1. Adolescents' Social and Psychological changes Dr. Mohammed Othman Al-Rukban Assistant professor College of Medicine. King Saud University, Riyadh, SA.

2. In This Presentation: What is Adolescence? What is Adolescence? Why Adolescents? Why Adolescents? Adolescent Social and Psychological Changes. Adolescent Social and Psychological Changes. Adolescence Pattern Adolescence Pattern What should we do? What should we do?

4. Adolescences Adolescence is the name given to the psychosocial life stage which starts around the time of puberty. Adolescence is the name given to the psychosocial life stage which starts around the time of puberty. The time of onset and duration varies from one person to another commonly occur between 12-18 years. The time of onset and duration varies from one person to another commonly occur between 12-18 years. It is difficult period of considerable physical and mental changes. It is difficult period of considerable physical and mental changes. Adolescents requires special understanding and social, psychological and health care. Adolescents requires special understanding and social, psychological and health care.

6. Why Adolescents? Those below 20 years of age represent the largest segment of the Saudi population (60-70%). Those below 20 years of age represent the largest segment of the Saudi population (60-70%). Adolescence is a critical period in the human life. It affects people future habits and practice. Adolescence is a critical period in the human life. It affects people future habits and practice. Poor diet and inactivity cause at least 300,000 deaths among U.S. adult each year. Poor diet and inactivity cause at least 300,000 deaths among U.S. adult each year.

7. Why Adolescents? The body appearance affecting self- esteem and confidence. The body appearance affecting self- esteem and confidence. Man usually adapted to habits performed at early years of his life. Man usually adapted to habits performed at early years of his life. Establishing healthy habits at a young age is critical because changing poor eating patterns in adulthood can be difficult. Establishing healthy habits at a young age is critical because changing poor eating patterns in adulthood can be difficult.

8. Why Adolescents? Eating disorders such as anorexia and bulimia, which can cause severe health problems and even death, are increasingly common among young people. Eating disorders such as anorexia and bulimia, which can cause severe health problems and even death, are increasingly common among young people. Poor eating habits and inactivity are the root causes of overweight and obesity. Poor eating habits and inactivity are the root causes of overweight and obesity. Obesity at this period lead to deterioration of the future health. Obesity at this period lead to deterioration of the future health.

9. Why Adolescents? The risk of coronary heart disease is doubled if the body mass index is > 25 and nearly quadrupled if the index is > 29. The risk of coronary heart disease is doubled if the body mass index is > 25 and nearly quadrupled if the index is > 29. The risk of developing diabetes increases with increasing weight, and people with a body mass index > 35 have a 40 fold higher risk of developing the disease than non- obese people. The risk of developing diabetes increases with increasing weight, and people with a body mass index > 35 have a 40 fold higher risk of developing the disease than non- obese people. Osteoarthritis and Respiratory diseases are more common in obese people. Osteoarthritis and Respiratory diseases are more common in obese people. Obesity was significantly associated with an increase in blood pressure, stroke, and certain forms of cancer. Obesity was significantly associated with an increase in blood pressure, stroke, and certain forms of cancer.

10. Why Adolescent? Adolescents obesity has become epidemic. Adolescents obesity has become epidemic. About 25% of adolescents in the United States are overweight or at risk for overweight. About 25% of adolescents in the United States are overweight or at risk for overweight. Of U.S. young people aged 6-17 years, about 5.3 million, or 12.5%, are seriously overweight. Of U.S. young people aged 6-17 years, about 5.3 million, or 12.5%, are seriously overweight. The percentage of children and adolescents who are overweight has more than doubled in the past 30 years. The percentage of children and adolescents who are overweight has more than doubled in the past 30 years.

11. Why Adolescents? Overweight children become overweight adults particularly if obesity is present in adolescence. Overweight children become overweight adults particularly if obesity is present in adolescence. In Riyadh: In Riyadh: –13.8% of adolescents were overweight –20.5% were obese. In Jeddah: In Jeddah: – Overweight was reported in 13.4% – obesity in 13.5% of school students.

