CHAPTER 13 :

PROBLEMS IN ADOLEECENCE
AND EMERGING ADULTHOOD

NAMES MATRIC NO.

NORKHAIRI ILIAYANA BINTI SABRI D20141067090
SITI SARAH BINTI MOHD SUHARDI D20151071310
NUR FITRI LIYANA BINTI AMIR D20151070452
MARLIA BINTI ABD LATIF D20141066999
NOR HAYATUN RAHIMAH BINTI ROSLI D20151070965
13.1 Exploring Adolescent and
Emerging Adult Problems :
Discuss The Nature of
Problems in Adolescence and
Emerging Adulthoods
13.2 Problems and Disorders :
Describe Some Problems And
Disorders That Characterize
Adolescents And Emerging
Adult

13.3 Interrelation Of Problems

And Prevention
 13.1 EXPLORING ADOLECENT AND
EMERGING ADULT PROBLEMS

Characteristics of
The Biopsychosocial The Development Adolescent and
Approach Psychopathology Emerging Adult
Approach Problems

Stress and Coping Resilience

The Biopsychosocial
Approach
The Biopsychosocial Approach

Biological factors

Psychological Social
factors factors
 Biological
• Caused by
malfunctioning of the
body that focused on
genes, puberty, hormones,
and the brain.
• Hormonal changes
associated with puberty
have been proposed as a
factor in the higher rate of
depression in adolescent
girls than adolescent
boys.
• How the adolescents
handle their emerging
their sexual interest also
is linked to whether
Psychological Social
• Influence the identity, • Social contexts of family,
personality traits, peers, school,
decision making, and socioeconomic status,
self-control. poverty, and
• Emphasized on how neighborhoods.
developing a positive • Adolescent who do not
identity is central to connect to the peers may
healthy adjustment in develop problems
adolescence and • Rejected by peers are
emerging adulthood. prove to development of
• Describe about emotional problems but too much
swing that characterize hang out also contributes
adolescent cause sadness to problem
and depression. • One who grow up in a
• Low self-control are more high crime rates and have
likely to cause problems poor quality of school are
than high self-control. increased to
developtproblems
The Development
Psychopathology
Approach
 The Development Psychopathology Approach

 Psychopathology – Study of mental illness

 Describing and exploring the developmental
pathways of problems
 Early negative parenting cause the adolescent to
delinquency.
 This approach often involves the use of
longitudinal studies to track the unfolding
problems over time.
 Externalizing
Internalizing Problems
problems

Occur when individual turns their

problems inward.
Occur when individual turns their
problems outward.
 Characteristics of
Adolescent and Emerging
Adult Problems
 Characteristics of Adolescent and Emerging Adult
Problems

 The spectrum are wide but the problems are vary in

their severity and in how common they are for
females and males and different socioeconomic
groups.
 Some are short-lived, but others can persist over
many years.
 The behavioral problems are more likely to cause
adolescents to be referred to a clinic for mental health
treatment were feelings of unhappiness, sadness, or
depression and poor school performances.
 AGE
Older Adolescent Younger Adolescent
Depression, truancy and Arguing, fighting, being so loud,
drug abuse vandalize

SOCIOECONOMICS

Low SES backgrounds Middle SES backgrounds

• More problems than middle SES • Girls are more likely over controlled and
• Under controlled – externalizing internalizing behavior such as anxiety,
behavior such as fighting, vandalize, depression.
• More boys than girls
Female Male
 40 Developmental Assets

20 External Assets 20 Internal Assets

Support, Empowerment, Commitment to learning, Positive

Boundaries and expectations, values, Social competencies,
Constructive use of time. Positive identities
 20 External Assets

Empowerment

Support

Boundaries and Expectation Constructive use of time

 20 Internal Assets

Commitment to learning Positive Value

Social Competencies Positive Identity

STRESS AND COPING
 Stress

 Although G. Stanley Hall (1904) and others

overdramatized the extent of storm and stress in
adolescence, many adolescents and emerging adults
today experience stressful circumstances that can affect
their development.
 Stress???
The response of individuals to stressors, circumstances
and events that threaten them and tax their coping
abilities
Stress

