Chapter 13 psychosocial problems in adolescence
Some general principles about problems in adolescence
- Experimenting is normal in adolescence and is part of the transition
- Most teenagers who have recurrent problems with the law had problems at home
and at school from an early age
- Many of the behavioral problems experienced by adolescents are resolved by the
beginning of adulthood, with few long-term repercussions (substance abuse,
delinquency, and eating disorders)
- Problem behavior during adolescence is virtually never a direct consequence of the
normative changes of adolescence itself >> puberty is not the main cause
Psychosocial problems: their nature and covariation
- Three broad categories of problems:
1. Substance abuse: the maladaptive use of drugs
2. Externalizing disorders: when the young person’s problems are turned outward
and are manifested in behavioral problems
3. Internalizing disorders: when the young person’s problems are turned inward and
are manifested in emotional and cognitive distress
- Substance abuse problems co-occur, or are comorbid, with both externalizing and
internalizing problems
- Multiproblem adolescents have more and more serious problems
- In girls >> internalizing problems usually precede conduct problems
- In boys >> they are more likely to have conduct problems that lead to depression
Comorbidity of externalizing problems
- Problem behavior syndrome: the covariation among various types of externalizing
disorders believed to result from an underlying trait of unconventionality
- Unconventional individuals in unconventional environments are more likely to engage
in a wide variety of risk-taking behavior
- Possibilities of the origins of unconventionality:
1. A predisposition toward deviance may actually be inherited
2. Biologically based differences among individuals in arousal, sensation seeking,
and fearlessness
3. The early family context in which deviance-prone children are reared and frames
problem behavior as an adaptive response to a hostile environment
- Involvement in a given problem may lead to involvement in a second one
- Social control theory: individuals who do not have strong bonds to society’s
institutions will be likely to behave unconventionally >> underlying weakness in
attachment to society
- It is important to differentiate between problem behavior that adults disapprove of
but that many adolescents consider normative versus problem behavior that both
adolescents and adults view as serious
Comorbidity of internalizing problems
, - Negative emotionality: Various indicators of internalizing problems may be thought
of as different manifestations of a common underlying factor >> becoming distressed
easily >> greater at risk for depression and anxiety disorders
- Anhedonic: having difficulty experiencing positive emotions >> prone to depression
Substance use and abuse
- The mixed signals sent to young people about drugs reflect the inconsistent way that
we view these substances as a society
Prevalence of substance use and abuse
- Monitoring the future: an annual survey of a nationwide sample of American 8 th, 10th,
and 12th graders, mainly known for its data on adolescent substance use
- Alcohol is the most commonly used and abused substance, followed by vaping and
marijuana
- Today, sex differences in the prevalence of drug use are virtually nonexistent
- One of the best ways to examine the nature and extent of drug use is to look at the
percentage of young people who report using substances daily
- New concern is vaping >> adolescents view vaping as less harmful
- Experimentation with alcohol, marijuana, and tobacco is less common among
younger teens than 20 years ago
- Looking in the number of 8th-graders who smoke is a good way of forecasting rates of
smoking among adults in the future >> the typical adolescent who smokes begins
around the 7th/8th grade
- White, Latinx, and Native American adolescents are more likely to drink than Black
youth
- Asian youth are less likely to drink than any other group
Does substance use follow a particular progression?
