Problems of Adolescence

Problems of Adolescence
Chapter 14 Problems of Adolescence Copyright © 2013 by Elsevier Inc. All rights reserved.

Copyright © 2013 by Elsevier Inc. All rights reserved.
Learning Objectives Describe three common problems of adolescence. Discuss three problems faced by adolescents with troubled family lives. Identify the diagnostic criteria for behavioral disorders. Explain how the signs and symptoms of adolescent depression differ from those seen in adult depression. Copyright © 2013 by Elsevier Inc. All rights reserved.

Learning Objectives Define two eating disorders, and describe the associated signs and symptoms and behaviors. Describe the stages of chemical dependency in adolescence. List four signs or symptoms indicating a potentially suicidal teen. Identify four therapeutic interventions designed specifically for adolescent clients. Explain how health care providers help adolescents develop effective coping skills. Copyright © 2013 by Elsevier Inc. All rights reserved.

Adolescent Growth and Development (p. 155)
Adolescents undergo great changes in the physical, intellectual, emotional, social, and spiritual areas of their lives. Care providers should understand how adolescents grow and change if they are to assist them through this important developmental stage. Many adult problems find their roots in adolescence. Describe common problems of adolescence. Copyright © 2013 by Elsevier Inc. All rights reserved.

Physical Development (p. 155)
Maturation Process of attaining complete development Puberty Stage during which an individual becomes physically capable of reproduction Sexual development Menarche in girls usually is established at about 12 years of age. The male growth spurt begins at about 11 years of age and continues until about 14 years of age. Puberty lasts until about 18 years of age. Copyright © 2013 by Elsevier Inc. All rights reserved.

Psychosocial Development (p. 156)
Refers to the nonphysical realms of functioning Developmental tasks for each psychosocial area of functioning: Intellectual changes Emotional development Social development Spiritual development Copyright © 2013 by Elsevier Inc. All rights reserved.

Common Problems of Adolescence (p. 157)
Internal development problems Most difficulties of early adolescence arise from within the individual. An important developmental problem of adolescence is defining oneself. Problems that threaten self-esteem or confidence routinely arise during the journey to adulthood. What factors contribute to stress in the adolescent? (Some stressors might include fear of failure due to the need to be successful in all aspects of life, fear of rejection by their peers, lack of adequate physical growth, or the need to balance work, school, and socialization with involvement in organized sports.) Ask volunteers to share some of the problems experienced in their own adolescence. Compare older students’ responses with the younger students’ responses. Have the problems associated with adolescence changed? Copyright © 2013 by Elsevier Inc. All rights reserved.

Common Problems of Adolescence cont’d. (p. 157)
External (environmental) problems Problems that arise outside the teen Family problems change as the adolescent develops independence. Many adolescents must cope with physical violence, sexual abuse, neglect, or parents who abuse alcohol or drugs. Adolescents also are challenged by numerous social problems: Gangs Peer groups Intimacy Problems in the environment can threaten basic needs. What problems are faced by adolescents with troubled family lives? A nurse at a middle school has been asked by a supervisor to develop a brochure on the aspects of family and the adolescent. What information would be helpful to include in the brochure? The increased need for independence by the adolescent will challenge the family to adapt. Many teenagers are seeking freedom but still require guidance, emotional support, nurturing, and limits. The parent should encourage the adolescent to make decisions. This factor will increase the adolescent’s maturation and decision-making processes. Copyright © 2013 by Elsevier Inc. All rights reserved.

Mental Health Problems of Adolescence (p. 159)
Mental health services for adolescents focus on promoting Positive life skills Prevention Treatment of dysfunction Nursing interventions focus on promoting Health education Assisting with group therapy Individual therapy Medication management Setting of limits Provision of emotional support Copyright © 2013 by Elsevier Inc. All rights reserved.

Behavioral Disorders (p. 160)
Teens with behavioral disorders exhibit behaviors that begin to disrupt Their families Social interactions Performance at school Disruptive behavioral disorders consist of two basic diagnoses: Attention-deficit/hyperactivity disorder Conduct disorder List and discuss the diagnostic criteria for behavioral disorders. Copyright © 2013 by Elsevier Inc. All rights reserved.

Emotional Disorders (p. 161)
When moods or feelings disrupt the teen’s daily activities, mental health care may be needed. Problems that affect the emotional realm of human functioning include the following: Anxiety disorders The adolescent’s ability to adapt is overwhelmed. Mood disorders Wide range of behaviors from profound depression to racing hyperactivity Depression in adolescence is characterized by irritable moods and acting-out behaviors. How do the signs and symptoms of adolescent depression differ from those of adult depression? Other symptoms of teenage depression include decreased social activity, decreased school performance, feelings of hopelessness, difficulty in thinking, inability to concentrate, diminished decision making, and numerous physical complaints such as loss of energy, headache, nausea, stomach pain, and altered sleep patterns. Copyright © 2013 by Elsevier Inc. All rights reserved.

Eating Disorders (p. 162) “Severe disturbances in eating behavior” Obesity Body weight that is 20% or more above the average weight for a person of the same height and build Anorexia nervosa Prolonged refusal to eat to keep body weight at a minimum Bulimia A cycle of binge eating followed by purging What are the distinguishing characteristics of anorexia nervosa in adolescents? What are the distinguishing characteristics of bulimia in adolescents? What reasons might explain why these disorders are more prevalent in females? Copyright © 2013 by Elsevier Inc. All rights reserved.

