1
PowerPoint slides prepared by Leonard R. Mendola, PhD
Touro College
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
2
Chapter 13: Problems in Adolescence and Emerging Adulthood
Outline
•
EXPLORING ADOLESCENT AND EMERGING ADULT
PROBLEMS
– The Biopsychosocial Approach
– The Developmental Psychopathology Approach
– Characteristics of Adolescent and Emerging Adult
Problems
– Stress and Coping
– Resilience
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
3
Chapter 13: Problems in Adolescence and Emerging Adulthood
Outline
• PROBLEMS AND DISORDERS
– Drug Use
– Juvenile Delinquency
– Depression and Suicide
– Eating Disorders
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
4
Chapter 13: Problems in Adolescence and Emerging Adulthood
Outline
•
INTERRELATION OF PROBLEMS AND
PREVENTION/INTERVENTION
– Adolescents with Multiple Problems
– Prevention and Intervention
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
5
Exploring Adolescent and Emerging Adult
Problems
• The biopsychosocial approach
– Emphasizes that biological, psychological,
and social factors interact to produce the
problems that adolescents, emerging
adults, and people of other ages develop.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
6
Exploring Adolescent and Emerging Adult
Problems
• Biological Factors:
– Adolescent and emerging adult problems
are believed to be caused by a
malfunctioning of the body.
– Focus on the brain and genetic factors as
causes of adolescent and emerging adult
problems.
– Drug therapy is frequently used to treat
problems.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
7
Exploring Adolescent and Emerging Adult
Problems
• Psychological Factors:
– Distorted thoughts
– Emotional turmoil
– Inappropriate learning
– Troubled relationships
– Family and peer influences
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
8
Exploring Adolescent and Emerging Adult
Problems
• Social Factors:
– Socioeconomic status (SES)
– Neighborhood quality (Leventhal, Dupere, &
Brooks, 2009; McLoyd & others, 2009).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
9
Exploring Adolescent and Emerging Adult
Problems
• The Developmental Psychopathology
Approach
– Focuses on describing and exploring the
developmental pathways of problems.
– Adolescent and emerging adult problems
can be categorized as internalizing or
externalizing.
• Internalizing problems
• Externalizing problems
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
10
Exploring Adolescent and Emerging Adult
Problems
• The Developmental Psychopathology
Approach (Continued)
– Internalizing problems
• Occur when individuals turn their problems
inward.
– Examples: anxiety and depression.
– Externalizing problems
• Occur when problems are turned outward.
– An example: juvenile delinquency.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
11
Exploring Adolescent and Emerging Adult
Problems
• Characteristics of Adolescent and Emerging
Adult Problems
– The spectrum is wide.
– The problems vary in their severity and in how
common they are for females and males, and for
different socioeconomic groups.
– Some problems are short-lived; others can persist
over many years.
– Some problems are more likely to appear at one
developmental level than at another.
– SES background differences.
– Internal versus external assets.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
12
Exploring Adolescent and Emerging Adult
Problems
The Two Items Most Likely to Differentiate Clinically
Referred and Nonreferred Children and Adolescents
Fig. 13.1
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
13
Exploring Adolescent and Emerging Adult
Problems
• Stress and Coping
– Stress is the response of individuals to stressors,
which are circumstances and events that threaten
them and tax their coping abilities.
– Some stressors are acute.
– Some stressors are chronic.
– Stress may come from many different sources
(Compas & Reeslund, 2009; Greenberg, 2009; Mash &
Wolfe, 2009).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
14
Exploring Adolescent and Emerging Adult
Problems
• Life events, daily hassles
– Individuals who have had major life changes (loss
of a close relative, the divorce of parents) have a
higher incidence of cardiovascular disease and
early death than those who do not (Taylor, 2009).
– Researchers have found that, when several
stressors are simultaneously experienced, the
effects may be compounded (Rutter & Garmezy,
1983).
– The most frequent daily hassles of college students
were wasting time, being lonely, and worrying
about meeting high achievement standards (Kanner
& others, 1981).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
15
Exploring Adolescent and Emerging Adult
Problems
• Socio-cultural Factors
– Help to determine:
• Which stressors individuals are likely to encounter.
• Whether they are likely to perceive events as stressful or
not.
• How they believe stressors should be confronted.
(Matsumoto & Juang, 2008).
• Acculturative stress
– Refers to the negative consequences that result
from contact between two distinctive cultural
groups.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
16
Exploring Adolescent and Emerging Adult
Problems
• Acculturative stress (Continued)
– Many individuals who have immigrated to the
United States have experienced acculturative
stress (Liu & others, 2009; Wong & others, 2009).
