Depression, self-harm and suicide - Universiteit Utrecht

Lecture 12 Depression, self-harm and suicide 

Moods and emotions 

  • Relatively sudden changes in both positively- and negatively valanced affect 

  • The intensity and/or frequency of negative emotion peaks in early adolescence 

  • Young adolescents also experience less positive emotions 

  • Emotions become more complex with a comprehension of mixed emotions 

  • Dramatic changes of mood 

  • The incidence of dysphoric or depressed moods radically increases, especially for girls 

  • Social aspects of emotion expression and regulation become more developed 

  • Increased in the ability to mask emotions 

  • The use of emotion to manage relationships 

  • Yet, emotional expression during early adolescence 

  • The social referencing aspects of emotion become highly attuned 

  • in early adolescence, there is a sharp increase in the awareness of other's perceptions of the self, and therefore shame 

  • More daily fluctuations in self-esteem 

  • Adolescents are more “moody” or variable in their emotions across the course of a day or week 

Changes in negative and positive mood in mid-adolescence 

  • Significant drop in positive mood, no change in negative mood 

  • Mood variability across adolescence using daily internet diaries 

  • Three times a year at age 13-18 

  • 4 different moods: happiness, sadness, angry, anxiety 

  • Steady decrease across mid- to late adolescence in variability  

  • Anxiety: does not show the same pattern, slight decrease but not an entire decrease 

  • Moodiness decreases across adolescent period 

Depression in all its forms 

  • Depression: an enduring period of sadness 

  • Depressed mood: an enduring period of sadness, without any other related symptoms 

  • Depressive syndrome: sadness plus other symptoms such as crying, feelings of worthlessness, and feeling guilty, lonely or worried 

  • Major depressive disorder: depressed mood or loss of interest or pleasure in almost all activities plus 4 of other symptoms (for at least 2 weeks) 

  • Clinical valuation on slide 

Gender differences in CDI depression in mid-adolescence 

  • Girls show higher levels of depression than boys 

  • Depression over the lifespan 

  • 5-9: boys are more depressed than girls, but as soon as adolescence hit, then girls show higher rates of depressive disorders than boys. Across the lifespan, women show higher levels of depression than men. 

  • But: men also show a significant increase in depression across the lifespan as well. 

Self-harm 

  • NSSI: non-suicidal self-injury 

What is self harm? 

  • A variety of behaviors in which an individual intentionally inflicts harm to his or her body for purposes not socially recognized or sanctioned and without suicidal intent 

  • Includes: see slide 

Prevalence 

  • 4% of adults report a history 

  • 14% of adolescents 

  • High school populations in the US and Canada consistently show a 13-24% prevalence rate 

  • 17% of young adults 

Developmental course 

  • Two developmental pathways: early onset and long-lasting, adolescence-limited 

  • Early onset self-injury is common around the age of 7 

  • Most often, however, self-injury behaviors begin in middle adolescence between the ages of 12 and 15 

  • Can last for weeks, months, or years 

  • 30-40% of college respondents report initiating self-injury while 17 years old or older and stopped within 5 years 

Frequency and other facts 

  • Lifetime frequency varies dramatically – one to 100s of incidents 

  • The number of forms used by an individual varies from 1 to over 10 

  • 1 in 5 self-injurious university students indicated that they had hurt themselves more than intended at least once 

  • 1 in 10 indicated that they had hurt themselves so badly that they should have been seen by a medical professional 

Who self-injures? 

  • Gender 

  • Females are significantly more likely to self-injure than males 

  • Other study: males are equally likely to self-injure as females, particularly among non-clinical samples 

  • Ethnicity 

  • more common among Caucasians 

  • Others showing similarly high rates in minority samples 

Is self-harm contagious? 

  • No hard and fast conclusions can be drawn – no good study of this effect 

  • Anecdotal reports from adults working with youth in school settings report a fad quality to the behavior. There could be groups that intend to injure together. 

  • Survey results of secondary school nurses, counselors and social workers suggest that there are groups of youth injuring together or separately as part of a group membership 

  • Media – increasing prevalence of self-injury in movies, books, and news reports may play a role in the spread of self-injury 

Why do people self-injure? 

  • Emotional triggers: overwhelming sadness, anxiety, or emotional numbness 

  • A way to manage intolerable feeling or experience some sense of feeling 

  • Used as means of coping with anxiety or other negative feelings and to relieve stress or pressure 

  • To feel in control of their bodies and minds 

  • To express feelings 

  • To reenact a trauma in attempt to resolve it or to protect others from their emotional pain 

Two different pathways: 

  • Dealing with stress 

  • Hyperstress: overwhelmed, not able to cope > trigger (images of self-harm etc.) > self-injury > feeling relieved, being in control, being calm 

  • Dealing with dissociation from the world 

  • Feeling numb, lost, alone, disconnected and/or unreal > self-injury > feeling real, alive and/or able to function again 

Nock & Prinstein Model (2004) 

  • Reasons for self-injury > two by two table: look at function of self-injury, why do we keep repeating it? (positive reinforcement (positive stimuli) or negative reinforcement (removal of a negative stimulus)) 

  • Functions 

  • Automatic: a function towards the self: we want to feel something > positive reinforcement and serving the self. Doing it to stop bad feelings > negative reinforcement + feeling relieved 

  • Social: to get attention, express something to people. Positive reinforcement (to get attention) or negative reinforcement (to avoid punishment from others) 

Self-harm cycle 

  • Self-harm is causing the harm to the self. As a result of the pain > release (feeling of relief, wanting to do it again) > shame (to the self for self-harming) > hurt (emotional turmoil) > trigger for self-harm 

Psychiatric heterogeneity 

  • 12% of adolescent self-injurers do not fit criteria for any mental disorder 

  • Skin cutters report more anxiety 

  • Endorsers of automatic functions (e.g., to stop bad feelings, feel relaxed) - more likely: suicide attempt, feel hopeless, PTSD symptoms 

  • Users of a range of methods and experience less pain – more likely to have a suicide attempt 

Is self-injury a suicidal act? 

