Abstract

1. Eric Hazen, MD* 2. Steven Schlozman, MD† 3. Eugene Beresin, MD‡ 1. *Instructor in Psychiatry, Harvard Medical School, Boston, Mass 2. †Assistant Professor of Psychiatry, Harvard Medical School, Boston, Mass 3. ‡Professor of Psychiatry, Harvard Medical School, Boston, Mass After reading this article, readers should be able to: 1. Discuss the processes of physical, emotional, social, cognitive, and moral development in adolescence. 2. Know the contributions of major developmental theorists, including Erik Erikson, Jean Piaget, and Lawrence Kohlberg, to the understanding of adolescent development. 3. Describe the relationship between adolescent behavior and recent findings from studies of brain development. 4. Identify the primary tasks of adolescent development. Adolescent patients present a unique set of challenges to pediatricians. A polite, compliant child can appear to transform into a surly, rebellious teen before a doctor's eyes. Adolescence can be a tumultuous time, even when it is unfolding in a healthy manner. For this reason, and because there is so much individual variation in adolescent development, it can be particularly challenging to determine what is “normal” in adolescent development. Although previously believed to be uniformly a time of turmoil, this view has not been substantiated by large-scale studies. (1) Most teenagers progress through this period of life with few obvious behavioral problems. However, a sound and trusting doctor-patient relationship is required to appreciate the inner struggles many adolescents endure. A working understanding of the developmental tasks of adolescence and the processes through which they are achieved provides the best tool for a pediatrician in evaluating an adolescent's development. Any discussion of adolescent development should include a definition of adolescence itself. Determining the exact onset and conclusion of adolescent development can be difficult, with complex biologic, psychological, and social paradigms all playing roles. Cultural factors also must be considered in determining the developmental norms of adolescence. Normal development from one cultural perspective may appear aberrant when viewed through the lens of another culture, and in an increasingly multicultural society, such considerations are especially important. For example, an Asian youth who begins to question his parents’ values may …

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