Risky Behaviors in Adolescence

1. Risky Behaviors in Adolescence Understanding Teens and their Vulnerabilities Pamela D. Dodge, MSN, RN Magee-Womens Hospital Pittsburgh, PA

2. A Unique Developmental Stage • Distinct from both childhood and adulthood • A time of physical and emotional changes • A time to test independence from the family • A time for new relationships-peers, partners, parents

3. Mortality and Morbidity • Injury • Violence • Accidents • Homicides • Suicides

4. Accidents • Motor vehicles • Drinking and driving • Driving with someone who has been drinking • Not using seatbelts • Riding motorcycles without a helmet

5. Homicides and Violence • More males than females • Murder with guns • Carrying weapons: guns, knives, clubs

6. Suicides • Increasing among teens • More males complete the suicidal act • Rate of suicide attempts is unknown • More females attempt suicide • Suicidal ideation is common in adolescents • 25% of high school students have thought about suicide • 17% have made a suicide plan

7. Tobacco Use • Smoking among teens is on the rise • Ages 11-15 start of smoking behavior • Girls • Smoke to look cool • To keep from gaining weight • Boys use smokeless tobacco: chew and snuff

8. Alcohol • Experimentation is common • First use of alcohol often before 13 years old • Regular use of alcohol is prevalent in ages 15-18 • Daily use and heavy drinking more common in males

9. Drug Use • Marijuana use is common • Inhalants • Hallucinogens • Use of cocaine and crack cocaine is low • Injecting drugs is not a usual risk behavior

10. Sexual Behavior • By age 17, 50% of teens have engaged in sexual intercourse • Consistent use of contraception is on the increase • Condom use is up • DepoProvera is a popular method for girls

11. Sexually Transmitted Diseases • Most common and destructive infections among teens • Chlamydia • Gonorrhea • Syphilis • HIV • AIDS

12. Exercise, Diet and Weight • At least one physical activity each week • Decreases as teens get older • Most do not eat five or more servings:fruits and vegetables • High fat content: french fries, hot dogs, hamburgers, sweets • Meals are on the run and not planned • 1/3 think they are overweight and are trying to lose weight

13. Behavioral Links • Behaviors do not occur in isolation • Substance use and sexual behavior • Sexually active more likely to use drugs and alcohol • Unintended pregnancy • Increases in sexually transmitted diseases • Multiple sex partners • Sexually active more likely to ride in a car under the influence of alcohol/drugs • Fatal accidents, homicides and suicides related to alcohol intoxication

14. Theories • Problem Behavior Theory • Look at behaviors as purposeful, meaningful, goal oriented and functional rather than arbitrary or perverse • Gaining peer acceptance, establishing autonomy from parents • Psychosocial proneness: teens who engage in one type of risk behavior are also likely to engage in other types

15. Theories • Biopsychosocial Model • Biological:pubertal timing, hormonal effects, genetic predisposition • Psychological:self-esteem, sensation seeking, cognitive and emotional states • Social:how parents, peers and school influence an adolescents life

16. Behavioral Links • Relationship between smoking and other high risk behaviors: marijuana use • Fatal accidents, homicides and suicides linked