Adolescence: Contemporary Issues & Resources.
Adolescence: Contemporary Issues & Resources.
Adolescents face a range of issues today, which are not only complex and require effective interventions from stakeholders, especially mental health. More teens are suffering from depression due to a host of factors that include peer influence, substance use and abuse, and even eating disorders like anorexia nervosa. As such, this essay discusses depression as a contemporary issue facing adolescents and their effects on their behavior.
Adolescent depression is a critical public health issue and concern. The association illustrates that close to 11 percent of youth encounter depression, and these events are linked to downstream negative results later in adolescence and even in adulthood (Auerbach, 2015). The most alarming aspect of depression among adolescents is that close three-quarters who experience it may attempt suicide in adulthood.
Depression among adolescents affects how they think, feel, and behave, leading to emotional, functional, and physical problems. While depression can occur at any moment in life, symptoms may differ between adolescents and adults (Rice et al., 2017). Signs and symptoms of depression among adolescents comprise changes in behavior and attitude that may cause significant distress and problems at home or school and social activities. Emotional changes may include feelings of sadness and frustrations and anger, feeling hopeless and empty, and being irritable or moody. Some may lose interest in and be in conflict with friends and have low self-esteem and experience worthlessness or guilt. In some instances, adolescents may contemplate suicidal thoughts.
Behavioral changes may include loss of energy and insomnia, as well as changes in appetite and use of drugs, among other substances. Social isolation and self-harm may also manifest alongside angry outbursts (Bernaras et al., 2019). Parents should understand the symptoms and signs of depression and seek relevant interventions through counseling and other therapies since depression is treatable.
A range of external stressors exacerbates depression among adolescents. For instance, adolescents experience depression when they fail to live to their expectations in their academic work, social presence, unhealthy lifestyles, peer pressure, and social media. Firstly, adolescents are frequently under pressure to excel academically to attain good grades by their parents and join reputable colleges and universities. Studies indicate that adolescents have poor time management skills that make it difficult for many to excel academically (Bernaras et al., 2019). The failure to excel in academics causes heightened stress levels. Secondly, external stress from conformity to social life and peer pressure exacerbates depression as teenagers want to make friends and social presence through different platforms, especially increased use of social networking sites like Facebook, Instagram, and Snapchat, among others (Auerbach, 2015). Teenagers may also find it difficult to maintain different social relationships because of a lack of effort and even social skills. Unhealthy lifestyle habits, like eating disorders, also lead to depression. Staying awake at night and consumption of unhealthy fast foods are building blocks of stress and depression.
Assessment Strategies to Screen Depression
The assessment strategies to screen depression are based on accepted and recommended tools that include the Diagnostic Statistical Manual (DSM-5) developed by the American Psychology Association (APA). Using the criteria in DSM-5, practitioners can assess symptoms and signs of depression among teenagers. Further, the American Medical Association’s Guidelines for Adolescent Preventive Services (GPS) recommend that primary providers should start screening depression at age 11 and continue each year after that (Bernaras et al., 2019). Again, professional organizations recommend that adolescents aged 12 to 18 years be screened for major depressive disorders.
Lack of resources, external stressors can impact the assessment strategies for the screening of adolescent depression. Studies show that close to 65% of adolescents with depression do not access critical services and resources to help treat their condition (Rice et al., 2017). The deployment of assessment strategies requires increased investment in mental health targeted to adolescents.
Additional Assessment Questions & Ethical Parameters
Assessment questionnaires are the most significant step in determining how depression taints adolescent mental health. Depression can lead to suicide and other adverse health effects. Depression has various signs, as mentioned. Additional assessment questions entail asking the role of parents and guardians in identifying and recognizing depression symptoms and reporting to the appropriate agencies. Ethical parameters on what to share with parents and guardians entail ensuring that the affected adolescents are not exposed since they are minors (Auerbach, 2015). Secondly, ethical issues may include the need to uphold the impacted adolescents’ privacy and confidentiality to provide adequate care.