Stressors

Acute Chronic
(Sudden event or stimuli) (Long-lasting)
 Stress

 A recent study of 12- to 19-year-olds revealed that

perceptions of having stress decreased in late
adolescence, and that active and internal coping
strategies increased as adolescents got older (Seiffgre-
Krenke, Aunola, & Nurmi, 2009)
 Stress may come from different sources for adolescents
and emerging adults Stress may come from different
sources for adolescents and emerging adults 
 Sources include life events, daily hassles, and
sociocultural factors
 Life Events and Daily Hassles
 Is it a big problems or clusters like breakup a long-lasting
relationship or death of someone you loved, or injuries.
 Individual who have major life changes have higher
incidence of cardiovascular disease and early death.
 College students –being lonely, fear of failling in success-
oriented world also plays role in students’ depression.
 The daily-hassles and daily-uplifts scales have not been
consistently related to objective measures of health and
illness.
 Sociocultural Factors
 Help to determine which stressors individuals are likely to
encounter whether they are perceive events as stressful or
not, and how they believe stressors should be confronted.
 Do males and females responds to stressors in the same way?
- Female are less likely to respond to stressful .
- Male are threatening situation with a fight- or-flight response.
 There is no differences in the stress and cope with it in
similar or dissimilar ways of adolescent boys and girls.
 Girls indicates that they experience more stress in peer
relations.
 Acculturative stress
 Negative sequences that result from contract between two
distinctive cultural groups.
 Many individuals who immigrated to the United States have
experienced acculturative stress.
 Conditions such as inadequate housing, dangerous
neighborhoods, burdensome responsibilities, and economic
uncertainties are potent stressors in the lives of the poor.
 Adolescents are more likely to experience threatening and
under controllable life events if they live in low-income
context than they live in more economically robust contexts.
 Problem-
focused
coping

Emotion-
Context
focus
and coping
coping
COPING

Suppor Think
t positive
RESILIENCE
 Resilience
Source Characteristic

Individual Good intellectual functioning

Appealing, sociable, easygoing disposition
Talents
Faith
Family Close relationship to caring parent figure
Authorities parenting : warmth, structure, high expectations
Socioeconomic advantages
Connections to extended supportive family networks
Extra familial Bonds to caring adults outside the family
context Connections to positive organizations
Attending effective schools
CRISTIANO RONALDO
 13.2 Problems and Disorders :
Describe Some Problems And
Disorders That Characterize
Adolescents And Emerging Adult
PROBLEMS AND DISORDERS

ALCOHOL

DEPRESSA BARBITURATES

NTS TRANQUILIZERS

OPIATES
STIMULA
DRUG USE
NTS AMPHETAMINES

COCAINE

HALLUCINO
GENS LSD
ALCOHOL
It is an extremely potent drug and its classed as a
depressant, meaning that it slows down vital functions.
Resulting in slurred speech, unsteady movement,
disturbed perceptions and an inability to react quickly.

ALCOHOL CONTENTS
Beer 2–6% alcohol
Cider 4–8% alcohol
Wine 8–20% alcohol
Tequila 40% alcohol
Rum 40% or more alcohol
Brandy 40% or more alcohol
Gin 40–47% alcohol
Whiskey 40–50% alcohol
Vodka 40–50% alcohol
Liqueurs 15–60% alcohol
DEPRESSANTS
• It is a drugs that slow down the central nervous system,
bodily functions and behaviour.
• In medically, depressants have been used to reduce
anxiety and to induce sleep.
• Barbiturates are depressant drugs that induce sleep or
reduce anxiety.
• Tranquilizer are drugs that reduce anxiety and induce
relaxation.
• Opiates which is consists of opium and its derivatives,
depress the activity of the central nervous system.
• For several hour after taking an opiate, an individuals
feels euphoria and pain relief.
 EFFECTS OF ALCOHOL ON ADOLESCENTS AND EMERGING
ADULT’S BEHAVIOR AND BRAIN ACTIVITY

