Adolescence

§ Biological & Neurological context

§ 2 phases of puberty

§ neuroanatomical development
Adolescence § Social context

§ Psychological context

§ Psychopathologies of adolescence
 § the timing of the maturation of
the adrenal gland, a small gland
located just above the kidneys

§ between 6 and 11 years

§ 6-8 years: gland secretes low

Adrenarche levels of DHEA, the metabolism
of which leads to the circulation
of both testosterone and
estradiol (primary sex steroids)

§ “underground” biological
processes - timing of first
crush...
 § ages of 13 to 20

§ Menarche: A girl’s first menstrual

period

§ Spermarche: A boy’s first ejaculation

Gonadarche § pituitary gland (near the hypothalamus) is
activated - growth hormones, maturation of
sex organs (release of mature ova, which
have been there since before birth) and
manufacture of sperm

§ secondary sex characteristics are changing

 § down by @ 2 years over past 150 years
§ triggered by fat stores

§ health successes and social changes

Timing § improved childhood nutrition and health

status through reduction in childhood
infections

§ stress is also a puberty accelerator, with

familial disruption, including father
absenteeism, being one of the most
effective stressors,
§ evolutionary theory that posits that early stressors can lead to early
puberty

§ taken from the original “parental investment theory” (Trivers, 1974), the
idea is that you model your ideas of parental investment on your childhood
environment and that can trigger differences in pubertal onset (i.e., do you
think pair-bonds will be enduring or not?)
 Adolescent Growth Spurt
At about age 13 for girls, 16 for boys, there is a final maturational growth spurt in
height
Puberty and Body Image in Girls

§ Girls who mature

earlier than their peers
are usually less
satisfied with their size,
weight, and figure.
Puberty and Body Image in Boys

§ Boys who mature later than their

peers have only temporary
decreases in body image.
 early maturation

girls: lower self control, less

boys: lower self control, less
emotional stability, more risky
behaviour, more legal troubles
emotional stability, earlier
sexual activity, deteriorating
school performance, more
truancy, risky behaviour, more
shoplifting, running away
• evoking attention of older boys
 neuroanatomical changes

brain regions
associated with • reflecting on one’s own thoughts or
self-reflection on personality trait adjectives that
(dorsal MPFC) describe oneself activate dMPFC
develop

shifting from
• different neurocognitive strategies
MPFC to temporal
used when making self-referential
regions between judgments/ neuroanatomical
adolescence and changes during adolescence
adulthood
 neural correlates

§ cognitive control (risk taking behaviour)

§ cortical:
§ prefrontal cortex; circuitry becomes more fine-
tuned, refined in development, less activation
(less relevant regions attenuate) is needed to
overcome interference

§ subcortical:
§ striatum (spec: caudate nucleus) connects with
PFC
Hare & Casey, 2005
 social context

§ demographic evidence
§ 1950s - 50% married by 20 (women) & 23
(men) and was related to entrance to the
labour force, onset of sexual relations

§ 1960s - unravelling of this grouping, by 2000

marriage etc extended to late 20s/30s, but
onset of sexual relations got younger
 cultural analysis

§ adolescence becomes culturally defined as a life stage

when full-time education replaces full-time employment as
the primary activity of young people

§ societies with advanced economies, premium placed on

education & training

§ sheltered from the adult world - youth based social

world that is age-segregated

§ central paradox: advanced industrial societies create

adolescence and early adulthood as life stages in ways that
inevitably render them problematic (simultaneously
indulged and castigated)
psychological context
“passionate, irascible and apt to be
carried away by their impulses” -
Aristotle’s view of youth
 § There is a "mutual fit of individual and
environment…that is, of the individual's
capacity to relate to an ever expanding
The life space of people and institutions, on
the one hand, and, on the other, the
Individual readiness of these people and

and Society institutions to make him part of an

ongoing cultural concern."

