Valerie F. Reyna and Frank Farley

1. Risk and Rationality in Adolescent Decision Making:Implications for Theory, Practice, and Public Policy Valerie F. Reyna and Frank Farley http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

2. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

3. CONTENTS Volume 7 Number 1 September 2006 • 2 Introduction • 4 Background and Perspectives • 7 Significance of the Problem • 16 Explanatory Models of Adolescent Risk Taking • 24 Key Findings: Description • 29 Developmental Differences in Judgment and Decision Making • 33 General Discussion: Implications of Data and Development for Risk Reduction and Avoidance http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

4. Importance: Social, Health, and Economic • Life-threatening risks • Crime, smoking, drug use, reckless driving, binge drinking, eating disorders and many others • Debut during adolescence and young adulthood • Enormous toll in disease, injury, human suffering and associated economic costs http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

5. Males and females 16-20 are (at least) 2X as likely to be in car accidents than drivers 20-50. • Auto accidents are the leading cause of death among 15- to 20-year-olds, and 31% of those killed in 2003 had been drinking. • 3 million adolescents contract sexually transmitted diseases every year. • > 50% all new cases of HIV infection in U.S. occur in people younger than 25 (2 infected every hour). • AIDS is the 7th leading cause of death among 13- to 24-year-olds. • 40% of adult alcoholics report having their first drinking problems between 15 and 19. • Pathological or problem gambling is found in 10%-14% of adolescents, and gambling typically begins by age 12. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

6. Programs to Prevent or Change Risky Behaviors Must… • Normative • What behaviors, ideally, should the program foster? • Descriptive • How are adolescents making decisions in the absence of the program? • Prescriptive • Which practices can realistically move adolescent decisions closer to the normative ideal? http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

7. Normative Ideals: What is Rational or Adaptive is Not So Simple • Evolutionary theories have serious shortcomings. • Behaviors that promote positive physical and mental health outcomes in modern society ≠ those selected for by evolution (e.g., early procreation). • Behavioral decision making and decision analysis have serious shortcomings. • Economic models and psychological theories say rational = reach our goals. Adolescents’ goals are more likely to maximize immediate pleasure, and strict decision analysis implies that many kinds of unhealthy behavior, such as drinking and drug use, would be deemed rational. • Data show developmental changes in goals; important for policy to promote positive long-term outcomes rather than adolescents’ short-term goals. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

8. The Future Self http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

9. Descriptive Reality • In principle, capable of rational decision making. • In practice…developmental differences. • Heat of passion • Presence of peers • Behavioral inhibition required (impulsivity) • Brain maturation incomplete • However, more pruning occurs and less logical thinking as the brain matures • Thinking process: Trading off vs. categorical gist http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

10. Decision Processes Develop • Literature shows perceptions of risks and benefits predict risk taking in adolescence. • Rational calculation • Do not believe that they are invulnerable! • Overestimate key risks (lung cancer from smoking; HIV risk) • But nevertheless take risks because benefits outweigh risks http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

11. Learning from negative outcomes increases with age...the school of hard knocks packs a bigger punch http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

12. Major Theories: Two Types • Reasoned: Deliberate trading off of risks and benefits • Theory of reasoned action; theory of planned behavior; health belief model; behavioral decision making framework; etc. • Reactive: Non-deliberative reaction to gists or prototypes • Fuzzy-trace theory • Prototype-willingness model http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

13. Laboratory and Public Health Research: Converging Evidence • Adolescents are more logical than adults. • Quantitatively trade off risks and benefits. • Russian roulette is justified if payoff large enough. • Adults avoid risks because of increase in gist processing. • Process risk information qualitatively (often categorically). • Example: Framing and other biases increase from childhood to adulthood. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

14. Risk Taking Declines http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

15. Risk Sensitivity Increases http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

16. If Risk Preference Decreases and Risk Sensitivity Increases… • Why do teenagers take more risks than younger kids? • Greater access to risks: Opportunity http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

17. Thinning of Gray Matter: Less is More http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

18. Images, Insula vs. Effortful Reasoning http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

19. Brain Results Support Gist • Adult brain: Pruning, not more connections • Adolescents: More deliberation, effortful reasoning about risky decisions (swim with sharks) • Baird & Fugelsang, 2004; Baird, Fugelsang, & Bennett, 2005) http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

