The 20th Congress of RSCANP,

Băile Felix, 18-21.09.2019

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20th RSCANP Congress
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The 42st National Conference of Child and Adolescent Neurology and Psychiatry and Allied Professions with international participation


Autor: Dana - Cristina Herţa Alina Ispas Alexandra Marc Marius Nicula Irina Pop
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The authors overview the developmental approach to adolescence, and also the current trends în the research of psychological, social and trans-cultural issues entailed by adolescence. The subject and the social environment form a cohesive, dynamic structure, hence the necessity of taking into account the role of family, peers, and cultural influences în understanding specific age-related problems în specific teenagers. The theoretical background of the issue în question has elicited many different approaches, from psychoanalytical concepts and descriptions to modern day anthropology, sociology and trans-cultural psychiatry. Nevertheless, one core concept appears to be common – the developmental task, defined as socially-relevant ability, required for adequate social functioning, common to all individuals and acquired at a certain age, în a specific, individual manner. Pointing out the developmental tasks that adolescents have to deal with, în order to fully develop towards the status of well-adjusted adults, may prove beneficial for the teenager, the family, but also for mental health experts and the school system, as well as all the parties involved în education, prevention, legislation, health care and assistance for this particular age group.



“The modem world needs people with a complex identity who are intellectually autonomous and prepared to cope with uncertainty who are able to tolerate ambiguity and not be driven by fear into a rigid single solution approach to problems, who are rational and can control their behaviour în the light of foreseen consequences, who are altruistic and enjoy doing for others, and who understand social forces and trends.”

Robert J. Havighurst


Adolescence is currently viewed as a process that involves major physical changes, expanding psychological and cognitive abilities, and social transformations shaped by the broader cultural and historical context. Ceasing to dwell on the somewhat expected, normal and necessary turmoil, marked emotional reactivity, volatile behavior, unpredictability, dramatic severing of family ties, and disruptions in the sense of self, more recently, authors emphasize that adolescence encompasses reordering, realignment, transformation, physical and cognitive development, relational change, psychological differentiation, interdependence, and greater self coherence. It is suggested that severe emotional disturbance or dramatic disruptions in family relationships and self-concepts actually occur in only about 10-20% of teenagers. (1)

Studies of normaladolescentdevelopment reveal (2):

  1. continuity and metamorphosis— moving forward toward maturity and reaching backward toward childhood for familiarity and grounding
  2. the role of historical, cultural, socioeconomic, and geographical context
  3. gender-specific features underlying certain processes (sexuality, sources of self-esteem, relationship needs, paths of separating from parents)
  4. the psychological impact of timing of physical development
  5. generic blueprints of development (instead of typical phases and behaviors) consisting of individual ways of adjustment to particular contexts and experiences
  6. the steering, directive powerof dialogue between teenager and total environment
  7. adultandpeerresponsetonewinterests, feelings and behaviors of adolescents plays an important role in shaping the environment of teenagers and, thus, the nature and quality of teenager-environment dialogue
  8. changes in thought processing patterns in adolescence:
  • formal or abstract thought
  • more efficient information-processing and decision-making strategies
  • enlarged knowledge base, short- and long-term memory, attention selectivity
  • multidimensional, abstract, relative rather than single-issue, concrete, absolute descriptions and conceptions of knowledge
  • integration of experiences, memories, inferences, historical facts, scenarios
  • emerging of moral categorizations and higher-order dimensions of the self
  • more complex understanding of causality and multileveled reality

Cognitive development în adolescence and the use of new thinking benefit academic pursuits but are not yet typical for everyday thinking, which is more influenced by psychological and affective pressures; they are shaped by personality, gender, culture, and social class, to create individual pathways for the process of building complex, highly personal, sometimes subjective or distorted views of self, others, and society, through

  • the ability to separate one’s thinking from that of others
  • enhanced capacity for perspective and empathy
  • entertaining of future or ideal possibilities, self-reflection and self-awareness
  • propensity to “what ifs” that generates inspiration or despair
  • complex emotional reactions to emerging thoughts of ideal people, worlds, self
  • extended periods of private introspection
  • self-consciousness leading to (false) assumptions about others, and to (inaccurate) application of new cognitive skills (3)

Actually, multiple and equally adaptive individual pathways for negotiating the biological, cognitive, psychological, and social transitions of adolescence can be observed, and longitudinal research shows more variability than conformity în development, which means that adolescence is not an unitary, predictable, typical process, with clear-cut phases and profiles. Multiple paths of adolescent ego development shape the meanings assigned to inner experiences and perceptions, that generates an extensive and flexible repertoire of responses to life experiences and facilitates balance of autonomy and involvement with others. (2) In adolescence, a person is male or female

Who am I?

Do people like me?

 Do I measure up? Am I normal?

Is my body all right?

Am I attractive? Am I smart?

