Adolescence: Contemporary Issues & Resources.

Depression Among Adolescents

Adolescent depression is a critical public health issue and concern. The association illustrates that close to 11 percent of youth encounter depression, and these events are linked to downstream negative results later in adolescence and even in adulthood (Auerbach, 2015). The most alarming aspect of depression among adolescents is that close three-quarters who experience it may attempt suicide in adulthood.

Depression among adolescents affects how they think, feel, and behave, leading to emotional, functional, and physical problems. While depression can occur at any moment in life, symptoms may differ between adolescents and adults (Rice et al., 2017). Signs and symptoms of depression among adolescents comprise changes in behavior and attitude that may cause significant distress and problems at home or school and social activities. Emotional changes may include feelings of sadness and frustrations and anger, feeling hopeless and empty, and being irritable or moody. Some may lose interest in and be in conflict with friends and have low self-esteem and experience worthlessness or guilt. In some instances, adolescents may contemplate suicidal thoughts.

Behavioral changes may include loss of energy and insomnia, as well as changes in appetite and use of drugs, among other substances. Social isolation and self-harm may also manifest alongside angry outbursts (Bernaras et al., 2019). Parents should understand the symptoms and signs of depression and seek relevant interventions through counseling and other therapies since depression is treatable.

A range of external stressors exacerbates depression among adolescents. For instance, adolescents experience depression when they fail to live to their expectations in their academic work, social presence, unhealthy lifestyles, peer pressure, and social media. Firstly, adolescents are frequently under pressure to excel academically to attain good grades by their parents and join reputable colleges and universities. Studies indicate that adolescents have poor time management skills that make it difficult for many to excel academically (Bernaras et al., 2019). The failure to excel in academics causes heightened stress levels. Secondly, external stress from conformity to social life and peer pressure exacerbates depression as teenagers want to make friends and social presence through different platforms, especially increased use of social networking sites like Facebook, Instagram, and Snapchat, among others (Auerbach, 2015). Teenagers may also find it difficult to maintain different social relationships because of a lack of effort and even social skills. Unhealthy lifestyle habits, like eating disorders, also lead to depression. Staying awake at night and consumption of unhealthy fast foods are building blocks of stress and depression.

Assessment Strategies to Screen Depression

The assessment strategies to screen depression are based on accepted and recommended tools that include the Diagnostic Statistical Manual (DSM-5) developed by the American Psychology Association (APA). Using the criteria in DSM-5, practitioners can assess symptoms and signs of depression among teenagers. Further, the American Medical Association’s Guidelines for Adolescent Preventive Services (GPS) recommend that primary providers should start screening depression at age 11 and continue each year after that (Bernaras et al., 2019). Again, professional organizations recommend that adolescents aged 12 to 18 years be screened for major depressive disorders.

Lack of resources, external stressors can impact the assessment strategies for the screening of adolescent depression. Studies show that close to 65% of adolescents with depression do not access critical services and resources to help treat their condition (Rice et al., 2017). The deployment of assessment strategies requires increased investment in mental health targeted to adolescents.

Additional Assessment Questions & Ethical Parameters

Assessment questionnaires are the most significant step in determining how depression taints adolescent mental health. Depression can lead to suicide and other adverse health effects. Depression has various signs, as mentioned. Additional assessment questions entail asking the role of parents and guardians in identifying and recognizing depression symptoms and reporting to the appropriate agencies. Ethical parameters on what to share with parents and guardians entail ensuring that the affected adolescents are not exposed since they are minors (Auerbach, 2015). Secondly, ethical issues may include the need to uphold the impacted adolescents’ privacy and confidentiality to provide adequate care.

Support Options

Adolescents experiencing depression have different support options, from family support to community and institutional-based support from mental health facilities. Having supportive friends is essential in encountering adolescents’ external stressors with depression (Zuckerbrot et al., 2018). Support options are also available through professional resources, which can help the adolescent cope with depression. Caregivers and parents who seek professional assistance from mental health experts like psychiatrists should understand that adolescents have the right to ensure that their information is not disclosed (Rice et al., 2017). Depressed adolescents can also find support systems through their communities, especially if they run mental health programs.

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Conclusion

Knowledge of contemporary issues that impact adolescents is essential and offers immense benefits for the youth, especially the physical and emotional aspects. It is essential to offer support during this critical stage as adolescents make the transition to adults. The transition can have several external stressors that may impact the mental health of adolescents. Therefore, using assessment tools and observation and external resources can be useful in providing an outlet for adolescents to deal with depression.

References

Auerbach, R. A. (2015). Depression in adolescents: Causes, correlates, and consequences.

American Psychological Association (APA). Retrieved from https://www.apa.org/science/about/psa/2015/11/depression-adolescents

Bernaras, E., Jaureguiza, J. & Garaigordobil, M. (2019). Child and Adolescent Depression: A

Review of Theories, Evaluation Instruments, Prevention Programs, and Treatments. Frontier Psychology. https://doi.org/10.3389/fpsyg.2019.00543

Rice, F., Eyre, O., Riglin, L. & Potter, R. (2017). Adolescent depression and treatment gap. The

Lancet Psychiatry, 4(2): 86-87.

