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Specific behavioral changes are associated with puberty and its timing.1-3 Androgens have been implicated as the cause of many of the changes associated with adolescence.4,5 Family relationships undergo a transformation during puberty.6,7 During peak height velocity (Tanner and Marshall sexual maturity rating [SMR] 3–4), boys experience more conflict with their parents, especially their mothers. This conflict tends to subside after completion of puberty, with mothers deferring more to their sons. Girls experience conflict with their mothers, and girls report decreased contact with their fathers. Hormones have been implicated as the cause of many of the behavior changes associated with normal and abnormal adolescence. Sexual behavior is associated with changes in androgens.8 Boys, with rising levels of testosterone, initiate coitus, and they are reported to be more impatient, aggressive, and irritable. For girls, an increase in masturbatory activity is associated with rising levels of androgens.

Specific psychosocial effects have been correlated with timing of pubertal maturation.2 Earlier maturation for girls is associated with greater dissatisfaction with physical characteristics, lower self-esteem, and general unhappiness. Early-developing girls receive less recognition from same-sex peers and tend to associate with older adolescents. The early-maturing girl shows increased interest in sexuality, early identity crises, greater interest in independence and decision-making, and more problem behavior in school with decreased interest in academic activities.9,10

For boys, early pubertal maturation is also associated with an increased tendency to initiate coitus. Late pubertal development in boys may be associated with adverse psychological effects. Late-developing boys may exhibit a more negative self-concept and body image with an increased frequency of identity crises than other same-aged boys of normal development.

For both girls and boys, late physical maturation appears to be protective for initiation of most risky behaviors. The social environment tends to provide more guidance and support for these physically immature adolescents.9

While adolescence is often characterized as a period of psychological turmoil, most adolescents successfully navigate the important transitions of this period in the life cycle.11-13 The growing field of positive youth development has focused on developing personal, environmental, and social assets that enable successful transition from childhood through adolescence and into adulthood.14,15 Despite adversity, many adolescents are surprisingly resilient.13 Most adolescents are attached to their families and communities, succeed in school, and traverse their teen/emerging adult years without serious problems.14

The adolescent is confronted with a series of psychological changes that, if mastered, allow for optimal functioning as an adult. An understanding of psychological development in adolescence enables the clinician to assess whether psychosocial development of the teenager is normal as well as helps the clinician to be an effective communicator with teenagers.11,15 Successful psychological development during adolescence involves developing competence in a number of realms: cognitive, moral, emotional, and social.

  1. 1. Cognitive development, or the ...

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