Issues of adolescent psychological development in the 21st century.

Abstract

1. Margaret E. Gutgesell, MD, PhD* 2. Nancy Payne, MD† 1. *Associate Professor of Pediatrics and Psychiatric Medicine 2. †Assistant Professor of Pediatrics, University of Virginia Health System, Charlottesville, VA After completing this article, readers should be able to: 1. Describe outside influences on adolescent psychological development. 2. Explain why cognitive development advances during adolescence should be assessed before initiating counseling. 3. Describe the relationship between risk-taking behaviors of adolescents and cognitive maturity. 4. Explain how visible and nonvisible health conditions affect the adolescent’s view of self. 5. Discuss how physicians can help improve compliance in an adolescent. Dealing with adolescents always has been a challenge for both parents and clinicians. In today’s society, adolescence is a prolonged developmental stage that lasts approximately 10 years, nominally described as between the ages of 11 and 22 years. An adolescent progresses through stages of biologic development as well as changes in psychological and social functioning. It is in this period that a person becomes both physically and psychologically mature and capable of independent living. Although some recent data show that 75% of adolescents and their families have a transitional experience that is trouble-free, many have described this period as one of “storm and stress.” Physicians caring for adolescents need to know how the influences of family and the adolescent peer group affect teenagers as they progress through the early (11 to 14 y), middle (15 to 17 y), and late (18 to 21 y) stages of development. Although the outcome might be the same (eg, a healthy and independent adult), individual variation in the progression through these stages can be substantial; adolescence is a highly variable and somewhat asynchronous process. Progression through the various stages does not follow the same timelines for each adolescent. Finally, physicians need to know how to address the major issues of sexuality, risk-taking, and other health-related concerns of adolescents. This article will help the pediatrician manage these issues of adolescence, especially in the setting of the United States. However, many of these …