Title: Psychological and behavioural concerns
Course: Adolescent and Youth Reproductive Health - Ethiopia (Full)

Psychological and behavioural concerns

As children grow up they have concerns about their social relationships. They worry about the way others see and judge them and they often have doubts about their own self-worth. These feelings can become very strong during adolescence. These concerns, in turn, have a significant influence on sexual decision-making and reproductive health.

What might these concerns be?

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Adolescents want to be accepted by their peer group and they want to be liked. So they will be concerned to behave in a way that is admired by the rest of the group. They will worry over their appearance and their speech, often feeling unsure that what they say and do is appropriate. Their feelings toward the opposite sex will be changing in a way that most find confusing.

There are a number of important issues that emerge during the adolescent period. You will probably have experienced these yourself to a greater or lesser extent so will be in a good position to be able to help younger people understand their confused feelings. Letting them talk to you and just listening in a non-judgemental way can, in itself, be a tremendous help to them. It can be a relief to them to hear from you that their feelings are not abnormal.

The following list explains some of the areas where adolescents can feel confused.

Peer relationships and peer pressure. Adolescents develop very close relationships with their peers, conforming to language, dress and customs. This helps them feel safe and secure and gives them a sense of belonging to a large group. Given the significance of peer influence, this power can sway adolescents and young people toward greater or lesser risk taking. For example, studies show that adolescents and young people tend to match their sexual behaviour, including timing of sexual debut and use of contraceptives, to what they perceive their peers are doing. Peer pressure, combined with gender inequities within a sexual relationship, can mean that males have undue power to dictate sexual decisions to females.

Relationships with parents and other adults. During adolescence relationships with parents become more confrontational as the young person tests limits and moves toward greater independence. At the same time, parents have significant influence over, and responsibility for, adolescents. Parents or other caring adults tend to strengthen adolescents' resilience and flexibility and their ability to avoid risk-taking behaviour. Hence, when you get the opportunity, you can influence the family by encouraging communication between parents and their adolescent offspring.

Gender roles. Although boys and girls, worldwide, are treated differently from birth onward, it is during adolescence that gender role differentiation intensifies. More often than not, boys achieve more autonomy, mobility, and power, whereas girls tend to get fewer of these privileges and opportunities. Importantly, boys' power relative to girls' translates into dominance in sexual decision-making and expression, often leaving girls unable to fully assert their preferences and rights to protect their health.

Self-esteem. Self-esteem is the ability to feel confidence in, and respect for, oneself. It is a feeling of personal competence and self-worth. While self-esteem involves feelings about oneself, it develops to a great extent from interactions with family, friends and social circumstances throughout life. Self-esteem can be challenged during adolescence by rapid physical and social changes and the development of one's own values and beliefs. Yet self-esteem is critically important at this stage in life.

Take a moment to think about why this might be so and what role adults might have.

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Specifically for reproductive health, self-esteem influences how young people make judgements about relationships, sex and sexual responsibility. Adults can help young people to strengthen their self-esteem by showing them respect and by demonstrating confidence in these young people's abilities.