mental health

  1. physical development
    • occurs in 2 stages- physical(wt, ht, muscles, organs, voice) & sexual( production of gonadotropin when puberty starts)
    • puberty- body able to reproduce

    • Girls
    • start puberty @ 8-14y/o, they expirience 24-36 mo. puberty growth spurt around 9 yrs start period 12yrs 9mo. could start @ 10yrs or as late as 16yr, breast developmet, fat distribution, ends by 16-18yr

    • Boys
    • devolope slower, starts @ 10-12yr, testes enlarge, growth of pubic hair, penis grows in lenth & width, growth spurt @ 11-14yr, pubery lasts until 18yr, but they could father @ 12yr
  2. Psychosocial develpoment
    • refers to the nonphysical realm of functioning
    • teens have a period when they feel awkward, inadequate, & unworhty
  3. cognitive development- learning 2 use abstract thiking
    • childrens thinkin is concrete, based on what is observed/expirienced @ present time
    • young adolescents(10-13yr) have trouble thinking realistically bout future
    • teens- thinking moves from present to concrete future & what is possible ( relationship, problem solving thru reasoning & logic)
    • middle teen-14-17yr, abstract thinking(adaptable, flexible thinking(using concepts, generalization, problem solving), feeling of power & self-centeredness
    • @17yr- abstract thinking becomes more realistic, are able to plan reachable actions, goals, & careers
  4. Emotional development
    • during adolescence rapid change & adjustment
    • 10-13yr emotional stabilty replaced w/ worry about body changes leading 2 low self-esteem, body image, & self-concept, it becomes a confusing time.
    • mood changes- inprdicatable, aggressive, withdrawn, depressed
    • daydreaming- allows them 2 try new roles & they place themselves in "what if " situations
    • intense emotions @ 14-17yr, a lonely/troubled time, question if/how they fit in the get self control by 18yr
  5. social develpoment
    younger teens seek personal identity & belonging w/ differant groups to find the differance btween self & parants it serves as a stepin stone od individual identity & seperating from family

    middle teen- see themselves in differant way, groups determines new ways to dress, behaviors, & activities, they start to see themsleves as other do, they a usually self-centered, sex is important, by 18yr already had sex

    17yr- shift from group 2 individual, caring 4 other, dateing is personal & intimate
  6. spiritual development
    • adolescents start 2 ? family values & beliefs, stop goin 2 church, or worship alone
    • attracted to other religions that gives more acceptance & love @ this time they spiritual concerns needing understanding, patience
  7. Common problems
    (internal developemet)
    • emotional up/down
    • Introspection- process of examing one's own thoughts, emotions, reactions, attitudes, opinions, values, & behaviors by looking @ inner self, ? who they are, how other see them, this process looking inward help define themselves, but also brings changes in mood

    this is when they need feel secure & emotionaly supported
  8. common problems
    (externl problems) enviromental

    3 areas- family, social, enviromental
    early adolescencs 11-14yr, want to stay dependant & also be indepentant, want freedom but req. emptional ties w/ family\

    midadolescence 14-17yr, want all independance they detach from family (family can b overprotective 2 not not caring bout them), some deal w/ physical violance, sexual abuse, parents that do drugs, neglect, they deal w/ gangs, peer groups are usually run by adults & are positive 4 teens, star being interested in other sex until 2yr relationship is based on a sense of giving other than recieving

    other external problems- air pollution, quality & quantity of foods, purity of water, exposure to drugs, violance, crimes, media
  9. Attention-deficit disorder/hyperactivity disorder
    • Dx- in early childhood but last till adult
    • they have low attention/focus span, impulsive, bad behavior, can't relate 2 others, they get unhappy
    • TX- multidisciplinary approach w/ sm., structured, classes & firm, non-judgemental teachers needed, these kids need to be rewarded 4 good behaviors
    • behavioral therapy good 4 kid & parents, parents taught to enforce limits w/o being harsh inconsistant, or angry
    • Meds- stimulants, antidepressants, antipsychotics

    w/o judgement get info on any hx of past/current substance abuse, b/c of drug interactions
  10. Conduct disorders
    • defience of authority & aggression to others, usually in boys w/ academic problems
    • Factors- harsh parents w/ physical punishment
    • symptoms- fighhting, tempertantrums, running away, destroying properties, stealing, setting fires, truancy, vandalism, & substance abuse, many have w/ violant hx also have anxiety, & depression
    • Tx- stabalizing home enviroment, improve family interactions w/ therapy & disciplinary tech., teaching self control by emotional, behavior, cognitive therapy, inpatient tx when kids is a harm to self or others, these kids usually become antisocial as adults

    they need caregivers that have patience, willing to set limits, & that they enforce those limits
  11. emotional disorders
    they are usually a normal part of life, but when they interfere w/ ADL mental health care is needed

    • Anxiety- when kid is overwhelmed/overstressed, they go into an emotional state that triggers physical changes as body tries to adapt
    • physical & emotional symptoms can lead to panic disorders, phobias, OCD, Posttraumatic SD, substance abuse, & depression

