Psychological Problems during Adolescence
Four Areas of Adolescent Mental Health Problems
Substance Abuse:
Maladaptive use of legal and illegal drugs and alcohol.
Internalizing Symptoms:
Reflects symptoms that are turned inward and are manifested in emotional cognitive distress (ex., depression, anxiety).
Externalizing Problems:
Refers to problems that are turned outward and are manifested in behavior problems (ex., delinquency, antisocial behavior, aggression).
Risky Sexual Behavior:
Reflects either risky or precocious (ex., too young or too early) sexual behaviors.
Important Concepts
Risk Factor vs. Protective Factor
risk factor: a variable that increases the probability of a negative outcome occurring.
Risk factors are probabilistic (ex., increase probability), not deterministic (ex., everyone experiencing a risk factor will have negative outcomes).
Protective factor: a variable that lowers, reduces, or attenuates the risks associated with a particular risk factor (ex., buffer).
Some protective factors may be more beneficial for different individuals
Equifinality:
Reflects situations in which there are multiple pathways to a particular outcome.
Multifinality
Reflections on situations in which there are multiple outcomes for a particular risk factor.
General Principles
Distinguishing between occasional experimentation and enduring patterns of negative behavior.
Distinguishing between problems that start during adolescence and those that originated in earlier developmental periods.
Most adolescent problems are transitory and are resolved before adulthood.
Teen behavior problems are NOT the result of normative developmental changes.
Substance Use during Adolescence
Common terms used in research
prevalence: percentage of teens who have ever used alcohol or drugs
recency of use: percentage of teens who have used alcohol or drugs within a certain period of time (ex., month).
Various estimates:
80% of all teens have tried alcohol
50% of all teens have tried cigarettes
50% of all seniors have tried marijuana
20% of teens have smoked marijuana within the past month
20% high school seniors smoked cigarettes daily
4% of seniors drank alcohol daily
6% of seniors used marijuana daily
20% of all 8th graders report drinking alcohol regularly
10% of 8th graders report smoking cigarettes once a month.
Why is early drug use a problem?
Scholars believe that early experimentation with drugs and alcohol is more harmful than doing it at a later age.
Younger teens may lack the maturity of judgement necessary to use drugs/alcohol in moderation or under safe situations.
Early substance use is related to several negative outcomes:
dropping out of school
having unsafe sex (including STD and pregnancy)
becoming involved in delinquency and antisocial behavior
Causes and consequences
Distinction between experimentation and regular use.
Some scholars have speculated that occasional use has been almost normative to such an extent that many psychologically healthy teens have used alcohol/drugs at least once.
Indeed, compared to teens who abstain from alcohol/drugs completely, teens who occasionally use alcohol/drugs are well-adjusted as long as it isn’t too young or too risky.
Risk factors:
Important note: the more risk factors that are present for an individual, the more likely he/she is use alcohol/drugs.
Psychological risk factors:
anger
impulsivity
greater tolerant attitudes towards alcohol/drugs
Greater expectations that alcohol/drugs will improve relationships.
Family risk factors:
genetic factors
distant, hostile, and conflicted family relationships
permissive, uninvolved, neglectful, or rejecting parenting
having one family member (parent or sibling) who uses alcohol/drugs
Social risk factors:
having friends who use and/or tolerate alcohol/drugs
peers - adolescent substance use
Peers reinforce teens’ use of alcohol/drugs.
Contextual risk factors:
availability of drugs
community norms
The degree to which drug/alcohol laws are enforced
The way alcohol/drug use is portrayed in the media
Antisocial Behavior
Prevalence
Between 1950-1980, there were steady increases in juvenile arrests in the U.S. for virtually all classes of misbehavior, including violent crime.
Why is exposure to violence and poverty related to antisocial behavior?
Parents from poor neighborhoods display low levels of nurturing and monitoring.
Concentrated poverty upsets the neighborhood’s social fabric, making it difficult for adults in the community to provide the guidance and supervision that teens need.
In many inner-city communities devastated by unemployment, aggression is used to demonstrate standing and power rather than occupation/educational success.
Repeated exposure to violence - whether in the home or in the neighborhood - breeds violence itself.
Prevalence based on arrest records
This information may be underreported because many teens commit crimes but don’t get caught.
This information may be overreported because lower-class individuals and adolescents who are persons of color are often arrested more and treated more harshly by the judicial system.
Prevalence based on teen reports:
Surveys indicate that a very large proportion of teens (60-80%) have engaged in delinquent behavior at one time or another.
Surveys of teens themselves indicate that ethnic differences in the prevalence of delinquent and criminal activity are smaller than what one would think based on official arrest records.
Physical aggression typically decreases and desists in most children by the time they are five years old.
Life Course Persistent Offenders
Definition: offenders who demonstrate high levels of antisocial behavior before, during, and after adolescence.
The earlier a person starts committing violent crimes, the more chronic their behavior will become.