  • Self-injury is often undertaken as a means of avoiding suicide 

  • Individuals who report self harm are also more likely to have considered or attempted suicide 

  • Nevertheless, the majority of individuals with self-harm history do not report considering suicide 

  • Non-suicidal self-injury may best be understood as a symptom of distress that, if unsuccessfully mitigated, may lead to suicide behavior 

What distinguishes NSSI that attempt suicide from those who do not? 

  • Study of Brausch 

  • Self harm behavior questionnaire 

  • Results 

  • Significant differences on anhedonia, negative self-evaluation and negative self-esteem. 

  • Anhedonia: inability to feel pleasure in normally pleasurable activities 

  • Self-injury only: better of in lower levels of anhedonia, lower sense of negative self-evaluation and higher self-esteem 

  • Graph: parent support, peer support and disordered eating 

  • Sign. Difference: parent support. Individuals who self-harmed only had higher levels of parent support 

  • Conclusion:  

  • Cumulative risk: anhedonia, low levels of parent support, negative self-evaluation etc. 

  • Peers not as important as parents at times of distress > family interventions are important 

Study BMJ 

  • Aims... 

  • Results 

  • Higher self harm rates in girls 37,4 compared with boys 12,3 per 10000 

  • Higher incidence rates in low SES (deprived) 27,1 compared to higher SES (nondeprived) 19,6 

  • Girls in 13-16 age group showed 68% increase across time from 45,6 in 2011 to 76,9 in 2014 

  • What’s happening? Referred to mental health services? 

  • No referral for 55,8% 

  • 12,4% referred for self harm episode (direct) 

  • 14,1% referred within a one year afterwards 

  • Those in deprived areas are less likely to be referred 

  • More than a fifth were prescribed antidepressants, with more girls prescribed them than boys 

  • Boys were more likely to be prescribed hypnotics or anxiolytics than girls 

  • Risks to mortality 

  • A total of 43 deaths occurred among young people in the self harm cohort and 176 in the comparison cohort (this group is 20x bigger) 

  • 65% (self harm cohort) compared with 26,6% (comparison cohort) were classified as unnatural deaths 

  • Those who self harmed were an estimated nine times more likely to die unnaturally during the follow-up period than their unaffected peers 

  • In the self harm cohort the risk for mortality was increased for: 

  • All causes of mortality and for each cause of death category 

  • Suicide 

  • Fatal acute alcohol or drug poisoning 

  • Accidents 

  • Boys in the self harm cohort had a higher increase in risk of all cause mortality compared to all other groups 

  • Conclusion 

  • Need to investigate reason for increase among 13-16 year-old girls 

  • Primary care important target for identification and early intervention 

  • More work on prevention needed 

  • Intervention 

  • Focus on: 

  • Enhancing awareness of the environmental stressors that trigger self-injury 

  • Helping individuals identify, practice and use more productive and positive means of coping with their emotional states 

Overall conclusion: NSSI represents a continuum of self-harm behaviors, where suicide is the final endpoint 

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Adolescence Development - Lectures - Universiteit Utrecht

Adolescent Development - Universiteit Utrecht

Adolescent Development - Universiteit Utrecht

Lecture 1 

Part 1 

10 risk behaviors 

  1. Alcohol 

  1. Delinquency 

  1. Gambling 

  1. Internet 

  1. “extreme sports” 

  1. Smoking 

  1. School 

  1. Unsafe sex 

  1. Softdrugs 

  1. Traffic 

  • When being different becomes the norm: how microaggressions affect Dutch lesbian, gay, bisexual and transgender youth. 

Who are adolescents? 

  • Beginning: 10/11 years old children > you see differences in size and how old they look.  

  • The end: physique that is like the adult level. So huge change in physical appearance, but also from being relatively immature to much more mature. 

Defining adolescents 

  • The period between the onset of sexual maturation and the attainment of adult roles and responsibilities. 

  • The transition from: 

  • “child” status (requires adult monitoring) 

  • To “adult” status (self-responsibility for behavior) 

Adolescents in action 1 

  • Video ‘tieners reageren op Nederland verwelkomt Trump’ 

  • The adolescents understand this form of comedy and can reflect on it and can see what other countries think.  

Part 2 

The health paradox of adolescence 

  • Adolescence is the healthiest and most resilient period of the lifespan 

  • From childhood to adolescence:  

  • Increase strength, speed, mental reasoning, immune function 

  • Resistance to cold, heat, hunger, dehydration, and most types of injury 

  • Yet: overall morbidity and rates increase 200-300% from childhood to late adolescence 

Sources of morbidity and mortality in adolescence: 

  • Primary causes of death/disability are related to problems of control of behavior and emotion. 

