable and imaginary audience

Question 19

What is the belief held by many adolescents telling them that they are special and unique, so much so that none of life’s difficulties or problems will affect them regardless of their behavior?

Answer 19

Personal fable

Question 20

What is the belief that multitudes of people are enthusiastically listening to or watching him or her?

Answer 20

Imaginary audiences

Question 21

What is identity?

Answer 21

The answer to the question, “Who am I?”; Mature self definition;

Question 22

What is the uncertainty and discomfort adolescents experience when searching for an individual and societal role?

Answer 22

Identity crisis

Question 23

Identity includes two concepts - what are they?

Answer 23

Self-concept; self-esteem

Question 24

What is the set of beliefs one has about oneself?

Answer 24

Self-concept

Question 25

What is the evaluation of how one feels about one's self-concept?

Answer 25

Self-esteem

Question 26

What are the 4 identity statuses proposed by James Marcia?

Answer 26

1. Identity achievement: both searching and committed 2. Identity diffusion: neither searching nor committed 3. Identity moratorium: searching, not committed 4. Identity foreclosure: not searching, committed

Question 27

Adolescence is bio-medically the "healthiest" period of the life span, yet overall morbidity and mortality rates increase 200-300% from childhood to late adolescence. Why?

Answer 27

Behavioral risk factors for the most common adult diseases begin during this period

Question 28

What are three protective factors of adolescents?

Answer 28

Social support, sense of safety and security, and rules/boundaries/limitations

Question 29

What are the developmental concerns, cognitive changes, social changes, and sexual changes associated with early adolescence (11-14)?

Answer 29

Developmental concerns: Body image, friendships Cognitive: Concrete thought Social: start of emotional separation from parents, start of strong peer identification Sexual: increased awareness of sexual feelings

Question 30

What are the developmental concerns, cognitive changes, social changes, and sexual changes associated with middle adolescence (14-17)?

Answer 30

Developmental concerns: independence, identity, ideas/morality Cognitive: emergence of abstract thought, questioning mores of family, society Social: stronger emotional separation from parents and strong peer identification Sexual: interest and initiation of relationships and behaviors, sexual identity awareness

Question 31

What are the developmental concerns, cognitive changes, social changes, and sexual changes associated with late adolescence (17-21)?

Answer 31

Developmental concerns: vocational plans, intimacy Cognitive: complex abstract thinking, ability to think independently Social: social autonomy, ability to form intimate relationships Sexual: solidification of sexual identity, intimacy

Question 32

True or false - most structural brain development is not completed by early childhood; changes occur through the early 20s.

Answer 32

True

Question 33

Which portion of the brain matures first?

Answer 33

The back of the brain; pathways originating from sensory and motor regions mature earlier than frontal areas associated with executive functions.

Question 34

Describe the developmental asynchrony in puberty.

Answer 34

Rapid physical, endocrine, and social changes create early affective motivations and challenges. Development of affect regulation and maturation of cognitive/self-control skills occurs later

Question 35

75% of deaths of adolescents are from the 3 most common - what are these?

Answer 35

Accidents, homicide, and suicide

Question 36

The most common reasons that adolescents need health care are...

Answer 36

...psychiatric problems, pregnancy and related problems, STIs, substance use/abuse, obesity and eating disorders

Question 37

How do providers evaluate the developmental status of their teen patients and screen for possible risks to health?

Answer 37

The generally accepted method is to carry on a broad discussion of their life domains. Use the HEADS mnemonic: ``` H - Home environment E - Education A - Activities D - Drugs S - Sexuality ``` *Can be expanded to include Eating, Affect/Anxiety, Safety, and Suicide

Question 38

What are some barriers to service of adolescents in the healthcare system?

Answer 38

Lack of age appropriate sites for care, lack of confidential sites for care, lack of provider training in adolescent medical problems, belief that adolescents are "generally healthy" and don't need services, less compelled to come in for services, care is time-consuming, unfavorable reimbursements for providers

Question 39

What are the three general goals of primary care in adolescence?

Answer 39

1. Screen for illness and illness risk 2. Education patient regarding health areas 3. Promote healthy behavior