Depressant and slows down the brain activities

 Damage or kill biological tissues including muscle and
brain cells
Reduce inhibition and impaired judgment
Initially, drinker feel more talkative and more
confident
Low skilled performanced
Drowsy
Fall asleep
With extreme intoxication, the drinker may lapse into
coma.
 HEREDITY

RISK FACTORS FAMILY

CERTAIN IN ALCOHOL
PERSONALITY INFLUENCES
ABUSE

PEER
RELATIONSHIP
• TRENDS IN OVERALL DRUG USE
STIMULANTS ………… Cigarette smoking
………… Cocaine
………… Amphetamines
• Stimulants are drugs that increase the activity of the
central nervous system. The most widely used stimulants
are caffeine, nicotine, amphetamines and cocaine.
• Its can increase heart rate, breathing and temperature
but decrease appetite.
• They increase energy, decrease feelings of fatigue, lift
mood and self-confidence.
• After wear off, the user often becomes tired, irritable
and depressed, may experience headaches and may
physically addictive.
AMPHETAMINES
• It is often called “pep pills” and “uppers” are widely
prescribed stimulants, something appearing in the
form diet pills.
• Amphetamines use among high school seniors has
decreased significantly.
COCAINE
• Cocaine is stimulant that comes from the coca plant,
native to Bolivia and Peru.
• For many years they chewed to increase their stamina.
• Today, cocaine is heather heated and the fumes inhaled
or it is injected in the form or crystals or powder.
• The effects is rush of euphoric feelings which is
eventually wear off.
• Followed by depressed feelings, lethargy, insomnia and
irritability.
• Cocaine can have a number seriously damaging effects
on the body including heart attacks, strokes and brain
seizures.
COCA PLANT
CIGARETTE SMOKING
• Cigarette smoking in which the active drug is
nicotine.
HALLUCINOGENS
It also called psychedelic ( mind-altering) drugs, are
drugs that modify an individual’s perceptual
experiences and produce hallucinations. It is divided
by two type which is LSD and marijuana.
LSD ( Lysergic acid diethylamide )
 It is a hallucinogen that even in low doses and it
produces striking perceptual changes. Objects
glow and change shape. Colours become
kaleidoscopic.
 Fabulous images unfold as users close their eyes.
Sometimes the images are pleasurable,
sometimes unpleasant or frightening.
 LSD effects on the body may include dizziness,
nausea and tremors.
 Emotional and cognitive effects may include rapid
mood swings or impaired attention and memory
MARIJUANA
o A milder hallucinogen than LSD, comes from the hemp
plant Cannabis Sativa which is originated in Central
Asia but is now grown in most part in the world.
o Physical effects is increase in pulse rate and blood
pressure, reddening of the eyes, coughing and dryness
of the mouth.
o An individual who is “high” on marijuana become very
talkative or may cease talking.
o Can impair attention and memory.
o If it is used daily in heavy amounts, it also can impair
the human reproductive system and may be involved
in some birth defects.
CANNABIS
PLANT

CANNABIS
PLANT
ECTASY
Its The street name for the synthetic drug MDMA
has stimulant and hallucinogenic effects.
 chemical structure is similar to methamines and
usually comes in a pill form.
 Tolerance builds up rapidly so users may take
three or four pills at a time.
 Produces euphoric feelings and heightened
sensations.
 users often become hyperactive and sleepless.
 Can lead to dangerous increases in blood pressure
like stroke or a heart attack.
Repeated ectasy use may damage the areas of the
brain involve learning and memory, regulation of
ECTASY
ANABOLIC STEROID
 A drugs derived from the male sex hormone,
testosterone
 Promote muscle growth and increase lean body
mass.
 in medical uses, they increasingly have been
abused by some atheletes and others to improve
their sports performance and physical
attractiveness.
 If users take in large doses, it can change in
sexual characteristics.
 In male, its can involve a shrinking of the
testicles, reduce sperm count, impotence,
premature baldness, enlargement of prostate
ANABOLIC STEROID
INHALANTS
 Inhalants are ordinary household products that are
inhaled or sniffed by children and adolescents to
get high.
 Short term can cause intoxicating effects that last
for several minutes or even several hours if
inhalants are used repeatedly.
 Initially, users feel slightly stimulated then may feel
less inhibited.
 They can lose consciousness.
 Long term can lead to heart failure and even
death.
Drug Medical Uses Short-term Overdose Health Risks Risk of Physical/
Classification Effects Psychological
Dependence