§
Erik Erikson
Erik Erikson

§ Epigenetic principle
(development is predetermined)

§ Crisis

§ Immature phase

§ Critical phase

§ Resolution phase

§ Ego strength v. ego weakness

§ Variation within universal steps

 Identity vs Role Confusion(Adolescence)

§ Loyalty and
friendship
 § Identity
§ defining who you are, what
Erikson’s you value, and direction in
Theory: life

Identity vs. § commitments to vocation,

personal relationships,
Role sexual orientation, ethnic
Confusion group, ideals
§ exploration, resolution of
“identity crisis”
 § Role Confusion
Erikson’s § lack of direction and
Theory: definition of self
Identity vs. § restricted exploration
Role in adolescence
Confusion § unprepared for stages
of adulthood
 Piaget’s Adolescence

§ Piaget: Formal Operational Stage (11 years +)

§ Hypothetico-deductive reasoning
§ from general theories to specific predictions
§ propositional thought
§ logical evaluation without real-world referents
§ abstract thought
§ consequences....
 § adolescents’ capacity to think abstractly,
Consequences combined with physical changes means they
think more about themselves
of abstract § Piaget - new form of egocentrism: the
thought inability to distinguish the abstract
perspectives of self and others

https://www.youtube.com/watch?v=6oKsikHollM 4.33 on
Development of perspective-
taking
§ Imaginary audience

§ increased awareness of others’

perspectives:

§ convinced that you are the focus of

everyone’s attention and concern

§ extremely self-conscious, sensitive

to public criticism

§ RT between 1st person and 3rd

person perspective taking
decreased with age indicting
increased proficiency - or they are
using their self as the standard
more often (Blakemore article)
Development of “Imaginary
Audience”
§ New Look Theory (Lapsley)

§ separation-individuation: develop own identity as

separate from their parents (self-conscious --> imaginary
audience)

§ social perspective-taking: awareness that others have the

capacity to evaluate you (leads to overestimations of
prevalence of this happening)
Development of perspective-
taking

§ Personal fable

§ inflated opinion of own importance

(b/c of “imaginary audience”

§ feeling that you are experiencing

things that no one else could
understand

§ feeling invulnerable
 § “the looking glass self” - reflected
Development appraisals based on our beliefs of how

of others see us; the self as viewed by

other people
perspective- § self-concept becomes more coherent
taking with age, adolescents then use the self
as a basis for judging others
 Thoughts
About
Adolescence
Subjective Age

§ Younger people tend to feel older

than they are

§ Older people tend to feel younger

than they are

§ This effect is most pronounced in

the oldest and youngest
 § Preconventional Level
§ Punishment and obedience
§ Instrumental relativism
Kohlberg’s § Conventional Level
Stages of § Good boy-nice girl
Moral § Society-maintaining
Reasoning § Postconventional Level
§ Social contract
§ Universal ethical principles
 Moral
Reasoning
§ Most 7-10 year olds are reasoning at the
preconventional level

§ Most 13-16 year olds are reasoning at the

conventional level

§ Few subjects show the postconventional type of

reasoning
 Criticisms of Kohlberg’s Theory
Cultural Bias
• Some cultural differences not reflected in this
theory

Gender Bias
• The equation of moral competence and
development with justice and rights.

Connection between moral

reasoning and moral behavior is
often indirect
 Social
Development
Identity Crisis: An adolescent’s
struggle to establish a personal
identity, or self-concept
Self-Concept in
Adolescence

§ Unify separate traits into

larger, abstract ones

§ May describe contradictory

traits; social situations

§ Gradually combine traits

into organized system

§ qualifiers

§ integrating principles
 Self-Esteem in Adolescence
Continues to differentiate

• new dimensions

Generally rises

• temporarily drops at school transitions

Individual differences become more stable

Self-esteem linked to value of activities, adjustment

Influenced by family, culture

What Do Parents and Teenagers Fight About?
Adolescent Disengagement

§ The proportion of time spent with

the family decreases almost 3% per
year

§ Not true for time spent alone with

parents
Adolescent Transformation

§ Boys feel worse while in family

settings from grades 5-8, then
improve

§ Girls feel worse while in family

settings from grades 5-10

§ improvement later
 Debunking § “Storm and stress in adolescence is not

the Myth: something written indelibly into the

human life course. On the contrary, there

Adolescence are cultural differences in storm and

stress, and within cultures there are
is Not Always individual differences.”

