Transcript Adolescent Mental Health

Adolescent Mental Health
Oliver O’Connell
Psychiatrist
Adolescent Mental Health
• Definition of Adolescence
• Biopsychosocial development during
adolescence
• Biopsychosocial tasks of adolescence
• Normal vs. abnormal adolescent behaviour
• Resolution of Adolescence
• Mental Illnesses arising in adolescence
Adolescent Mental Health
• 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.
Adolescent Mental Health
• 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.
Adolescent Mental Health
• 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
Adolescent Mental Health
• 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.
Adolescent Mental Health
• Physical development
A 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.
Adolescent Mental Health
• Physical Development
Growth 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
Adolescent Mental Health
• Psychosocial Development through adolescence.
 Early adolescence:
o Growth spurt
o Puberty commences
o Social move away from family towards peers
(peer group becomes an alternative for life
advice)
o Thinking is concrete
Adolescent Mental Health
Mid Adolescence: 14-17years
o Ability to think abstractly
o Metacognition
o Beginning of consolidation of the sense of self
o Scant empathy and lack of tolerance for views
of others
Adolescent Mental Health
Late Adolescence: 18 to mid twenties
o Abstract thinking and ability to consider the
future, deductive reasoning
o Idealism becomes more practical and less
doctrinaire
o Parental values less likely to be challenged
automatically
Adolescent Mental Health
• Biopyschosocial tasks of adolescence:
 To come to terms with body/brain changes
 To cope with sexual development and
psychosexual drives
 To establish and confirm sense of identity
 To learn more about sex roles
 To synthesize personality
 To 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 Age
 How 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 Differences
 Use your intuition
Adolescent Mental Health
• Normal Adolescent Behaviour
Risk taking
Impulsivity
Novelty seeking
Reckless behaviour
Disobedience
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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
Adolescent Mental Health
• 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 life
 Attainment of a stable sexual identity
 Ability to form a long-term sexual relationship
 Attainment of a steady job or the preparation for
a career
 Attainment of a personal value system that
respects both the needs of the self and the needs
of others
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Epidemiology
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
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Biology/Genetics
o Risk factors:
Family history
o Protective factors:
High Intelligence
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Social Environment
o Risk Factors
Poverty
Discrimination based on race, religion etc.
Bullying, trauma, sexual abuse
Criminal opportunities
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Social Environment
o Protective factors
Quality Schools
Cohesive Family
Neighbourhood Resources
Interested Adults
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Perceived Environment
o Risk Factors
• Models for deviant behaviour
• Parent-friends conflict the norm
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Perceived Environment
o Protective Factors
Models for conventional behaviour
High control against deviant behaviour
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Personality
o Risk Factors
Low perceived life chances
Low Self-Esteem
Risk-Taking Propensity
Adolescent Mental Health
• Mental Illnesses arising in adolescence
Personality
o Protective Factors
Value on achievement
Value on health
Intolerance of deviance
Adolescent Mental Health
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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
Adolescent Mental Health
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Mental Illnesses arising in adolescence
Learning Disorders
Psychosis
Schizophrenia
Tourette’s
Adolescent Mental Health
• Alcohol and drug abuse
Warning Signs
A drop in school performance
A change in group of friends
Delinquent behaviour
Deterioration in family relationships
Adolescent Mental Health
• Alcohol and drug abuse
Warning Signs
Red eyes
Persistent cough
Changes in eating and sleeping patterns
Anxiety and depression
Adolescent Mental Health
• Anorexia and Bulimia
Warning signs
Preoccupation with body image or food
Bingeing, restricting, dieting
Rapid weight changes
Social withdrawal
Irritability
Moodiness
Adolescent Mental Health
• Anxiety Disorders
Obsessive Compulsive Disorder
Phobias
Post Traumatic Stress Disorder
Panic Attacks and Panic Disorder
Adolescent Mental Health
• Attention Deficit Hyperactivity Disorder
• Normally begins in childood
Inattention
Daydreaming or hyperactive
Forgetfulness
Impulsivity
Inability to complete tasks
Interrupts others
Adolescent Mental Health
• Conduct Disorder
Repetitive and persistent pattern of behaviour
in which the basic human rights of others or
major age-appropriate norms are violated
Adolescent Mental Health
• Bipolar Disorder/Depression
Increased risk taking and recklessness
Impulsivity
Poor school performance
Low self-esteem
Insomnia or Hypersomnia
Changes in appetite or weight
Loss of emotional control
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Mental Illnesses arising in adolescence
Learning Disorders
Psychosis/Schizophrenia
Tourette’s
Adolescent Mental Health
• Psychosis/Schizophrenia
Adolescent Mental Health
• Tourettes
Co-occur with ADHD and OCD
Tic disorder