Chapter Outline

Some General Principles About Problems in Adolescence

• There are four basic principles that govern our understanding of psychosocial problems during adolescence. First, a distinction must be made between experimentation and ongoing troublesome behavior. Next, we must acknowledge the difference between behavior patterns that have their roots in childhood and those that appear in adolescence. Third, it should be understood that most of the problems of adolescence are resolved by adulthood. Fourth, serious, ongoing problems are not a typical or normal part of the adolescent experience.

1. Psychosocial Problems: Their Nature and Covariation
• There are three broad categories of psychosocial problems: substance abuse (misuse of legal and illegal drugs), internalizing problems (problems turned inward that are emotional and cognitive in nature), and externalizing problems (problems turned outward that are behavioral in nature). These tend to co-occur.
1. Problem behavior syndrome
• Problem behavior syndrome is the phrase used to describe the co-occurence of externalizing problems or externalizing problems and substance abuse.
• Many theories to account for problem behavior syndrome have been proposed, including problem behavior theory (which holds that it is due to unconventionality), social control theory (which holds it is due to a lack of ties to social institutions), and another theory which suggests that problem behaviors clump together because involvement in one problem behavior leads to involvement in another problem behavior.
2. Comorbidity of internalizing problems
• Internalizing problems also co-occur. One common underlying factor that has been proposed to account for this is negative affectivity.
• Negative affectivity has both biological and environmental bases.
2. Substance Use and Abuse in Adolescence
1. The prevalence of substance use and abuse in adolescence
• American teenagers receive mixed messages about alcohol and drug use. There are also considerable misunderstandings about the nature of adolescent substance use and abuse.
• Some of the most reliable information about adolescent drug and alcohol use comes from the Monitoring the Future studies conducted at the University of Michigan.
• These studies indicate that the most commonly used substances among American teenagers are alcohol and nicotine. Marijuana is a distant third.
• Nicotine is the drug used most on a daily basis and alcohol is the most widely used drug.
• Most adolescents experiment with these substances rather than abuse them.
• Recent information from the Monitoring the Future surveys do indicate that since the mid-1990s use of marijuana, stimulants, cocaine and LSD is rising among the adolescent population. Also there is an indication that experimentation with drugs is occurring at an earlier age.
• There are ethnic differences in substance use and abuse.
• White youngsters and Hispanic youngsters are more likely to use substances than African American and Asian American adolescents. Native American youth have the highest rate of use out of all these groups.
• Adolescents who experiment with drugs and alcohol and those who have rational reasons for abstaining appear to be psychologically better adjusted than young people who are frequent users of drugs and alcohol, or those who abstain irrationally.
• Of the three most widely used substances, cigarette use appears to have the most deleterious health consequences.
• Adolescents who abuse substances suffer from a myriad of psychological and social problems.
2. The causes and consequences of adolescent substance use and abuse
• Three sets of risk factors for substance abuse have been uncovered. One set is psychological in nature and involves the personality of the individual. Personality characteristics of substance abusers are anger, impulsivity and depression.
• Interpersonally (the second set of risk factors), adolescents who have troubled family backgrounds tend to develop drug and alcohol problems more than adolescents who don't have such family relationships.
• Finally, adolescents who become substance abusers tend to live in environments where drugs and alcohol are more prevalent and where it is more acceptable to use substances.
3. Prevention and treatment of substance use and abuse
• Effective prevention programs for substance use and abuse tend to combine social competence training with community wide intervention designed to reduce the availability and acceptability of drug and alcohol use.
• Programs that merely provide information or use scare tactics have generally not been found to be effective in reducing substance use and abuse among teenagers.
3. Antisocial Behavior, Violence, and Other Externalizing Problems
• Adolescents violate the law more frequently than children and adults.
• Violent crime among youth is on the rise while property crime is remaining pretty steady.
• Adolescents are most likely to violently victimize other adolescents.
• Violence among youth is strongly linked with poverty.
1. The prevalence of anti-social behavior in adolescence
