chapter 13 adolescence final

externalizing problems are…

Primarily affect person’s external world

examples of externalizing problems

• E.g., delinquency, fighting, substance use, risky driving

• Comorbidity

internalizing problems are…

affect person’s inside world

what does internalizing problems usually come from

• Controlling family style

• Over-controlled, critical, punishing inner voice

• Usually experience distress associated with problems

what are some examples of internalizing problems

• depression, anxiety, eating disorders

which of the problems is more common in females and which in males

internalizing =female, externalizing= male

over controlled =

internalizing problems

under controlled =

externalizing problem

what are some symptoms of externalizing problems/where it comes from

• Aloof family style

• Lack of self control

• Often do not experience distress associated with problem behavior

what is the leading death among adolescents and emerging adults

Leading cause of death among adolescents and emerging adults

what age range does the most car accidents occur

16-24

young drivers are more likely to…

• Drive at excessive speeds

• Follow others too closely

• Violate traffic signs and signals

• Take more risks in lane change / passing others

• Fail to yield

• Drive under influence of alcohol

• Less likely to wear a seatbelt

factors related to risky driving

• Parental involvement and monitoring of driving practices

• Media glamorizing risky driving behaviors

• Sensation seeking and aggressiveness

• Optimistic bias / “I’m superman”

what is increased car accidents in youth related to

•  experience (but this drops drastically after ~1yr of driving)

• Heavily related to risky driving behaviors

what are interventions of risky behavior

Graduated Driver’s Licenses vs. Driver’s Ed

what are the characteristics of drivers ed

• Not very helpful

what surprisingly might increase accidents in youth

drivers ed-(by falsely increasing confidence, allow teens to get full licenses early on, teens often not focused on learning skills)

graduated drivers licensing (GDL)

• Person goes through graduated stages of licensure based on safe driving record

  • E.g., Supervised by adult > No driving alone at night > Full license

what is the effectiveness of a GDL

Reduces crash risk by 20-40%

what are the kinds of “substance abuse” in America

• Alcohol

• Cigarettes /other kinds of tobacco

• Marijuana

• LSD

• Ecstasy

• Cocaine

what does substance abuse peak

Peaks in early 20s / Declines in late 20s

what are the four main styles of substance abuse

1.Experimental

2. Social

3. Medicinal / “self-medication”

4. Addictive

experimental use of substance

Try it a few times to “see what it’s like”
 Tied to sensation seeking

Social substance abuse

Group / social activity

Nearly all adolescent substance abuse occurs as part of a

group activity

medicinal/self medication substance abuse

Used to relieve unpleasant emotions (e.g., sadness,
depression, anxiety, stress)
 Higher rate than experimental or social

addictive substance abuse

Dependent on regular use of substance to feel “good”
 Can experience withdrawal when stopping substance use
 Highest rate of use
Substance Use Styles

which of the substance abuse types see more problems in adolescents

Medicinal / addicted users tend to report more
problems than social / experimental users

what are the frequent underlying reasons for substance abuse in adolescents

Problems in school
 Problems in relationships with parents
 Delinquent behavior

delinquency

is when a crime is committed by a
juvenile (defined as being under age 18 in most
countries)

what are the characteristics of delinquency in the US

Majority of crimes committed by young males
age 12 – 25 years
 Males also most likely to be victims of all types of violent
crimes (aside from sexual assault)

More commonly take place within peer groups
 Seldom motivated by economic reasons

what are the risk factors of delinquency

More independence
 More time spent with peer groups
 More likely to value sensation seeking and norm-breaking

what are the two difference types of delinquency

life-course-persistant deliquency

adolescence-limited deliquency

life course delinquency

Problems with temperament and behavior at early age
 Pattern of criminal offenses continue into adulthood
 Neuropsychological deficits (e.g., ADHD, learning disabilities, psych
disorders)
 High-risk environment (e.g., single parent, low-income family, psych
disorders in parents)

adolescence-limited delinquency

Limited mostly to adolescence / early adulthood
 E.g., vandalism, petty theft, substance use
 Lack of same risk factors listed above
Delinquency and Crime

what are the interventions for delinquency

Therapy
 Vocational training
 “Scared straight”
 Not very successful..

Multi-systemic approach
 Intervene at home, school, and neighborhood level
 Parent training
 Job / vocational counseling
 Development of neighborhood resources (e.g., youth centers
/ athletic leagues)
 Redirect youth energy to be more constructive

what is the most common problem in adolescence

depressed mood

what must a person have to develop a disorder

A person must have both a diathesis and a triggering
stressor to develop the disorder

Diathesis

Any pre-existing vulnerability (e.g., genetics,
temperament, personality factors, traumatic events, life history)
for a disorder to develop

depressed mood

somewhat normative, especially during
adolescence
 35% of adolescents in past 6 months

symptoms of major depressive disorder

5 or more during a 2-week period
✓ Depressed or irritable mood for most of the day, nearly every day
✓ Reduced interest or pleasure in all or almost all activities, nearly everyday
 Significant weight loss or weight gain, or shift in appetite
 Insomnia or oversleeping (sleep disturbance)
 Psychomotor agitation or retardation, observable by others
 Low energy or fatigue
 Feelings of worthlessness or inappropriate guilt
 Diminished ability to think or concentrate
 Recurrent thoughts of death or suicide
Depression

what are the risk factors of a depressed mood

Conflict with friends or family
 Rejection in love
 Poor school performance

risk factors of MDD

Diathesis-stress model
 Emotional unavailability of parents
 High family conflict
 Poor peer relationships (negative cycle)
 Hopelessness
 Isolation
 Low self-esteem / negative self-statements

what are the gender differences in depression

Rates substantially higher for females starting in adolescence
 Boys direct outward, girls direct inward
 Girls more likely to ruminate, boys more likely to distract self
 Males more likely to abuse substances, possibly as way of self-medicating

gender differences in suicide

Women much more (~4x) likely to attempt
 Men much more (~4x) likely to succeed

anorexia

is an eating disorder that involves a drastic
reduction in food intake and an unhealthy loss of weight

what are the symptoms of anorexai

Markedly low bodyweight
 Intense fear of gaining weight
 Distorted perception of their own body shape
 Preoccupation with body shape / avoiding eating

bulimia

involves pattern of binging on food
followed by purging (e.g., vomiting, laxative use) or other
means to prevent weight gain

negative effects of bulimia

Same risks as anorexia if accompanied by malnutrition
 Person may have normal bodyweight
 Stomach ulcers, erosion of dental enamel, tooth decay, soar
throat, damage to esophagus from vomiting
 Anxiety, depression, impaired social functioning

treatment of eating disorders

First priority is often to restore person’s body weight and nutrition to
stable level depending on current risks
 Depending on severity of case, hospitalization may initially be required to
monitor vitals if risk of heart / organ failure
 Most effective form of treatment involves psychotherapy
 Best to involve family (in adolescents)
 Treatment can be difficult and long-term prognosis is not great
 Many have lifelong struggles with eating problems and associated distress

protective factors of relilience

High intelligence
 At least one good relationship with a caring adult
 Environment (school, community)
 Religiosity
Resilience