Adolescent Mental Health

Adolescent Mental Health

Oliver O’ConnellPsychiatrist


• Definition of Adolescence• Biopsychosocial development during

adolescence• Biopsychosocial tasks of adolescence• Normal vs. abnormal adolescent behaviour• Resolution of Adolescence• Mental Illnesses arising in adolescence


• Definition: Adolescence is the developmental phase that

spans the transition period from the ending of the relatively complete childhood reliance on parents to the relatively complete reliance on oneself to manage one's own life. Thus the beginning and end dates vary greatly.


• Definition: “adolescence begins in biology and ends in culture”

longstanding definition of the onset of adolescence links it to puberty, when hormone activity produces the development of secondary sex characteristics (pubic hair and voice change in males; breast development and menarche in females). However, while these biological changes are evidence of the transition from childhood to adolescence, the transition out of adolescence is less well defined.


• Definition: A hundred years ago, notions of adolescence were

scarcely understood, since teens did not attend high school and most assumed adult roles of providing for their family and getting married at average ages of 14 and 15.

the time period of adolescence has been extended to include the ages of 10 through the mid twenties, with most researchers dividing the age span into early (10–13), middle (14–17) and late (18–mid twenties) adolescent


• Biopyschosocial tasks of adolescence: (Physical, psychological and social development ).

The problem is that these three domains may not keep up with each other. In the last 100 years the average age of puberty occurs 2 years earlier but there is no evidence that psychosocial developmental has kept pace.


• Physical developmentA growth spurt precedes puberty by 1 year

with girl's commencing about two years before boys and finishing at an earlier age. Emotional adjustment may be a problem for those whose pubertal level is out of synchrony with their peers. It is noted to be a problem for very early developing girls and late developing boys.


• Physical DevelopmentGrowth and maturation of the brain This leads to new behaviours that irritate

and frustrate parents including changes in attention motivation…………need reward risk taking behaviour


• Psychosocial Development through adolescence.

Early adolescence: o Growth spurto Puberty commenceso Social move away from family towards peers

(peer group becomes an alternative for life advice)

o Thinking is concrete


Mid Adolescence: 14-17yearso Ability to think abstractlyo Metacognitiono Beginning of consolidation of the sense of selfo Scant empathy and lack of tolerance for views

of others


Late Adolescence: 18 to mid twentieso Abstract thinking and ability to consider the

future, deductive reasoningo Idealism becomes more practical and less

doctrinaireo Parental values less likely to be challenged

automatically


• Biopyschosocial tasks of adolescence:To come to terms with body/brain changesTo cope with sexual development and

psychosexual drivesTo establish and confirm sense of identityTo learn more about sex rolesTo synthesize personalityTo struggle for independence and emancipation

from family

Adolescent Mental Health• Normal adolescent behaviour: • is it normal to be abnormal in adolescence?What Is Normal?Become Aware of the Attitudes and Behaviours of

Adolescents Your Child's AgeHow Often Does the Behaviour Occur?Does the Behaviour Interfere with the Teenager's Ability

to Function in the Environment?Does the Behaviour Interfere with Others?Consider Individual DifferencesUse your intuition


• Normal Adolescent BehaviourRisk takingImpulsivityNovelty seekingReckless behaviourDisobedience


• Normal Adolescent Behaviour: • Inconsistent, unpredictable, and paradoxical behaviour• Exploration and experimentation with self and world• Eagerness for peer approval and relationships• Strong moral and ethical perceptions• Competitive in play; erratic work play patterns• Better use of language and other symbolic material• Critical of self and others• Alternates between anxiety over loss of parent

nurturing and hostility to parents

Adolescent Mental Health• Abnormal Adolescent Behaviour: Apprehensions, fears, guilt and anxiety about sex, health,

education Defiant, negative, impulsive or depressed behaviour Frequent somatic or hypochondriacal complaints Illness denying behaviour Learning erratic or deficient Sexual preoccupation Poor or absent personal relationships with adults or peers Immature or precocious behaviour Unwillingness to assume greater autonomy Complete inability to substitute or postpone gratifications


• Severely abnormal Adolescent Behaviour: Complete withdrawal into self, extreme depression Acts of delinquency, asceticism, ritualism, obsessions Neuroses, especially phobias; persistent anxiety,

compulsions, inhibitions, Persistent hypochondriasis Sexual deviance Complete inability to socialize or study Anorexia, Bulimia, Psychoses:

Adolescent Mental Health• Resolution of Adolescence:Separation from parents commensurate with

being able to decide the course of one's own lifeAttainment of a stable sexual identityAbility to form a long-term sexual relationshipAttainment of a steady job or the preparation for

a careerAttainment of a personal value system that

respects both the needs of the self and the needs of others


• Mental Illnesses arising in adolescenceEpidemiology 1 in 4 have a mental disorder 9% are highly distressed 18-24year olds have the highest prevalence Youth suicide is the leading cause of death

in 15-20 year olds


• Mental Illnesses arising in adolescenceBiology/Geneticso Risk factors:Family history

o Protective factors: High Intelligence


• Mental Illnesses arising in adolescenceSocial Environmento Risk FactorsPovertyDiscrimination based on race, religion etc.Bullying, trauma, sexual abuseCriminal opportunities


• Mental Illnesses arising in adolescenceSocial Environmento Protective factorsQuality SchoolsCohesive FamilyNeighbourhood ResourcesInterested Adults


• Mental Illnesses arising in adolescencePerceived Environmento Risk Factors• Models for deviant behaviour• Parent-friends conflict the norm


• Mental Illnesses arising in adolescencePerceived Environmento Protective FactorsModels for conventional behaviourHigh control against deviant behaviour


• Mental Illnesses arising in adolescencePersonalityo Risk FactorsLow perceived life chancesLow Self-EsteemRisk-Taking Propensity


• Mental Illnesses arising in adolescencePersonalityo Protective FactorsValue on achievementValue on healthIntolerance of deviance


• Mental Illnesses arising in adolescence• Alcohol and drug abuse• Anorexia, bulimia and other eating disorders• Anxiety disorders, OCD, Phobias, PTSD, PD• Attention Deficit Hyperactivity Disorder• Conduct Disorder• Bipolar Disorder/Depression


• Mental Illnesses arising in adolescence• Learning Disorders• Psychosis• Schizophrenia• Tourette’s


• Alcohol and drug abuse Warning Signs

A drop in school performanceA change in group of friendsDelinquent behaviourDeterioration in family relationships


• Alcohol and drug abuse Warning Signs

Red eyes Persistent coughChanges in eating and sleeping patternsAnxiety and depression


• Anorexia and Bulimia Warning signsPreoccupation with body image or food

Bingeing, restricting, dietingRapid weight changesSocial withdrawalIrritabilityMoodiness


• Anxiety DisordersObsessive Compulsive DisorderPhobiasPost Traumatic Stress DisorderPanic Attacks and Panic Disorder


• Attention Deficit Hyperactivity Disorder• Normally begins in childood Inattention Daydreaming or hyperactive Forgetfulness Impulsivity Inability to complete tasks Interrupts others


• Conduct DisorderRepetitive and persistent pattern of behaviour

in which the basic human rights of others or major age-appropriate norms are violated


• Bipolar Disorder/DepressionIncreased risk taking and recklessnessImpulsivityPoor school performanceLow self-esteemInsomnia or HypersomniaChanges in appetite or weightLoss of emotional control


• Mental Illnesses arising in adolescence• Learning Disorders• Psychosis/Schizophrenia• Tourette’s


• Psychosis/Schizophrenia


• TourettesCo-occur with ADHD and OCDTic disorder

Documents

Adolescent Mental Health