    • Mood disorders(affective disorders)- wide range of behaviors from depression 2 hyperactivity, when up/down are 4 long-term an emotional disorder suspected
    • S/S- mood swings, acting out, antisocial, low performance in school, loss of energy, headache, stomach ache, eating/sleeping problems, problems w/ family, theft, vandalism,

    Best prevention is early recog. if untreated leads 2 serious mental health disorders in adulthood
  12. Eating disorders
    Obesity- wt that is 20% or more, b/c eating patterns of obese teens is not a immediate threat, chronic overeating not considered a mental disorder, many use food in troubled times, most affected are girls or athlete boys, mortality is 9%

    Anorexia nervosa- refusal to eat, seen by 12yr, peaks @ 13-14yr & again @ 17-18yr, over cooperative, achievement-oriented, thinks she is overwt & start diets & get obsessed of wt, may b hx of eating or mood disorders in family, may restrict calories, exercise alot, vomit, use laxitives/diuretics, pills, even drugs, avoids friends & family, becomes irritable, anxious, & depressed, will deny problem, can be fatal

    • Bulimia- binge eating them purging, occurs @ 17yr, harder to detect, start w/ big interest in diets, they eat 5,000-20,000 calories of high-carbs, then feelin guilt/depression, to control wt gain they thowup exersice, use drugs even starvation, may loss wt but remains w/i 2% norm., usually b/c of stressfull event
    • Compl.- erosion of tooth enamel gastric dialation, pancreitis, electrolyte inbalance, most know they have problem but won't admit it
    • Tx- 3 Goals
    • 1.manage medical danger like metabolic disturbance, cardiac problems, & dehydration
    • restore norm. nutrition & eating patterns
    • psychiatric tx needs 4 all involved
    • force feeding not recommended b/c goalis 4 pt to choose to eat

    Both disorders decrease by 30yr, nurse help with identifing stressor, & find better coping skills
  13. Chemical Dependancy
    • state in which one physically or psychologically req. drugs
    • 4 adolescents temptation is 2 find out whats its like, way of coping w/ life, usually don't become addicted, but usually become sexually active

    • 4 stages:
    • 1.experimentation- try for the 1st time, to be lik peers
    • seeking- want the feeling of being under the influence, friends will only be others that use drugs too
    • 3.peoccupation- feel that can't be w/o dug, may start other drugs, used to prevent withdrawals, friends lost, gets violent
    • 4.burnout- can't function w/o it,
    • S/S- changes in moods, habits, personality, they disappear w/ friends & avoid family
    • TX- finding other coping skills, behavioral & cognative therapies, provide safe enviroment b/c most are suicidal, prevention & early recog. best tool
  14. personality disorders
    • comb. of behavior patterns devoleped 4 coping, or for our identity
    • TX- psychotherapy, meds
    • disorders thought to be RT problems w/ serotonin, tx w/ SSRI like floxetine hydrocloride (prozac), found sucessfull
    • Impulsivity- do harmful acts, inappropiate actions (overeating, casual sexual acts, thrill seeking, all or nothing concept
    • introspection is low, anger, depression, low self-esteem, fear of being alone/abandoned), most try suicide
  15. sexual disorders
    • characterized by distress & impaired ability to function
    • gender indentity- discomfort of own gender
    • may want hormonal therapy, surgery,
    • Tx- medical & mental therapy
    • sexual acting ouit is normal 4 teens, but could be harmful b/c society sees behavior as inappropiate
    • could be solved w/ good communication skills
  16. psychosis
    • schizophrenia- impaired ability 2 function b/c of not being in touch w/ reality, onset is usually in adolescencs, good child that start w/ wierd behaviors & acts, loss of contact w/ reality,
    • S/S- hallucinations, delusions, feeling of paranoia, lack judgement, impulsive, lil insight, inappropriat, ritualistic, repetative behaviors, bad hygiene, not eating
    • Tx- psychotherapy & meds like antipsychotics, antidepressants, & lithium
    • Care focused on basic needs (ADL), safe environment, & developi skills 4 good living

    itz life-long & the major problem w/ management is poor complience in taking RX meds, family encouraged to join a support group
  17. Suicide
    • girls attempted 3x more, but boy more successful b/c they choose more lethal methods
    • itz a call 4 help, or attention
    • factors- abuse, neglect, instability w/i family, depression, illness, availability of guns, drugs/alcohol, comptition
    • teens who attempt suicide fall into 3 groups:
    • 1.depression
    • 2.trying to influence others
    • 3.teens w/ mental health problems
    • teens could be trying to getback @ others, or to scare other , usually seen girls
    • white males @ higher risk
    • Tx- to protect them, build trust, help w/ coping skills
  18. theraputic interventions
    • 4 suicidal thoughts
    • *survielance- safety, making good decisions, making sure they follow rules (Degree of problem determines amount of surveillance)
    • *limiting settings, enforcing them, praise them
    • *building self-esteemeye contact, active listening, call by 1st name, don't lecture
    • *role modeling
    • *skill developing- cognative, social, living skills
Card Set
mental health
ch 14