Psychological Characteristics of Adolescents and Their Health Care Problems and Needs
Cognitive and identity development
Adolescent psychology is organized around two threads: cognitive maturation and identity formation. Piaget's formal operational stage (emerging around 11-12) allows abstract reasoning and hypothetical thinking, but psychosocial maturity (impulse control, future orientation) lags behind intellectual maturity into the mid-20s. Erikson frames the central task as identity versus role confusion. Questions often test whether a behavior is developmentally expected or a red flag.
Common psychological problems
Depression, anxiety, disordered eating, and substance use are the high-yield conditions. Depression in teens may present as irritability rather than sadness, and somatic complaints (headache, abdominal pain) are common. Screening tools such as the PHQ-9 modified for adolescents are validated. Eating disorders: anorexia nervosa features low weight, fear of weight gain, and body image distortion; bulimia features binge-purge cycles often at normal weight. Suicide risk assessment should ask directly about ideation, plan, means, and prior attempts.
Traps in questions
- Equating normal risk-taking or moodiness with pathology; developmentally expected experimentation is not a disorder.
- Missing depression because the teen is irritable or presents with somatic complaints.
- Assuming normal weight rules out an eating disorder (bulimia often occurs at normal weight).
- Forgetting confidentiality limits: safety concerns (suicidality, abuse) override confidentiality.
Worked example
A 15-year-old presents with recurrent headaches and declining grades. The exam is normal. Rather than stopping at reassurance, screen for depression and anxiety, ask about sleep, substance use, and bullying. Developmentally, declining function plus somatic symptoms is a red flag for a mood disorder.