12. Youth Risk Behavior Surveillance, USA (2003) Overweight17.5%14.4%16.0% Overweight17.5%14.4%16.0% Obesity11.9% 7.9% 9.9% Obesity11.9% 7.9% 9.9% Attempted weight control Attempted weight control 49.5%67.4%58.4% 49.5%67.4%58.4% Used medicine to loss weight Used medicine to loss weight 4.4%10.9% 7.9% 4.4%10.9% 7.9% 9.2% of high school girls vomit, take laxatives, or take diet pills to lose or keep from gaining weight. 9.2% of high school girls vomit, take laxatives, or take diet pills to lose or keep from gaining weight. Harmful weight-loss practices have been reported among girls as young as 9 years old. Harmful weight-loss practices have been reported among girls as young as 9 years old.

13. Adolescent Nutrition Nationally: Nationally: The researches are scanty. The researches are scanty. Soda drink and sweat consumption: Soda drink and sweat consumption: 2-3 times daily. 2-3 times daily. Most of the fast food customers are from this age group. Most of the fast food customers are from this age group. Nutritional habits of Early adolescent Nutritional habits of Early adolescent are better than late. are better than late.

14. Adolescent Nutrition %

16. Rates of Adolescent Sexual Activity by Gender, Ethnic Group, and Grade Note:Percentages are of high school students who report ever having sexual intercourse Source: Center for Disease Control (1992) Sex Male Female Total 56.4% 47.0 51.6 Ethnic GroupGrade 87.8% 60.0 72.3 63.0% 45.0 53.4 48.7% 31.9% 39.6 52.5% 42.9 47.6 62.6% 52.7 57.3 76.3% 66.6 71.9 60.8% 48.0 54.2 White African American Hispanic 9101112Total

17. 1978 5 0 10 15 20 25 30 35 40 12 - 17 Years 1980198219841986 Percent of Teenagers Using Illegal Drugs 19881990199219941996 18 - 25 Years26 - 34 Years 35 Years and olderAll Americans 12 Years and over

19. In a survey of 11,631 students, grades 9-12, representing every state:In a survey of 11,631 students, grades 9-12, representing every state: More than one-third watch TV for 3 or more hours every school day.More than one-third watch TV for 3 or more hours every school day. 70% spend at least one hour per day watching TV.70% spend at least one hour per day watching TV. In a survey of 11,631 students, grades 9-12, representing every state:In a survey of 11,631 students, grades 9-12, representing every state: More than one-third watch TV for 3 or more hours every school day.More than one-third watch TV for 3 or more hours every school day. 70% spend at least one hour per day watching TV.70% spend at least one hour per day watching TV. Adolescent Television Habits Source: National Centers for Disease Control and Prevention (1994)

21. Adolescence Pattern Early adolescence (11-14 years): Early adolescence (11-14 years): –Puberty period. –Dominated by adjustment to physical and psychosexual changes and beginnings of psychological independence from parents. –Girls > Boys.

22. Adolescence Pattern Middle adolescence (14-17 years): Middle adolescence (14-17 years): –Search for independence period. –Sexual relationships. –Intellectual knowledge and cognitive processes became quite sophisticated. –Experimental and risk-taking behavior is a feature.

23. Adolescence Pattern Late adolescence (17-20 years): Late adolescence (17-20 years): –Maturity period. –Self-confidence with relationships –Successful rapport with parent. –Thought is more reality-based.

28. INDIVIDUATION: Process by which adolescent develops a unique personal identity or sense of self, distinct and separate from all others DIFFERENTIATION (early adolescence): Recognizes psychological difference between self and parentsDIFFERENTIATION (early adolescence): Recognizes psychological difference between self and parents PRACTICE AND EXPERIMENTATION (14- 15 YRS.): Feels all- knowing, self-sufficient;actively challenges parents and seeks approval of peersPRACTICE AND EXPERIMENTATION (14- 15 YRS.): Feels all- knowing, self-sufficient;actively challenges parents and seeks approval of peers RAPPROCHEMENT (mid-adolescence): After achieving a fair degree of separateness from parents, returns to home base and conditionally and partially reaccepts parents' authorityRAPPROCHEMENT (mid-adolescence): After achieving a fair degree of separateness from parents, returns to home base and conditionally and partially reaccepts parents' authority CONSOLIDATION OF SELF (until end of adolescence): Develops a sense of personal identity, which serves as the basis for self- understanding and for maintaining a sense of autonomy, independence, and individualityCONSOLIDATION OF SELF (until end of adolescence): Develops a sense of personal identity, which serves as the basis for self- understanding and for maintaining a sense of autonomy, independence, and individuality INDIVIDUATION AND IDENTITY DEVELOPMENT (Josselson, 1980)

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