Am I strong?


What do people say about me?

What am I doing în my life?

Who can I trust?

What lasts?

Where do I want to be?

Am I and will I be like my parents?

Am I în control?

What about me will change, what will

stay the same?


Can I meet my parents’


Am I too dependent on money?

Am I being true to myself?

Can I be happy?

Can I do what I really want to do?

Will I like my work?

Can I do good works?


Table 1: Common issues în adolescence

first and an adolescent second, so that timing, gender, match, and also adult and societal attitudes and expectations are crucial for the subjective perceptions of developmental experiences and socialization challenges. (4) The context of development entails the environmental frame that shapes

  • the individual developmental pathway of a teenager
  • the use of guidelines, resources and possibilities
  • the exposure to specific social factors
  • the sense, consequences, meaning of change

Certain context variables mediate development in adolescence, such as sex and gender, socioeconomic status, historical context, family framework (education, structure, parent-child dialogue), culture, race, ethnicity, religion, geographic location, community values, sexual orientation and practices, marginality. (2)


Living, from birth to death, is a process with several developmental stages – each stage with its own specific agenda. It is suggested that failure to complete these tasks leads to unhappiness, disapproval by society and problems in later stages, while successful completion of developmental tasks leads to happiness and underlies social learning for future stages. (4)

American researcher Robert J. Havighurst stated that the number of tasks in different age levels depends on the person and the society he lives in. Some tasks are common to all humans and rely on genetic factors (e.g. learning to crawl and walk), while others exist in different forms and degrees in different environments, as they depend on societal/ cultural elements (e.g. getting a job, finding a spouse). Havighurst added that biology,

1. Adjust to sexually maturing bodies and feelings.


Teens’ bodies as much as double în size and acquire sexual characteristics. Teens need to learn to manage the accompanying biological changes and sexual feelings and to engage în healthy sexual behaviors, which also includes establishing a sexual identity and developing the skills for romantic relationships.


2. Develop and apply a more cowmplex level of thinking skills.


Teens undergo dramatic changes în their way of thinking, allowing them to more effectively understand and coordinate abstract ideas, to think about possibilities, to try out hypotheses, to think ahead, to think about thinking and to construct philosophies.


3. Develop and apply a more complex level of perspective thinking.


Teens acquire a powerful new ability to understand human relationships. Having learned to “put themselves în another person’s shoes,” they take into account both their perspective and another person’s at the same time, and to use this new ability în solving relationship problems and conflicts


4. Develop and apply new coping skills în areas such as decision making, problem solving, and conflict resolution.


Teens are involved în acquiring new abilities to think about and plan for the future, to engage în more sophisticated strategies for decision making, problem solving, and conflict resolution, and to moderate their risk taking to serve goals rather than jeopardize them.


5. Identify meaningful moral standards, values, and belief systems.


Building on these changes and resulting skills, teens develop a more complex understanding of moral behavior and underlying principles of justice and care, by questioning beliefs from childhood and adopting more personally meaningful values, religious views, and belief systems to guide their decisions and behavior.


6. Understand and express more complex emotional experiences.


Also related to these changes, teens develop an ability to identify and communicate more complex emotions, to understand the emotions of others în more sophisticated ways, and to think about emotions în abstract ways.
7. Form friendships that are mutually close and supportive.


Although youngsters have friends throughout childhood, teens generally develop peer relationships that play much more powerful roles în providing support and connection în their lives by shifting from friendships based on shared interests and activities to those based on shared ideas and feelings,

with the development of mutual trust and understanding.


8. Establish key aspects of identity


Identity formation is a lifelong process, but crucial aspects of identity are typically forget at adolescence, including developing an identity that reflects a sense of individuality as well as connection to valued people and groups. Also, a positive identity around gender, physical attributes, sexuality and ethnicity is developed and, if appropriate, a sensitivity to the diversity of groups that make up society.


9. Meet the demands of increasingly mature roles and responsibilities.


Teens gradually take on roles that will be expected of them în adulthood, learning to acquire the skills and manage the multiple demands that will allow them to move into the labor market, as well as to meet expectations regarding commitment to family, community, and citizenship


10. Renegotiate relationships with parenting roles.


Although the task of adolescence has been described as “separating” from parents and caregivers, it is more widely seen now as a negotiation between adults and teens, working together towards a relationship change that balances autonomy and ongoing connections, depending în part on the family’s ethnic background.

Table 2. The ten developmental tasks în adolescence (4)


society and personal values as well, have an influence on identifying developmental tasks, and designed a biopsychosocial model in which biology is the first important issue, psychology comes second, and sociology last. However, he defined these issues through the cultural viewpoint of middle class America, which entails certain biases and limitations. (5)

Havighurst identified 3 sources of developmental tasks: (4)

  1. Tasks that arise from physical maturation: behaving in an acceptable manner towards opposite sex.
  2. Tasks that arise from personal values: choosing an occupation, figuring out one’s philosophical outlook.
  3. Tasks that have their source in the pressures of society: learning to be a responsible citizen.

