This assignment will argue why it is of fundamental importance that workers in the health and social care sector understand research of the three stages of development experienced by teenagers, which are pre-puberty, puberty and adolescence, drawing upon relevant theories. It will also contain some biological, social and psychological explanations for their growth, with reference to the ‘Nature and Nurture’ debate. Reference will also be made to two mental health conditions teenagers may face: Post-Traumatic Stress Disorder and Schizophrenia, examining how each of them affect the behaviour and day to day life of a sufferer.

Pre-puberty, puberty and adolescence are the stages of development experienced throughout the ‘teenage’ years. This section will not contain when each are experienced as they vary for different people – some develop at quite a young age whereas others may do so at a slightly older age. It should be mentioned, however, that NHS (2016) [online] warns that if puberty is experienced prior to the age of eight or after fourteen then they should see a doctor in case it is due to something more serious.

The pre-puberty period is simply the last few years one has prior to going through puberty. It is in this time that children are pressured to meet certain ‘standards’ through their schoolwork and examinations, and should they be successful they will develop a strong self-esteem, and if not, they will not (Hendry et al., 2012 [online]). This may be a factor for explaining why some children rebel against adults with power (teachers and parents), as they are feeling worthless, and is not helped by the fact they have little control in what they do. They may envy other siblings for getting attention from parents, which links to Bowlby’s (1973) Attachment Theory, which is touched upon further in the essay. The NHS (2016 [online]) inform how sweating more, pubic hair and getting acne can be signs of puberty regardless of gender. Breasts enlarging and periods are specifically encountered by girls whilst boys’ voices break and they produce sperm (NHS, 2016) [online], and these changes do not occur all at once (Cobb, 2010). The last stage is adolescence, which may be when maturity kicks in, however it is difficult to distinguish this stage from the one prior due to it having so many similarities and because it happens so suddenly.

‘Nature’ understands that genes help determine what makes someone who they are, whereas the ‘Nurture’ argument claims our surroundings have an impact (Simply Psychology, 2017 [online]). An example of the debate for ‘nature’ would be Noam Chomsky (1965), who believed language is innate, whilst Skinner (1957), who thought of language as being learnt through imitation, would be in favour of ‘nurture’ (Simply Psychology, 2017 [online]).

Biological rationalizations for teenage development and behaviour include things being passed down genetically from parents to their offspring, which may include illnesses, eye colour (NHS, 2016 [online]), and possibly even intelligence. King’s College London (2015 [online]) reveal that the genes we inherit could explain educational achievement. This strongly implies that the ‘nature’ argument has validity for the way young people grow and develop as human beings, though Kan et al (2013 [online]) recognise that it is debatable whether one (nature/nurture) has more of an influence than the other.

The Collins English Dictionary defines a hormone as being ‘a chemical, usually occurring naturally in your body that makes an organ of your body do something’. One of the many hormones that affect adolescents is the growth hormone (GH), which is made by the pituitary gland (which is manipulated by the hypothalamus in the brain) (Luck, 2014 [online]). NHS (2017 [online]) educates readers how having substantial hands and feet, deep voice and joint pain are all indicators you may have acromegaly, which is caused by excess of growth hormone and can lead to further health issues such as Type 2 Diabetes without early intervention. Despite this evidence, Luck (2014 [online]) declares ‘genes do not determine characteristics’ and instead thinks we should focus on social factors like diet. This does not correlate with the research undertaken by Akaltun et al. (2018 [online]), though. They found that a lack of GH resulted in participants having anxiety disorders, showing that the right amount of it is essential to the growth and development of adolescents, therefore supporting the aforementioned ‘Nature’ argument. This evidence proves that biology should not be ignored when examining human growth and development.

Erikson theorised that there are eight stages humans experience at different moments of their lives. Our personalities adapt in a specific sequence, one after the other, which is named the epigenetic principle, and by passing these stages you gain positive attributes (Macleod, 2018 [online]). Stages 4, 5 and 6 are the ones most relevant to adolescents since they are supposed to occur during those years. Stage 4 is ‘Industry vs. Inferiority’, stage 5 is ‘Identity vs. Confusion’ whilst ‘Intimacy vs. Isolation’ is stage 6 (Knight, 2016: 1050). Stage 4, ‘Industry vs. Inferiority’, is normally undergone during childhood by about the age of eleven, and if successful the person gains competence (Knight, 2016:1050 [online]). At Stage 5, which is experienced during the teenage years, is Identity vs. Role Confusion, where the individual identifies what makes them who they are. Accomplishing this step means that they then acquire fidelity (Dunkel et al., 2017:59 [online]), which could be argued that those who cheat the benefits system do so as they have not passed this vital stage. The sixth stage, labelled ‘Intimacy vs. Isolation’, makes one possess the asset love should they establish loving bonds and relationships with others, otherwise it can lead to promiscuity (Knight, 2016:1050 [online]). A strength of Ego Development is highlighted by Hamachek (1998 [online]) is that it considers the biological, social and psychological occurrences that shape the way in which we develop. A limitation Hamachek (1998 [online]) found with the theory is that it is quite ambiguous regarding what happens when.

