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

Adolescents' Adolescents' Social and Social and

Psychological Psychological changes changes

Dr. Mohammed Othman Al-RukbanDr. Mohammed Othman Al-Rukban Assistant professorAssistant professorCollege of Medicine.College of Medicine.

King Saud University, Riyadh, SA.King Saud University, Riyadh, SA.

In This PresentationIn This Presentation::

What is Adolescence?What is Adolescence? Why Adolescents?Why Adolescents? Adolescent Social Adolescent Social

and Psychological and Psychological Changes. Changes.

Adolescence PatternAdolescence Pattern What should we do?What should we do?

AdolescencesAdolescences

AdolescenceAdolescence is the name given to the is the name given to the psychosocial life stage which starts psychosocial life stage which starts around the time of puberty.around the time of puberty.

The time of onset and duration varies The time of onset and duration varies from one person to another commonly from one person to another commonly occur occur between 12-18 yearsbetween 12-18 years..

It is It is difficult perioddifficult period of considerable of considerable physical and mental changes.physical and mental changes.

Adolescents requires Adolescents requires special special understanding and social, understanding and social, psychological and health care. psychological and health care.

Environmental Settings

YOUTH

Pee

rs

Community

School

Family

Neighborhood

Media/Internet

Why AdolescentsWhy Adolescents??

Those below 20 years of age Those below 20 years of age represent the largest segment of the represent the largest segment of the Saudi population Saudi population (60-70%)(60-70%). .

Adolescence is a critical period in the Adolescence is a critical period in the human life. It human life. It affects people futureaffects people future habits and practice.habits and practice.

Poor diet and inactivity cause at Poor diet and inactivity cause at least least 300,000 deaths300,000 deaths among U.S. among U.S. adult each year.adult each year.

Why AdolescentsWhy Adolescents??

The body appearance The body appearance affecting self-affecting self-esteemesteem and and confidenceconfidence..

Man usually Man usually adaptedadapted to habits to habits performed at early years of his life.performed at early years of his life.

Establishing healthy habits at a Establishing healthy habits at a young age is critical because young age is critical because changing poor eating patternschanging poor eating patterns in in adulthood can be difficult.adulthood can be difficult.

Why AdolescentsWhy Adolescents??

Eating disordersEating disorders such as anorexia such as anorexia and bulimia, which can cause and bulimia, which can cause severe health problems and even severe health problems and even death, are increasingly common death, are increasingly common among young people.among young people.

Poor eating habits and inactivity Poor eating habits and inactivity are the are the root causes of overweightroot causes of overweight and and obesityobesity. .

Obesity at this period lead to Obesity at this period lead to deterioration of the future healthdeterioration of the future health..

Why AdolescentsWhy Adolescents??

The risk of The risk of coronary heart diseasecoronary heart disease is is doubleddoubled if the body mass index is > 25 and if the body mass index is > 25 and nearly nearly quadrupledquadrupled if the index is if the index is >> 29. 29.

The risk of developing The risk of developing diabetesdiabetes increases increases with increasing weight, and people with a with increasing weight, and people with a body mass index > 35 have a body mass index > 35 have a 40 fold40 fold higher risk of developing the disease than higher risk of developing the disease than non-obese people.non-obese people.

OsteoarthritisOsteoarthritis and and Respiratory diseasesRespiratory diseases are more common in obese people.are more common in obese people.

Obesity was significantly associated with Obesity was significantly associated with an increase in an increase in blood pressureblood pressure, , strokestroke, and , and certain forms ofcertain forms of cancer cancer..

Why AdolescentWhy Adolescent??

Adolescents obesity has become Adolescents obesity has become epidemicepidemic..

About 25%About 25% of adolescents in the of adolescents in the United States are overweight or at United States are overweight or at risk for overweight.risk for overweight.

Of U.S. young people aged 6-17 Of U.S. young people aged 6-17 years, about 5.3 million, or years, about 5.3 million, or 12.5%, 12.5%, are seriously overweightare seriously overweight..

The percentage of children and The percentage of children and adolescents who are overweight has adolescents who are overweight has more than more than doubled in the past 30 doubled in the past 30 yearsyears..

Why AdolescentsWhy Adolescents??

Overweight children become Overweight children become overweight adults particularly if overweight adults particularly if obesity is present in adolescence.obesity is present in adolescence.

In Riyadh:In Riyadh:– 13.8% of adolescents were 13.8% of adolescents were

overweightoverweight– 20.5% were obese.20.5% were obese.

In Jeddah:In Jeddah:– Overweight was reported in 13.4% Overweight was reported in 13.4% – obesity in 13.5% of school students.obesity in 13.5% of school students.

Youth Risk Behavior Surveillance, Youth Risk Behavior Surveillance, USA (2003)USA (2003)

OverweightOverweight 17.5%17.5% 14.4%14.4% 16.0%16.0% ObesityObesity 11.9%11.9% 7.9%7.9% 9.9% 9.9% Attempted weight controlAttempted weight control 49.5%49.5% 67.4%67.4% 58.4%58.4% Used medicine to loss weightUsed medicine to loss weight 4.4%4.4% 10.9%10.9%

7.9%7.9% 9.2%9.2% of high school girls vomit, take of high school girls vomit, take

laxatives, or take diet pills laxatives, or take diet pills to lose or to lose or keep from gaining weightkeep from gaining weight. .

Harmful weight-loss practices have Harmful weight-loss practices have been reported among girls as young as been reported among girls as young as 9 years9 years oldold..

