1. Adolescent Problems - DSM – IV Disorders usually first diagnosed in infancy, childhood, or adolescence Disorders usually first diagnosed in infancy, childhood, or adolescence Mental Retardation Mental Retardation Learning Disorders Learning Disorders Developmental Coordination Disorder (motor coordination) Developmental Coordination Disorder (motor coordination) Expressive Language Disorder (standardized tests of expressive language) Expressive Language Disorder (standardized tests of expressive language) Phonological Disorder (speech sounds) Phonological Disorder (speech sounds) Stuttering Stuttering Autistic Disorder (social interaction deficits) Autistic Disorder (social interaction deficits)

2. Rett’s Disorder (head size, hand movement, social engagement – deficits after early normality) Rett’s Disorder (head size, hand movement, social engagement – deficits after early normality) Childhood Disintegrative Disorder (after normal development, progressive deterioration of language, social, physical skills) Childhood Disintegrative Disorder (after normal development, progressive deterioration of language, social, physical skills) Asperger’s Disorder (nonverbal behaviors, peer skills, peer enjoyment, emotional reciprocity) Asperger’s Disorder (nonverbal behaviors, peer skills, peer enjoyment, emotional reciprocity) ADHD ADHD Pica (eating objects) Pica (eating objects)

3. Rumination (regurgitation, rechewing) Rumination (regurgitation, rechewing) Feeding Disorder (failure to eat adequate amount) Feeding Disorder (failure to eat adequate amount) Tourette’s Disorder (motor, vocal outbursts) Tourette’s Disorder (motor, vocal outbursts) Encopresis (feces) Encopresis (feces) Enuresis (wetting) Enuresis (wetting) Separation Anxiety Disorder (excessive anxiety) Separation Anxiety Disorder (excessive anxiety) Selective Mutism Selective Mutism Reactive Attachment Disorder (hypervigilant or diffuse attachments) Reactive Attachment Disorder (hypervigilant or diffuse attachments) Stereotypic Movement Disorder (repetitive and non-functional motor behavior) Stereotypic Movement Disorder (repetitive and non-functional motor behavior)

4. Conduct Disorder (rights of others are violated) – as early as 5-6, usually in late childhood or early adolescence, rarely after 16 Conduct Disorder (rights of others are violated) – as early as 5-6, usually in late childhood or early adolescence, rarely after 16 Oppositional Defiant Disorder (negativistic, defiant, disobedient, hostile behavior toward authority figures) – usually before age 8 Oppositional Defiant Disorder (negativistic, defiant, disobedient, hostile behavior toward authority figures) – usually before age 8

5. Externalizing problems Externalizing problems Problem behavior theoryProblem behavior theory Risky automobile drivingRisky automobile driving Substance useSubstance use Delinquency and crimeDelinquency and crime Factors involved in risk behaviorFactors involved in risk behavior Internalizing problems Internalizing problems DepressionDepression Eating disordersEating disorders

6. Two Broad Problem Types 1. Externalizing Problems – create difficulties in a person’s external world (a.k.a. “undercontrolled”) Tend to go together (a person that fights is also more likely to commit other crimes) Tend to go together (a person that fights is also more likely to commit other crimes) More common among males More common among males Often motivated by desire for excitement, not necessarily underlying unhappiness or psychopathology Often motivated by desire for excitement, not necessarily underlying unhappiness or psychopathology 2. Internalizing Problems – primarily affect a person’s internal world (A.k.a. “overcontrolled”) Tend to go together (a person who is depressed is also more likely to have an anxiety disorder) Tend to go together (a person who is depressed is also more likely to have an anxiety disorder) More common in females More common in females Associated with experiencing distress Associated with experiencing distress

7. Problem Behavior Theory Problem Behavior Syndrome = Pattern of correlations between externalizing problems Problem Behavior Syndrome = Pattern of correlations between externalizing problems Theory: Problems have common origins Theory: Problems have common origins Background factors – e.g., family incomeBackground factors – e.g., family income Personality factors – e.g., self-esteemPersonality factors – e.g., self-esteem Social factors – e.g., parental controlSocial factors – e.g., parental control