Environment and socio-economic status have a big influence on how one progresses through life. Many understand ‘social class’ to be an abstract concept which makes identifying which category you belong in problematic. Health and social care workers must apprehend there will be residential areas that go against the expected stereotype people perceive them to have as a consequence of how they (e.g. social housing estates) are portrayed in the media but overall, less privileged areas tend to be viewed as more vulnerable than a more middle-class area would be viewed. Pino et al. (2018 [online]) share this view, identifying a correlation between social class and mental health. They disclose that being in the working class makes you more susceptible to abysmal mental health disorders like depression and anxiety, a reason of which being education (Pino et al., 2018 [online]), perhaps if they are not doing so well due to not being able to afford things like study books, school trips and tutors, as well as socialisation having an impact. This evidence surrounding education is further authenticated by a study by University College London and Kings College London did, as reported by reputable broadsheet newspaper The Guardian (2006), reinforcing how the social class of an adolescent contributes to determining the kind of results they would receive in school. As a support worker you should realise how environments shape people in life in terms of details of employment and higher education, helping that person get the best future possible regardless of their social status.

Bowlby (1973) believed that attachment theory, which looks at the bonds we have with parents and caregivers, has the greatest impact on one’s development, and should an adolescent acquire negative relationships then they could have a damaging effect on them psychologically (Marmarosh et al, 2013 [online]). Konishi et al. (2014 [online]) explain people develop insecure attachments when they receive negative treatment from caregivers, which Bowlby (1973) alleged could lead to dysfunctional anger. Childhood experiences in relation to attachment may also be a contributor to people being diagnosed with mental health problems (Mikulincer et al., 2012:11-15 [online]) This evidence helps explain why some adolescents rebel against their parents/guardians – it could possibly be due to vulnerable relationships. Broberg (2001 [online]) voices that data obtained by Wallis and Steele is confirmation that research into psychology is very useful and has a lot more to add, thus should be continued to look into.

Post-Traumatic Stress Disorder (PTSD) is a mental health condition which is believed to have affected, in the last year alone, 3.6% of people around the world, according to The World Health Organisation (WHO) (2018 [online]), and as stated by Danielson et al (2016 [online]), almost half of young people who are witnesses of traumatic incidents ‘develop clinically elevated posttraumatic stress disorder’. It is described as a type of ‘anxiety disorder’ by the National Health Service (NHS, 2018 [online]) caused by one experiencing something of a distressing nature.

Symptoms of PTSD include “re-experiencing” (NHS, 2018 [online]), for example having constant flashbacks and nightmares relating to a particular incident that they have endured, with the nightmares being a factor contributing toward developing insomnia (NHS, 2018 [online]), which is struggling to go to sleep. Anxiety and anger are emotions the person with PTSD may feel (Mind, 2018 [online]), and they may also avoid anything that brings back unpleasant memories about the trauma, as well as have issues trusting people (Mind, 2018 [online]). Mind (2018 [online]) demonstrates how detrimental the condition is to somebody from a social viewpoint, as it may result in people having difficulty keeping a job, having good relationships and relishing in hobbies.

The sort of occurrences that an adolescent can have that leads to PTSD could be: that they were victim to violent or sexual crime; bullying and car accidents (Mind, 2018 [online]). Mind (2018 [online]) goes on to inform how some people are more at risk of being diagnosed with the condition than others, including if you have an existing experience of depression and anxiety and not feeling you have much of a support group of family or friends. Danielson et al. (2016 [online]) expresses how there are further factors that add to the chance of someone getting PTSD, such as their gender, social status and mental wellbeing prior to the trauma. This is evidence supporting the ‘nurture’ argument – that our environment plays a part in determining our behaviour and development. Despite believing that our surroundings can provide a negative effect on our mental wellbeing, as well as PTSD resulting in the sufferer choosing to make poor choices in life, it does not excuse criminal activity (Psychology Today, 2010 [online]). It is therefore essential that health and social care workers look at other explanations for why a criminal has done the things they have done, rather than blame the condition.

