Adolescence

CNUR 106 2024

 •Describe the physical, cognitive & •Prevention: Health risks
social development (relationships –
family, peer and sexual relations)
during adolescence.
•Integrate principles of growth and
development into the education
process.
Critical Learning Elements:
Content Adolescence:
Outline •Physical, Cognitive Development,
and Psycho-Social Development
•Communication & Language
development
•Cultural influences
•Emotional & social development,
•Sexual Health, Health Screening
Physical  Physical growth and puberty indicate onset of
adolescence; changes start between ages 8 and 14
Development
 Diet, exercise (environmental factors), and hereditary
in factors influence adolescents’ height, weight and body
Adolescence characteristics ; adolescents are taller and heavier than
their ancestors, puberty is earlier
 Hormone balance triggers puberty
 Primary and secondary sexual characteristics develop,
reproductive maturity is achieved
  Growth spurts: Girls (age ~8-13) Boys (age ~10-16)
 Increased height weight, reach adult proportions,
increased heart and lung capacity = increased strength
and capacity = increased motor skills, endurance
 Early developers
 Girls: often get unwanted attention, teasing
Physical  Increased risk for depression, eating disorders, early
sexual activity, substance use
Growth: The  Boys: may be more athletic, taller
Growth Spurt  Increased risk for substance abuse, early sexual
activity
 Late developers
 Boys: risk of bullying, depression, conflict with parents
 Girls: risk of teasing, bullying
 Overall, more positive outcomes for late-maturing
girls than early-maturing girls
Cognitive  Adolescents are capable of abstract thought - progressing
from a concrete framework of thinking to an understanding
Development that reality is not either/or
Piaget’s  Hypothetical thinking (what if?)/Scientific thinking; both
Formal inductive and deductive reasoning, propositional thinking;
complex logical reasoning, develops ability to think outside
Operations of the present; can incorporate concepts that might and do
stage, Age 11 exist into thinking
+
 Information Processing
•Increase in executive functioning (attention,
Cognitive memory, cognition)
Development
Piaget’s Selective and divided attention
Formal •Selective attention: focusing on one stimulus and
Operations tuning out another
stage, Age 11 •Divided attention: pay attention to more than two
+ stimuli at the same time
 Critical thinking
•Convergent thinking - used to find one correct
answer
•Divergent thinking - used when a problem has
Cognitive many possible answers
 •

Development Metacognition
•Thinking about thinking, involves planning
ahead, seeing consequences, and providing
alternate explanations.
  Imaginary audience: belief others are watching
and judging one’s behaviors, intense personal
preoccupation
Adolescent  Personal fable: belief one is special, that one
Egocentrism has unique qualities, part of imaginary audience
David Elkind
construction. A personal fable is linked to youth
feeling that probabilistic consequences don’t
apply to themselves and that they are
invincible.
  Risky behavior (alcohol consumption and drug
use, reckless or distracted driving, and
unprotected sex)
 Behavioral decision-making theory - weigh
rewards and consequences
Risk Taking  Adolescents favour rewards and value social
relationships and status rather than long-term
consequences.
 Invincibility fable: adolescents are above some
of the rules, disciplines, laws, and consequences
that apply to others
  Adolescents compare their self image to ideal image
 Fluctuating self esteem, struggles to establish own
identity, match their skills with possible careers
Erikson’s Theory  Adjusting to body changes, concern for appearance
of Psychosocial  Increased responsibility for behaviours
Adolescent  Separation from parents to establish own identity
development  High need for acceptance/support from peers, coping
Identity vs Role skills
Confusion  Importance of personal space, privacy, confidentiality
 Some teens follow family and cultural values while
others may oppose these but align with their peer
group.
  Adolescents work to form identity
 spend time with peers
 renegotiate parent-child relationships - some report
Psychosocial positive relationships, some disagree /have conflict with
parents over homework, money, curfews, clothing,
Development chores and friends
 Peer groups/peers can serve positive (social support,
companionship) and negative (prompt risky behaviours)
functions; peer groups can be crowds
  Romantic relationships emerge, contribute to identity
formation
Psychosocial  Diversity - different supports, opportunities for risk
Development taking, and sanctions for behaviour based on laws and
values for adolescents in different areas.
 Different cultural norms regarding family and peer
relationships shape adolescents’ experiences
 • may face many challenges
• may behave unpredictably Set aside time for
A challenge is
establishing a
discussion with no
• inconsistent with their interruptions
trusting/therapeutic
relationship
need for independence
Adolescents • have sensitive feelings Ask questions to
Talk face to face-
assess their
assess body
• may interpret situations perspectives-
language
Communication
LISTEN
differently from what
Strategies others interpret situation
Be aware of YOUR
Be direct with what
• Have a strong desire to tone and body
you mean
language
belong; friends are
extremely important
  Identity confusion/diffusion- no commitment or
exploration of any identities
 Identity foreclosure- commits to an identity without
exploring other possibilities
Marcia’s Iden  Identity moratorium- actively exploring but not
tity Statuses committed
 Identity achievement- made commitments after
discovering their purpose and exploring other identities
 Sex- biological differences such as genitalia and genetics

Gender- socially constructed male/female characteristics.

