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Adolescent Crisis: Challenge for Patient, Parent, and Internist

DEREK MILLER, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Derek Miller, M.D., Neuropsychiatric Institute, 1405 E. Ann St., Ann Arbor, MI 48104.


Ann Arbor, Michigan


Ann Intern Med. 1973;79(3):435-440. doi:10.7326/0003-4819-79-3-435
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The physiological crisis of puberty and adolescence, historically attenuated by environmental supports, is now reinforced by societal changes. A major pressure on adolescents is the loss of the extended family, with its consequent social isolation, especially produced by social mobility. Psychological maturation is difficult if adolescents do not have meaningful emotional attachments to adults who are not their parents, as well as to a stable peer group. Educational and care delivery systems could help. Particular problems have been created for the present generation of teenagers by changes in child rearing practices, the confusion of roles among parents, and the passivity induced by television watching. Problems in the school system are reinforced by an abrupt mix of social class and ethnic groups. The implication of adolescent stress in physical illness and its treatment, as well as the effect of syndromes such as epilepsy and diabetes on maturation, are reviewed.

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