Introduction

The field of adolescent medicine began in 1952 when internist J.R. Gallagher established the first adolescent unit to ensure a physician's tendency to consider his or her patient and not just focus upon disease alone (3). Unlike with children, the developmental characteristics of adolescents have long been neglected—misleadingly, since adolescence differs in many ways from adulthood, too. The most prominent characteristic of adolescence is the occurrence of multiple transitions (2) ranging from biological to psychological and social processes, all of which are strongly interrelated. Starting with activities of the hormonal regulatory systems, puberty is characterized by rapid growth in height and weight, changes in body composition and tissues, and the acquisition of primary and secondary sex characteristics (see Chapter 3) (4). In addition to these very profound biological transformations, the young person also has to face a multitude of additional psychosocial adaptations and transformations (see "Developmental Issues and Chronic Illness"). These are labeled normative stresses since everybody has to cope with them more or less at the same time (5, 6). Not surprisingly, coping with normative stresses may severely be affected by non-normative stresses, such as a chronic illness: "an adolescent without any significant health problems can have a difficult enough time coping with all these changes, which are occurring more or less concurrently. Consider the impact of a chronic health disorder on one or more of these components of development: the effect can be devastating" (3).

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