DEPRESSANTS

Alcohol Pain relief Relaxation, Disorientation, loss Accidents, brain Physical:

depressed brain of consciousness, damage, liver moderate,
activity, slowed even death at high disease, heart psychological:
behaviour, reduced blood-alcohol disease, ulcers, moderate
inhibitions levels birth defects

Barbiturates Sleeping pills Relaxation, sleep Breathing difficulty, Accidents, coma, Physical and
coma, possible possible death psychological:
death moderate to high

Tranquilizers Anxiety reduction Relaxation, slowed Breathing difficulty, Accidents, coma, Physical: low to
behavior coma, possible possible death moderate;
death Psychological:
moderate to high
Opiates Pain relief Euphoric feelings, Convulsions, coma, Accidents, Physical: high
( narcotics) drowsiness, nausea possible death infectious diseases psychological:
such as AIDS moderate to high
(when the drug is
injected)
STIMULANTS

Amphetamines Weight control Increased Extreme irritability, Insomnia, Physical: possible

alertness, feelings of hypertension, psychological:
excitability, persecution, malnutrition, moderate to high
decreased fatigue convulsions possible death
irritability
Cocaine Local anesthetic Increased Extreme irritability, Insomnia, Physical: possible;
alertness, feelings of hypertension, psychological:
excitability. persecution, malnutrition, moderate
Euphoric feelings, convulsions possible death (oral) to very high
decreased fatigue, (injected or
irritability smoked)
HALLUCINOGENS

LSD None Strong Severe mental Accidents Physical: none;

hallucinations, disturbance, loss of psychological: low
FACTORS IN ADOLESCENT AND
EMERGING ADULT DRUG ABUSE
 Being born into a high risk family especially
a poor, single or teenage mother.
 Experiencing an increase in harsh parenting
in childhood.
 Having conducts problems in school and
getting rejected by peers in childhood.
 Experiencing increased conflict with
parents in early adolescence.
 Having low parental monitoring by parents.
 Hanging out with deviant peers in early
adolescence and increased substance use.
 Juvenile Delinquency
 The term juvenile delinquency refers to a
broad range behaviors, from socially
unacceptable to status offenses to
criminal act.
 Index Offenses
The term index offenses are criminal
acts, whether they are commited by
juveniles or adult.
 Status offenses
 They are performed by youth under specified age,
which classifies them as juvenile offenses.

Example :

1. Underage drinking
2. Running away
3. Truancy
 Conduct Disorder
 Conduct disorder is the psychiatric
diagnostic category used when multiple
behaviors occur over six-month period.
 For example, running away, truancy,
cruelty to animals, excessive fighting
and the others.
 When three or more this behavior co-
occur before the age of 15, and the
child and adolescent is considered
unmanageable or out of control, the
clinical diagnosis is conduct disorder.
 Antecedents of Juvenile Delinquency
 Predictor of delinquency include conflict with
authority, that are followed by property damage
and other more serious acts, minor aggresion
followed by fighting and violence, identity (negative
identity), self control, cognitive distortions, age,
sex, expectations for education, school
achievement, peer influence, sosioeconomic status,
parental role, siblings, and neighborhood quality.
DEPRESSION AND
SUICIDE
 WHAT IS DEPRESSION ?

In major depressive disorder, an individual experiences

a major depressive episode and depressed characteristics
, such as “lethargy” and “hopelessness”, for at least two
weeks or longer and daily functioning becomes
impaired.
“Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM –
IV)” , By ( American Psychiatric Association, 1994).

