Adolescence and Beyond: Family Processes and Development

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This module will outline changes that occur during adolescence in three domains: physical, cognitive, and social. Within the social domain, changes in relationships with parents, peers, and romantic partners will be considered. For both boys and girls, these changes include a growth spurt in height, growth of pubic and underarm hair, and skin changes e. Boys also experience growth in facial hair and a deepening of their voice.

Girls experience breast development and begin menstruating. These pubertal changes are driven by hormones, particularly an increase in testosterone for boys and estrogen for girls. Major changes in the structure and functioning of the brain occur during adolescence and result in cognitive and behavioral developments Steinberg, Cognitive changes during adolescence include a shift from concrete to more abstract and complex thinking.

Such changes are fostered by improvements during early adolescence in attention, memory, processing speed, and metacognition ability to think about thinking and therefore make better use of strategies like mnemonic devices that can improve thinking. The difference in timing of the development of these different regions of the brain contributes to more risk taking during middle adolescence because adolescents are motivated to seek thrills that sometimes come from risky behavior, such as reckless driving, smoking, or drinking, and have not yet developed the cognitive control to resist impulses or focus equally on the potential risks Steinberg, The result is that adolescents are more prone to risky behaviors than are children or adults.

Although peers take on greater importance during adolescence, family relationships remain important too. One of the key changes during adolescence involves a renegotiation of parent—child relationships. As adolescents strive for more independence and autonomy during this time, different aspects of parenting become more salient. As children become adolescents, they usually begin spending more time with their peers and less time with their families, and these peer interactions are increasingly unsupervised by adults.

During adolescence, peer groups evolve from primarily single-sex to mixed-sex. Peers can serve both positive and negative functions during adolescence. Negative peer pressure can lead adolescents to make riskier decisions or engage in more problematic behavior than they would alone or in the presence of their family. For example, adolescents are much more likely to drink alcohol, use drugs, and commit crimes when they are with their friends than when they are alone or with their family. However, peers also serve as an important source of social support and companionship during adolescence, and adolescents with positive peer relationships are happier and better adjusted than those who are socially isolated or have conflictual peer relationships.

Crowds are an emerging level of peer relationships in adolescence. Adolescence is the developmental period during which romantic relationships typically first emerge. Initially, same-sex peer groups that were common during childhood expand into mixed-sex peer groups that are more characteristic of adolescence. Although romantic relationships during adolescence are often short-lived rather than long-term committed partnerships, their importance should not be minimized.

However, sexuality involves more than this narrow focus. Thus, romantic relationships are a domain in which adolescents experiment with new behaviors and identities. Theories of adolescent development often focus on identity formation as a central issue.

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Marcia described identify formation during adolescence as involving both decision points and commitments with respect to ideologies e. He described four identity statuses: foreclosure, identity diffusion, moratorium, and identity achievement. Foreclosure occurs when an individual commits to an identity without exploring options.

Identity diffusion occurs when adolescents neither explore nor commit to any identities. Moratorium is a state in which adolescents are actively exploring options but have not yet made commitments. Identity achievement occurs when individuals have explored different options and then made identity commitments. Building on this work, other researchers have investigated more specific aspects of identity. For example, Phinney proposed a model of ethnic identity development that included stages of unexplored ethnic identity, ethnic identity search, and achieved ethnic identity.

Several major theories of the development of antisocial behavior treat adolescence as an important period. According to the theory, early starters are at greater risk for long-term antisocial behavior that extends into adulthood than are late starters. Late starters who become antisocial during adolescence are theorized to experience poor parental monitoring and supervision, aspects of parenting that become more salient during adolescence.

Late starters desist from antisocial behavior when changes in the environment make other options more appealing. However, as they continue to develop, and legitimate adult roles and privileges become available to them, there are fewer incentives to engage in antisocial behavior, leading to desistance in these antisocial behaviors.

Developmental models of anxiety and depression also treat adolescence as an important period, especially in terms of the emergence of gender differences in prevalence rates that persist through adulthood Rudolph, Starting in early adolescence, compared with males, females have rates of anxiety that are about twice as high and rates of depression that are 1. Although the rates vary across specific anxiety and depression diagnoses, rates for some disorders are markedly higher in adolescence than in childhood or adulthood.

The primary risk factor is the history of trauma, and the primary protective factor is the parent-child relationship. To assess for trauma, relevant factors include the type of event, the age at trauma, the severity of trauma, whether the trauma is acute or chronic, the relationship of the victim to the perpetrator, the reminders of the trauma, and protective factors. From a clinical perspective, an important consideration is how the caregiver talks about the experience.


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Does the caregiver believe that the child remembers what happened? Or is the caregiver somehow disconnected from the experience? Symptoms to be assessed include those of posttraumatic stress disorder although this can be difficult to interpret in young children , oppositional defiant disorder, separation anxiety disorder, attention deficit hyperactivity disorder, depression, or anxiety. Again, an important clini-. Examples of traditional relationship constructs include warmth, responsiveness, affect such as anger or frustration , limit setting, and the level of stress in a relationship.

