#Adolescent #mental_health #psychiatry #youth [[Book - Adolescent Psychiatry in Clinical Practice edited by Simon G Gowers]] # Normal Development in Adolescence. - We lack a unified theory of development in Adolescence. - Adolescence is a period of "movement from family into wider world" (Durken 1995) - 5 - 15% of adolescent have severe psychological disturbance (Kazdin 1990) - **The Importance of Context** - Family relationships predict adjustment to school, quality of peer relationships - The importance of family life. - Start from home. It affect peer relationships, behavior in school, academic performance. - School life intern affect access to world of work. - Hard to define adolescence period. Depending on culture. - Cannot define based on financial independence because factors in socioeconomic situations will affect it. - ## What is the developmental task of adolescence? - Culturally, the tasks changes over time, and depend on gender role. - Attachment Theory [[Attachment Theory]] | [[Attachment Theory]] : How well they navigate relationship at home will give them prior experience, which influence how they use that later in life. - Moving from small familiar setting to larger impersonal ones. - Peer group is important. - Cultural and socioeconomic conditions have impact on development. - Rutter and Ruttter (1992) principles - Gender, Biological factors. - bodily change - Timing - of puberty - Active - Whether they actively participate on their own development. - Meaning of these changes. - ### Attachment in Adolescence - Secure - Anxious avoidant - Anxious avoidant - 12 - 18 months predict later behavior in other settings. - Internal working model - a model of interpersonal relationship, in the context of earlier attachments. - ==The quality of attachment relationships rather than family structure was found to be important in preventing delinquent behavior (Sokol - Katz eg al, 1997)== ## Development in Adolescence ### Physical and Biological Development - Boys 10 - 16 years old. Average 13 - Growth spurt - Girls 7,8, 12-14. Average 11 - Growth spurt - Physical change lead to much preoccupation with the self. Culturally determined meaning which affect self-perception. Timing of these changes influence behavior and self concept. - #### Girls - age of menarche has reduced in industrial societies, - also can be influenced by family relationship; family conflict, absent father, behavior (dating earlier, drinking and smoking) - Meaning of menstruations will influence stress, expectations. - Timing also important - young girls now have to confront new norms, stresses. Psychologically may not be ready. So later is better. #### Boys - Sexual maturation for boys 18-24 months after girls. - Associated with peer status. - Mature early, perceived more positivity by peers. - Girls usually have talk with their female caregivers about menstruations, not boys with their father about their sexual development. ### Sexual Behavior - Concurrent development in self-awareness, self-esteem --> also development of sexual awareness --- this increases vulnerability. - Masturbation & Sexual Activity - If parents have new partner, this may expose them to awareness of sexuality. Or stretched/stress/busy parents may also have reduce monitoring of adolescent activities - value of chastity across cultures - View of males as predator - Social Script for Sex - Male - first sex - highly regarded - Female - more anxious - Homosexual activities - experimentation, Baker & Bellis 1995. - If youth is gay, then will have to consider support, interventions as this influence self image and acceptance. [[Book - The Velvet Rage]] ### Cognitive and Social Development - Piaget - Schemes - Assimilation - Accommodation - 7 - 11 year old - can formulate hypothesis, explain concrete events. Concreate operation. - 18-20 years old - Formal Operation - Can do abstract thinking, arguments. - Metacognition - thinking about thinking - Self examination and exploration -- which may increase anxieties and depression. - That's when family context and history of relationships influence this stage - Egocentrism (Piaget 1972) - They are expose to new ideas, new challenge may lead to increase in self-absorption (Vygotsky 1962) - Elnard 1985 - "Imaginary audience" - Youth have imaginary audience, let them rehearse, social interactions #### Information Processing - (Jacklin 1989) The difference between girls showing more Verbal IQ and boys more math and spatial is now disproven. It's mainly due to social environmental pressure. ### Social Cognition - The ability to think about people, social relationships and social interaction. - Adolescents who have higher levels of development in their social cognition ability appear to be able to behave in more socially competent ways (Ford, 1982) #### Self-Esteem - Start comparing from age 6 - 7 years old - ==How adolescent evaluate themselves in different contexts, so remember to have more than one context so that they cushion the impact== (Not all eggs in one basket.) ### How identity influence / relate to attachment and family life? - Erikson (1959), life long journey - Marcia (1966), four types of identity status: - Identity Diffusion - Adam (1994) -- Rejecting/Detachment family style - Identity Foreclosure -- Child centered, conforming - Moratorium and Identity achievement -- Both warm and supportive, encouragement of initiative and independence. - Culture may be protective to youth from identity confusion -- providing a place within extended family, in the community (e.g Islam, Durkin 1995) ## Adolescent development and Family Life Cycle - Not only the child is changing, the parents are also going through middle adulthood changes. - Mother menopause, father loss of potency, etc. - Adolescent's future is "full of possibilities", but to the adult, feeling increasingly trapped in circumstances - The parents are also concerning of the grandparents health. ## Parenting Style - Authoritative - Authoritarian - Indulgent - Indifference [[# Brain imaging study finds parental criticism disrupts children’s adaptive responses to rewards and losses]] [[202107151404 Book Notes - Think Again]]