Stormy § J. J. Arnett
social life
friends and cliques
 Functions of Friendships

In highly stressful
Adolescents report that
situations, however,
friends are more
support from adults may
important confidants and
be more important for
providers of support than
children’s well-being
are parents
than support from friends
Effects of Friendships

§ PEER PRESSURE

§ The extent to which friends’ use of

drugs and alcohol may put an
adolescent at risk seems to
depend, in part, on the nature of
the child-parent relationship

§ If the adolescent’s parents are

authoritative in their parenting
rather than cold and detached,
the adolescent is more likely to
be protected against peer
pressure to use drugs
 § Formed from proximity, similarity
§ Peer culture
Peer Groups § behavior, vocabulary, dress code
§ can include relational aggression and
exclusion
 § Personal qualities, trust become
important

§ More selective in choosing friends

Friendships § choose friends similar to self

from middle § Friendships can last several years.

childhood to § must learn to resolve disputes

adolescence § Type of friends influences

development.

§ Aggressive friends often magnify

antisocial acts.
 Cliques and Social Networks
in Adolescence

From ages 11 to 18, there is an

increase in the number of
adolescents who have ties to
many cliques and an increase in
the stability of cliques

During early and middle

With increasing age, adolescents
adolescence, children report
are more autonomous and tend to
placing a high value on being in a
look more to individual
popular group and in conforming
to the group’s norms regarding relationships than to group
relationships
dress and behavior
 Cliques and Social Networks
in Adolescence

§ Although older adolescents seem to be less tied

to cliques, they still often belong to crowds (i.e.,
groups of adolescents who have similar
stereotyped reputations)

§ Being associated with a crowd may enhance or

hurt adolescents’ reputations and influence how
peers treat them
 Boys and Girls in
Cliques and Crowds

§ Adolescent girls tend to be more integrated into cliques

§ Adolescent boys have a greater diversity of friends
§ Starting in seventh grade, girls and boys tend to
associate with one another more and dyadic dating
relationships become increasingly common

§ By high school, cliques of friends often include

adolescents of both sexes
 Romantic Relationships
§ In the United States, 25% of 12 year olds and 70%
of 18 year olds report having had a romantic
relationship in the past 18 months

l Although 14-18 year olds

tend to balance the time
they spend with romantic
partners and friends, by
young adulthood, time with
romantic partners increases
to the point that it is at the
expense of involvement with
friends and crowds
Romantic
Relationships
§ Although young adolescents tend
to select partners that bring them
status, older adolescents are more
likely to select partners based on
compatibility and characteristics
that enhance intimacy

§ Romantic relationships can have

positive and negative effects on
development, depending on the
age of the individual

§ Romantic relationships appear to

be affected in multiple ways by
youths’ history of relationships
 Negative Influences

Perhaps the greatest potential for

negative peer-group influence is
represented by membership in
gangs – loosely organized groups
of adolescents or young adults
that identify as a group and often
engage in illegal activities

Adolescents who do not live with

Family and cultural influences
their father or a stepfather and
affect the potential for peer-group
who have a poor relationship with
influences to promote problem
their mother may be especially
behavior vulnerable to such pressure
 Psychopathologies of adolescence

onset of onset of eating

depression schizophrenia disorders
 § positive social feedback becomes
increasingly rewarding during
adolescence & negative social
experiences leads to increased
Emotion incidence of affective disorders

regulation § emotion regulation - poor self-concept

leads to internalizing behaviours such
as depression/anxiety & externalizing
behaviours such as aggression &
delinquency
Emotions in Adolescence

§ Adolescence is a time of greater

negative emotion than middle
childhood

§ Although the increase in the

frequency and intensity of
negative emotions and the
decrease in positive emotions
is small for most adolescents,
a minority experience a
major increase in the occurrence
of negative emotions, often in
their relations with their parents
 Depression signs

more common in girls

• body image distortion

• loss of appetite or weight
• lack of satisfaction

more common in boys

• irritability
• social withdrawal
• drop in school performance
 Depression signs
fatigue, lassitude

inappropriate guilt, feeling worthless

cannot concentrate, be decisive, think clearly

dwells on thoughts of death, suicide

not due to medical problem, bereavement

 Depression
1% in 1-6yrs

2% in 7-12yrs

9% - 13% in teens and adults

no sex diff in children, by late teens twice as

many females, even higher in college students
Depression
§ Possible causes of depression include
genetic factors, maladaptive belief symptoms,
feelings of powerlessness, negative beliefs
and self-perceptions, and the lack of social
skills

