1. ISLAMIC MEDICAL EDUCATION RESOURCES029912-YOUTH (SINN AL SHUDD)Lecture to 2nd year medical students, Kulliyah of Medicine, International Islamic University, Kuantan, Malaysia 11thDecember 1999OUTLINE1.0 DEFINITIONSA. Adolescence, Sinn Al MurahaqatB. Puberty, Buloogh:C. Youth, Shabaab:D. Legally Responsible Adult, MukallafE. Correlations: Biology, Intellect, And Emotions 2.0 YOUTHS IN THE QUR’AN and SUNNATA. ProphetsB. Righteous Youths (Pre-Islam)C. Righteous Youths (Companions) 3.0 THE ADOLESCENTA. Physical Changes In MalesB. Physical Changes In FemalesC. Other Indicators Of MaturityD. Cognitive And Behavioral ChangesE. Age At Puberty: 4.0 THE YOUNG ADULT (early adulthood)A. DefinitionB. Biological aspectsC. Social aspectsD. Psychological aspectsE. Intellectual/cognitive aspects 5.0 DISORDERS OF ADOLESCENCE and YOUTHA. Concept of transitionB. Delayed and precocious puberty:C. Growh anomaliesD. Adolescent behavioral problems:E. Youth problems: 1.0 DEFINITIONSA. ADOLESCENCE, sinn al murahaqatAdolescence is a period of transition from childhood to adulthood. It is rapid, complex, and difficult. Like all transitional events, it can go wrong. It involves adjustment to rapidly changing biological and psychological attributes. Adolescence is part of the period of life called teenage that is traditionally defined as ages 13-19 years. B. PUBERTY, BULOOGH:Adolescence is a more general term and is sometimes used to refer to puberty. Puberty is strictly used to refer to the period when gonads are sufficiently developed to allow reproduction to occur.Puberty is defined both biologically and legally. We are here concerned with the biological definition. The biological definition is linked to the ability to procreate. In males puberty is defined as the appearance of the first sperms. In females it is defined as the first menstruation. In both genders attainment of the age of 15 years automatically defines puberty even if the biological signs have not been seen. C. YOUTH, shabaab: The period of youth, shabaab, is that between puberty and the age of 40 years. It is the period of strength,sinn al shudd (6:152, 12:22, 17:34, 18:82, 22:5, 40:68, 46:15. Istiwa is a Qur’anic term that is used to refer to physical maturity, nudhj jasadi (28:14). It is achieved in the early period of youth. D. LEGALLY RESPONSIBLE ADULT, mukallafLegal majority is attained at puberty. Thenceforward persons are fully responsible under the law. They have full rights to handle personal and financial affairs. They are fully accountable and responsible for acts of commission or omission. E. CORRELATIONS: BIOLOGY, INTELLECT, and EMOTIONSPhysical growth may not correlate with emotional and intellectual development. The period of youth represents the pinnacle of physical development but often emotional and intellectual development lag behind. There is a lag of wisdom behind intelligence. Many problems of this period arise from this discordance. 2.0 YOUTHS IN THE QUR’AN and SUNNATA. PROPHETSMUHAMMAD:The prophet Muhammad a herdsman in Makka (KS 478). He used to meditate when he was out in the desert rearing his animals. He did not join in the fun and sin of youths in Makka (KS 490). He also never joined idol worship. He was so honest that he was nicknamed the trusted one, al amiin. He participated in the rebuilding of the kaaba and averted a civil war by his wisdom (KS 478). He was always modest. While building the kaaba he did not uncover his nakedness as did others while carrying stones (KS 477). He traveled to Syria to trade on behalf of Khadijah (KS 477). Impressed by his honesty, Khadijah offered to marry him (KS 477). While a young man the prophet participated in the hilf al fudhuul MUSA:Musa came to the defence of an Israelite who was fighting an Egyptian. In the process, Musa killed the Egyptian and fled to Madyan. He was very kind to 2 young women he found and eventually married one of them after working hard honestly, al qawiyyu al amiin, and fulfilling his contract with their father. ISMAIL:As a youth he agreed to be sacrificed in obedience to Allah’s command 37:101-111 YUSUF:Allah gave Yusuf wisdom as a youth 12:22. His beauty was fitnat 12:23, 12:31-32. Women wanted to tempt him into sexual corruption. He was imprisoned for his refusal to accept their desires 12:32-36, 12:42. He undertook dawah while in prison 12:36-40. Later his innocence was proved 12:51-53, 12:26-29, 12:35. He was skilled in dream interpretation 12:6, 12:21, 12:36, 12:4, 12:46-49, 12:100-101. He knew economics and agriculture 12:47-49. He was honest and knowledgeable 12:55. He was therefore given authority 12:54-56. He eventually was forgiving and generous towards his brothers who had mistreated him 12:89-92. He honored his parents when he was reunited with them 12:100. B. RIGHTEOUS YOUTHS (PRE-ISLAM)YOUTHS OF THE CAVE (AHL AL KAHF): 18: LUQMAN’S SON: 31:12-19 C. RIGHTEOUS YOUTHS (COMPANIONS)ALI IBN ABI TALIB ABDULLAH IBN ABBAS ABDULLAH IBN OMAR ABDULLAH IN AMRE BIN AL AAS ABDULLAH IBN AL ZUBAYR 3.0 THE ADOLESCENTA. PHYSICAL CHANGES IN MALESSpermatogenesis: In males puberty can be defined as the age when sperms start appearing (24:58-59). Spermatogenesis indicates attainment of reproductive maturity. Pubertal growth spurt: Secondary sexual characteristics: The male secondary sexual characteristics are testicular enlargement, penile enlargement, sexual hair growth, voice changes, muscle enlargement, spermache, regular frequent erections with ejaculation start by the age of 15 indicating full sexual maturity. These characteristics further enhance gender differentiation