Chapter Thirteen: Psychosocial Problems in Adolescence

1. Chapter Thirteen: Psychosocial Problems in Adolescence

2. Problems in Adolescence Contrary to media portrayal, adolescents do not generally develop serious psychological or social problems, Most problems reflect transitory experimentation, not enduring patterns of bad behavior Not all problems begin in adolescence (some have their roots in childhood) Most problems do not persist into adulthood (especially drug and alcohol use as well as delinquency) Problems during adolescence are not biologically rooted or caused by the normative changes of adolescence (“raging hormones” do not cause problem behaviors)

3. Psychosocial Problems: Their Nature and Co-Variation Substance abuse – the maladaptive use of drugs (legal and illegal) Internalizing disorders – problems are turned inward (emotional and cognitive distress) Externalizing disorders – problems are turned outward (behavioral problems) Substance abuse problems are likely comorbid Insert DAL photo

4. Problem Behavior Syndrome Many adolescents with psychosocial problems have more than one type of problem at once The comorbidity of externalizing and substance abuse problems has led researchers to propose theoretical explanations for this phenomenon, sometimes called Problem Behavior Syndrome

5. Externalizing Problems • Problem behavior syndrome: Unconventionality in adolescents’ personality and social environment leads to risk-taking behaviors (Jessor) • Tolerance of deviance • Not connected to school/religious institutions • Highly liberal views • Problem clusters: Involvement in one problem behavior may lead to involvement in a second one (Kandel) • Cascading effects

6. Externalizing Problems Social control theory Individuals who do not have strong bonds to societal institutions, (family, work, school) will be likely to deviate and behave unconventionally Helps explain why behavior problems are far more prevalent among poor, inner-city, minority youths

7. The Comorbidity of Internalizing Problems Although less research has studied comorbidity among internalizing problems, one underlying factor appears to be negative affectivity Negative affectivity refers to how easily someone becomes distressed Adolescents high in negative affectivity are more likely to suffer from depression, anxiety, and other symptoms of distress

8. Substance Use and Abuse in Adolescence Society sends mixed messages to youth TV programs “Just say NO” TV football games and situation comedies“Having a good time is impossible without alcohol” Alcohol and nicotine are by far the most commonly used and abused substances, according to Monitoring the Future data

9. Prevalence of Substance Use and Abuse Most adolescents have experimented with alcohol, tobacco, and marijuana but not with other drugs Only a very small number of adolescents use any substance daily 10% smoke cigarettes every day; 3% use alcohol daily; 5% use marijuana daily

10. Earlier Age of Initiation Adolescents are experimenting with drugs at earlier ages than in the past The chances of becoming addicted to alcohol or nicotine are increased when use begins before age 15 Drugs can affect dopamine production in the brain, possibly altering it permanently The effects of alcohol and nicotine on brain functioning (especially memory) are worse in adolescence than in adulthood

11. Developmental Trajectories of Substance Abuse Gateway drugs Alcohol and marijuana Are typically used before harder drugs Studies have identified six patterns of substance use: Nonusers Alcohol Experimenters Low Escalators Early Starters Late Starters High Escalators

12. Risk and Protective Factors For Substance Abuse Adolescents who use alcohol, tobacco, or other drugs frequently are usually exhibiting symptoms of prior psychological disturbance More maladjusted as children and teenagers Major risk factors are: Personality – Anger, impulsivity, and inattentiveness Family – Distant, hostile, or conflicted relationships Socially – Friends who use and tolerate the use of drugs Contextual – Live in a context that makes drug use easy Major protective factors are: Positive mental health, high academic achievement, engagement in school, close family relationships, and involvement in religious activities

13. Prevention and Treatment of Substance Use and Abuse Efforts to prevent abuse target: The supply of drugs (most government attention and money focused here) The environment in which teens are exposed to drugs Characteristics of the potential drug user Experts believe it is more realistic to focus prevention efforts on adolescents’ motivation and environment

14. Prevention and Treatment of Substance Use and Abuse The most encouraging interventions are programs that combine: Social competence training for adolescents Community-wide interventions aimed at adolescents, peers, parents, and teachers These kinds of programs have reduced the use of alcohol, drugs, and cigarettes, especially if started in late childhood and continued through high school

15. Categories of Externalizing Disorders Conduct Disorder Aggression Juvenile Offending

16. Externalizing Problems: Conduct Disorder Conduct Disorder (CD) Clinical diagnosis A pattern of persistent antisocial behavior that routinely violates the rights of others and leads to problems in social relationships, school, or work Related diagnosis is oppositional-defiant disorder (less aggressive) If CD persists beyond age 18, may be diagnosed with antisocial personality disorder, characterized by a lack of regard for moral standards (psychopaths) Insert DAL photo

17. Externalizing Problems: Aggression Aggression – behavior that is done intentionally to hurt someone Physical fighting Relational aggression Intimidation Can be instrumental (planned) or reactive (unplanned) Usually declines over the course of childhood and adolescence

