Adolescents With HIV: Attachment, Depression, and Adherence By Er ...

Often, adolescents want to do things their own way or think about things in their own way, which motivates them to question the authority of doctors and caregivers. Physicians and nurses represent authority figures, and adolescents take a certain pride or joy in not doing what the doctor or nurse tells them to do (Elliott, 2001). Frequently, adolescents reject parental and authoritative dictates, such as taking medicines, by adopting opposing viewpoints and behaviors in an effort to establish their autonomy (Elliott; Rothenberg).

Furthermore, taking risks is a normal facet of the individuation and separation process. Feelings of grandiosity and omnipotence frequently fuel risk-taking behaviors. These feelings also are consistent with the denial of mortality (Rothenberg, 1990). An exaggerated sense of immortality allows adolescents to feel invincible, and consequently, to be less likely to take their medications (Elliott, 2001).

Peer influences and peer acceptance become critically important as adolescents move away from the family. A feeling of likeness bolsters self-esteem and self-confidence, so adolescents become slavishly conformist to their peers and seek constant approval. They feel compelled to connect with their peers, to join groups, and to participate in group activities (Rothenberg, 1990). Often they spend hours on the phone or on the computer fostering this connection. The odds are good, however, that members of their peer group, especially the ones who tend to be most admired, do not require medication everyday. Constrained by daily multiple doses of heavy medicines with unpleasant side effects, adolescents infected with HIV must follow a different routine. Quite often they choose fitting in with their peers over taking medicines (Elliott, 2001). Taking medications means having an understanding of oneself as a patient, and thus, dependent. This self-identification is in direct conflict with a normal adolescent’s struggle for independence.