Chapter 4. Assessing Adolescents

Steven P. Cuffe, M.D.
DOI: 10.1176/appi.books.9781585623921.452190



The psychiatric assessment of adolescents is more similar to assessment of adults than is the assessment of younger children. Adolescents are able to give historical information, verbalize feelings, be introspective, and many are able to think abstractly. However, clinicians assessing adolescents should be aware that adolescents are not just younger adults. Adolescents live in a complex web of interdependent relationships within their family, peer group, school, agencies (e.g., social services, juvenile justice), and broader community and cultural groups. The assessment of adults typically relies almost solely on that adult's report of symptoms and problems. To do this with adolescents would be a grave mistake. Developmental considerations are of critical importance in the assessment of adolescents. The brain continues to develop into the early 20s, especially the areas involved in executive functions such as inhibition, impulse control, and critical decision making (see for example, Sowell et al. 2001). Developmental immaturity of the brain places adolescents at much higher risk for multiple problems, including violence and aggression, substance abuse, motor vehicle accidents, and risky sexual behavior.

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FIGURE 4–1. Adolescent interview.Source. Adapted from Shea SC (ed): Psychiatric Interviewing: The Art of Understanding. Philadelphia, PA, W. B. Saunders, 1988, p. 8.
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TABLE 4–1. Elements of a comprehensive assessment
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TABLE 4–2. Elements of data collection during the adolescent interview
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TABLE 4–3. Elements of the mental status examination
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TABLE 4–4. Elements of data collection from parents


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Which of the following statements concerning the assessment of adolescents is true?
In the initial assessment of an adolescent, which of the following strategies is usually most productive?
What information obtained from adolescents should be shared with the parents?
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