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 Erikson’s 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 one’s 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 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 adolescent’s 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 physician’s instructions and maintain a …watchful eye over their child’s behaviour” (Seiffge-Krenke, 2009, p. 121). Some families have a pragmatic approach and perception of the adolescent’s chronic medical condition, whereas other families don’t. The adolescent’s 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 adolescent’s 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 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.