§ Family factors also contribute to

depression

§ In many cases depression is likely due to

a combination of personal vulnerability
and external stressful factors

§ Antidepressant drugs are most common

treatment
 § attentional biases in
genetics and depression
environment § daughters at risk for
in early depression (mothers

attentional with history): dot-probe

task:
biases
§ (Joormann, Talbot, &
Gotlib, 2007)
 § animal models of depression indicate
that behaviors reflecting greater
helplessness, a construct closely linked

genetics and to attributional styles (Seligman,1975),

have a strong genetic component

environment
(Solberg et al., 2003; El Yacoubi et al.,
2003).

in early § helplessness and attributional styles may

have a genetic basis in humans
attentional (Abramson, Metalsky, & Alloy, 1989;
Hamburg, 1998)
biases § Caspi et al. (2003) report that the effect of
life stress in depression might be
moderated by a polymorphism on the
serotonin transporter gene (5-HTT)

* Caspi, A., Sugden, K., Moffitt, T.E., Taylor, A., Craig, I.W., Harrington, H., McClay, J., Mill, J., Martin, J., Braithwaite, A.,
Pouton, R. (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT Gene. Science, 301 , 386—
389.
 § the serotonin transporter promoter
region polymorphism (5-HTTLPR)

§ the short allele has been associated with

predispositions to fear-related
behaviors and negative emotionality in
children and adults (Hayden et al., 2007;

5-HTTLPR Lesch et al., 1996), and some studies

suggest that this allele increases risk for
depression in individuals who
experience stressful life events (Caspi et
al., 2003; Zammit & Owen, 2006).

§ recently the Lg allele has been seen to

exhibit functional equivalence with the S
allele (Hu et al., 2005)
 § diurnal variation in hypothalamic
pituitary adrenal (HPA) -axis activity
(regulating hormonal response to stress)
related to 5-HTTLPR variation (Chen et
al., 2009)

§ SS girls (9-14 yrs) have

higher levels of waking
5-HTTLPR cortisol than LL girls
§ SS girls (9-14 yrs)have higher cortisol
reactivity to a lab stressor than LL girls
(Gotlib, et al., 2008)

§ SS children (7-yrs) show higher levels of

depressogenic attributions for negative
events (Sheikh et al., 2008)
 § children (8-12 yrs) of mothers
with a history of MDD during
children’s lives show higher
attentional avoidance of sad
5-HTTLPR + faces; no bias for happy
(Gibb, Benas, Grassia, &
attentional McGeary, in press)

biases § SS children showed the bias,

not LL children

§ specifically SS children
with MDD moms
schizophrenia

§ Eugen Bleuer (1857-1939)

§ originally known as dementia

praecox

§ from the Greek roots schizein ( "to

split") and phren- ("mind").
 § Inadequate parenting
Schizophrenia § Overzealous mothers
is not caused
§ Poor family relations
by:
§ It is not split personality
 schizophrenia

most common time

of first episode- genes +
mid- to late-teens, environment
early 20s
 DSM

A. Characteristic symptoms: Two (or more) of the following, each present for a significant
portion of time during a 1-month period (or less if successfully treated):
• delusions
• hallucinations
• disorganized speech (e.g., frequent derailment or incoherence)
• grossly disorganized or catatonic behavior
• negative symptoms, i.e., affective flattening, alogia, or avolition

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations
consist of a voice keeping up a running commentary on the person's behavior or thoughts, or
two or more voices conversing with each other.

B. Social/occupational dysfunction: For a significant portion of the time since the onset of
the disturbance, one or more major areas of functioning such as work, interpersonal
relations, or self-care are markedly below the level achieved prior to the onset (or when the
onset is in childhood or adolescence, failure to achieve expected level of interpersonal,
academic, or occupational achievement).
 DSM

1. Paranoid Type

A type of Schizophrenia in which the following criteria are met:

• Preoccupation with one or more delusions or frequent auditory hallucinations.
• None of the following is prominent: disorganized speech, disorganized or
catatonic behavior, or flat or inappropriate affect.