  • Increased rates of accidents, suicides, homicides, depression, alcohol & substance use, violence, reckless behaviors, eating disorders, health problems related to risky sexual behaviors 

  • Increased risk-taking, sensation-seeking, and erratic (emotionally influenced) behavior 

Recognized for a long time 

  • Youth are heated by Nature as drunken men by wine – Aristotle 

  • I would that there were no age between ten and twenty-three …. for there is nothing in between but getting wenches with child, wronging the ancientry, stealing, fighting... - Shakespeare 

Scientific questions (Ronald Dahl) 

  • What is the empirical evidence that adolescents are heated by Nature? 

  • Are these changes based in biology? 

  • In the hormones of puberty? 

  • In specific brain changes that underpin some behavioral and emotional tendencies & problems that emerge in adolescence? 

  • What are the implications for interventions? Should we intervene? 

If we don't intervene 

  • Onset of problems such as nicotine dependence, alcohol and drug use, poor health habits, etc. Will show up as mortality in adulthood. 

  • Many adult onset problems such as depression can be traced to early episodes in adolescence. 

The father

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Physical development, adolescent development- Universiteit Utrecht
Adolescent cognitive development - Universiteit Utrecht

Adolescent cognitive development - Universiteit Utrecht

Lecture 3  

Part 1 – adolescent cognitive development 

  • Conditional reasoning/propositional logic: Classic Modus Ponens (MP) inference: if p then q 

What is cognition? 

  • Cognition: aspects of mind related to the acquisition, modification, and manipulation of knowledge in particular contexts 

  • Cognitive development: changes in how an individual thinks, solves problems, and changes in memory, attention and information processing 

  • Two perspectives in text: Piagetian and Information Processing 

  • Piagetian perspective: focuses on what are the changes that we see all people go to 

  • Information processing perspective: how do we process information? How does this change across time? Based on individual differences.  

Textbook: adolescent thinking compared to children differ in (at least) 5 ways 

  1. Better at thinking about what is possible 

  1. Children: focus on here and now 

  1. Better at thinking about what is abstract 

  1. More often think about the process of thinking – able to think about how they think about things (metacognition) 

  1. Thinking is multidimensional (what persons say, how they say it and what they mean) 

  1. Able to see things as relative rather than absolute (not black - white) 

Cognitive development during adolescence: a Piagetian perspective 

  • Jean Piaget (1896-1980) Swiss cognitive psychologist 

  • Stage Theory of Cognitive Development (individuals in different stages think differently) 

  • How thinking changes in varies stages of adolescence. Piaget believed that children were active instructors of their knowledge (not only teachers/parents).  

Stages 

Age 

Brief Description 

Sensorimotor 

0–2 

Cog. dev. involves learning how to coordinate activities of the senses with motor activities 

  • Anything they see is connected to physical movements 

  • Objects can be nice to suck on, to cuddle with etc. 

Preoperational 

2–7 

Capable of representing the world symbolically  

(e.g. language) 

Concrete Operations 

7–11 

Become more adept at using mental operations which leads to a more advanced understanding of the world 

  • More abstract > operate on those concepts 

  • Begin to understand things like division and multiplication 

Formal Operations 

11–15+ 

Allows adolescents to reason about more complex tasks and problems involving multiple variables 

  • Mental operation on a mental operation 

 

Cognitive development during adolescence: a Piagetian perspective 

  • Formal operations – final stage of cognitive development 

  • Concrete: discuss world as it is 

  • Formal: as it might be/become 

  • Increase in ability for abstraction/abstract thought, speculation about the future 

  • --> Allows an individual to place their lives in a personal and societal perspective 

  • Needed to: achieve identity, form goals, select an occupation 

Adolescent cognitive abilities 

  • Understand impact of: past on present, present on future 

  • How one thing relates to another 

  • Greater capacity to evaluate immediate and long-range costs and benefits 

  • World as might be, ought to be 

Formal operations: 4 overlapping

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Morality - Universiteit Utrecht

Morality - Universiteit Utrecht

Lecture 4  

Morality: right and wrong. How do we know what is right/wrong? 

Trolley problem 1 

  • There is a runaway trolley barreling down the railway tracks.  Ahead there are 5 people tied to the tracks.  You are standing near a level that will switch the trolley to a different track where 1 person is tied. 

  • Should you pull the lever to divert the runaway trolley onto the sidetrack? 

  • Clash between utilitarianism – (actions that maximize happiness and well-being) and deontological ethics – the morality of an action should be based on whether that action itself is right or wrong under a series of rules, rather than based on the consequences of that action…  

  • 2 options: do nothing and allow the trolley to kill 5 people, or pull the lever divert the train and kill one? 

Trolley problem 2 

  • A trolley is hurtling down a track towards five people. You are on a bridge under which it will pass, and you can stop it by putting something very heavy in front of it.  There is a very fat man next to you – your only way to stop the trolley is to push him over the bridge and onto the track, killing him to save five. Should you proceed? 

  • Most people: do nothing, don't push an innocent person. 

  • This solution is essentially an application of the doctrine of double effect, which says that you may take action which has bad side effects, but deliberately intending harm (even for good causes) is wrong. 

  • Different rationale for making the same decision.  

Trolley problem 

  • A moral dilemma is a conflict in which you have to choose between two or more actions and have moral reasons for choosing each action. 