“SYMPTOMS”
define
Depressed mood MAJOR
most of the day DEPRESSIVE
EPISODE Recurrent thoughts of
death and suicide
Reduced interest OR pleasure
in all or most activities
Problems in thinking,
Significant weight loss or gain, “OR” significant concentrating, or making
decrease or increase appetite decisions

Trouble sleeping OR sleeping too

much Fatigue OR loss of energy

Feeling worthless OR guilty in an excessive

or inappropriate manner
“ WHY “ adolescents female have rate of
depression TWICE than adolescents male ?

Tend to ruminate in their depressed mood and amplify it.

Females’ self-images, especially their body images, are more

negative than males’

Females face more discrimination than males do

Hormonal changes alter vulnerability to depression in

adolescence, especially among girls.
 FACTORS associated with adolescent
depression

“ Family Factors ,” ( Graber &Sontag,2009 )

Parent adolescent conflict AND low
parental support ,( Sheeber & others,
2007)

“ Poor Peer relationships ,” ( Conley & Rudolf,

2009)

- Having less contact with friends

- Being rejected by peers
- Problems in adolescent
romantic relationships.
 TREATMENT OF
DEPRESSION ?

Took an antidepressants
AND received cognitive
behaviour therapy that
involved improving their
coping skills.
 WHAT IS SUICIDE ?

Depression is linked to an increased in

suicidal ideation and suicide attempts
ain adolescence ( Werth, 2004 )
Suspect someone is likely to attempt
“suicide .”?
What to do ?
Ask direct, straightforward questions in
a calm manner.
Be a good listener and be very
supportive without being falsely
reassuring.
Try to persuade the person to obtain
professional help and assist him or her
in getting this help.
Assess the seriousness of the suicidal
intent by asking questions about
feeling.
What not to do ?
Do not ignore the warning signs
Do not refuse to talk about suicide if a
person approaches you about it.
Do not abandon the individual after the
crisis has passed or after professional
help has commenced.
Do not react with humour, disapproval,
or repulsion.
Do not give false reassurances by saying
such things as “ everything is going to
be okay .”
“ EATING DISORDERS “

Become increasingly common among adolescents (Neumark-Sztainer ,

2009 ; Schiff,2009 ; Wardlaw&Smith, 2009 )
 EATING DISORDERS

Body Image

Sexual activity

Role models and the media

Parenting
 TYPES OF EATING
PROBLEMS ?

Overweight and Obesity

Adolescents

Anorexia Nervosa

Bulimia Nervosa
 OVERWEIGHT & OBESITY

Eating patterns established in

childhood and adolescence are
strongly linked to obesity on
childhood.

Both heredity and environmental factors

are involved in obesity ( Hahn, Payne,&
Lucas, 2009).
 ANOREXIA NERVOSA

An eating disorder that involves the

relentless pursuit of thinness through
starvation.

Having a distorted image of body shape.

Even when they
Are extremely thin ,anorexics see
themselves too fat.
 BULIMIA NERVOSA

An eating disorder in which the individual

consistently
Follows a binge-and-purge eating pattern.

Eating binge and then purges by self-inducing

vomiting or using laxative
13.3 INTERRELATION
OF
PROBLEMS AND
PREVENTION
 3. INTERRELATION OF
PROBLEMS AND
PREVENTION/INTERVENTION

ADOLESCENTS
PREVENTION AND
WITH MULTIPLE INTERVENTION
PROBLEMS
ADOLESCENTS WITH
MULTIPLE PROBLEMS
 The adolescents most at risk have more
than one of these problems.
 Researchers finds that problem behaviors in
adolescence are interrelated.
 Example: Heavy substance abuse is related
to early sexual activity, lower grades,
dropping out of school and delinquency.
 Delinquency is related to early sexual
activity, early pregnancy, substance abuse
and dropping out of school.
 As much 10% of the adolescent
population in the United State have
serious multiple problems behaviors.
 For example, adolescents who
dropped out of school or are behind in
their grade level, are users of heavy
drugs, regularly use cigarettes and
marijuana and are sexually active but
do not use contraception.
 Prevention
and
Intervention
Joy Dryfoos (1990,1997; Dryfoos & Barkin,
2006) described the 3 common
components of the successful programs:

