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Adolescent Development and Common Problems

Dr. Oğuzhan Zahmacıoğlu 2015. Adolescent Development and Common Problems. AIMS. a) Learning about the importance of knowing normal adolescent development when dealing with the adolescent patient. b) Understanding the developmental changes in adolescence.

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Adolescent Development and Common Problems

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  1. Dr. Oğuzhan Zahmacıoğlu 2015 Adolescent Development and Common Problems

  2. AIMS • a)Learning about the importance of knowing normal adolescent development when dealing with the adolescent patient. • b)Understanding the developmental changes in adolescence. • c)Differentiating age related problems of adolescence from psychiatric disorders. • d)Learning to relate to an adolescent patient. • a)Learning about the problems that may be a matter of concern for adolescent age group. • b)Understanding the problems of the adolescent and his/her family.

  3. “Puberty”Edward Munch, 1915

  4. ADOLESCENCE: Adolescence is the period in human life which begins with biological and emotional changes and proceeds to sexual and psychosocial maturity. This stage ends when the individual has gained autonomy and social produtivity. Relatively fastened physical and social changes are seen in this period.

  5. Developmental Changes in different areas: • 1. Physical Changes • 2. Cognitive development • 3. Social-emotional development • 4. Identity formation • 5. Sexual development

  6. ADOLESCENCE (Ergenlik) The change in the child that leads to adult individual abilities in cognitive and behavioral ways. • PUBERTY(Erinlik) The maturational changes in hypothalamo-pituatry-gonadal axis that lead to formation of gametosits.

  7. Şekil 5. Normal Kız ve Erkek Adolesanlarda Cinsel Gelişme Evreleri ve Yaşa Göre Kas Kitlesi, Boy ve Ağırlıkta Değişikler

  8. Şekil 2. Hipotalamus-Hipofiz-Gonad Aksı Hipotalamus (LHRH Nöronları) LHRH Hipofiz Gonadotrop Hücreler Gonadlar Testis Over Testosteron Estradiol Kaynak: Alikaşifoğlu A. Pubertenin Endokrin Yönü. Katkı Pediatri Dergisi. Cilt 21, Sayı 6, 742, Ankara, 2000.

  9. AGE LIMITS • 10-12 pre adolescence: adolescence behaviors begin. • 12-14 early adolescence: assimilitation of physical changes • 14-16 mid adolescence: interest in opposite sex begins, peer relations gain importance. • 17-19 late adolescence: plans and steps toward adulthood.

  10. Physical changes • Peak height velocity: (females: 11, males 14yrs) • Change in bodily ratios. • Vocal changes • Changes of body fat distrubition • Muscle development speeded in males. • Dermal changes • Pubic hair development • Development of sexual organs.

  11. Problems related to bodily changes • Clumsiness • Anxieties about height gain. • Efforts to hide bodily changes, skeletal abnormalities • Eating problems • Efforts to hide voice changes • Anxieties about lagging of sexual development. • Too much self consciousness leading to withdrawal.

  12. Developmental Timing Effects • Age of menarch in girls: 13 (1.5 yrs between early and late maturers) • Mean age for PHVin males: 14 (Two years between early and late maturers) • Genetics is the most important factor. • Differences between cultures • Differences between boys and girls • Biological changes translate to social changes according to culture.

  13. Cognitive Development Abstract thinking develops in adolescence: • 1. Adolescent can ask if questions, think on different possibilities. • 2. Thinks on abstract concepts. • 3. Can reflect on his/her own thought process. • 4. Can understand other people’s point of view. • 5. Can argue for and against . • 6. Can think on hypotheses. • 7. Social cognition develops which allows the adolescent to show different attitudes in different settings.

  14. Problems related to formal operational thought • These skills enable adolescents to argue with adults on their own terms. • They recognize the principles behind laws and rules, question rules and standards. . • Enables idealism and philosophical thought • As a newly acquired skill it is rehearsed exploratively • Can lead to existential doubt, to political questioning • To moralising and to endless arguments with parents and teachers.