• Arrest records are only one way of measuring juvenile crime. Because of the nature of this information, it may not provide a full picture of illegal activity among youth.
• Surveys given to large groups of young people indicate that a majority of adolescents have engaged in illegal behavior, and that racial and ethnic differences in criminal activity are small.
2. Causes of anti-social behavior in adolescence
• A distinction must be drawn between juvenile offenders who have a problematic early history and juvenile offenders who begin engaging in illegal activity in adolescence.
• Adolescent offenders with a history of aggression or violence in childhood are more likely to become chronic violent offenders and continue their illegal activities into adulthood. This pattern is known as life-course persistent antisocial behavior. Often these young people have serious psychological problems and were reared in hostile, indifferent families.
• Adolescence-limited antisocial behavior tends to peak during mid-adolescence. In this pattern, young people are drawn into illegal activities through peer support and pressure. These young people are not carefully monitored by parents.
• Despite media hype, only a very small portion of young people actually ever run away from home, and about half of those return home within a few days of having left.
• Running away from home is neither a typical nor normal part of adolescence.
• Adolescents who run away from home usually live in poverty and experience high levels of family conflict.
3. Prevention and treatment of externalizing problems in adolescence
• Prevention and treatment efforts with chronic juvenile offenders need to focus on family relationships. However, it is very difficult to carry out programs of this nature. Therefore, the prognosis for adolescents who have an early history of problems is not very good.
• Young people whose criminal activities are limited to adolescence are much easier to help. Effective strategies for prevention and treatment include assisting the adolescent in learning ways to handle peer influence, helping parents learn to monitor their adolescents more effectively and providing immediate consequences for any inappropriate behavior.
4. Depression, Suicide and Other Internalizing Problems in Adolescence
1. The nature and prevalence of adolescent depression
• Depression is the most common form of psychological problem for adolescents and adults. It is important to differentiate mild, transitory forms of sadness and ongoing, debilitating depression.
• Only around three percent of the adolescent population suffers from clinical depression.
• Males are more likely to be labeled depressed in childhood, but by adolescence females are more likely to suffer from depression. Numerous explanations have been given for sex differences in depression during adolescence, including hormonal differences and the intensification of gender role expectations, which is more devastating for females.
2. Adolescent suicide
• Less than 10 percent of the adolescent population in the United States has attempted suicide. A great majority of these attempts are not successful.
• Over the last 40 years, the suicide rate among American adolescents has dramatically increased. Identified risk factors for suicide include having a history of psychiatric problems, having a family history of suicide, experiencing stress and experiencing family conflict and disruption.
• Researchers have found that suicide attempts among young people do cluster and do tend to follow media stories focusing on suicide.
3. Causes of adolescent depression and internalizing disorders
• The diathesis-stress model is the most widely accepted model for explaining the origin of internalizing problems.
• It suggests that if individuals who are predisposed toward internalizing problems experience stress, it will bring on internalizing symptomatology, such as depression or anxiety.
• The predisposition toward turning stress inward likely has biological bases.
4. Treatment and prevention of internalizing problems in adolescence
• Primary prevention approaches teach all adolescents life skill to cope with stress
• Secondary prevention approaches focus on high risk individuals for the delivery of services.
• Behavioral and cognitive-behavioral approaches have been found to be the most successful in treating internalizing symptoms.
5. Stress and Coping in Adolescence
• Increasingly, adolescents report difficulty handling stressful circumstances in their lives.
• What makes some adolescents more able to cope than others? Three factors have been identified in an effort to address this question.
• First, the more stressors an individual is experiencing, the more difficult it will be for that individual to cope successfully with the stress.
• Second, individuals with more individual and environmental resources are better able to handle stress.
• Third, young people who use effective coping strategies such as primary control strategies are more likely to be able to function effectively while experiencing stress.