Role of Family and

Social Environment as
Influencing Factors of
Adolescent Disorders

Djauhar Ismail
Department of Child Health
Faculty of Medicine
Gadjah Mada University
 Adolescent
►A time of exploration and growth
► Establishes competence and confidence
► Experimentation in a potentially hazardous
contect  jeopadize the adolescent’s future
► Risk-taking behavior
Family Factors :
1. Family social support
2. Feeling valued by family members Healthy families

3. Family cohesion
1. Family social support (parents and/or sibling):
1. Provide advice
2. Act as confidants
2. Feeling valued by family :
perceptionis of being valued - important member
- a disappoinment
to my family
3. Family cohesion - very close to each other
- family togetherness
Risk-taking behavior  negative health
related consequences :
► Sexual activity
► Substance use (tobacco, alcohol and other drug –
AOD)
► Unintentional injury
Negative Consequence of Substance
Use
► Academic failure
► Addiction
► Curtailed employment opportunities
► AIDS
► Sexually Transmitted Diseases (STDs)
► Sexual activity :
 Unintended pregnancy
 STDs

► Injury risk behavior

 Permanent disability
 Death

Co-variable depending on age, gender, and

ethnicity or race
 The Biopsychosocial Model

► Factors :
 Biological
 Psychological
 Social

► Biological : ► Psychological :
 Hormonal effects  Self esteem
 Genetic  Sensation seeking
 Cognitive
 Affective states
► Social Variables :
 Role of peers, parents and school play
 Family structur
 Communication
 Emotional closeness
 Accepted norms
Normal Adolescent Development
► Increasing independence, autonomy from family
► Greater peer affiliation and importance
► Sexual awareness
► Identity formation
► Physiologic maturation
 Individual Risk-Taking Behaviors
Unintentional injury :
► Motor vehicles
► Motorcycles
► Bicycles
► Drowning
► Firearms
 Sexual Behavior
► Heterosexual sexual activity
► Homosexual sexual activity
► Contraception
 Tobacco, Alcohol, Substance Use

Tobacco use :
► Almost preventable cause of death
► Majority began smoking before 18 years of
age
► Begin at younger age, become heavier
smokers
► Increased risk of smoking attributable illness
Alcohol - implicated in death from :
► Motor vehicle accidents
► Drowning
► Fire related mortalities
► Fatal falls
 Factors Associated with
Individual Risk-Taking Behavior
► Gender
► Age
► Socio-economic status and ethnicity
► Family structure and function
► Peers
► School academic aspirations
► Religion
► Psychological factors
► Biological factors
 Consequences
► Unintended pregnancy
► STDs
► School failure
► Disability
► Premature death
 Conclusion
► Risk-taking behavior  most serious threat to
lives and health of adolescents
► Premature sexual activity  unintended
pregnancy and STDs including AIDS
► Substance use  school failure, early sexual
debut, increased rates of motor-vehicle and other
injury-related fatalities
► Injury-related behaviors  disability and death