- Adolescents who have not experimented with alcohol or marijuana by their 20s are
unlikely to ever use these or any other drugs
- Gateway drugs: drugs that, when used over time, lead to the use of other more
dangerous substances
- Adolescents whose substance use begins early or escalated rapidly are more at risk
for substance use problems as adults
Causes and consequences of substance use and abuse
- Four groups of adolescents:
1. Frequent drug users
2. Hard-drug users
3. Those who experiment with marijuana and alcohol but don’t use frequently
4. Those who abstain
- Experimenter and abstainers score higher on measures of psychological adjustment
- Cigarette use during adolescence has more harmful long-term consequences than
alcohol use
- Psychological adjustment increases the likelihood of alcohol and marijuana use >>
more likely to participate in social activities in which these drugs are present
- Drug and alcohol abuse during adolescence is often a symptom of prior psychological
disturbance
, - Four sets of risk factors have been identified for the likelihood of substance abuse:
1. Psychological
>> Certain characteristics more prone (anger, impulsivity, inattentiveness,
sensation seeking)
2. Familial
>> Distant, hostile, or conflicted family relationships or when parents are tolerant
of substance use behavior >> more likely
3. Social
>> Having friends who use and tolerate the use of drugs
4. Contextual
>> Having a social context that makes drug use easier
- Researchers have also identified important protective factors that decrease the
likelihood of adolescents’ engaging in substance abuse:
>> positive mental health, academic achievement, engagement in school, close family
relationships, and involvement in religious activities
- Protective factors: factors that limit individual vulnerability to harm
Drugs and the adolescent brain
- The potential for addiction is much greater in adolescence than adulthood
- Changes in the limbic system (rewards and punishment area) during adolescence
affects receptors for dopamine (influences experience of pleasure) >> recreational
drugs make users feel good because they affect the same receptors that are sensitive
to the dopamine that is in the brain naturally
- Frequent drug use during adolescence interferes with the normal maturation of the
brain’s reward processing regions
- Because the limbic system is especially malleable/plastic in adolescence, drugs can
permanently affect the way the brain functions >> alcohol does this too
- Repeated exposure to drugs during this period of heightened plasticity in the limbic
system can affect the brain in ways that make it necessary to use drugs to experience
normal amounts of pleasure
- The increased vulnerability of the adolescent brain to the addicting effects of alcohol
is compounded by the fact that adolescents don’t feel the negative consequences of
drinking as adults do
- Alcohol has harmful effects on the development of regions of the brain involved in
higher-order cognitive abilities
- Marijuana use can lead to brain abnormalities in the prefrontal cortex, regions that
play a role in memory, advanced thinking, and emotion regulation
Prevention and treatment of substance use and abuse
- Efforts to prevent substance use among teenagers focus on:
1. The supply of drugs
2. The environment in which teenagers may be exposed to drugs
3. The characteristics of the potential drug user
- Raising the price of alcohol and cigarettes reduces adolescents’ use of them
- Programs targeting drug use try to enhance adolescents’ psychological development
or help adolescents develop interests in other activities
Some general principles about problems in adolescence
- Experimenting is normal in adolescence and is part of the transition
- Most teenagers who have recurrent problems with the law had problems at home
and at school from an early age
- Many of the behavioral problems experienced by adolescents are resolved by the
beginning of adulthood, with few long-term repercussions (substance abuse,
delinquency, and eating disorders)
- Problem behavior during adolescence is virtually never a direct consequence of the
normative changes of adolescence itself >> puberty is not the main cause
Psychosocial problems: their nature and covariation
- Three broad categories of problems:
1. Substance abuse: the maladaptive use of drugs
2. Externalizing disorders: when the young person’s problems are turned outward
and are manifested in behavioral problems
3. Internalizing disorders: when the young person’s problems are turned inward and
are manifested in emotional and cognitive distress
- Substance abuse problems co-occur, or are comorbid, with both externalizing and
internalizing problems
- Multiproblem adolescents have more and more serious problems
- In girls >> internalizing problems usually precede conduct problems
- In boys >> they are more likely to have conduct problems that lead to depression
Comorbidity of externalizing problems
- Problem behavior syndrome: the covariation among various types of externalizing
disorders believed to result from an underlying trait of unconventionality
- Unconventional individuals in unconventional environments are more likely to engage
in a wide variety of risk-taking behavior
- Possibilities of the origins of unconventionality:
1. A predisposition toward deviance may actually be inherited
2. Biologically based differences among individuals in arousal, sensation seeking,
and fearlessness
3. The early family context in which deviance-prone children are reared and frames
problem behavior as an adaptive response to a hostile environment
- Involvement in a given problem may lead to involvement in a second one
- Social control theory: individuals who do not have strong bonds to society’s
institutions will be likely to behave unconventionally >> underlying weakness in
attachment to society
- It is important to differentiate between problem behavior that adults disapprove of
but that many adolescents consider normative versus problem behavior that both
adolescents and adults view as serious
Comorbidity of internalizing problems
, - Negative emotionality: Various indicators of internalizing problems may be thought
of as different manifestations of a common underlying factor >> becoming distressed
easily >> greater at risk for depression and anxiety disorders
- Anhedonic: having difficulty experiencing positive emotions >> prone to depression
Substance use and abuse
- The mixed signals sent to young people about drugs reflect the inconsistent way that
we view these substances as a society
Prevalence of substance use and abuse
- Monitoring the future: an annual survey of a nationwide sample of American 8 th, 10th,
and 12th graders, mainly known for its data on adolescent substance use
- Alcohol is the most commonly used and abused substance, followed by vaping and
marijuana
- Today, sex differences in the prevalence of drug use are virtually nonexistent
- One of the best ways to examine the nature and extent of drug use is to look at the
percentage of young people who report using substances daily
- New concern is vaping >> adolescents view vaping as less harmful
- Experimentation with alcohol, marijuana, and tobacco is less common among
younger teens than 20 years ago
- Looking in the number of 8th-graders who smoke is a good way of forecasting rates of
smoking among adults in the future >> the typical adolescent who smokes begins
around the 7th/8th grade
- White, Latinx, and Native American adolescents are more likely to drink than Black
youth
- Asian youth are less likely to drink than any other group
Does substance use follow a particular progression?