Transgender- identity does not match assigned at birth

Non-binary- may identify as non-gendered

Gender-nonconforming- don’t follow society’s stereotypes about how they should look or act

Cisgender: gender identity and expression match assigned at birth

Sexual Identity Heterosexual:

•Sexual attraction to members of the opposite sex

Homosexual:

•Sexual attraction to members of the same sex

•2SLGBTQ+:

•An acronym referring to lesbian (female), gay (male), bisexual, transgender individuals, and queer or questioning
  Sexual identity is linked to other aspects of identity, to
an individual’s interests, lifestyle and behaviour, and
evolving sexual orientation
 Questioning “traditional” gender roles- adolescents
use their analytic, hypothetical thinking to question
Sexual Identity roles and gender expression.
 Sexual orientation: sexual and romantic preference
 “Coming out” painful if family and friends are not
supportive
  Romantic relationships typically first emerge in
adolescence
 Often short-lived rather than long-term committed
partnerships
Romantic  Romantic relationships (or lack thereof) are related to
Relationships their positive and negative emotions (more so than to
friendships, family relationships, or school)
 Connected to their emerging sexuality
Challenges in Adolescence Leading Cause of Death

• Mental Health • Accidents

• Teen pregnancy • Homicide
• STI contraction • Suicide
• Drug and alcohol use
  Anxiety disorders & depression are most
common (females have twice the anxiety and 1.5-
3 times the rates of depression).
 During puberty: major depression affects 1 in 5
Mental girls and and 1 in 10 boys
Health  Suicide is the 2ND leading cause of death (PHAC,
Concerns 2016)High risk: First nations, 2SLGBTQ+, childhood abuse
***Suicide ideation and attempts should serve as a
warning that emotions may be overwhelming and
the teen needs help.
  Life balance, sleep and rest, activity, nutrition
 Personal care, hygiene, care of piercings, tattoo, sun
burn, teeth and gums
 Learning (academics, sports, hobbies)

Health  Sexual health: STIs, pregnancy, healthy sexual identity,

healthy romantic relationships
promotion  Rules, Discipline (parents) & Safety: vehicle, boat,
topics water, guns
 Substance use: tobacco, vaping, alcohol, cannabis,
illicit drugs
 Violence: Homicide, suicide, dating violence, gangs
 Establish trust

Nursing Adolescents can engage in abstract, hypothetical thinking

Approach Build on past learning/future oriented

During Reason by logic/scientific principles
Teaching Identify control focus

Adolescence Use peers for support and influence

12-19 years Negotiate for change, contract

Focus on details
Bastable (2017), p. 121
Make information meaningful to life
 Short Term Learning
1:1 instruction- confidentiality
 Allow participation in decision making- formulating teaching plans:
respecting autonomy
 Provide rationale to increase sense of control
 Avoid confrontation

Teaching  Expect negative responses

Peer group discussions: Learning with peers- confront health challenges or
Strategies change behaviour
 Benefit from others who have successfully dealt with same
Adolescents 12- experiences/issues
 smoking, alcohol & drug use, sexuality
19 yrs.
Long Term Learning
 Accept personal fable and imaginary audience as valid
 Acknowledge feelings as valid
 Allow for testing of personal convictions
 Bastable (2017), p. 135
  During ages 12-19 years individuals grow and develop from
childhood to adulthood: big changes
 Adapt to rapid body/mental changes- may be uncoordinated
with rapid growth

Adolescent  Preoccupation with appearance and sexual urges

 Assess mental health
Development
 Perspective of self and the world influences health: one of the
Summary most “at risk” populations (effects of poverty, pregnancy,
drug/alcohol use, STIs)
 Leading cause of death: accidents, homicide, & suicide
 Potential for obsessive thinking around what other people think
of them, yet striving to be autonomous
  Bastable, S.B. (2017). Essentials of patient education (2nd ed.).
Burlington, MA: Jones and Bartlett.
 Lumen Learning. (2017). Lifespan Development. CC By:
Attribution. Retrieved from
https://courses.lumenlearning.com/lifespandevelopment2/
References
 Public Health Agency of Canada. (2016a). Working together
to prevent suicide in Canada: The Federal Framework for
Suicide Prevention. Health Canada.
http://oaresource.library.carleton.ca/wcl/2016/20161221/HP3
5-61-2015-
eng.pdf