  • Trolley problem 1: 

  • Utilitarianism (greatest good; 1 person dead is better) vs. Deontological ethics (moral action regardless of consequence; putting the lever gets you involved in a situation > you become in a criminal act) 

  • Trolley problem 2: 

  • Utilitarianism: push the person 

  • Deontological: you don't push the person. Don't get involved. 

Nature-nurture debate on moral development 

  • Biological/evolutionary viewpoint 

  • Developmental process of maturation. Morality rises because of this maturation.  

  • Nature of the human being is ‘good’. Something built into us: we recognize who is helpful or not > nature of human is good. 

  • Cultural viewpoint 

  • Developmental process of interiorization/internalization 

  • Nature of the human being is ‘bad’ 

  • Teach people to have certain values (not built into us). Teach the child to move the original sin. 

  • Interactionist viewpoint 

  • Nature of the human being is morally neutral, neither good nor bad. It depends on what happens and how they interact and mature

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Self and Identity - Universiteit Utrecht

Self and Identity - Universiteit Utrecht

Lecture 5 Self and Identity 

Part 1 - Introduction  

Video: what kind of elements of identity do you recognize? 

  • Everybody wears a mask 

  • Insecurity, focus on others 

  • Different faces > multiple identities 

  • Showing her true face > search for autonomous identity: being yourself 

  • Social/peer identities, peer groups 

Why is identity an adolescent issue? 

  • Biological changes 

  • Puberty 

  • Appearance 

  • Changes on the outside have an impact on how one perceives oneself.  

  • Cognitive changes 

  • More self-conscious 

  • Develop a future orientation 

  • Imagine themselves from the outside, different time, able to consider different types of identities that they may want to adopt. 

  • Social changes 

  • Norms and values 

  • Social choices 

  • Educational choices 

  • What is important for them?  

Identity 

  • Who am I? 

  • Personal identity: who am I in terms of sense of self 

  • Central is the process of figuring out who one is 

  • Social identity: who am I in terms of group memberships 

  • Identifying with social group 

  • Central is one's sense of belonging to social groups 

  • These identities may influence ones believes about oneself > self-concept 

  • Mental image that one has about oneself 

  • Views about oneself, including: 

  • Values 

  • Attributes 

  • Goals 

  • Self-esteem 

  • Competence 

  • Self-concept clarity (consistent self-concept) 

  • Identity + self-concept > the self (the totality of me) 

Part 2 – personal identity 

Erikson's identity development 

  • Adolescence = psychosocial moratorium 

  • Time gap between childhood security and adult autonomy 

  • Adolescents experiment with numerous roles and identities 

  • Sense of insecurity: what is the future? What am I going to do? 

  • Crisis in adolescence 

  • Identity diffusion versus achievement 

  • Identity diffusion: failure to form a stable and secure identity 

  • Identity achievement: establishing a clear and definite sense of who you are and how you fit into the world around you 

  • Erikson: achievement by end of adolescence 

  • Characteristics that can help you to achieve identity achievement: 

  • Mental and emotional capacity (so, not possible before end of adolescence) 

  • Interactions with others (others serve as a mirror) 

  • Exploration (trying out possibilities, only possible in environment that gives you the opportunity to explore) 

  • Commitment (making choices among alternatives. Making decisions: who are you?) 

Marcia's 4 stages model (extension of Eriksons model) 

  • 4 markers: commitment vs crisis/exploration 

  • Absent/present  

  •  

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Family relations - Universiteit Utrecht

Family relations - Universiteit Utrecht

Lecture 6 Family relations 

Part 1 

  • How and why do (dynamics of) parents-adolescent relationships change during adolescence? 

  • How are adolescents affected by (changing) experiences in the parent-adolescent relationship, and vice versa? 

What is family? 

  • Dictionary definition: married, 2-parent, biological offspring 

  • But: different forms and sizes 

  • Definition may be culture-dependent 

  • Structures common ‘historically’ are not as common today 

  • Ruggles:  

  • Fragmentary household (1 parent, divorced etc.): increased 

  • Extended households (multiple generations, family-units): decreased 

  • In white and in non-white. But different slope of decrease and increase 

  • In all societies, the family fulfills similar functions: 

  • Socialization of children/adolescents 

  • Enduring source of (practical/economic & emotional/social) support 

  • Continuity of relationships across the life course = social embedding 

The family as a system 

  • Focus traditionally on mother (primary caregiver)-child/adolescent relationship 

  • Family systems theory: an organized whole, consisting of interrelated parts that influence each other 

  • System: set of elements standing in interrelation among themselves and with the environment 

  • Interrelation: not A affects B, but A & B affect each other 

  • Changing, self-organizing, and adapting to (changes in) its members and the outside environment  

  • System is flexible, but strives for stability (= equilibrium: each person a particular role) 

  • Family = cohesive emotional unit (emotional bond) 

Three aspects – family system theory 

  • Holism 

  • To understand family, not enough to look at members separately 

  • Roles (e.g., caretaker) 

  • Illustration of depression: mother can't take her role > influences the system > the child takes the ‘mother'-role 

  • ‘hierarchy’/structure 

  • Organized into subsystems 

  • By gender or generations 

  • Dyadic relationship 

  • Marital relationship 

  • Parent-child relationship 

  • Sibling relationship 

  • Triadic level 

  • Particular with both her parents 

  • Family level/whole 

  • Boundaries 

  • At every level (subsystems, inside/outside) 

  • Permeability varies across families 

  • Permeability evolves over time 

  • How much what happens when a specific subsystem of the family affects other subsystems or the entire family? 