Environmental causes:
poverty
divorced or high-conflict families
hostile, poor/inept, or neglectful parenting
failed to learn proper standards of behavior and self-control
Individual characteristics:
histories of aggressive and antisocial behavior
more impulsive, poor anger control, ADHD
low IQ and academic performance
poor peer relationships, including rejection and antisocial peers
Sex differences:
A greater proportion of males to females (10 to 1).
Adolescent-Limited Offenders
Definition: Offenders who engage in antisocial behavior only during adolescence do not ordinarily show signs of severe pathology.
The offences do not usually develop into serious criminality
Environmental causes (compared to never offenders):
They are less monitored by parents and more susceptible to peer pressure.
Have highly antisocial behavior friends.
Have more mental health and substance use problems even into adulthood.
Sex differences:
A slightly greater proportion of males to females (1 ½ to 1).
Internalizing Problems during Adolescence
In its mild form, depression is probably the most common mental health issue during adolescence.
Four types of symptoms:
emotional symptoms
dejection and low self-esteem
decreased enjoyment of pleasurable activities
cognitive symptoms
pessimism and hopelessness
motivational symptoms
apathy and boredom
physical symptoms
loss of appetite
difficulties sleeping
loss of energy
Prevalence of depressive mood and symptoms
More than 50% of teens occasionally feel sad and hopeless, and more than 33% say that they have nothing to look forward to.
At any one point in time, somewhat fewer than 10% of American teens report moderate to severe symptoms of depression.
Why does depression increase during adolescence?
The prevalence of stressful events at this age.
The cognitive changes permit the introspection and rumination that accompany depression.
Some research (albeit with mixed evidence) suggests that hormone changes at the beginning of adolescence may be a possible cause of depression.
Why is diagnosing depression tricky during adolescence?
Depression during adolescence is often accompanied by other problems that may draw more attention than depression.
Some professionals have been tempted to attribute nearly all difficulties in adolescence to unseen depression.
The popular stereotype of teens as normally disturbed leads many parents and teachers to fail to recognize genuine psychological problems when they appear.
Sex differences in depression:
Developmental change by sex.
Boys are somewhat higher in depressed mood in childhood and before puberty.
After puberty and into adulthood, twice as many females as males suffer from depressive mood and disorder.
Why are there sex differences in depression during adolescence?
Gender roles
Adolescent girls may be pressured to act in sex-sterotypical ways: passivity, dependency, and fragility.
Adolescence can be stressful for girls.
Body changes associated with puberty may be more stressful for girls.
Girls are more likely to experience multiple stressors at one time.
Girls are more likely to experience some stressful events than boys.
Girls react differently to stress.
Girls are more likely to react to stress by turning their feelings inward and engaging in ruminative behavior.
Boys are more likely to respond to stress by distracting themselves or by turning their feelings outward (ex., aggression).
If girls and boys are exposed to the same stressor, girls are more likely to become depressed.
Hormones
Some evidence (albeit mixed) suggested that estrogen is higher in adolescent girls and is linked to depression
Adolescent Suicide
Prevalence
More than 5% of female adolescents and more than 2% of male adolescents attempt suicide in any given year.
About 10% of teens have attempted suicide at some point in their lives.
Most teens who attempt suicide usually have made appeals for help and not found support from others.
Suicide in adolescence vs. adulthood
Attempted suicide is more common during adolescence than adulthood, whereas successful suicide is more common among adults than adolescents.
Risk factors for suicide during adolescence:
Having a psychiatric problem (especially depression or substance use).
Having a history of suicide in the family.
Being under stress, especially with respect to achievement and/or sexuality
Experiencing parental rejection, family disruption, or extensive family conflict
Suicide among sexual minorities
Some research has shown that gay, lesbian, and bisexual teens are 3X more likely to attempt suicide compared to heterosexual teens.
One study of Massachusetts youth found that 40% of GLB teens attempted suicide compared to 10% of straight youth.
This frequency may vary depending on the geographic location.
Causes of Internalizing Problems
Diathesis-stress model of depression:
Depression is more likely in teens who are genetically predisposed towards depression AND are exposed to chronic or acute stressors.
Biological risk factors
At least some of the risk may be due to problematic patterns of hormonal activity in the brain and nervous system, such as the hypothalamic-pituitary-adrenal (HPA) axis.
This may make it difficult for teens to regulate emotions, which in turn may make them susceptible to depression and other problems.
Cognitive risk factors:
People with tendencies toward helplessness, pessimism, and self-blame are more likely to interpret life events in ways that increase the likelihood of depression.
Experiences in family and peer relationships shape these cognitive styles
Cognitive risk factors - Depression (reciprocal links).
Environmental risk factors
Families characterized by high conflict, low cohesion, and divorce.
Peer rejection is linked to depression.
Experiencing chronic levels of daily stress is related to depressive symptoms during adolescence (and adulthood), perhaps through its impact on body hormones (ex., cortisol).
Adolescent Risky Sexual Behavior
Sexual Attitudes among American Adolescents
Three points to keep in mind:
While teenagers became more tolerant of premarital sexual relations, adults themselves also became more permissive
The changes in attitudes toward premarital sex cannot be understood apart from other attitudinal changes that took place during these decades, such as women’s rights, racial equality.