We can examine news stories and case studies that relate to PTSD, which fifty-two per cent of survivors of the Jupiter cruise ship (which sank), acquired (Yule, 2001:507 [online]). Crane et al (2005 [online]) describes how data given by parents of traumatised adolescents can be unreliable, as often parents may miscalculate how damaging the incident actually was for their son or daughter. This therefore validates that researchers should take more of a person-centred approach when assessing traumatised teenagers, ensuring they take into account how the individual feels regarding the incident they were involved in.

Psychological therapies normally used to treat PTSD are cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR) and group therapy, all of which are recommended by the NHS (2018 [online]). CBT is a talking therapy aimed at helping people identify what effects their thoughts have on their behaviour, and whether their beliefs are rational (VeryWellMind, 2018 [online]), aiding them to look at things from another angle. EMDR consists of the traumatised person remembering parts of the incident/s whilst making eye movements (Healthline, 2017 [online]). Finally, group therapy gives PTSD sufferers the opportunity to meet in a group and help tackle their illness together, all the time facilitating their issues surrounding trust and their nerves (Levi et al., 2017:1247 [online]). Social support is having people in your life, be it family, friends or professionals such as counsellors, who you can talk to regarding how you are feeling about the trauma you have faced, providing assistance through a variety of different forms – emotionally, informationally and practically, making the vulnerable person feel loved and a valued member of the community. Pinto et al (2017 [online]) argue that social support is not an operative form of treatment for adolescents due to reasons including that teenagers tend to have more chance of being involved in unsafe actions than younger children or older people (Nooner et al, 2012 [online]). This is in contrast to the opinions of Cherry (Very Well Mind, 2018 [online]), who believes that whilst social support may not work for everybody, it is a form of support that workers in the profession should put in practice for all service users as, ultimately, it helps people deal with stress in a much more productive manner than otherwise.

Schizophrenia is a chronic (ongoing) disease directly affecting over twenty-one million people out of the worldwide population (WHO, 2018 [online]), often during their adolescent years (Andreasen, 1995:477 [online]). It affects somebody in such a destructive way, altering the most unpretentious of things – mainly the way they recognise reality, and subsequently unfortunately deleteriously impacting how they act (WebMD, 2018 [online]).

It has a range of symptoms one with the condition may face, including so-called ‘positive symptoms’, explained by NHS (2016 [online]) as a change in behaviour or thoughts, like experiencing hallucinations (seeing, hearing, smelling, tasting or feeling things that are not real) and believing things that would be considered delusional to those free of the illness, for example fearing your neighbours are plotting to murder you despite having no evidence. A common example of an irrational belief schizophrenics may have is thinking that somebody has taken over their body (Mental Health Foundation, 2018 [online]). These positive symptoms can result in the person acting in a stressed manner and not in a way they would should they not be schizophrenic. The symptoms categorised as ‘negative’ are having a ‘lack of function’ (NHS, 2018 [online]), for example experiencing difficulties focussing and acquiring different sleep patterns (NHS, 2018 [online]), which can unfortunately be mistaken as emergence of hormones during adolescence. Helgeland and Svenn (2005 [online]) add that further indications of schizophrenia are having a low degree of intelligence and a deferred advancement in terms of language, adding to a dispirited quality of life.

Mind (2017 [online]) addresses that whilst the origin of the condition is unknown, there have been researchers examining it, with hectic life events such as being the victim of abuse thought of as a potential stimulate, with NHS (2018 [online]) enlightening that cannabis use could also play a part for someone more vulnerable. Evidence proposes that schizophrenia can also be passed genetically (NHS, 2018 [online]). All of these findings advocate that the cause can be nature or nurture, or a combination of the two, representing the prominence of both theories.

Anti-psychotics are a form of medication used to treat schizophrenia that obstruct ‘the effect of the chemical dopamine’ (NHS, 2016 [online]) , however Mind (2016 [online]) notes that side effects can include problems hormonally, weight gain and even feeling suicidal, which WebMD (2018 [online]) declares is more likely to be experienced by a male under the age of thirty with schizophrenia. Cognitive Behavioural Therapy is another option that could be of help, which lets the service user talk about their thoughts and feelings to a professional with the intention of changing them and perhaps consequently changing their behaviour (NHS, 2016 [online]).

In light of all this evidence, it would be deemed reasonable to contend that both nature and nurture play a part in an adolescent’s development throughout their entire life – from before they are at the pre-puberty stage and after being at adolescence: genes can have an input, as can social class and psychological components. With regard to one of the conditions spoken about previously, PTSD, that would be mainly, if not completely, ‘nurture’ as it is the traumatic experiences one has to endure that triggers the ailment, though there are other illnesses that ‘nature’ would apply to more if passed on by genetics.

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