  • Spillover vs. Compensation 

  • Associations between dyadic relationships within the whole family 

  • When there are loose boundaries between subsystems 

  • Spillover: do we see that what happens in a systems, affects what happens in other systems? 

  • Compensation: do we see that what happens in a particular system, is compensated in another system? 

  • Compartmentalization: systems are quite independent from each other 

  • Sherill:  

  • Interparental conflict >

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Peers - Universiteit Utrecht

Peers - Universiteit Utrecht

Lecture 7 Peers 

Book ‘The nurture assumption’: peers play a big role in development of youth (instead of (only) the parents) 

Part 1 - Importance of peers across adolescence 

 

  • Higher in needs fulfillment when you fulfilled the lower needs (survival needs) > belongingness and love needs and esteem needs. These are psychological needs.  

  • Importance also visible in the brain: social relationships. Example: exclusion from playing a game: social pain when excluded (analogous in its neurocognitive function to physical pain).  

Peers become more central in adolescence 

  • Time spent with family decreases 

  • Time spent with peers increases 

Peers compared to parents in adolescence 

  • Differences between the two relationships 

  • Parents = vertical (parents are more powerful), peers = horizontal relationship 

  • Being equal in experiences, characteristics etc. 

  • Shift from parents to friends as main source of support and happiness 

  • Discuss with friends for romantic issues, emotional issues; 

  • Discuss with parents for career/education issues; 

  • Thus: relationships are different and friends become more important 

Peers vs friends 

  • Peers 

  • Large network of same-age peers 

  • Friends 

  • People you know, like and with whom you develop a valued, mutual relationship (broad definition) 

  • More specifically: 

  • Mutual liking 

  • Emotional closeness 

  • Loyalty 

  • Reciprocal validation of self-worth 

  • General support 

  • Time spent together 

  • Childhood vs adolescence 

  • From shared activities (childhood) to intimacy: trust, loyalty, self-disclosure > relying on each other 

  • Why? It requires a certain role-play: perspective-taking, keep their own views and other's views in mind at the same time (that's complex to do) 

  • Social competences therefore increasingly important (conflict management, perspective-taking etc.)  

  • From same-sex to mixed-sex 

  • And “friends with benefits” 

  • From dyads (2) and small groups (3-4) to cliques (5-6) or larger crowds (these are larger to contain) 

  • “Subcultures” used to form identity > understand who you are 

Selection vs influence 

  • Friends are often similar to each other 

  • Is this due to selection or influence? 

  • Research:  

  • On the one hand: due to selection. Principles of interpersonal attraction: 

  • Proximity (being close by) 

  • Homophily/similarity (in values, interests, characteristics) 

  • Adolescents: orientation toward school, leisure activity, SES, ethnicity (perhaps due to attitudes/prejudice) 

  • Reciprocity 

  • So: selection plays a role > “birds of a feather flock together” 

  • But, parents also play a role in this selection process 

  • Expressing disapproval 

  • Type of school 

  • Neighborhood 

  • Extra-curricular activities 

  • Adolescent personality & behavior 

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    Adolescents in school - Universiteit Utrecht

    Adolescents in school - Universiteit Utrecht

    Lecture 8 

    Part 1 – adolescents in school 

    Schools: 

    • Educate young people: prepare them for adulthood 

    • Define young persons’ social world 

    • Context in which they spend most of their waking hours 

    • Shape their psychosocial development 

    Classroom factors: 

    • Classroom climate 

    • Teachers' expectations 

    • Instructional quality 

    • Emphasis on performance vs learning (grades) 

    • Friends' engagement 

    • Peer norms 

    Social organizations of schools 

    • School transition at age 12 

    • Educational tracks 

    • Select school 

    • Admission by lottery 

    • School size 

    Part 2 – Dutch school system 

    NL: freedom of education 

    • Guiding principle in educational governance is article 23 of the Constitution: 

    • Education shall be the constant concern of the Government 

    • All persons shall be free to provide education (start their own school), without prejudice to the authorities’ right of supervision 

    • Then: protestants vs Catholics 

    Now: many different school types 

    • Based on religion 

    • Based on teaching philosophy 

    • Relatively easy to change teaching principles as long as it meets the quality criteria 

    Consequences of freedom of education for classroom climate 

    • Diversity educational approaches 

    • Relatively large differences in learning outcomes in different schools 

    • Consistency values home & school 

    • Segregation: similar peers 

    • “free-market system” (popularity of schools varies > competition between schools) 

    NL: early educational tracking 

    • Level on which they receive their teaching 

    • Red countries: single school for both primary and lower secondary education 

    • Pink: transition between primary and lower secondary education, but still with common core curriculum for students 

    • Blue: differentiated branches/tracks 

    Decrease in combined educational tracks in the 1st year of secondary school 

    • E.g., havo-vwo 

    Consequences of early educational tracking for classroom climate 

    • Instruction adapted to level of understanding > teaching is more efficiently 

    • Similar performing classmates 

    • Achievement constrained by level of instruction 

    • Less contact between different social groups 

    • Lower status of vocational pathways 

    Selection based on? 

    • Test scores standardized achievement test 

    • Also based on achievement motivation and work ethic of the student 

    • Lower level advised to students with low SES parents > unequal opportunities 

    But: reading level at age 15 overlaps (PISA) 

    • Maybe students become different because we put them in different tracks 

    How is the Dutch system doing? 