Although teens became more permissive of premarital sex, they did not become proponents of “free love” or casual sex.
Sexual intercourse during adolescence:
Estimates of adolescent sexual behavior tend to vary depending on:
the sample surveyed
year of study and reason for study
reliability of the data collected
sex differences: Boys tend to overstate, and girls understate
Current estimates:
Since the mid-1990’s there are slightly fewer adolescents having sex, but those who are do so at a somewhat earlier age.
Ethnic differences
Males: AA = 15 years, EA 16 ½ years, LA 16 ½ years, Asian American 18 years
Females: Latino and Asian American > AA and EA
Girls’ first sexual experience isn’t voluntary if…
They are younger than 13 years old.
Their sexual partners are older.
Important figure:
25% of younger female teens (but only 10% of women older than 18 years) reported their first sexual intercourse experience was against their will.
Adolescent Sexual Activity
The percentage of teens who have had premarital sex increased from 1960-1980, after which it stabilized.
Most research focused on sexual intercourse.
Why would it be important to study other forms of sexual behavior?
Understanding all forms of sexual behavior during adolescence is critical because they have long-term physical and mental health implications.
A few years ago, there was an increase in STDs in a Midwest community where a large percentage of the teens signed virginity pledges or contracts.
After exploring the issue further, health officials discovered that these teens weren’t having vaginal intercourse, but they were having oral and anal sex, which they didn’t consider as sex.
Table 1: Percentage (15-19 year olds)
Vaginal Sex | Oral Sex | Anal Sex | |
All | 49.9% | 54.7% | 11.1% |
Females | 51.0% | 54.3% | 10.9% |
Males | 48.7% | 55.2% | 11.2% |
Table 2: Percentage by time since first vaginal sex (adolescents)
Oral Sex | Anal Sex | |
Never had vaginal sex | 26.3% | 1.3% |
0-6 months ago | 81.7% | 5.8% |
7-12 months ago | 86.1% | 20.5% |
13-24 months ago | 86.2% | 17.9% |
25-36 months ago | 84.9% | 27.8% |
More than 3 years ago | 91.7% | 27.3% |
Having sexual intercourse too early/young estimates:
Between 25-33% of all American teens are sexually active by 15.
The younger individuals are when they have sex, the more likely they are to have unprotected sex, exposing themselves to STDs.
The greatest increase in the prevalence of intercourse and the greatest decline in the age at first intercourse have been among females.
Sex differences in college are not very large.
Other important facts:
For most teens, sex is accompanied by affection, emotional involvement, and commitment to a relationship.
Promiscuity is not the norm.
The percentage of adolescents who use alcohol or other drugs before having sex has increased in recent years.
Are sexually active teens more troubled?
Sexual activity, per se, is not associated with psychological problems.
Losing one’s virginity in adolescence does not have psychological repercussions, either in the short or long term
Teens who do not have sex and those who are sexually active after age 16 are not significantly different.
Outcomes of early sexual activity:
experimentation with drugs and alcohol
low level of religious involvement
tolerance of deviant behavior
lower interest in academic achievement
Influences on teens’ sexual behavior:
Teens from authoritative parent homes are less likely to:
become sexually active at an early age or engage in risky sexual behavior
Other important parenting factors related to lower teen sexual behavior:
high levels of parental warmth
high levels of parental involvement
high levels of parental monitoring/supervision
These findings involving parenting were found across ethnic groups.
Interesting findings regarding parent and teen reports of teen sexual behavior:
Parent-child sex discussions: parent reports > teen reports
Parents underestimate their teens’ sexual activity.
Parents unrealistically assume that if they disapprove of sexual activity, their teen will be less likely to be sexually active.
Sexually active teens underestimate parents’ disapproval.
Mothers are viewed as better sex educators.
Other family factors:
Older and sexually active siblings - high adolescent sexual behavior.
High church attendance - low adolescent sexual behavior
Peer relationship factors:
Peer groups help establish norms regarding sexual behavior, especially leaders in the peer groups.
Peers influence each other through their reactions to each other’s sexual activity.
Peer also may influence the impact of certain community efforts to lower sexual behavior (ex., virginity contracts).
Sex Differences in the Meaning of First Sexual Experience
Adolescent Boys:
First sexual experience:
masturbation
Development of sexuality:
Integrating the ability to form close relationships into an already existing sense of sexual capability.
First sexual partner:
Someone they are only casually dating.
Effects:
Likely to keep matters of sex and psychological intimacy separate.
Interpreted in terms of recreation and fun, not emotional involvement.
View of first experience:
Males typically have positive views about early sexual experiences.
Adolescent Girls:
First sexual experience:
sexual intercourse with another person.
Development of sexuality:
Integrating sexual activity into an already existing capacity for psychological intimacy and emotional involvement.
First sexual partner:
Someone they are in love with.
Effects:
After having sex for the first time, the typical teen girl is more likely to encounter disapproval or mixed feelings from others.
View of first experience:
Females are likely to feel ambivalent: positive and negative emotions.