But there are also examples of newer, clinically based constructs, such as the caregiver as a protective shield, the ability to make meaning jointly about what has happened, or dyadic affect regulation.


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To assess the trauma history, the functioning of the child, and relationships, Ghosh Ippen and her colleagues use a variety of measures, none of which is perfect. One challenge in the use of these measures is inaccurate responding. Does she view it as safe to tell us her history? Does she view it as safe to say that Armando has problems? Does she view it as safe to get help? These are some of the questions that might come up. In another case, a child could not even pick up a toy at the end of an assessment, saying that the stuffed lion would bite him, that the car would run over him, and that the balloon would float him away to heaven.

It was clear, said Ghosh Ippen, that this mother could not focus on his symptoms because she was so focused on her own. Also, caregivers with multiple traumas sometimes can have affect charged, for example, by intrusive memories of the trauma. To overcome these barriers, it is essential to establish rapport—but rapid assessments make it difficult to do so. Another challenge is that questionnaires can be long and burdensome. They need to balance internal consistency with the threat to validity from the burden. Many instruments, in order to maximize internal consistency, ask about a symptom in many different ways.

This is a problem, especially with low-education immigrant families. With these families, clinicians have to read the instruments, and it can be awkward to ask the same question over and over. Caregivers also may have trauma symptoms that interfere with their responses. For example, avoidance is a core aspect of posttraumatic stress disorder. To manage this burden, questionnaires need to be developed with input from a clinical perspective. Often, research questionnaires are applied to clinical work. It would be helpful to have measures developed for clinical use that also provide research data.

Helpful modifications include the use of gating questions succeeded by follow-up. It also would be helpful to think about balancing the need for multiple items to obtain internal consistency with reducing the level of burden. It may be better clinically to organize items around the way people think, not according to diagnostic criteria. With measures of posttraumatic stress disorder, for example, the sleep items are separate rather than clumped together; it would make much more sense to ask people about similar behaviors at the same time.

Some items need to be worded more colloquially. A question such as whether a child has any re-experiencing symptoms is hard for most people to understand. Of course, most interviewers train clinicians to ask it a different way if the person does not understand the item, but it would be better if items were worded in ways that maximize the likelihood that people will understand them. Researchers and clinicians need to think creatively about using physical objects that can be manipulated.

People who have experienced trauma may be able to track and respond better when they are not only responding verbally. Development challenges include how adults perceive young children and their behavior given different ages, cultures, and contexts. For example, a measure may not cut across age ranges, requiring different measures for different developmental stages. As a child develops, the capacity to process what happened and to communicate distress changes. How does this affect research?

Adolescence and beyond: Family processes in development.

And how can distress be measured in babies and toddlers to determine whether they need treatment? Research is done to affect clinical practice, but clinicians need to be able to use the tools that are developed. For example, it would be helpful for trauma screening to be more procedural, allow for consistency in how trauma history is assessed, and provide wording that allows for more valid responses.

At the same time, many clinicians are not comfortable talking about trauma. Instruments need to be developed that they are comfortable using, and they need training to be able to use those instruments comfortably. We need contextually informed scientist-practitioner assessment tools. A strong knowledge base exists for family-centered strength-based preventive intervention across a wide array of conditions, said William Beardslee, professor of child psychiatry at Harvard Medical School and director of the Baer Prevention Initiatives in the Department of Psychia-.

The best way to understand mental health processes is to identify ways to enhance resilience factors and diminish risk factors to test conceptual models. Beardslee summarized the conclusions of two recent reports from the National Research Council—Institute of Medicine: one on depression among parents National Research Council and Institute of Medicine, a and one on preventing mental, emotional, and behavioral disorders among young people National Research Council and Institute of Medicine, b.

Depression is a highly prevalent and impairing problem that affects 20 percent of adults in their lifetimes. Rates of depression vary by age, ethnicity, sex, and marital status, but many adults who suffer from depression are parents. According to estimates made by the committee that produced the report, 7. Probably the best treatments in mental health are available for depression. Yet 40 to 70 percent of the adults who experience depression do not get treatment.

Depression among parents leads to sustained individual, family, and societal costs. For parents, depression can interfere with parenting quality and put children at risk for impaired health and poor development at all ages. Depression among parents affects employment, human capital, household production, parenting, and social capital, all of which have effects on children. And in the past year in the United States, at least Effective screening tools are available to identify adults with depression, and the U. Preventive Services Task Force has recommended screening for all adults once a year for depression.

Also, settings that serve parents at higher risk for depression do not routinely screen for prevention. In terms of treatment, a variety of safe and effective tools exist for treating adults with elevated symptoms or major depression. Medications are useful for some people. There is strong evidence base about the talking therapies, cognitive-behavioral therapy, and interpersonal therapy. There is a fairly strong evidence base about alternative treatments, such as meditation; however, evidence on the safety and efficacy of treatment.

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I think that the best way to reach parents who are depressed is not so much around their depression but around helping them to be more effective parents. That is what they care most about. I think if we oriented our health care that way, we would be more effective.