Adolescents experiencing depression have different support options, from family support to community and institutional-based support from mental health facilities. Having supportive friends is essential in encountering adolescents’ external stressors with depression (Zuckerbrot et al., 2018). Support options are also available through professional resources, which can help the adolescent cope with depression. Caregivers and parents who seek professional assistance from mental health experts like psychiatrists should understand that adolescents have the right to ensure that their information is not disclosed (Rice et al., 2017). Depressed adolescents can also find support systems through their communities, especially if they run mental health programs.
Knowledge of contemporary issues that impact adolescents is essential and offers immense benefits for the youth, especially the physical and emotional aspects. It is essential to offer support during this critical stage as adolescents make the transition to adults. The transition can have several external stressors that may impact the mental health of adolescents. Therefore, using assessment tools and observation and external resources can be useful in providing an outlet for adolescents to deal with depression.
Auerbach, R. A. (2015). Depression in adolescents: Causes, correlates, and consequences.
American Psychological Association (APA). Retrieved from https://www.apa.org/science/about/psa/2015/11/depression-adolescents
Bernaras, E., Jaureguiza, J. & Garaigordobil, M. (2019). Child and Adolescent Depression: A
Review of Theories, Evaluation Instruments, Prevention Programs, and Treatments. Frontier Psychology. https://doi.org/10.3389/fpsyg.2019.00543
Rice, F., Eyre, O., Riglin, L. & Potter, R. (2017). Adolescent depression and treatment gap. The
Lancet Psychiatry, 4(2): 86-87.
Zuckerbrot, R. A., Cheung, A., Jensen, P. S., Stein, R. E. K., & Laraque, D. (2018). Guidelines
for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics, 141(3) e20174081; DOI: https://doi.org/10.1542/peds.2017-4081
or Disease Control and prevention (CDC), child abuse and neglect is any act or series of acts of commission or omission by a parent, caregiver or another person in custodial role that results in harm, potential for harm or threat of harm to a child and it is preventable. Child abuse can occur in any age group usually the abusers are the nearest and dearest. Neglect, emotional, sexual and medical abuse are some of the abuses faced by infants. This age group is very prone to abuse because it is still very young and solely depends on the parents or caregiver and can not voice their concerns. Abusive head trauma , also known as Shaken head syndrome (SHS), is the worst form of abuse experienced by this population when a caregiver shakes the infant. The baby may experience trauma due to direct blow, when thrown to the ground or surfaces. This results in severe brain and neck injuries that may be irreversible and possibly death. Upon examination of the infant, lethargy or decreased muscle tone, poor feeding/suckling or vomiting for no cause, decreased level of consciousness or seizures are all cues to Abusive Head Trauma just to mention a few (Green S.Z,2018).
Several cultures today use folk remedies to treat various ailments. Moxibustion is the burning of rolled pieces of moxa herb (mugwort or Artemisia vulgaris) over the skin above acupuncture points and burns till start to feel pain. This is an Asian cultural practice for a variety of symptoms like fever and abdominal pain. The lesions from moxibustion look like a pattern of discrete, circular, target-like burns that maybe mistaken with cigarette burns from child abuse.
It is the nurses` duty to report any form of suspected child abuse. They are mandated reporters and should not assume that their colleagues will do the reporting. The supervisor is informed of any suspected case and law enforcement agents are engaged as well as the local county Department of Social Services: Child protection services.
Child Abuse and Neglect Prevention
Green S.Z. (2018) Health Assessment: Foundation For Effective Practice
Cultural Practices-Suspected Child Abuse
I agree that Children in the age group of birth to 1 year had the highest rate of victimization at 25.7 per 1,000 children of the same age in the national population. Most victims were from three races or ethnicities:6 White (43.5 percent), Hispanic (23.5 percent), and African American (20.9 percent). American Indian or Alaska Native children had the highest rates of victimization at 14.8 per 1,000 children in the population of the same race or ethnicity, and African American children had the second- highest rate at 13.8 per 1,000 children of the same race or ethnicity. Boys had a slightly higher child fatality rate than girls. The majority of children who died from maltreatment were one of three races or ethnicities8: White ,African-American or Hispanic .