9. Monitoring the Future, 2006 Any illicit drug use

10. Cigarettes

11. Alcohol

12. LSD

13. Cocaine

14. Other narcotics, including OxyContin, Vicodin Increase in 2002 due to inclusion of more types of drugs in the survey question

15. Ecstasy

16. Shope’s Model of Young Driver Crash Risks (2002)

17. Driver Crash Involvement: Property Damage Rates per 100,000: 1997

18. Driver Crash Involvement: Injury Rates per 100,000: 1997

19. Driver Crash Involvement: Fatality Rates per 100,000: 1997

20. Prevention: Two Approaches 1. Driver Education Generally hasn’t worked too well…Generally hasn’t worked too well… Get your license faster…you’re out there driving and getting into accidents!Get your license faster…you’re out there driving and getting into accidents! 2. Graduated Driver Licensing (GDL) More effectiveMore effective Address a variety of risk factorsAddress a variety of risk factors Restrict the conditions under which novices can driveRestrict the conditions under which novices can drive

21. Graduated Licensing Strategy Three Stages to a GDL program: Three Stages to a GDL program: 1.Learning License – getting driving experience under supervision of experienced driver 2.Restricted License – can drive unsupervised, but with restrictions designed to reduce crashes (e.g., driving curfews) 3.Full License – after 1 year restricted N L

22. Substance Use Alcohol Alcohol Cigarettes Cigarettes Illegal drugs (e.g., marijuana, cocaine, LSD, ecstasy…) Illegal drugs (e.g., marijuana, cocaine, LSD, ecstasy…) Adolescent substance use became target of a great deal of political attention, public policy programs and research In the 1980s and beyond….

23. Substance Use, 1975-1999 Source: Monitoring the Future, 2000

24. Alcohol & Marijuana Use by Age Notice the higher levels of use during age when unstructured socializing is most prevalent

25. Sequence of Substance Use 1.Drinking beer and wine 2.Smoking cigarettes and drinking hard liquor 3.Smoking marijuana 4.Using “hard” drugs

26. Adolescents use in different ways… Experimental curiosity “to see what it’s like” curiosity “to see what it’s like” Once or twice Once or twice Social Use during social activities with one or more friends Use during social activities with one or more friends Medicinal To relieve unpleasant emotional state such as sadness or anxiety To relieve unpleasant emotional state such as sadness or anxiety Addictive Dependency either physical or psychological Dependency either physical or psychological

27. Delinquency and Crime: Definitions Delinquency – when “juveniles” commit crimes: Delinquency – when “juveniles” commit crimes: 1.Status Offences – only a violation of the law because committed by juvenile 2.Index Crimes – serious crimes at any age Violent Crimes Violent Crimes Property Crimes Property Crimes 3. Nonindex Crimes – less serious offenses such as gambling, disorderly conduct

28. Age and Crime 1842 1977

29. Two Types of Delinquency Life-course-persistent delinquents Pattern of problems from birth on up Pattern of problems from birth on up Originate in neuropsychological deficits (difficult temperament, LD) Originate in neuropsychological deficits (difficult temperament, LD) Likely to grow up in high risk environment Likely to grow up in high risk environment Adolescent-delimited delinquents No signs of problems in infancy or childhood No signs of problems in infancy or childhood Period of occasional criminal activity between ages of 12-25 (e.g., vandalism, illegal drug use) Period of occasional criminal activity between ages of 12-25 (e.g., vandalism, illegal drug use) (Moffit, 1993)

30. Preventing Crime & Delinquency Prevention programs for children who show signs of risk for LCPD and for adolescents engaging in serious delinquency Prevention programs for children who show signs of risk for LCPD and for adolescents engaging in serious delinquency Varied Strategies: Varied Strategies: Individual therapyIndividual therapy Group therapyGroup therapy Vocational trainingVocational training Outward Bound type programsOutward Bound type programs Scared Straight “Boot Camp” type programsScared Straight “Boot Camp” type programs

31. Preventing Crime & Delinquency Two problems with prevention programs: Two problems with prevention programs: 1.Participation is typically non-voluntary or against one’s will 2.Prevention comes too late (in adolescence) after behavior patterns have been established The Multisystemic Approach has been met with some success MST includes parent training, job training, vocational counseling, development of neighborhood activities and centers – directing the energy of delinquents in positive directions.

