Adolescence psychology

1. DPH121 HEALTH PROBLEMS OF
ADOLESCENTS, ADULTS & THE
HANDICAPPED
1
MODULE LEADER:
DR ALIYU MUHAMMAD MAIGORO
MBBS(BUK), MPH(Malaya), MBA(BUK), FWACP
CONSULTANT PUBLIC HEALTH PHYSICIAN
FEDERAL MEDICAL CENTRE AZARE
BAUCHI STATE
REDESIGNED BY
MUHAMMAD KABIR DANJUMA

2. HEALTH PROBLEMS OF
ADOLESCENTS
OUTLINE:
1. Introduction: Definitions & Concepts
2. Rationale for Focusing on Adolescents
3. Adolescent Developmental Processes
4. Resilience Theory & The Adolescent
5. Nigerian Situation
6. “Priority” (Key) Health Problems of Adolescents
7. Public Health Interventions for Improving
Adolescent Health
8. Adolescent & Youth Friendly Services
™

3.  Adolescent Developmental
Processes

4. Adolescent Dev Stage Progression
Biologic factors Socioecon, cultural &
env. factors
Interaction
with peers &
adults
Preadolescence
Early adolescence
Middle adolescence
Late adolescence
Youth

5. DEVELOPMENTAL CHANGES
1. PHYSICAL
2. PSYCHOLOGICAL
3. SOCIAL

6. PHYSICAL
Puberty
 Activated by neuro-endocrinal network
changes
 Results in capacity to reproduce
 Earlier (2yrs) in girls than boys
 Changes in body size, shape and
composition

7.  Preoccupation with body image is
especially strong in early adolescence
Girls are generally less happy with their
bodies than boys and become more
dissatisfied over time
Boys typically become more satisfied
as they move through puberty

8. TANNER STAGING
 5 stages from childhood to full
maturity
 Marshall and Tanner (P1 – P5)
 Reflect progression in changes of the
external genitalia and of sexual hair
 Secondary sexual characteristics
8-13yrs in girls
9-17yrs in boys

9. Male Pubertal Development
♦ Occurs between 9-17 years;
♦ May last up to 5 years
♦ Pattern of development
 Early: penis, testes, pubic hair
 Late: Facial hair, height, voice changes

10. Female Pubertal Development
♦ Begins 8-13 years
♦ Duration: range of 2 to 5 years
♦ Menarche 2-2.5 years after thelarche

11. Compared with Females, Male
Development
♦ Occurs 18-24 months later;
♦ Progresses slowly through
middle-late adolescence;
♦ Early changes are not often as
visible.

12. Sequential Events of Puberty:
Male
 Growth of
testicles
 Pubic hair
appears
 Growth of penis
and scrotum
 Axillary hair
 Facial hair

13. Sequential Events of Puberty:
Female
 Breast bud
appears
 Pubic hair
appears
 Breasts mature
 Axillary hair
 Menarche
 Adult height

14. Menarche
 Average age 12-13 years
 Irregular bleeding first 1 - 2 years
 Ovulation after 1- 2 years
 Causes of delay
Poor health
Intense exercise
Low body weight
Emotional distress
Poor nutrition

15. Tanner Staging
 Measurement tool to assess pubertal
development
 Changes assessed:
Boys: Penis, pubic hair, and
testicular size
Girls: Breast size and pubic hair

16. Tanner Stages in Females
Breast Development
1. Prepubertal
2. Breast bud beneath
areolar
3. Enlargement of
breast, no secondary
mound
4. Enlargement of
areola as secondary
mound
5. Adult breast with

17. Tanner Stages in Females (contd.)
Pubic Hair Development
1. No hair
2. Straight hair along labia
3. More and darker hair in
female triangle
4. Hair dense, curled, adult
in distribution
5. Abundant hair, adult
pattern, extend to thighs

18. Tanner Stages in Males
Male genital
development
1. Prepubertal,
2. Scrotum and
testes enlarge
(2.5cm)
3. Penis lengthens
4. Penile growth in
length & breadth
5. Testes, scrotum
adult size
Pubic hair
development
1. No pubic hair
2. Sparse slightly
pigmented hair
3. Hair darker and
curlier
4. Hair adult in type
5. Adult in quantity,
inner borders of
thighs

19. PSYCHOLOGICAL
DEVELOPMENT
 Cognitive development (i.e. changes in
thinking patterns)
 Concrete to abstract thinking
 Development of creative thinking
(critical and reflective)
 Development of egocentric thinking

20. EMOTIONAL
 Experience a mix of emotions
 Experience changes in moods from
feeling superior/inferior
 Desire to be accepted by peers
 Sensitive to criticism

21. SOCIAL
 movement from dependency to
interdependency
 building social capital (skills for personal
life & livelihoods)
 establishing identity (forming
commitments to broader society & pro-
social values)
 exploring sexuality

22. Dev. Tasks of Adolescents
Task Early
Adolescence
(10-13 years)
Middle
Adolescence
(14-16 years)
Late
Adolescence
(17-19 years)
Body Image Adjusting to
pubertal changes
Trying out different
images
Integration of
satisfying body
image
Central Question Am I normal? Am I liked? Am I loved?
Independence Emotional break
from parents;
Prefer friends;
needs privacy &
approval
Ambivalence: peak
of parental conflict
Integration of
independence
Sexual drives Sexual curiosity Social
experimentation
Beginning of
intimacy
Relationships Unisex peer
group: crushes on
adults
Begins
heterosexual peer
group; multiple
Intimate
relationship
more imp. Than

23. Dev. Tasks of Adolescents
Task Early
Adolescence
Middle
Adolescence
Late
Adolescence
Career Plans Vague &
unrealistic;
economically
dependent
Moving from vague
to specific;
economically
dependent to
independent
Specific,
tangible;
economically
independent
Conceptualization Concrete
thoughts;
monosyllabic
answers
Self-centered;
experimentation
Abstract
thoughts; future
oriented
Value system Testing of the
parents’ moral
system
Moral development
begins
Incorporation of
own values &
beliefs

24. Psychosocial Development of Adolescents
Early Adolescence Middle Adolescence Late Adolescence
Family independence
Less interest in parental
activities
Peak of parental conflicts Reacceptance of
parental advice and
values
Body Image
Preoccupation with self
and pubertal changes
Uncertainty about
appearance
General acceptance of
body
Concern over making
body more attractive
Acceptance of pubertal
changes
Interpersonal
relationships
Intense relationships
with same sex
Peak of peer
involvement
Conformity with peer
values. Increased sexual
activity and
experimentation
Peer group less
important
More time spent sharing
intimate relationships
Self perception
(identity)
Increased cognition,
Personal fantasy,
Idealistic vocational
goals, Increased need
Increased scope of
feelings
Increased intellectual
ability
Feelings of omnipotence
Risk-taking behaviour
Practical realistic
vocational goals
Refinement of moral,
religious and sexual
goals
Ability to compromise