Topic 2 DQ 1
Child abuse and maltreatment entail all types of physical, emotional, or sexual ill-treatment and negligence or exploitation, which causes or poses potential harm to a child’s health, development, and dignity. The intentional acts of abuse are usually perpetrated by an adult responsible for the child’s care (Gonzalez, Mirabal & McCall, 2020). Child abuse and maltreatment among preschool children is a major concern and occurs mostly in children who lack adequate care and protection from their parents, guardians, or relatives. Types of abuse commonly seen in preschool children include physical, emotional, and sexual abuse (Gonzalez et al., 2020). Warning signs of physical abuse in the preschool child include lacerations, bruises, cutaneous lesions, fractures, abrasions, burns, head trauma, dental trauma, acute abdomen, and ligature marks, scars, and injuries in multiple stages of healing.
Emotional abuse occurs in various forms, such as verbal abuse, rejection, criticizing, isolation, and ignoring children, which erodes a child’s self-esteem. Signs of emotional abuse include a child with a blank face, marked withdrawal, and lack of response to outward stimulation or painful procedures (Gonzalez et al., 2020). Forms of sexual abuse that commonly occur in preschool-age children include oral-genital and contact intercourse, incest, sexual assault, and pedophilia. Warning signs of sexual abuse include direct statements about sexual abuse and sexualized play or behavior (Gonzalez et al., 2020). The nurse should also consider probable abuse if a preschool child presents with sleep disturbances, appetite disturbances, depression, social withdrawal, anxiety, temper tantrums, aggression, impulsiveness, low self-esteem, and feelings of helplessness.
The nurse can misidentify cultural practices of health practices as child abuse, such as spooning, coining, salting, cupping, caida de mollera, and moxibustion. For instance, coining, a Vietnamese cultural health practice used to treat minor symptoms of fever, chills, and headache, results in patches, erythematous petechiae, and purpura on the skin (Killion, 2017). Moxibustion, an Asian practice, involves burning rolled pieces of the moxa herb on the skin and the herb burning until there is pain to manage fever and abdominal pain (Killion, 2017). The practice results in burns, which can be misinterpreted for physical abuse. It is essential that the nurse conducts a detailed cultural assessment to identify these cultural practices and inquire on alternative forms of treatment that have been used to alleviate the current symptoms.
In New Jersey, any individual having reasonable cause to believe that a child has been subjected to abuse should immediately report the information to the Division of Child Protection and Permanency (DCP&P). Child abuse reports must be made immediately by telephone. When reporting a suspected child abuse case, the nurse’s responsibilities include providing key information about the child and type of abuse. The information includes the child’s names, age, and addresses and the parent, guardian, or other individual having custody and control of the child. The nurse should also indicate the nature and extent of the child’s injuries, abuse or maltreatment, and any evidence of previous injuries, abuse, or maltreatment.
Gonzalez, D., Mirabal, A. B., & McCall, J. D. (2020). Child abuse and neglect. StatPearls [Internet].
Killion, C. M. (2017). Cultural Healing Practices that Mimic Child Abuse. Annals of Forensic Research, 4(2), 1042.
Adolescents encounter real-life problems daily as they experience the most dramatic growth changes. They face social, puberty, and social pressures, hormonal changes, and school pressures (Collishaw, 2015). They are expected to cope with each of these life struggles, which often leaves them overwhelmed. The typical contemporary issues adolescents face today include bullying, alcohol and substance use, cyber addiction, depression, teen pregnancy, peer pressure, and eating disorders (Collishaw, 2015). These issues are connected, with one resulting in another. This paper seeks to explore the contemporary adolescent issue on depression and will include assessment strategies and support options for depression in adolescents.