2. Catatonic Type

A type of Schizophrenia in which the clinical picture is dominated by at least two of

the following:
• motoric immobility as evidenced by catalepsy (including waxy flexibility) or
stupor
• excessive motor activity (that is apparently purposeless and not influenced by
external stimuli)
• extreme negativism (an apparently motiveless resistance to all instructions or
maintenance of a rigid posture against attempts to be moved) or mutism
• peculiarities of voluntary movement as evidenced by posturing (voluntary
assumption of inappropriate or bizarre postures),
• stereotyped movements, prominent mannerisms, or prominent grimacing
• echolalia or echopraxia
 Structural
changes in
brain
Increased loss of gray matter in
adolescence
 EATING DISORDERS (EDs)

Types of EDs risk factors treatment/prevention

 Types of EDs

§ Anorexia Nervosa (restriction of energy intake, weight loss, fear of weight

gain and distorted body image)

§ Bulimia (Recurrent overeating and use of inappropriate measures to

prevent weight gain afterwards, such as purging, fasting or exercising
excessively.

§ Binge Eating Disorder (Recurrent and persistent episodes of binge eating,

followed by marked distress, but absence of purging)

§ In Western society, eating disorders are the third most common illness in
adolescent females

§ Between 1.25 and 3.4 million people in the UK are affected by an eating
disorder (Beat, and Anorexia and Bulimia Care), 25% of these are male
•Galmiche M, Déchelotte P, Lambert G, Tavolacci MP (2019) Prevalence of eating
disorders over the 2000-2018 period: a systematic literature review. Am J Clin
Nutr. 109(5), 1402-1413.
 Anorexia (AN)

prevalence/incidence

• 10% of those suffering from an ED have AN. The actual numbers vary
widely depending on where you look (which country for example)

gender divide

• more females than males (with males estimated between 10 and 25%
of AN sufferers). Males tend to be diagnosed later than females and
therefore are higher risk of worse outcomes

Prognosis

• protracted course of illness and highest mortality rate among all

psychiatric illnesses
 Symptoms and illness

§ The resulting malnutrition and low body weight may result in massive
impairment to health

§ The consequences of starvation can have a negative impact on bone density,

growth, and brain maturation

§ Often it takes years for patients with AN to achieve a first remission or to

recover permanently.

§ A quarter of adult patients go on to develop an enduring form of the

disorder, and one-third of patients continue to suffer from residual
symptoms in the long-term. Adolescent-onset has slightly more favourable
outcomes
 AN Risk Factors

Sociocultural Family Individual Genetics

 § sociocultural – focusses on pressure to look a certain way

§ The cultural pressures may be necessary conditions

for the development of eating disorders, but they are
clearly not sufficient. Virtually all young women are
exposed to these risk factors and yet only a very small
percentage develop AN.

AN Risk § Dieting behavior may be the most well-established

Factors
risk factor for the development of AN. Severity of
dieting is the most important predictor of the
development of an eating disorder in adolescent girls.
Earlier age of dieting is also associated with increased
risk. Again, only a small percentage of women who
diet develop a clinically diagnosable eating disorder

§ social media

§ as a way of promoting disordered body image

§ PRO ANA and PRO MIA websites

 AN Risk Factors

family
• family history of AN and/or other weight issues
• family history of anxiety/depression
• patterns of family interactions à rigidity,
overprotectiveness, excessive control, and marital
discord. But there is no “typical” anorexia family.

individual
• distorted self-image, body dysmorphia
• obsessionality
premorbid traits
• perfectionism
• low self-esteem
 AN Risk Factors

§ genetics

§ The Anorexia Nervosa Genetics Initiative (ANGI)

§ https://angi.se/?lang=en

§ Genetic factors play a substantial role in liability to anorexia.

Twin studies estimate heritability at 48%–74%
 Treatment
for severe cases tends to be inpatient programmes, which show significantly higher
weight gain across weeks than outpatient treatment.
• for children and adolescents, outpatient treatment is proposed as the first line treatment, if they are in a
stable medical state
• In the UK, guidelines suggest admitting children and young people to a setting with age-appropriate
facilities, which are near to their home and have the capacity to provide appropriate educational activities

psychotherapy
• both individual and family-centered

nutritional management
• this ranges from food plans to nasogastric feeding

Psychopharmacology
• not a lot of evidence – mainly used for comorbid factors (e.g., anxiety)
• needs to be well managed due to potential medical issues with the patients (e.g., cardiac issues)
 In sum

for all these pathologies, there is a mix of

genetics and environmental triggers

prognosis and treatments differ in outcomes

and effectiveness

early assessment and intervention would seem

to be key in all developmental spectrums and
pathologies
OK

§ so to sum up

§ quite a few theories of change in

adolescence

§ cognitive

§ brain development

§ emotional, social, friends etc

§ specific pathologies