Development: Adolescents (Ages 12 to 18)

Overall Goal for PTs

Treating a human undergoing rapid physical, cognitive, and emotional transformation.

The adolescent brain dynamic

Adolescent behavior is driven by an imbalance

Lambic system role

Emotions, reward, sensation-seeking, hormonal changes

Lambic system status in adolescence

Develops Early. Drives excitement and risk-taking.

Prefrontal cortex role

Executive function, planning, rationality, impulse control

Prefrontal cortex status in adolescence

Develops Later.Struggle to inhibit immediate desires.

Physical foundations & lifestyles

Growth, recovery, and risk

• puberty & physical changes: growth spurts, secular trend, menarche

• Lifestyle Factors for PT recovery (pillars): sleep & nutrition

Cognitive & Risk Factors

The biggest barrier to adherence

• adolescent egocentrism (Piaget): imaginary audience

• Invincibility fable/personal fable

Socioemotional Context

Identity, Peers, and Motivation

• identity vs. role confusion (Erickson)

• Self concept & body image

• Cliques/crowd/peer group influence

Family dynamics

• authoritarian vs. authoritative

• De-idealization

Invincibility Fable clinical problem

Risk of re-injury is underestimated.

Invincibility Fable: PT communication strategy

Use Hypothetical Reasoning (Ask, don't tell).

Imaginary Audience: clinical problem

Embarrassment/Refusal to do exercises.

Imaginary Audience: PT communication strategy

Frame exercises as personalized, high-level, or private.

Limbic system drive clinical problem

Low adherence due to boredom/instant gratification.

Limbic system drive: PT communication strategy

Keep activities challenging, engaging, and directly link to a short-term reward (returning to a desired activity).

Clique/identity clinical problem

Motivation tied to social status.

Clique/identity: PT communication strategy

Tie PT goals to their sense of self (e.g., "This is what a dedicated athlete does")

Thelarche

development of the breasts in girls

Thalamus

brain structure responsible for sensory integration and relay

Spermarche

development of the testes in boys resulting in semen, sperm, and the first ejaculation

Sex positivity

approach to adolescent sexuality that encourages exploration and experimentation within safe and openly discussed parameters

Secular trend

the tendency for successive generations to reach puberty earlier, such as an earlier age of menarche among females today than their counterparts from past cohorts.

Secondary sex characteristics

physical developments that accompany primary sex characteristics but are not directly related to the ability to reproduce

Relativistic thinking

ability to think in multiple dimensions and to realize that most statements of fact are relative to the position of the observer

Puberty

period of time and the process whereby children transition to physical and reproductive maturity

Sexually transmitted disease (STD)

sexually transmitted infection that has led to some symptom of disease

Sexually transmitted infection (STI)

infection transmitted through sexual contact, caused by bacteria, viruses, or parasites

Propositional logic

ability to make a logical conclusion based on the imagined outcome of a scenario rather than the observation of the actual scenario

Primary sex characteristics

physical developments that are directly related to the ability to reproduce

Personal fable

belief that adolescents have about their uniqueness in emotions and immortality

Perceptual speed

ability to automatically and efficiently process novel visual information and make quick decisions

Menarche

first menstruation in girls

Limbic system

set of brain structures that develop over the course of adolescence in terms of their primary functionality as well as their connections and coordination with other areas of the brain

Invincibility fable

feature of the personal fable where adolescents believe that they cannot be harmed or defeated

Imaginary audience

distinct sense that everyone is watching, thinking and interested in oneself; a consequence of adolescent egocentrism

Hypothalamus

brain structure responsible for hormonal production and control center

Hippocampus

brain structure responsible for memory formation

Hypothetical reasoning

ability to make predictions about what might occur given a set of circumstances

Formal operations

stage of cognitive development in which the adolescent has achieved formal adult thinking capabilities, including the ability to reason using formal logical systems and symbols

Deductive reasoning

process of testing out statements, or propositions, in a logical and orderly way based on a general premise

Comprehensive sex education

offers medically accurate, age-appropriate information about development, sexual behavior, abstinence, consent, healthy relationships, life and communication skills, sexual orientation, and gender identity

Circadian rhythm

individual’s biologically based pattern of physiological events that occur on a daily cycle

Amygdala

brain structure responsible for emotional processes

Adolescent egocentrism

kind of self-centeredness whereby adolescents tend to view themselves as the central figure in a drama unfolding daily

Adolescence

transition period of physical, cognitive, social, and emotional growth and development of an individual from childhood to adulthood

Abstinence-plus education

promotes abstinence but includes information about contraception and condoms

Abstinence-only education

teaches that abstaining from sex is expected until marriage; this educational track typically excludes information about the utility of contraception and condoms to prevent pregnancy and sexually transmitted infections

Body image

our mental image or representation of our body

Clique

close group of three to a dozen or so friends

Crowd

large social grouping of many dozens or more members in the social milieu of adolescents

Cultural heritage

adaptations to the natural and social world that have shared meaning and are passed from generation to generation

De-idealization

tendency of adolescents to see a mismatch between the values their parents proclaim, the rules they put forward, and the way imperfect parents lead their own imperfect lives

Gender intensification hypothesis

prediction that conforming to gender roles is of heightened relevance during adolescence

Gender nonconforming behavior

behavior that does not match society’s expectations for the individual’s assigned gender

Heteronormativity

idea that heterosexuality is the norm or preferred sexual orientation and that opposite-sex people are best suited for sexual and marital relationships

Identity achievement

realization and commitment to a coherent understanding of oneself and our relationship with society after exploring various identities

Identity diffusion

identity status in which the individual has low commitment and does not actively seek an identity; most closely aligns with Erikson’s role confusion

Identity foreclosure

identity status in which an individual has shown an early commitment to an identity without any prior exploration

Identity moratorium

stage in which individuals are actively exploring various identities but not declaring an identity to be fully formed

Identity versus role confusion

fifth stage of Erikson’s psychosocial development, which involves forming a stable and whole identity by first exploring various roles and identities

Possible selves

various identities toward which adolescents may work in the future

Relational aggression

practice of including or excluding others or otherwise threatening a sense of belonging such as by spreading gossip

Rite of passage

socially or culturally explicit markers to recognize the transitioning adolescent’s progress and achievement of adult status in one or more dimensions

Stereotype threat

phenomenon where individuals experience anxiety or fear of confirming negative stereotypes about their social group, which can impair their performance in academic or other achievement-related tasks