Problems in Adolescence -- Overview “Storm and Stress” legacy “Storm and Stress” legacy In...
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Problems in Adolescence -- OverviewProblems in Adolescence -- Overview
““Storm and Stress” legacyStorm and Stress” legacy In reality, most A’s manage and many are In reality, most A’s manage and many are
resilientresilient when coping with problems when coping with problems Still, Still, teens and twentiesteens and twenties are a time when various are a time when various
probs are probs are more likely more likely to occur to occur (e.g., risky automobile (e.g., risky automobile driving; schizophrenia)driving; schizophrenia)
Are problems “A-limited” – transitory – or “life-Are problems “A-limited” – transitory – or “life-course”? (Origin & onset is important.)course”? (Origin & onset is important.)
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Factors involved in problemsFactors involved in problems
Bio-Psycho-Bio-Psycho-Social Social
perspectiveperspective
Biological(e.g. prefrontal
cortex;Puberty)
Psychological(e.g., sensation-
seeking, resiliency, abilityto manage stress)
Socio-cultural(e.g., expectations,
gender roles, Peers, neighborhood)
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Two Broad Problem TypesTwo Broad Problem Types
1.1. InternalizingInternalizing Problems – primarily affect a person’s Problems – primarily affect a person’s internal world (cause distress)internal world (cause distress)
More common in femalesMore common in females
2.2. ExternalizingExternalizing Problems – create difficulties in a Problems – create difficulties in a person’s external worldperson’s external world
More common among malesMore common among males Often motivated by Often motivated by thrill-seekingthrill-seeking, not necessarily , not necessarily
underlying unhappiness or psychopathologyunderlying unhappiness or psychopathology
Reality: Not so distinct -- problems are often a combo of internal/external (e.g., substance abuse)
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Internalizing ProblemsInternalizing Problems
Examples: Schizophrenia (The Secret Life of the
Brain, PBS DVD
Eating disorders Depression and anxiety
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Externalizing ProblemsExternalizing Problems
Examples:Risky driving behaviorDelinquency issuesSubstance abuse
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Driver Crash Involvement: Driver Crash Involvement: FatalityFatality
Rates per 100,000: 1997
Sex and age diffs
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Risky DrivingRisky Driving
16 – 24 year olds have the 16 – 24 year olds have the highest rates of auto accidents, highest rates of auto accidents,
injuries, & fatalitiesinjuries, & fatalities
Possible Reasons?Possible Reasons?
Driver Inexperience?Risks taken while drivingDriving while impairedNot wearing a seatbeltLack of parental monitoringCultural norms that glorify speeding and racingBelief that friends
approve of risky drivingSensation-seeking
personalityAggressivenessOptimistic Bias
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Shope’s Model of Young Driver
Crash Risks (2002)
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Delinquency issuesDelinquency issues
(Increasing in severity)(Increasing in severity)• Delinquency – destructive, antisocial, and/or Delinquency – destructive, antisocial, and/or
lawbreaking activitieslawbreaking activities• Oppositional Defiant Disorder Oppositional Defiant Disorder (DSM-IV criteria)(DSM-IV criteria)
• Conduct disorder Conduct disorder (DSM-IV criteria)(DSM-IV criteria)
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Two Types of DelinquencyTwo Types of Delinquency
Life-course-persistentLife-course-persistent delinquents delinquents
Pattern of problems from childhoodPattern of problems from childhood
May originate in neuropsychological deficits May originate in neuropsychological deficits (difficult temperament, LD) (difficult temperament, LD) (see next slide)(see next slide)
Likely to grow up in high risk environmentLikely to grow up in high risk environment
Adolescence-delimitedAdolescence-delimited delinquents delinquents
No signs of early problemsNo signs of early problems
Period of occasional criminal activity between Period of occasional criminal activity between ages of 12-25 (e.g., vandalism)ages of 12-25 (e.g., vandalism)
(Moffit, 1993)
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– A’s with conduct disorderA’s with conduct disorder
Fail to show normal fearFail to show normal fear
Fail to avoid punishmentFail to avoid punishment
May have under-aroused May have under-aroused CNSCNS
(next slide)(next slide)
– A’s with conduct disorderA’s with conduct disorder
Fail to show normal fearFail to show normal fear
Fail to avoid punishmentFail to avoid punishment
May have under-aroused May have under-aroused CNSCNS
(next slide)(next slide)
Neurobiological influences in Neurobiological influences in conduct problemsconduct problems
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Arousal level in boys (as a Arousal level in boys (as a predictor of criminality)predictor of criminality)
Adrenalineexcretion(ng/min)
15
10
5
0 Nonstressfulsituation
Stressfulsituation
Those with laterconvictions have lower
levels of arousal
No criminal convictionCriminal conviction
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Prevention and TreatmentPrevention and Treatment
Prevention programs for children who Prevention programs for children who show signs of risk for serious delinquency show signs of risk for serious delinquency (life-course pattern)(life-course pattern)
• Individual and family therapyIndividual and family therapy• Group therapyGroup therapy• Scared StraightScared Straight “Boot Camp” “Boot Camp”• Outdoor Behavioral Healthcare (OBH)Outdoor Behavioral Healthcare (OBH)
Wilderness &/or outdoor adventure therapyWilderness &/or outdoor adventure therapy
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Preventing Crime & DelinquencyPreventing Crime & Delinquency
Problems with prevention programs:Problems with prevention programs:
1.1. Participation is typically non-voluntaryParticipation is typically non-voluntary
2.2. Prevention comes too late (in adolescence) Prevention comes too late (in adolescence) after behavior patterns have been establishedafter behavior patterns have been established
3.3. Often have too narrow an approachOften have too narrow an approach
• The Multisytemic Approach has been met with some success
• MST includes parent training, job training, vocational counseling, development of neighborhood activities and centers – directing the energy of delinquents in positive directions.
• See the next slide for data on MST.
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Preventing Crime & DelinquencyPreventing Crime & DelinquencyMultisytemic therapy (MST) vs. usual Juvenile Justice Multisytemic therapy (MST) vs. usual Juvenile Justice Services for serious adolescent offendersServices for serious adolescent offenders
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Substance UseSubstance Use& Abuse& Abuse
ATOD – Alcohol, Cigarettes, ATOD – Alcohol, Cigarettes, other drugs (e.g., MJ, cocaine, other drugs (e.g., MJ, cocaine, LSD, X)LSD, X)
A & T use common in A & T use common in adolescence and emerging adolescence and emerging adulthoodadulthood
When is use problematic (e.g., When is use problematic (e.g., “addiction,” substance “addiction,” substance abuseabuse)? )? Biopsychosocial approach Biopsychosocial approach (“teen (“teen brain DVD”)brain DVD”)
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GatewayGateway theorytheory in Substance abusein Substance abuse
1.1. Drinking beer and wineDrinking beer and wine
2.2. Smoking cigarettes and drinking hard Smoking cigarettes and drinking hard liquorliquor
3.3. Smoking marijuanaSmoking marijuana
4.4. Using “hard” drugsUsing “hard” drugs