  15. SOCIAL EMOTIONAL DEVELOPMENT • One of most important steps in identiy formation. • Adolescent tries to answer the question about identity. “Who am I?”. • Needs more autonomy, rebels against parental authority. • Peer group becomes more important. • Attachment relations toward to opposite sex. • Tries to be like people whom he/she idealizes,

  16. Orta ergenlik Ergenin aileye bağımlılığı Ergenin kendine dayanması Ergenin arkadaş çevresi baskısına direnci

  17. Friendships • Males and females have different patterns. • At different stages of adolescence friendships gain different importance.

  18. SEXUAL DEVELOPMENT • This is a time the adolescent realizes his/her sexuality. The pressure on sexual feelings and behaviors should be reduced. • Biological changes are given meaning according to societal rules. • Modelling others is an importan factor in taking up sexual roles. • Friendships with opposite sex help the adolescent to develop his gender identity and try gender roles. • The adolescent realizes that there are different types of love.

  19. Problems related to sexual development • Perception of sexuality as a quality that should be repressed makes the adolescent feel shaem and guilt about himself/herself. • Perception of sexuality only as a physical act leads the adolescent to go into relations that are not accompanied by emotional closeness. These type of relations may hurt the adolescent.

  20. IDENTITY • As the adolescent tries to find the answer to the question “who am I” he slowly develops a theory about himself/herself, about his/her relations. This theory about self is open to experimentation and may change in time. His/her view about himself/herself slowly integrates into a whole. • Paralelling this identity theory the adolescent develops a world view and in this context develops his/her own values. • As the adolescent determines his/her role in the society he begins to make plans about his future and takes steps accordingly.

  21. ADOLESCENTS AND FAMILY RELATIONS • Relations outside the family gain prominence. By early adolescence he/she becomes reluctant in family activities. By middle adolescence he/she accepts peer group norms. This precipitates the confict with the family. Late adolescence is the time when the relations are more balanced.

  22. Developmental Task of Families with an adolescent: • To change the flexibility of family boundries: “to provide a balance between “Control and Autonomy” For the adolescent ”

  23. Steinberg ve Duncan; 2002, What are the needs of families to support adolescent development: • They need to know about normal developmental changes in adolescence. They need to know about effective parenting styles Need to know about changes in a family at this period. • Need a health system to support them in their difficulties. .

  24. RELATIONS BETWEEN BEHAVIOR, AFFECT AND THOUGHTS Belief systems Feelings Thoughts Behavior

  25. Reasons for conflict between adolescents and parents • Psychiatric problems of adolescent or parents • Academic problems (failure, stress, tiredness) • Parental relational problems. • Adolescent’s problems about peer group.

  26. Becker’in ebeveyn stilleri modeli Yüksek düzeyde duygusal destek AŞIRI İZİN VERİCİ EBEVEYNLER YETKİLİ EBEVEYNLER Düşük düzeyde kontrol Yüksek düzeyde kontrol İHMAL EDEN EBEVEYNLER OTORİTER EBEVEYNLER Düşük düzeyde duygusal destek

  27. School Problems in Adolescence: • Problems about academic failure • School violence • Problems related to educational system.

  28. Reasons for school failure • Psychiatric problems • Exam anxiety • Decreased motivation

  29. Psychiatric Disorders • 1. Disorders that have been present since childhood • 2. Disorders that emerge in adolescence • 3. Andecedents of adult psychiatric disorders.

  30. Childhood onset psychiatric disorders • Mental retardation • ADHD • Disruptive disorders

  31. Psychiatric disorders that emerge in adolescence • Anxiety disorders • Depression and mood disorders • Eating disorders • Alcohol and drug abuse • School refusal • Adjustment disorder

  32. Antecedents of Adult Psychiatric Disorders • Schizophrenic disorder • Mood disorders

  33. Exam Stress • Performance anxiety • Related to high expectations • More frequent in adolescents who have high anxiety sensitivity • Wrong preconceptions about being exited precipitate the problem. • All children need to learn how to cope with stress

  34. Reasons for adolescent violence • I: Individual factors: • Personal attitudes and belifs • Communicaton problems. c) Alcohol and drug abuse. d) Being victim of violence. e) Psychiatric disorders II: Family factors Violence at home Neglect and lack of warmth Criminal behavior in family members III. Economical and societal reasons: Discrimination in the society. Low SES, overcrowding at cities. Media effects. Guns being easily reachable. Societal norms that support violent behavior.

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