in preparation for adulthood. Growth of the beard is a very prominent male characteristic. It is recommended to let it grow (MB # 1997 p. 949). Behavioral changes: B. PHYSICAL CHANGES IN FEMALESTelarche (development of breasts) Puberchy (development of pubic hair) Menarche (1st menstrual period). Menarche is the legally-accepted definition of puberty.Secondary sexual characteristics: Female secondary sexual characteristics include breast development, sexual hair growth, increase in body fat. Other changes: changes in sensory organs, changes in functional organsBehavioral changes: Intellectual/psychological changes. Emotional changes: moodiness, depressive effects C. OTHER INDICATORS OF MATURITYThere are other indices of cognitive and physical maturity that can guide but can not legally define puberty. Indices of physical maturity such as dental age and skeletal age. Indicators of functional maturity such as reproductive age, behavioral age, and emotional age. Acquisition of abstract thinking and ability of responsible decision-making that considers the consequences of actions. The orphans’ intelligence is tested to see whether they are fit to be given their property (4:6). D. COGNITIVE and BEHAVIORAL CHANGESAdolescence is a time of tension and contradictions. The adolescent is physically an adult who could even start a family. He feels independent but can not live without dependence on parents. His bahavior is impulsive and he tries to rebel against childhood restrictions but is yet unsure of what roles to play: childhood or adult roles?Acquisition of abstract thinking gives the teenagers more powerful reasoning abilities and they feel very intelligent. They become intellectually arrogant reasoning things out and acting on erroneous conclusions. They are often wrong in their reasoning because they lack wisdom and experience. E. AGE AT PUBERTY:EARLIER FEMALE PUBERTYFemales experience an earlier pubertal spurt. VARIATION OF AVERAGE AGE AT PUBERTYThe age at puberty is declining in many industrialized countries. LEGAL DEFINITION OF PUBERTYThe age at puberty can be defined legally as attaining 15 years. The prophet did not allow Ibn Umar to go to war until he was 15 (MB # 1181 p 559). 4.0 THE YOUNG ADULT (early adulthood)A. DEFINITIONPhysical growth essentially stops at the age of 21. Then the period of young adulthood starts and ends at the age of 39. B. BIOLOGICAL ASPECTSThe period of young adulthood is characterized by optimal health status. It is a period of maximal energy. The person has overcome the problems of adolescent transition and has settled down to a permanent pattern of life that largely defines the future course of life. C. SOCIAL ASPECTSThe period of young adulthood is when the person starts a career and a family. It is a period of ambition. The leadership potential of young adults was emphasized by the prophet when he appointed Usamah Ibn Zayd to command an army that had some of the leading companions like Omar Ibn al Khattaab as ordinary soldiers. The prophet insisted that Usamah assume leadership even if there were murmurings of disapproval. D. PSYCHOLOGICAL ASPECTSThe period of young adulthood can also be a time of stress and tension. The young adult is trying to achieve career success while grappling with the problems of the spouse and the family. Competition with peers is acute. Despondency arises as some realize that they will never be able to achieve their ambitions and realize their full potential. INTELLECTUAL/COGNITIVE ASPECTSAt this stage of life, cognitive capacity is balanced with emotions and responsibility. There is a balance between idealism and pragmatism. It is also a time when religiosity is tested and many young adults have tenuous attachment to religion. 5.0 DISORDERS OF ADOLESCENCE and YOUTHCONCEPT OF TRANSITIONThe problems of teenagers and adolescents are problems of a rapid transition. Many of these problems did not exist in simpler agrarian societies in which introduction to adult roles started earlier and was slower and more gradual. The period of transition itself was slower; by 15 most males and females were already fully-functioning adult members of society. B. DELAYED and PRECOCIOUS PUBERTY:Three factors may lead to delayed puberty: hypothalamic-pituitary dysfunction, ovarian failure, and anatomical anomalies. Precocious puberty is defined as puberty below 8 years in girls and below 9 years in boys. It could lead to early sexual experience. C. GROWTH ANOMALIESThe anatomical anomalies include: imperforate hymen, testicular feminization, absent uterus and vagina. These anomalies cause stress and worry as comparisons are made with peers. D. ADOLESCENT BEHAVIORAL PROBLEMS:CAUSE OF ADOLESCENT PROBLEMS:discordance between biological maturity on one hand and psychological and emotional maturity on the other. Industrial society has also made the transition artificially longer than it should be. COPING WITH ADOLESCENCE:One of the practical solutions to the problems of adolescence is to follow Islamic guidelines and make the transition shorter while at the same time giving adult responsibilities and accountability earlier. The adolescent needs a lot of guidance (wasiyat al ghulam) (KS p. 122) E. YOUTH PROBLEMS:According to Abu A'ala Maududi youths are characterized by a lot of energy, open-mindedness, and commitment to whatever course of action they decide on. Often they may be committed to the wrong and end us misusing their youth energy. They will be questioned on the Last Day on how they employed their youth. © Professor Omar Hasan Kasule December 1999