Zuckerbrot, R. A., Cheung, A., Jensen, P. S., Stein, R. E. K., & Laraque, D. (2018).  Guidelines

for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics, 141(3) e20174081; DOI: https://doi.org/10.1542/peds.2017-4081

or Disease Control and prevention (CDC), child abuse and neglect is any act or series of acts of commission or omission by a parent, caregiver or another person in custodial role that results in harm, potential for harm or threat of harm to a child and it is preventable. Child abuse can occur in any age group usually the abusers are the nearest and dearest. Neglect, emotional, sexual and medical abuse are some of the abuses faced by infants. This age group is very prone to abuse because it is still very young and solely depends on the parents or caregiver and can not voice their concerns. Abusive head trauma , also known as Shaken head syndrome (SHS), is the worst form of abuse experienced by this population when a caregiver shakes the infant. The baby may experience trauma due to direct blow, when thrown to the ground or surfaces. This results in severe brain and neck injuries that may be irreversible and possibly death. Upon examination of the infant, lethargy or decreased muscle tone, poor feeding/suckling or vomiting for no cause, decreased level of consciousness or seizures are all cues to Abusive Head Trauma just to mention a few (Green S.Z,2018).

Several cultures today use folk remedies to treat various ailments. Moxibustion is the burning of rolled pieces of moxa herb (mugwort or Artemisia vulgaris) over the skin above acupuncture points and burns till start to feel pain. This is an Asian cultural practice for a variety of symptoms like fever and abdominal pain. The lesions from moxibustion look like a pattern of discrete, circular, target-like burns that maybe mistaken with cigarette burns from child abuse.

It is the nurses` duty to report any form of suspected child abuse. They are mandated reporters and should not assume that their colleagues will do the reporting. The supervisor is informed of any suspected case and law enforcement agents are engaged as well as the local county Department of Social Services: Child protection services.

References:

Child Abuse and Neglect Prevention

https://www.cdc.gov/violenceprevention/childabuseandneglect/index.html

Green S.Z. (2018) Health Assessment: Foundation For Effective Practice

https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/#/1

Cultural Practices-Suspected Child Abuse

hhtps://www.visualdx.com/visualdx/diagnosis/cultural+practices?diagnosisld=54451&moduleld=43

I agree that Children in the age group of birth to 1 year had the highest rate of victimization at 25.7 per 1,000 children of the same age in the national population. Most victims were from three races or ethnicities:6 White (43.5 percent), Hispanic (23.5 percent), and African American (20.9 percent). American Indian or Alaska Native children had the highest rates of victimization at 14.8 per 1,000 children in the population of the same race or ethnicity, and African American children had the second- highest rate at 13.8 per 1,000 children of the same race or ethnicity. Boys had a slightly higher child fatality rate than girls. The majority of children who died from maltreatment were one of three races or ethnicities8: White ,African-American or Hispanic .

Topic 2 DQ 1

Child abuse and maltreatment entail all types of physical, emotional, or sexual ill-treatment and negligence or exploitation, which causes or poses potential harm to a child’s health, development, and dignity. The intentional acts of abuse are usually perpetrated by an adult responsible for the child’s care (Gonzalez, Mirabal & McCall, 2020). Child abuse and maltreatment among preschool children is a major concern and occurs mostly in children who lack adequate care and protection from their parents, guardians, or relatives. Types of abuse commonly seen in preschool children include physical, emotional, and sexual abuse (Gonzalez et al., 2020). Warning signs of physical abuse in the preschool child include lacerations, bruises, cutaneous lesions, fractures, abrasions, burns, head trauma, dental trauma, acute abdomen, and ligature marks, scars, and injuries in multiple stages of healing.

Emotional abuse occurs in various forms, such as verbal abuse, rejection, criticizing, isolation, and ignoring children, which erodes a child’s self-esteem. Signs of emotional abuse include a child with a blank face, marked withdrawal, and lack of response to outward stimulation or painful procedures (Gonzalez et al., 2020). Forms of sexual abuse that commonly occur in preschool-age children include oral-genital and contact intercourse, incest, sexual assault, and pedophilia. Warning signs of sexual abuse include direct statements about sexual abuse and sexualized play or behavior (Gonzalez et al., 2020). The nurse should also consider probable abuse if a preschool child presents with sleep disturbances, appetite disturbances, depression, social withdrawal, anxiety, temper tantrums, aggression, impulsiveness, low self-esteem, and feelings of helplessness.

The nurse can misidentify cultural practices of health practices as child abuse, such as spooning, coining, salting, cupping, caida de mollera, and moxibustion. For instance, coining, a Vietnamese cultural health practice used to treat minor symptoms of fever, chills, and headache, results in patches, erythematous petechiae, and purpura on the skin (Killion, 2017). Moxibustion, an Asian practice, involves burning rolled pieces of the moxa herb on the skin and the herb burning until there is pain to manage fever and abdominal pain (Killion, 2017). The practice results in burns, which can be misinterpreted for physical abuse. It is essential that the nurse conducts a detailed cultural assessment to identify these cultural practices and inquire on alternative forms of treatment that have been used to alleviate the current symptoms.

In New Jersey, any individual having reasonable cause to believe that a child has been subjected to abuse should immediately report the information to the Division of Child Protection and Permanency (DCP&P). Child abuse reports must be made immediately by telephone. When reporting a suspected child abuse case, the nurse’s responsibilities include providing key information about the child and type of abuse. The information includes the child’s names, age, and addresses and the parent, guardian, or other individual having custody and control of the child. The nurse should also indicate the nature and extent of the child’s injuries, abuse or maltreatment, and any evidence of previous injuries, abuse, or maltreatment.

References

Gonzalez, D., Mirabal, A. B., & McCall, J. D. (2020). Child abuse and neglect. StatPearls [Internet].

Killion, C. M. (2017). Cultural Healing Practices that Mimic Child Abuse. Annals of Forensic Research, 4(2), 1042.

https://www.lsnjlaw.org/Family-Relationships/DYFS-Child-Welfare/Child-Abuse-Neglect/Pages/Reporting-Abuse-Neglect-of-Child.aspx