Depression in Adolescence
Unipolar depressive disorder is a major mental health problem affecting adolescents globally. It has an estimated prevalence of 4-5% in mid to late adolescence lasting for one year. The incidence of suicide, particularly in girls, increases dramatically after puberty and, by the end of adolescence (Thapar, Collishaw, Pine & Thapar, 2012). The burden of depression is highest in middle-income and low-income countries (Avenevoli et al., 2015). Depression in adolescents has been associated with the increasing rates of suicide, which has been ranked as the third cause of death among adolescents (Avenevoli et al., 2015). More than 50% of reported adolescent suicide cases had depressive symptoms at the time of death. Depression has resulted alcohol use, and obesity among adolescents (Thapar et al., 2012). It is thus vital that the disorder is recognized early and treated.
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Risk factors for adolescent depression can be categorized into genetic, biological, and psychosocial factors. The greatest risk factors include exposure to psychosocial stress and a family history of depression (Collishaw, 2015). Acute stressful situations that contribute to depression include bereavement and personal injury, while chronic conditions include chronic physical illness, maltreatment, poverty, bullying by peers, and family discord (Thapar et al ., 2012). Stressful life situations are mostly associated with the initial onset of a depressive disorder rather than its recurrence. Furthermore, girls have a higher risk of being affected by external stressors compared to boys (Thapar et al., 2012). The stressors also have a higher impact on adolescents who have had a history of multiple negative life situations than those exposed to one situation (Avenevoli et al., 2015). Children exposed to traumatic events such as torture, war, orphanhood, displacement, and HIV infection are at risk of developing a long-term depressive disorder if they are exposed to multiple traumas or if there is a family history of depression.
Assessment Strategies for Screening Depression in Adolescents
Despite adolescents being a high-risk group for depression, the disorder is often under-diagnosed. It is, therefore, essential for health professionals caring for the age group to be aware of the possibility of every adolescent patient having a depressive disorder. One of the most commonly used screening strategies is the use of questionnaires, which are preferred since they are economical and quick (Siu, 2016). Two of the most used questionnaire tools are the Patient Health Questionnaire for Adolescents (PHQ-A) and Beck Depression Inventory (BDI).
Since the questionnaire depends on the adolescent self-report, all responses should be confirmed by the examiner. The author will need to ask additional assessment questions about the depressive symptoms, severity, duration, and any associated impairments (Siu, 2016). For instance, the author will ask: How long have you experienced a low mood? When did you start to experience poor concentration in school? How have the symptoms affected your academic performance? Have the symptoms contributed to other health problems? Do you ever think that you are better off dead? Have you contemplated of ending it all?
Information from the parent is vital since a diagnosis established from several informants has greater reliability and validity. Despite obtaining information from the parent, ethical principles require the examiner to restrain from communicating about the problem with the parent without written consent from the adolescent (Thapar et al., 2012). The clinician should discuss with the adolescent whether to share the health findings with the parents and obtain the written consent. The adolescent should also consent whether the information should be provided once or regularly (Thapar et al., 2012). Nevertheless, the health provider is permitted to discuss with the adolescent’s guardian if there is a medical emergency or if the provider suspects assault, child abuse, or bullying.
Support Options for Adolescents Encountering External Stressors
Available support options for adolescents facing external stressors include community support groups where they are trained on how to address life stressors positively. They are also taught how to recognize a person having external stressors and treatment options available for them (Ames et al., 2014). Support options for adolescents with depression include psychotherapy programs on cognitive-behavioral therapy (CBT) strategies. CBT entails training adolescents on cognitive restructuring and behavioral strategies to enable them to change negative thoughts and solve maladaptive responses (Ames et al., 2014). In addition to CBT, adolescents are educated on depression, including symptoms, impact, and treatment options for depression. The strategies also target adolescents with parents with a history of depression, those with sub-threshold depressive symptoms, and a history of depressive disorder.