There is a lot of speculation about the timing of these tasks. It is suggested that they are not supposed to be completed in a specific order. However, Havighurst mentioned that certain tasks continue for a lifetime, while others are critical for a certain stage, and failure of timing may result in difficulties with future tasks. (5)

3. Transcultural perspective on adolescence

Culture plays a pivotal role in shaping identity, values, beliefs, social roles and behaviors. However, there can be enormous diversity in any given culture – with a variety of ethnic, language and religious backgrounds. Therefore, ascribing a definitive set of cultural attributes, attitudes, values and practices to all people from a particular cultural background is highly misleading. (1)

Cultural values and norms regarding the central tasks of adolescence are subjected to considerable variations. Achievement of independence and individual identity are highly valued by some cultures, while others define a competent adolescent as someone who meets his/her obligations to their family. While in certain countries adolescence is regarded as a time of strengthening family bonds and taking on new roles and responsibilities within the family, teenagers from other communities are more restricted and closely monitored. Also, there are countries where traditional family roles have changed, which entails that adult roles which teenagers gradually take on are different from traditional communities. If dramatic social shifts occur, adolescents pick up the trends faster than their parents, therefore they may be torn between their family’s expectations – framed within values and customs of their ‘old’ culture, and the need to fit in with their peers who belong to the ‘new’ culture. Girls, in particular, may be subject to strict controls – especially if parents feel threatened by their exposure to the values of the new culture. (3)

Young people from mixed cultural backgrounds face the additional challenge of deciding about their ethnic identity, which can lead to an identity crisis as the young person attempts to work out their cultural affiliation, and potentially give rise to family conflicts generated by the fear of losing control of the adolescent. Non-Western cultures generally place less emphasis on the individual – the family and ethnic identity are valued above the attainment of an individual identity, consecutively shaping the development of the adolescent’s identity. The way in which adolescents resolve these ethnic identity conflicts has an important impact on their mental health. Those who manage to mix the fundamental elements of their original culture with emerging skills to adapt to the new one, appear to cope best. (1)

Puberty involves the most rapid and dramatic physical changes experienced by a person, and is subjected to great variability in time of onset, velocity of change and age of completion. The growth spurt occurs earlier in girls than in boys, and the experience of a changing body may be perceived as ‘out of control’. Young people’s behavior, needs, physical and psychosocial concerns, cognitive abilities and capacity for understanding choices,   making   decisions   and   giving informed consent, communication strategies, progression from one developmental stage to the next are very different and should be viewed from a developmental perspective. Age in itself does not define maturity and the multiple areas of adolescent development are not necessary synchronized. (2)

Cultural sensitivity is required in order to gain awareness on the wide range of diversity, both across and within cultures. We need to: (1)

  • understand that adolescents’ beliefs are shaped by their cultural background and values
  • be aware of the impact of the individual’s cultural background upon the developing identity
  • adopt a respectful and non-judgemental approach to differing cultural norms and practices
  • not label and make assumptions about the young person based on cultural stereotypes

4. Brief overview

Ayoung person’s experience of identifying withtheculturalvaluesofaparticularcommunity can be a major protective factor in promoting overall wellbeing. This sense of belonging, identity and support enables adolescents not only to survive hardships, traumas, and losses, but in fact to be strengthened by these experiences. A strong cultural identification enhances the adolescent’s resilience when faced with adverse experiences:

  • the conflict of identity between the dominant culture and the family’s culture
  • social isolation
  • adjustment to a new culture
  • exposure to war
  • the experience of being a refugee
  • separation from family
  • torture or trauma
  • language difficulties, racism and discrimination
  • post-traumatic stress

In a rapidly changing ‘global community’, a critical perspective on Havighurst’s concept of developmental task is necessary for a flexible and individualized assessment of adolescent development. However, we should keep in mind that certain steps will always remain as landmarks on the roadmap of the human being’s journey, and may be employed in the comprehensive assessment of any teenager by professionals all over the world.


  1. Bennett, D.L., Kang, M. Adolescence, in Oates K, Currow K, and Hu W. (2001) Child Health: a practical manual for general practice. Maclennan and Petty, Australia
  2. Cotton, N.S. (2000) Normal adolescence, in Sadock, B.J., Sadock, V.A. (Editors) Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, 7th edition, Lippincott Wlliams & Wilkins Publishers
  3. Semple D., Smyth R., Burns J., Darjee R., Mcintosh A. (2005) Oxford Handbook of Psychiatry, Oxford University Press, Oxford
  4. Simpson, A. Rae (2001) Raising Teens, A synthesis of research and a Foundation for Action, Harvard School of Public Health, 2001