1. Psychosocial Problems in Adolescence
What can go wrong

2. Problems in Adolescence
In general, adolescents do not develop serious psychological or social problems, contrary to media portrayals
Most problems reflect transitory experimentation, not enduring patterns of bad behavior
Not all problems begin in adolescence (some have their roots in childhood)
Most problems do not persist into adulthood (especially drug and alcohol use, unemployment, and delinquency)
Problems during adolescence are not caused by adolescence (“raging hormones” do not cause problem behaviors)
An important distinction needs to be made between experimentation and enduring patterns of behavior

3. Psychosocial Problems: Their Nature and Co-Variation
Substance abuse – the maladaptive use of drugs (legal and illegal)
Internalizing disorders – problems are turned inward (emotional and cognitive distress)
Externalizing disorders – problems are turned outward (behavioral problems)
Substance abuse problems tend to be externalizing problems
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Comorbid: substance abuse problems co-occur with the other problems. Page 442

4. Problem Behavior Syndrome
Many adolescents with psychosocial problems have more than one type of problem at once
The comorbidity of externalizing and substance abuse problems has led researchers to propose theoretical explanations for this phenomenon, sometimes called Problem Behavior Syndrome
Unconventional individuals are tolerant of deviance in general, are not highly connected to school or to religious institutions, and are very liberal in their social views. Page 443
Unconventional individuals are tolerant of deviance in general, are not highly connected to school or to religious institutions, and are very liberal in their social views. Page 443

5. Problem Behavior Syndrome: Theoretical Explanations
Unconventionality in adolescents’ personality and social environment leads to risk-taking behaviors (Jessor)
Tolerance of deviance
Not connected to school/religious institutions
Highly liberal views
Involvement in one problem behavior may lead to involvement in a second one (Kandel)
Cascading effects
Social control theory
Individuals who do not have strong bonds to society’s institutions, (family, work, school) will be likely to deviate and behave unconventionally
Page 443

6. The Comorbidity of Internalizing Problems
Although less research has studied comorbidity among internalizing problems, one underlying factor appears to be Negative Affectivity
Negative Affectivity refers to how easily someone becomes distressed
Adolescents high in negative affectivity are more likely to suffer from depression, anxiety, and other symptoms of distress
Pages

7. Substance Use and Abuse in Adolescence
Society sends a mixed message to youth
TV programs “Just say NO”
TV football games and situation comedies “Having a good time is impossible without alcohol”
Alcohol and cigarettes are by far the most commonly used and abused substances, according to Monitoring the Future data

8. Prevalence of Substance Use and Abuse
A large proportion of adolescents have experimented with alcohol, tobacco, and marijuana but not with other drugs
out of high school seniors: 70% have tried alcohol; 46% have smoked marijuana, and 40% have smoked cigarettes
only about 9% have used an illicit drug (other than marijuana) in the last month

9. Earlier Age of Initiation
Experimentation with drugs is less common among younger teens than in the past
The chances of becoming addicted to alcohol or nicotine are increased when use begins before age 15
drugs can affect normal maturation of the brain’s dopamine system
The effects of alcohol and nicotine on brain functioning (especially memory and impulse control) are worse in adolescence than in adulthood

10. Ethnic Differences in Substance Use
American Indian adolescents use the most substances
followed by Hispanic and White; then Black and Asian youth
immigrant paradox
foreign-born and less Americanized minority youth are less likely to use drugs, alcohol, and tobacco than their American- born counterparts

11. Risk and Protective Factors For Substance Abuse
Adolescents who use alcohol, tobacco, or other drugs frequently are usually exhibiting symptoms of prior psychological disturbance
More maladjusted as children and teenagers
Major risk factors are:
Personality – Anger, impulsivity, and inattentiveness
Family – Distant, hostile, or conflicted relationships
Socially – Friends who use and tolerate the use of drugs, living in a context that makes drug use easy
Major protective factors are:
Positive mental health, high academic achievement, engagement in school, close family relationships, and involvement in religious activities

12. Prevention and Treatment of Substance Use and Abuse
What works?
Efforts to prevent abuse target:
the supply of drugs (most government attention and money focused here)
the environment in which teens are exposed to drugs
characteristics of the potential drug user
WHY DO THEY FAIL??
Experts believe it is more realistic to focus prevention efforts on adolescents’ motivation and environment

13. Prevention and Treatment of Substance Use and Abuse
Most encouraging programs combine some sort of social competence training with a communitywide intervention (aimed at the adolescents, peers, parents, and teachers)

14. Categories of Externalizing Disorders
Conduct Disorder
Aggression
Juvenile Offending

15. Externalizing Problems: Conduct Disorder
Conduct Disorder (CD)
clinical diagnosis
a pattern of persistent antisocial behavior that routinely violates the rights of others and leads to problems in social relationships, school, or work
related diagnosis is oppositional-defiant disorder (less aggressive)
If CD persists beyond age 18, may be diagnosed with antisocial personality disorder, characterized by a lack of regard for moral standards (psychopaths)

16. Externalizing Problems: Aggression
Aggression – behavior that is done intentionally to hurt someone
Physical fighting
Relational aggression
Intimidation
Can be instrumental (planned) or reactive (unplanned)
Usually declines over the course of childhood and adolescence
Pages

17. Externalizing Problems: Juvenile Offending
“Juvenile offending” is legal term
Violent (e.g., assault, rape, robbery, and murder) and property crimes (e.g., burglary, theft arson)
increase in frequency between the preadolescent and adolescent years
peak during high school then declines in young adulthood (the age-crime curve)
Status offenses – behaviors that are not against the law for adults (truancy, running away, drinking)

18. Externalizing Problems: Juvenile Offending
Antisocial behavior takes the form of:
Authority conflicts (running away)
Covert antisocial behavior (stealing)
Overt antisocial behavior (attacking someone with a weapon)
Most serious delinquency begins between ages 13 and 16
Page 456
Despite the fact that juvenile offending decline during the 1990s, there was a steady increase during the same time period in the number of adolescents who were arrested (Mendel, 2003). Page 457

19. Two Types of Adolescent Offenders
Life-course persistent offenders
Demonstrate antisocial behavior before adolescence
Are involved in delinquency during adolescence
Are at great risk for continuing criminal activity in adulthood
Adolescent-limited offenders
Engage in antisocial behavior only during adolescence
These two types have very different causes and consequences
Because antisocial behavior in the child typically provokes further parental ineffectiveness and association with other antisocial children, aggressive children often get caught up in a vicious cycle.