18. Externalizing Problems: Juvenile Offending Juvenile offending is defined legally Violent (e.g., assault, rape, robbery, and murder) and property crimes (e.g., burglary, theft arson) Increase in frequency between the preadolescent and adolescent years Peak during high school then declines in young adulthood (the age-crime curve) Delinquency v. criminal behavior Status offenses – behaviors that are not against the law for adults (truancy, running away, drinking)

19. Externalizing Problems: Juvenile Offending Antisocial behavior takes the form of: Authority conflicts (running away) Covert antisocial behavior (stealing) Overt antisocial behavior (attacking someone with a weapon) Onset of serious delinquency begins between ages 13 and 16

20. Changes in Juvenile Offending Over time • Juvenile crime rate has declined since its peak in the early 1990s • However, adolescents still account for a disproportionately high number of crimes • Substantial decline in the gender gap in serious offending over the past several decades • Not clear whether this change is mainly due to changes in actual offending or changes in arrest practices among girls

21. Two Types of Adolescent Offenders Life-course persistent offenders Demonstrate antisocial behavior before adolescence Are involved in delinquency during adolescence Are at great risk for continuing criminal activity in adulthood Adolescent-limited offenders Engage in antisocial behavior only during adolescence These two types have very different causes and consequences

22. Life-Course Persistent Offenders Usually are poor, male, perform poorly in school From disorganized families with hostile or inept parents Harsh parenting may affect brain chemistry (serotonin) Worse behavior elicits more bad parenting, leads to a vicious cycle Have histories of aggression identifiable as early as age 8 Have problems with self regulation More likely than peers to suffer from ADHD Exhibit hostile attributional bias – interpret ambiguous interactions with others as deliberately hostile and retaliate

23. Adolescent-Limited Offending Do not usually show signs of psychological problems or family pathology Still show more problems than teens who are not at all delinquent More mental health, substance abuse, and financial problems Risk factors include: Poor parenting (especially poor monitoring) Affiliation with antisocial peers

24. Internalizing Problems and Depression in Adolescence Depression is the most common psychological disturbance among adolescents Emotional symptoms–dejection, decreased enjoyment of pleasurable activities, low self-esteem Cognitive symptoms–pessimism and hopelessness Motivational symptoms–apathy, boredom Physical symptoms–loss of appetite, difficulty sleeping, loss of energy Insert DAL photo

25. Imprecise Use of the Word “Depression” • Depressed mood • Feeling sad • Depressive symptoms • Having multiple symptoms of depression • Depressive disorder • Having enough symptoms to be diagnosed with the illness

26. Sex Differences in Depression Before adolescence, boys are more likely to exhibit depressive symptoms After puberty, females are more likely to be depressed, possibly because of: Gender roles–pressure to act passive, dependent, and fragile, heightened self-consciousness over physical appearance Greater levels of stress during early adolescence Ruminating more–turning feelings inward Greater sensitivity to others (oxytocin)

27. Adolescent Suicide ~20% of girls and 10% of boys think about killing themselves every year (suicidal ideation) 10% girls & 5% boys make attempts serious enough to require treatment Risk factors include: Having a psychiatric problem Especially depression or substance abuse Having a family history of suicide in the family Experiencing extreme family conflict Parental rejection, family disruption Being under intense stress Suicide rate is highest among American Indian and Alaskan Native adolescents Lowest among Black and White adolescents

28. The Diathesis-Stress Model of Depression Depression occurs when people with a predisposition (a diathesis) toward internalizing problems are exposed to chronic or acute stressors (a stress) Those without the diathesis are able to withstand a great deal of stress without developing psychological problems The Diathesis May be biological in origin (neuroendocrine or genetically linked), or because of cognitive style The Stress Primarily from having a high-conflict and low cohesion family, being unpopular, or reporting more chronic and acute stressors

29. Treatment and Prevention of Internalizing Problems Treatment approaches: Biological therapies–Antidepressant medications (SSRIs) that address the neuroendocrine problems that may exist Psychotherapies–Designed to help adolescents understand the roots of their depression or change their cognitions Family therapy–Changing patterns of family relationships that contribute to symptoms Evidence-based approaches are superior to approaches that do not have a scientific basis

30. Stress and Coping Stress responses vary, so some adolescents experience: Internalized disorders (anxiety, depression, headaches, indigestion, immune system problems) Externalized disorders (behavior and conduct problems) Drug and alcohol abuse problems Stress does not always lead to negative outcomes Resilience in the face of adversity Insert DAL photo

31. What Explains Stress Vulnerability? Multiple stressors have a much greater impact than single stressors (multiplicative) Adolescents who have internal and external resources are less likely to be affected by stress than their peers Internal: high self-esteem, healthy identity development, high intelligence External: social support from others Using more effective coping strategies also buffers the effects of stress Primary control: taking steps to change the source of stress (usually the best strategy) Secondary control strategies: trying to adapt to the problem (better when situation is uncontrollable)