Community- Early
Intensive
wide, identification
individualized
multiagency and
attention
collaborative intervention
approaches
 INTENSIVE INDIVIDUALIZED
ATTENTION
• High-risk youth are attached to a responsible adult
who gives the youth attention and deals with the
child’s needs.
• Occurred in a number of difference programs.
• Example: in a substance-abuse program , a student
assistance counselor was available full-time for
individual counseling and referral for treatment.
 Require highly trained personnel and they
extend over a long period to remain successful.
 Community-wide,
multiagency collaborative approaches

 The basic philosophy of community-wide programs

is that a number of difference programs and services
have to be in place.
 Example: A community-wide health promotion
campaign was implemented that used local media
and community education in concert with a
substance-abuse curriculum in the schools.
 Community programs that include policy
changes and media campaigns are more
effective when they are coordinated with
family, peer and school components.
 Early identification and
intervention
Reaching children and their families
before children develop problems, or at
beginning of their problems.
Three Prevention Programs/ Research
Studies That Merit Attention

High Fast
Scope Track
National
Longitudinal
Study on
Adolescent
Health
 High Scope
 One preschool program serves as an excellent model for the prevention of
delinquency, substance abuse, and dropping out of school.
 Perry Preschool ( Directed by David Weikart, services disadvantages African

American children) had a long-term positive impact on its student.

 They attend a high-quality two years preschool program and receive weekly

home visits from program personnel.

 Impact: By age 19 individuals who had attended the Perry Preschool program

were less likely to have been arrested and fewer offenses than a control
group.
 The students also were less to drop out school and teachers rated their

behavior as more competent than that of a control group who did not receive
the enriched preschool experience.
 At age 40 those who had been in the Perry Preschool program were more

likely to be in workforce, own their own homes and had fewer arrests.
• Impact: By age 19 individuals who had attended the
Perry Preschool program were less likely to have been
arrested and fewer offenses than a control group.
• The students also were less to drop out school and
teachers rated their behavior as more competent than
that of a control group who did not receive the enriched
preschool experience.
 Fast Track
 High-risk children who showed conduct problems at
home and at kindergarten were identified.
 During the elementary school years, the atrisk children
and their families were given support and training in
parenting, problem-solving and coping skills, peer
relations, classroom atmosphere and curriculum,
academic achievement and home-school relations.
 Ten project interventionists worked with the children,
their families and schools to increase the protective
factors and decrease the risk factors in these areas.
 Results: The improvement in parenting practices and
children’s problem –solving and coping skills, peer
relations, reading achievement and problem behavior
at home and school during the elementary school
years compared with a control group of high-risk
children who did not experience the intervention.
 However, more recent analysis of this program
participants indicated that long-term outcomes were
positive only for the highest-risk group of chidlren.
 The intervention reduced their likelihood of
developing conduct disorder by one-half.
 National Longitudinal Study on
Adolescent Health
 Based on interviews with 12,118 adolescents and has
implications for the prevention of adolescents problems.
 Perceived that adolescents connectedness to a parent and to a
teacher were the main factors that were linked with
preventing these adolescent problems: emotional distress,
suicidal thoughts and behavior, violence, use of cigarettes,
use of alcohol, use of marijuana and early sexual intercourse.
 Provides support for the first component of successful
prevention/intervention programs described under the
preceding number 1.
 Intensive individualized attention is especially important
when coming from important people in the adolescent’s life
such as parents and teachers.
Prevention Steps of Adolescents Problems
in Malaysia
 Drug abuse
-Drug prevention education (Skim Lencana
Antidadah (SLAD) )
 Rehabilitation centres
-C & C Rehabilitation Centre
 Juvenile delinquency
-Kelab Pencegah Jenayah (KPJ)
 -Sekolah Tunas Bakti
 -Sekolah Henry Gurney
 Sexual problems
 shelter adolescent pregnant out of wedlock
 Rumah Perlindungan Pemulihan Wanita Darul
Wardah, Selangor
 Baby hatch
 School-related problems
-Introduction of Subjects Civics and Citizenship