Adolescents are exposed to several devastating internal and external life struggles, which result in issues such as depression. The most common risks for adolescent depression include external stressors such as peer victimization through bullying, maltreatment, and negative family relationships. Girls faced with external stressors have a higher susceptibility to depression than boys. Besides, depression has contributed to alcohol and substance use, decline in academic performance, and suicide in adolescents. Depression screening tools available for the adolescent population include PHQ-A and BDI. The clinician should also ask questions to determine the onset, severity, and associated comorbidities. Support options available include support groups and psychotherapy programs to help adolescents have cognitive restructuring and behavioral strategies.
Ames, C. S., Richardson, J., Payne, S., Smith, P., & Leigh, E. (2014). Mindfulness‐based cognitive therapy for depression in adolescents. Child and Adolescent Mental Health, 19(1), 74-78.
Avenevoli, S., Swendsen, J., He, J. P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey–adolescent supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 37-44.
Collishaw, S. (2015). Annual research review: Secular trends in child and adolescent mental health. Journal of Child Psychology and Psychiatry, 56(3), 370-393.
Siu, A. L. (2016). Screening for depression in children and adolescents: US Preventive Services Task Force recommendation statement. Annals of internal medicine, 164(5), 360-366.
Thapar, A., Collishaw, S., Pine, D. S., & Thapar, A. K. (2012). Depression in adolescence. Lancet (London, England), 379(9820), 1056–1067. https://doi.org/10.1016/S0140-6736(11)60871-4
One stressor that I believe is particular to teenagers has to do with school and academic life, but after reading several articles from other students, I decided to concentrate mostly on the stress that relationships have on adolescents. One source of stress for teenagers is the academic pressure they face from their family’s or parents’ expectations. According to the American Psychological Association, perfectionism among college students is on the rise, which can have negative effects on mental health. This finding is supported by research showing that parents’ increasing expectations and criticism are associated with perfectionism. “Perfectionism contributes to many psychological conditions, including depression, anxiety, self-harm, and eating disorders” (Curran, 2022).
Adolescents who start their high school careers, have this associated overwhelming pressure placed on them where they feel the urgency and necessity to succeed in achieving the best grades, getting into college or excelling programs, and preparing for their future careers. This can lead to risk-taking behaviors that are linked to burnout, with a decrease in sleeping, eating, self-harm, or acting out aggressively or in isolation. It can also cause them to place high standards on themselves, similar to what their parents did, where they constantly strive to succeed and be the best; however, when faced with failure, making mistakes, and falling short of their goals, this can result in several mental health problems and a generally poor state of wellbeing. Additionally, “parental expectations had a larger impact than parental criticism,” which indicates that parents should be aware of the impact they have on their children, recognize, and avoid having unrealistically high expectations set for their kids (Curran, 2022).
The romantic relationships adolescents struggle with as teenagers are another stressor I find particular to adolescents. Around fifty percent of “young people have dated by age 15” and with that, I’ve also learned that “romantic relationship concerns are a major reason for adolescent help-seeking from counseling services” (Price et al., 2016). After reading the study, a lot of teenagers, ranging in age from 10 to 18, sought assistance from counseling resources for problems they had been having with romantic relationships. Relationship breakups were both genders’ most often expressed worry among all age groups. Adolescents are also “more likely to be associated with concurrent mental health issues (36.8%), self-harm (22.6%), and suicide (9.9%)” after a breakup (Price et al., 2016). Once more, this puts the adolescent’s mental health in danger by encouraging risk-taking behaviors such as self-harm and the desire to act out sexually to cope. It’s important to actively maintain an open dialogue, a support system for them to have meaningful relationships, as well as prevention/interventions and resources to give to the adolescent for them to grow their ability to cope with romance especially given their age.
Curran, T. (2022, March 31). Rising Parental Expectations Linked to Perfectionism in College Students. American Psychological Association. https://www.apa.org/news/press/releases/2022/03/parental-expectations-perfectionism
Price, M., Hides, L., Cockshaw, W., Staneva, A. A., & Stoyanov, S. R. (2016, May 6). Young love: Romantic concerns and associated mental health issues among adolescent help-seekers. Behavioral sciences (Basel, Switzerland). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931381/
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