32. Preventing Crime & Delinquency Multisytemic therapy (MST) vs. usual Juvenile Justice Services for serious adolescent offenders Note: Lower is better!

33. Factors involved in Risk Behavior

34. Socialization and Delinquency What is a “socialized delinquent”? An “unsocialized delinquent”? What is a “socialized delinquent”? An “unsocialized delinquent”?

35. Culture and Risk Behavior In traditional cultures, Schlegel and Barry (1991) found that boys and not girls tend to engage in risk behavior during adolescence In traditional cultures, Schlegel and Barry (1991) found that boys and not girls tend to engage in risk behavior during adolescence Evidence of antisocial behavior in less than half of the cultures studied Evidence of antisocial behavior in less than half of the cultures studied In Western countries other than the USA, engage in less risky driving behavior In Western countries other than the USA, engage in less risky driving behavior USA has highest rates of violent crimes USA has highest rates of violent crimes

36. Deaths from Suicide & Homicide The USA has the highest homicide rate; Canada the highest suicide rate

37. 15-year olds Who Report Smoking Daily

38. Levels of Depression Depression is an enduring period of sadness: Depression is an enduring period of sadness: Depressed mood: enduring period of sadness without any related symptomsDepressed mood: enduring period of sadness without any related symptoms Depressive syndrome: addition of symptoms such as frequent crying, feeling guilty, lonely or worriedDepressive syndrome: addition of symptoms such as frequent crying, feeling guilty, lonely or worried Major Depressive Disorder: Episode includes five or more symptoms during a two-week period and disrupt functioningMajor Depressive Disorder: Episode includes five or more symptoms during a two-week period and disrupt functioning

39. Major Depressive Disorder 1. Depressed or irritable mood for most of the day, nearly every day. 2. Reduced interest or pleasure in all or almost all activities, nearly every day. 3. Significant weight loss or gain, or decrease in appetite. 4. Insomnia or oversleeping. 5. Psychomotor agitation or retardation, observable by others. 6. Low energy or fatigue. 7. Feelings of worthlessness or inappropriate guilt. 8. Diminished ability to think or concentrate. 9. Recurrent thoughts of death, recurrent suicidal thoughts.

40. Cognitive Behavior Therapy (CBT) recognizes that depression is characterized by negative attributions, and a belief that the situation is permanent and uncontrollable The goal of CBT is to help the young person recognize the cognitive habits that are promoting depression and work to change those habits. Strategies include discussion, role play, practicing new ways of interacting Treating Depression with CBT… Relapse is less likely after CBT treatment than drug treatment

41. Suicide: Risk Factors and Facts Risk factors: Risk factors: DepressionDepression Family disruptionFamily disruption Substance abuse problemsSubstance abuse problems Relationship problems outside familyRelationship problems outside family Result of series of difficulties over timeResult of series of difficulties over time Females 4 times more likely than males to attempt suicide Males 4 times more likely than females to complete suicide Rates are highest where guns are most available Third most common cause of death ages 15-19 Higher rates among White than Black youth Rates highest among Native American youth

42. Eating Disorders Anorexia Nervosa – intentional self-starving Anorexia Nervosa – intentional self-starving Bulimia – binge eating and purging Bulimia – binge eating and purging Cultural ideal of thinness Puberty and body changes More common among upper and middle socioeconomic classes Girls who read magazines like “Seventeen” are more likely to strive for thinness Occurs most often among females in teens and early 20s Warm and controlling parents