Mickey Ngo, S00150215

Discuss the impact of chronic medical conditions on adolescents (12-18yo) and identify

ways of promoting resilience or positive development.

Adolescence is a difficult time for individuals, according to Stage 5 of Eriksons

Psychosocial Development, this is a phase where individuals undergo identity difficulties. It

is a period where the individual is undergoing transition and development, the individual also

comes to terms with their new found sense of identity. In this stage the chronically ill

adolescent attempts to differentiate between personal identity and the illness they have, and

separate whether their condition is part of their identiy. (Vogel-Scibilia, McNulty, Baxter Et

al, 2009). This essay will explore the adversity adolescents with chronic medical conditions

must endure and overcome a series of obstacles in everyday mundane situations. This chronic

medical condition becomes even more hindrance in the everyday functioning of the

individual and for his or her family. However there are strategies that can be utilised to

promote resilience and positive development for the individual.

Adolescents with chronic medical conditions may have been affected cognitively,

such as their perception on the world or their self-concept. Individuals with a chronic medical

condition may have an altered perception of themself and hence result in them manifesting a

low self-esteem. Chronically ill adolescents may have subsequently increasing the degree of

separation between ones self-concept and reality (Gil, 2012), also known as incongruence.

The self-concept of chronically ill adolescents is impaired as opposed to those adolescents

without medical conditions, this hypothesis has been supported by a study conducted by

Seiffge-Krenke (2009) that found low self-esteem in adolescents suffering from diabetes. The

study found that the diabetic adolescents in the study had more depressive self-image than

healthy adolescents. It is clearly evident that adolescents who have chronic medical
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conditions have lower self-esteem or more negative self-concept than adolescents without

chronic illnesses.

Negative emotions can be interrelated with low self-esteem resulting from chronic

medical conditions. Adolescents who have chronically medical conditions are likely to suffer

from emotional problems. One consequence of negative emotions from chronic medical

conditions include suicidal thoughts which is quite common in adolescents, especially for

those suffering from epilepsy as it is also a risk factor for suicide (S Rosen, 2003). It was also

shown in a study that female adolescents with chronic conditions are at higher risk for

emotional distress and suicidal thoughts than non-chronically ill female adolescents (Suris,

Michaud, Viner 2005). Adolescents with chronic illnesses may as a result, display symptoms

of depression due to living with their medical condition. This hypothesis is supported by a

study conducted by Rohde (2011) who found that on average, adolescents with chronic

medical conditions had higher levels of depressive symptoms than healthy adolescents. The

study also concluded that signs of depression were higher in adolescents suffering from

chronic fatigue syndrome.

Not only does the chronic medical condition have an effect on adolescents

themselves, but their illness also takes a toll on their family. There is struggle within some

families to cope with the new processes to reduce emotional stress and allow the family to

adjust with the adolescents needs while others are more concerned with the stress cause by

the illness (Seiffge-Krenke, 2009). The aspect of an adolescent with a chronic condition

becomes a hindrance for the parents. The demands of managing a chronic illness and the

restrictions on lifestyle, for example an increase in dependence on the family for basic needs

(Suris, Michaud, Viner 2005). In the case of diabetes, the family must follow the

physicians instructions and maintain a watchful eye over their childs behaviour (Seiffge-
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Krenke, 2009, p. 121). Some families have a pragmatic approach and perception of the

adolescents chronic medical condition, whereas other families dont. The adolescents illness

thereby becomes a major source of stress for the entire family which may cause the family

members to adjust to a different lifestyle to adjust to the adolescents medical condition.

The behaviours of adolescents with chronic medical conditions is highly affected by

others, such as their peers. Another impact on adolescents suffering from chronic medical

conditions includes segregation from their peers to undergo special education, which may

affect the way these individuals are treated by their fellow students. According to Jackson

(2012) the behaviour of peers, parents and staff members can have a dramatic impact on the

academic results of students with chronic illnesses. Adolescents with chronic medical

conditions may also endure abuse from members of their peers due to the connotation

associated with chronic conditions. Adolescents with chronic conditions will be affected

academically as they will miss more school days due to their medical requirements, or due to

abuse from their peers. This statement is supported by the evidence from the studies of

adolescents conducted Kunz, Greenley, Mussatto (2013), which found that students with

chronic arthritis also indicate a higher school absence rate than the others.

When adolescents suffer from low self-esteem caused by their chronic medical

condition, as a result the individual is likely to develop low resiliency. Resilience is the

process reflecting relatively positive adaptions of adversity or trauma (Luthar, 2005, p. 1).

Adolescents with low resiliency could lead to bad decision making as a response to

significant sources of stress, therefore it is important for adolescents with chronic medical

conditions to build their resilience. According to Paperny (2011), when building resilience

the individual must be subjected to a positive environment where there is a strong

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relationship between the adolescent and family. Providing information is also important so

that the individual may be able to conduct themselves in a matter deemed as positive in the

face of adverse conditions.

As the individual develops, he or she may have succumbed to the aforementioned

suicidal ideation, developing depressive symptoms or negative self-concept. It is therefore

vital for adolescent with chronic medical conditions to have a positive development. One

strategy of promoting positive development is a peer mentoring program where the

adolescent is mentored by an older peer who also has a chronic illness. In a study involving

written survey responses conducted by The Leadership Adolescent Council (2013), the study

showed that the short term effect of the program can lead to elevated levels of confidence as

well as increased academic success. In an article about another peer support program by

Olsson, Boyce, Toumbourou, Et al. (2005), suggested that using a peer support program to

promote positive development achieved positive outcomes.

In summation, adolescents who suffer from chronic medical conditions may be

subjected to negative self-concept due their perception of the illness being part of their

identity. Adolescents living with a chronic medical condition may also be affected

emotionally, and display signs of depressive symptoms which may lead to suicidal thoughts.

However the adolescent is not the only one affected, the whole family may be involved as the

daily regime and lifestyle may need to be altered to suit the needs of the individual. This may

later lead to stress within the family, if they fail to cope with the adjustment. Conversely,

there are strategies put in place to promote resilience and positive development such as peer

mentoring programs set up in an attempt to promote positive development. It is

recommended, as supported by the evidence gathered in the studies that adolescents with

chronic medical conditions seek social interaction with others to develop positively.