    • PISA scores 2018: Netherlands score average on performance, but in regard to variation, there is more variance in comparison with other countries 

    Conclusion: the way a society organizes a school system shapes the experiences of adolescents in the classroom. 

    Part 3 – school transition 

    School transition involves many changes 

    .....read more
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    Media use - Universiteit Utrecht

    Media use - Universiteit Utrecht

    Lecture 9 Media use 

     

    • Adolescents are heavy users of media.  

    • How does this media use impact the development? (2) 

    • How does adolescent development influence media use? (1) 

    Moderate discrepancy hypothesis (MDH) 

    • Children and adolescents are predominantly attracted to entertainment that deviates only moderately from the things they know, understand, and are capable of.  

    • Children and adolescents are not or less interested in entertainment that deviates too much from their existing framework and experiences.  

    • Developmental approach: Hypothesis is a viable explanation of why media preferences differ so much among different age groups. As children develop, they learn and understand more, so what attracts them in media also changes.  

    • Children and adolescents like to be challenged, but not too much. It has to relate to the things they know.  

     

    • Media can be used to gratify certain needs. Individuals select media to gratify needs that they have (e.g., needs to lift your mood (> choose a happy song)) 

    • Needs are determined by developmental level 

    • Depends on different situational and individual factors, including development 

    Five main developmental characteristics that inform needs and gratifications 

    1. Identity exploration  

    1. Autonomy and self-efficacy  

    1. Peer orientation (and romantic partners) 

    1. Emotionality and sensation seeking 

    Physical development (hormonal changes) 

    • Changes in appearance 

    • Interest in sex (curious and questions) 

    • Impact on mood (moody, fluctuations in mood) 

    Link to media 

    • Needs in media preferences  

    • Adolescents have a need for information: insecure about bodies, interest in sex > what should a body look like? What is attractive? 

    • Media can used to seek advice about these topics 

    • Risky consequence: e.g., boys asking girls for nude selfies, difficult to oversee the consequences  

    Physical development 

    • Pruning: decline grey matter > more efficient processing 

    • Cell bodies and synapses  

    • ‘Use it or lose it’ 

    • Explains why after this process of pruning, it becomes much harder to learn new things 

    Cognitive development 

    • Formal operational thinking: logical, abstract hypothetical, problem-solving, interest in future 

    • Only completely in place at the end of adolescence  

    • Adolescents will switch between concrete and formal operational thinking 

     

    • Disadvantages:  

    • Egocentrism is on overdrive. They imagine this audience: what would other people think about what I’m doing? 

    • This all has implications for media use 

    Media implications 

    • More complexity in story lines  

    • More complex characters  

    • Topic that deal with big world issues > war movies, science fiction 

    • Fast-pace media which stimulates problem-solving skills 

    • Multiple levels: not easily get bored 

    .....read more
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    Love and sex - Universiteit Utrecht

    Love and sex - Universiteit Utrecht

    Lecture 10 Love and sex 

    Part 1 &2 – Adolescent romance 

    • Not only being in a romantic relationship, but also: 

    • Daydreaming about the person in front of you in class with whom you have never spoken 

    • Claims to have a boyfriend, but denied by the boy 

    • Talk on phone everyday (or texting), but never seen in public together for fear of being ridiculed 

    • Going together but only spend time together with other members of their crowd 

    • Going steady for 3 years (the “real” thing) 

    • Fantasies to interactions to relationships = romantic experiences 

    Romance  

    • Love or romance is central theme in 68% of pop music 

    • One of top 5 script themes for adolescent characters on TV 

    • Adolescent girls attribute 34% of their strong emotions to real or fantasized heterosexual relationships 

    • Adolescent boys 25% 

    • Substantially higher than any other topic 

    • Organizing principles of peer culture 

    • Focal topic of conversation in leisure time 

    Romantic relationship 

    • Romantic Relationship = mutually acknowledged ongoing voluntary interactions.  

    • Compared to other peer relationships, romantic ones typically have a distinctive intensity, commonly marked by expressions of affection and current or anticipated sexual behavior.  

    • Applies to same-gender, as well as mixed-gender, relationships. 

    Romantic experiences 

    • Refers to activities and processes that include romantic relationships and also behavioral, cognitive, and emotional phenomena that do not involve direct experiences with a romantic partner.  

    • Includes:  

    • fantasies and one-sided attractions (“crushes”),  

    • interactions with potential romantic partners (including flirting) and  

    • Brief, nonromantic sexual encounters (e.g., “hooking up,” or casual involvement in activities usually thought to take place with romantic partners, from “making out” to intercourse) 

    Adolescent romance 

    • Romantic relationships support the development of interpersonal skills and promote a sense of identity.  

    • Experiment with romantic relations  

    • may facilitate healthy relations in adulthood.  

    • Opportunities to gain skills in the expression and regulation of emotions, empathy and intimacy. 