Adolescent NutritionAdolescent Nutrition

Nationally:Nationally: The researches are scanty.The researches are scanty. Soda drink and sweat consumption:Soda drink and sweat consumption:

2-3 times daily2-3 times daily.. Most of the Most of the fast food customersfast food customers are are

from this age group.from this age group. Nutritional habits of Nutritional habits of Early adolescent Early adolescent

are better than lateare better than late..

Adolescent NutritionAdolescent Nutrition

0102030405060708090

100

Breakfast Soda Drink FAST FOOD MILK FRUIT &

VEGITABLE

SWEET

>5 DAIES/W

2-4DAIES/W

<ONE DAY /W

% %

Eating Disorders:approx.1% of girls (12-18) anorexic1-3% bulimic20% (estimated) engaged in less extreme unhealthy dieting

Nutrition:¾of adolescents do not eat recommended servings

Overweight: ages 12-19 (1971– 2002)Boys 6.1% - 16.7% Girls 6.2% - 15.4%Physical activity level drops dramatically( 9? 12 grade)

Biological Development

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 Group Grade

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

WhiteAfricanAmerican Hispanic 9 10 11 12 Total

1978

5

0

10

15

20

25

30

35

40

12 - 17 Years

1980 1982 1984 1986

Per

cent

of T

eena

gers

Usi

ng Il

lega

l Dru

gs

1988 1990 1992 1994 1996

18 - 25 Years 26 - 34 Years

35 Years and older All Americans 12 Years and over

• In a survey of 11,631 students, grades 9-12, In a survey of 11,631 students, grades 9-12, representing every state:representing every state:

• More than one-third watch TV for 3 or more hours More than one-third watch TV for 3 or more hours every school day.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, In a survey of 11,631 students, grades 9-12, representing every state:representing every state:

• More than one-third watch TV for 3 or more hours More than one-third watch TV for 3 or more hours every school day.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 HabitsAdolescent Television Habits

Source: National Centers for Disease Control and Prevention (1994)

Adolescence PatternAdolescence Pattern

Early adolescence (11-14 Early adolescence (11-14 years):years):– Puberty period.Puberty period.– Dominated by adjustment to Dominated by adjustment to

physical and psychosexual physical and psychosexual changes and beginnings of changes and beginnings of psychological independence from psychological independence from parents.parents.

– Girls > Boys.Girls > Boys.

Adolescence PatternAdolescence Pattern

Middle adolescence (14-17 Middle adolescence (14-17 years):years):– Search for independence period.Search for independence period.– Sexual relationships.Sexual relationships.– Intellectual knowledge and Intellectual knowledge and

cognitive processes became quite cognitive processes became quite sophisticated.sophisticated.

– Experimental and risk-taking Experimental and risk-taking behavior is a feature.behavior is a feature.

Adolescence PatternAdolescence Pattern

Late adolescence (17-20 Late adolescence (17-20 years):years):– Maturity period.Maturity period.– Self-confidence with Self-confidence with

relationshipsrelationships– Successful rapport with parent.Successful rapport with parent.– Thought is more reality-based.Thought is more reality-based.

Challenge #2

to argue for the sake of arguing

to be self- centered

to constantly find fault in adult’s position

to be overly dramatic

Normal adolescent behavior?

Y E S !

Cognitive Development

Cognitive Development different arrow

• ability to think abstractly

• ability to analyze situations logically

• ability to think realistically about the future, goal setting

• moral reasoning

• Entertain hypothetical situations, use of metaphors

Need guidance for rational decision making

10 years

19 years

Brain Research Findings

The brain continues to develop during adolescence.

Areas under construction:

• Prefrontal cortex – responsible for organizing, setting priorities, strategizing, controlling impulses

• Brain functions that help plan and adapt to the social environment

• Brain functions that help put situations into context; retrieve memories to connect with gut reactions

Challenge #3

Who am I? Where do I belong?

- Identity development (gender, sexual, ethnic)

- Self-esteem

- Role of peer group

Social Emotional Development

How do I relate to others?

- Social Skills

- Emotional Intelligence

INDIVIDUATION: Process by which adolescent develops a unique INDIVIDUATION: Process by which adolescent develops a unique personal identity or sense of self, distinct and separate from all otherspersonal identity or sense of self, distinct and separate from all others

• DIFFERENTIATION (early adolescence): Recognizes psychological DIFFERENTIATION (early adolescence): Recognizes psychological difference between self and parentsdifference between self and parents

• PRACTICE AND EXPERIMENTATION (14- 15 YRS.): Feels all-PRACTICE AND EXPERIMENTATION (14- 15 YRS.): Feels all-knowing, self-sufficient;actively challenges parents and seeks knowing, self-sufficient;actively challenges parents and seeks approval of peersapproval of peers

• RAPPROCHEMENT (mid-adolescence): After achieving a fair degree RAPPROCHEMENT (mid-adolescence): After achieving a fair degree of separateness from parents, returns to home base and of separateness from parents, returns to home base and conditionally and partially reaccepts parents' authorityconditionally and partially reaccepts parents' authority

• CONSOLIDATION OF SELF (until end of adolescence): Develops a CONSOLIDATION OF SELF (until end of adolescence): Develops a sense of personal identity, which serves as the basis for self-sense of personal identity, which serves as the basis for self-understanding and for maintaining a sense of autonomy, understanding and for maintaining a sense of autonomy, independence, and individualityindependence, and individuality

INDIVIDUATION AND INDIVIDUATION AND IDENTITY DEVELOPMENTIDENTITY DEVELOPMENT

(Josselson, 1980)

THANK THANK YOUYOU