Reciprocal effects of chronic illness or disability and adolescent development68–72
| Effects of chronic illness or disability on development | Effects of developmental issues on chronic illness or disability |
|---|---|
| Biological | Biologically |
| Delayed/impaired puberty | Increased caloric requirement for growth may negatively impact on disease parameters |
| Short stature | Pubertal hormones may impact on disease parameters (e.g. growth hormone impairs metabolic control in diabetes) |
| Reduced bone mass accretion | |
| Psychological | Poor adherence and poor disease control due to: |
| Infantilisation | Poorly developed abstract thinking and planning (reduced ability to plan and prepare using abstract concepts) |
| Adoption of sick role as personal identifier | Difficulty in imagining the future; self-concept as being “bullet proof” |
| Egocentricity persists into late adolescence | Rejection of medical professionals as part of separation from parents |
| Impaired development of sense of sexual or attractive self | Exploratory (risk taking) behaviours |
| Impaired development of cognitive functions and information processing | |
| Social | Associated health risk behaviours |
| Reduced independence at a time of when independence is normally developing | Chaotic eating habits may result in poor nutrition |
| Failure of peer relationships then intimate (couple) relationships | Smoking, alcohol and drug use often in excess of normal population rates |
| Social isolation | Sexual risk taking, possibly in view of realisation of limited life span |
| Educational failure and then vocational failure; failure of development of independent living ability |