    Developmental progression of romantic and sexual interest and behavior 

    • 8-11 (Pre and early puberty) adrenarche  

    • First crush  

    • Sexual attraction  

    • Sexual arousal  

    • More awareness of social rules 

    • 12-17 Mid and late puberty  

    • Gender intensification  

    • Gender binary  

    • conformity increases and then subsides  

    • Romantic relationships  

    • Duration longer  

    • More intense  

    • Some life-long partners  

    • Sexual Experiences increase 

    • Not until adolescence do truly intimate relationships first emerge  

    • Characteristics of true intimacy:  

    • Openness, honesty, self-disclosure, and trust  

    • Intimacy becomes an important concern due to changes of  

    • Puberty  

    • Cognitive changes  

    .....read more
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    Alcohol use and delinquency - Universiteit Utrecht

    Alcohol use and delinquency - Universiteit Utrecht

    Lecture 11 Alcohol use and delinquency 

    Intro  

    Under the influence of alcohol, youth are at higher risk to be involved in aggressive behavior and violent behaviors.  

    Part 1 – alcohol use and delinquency 

    Do the Dutch drink? 

    • Underage drinking 

    • 13 years old > monthly drinking = 8.8% 

    • 15 year old drinkers > binge drinking = 70.8% 

    Are they delinquent? 

    • Self-reported criminal behavior (at least one delinquent act in the last 12 months): 

    • 12-17 year 

    • 2010: 38% 

    • 2015: 35% 

    • 10/11 year old 

    • 2010/2015: 20% 

    • Most prevalent delinquent acts:  

    • Violence acts 

    • Threatening 

    • Vandalism 

    • Registered minor suspects: 

    • 50% fewer registered minor suspects in 10 year 

    Part 2 – Similarities and differences between alcohol use and delinquency 

    Shared similarities 

    • Interrelated 

    • Correlated and co-occurrence 

    • Table: number of offenses and prevalence rate of different drinking behaviors. Those adolescents who were not involved in any offense, half of them had drunk alcohol at least once in their life. Number of kids that had been involved in lifetime drinking, increases in amount of offenses 

    • Longitudinal predictions: most studies find no predictive effect of alcohol use on delinquency, whereas delinquency mostly is a significant predictor of alcohol use 

    • Peak in adolescence 

    • Predictor of other risk behaviors (e.g., drug use, risky sex) 

    • Shared underlying mechanisms (e.g., self-control, peers) 

    • Importance of parental control and warmth 

    • Decline in recent years 

    • decline started from 2006/2007 onwards 

    • Registered minor suspects: also a decline starting from 2006/2007 

    • What is going on there? 

    Differences 

    • Development 

    • Alcohol use: increases up to at least 25 years 

    • Delinquency: decline 18 year onwards 

    • Across gender 

    • Alcohol use: hardly any differences between boys and girls 

    • Delinquency: boys are more likely to be involved in delinquent behavior than girls 

    • Representation ethnic minorities 

    • Alcohol use: less likely to drink 

    • Delinquency: more likely to be involved 

    • Behavior-specific vs general parenting 

    • Age restriction 

    • Alcohol-specific rules/communication 

    • Delinquency: general parenting 

    • No age restriction 

    • Level of control and support are important in both parenting behaviors 

    • Four different parenting styles 

    • Neglectful: these kids are most likely to drink and engage in risky behaviors 

    • Balance between control and support – alcohol use 

    • Most of the parents in authoritative/average authoritative group 

    .....read more
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    Depression, self-harm and suicide - Universiteit Utrecht

    Depression, self-harm and suicide - Universiteit Utrecht

    Lecture 12 Depression, self-harm and suicide 

    Moods and emotions 

    • Relatively sudden changes in both positively- and negatively valanced affect 

    • The intensity and/or frequency of negative emotion peaks in early adolescence 

    • Young adolescents also experience less positive emotions 

    • Emotions become more complex with a comprehension of mixed emotions 

    • Dramatic changes of mood 

    • The incidence of dysphoric or depressed moods radically increases, especially for girls 

    • Social aspects of emotion expression and regulation become more developed 

    • Increased in the ability to mask emotions 

    • The use of emotion to manage relationships 

    • Yet, emotional expression during early adolescence 

    • The social referencing aspects of emotion become highly attuned 

    • in early adolescence, there is a sharp increase in the awareness of other's perceptions of the self, and therefore shame 

    • More daily fluctuations in self-esteem 

    • Adolescents are more “moody” or variable in their emotions across the course of a day or week 

    Changes in negative and positive mood in mid-adolescence 

    • Significant drop in positive mood, no change in negative mood 

    • Mood variability across adolescence using daily internet diaries 

    • Three times a year at age 13-18 

    • 4 different moods: happiness, sadness, angry, anxiety 

    • Steady decrease across mid- to late adolescence in variability  

    • Anxiety: does not show the same pattern, slight decrease but not an entire decrease 

    • Moodiness decreases across adolescent period 

    Depression in all its forms 

    • Depression: an enduring period of sadness 

    • Depressed mood: an enduring period of sadness, without any other related symptoms 

    • Depressive syndrome: sadness plus other symptoms such as crying, feelings of worthlessness, and feeling guilty, lonely or worried 

    • Major depressive disorder: depressed mood or loss of interest or pleasure in almost all activities plus 4 of other symptoms (for at least 2 weeks) 

    • Clinical valuation on slide 

    Gender differences in CDI depression in mid-adolescence 

    • Girls show higher levels of depression than boys 

    • Depression over the lifespan 

    • 5-9: boys are more depressed than girls, but as soon as adolescence hit, then girls show higher rates of depressive disorders than boys. Across the lifespan, women show higher levels of depression than men. 

    • But: men also show a significant increase in depression across the lifespan as well. 