Treatments need to be flexible, efficient, inexpensive, and acceptable to the participants in a wide variety of clinical and community settings. For a disorder with a 20 percent lifetime prevalence, treatments are needed in many different languages and in many different settings. A wide variety of prevention options exist across the life span Figure In addition, three areas need attention across the life span: tools to cope with specific family adversities, community interventions, and policy.

Considerable promise surrounds several different strategies, including preventing or improving depression in parents, targeting the vulnerabilities or strengths of depressed parents, improving parent-child relationships, and using a two-generation approach. In addition, depression is overrepresented in high-risk populations, so programs for those populations need to be augmented with depression prevention.

The key challenge now is to take effective interventions to scale through community, state, federal, and international initiatives. One strategy would be to gather data about children when assessing parents. Another would be to embed strategies to help parents who are struggling in existing programs like Head Start, with prevention services delivered to the family rather than just the individual.

More than three-quarters of the major mental illnesses in adulthood have their origins in childhood, so prevention needs to begin early in life. Successful prevention is inherently interdisciplinary. It has mental, emotional, behavioral, and physical dimensions. Prevention is very different from treatment. It requires a new paradigm about what a child needs one, three, and five years in the future. Coordinated community-level systems are needed to support young people before the age of highest risk, at the age when prevention is likely to have the largest impact.

Can concepts adopted from evolutionary theory explain the reproductive history of substance-abusing men who are assumed to be at risk for socially irresponsible fathering? Thomas McMahon, associate professor of psychiatry and child study at the Yale University School of Medicine, explored this question using data from a study of such men in New Haven, Connecticut.

Following the passage of the Welfare Reform Act of and the Adoption and Safe Families Act of , the federal government convened a working group on the status of fatherhood.

Adolescence and beyond : family processes and development

The group highlighted the pressing need for more information about the ways that men go about producing and parenting children, particularly men who were likely to be affected by changes in federal policy and programs. McMahon has been interested in whether life history theory can explain individual differences in the reproductive behavior of humans.

Life history theory is a broad conceptual framework borrowed from evolutionary biology that focuses on the way organisms balance or negotiate competing life functions. Life history scholars distinguish between somatic effort, which represents the energy that the organism devotes to growth and survival as an individual, and reproductive effort, which is the effort that the organism devotes to supporting the growth and survival of the species. The terms r and K come from a standard equation used to describe population dynamics.

Species mature very quickly, produce large litters of offspring relatively few times over the course of a life span, and devote less energy to parenting or to caretaking, in part because the organism has a shorter life span and a high risk of early mortality in the ecological niche in which it lives. In the world of mammals, mice and rabbits tend to be at this end of the continuum. At the K end of the continuum, somatic effort takes precedence over reproductive effort. Species mature very slowly, produce smaller litters of offspring over a more extended period, and devote more energy to caretaking, in part because they have a longer life span and they live in environments in which risk of early mortality is more limited.

Elephants, whales, and humans tend to fall at this end of the continuum. This theory was originally developed to highlight differences across species, but some have extended it to look at the differences within species.

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In humans, it has been used to account for individual differences in reproductive behavior. When children live in unstable, stressful early family environments in which caretaking is inconsistent or insensitive and family resources are limited, they may develop insecure attachments, a negative view of the future, and a short-term orientation to life. As these children enter adolescence, life history theorists argue, they are at risk of pursuing a short-term or low- K approach to reproduction characterized by early puberty, early first sexual intercourse, less stable sexual partnerships, early birth of a first child, more children spaced closer together conceived with more partners, and less investment in parenting.

This approach to reproduction is adaptive for individuals given the ecological niche that they had to negotiate as a child. However, social policy labels these actions as socially irresponsible, because they typically leave children without the skills or resources needed to support their positive development in a modern technologically oriented culture. In contrast, when children live in stable, supportive early family environments characterized by consistent, sensitive caretaking and adequate family resources, they typically develop secure attachments, a positive view of the future, and a longer term orientation to life.

As they enter adolescence, these children are thought to be more likely to pursue what life history scholars call a high-K or long-term approach to reproduction, characterized by later onset of puberty, later first sexual intercourse, stable sexual partnerships, and later first birth of a child.

They typically have fewer children spaced farther apart, conceived with the same sexual partner, with more investment in parenting. Again, from the perspective of the individual, this is generally viewed as adaptive, given the ecological niche negotiated as a child.

Piaget theory of cognitive development

Society labels this behavior as socially responsible. The men were an average of about 40 years of age and included white, black, and Hispanic men.

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As a group they had an average of about 13 years of education. The researchers found that there was no significant difference between the substance-abusing men and the control group in whether or not the parents of these men were legally married at some point during their childhood.

They also found that there was no significant difference in whether or not the men had lived with their biological father at some point before their 18th birthday. However, the drug-abusing fathers were more likely to have experienced the separation of their parents sometime before their 18th birthday. There was no difference in self-report of the quality of early relationships with mothers, but the drug-abusing fathers were less likely to report that they had ever been close with their biological father during childhood.

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