Eating Disorders cont’d. (p. 162)
Treatment for eating disorders has three goals: To manage the medical dangers To restore normal nutrition and eating patterns To meet the psychiatric treatment needs of the client and family What therapeutic interventions should be used for teen clients with eating disorders? Copyright © 2013 by Elsevier Inc. All rights reserved.

Chemical Dependency (p. 163)
Problems associated with substance abuse: Accidents caused by lack of judgment Interpersonal violence Depression Worsening relationships with others Chemical dependency is a state in which one physically and psychologically requires a drug. Treatment focuses on helping the teen replace the use of chemicals with more effective coping skills. List and define the stages of chemical dependency in adolescence. Teens at high risk for becoming chemically dependent include those who: were abused as children. come from families who approve of, use, or promote the use of chemicals. have other mental health problems. Copyright © 2013 by Elsevier Inc. All rights reserved.

Personality Disorders (p. 164)
Combination of behavioral patterns that each of us develops to cope with living Teens with history of inappropriate or maladaptive behaviors may be given the diagnosis of personality disorder. A major characteristic of a personality disorder is impulsivity. Copyright © 2013 by Elsevier Inc. All rights reserved.

Personality Disorders cont’d. (p. 164)
Treatment for teens with personality disorders: Psychotherapy Treatment with medications, such as selective serotonin reuptake inhibitors (SSRIs) Fluoxetine (Prozac) Copyright © 2013 by Elsevier Inc. All rights reserved.

Sexual Disorders (p. 164) Characterized by significant distress and impaired ability to function Gender identity disorders Sexually acting out is common for teens Many sexual problems faced by adolescents can be solved with the use of good communication skills. Replacing ignorance with accurate knowledge can assist a teen along the road toward healthy sexual maturity. Copyright © 2013 by Elsevier Inc. All rights reserved.

Psychosis (p. 165) The adolescent with schizophrenia is typically a good child who begins to develop a whole new set of behaviors and activities. The major characteristic of adolescent psychosis is loss of contact with reality. Treatment for psychosis includes a combination of Psychotherapy Medications Antipsychotics Antidepressants Lithium Copyright © 2013 by Elsevier Inc. All rights reserved.

Suicide (p. 165) Adolescent girls attempt suicide three times more often than their male counterparts. Boys are more successful because they choose more lethal methods. Teenagers who attempt suicide fall into three groups: Teens with depression Teens who are trying to influence others Teens with a serious mental health problem List four signs or symptoms that indicate a potentially suicidal teen. The availability of what “tools” may increase the risk of suicide? Why might suicide attempts proliferate at a school in which there has been a suicide or attempted suicide? Copyright © 2013 by Elsevier Inc. All rights reserved.

Suicide cont’d. (p. 165) Goals of treatment Protect them from harm. Build trusting therapeutic relationships. Assist them in developing self-awareness and alternate coping skills. Copyright © 2013 by Elsevier Inc. All rights reserved.

Therapeutic Interventions (p. 166)
Building self-esteem Facilitating skill development Setting limits Providing surveillance Identify four therapeutic interventions designed specifically for adolescent clients. Explain how health care providers help adolescents develop effective coping skills. The goal of setting limits is to encourage responsibility. A teenager who has attempted suicide is admitted to the mental health inpatient facility and is acting out violently. How should the health care provider intervene? The health care provider must protect him from injuring himself or others. The health care provider should explain to the teen which behaviors are acceptable and the consequences of unacceptable behavior. These interventions will assist in developing problem-solving abilities in the adolescent. Copyright © 2013 by Elsevier Inc. All rights reserved.

Question 1 Approximately what percentage of teenagers with attention-deficit/hyperactivity disorder (ADHD) reaches mid-adolescence with no diagnosable psychiatric disorder? One fourth One third One half Three fourths Correct Answer: 2 Copyright © 2013 by Elsevier Inc. All rights reserved.

Question 2 The nurse is taking care of a male teenage client who admits to using drugs. The client tells the nurse that his only friends are other teenagers who use drugs. His schoolwork and family relationships have declined. The client is in what stage of chemical dependency? Experimental Actively seeking Preoccupation Burnout Correct Answer: 2 Copyright © 2013 by Elsevier Inc. All rights reserved.

Question 3 The nurse is taking care of a teenager who believes that she cannot cope without chemicals. She has become antisocial and violent at times. The client is in what stage of chemical dependency? Experimental Actively seeking Preoccupation Burnout Correct Answer: 3 Copyright © 2013 by Elsevier Inc. All rights reserved.

Question 4 The nurse is taking care of a male teenager who has attempted suicide in the past. His mother is very worried about him and would like to know what signs to look for in the future. The nurse knows that all of the following are warning signs of teen suicide except: Rapidly changing highs and lows Loss of initiative Hints about intentions Valuing prized possessions Correct Answer: 4 Copyright © 2013 by Elsevier Inc. All rights reserved.

Question 5 Therapeutic interventions for suicidal teens include: Financial independence Giving freedom to the teenager Securing a job Skill development Correct Answer: 4 Copyright © 2013 by Elsevier Inc. All rights reserved.

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