    Self-harm 

    • NSSI: non-suicidal self-injury 

    What is self harm? 

    • A variety of behaviors in which an individual intentionally inflicts harm to his or her body for purposes not socially recognized or sanctioned and without suicidal intent 

    • Includes: see slide 

    Prevalence 

    • 4% of adults report a history 

    • 14% of adolescents 

    • High

    .....read more
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    Suicide and related problems in adolescence - Universiteit Utrecht

    Suicide and related problems in adolescence - Universiteit Utrecht

    Lecture 12a suicide and related problems in adolescence 

    Suicide in the Netherlands 

    • 1% of all deaths 

    • Males commit suicide 2 times more than females 

    • Cause of death of young people in NL 

    • 10-25 years 

    • Traffic accidents 

    • Suicide 

    • 25-40 years 

    • Suicide 

    • 40-60 years 

    • Health related causes 

    • Suicide 

    • Methods of suicide 

    • men: violent method: 50% hanging, 1 in 9 jump in front of train (more often among youth) 

    • Women: less violent: 33% hanging, 25% medication overdose, 1 in 9 jump in front of train (more often in youth) 

    Leading cause of death US youth 

    • Second cause of death 

    • Also a high homicide rate 

    • Across various ages: 

    • Suiciding is the leading cause of death among individuals between 1 and 65 years of age 

    • Suicide methods US: children and others 

    • Availability of guns > firearms is the leading methods, then suffocation/hanging, ingestion, CO poisoning, jumping from a height, cutting, other causes 

    Suicide rates by race/ethnicity 

    • Males are more likely to attempt suicide 

    • Rural areas 

    Frequency of suicidal ideation and attempts 

    • Thinking of suicide > ideation > attempt > suicide 

    • Once one attempts suicide, they are more likely to do it again (15-fold) 

    • Most common diagnoses in teen suicides: 

    • Depression 

    • Antisocial 

    • Substance abuse 

    • Anxiety 

    • Despite the high rates of depression, among those who commit suicide, 24% who have completed suicide, were prescribed antidepressants, but zero found at autopsy: lack of using antidepressants > increases changes of suicide 

    • Why do males complete more suicides than females, even though females are more likely to attempt suicide? 

    • Gender paradox of suicidal behavior: 

    • Areas with lower prescription rates (antidepressants), the rates of suicide are higher 

    • If males are not going into doctors to get treatment, then this could be a potential explanation for why we see more suicides completions among males 

    Factors that predispose to suicide 

    • Personal characteristics 

    • Psychopathology 

    • History of prior suicide attempt 

    • Cognitive and personality (hopelessness & poor interpersonal problem-solving) 

    • Homosexuality 

    • Biological factors 

    • Family characteristics 

    • Family history of suicidal behavior 

    • Higher rates of parental psychopathology 

    • Non-intact families 

    • Impaired parent-child relationships 

    • Adverse life circumstances 

    • Stressful life events 

    • Childhood physical abuse 

    • Sexual abuse 

    • Contextual factors 

    .....read more
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    The end of adolescence - Universiteit Utrecht

    The end of adolescence - Universiteit Utrecht

    Lecture 12b the end of adolescence 

    When does adolescence end? 

    • In the past – criteria that have been used to mark entry into adulthood include: 

    • Events such as marriage, child-bearing 

    • Important responsibilities to provide, protect, and procreate – duties towards others 

    • Gender-specific criteria 

    • Average age of marriage in the Netherlands 1950-2018 

    • Shift in percentage who marry + older ages 

    • Average age of the mother at the birth of a child in NL in 2018 

    • 29,9. Age of marriage: 35 

    • Shift in society to say that we don't need to marry first to have children 

    • Demographic distinctions 

    • Median age of marriage and child birth is now much later than it was in the past 

    • Young people attend school and college longer than in the past 

    • In addition, more young people are going to college before starting work 

    • From jobs to career 

    Arnett's theory of emerging adulthood 

    • Influenced by theories of  

    • Erikson: prolonged adolescence 

    • Love, work, worldviews 

    • Levinson: novice phase 17-33 

    • Keniston: youth (role exploration) 

    • What is emerging adulthood? 

    • In Western cultures, could last from about 18 until the mid 20's 

    • A life period which is typically characterized by an ongoing exploration of, and experimentation with possible life directions 

    • Young people have left the dependency of childhood and adolescence, but have not entered the enduring responsibilities of adulthood 

    • Emerging: it is a process of becoming an adult 

    • In Western cultures 

    • Young people no longer consider marriage and other events (such as finishing school, getting a job, etc.) as criteria for adulthood 

    • They emphasize the capacity of the individual to stand alone as a self-sufficient person as the criterion for adulthood 

    Top 3 criteria defining adulthood 

    • Responsible behavior, accept one's responsibility 

    • Autonomous, independent decision making 

    • Financial independence 

    • Individualistic qualities of character 

    • Criteria like chronological age and role transitions ranked very low 

    5 aspects of emerging adulthood 

    • Age of identity exploration 

    • Trying out various possibilities, especially in love and work 

    • Difference between US and European educational system 

    • Us: university level: orientation where you can study different areas before you make a choice of your major 

    • European: more specialized, stronger connection to the work that you will be doing 

    • Difference between US and Southern Europe versus Nothern Europe in cohabitation (become smaller) 

    • Cohabitation more common in Northern Europe 

    .....read more
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