20. Life-Course Persistent Offenders
Usually are poor, male, perform poorly in school
From disorganized families with hostile or inept parents
Harsh parenting may affect brain chemistry (serotonin)
Worse behavior elicits more bad parenting, leads to a vicious cycle
Have histories of aggression identifiable as early as age 8
Have problems with self regulation
More likely than peers to suffer from ADHD
Exhibit hostile attributional bias – interpret ambiguous interactions with others as deliberately hostile and retaliate

21. Adolescent-Limited Offending
Do not usually show signs of psychological problems or family pathology
Still show more problems than teens who are not at all delinquent
More mental health, substance abuse, and financial problems
Risk factors include:
Poor parenting (especially poor monitoring)
Affiliation with antisocial peers
ADHD - Page 461
hostile attributional bias – page 462
Food for Thought: Given what we know about differences between life-course persistent offenders and adolescence-limited offenders, should we take this distinction into account when deciding how to treat violent juvenile offenders? Page 465

22. Depression
A pervasive unhappy mood disorder more severe than the occasional blues or mood swings everyone gets from time to time
The symptoms are so universal that it is sometimes called “the common cold of psychopathology”
Children who are depressed can’t shake their sadness and it interferes with their daily routines, social relationships, school performance, and overall functioning
often accompanied by anxiety or conduct disorders
often goes unrecognized and untreated

23. Internalizing Problems and Depression in Adolescence
Depression is the most common psychological disturbance among adolescents
Emotional symptoms – dejection, decreased enjoyment of pleasurable activities, low self-esteem
Cognitive symptoms – pessimism and hopelessness
Motivational symptoms – apathy, boredom
Physical symptoms – loss of appetite, difficulty sleeping, loss of energy
Page 465

24. Sex Differences in Depression
Before adolescence, boys are more likely to exhibit depressive symptoms
After puberty, females are more likely to be depressed, possibly because of:
Gender roles – pressure to act passive, dependant, and fragile
Greater levels of stress during early adolescence
Ruminating more – turning feelings inward
Greater sensitivity to others (oxytocin)
Page 467
There is little evidence that the sex difference in depression is directly attributable to sex difference in hormones.
Change in social relationships around the time of puberty may leave girls more vulnerable than boys to some forms of psychological distress and depression may be a stereotypically feminine way of manifesting it. Page 467

25. Adolescent Suicide
~20% of girls and 10% of boys think about killing themselves every year (suicidal ideation)
10% girls and 6% boys make attempts serious enough to require treatment
Some adolescents commit acts of nonsuicidal self-injury (NSSI)
such as deliberately burning or cutting oneself
~25% of adolescents have done this at least once

26. Risks for Suicide Having a psychiatric problem
especially depression or substance abuse
Having a family history of suicide in the family
Experiencing extreme family conflict
parental rejection, family disruption
Being under intense stress

27. The Diathesis-Stress Model of Depression
Depression occurs when people with a predisposition (a diathesis) toward internalizing problems are exposed to chronic or acute stressors (a stress)
those without the diathesis are able to withstand a great deal of stress without developing psychological problems

28. The Diathesis-Stress Model of Depression
may be biological in origin (neuroendocrine or genetically linked), or because of cognitive style
The Stress
primarily from having a high-conflict and low-cohesion family, being unpopular, or reporting more chronic and acute stressors

29. Treatment and Prevention of Internalizing Problems
Treatment Approaches:
Biological therapies – Antidepressant medications (SSRIs) that address the neuroendocrine problems that may exist
Psychotherapies – Designed to help adolescents understand the roots of their depression or change their cognitions
Family therapy – Changing patterns of family relationships that contribute to symptoms
Prevention Approaches:
Primary prevention – Teaching adolescents life skills to help them cope with stress
Secondary prevention – Aimed at adolescents who are at risk for depression or are under stress
Primary prevention approaches emphasize teaching all adolescents social competencies and life skills that will help them cope with stress.
Secondary Prevention approaches aim at adolescents who are believed to be at high risk for developing depression, such as teenagers with a depressed parent (who are at risk because of the genetic and environmental risks associated with this).

30. Stress and Coping Insert DAL photo
Stress responses vary, so some adolescents experience:
Internalized disorders (anxiety, depression, headaches, indigestion, immune system problems)
Externalized disorders (behavior and conduct problems)
Drug and alcohol abuse problems
Stress does not always lead to negative outcomes
Resilience in the face of adversity
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Nearly half of all adolescents report difficult in coping with stressful situations at home or at school. Page 473

31. What Explains Stress Vulnerability?
Multiple stressors have a much greater impact than single stressors (multiplicative)
Adolescents who have internal and external resources are less likely to be affected by stress than their peers
internal: high self-esteem, healthy identity development, high intelligence
external: social support from others

32. Coping Strategies
Using more effective coping strategies also buffers the effects of stress
primary control: taking steps to change the source of stress (usually the best strategy)
secondary control strategies: trying to adapt to the problem (better when situation is uncontrollable)