- Adolescents who have not experimented with alcohol or marijuana by their 20s are
unlikely to ever use these or any other drugs
- Gateway drugs: drugs that, when used over time, lead to the use of other more
dangerous substances
- Adolescents whose substance use begins early or escalated rapidly are more at risk
for substance use problems as adults
Causes and consequences of substance use and abuse
- Four groups of adolescents:
1. Frequent drug users
2. Hard-drug users
3. Those who experiment with marijuana and alcohol but don’t use frequently
4. Those who abstain
- Experimenter and abstainers score higher on measures of psychological adjustment
- Cigarette use during adolescence has more harmful long-term consequences than
alcohol use
- Psychological adjustment increases the likelihood of alcohol and marijuana use >>
more likely to participate in social activities in which these drugs are present
- Drug and alcohol abuse during adolescence is often a symptom of prior psychological
disturbance
, - Four sets of risk factors have been identified for the likelihood of substance abuse:
1. Psychological
>> Certain characteristics more prone (anger, impulsivity, inattentiveness,
sensation seeking)
2. Familial
>> Distant, hostile, or conflicted family relationships or when parents are tolerant
of substance use behavior >> more likely
3. Social
>> Having friends who use and tolerate the use of drugs
4. Contextual
>> Having a social context that makes drug use easier
- Researchers have also identified important protective factors that decrease the
likelihood of adolescents’ engaging in substance abuse:
>> positive mental health, academic achievement, engagement in school, close family
relationships, and involvement in religious activities
- Protective factors: factors that limit individual vulnerability to harm
Drugs and the adolescent brain
- The potential for addiction is much greater in adolescence than adulthood
- Changes in the limbic system (rewards and punishment area) during adolescence
affects receptors for dopamine (influences experience of pleasure) >> recreational
drugs make users feel good because they affect the same receptors that are sensitive
to the dopamine that is in the brain naturally
- Frequent drug use during adolescence interferes with the normal maturation of the
brain’s reward processing regions
- Because the limbic system is especially malleable/plastic in adolescence, drugs can
permanently affect the way the brain functions >> alcohol does this too
- Repeated exposure to drugs during this period of heightened plasticity in the limbic
system can affect the brain in ways that make it necessary to use drugs to experience
normal amounts of pleasure
- The increased vulnerability of the adolescent brain to the addicting effects of alcohol
is compounded by the fact that adolescents don’t feel the negative consequences of
drinking as adults do
- Alcohol has harmful effects on the development of regions of the brain involved in
higher-order cognitive abilities
- Marijuana use can lead to brain abnormalities in the prefrontal cortex, regions that
play a role in memory, advanced thinking, and emotion regulation
Prevention and treatment of substance use and abuse
- Efforts to prevent substance use among teenagers focus on:
1. The supply of drugs
2. The environment in which teenagers may be exposed to drugs
3. The characteristics of the potential drug user
- Raising the price of alcohol and cigarettes reduces adolescents’ use of them
- Programs targeting drug use try to enhance adolescents’ psychological development
or help adolescents develop interests in other activities