20. Summary • Many studies show perceptions of risks and benefits predict risk taking behavior and intentions. • Meta-analyses confirmed: • Theory of Reasoned Action: 38% of variance • Behavioral Decision Making Framework • Take risks, despite overestimation, because benefits outweigh risks http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

21. But Not All Risk Taking is Reasoned and Intentional • Risky deliberator, but also… • Risky reactor (emotion, impulse) • Gist-based risk avoider (less analysis, less risk taking) http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

22. Counterintuitive Conclusions • Despite conventional wisdom, adolescents do not perceive themselves to be invulnerable, and perceived vulnerability declines with increasing age; • Although the object of many interventions is to enhance the accuracy of risk perceptions, adolescents typically overestimate important risks, such as HIV and lung cancer; • Despite increasing competence in reasoning, some biases in judgment and decision making grow with age, producing more ‘‘irrational’’ violations of coherence. • Occurs because of a known developmental increase in gist processing with age. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

23. Implications • Traditional interventions stressing accurate risk perceptions are apt to be ineffective or backfire because young people already feel vulnerable and overestimate their risk. • Experience is not a good teacher for younger adolescents, because they learn little from negative outcomes (favoring effective deterrents, such as monitoring and supervision). • Novel interventions that discourage deliberate weighing of risks and benefits by adolescents may ultimately prove more effective and enduring. • Mature adults intuitively grasp the gists of risky situations, retrieve appropriate risk-avoidant values, and never proceed down the slippery slope of actually contemplating tradeoffs between risks and benefits. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

24. Is the teen brain too RATIONAL? http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

25. Thank you! Steve Ceci Morton Ann Gernsbacher Frank Farley Keith Stanovich Chuck Brainerd

26. TABLE 4 Empirically Supported Recommendations for Policy and Practice 1. Reduce risk by retaining or implementing higher drinking ages, eliminating or lowering the number of peers in automobiles for young drivers, and avoiding exposure to potentially addictive substances (rather than, for example, exposing minors to alcohol to teach them to drink responsibly). 2. Develop psychometric instruments that reliably distinguish risky deliberators who make decisions on the basis of perceived risks and benefits from those who merely react to environmental triggers. 3. Develop reasoned arguments and facts-based interventions (including information about social norms) for the risky deliberators, focusing on reducing perceived benefits of risky behaviors (and increasing perceived benefits of alternative behaviors) and spelling out consequences of risk taking. For younger or less mature adolescents, short-term costs and benefits should be highlighted. 4. Identify factors that move adolescents away from considering the degree of risk and the amount of benefit in risky behaviors toward categorical avoidance of major risks until they are developmentally prepared to handle the consequences. • 1. Reduce risk through higher drinking ages, eliminating or lowering the number of peers in automobiles, and avoiding exposure to potentially addictive substances (not exposing minors to alcohol to teach them to drink responsibly). • 2. Develop psychometric instruments... • Develop reasoned arguments and facts-based interventions for risky deliberators. • Reducing perceived benefits of risky behaviors (and increasing benefits of alternative behaviors). • For younger adolescents, highlighting short-term costs and benefits. • 4. Identify factors that move adolescents away from considering the degree of risk and the amount of benefit in risky behaviors toward categorical avoidance of major risks. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

27. 5. Monitor and supervise younger adolescents. • Rather than rely on reasoned choices, remove opportunity (e.g., occupy time with positive activities). • 6. Seek practical self-binding strategies (avoiding situations that elicit temptation or require behavioral inhibition). • 7. Encourage development of positive prototypes (gists) or images using visual depictions, films, novels, serial dramas and other emotionally evocative media. • 8. Emphasize understanding of risk, deriving the gist or bottom line of messages that will endure in memory longer than verbatim facts. • Harmful consequences may not be understood because young people lack relevant experience; develop intuitive understanding. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf

28. 9.Do not assume that adolescents think that they are immortal. • On the contrary, provide concrete actions that they feel capable of taking that will reduce their risk. Teach self-efficacy, help them practice skills, and show them how they can control specific risk factors. • 10. Provide frequent reminders of relevant knowledge and risk-avoidant values. • Even medical experts fail to retrieve what they know about STDs without cues. • 11. Provide practice at recognizing cues in the environment that signal possible danger before it is too late to act. • 12. Treat comorbid conditions, such as depression. http://www.psychologicalscience.org/pdf/pspi/pspi7_1.pdf