– Poverty can cause considerable stress for
individuals and families (Healey, 2009; Leon-Guerrero,
2009).
– Adolescents are more likely to experience
threatening and uncontrollable life events if they
live in low-income contexts than if they live in more
economically robust contexts (Conger & Conger,
2008).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
17
Exploring Adolescent and Emerging Adult
Problems
• Coping
– Coping involves managing taxing circumstances,
expending effort to solve life’s problems, and
seeking to master or reduce stress.
– Success in coping has been linked with several
characteristics:
• A sense of personal control
• Positive emotions
• Personal resources
• The strategies used
• The context
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
18
Exploring Adolescent and Emerging Adult
Problems
• Problem-focused coping
– The strategy of squarely facing one’s troubles and
trying to solve them.
– Problem-focused coping was associated with
positive change following trauma and adversity
(Linley & Joseph, 2004).
• Emotion-focused coping
– Responding to stress in an emotional manner,
especially by using defensive mechanisms.
– Coping includes avoiding a problem, rationalizing
what has happened, denying it is occurring,
laughing it off, or calling on our religious faith for
support.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
19
Exploring Adolescent and Emerging Adult
Problems
• Thinking Positively
– Thinking positively and avoiding negative thoughts
is a good strategy when trying to handle stress in
just about any circumstance (Greenberg, 2009).
– A positive mood improves our ability to process
information efficiently and enhances self-esteem.
– An optimistic attitude is superior to a pessimistic
one. It gives us a sense that we are controlling our
environment.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
20
Exploring Adolescent and Emerging Adult
Problems
• Support
•
– An important aspect of being able to cope with
stress (Mash & Wolfe, 2009; Taylor, 2009).
– Close, positive attachments to others consistently
act as buffers to stress.
Contexts and Coping
– Coping is not a stand-alone process.
– Coping is influenced by the demands and
resources of the environment.
– Coping flexibility
• Modify coping strategies to match the demands
of the situation.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
21
Exploring Adolescent and Emerging Adult
Problems
• Resilience
– Masten (2001, 2006, 2007) analyzed the research
literature on resilience and concluded that a
number of factors were involved:
• Individual factors
(such as good intellectual functioning)
• Family factors
(close relationship to a caring parent figure)
• Extrafamilial factors
(bonds to prosocial adults outside the family)
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
22
Exploring Adolescent and Emerging Adult
Problems
Characteristics of Resilient Children and
Adolescents
Fig. 13.2
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
23
Problems and Disorders
• Trends in Overall Drug Use
– The 1960s and 1970s were a time of marked
increases in the use of illicit drugs.
– Many youth turned to marijuana, stimulants, and
hallucinogens.
– Increases in adolescent and emerging adult alcohol
consumption during this period were also noted
(Robinson & Greene, 1988).
– In the late 1990s and early part of the 21st century,
the proportion of secondary school students
reporting the use of any illicit drug has been
declining.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
24
Problems and Disorders
• Trends in Overall Drug Use (Continued)
– Marijuana is the illicit drug most widely used in the
United States and Europe (Hibell & others, 2004;
Johnston & others, 2009).
– The recent downturn in drug use by U.S.
adolescents has been attributed to an increase in
the perceived dangers of drug use on youth
(Johnston & others, 2007).
– In the United States, drug use increases in
emerging adulthood (Park & others, 2006).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
25
Problems and Disorders
Trends in Drug Use by U.S. 8th-, 10th-, and 12th-Grade Students
Fig. 13.3
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
26
Problems and Disorders
• Alcohol
– An extremely potent drug.
– Acts on the body as a depressant and slows
down the brain’s activities.
– If used in sufficient quantities, it will
damage or even kill biological tissues,
including muscle and brain cells.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
27
Problems and Disorders
• Alcohol (Continued)
– The mental and behavioral effects of alcohol
include reduced inhibition and impaired judgment.
Initially, adolescents feel more talkative and more
confident when they use alcohol.
– Most widely used by U.S. adolescents and
emerging adults.
– The third-leading killer in the United States.
– A special concern is the increase in binge drinking
by females during emerging adulthood (Young &
others, 2005).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
28
Problems and Disorders
• Risk Factors in Alcohol Abuse:
–
–
–
–
Heredity.
Family influences.
Peer relations.
Certain personality and motivational characteristics
(Pinger
& others, 2009).
– Genetic predisposition (Hart, Ksir, & Ray, 2009).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
29
Problems and Disorders
• Hallucinogens
– Also called psychedelic (mind-altering) drugs.
– Modify an individual’s perceptual experiences and
produce hallucinations.
– LSD (lysergic acid diethylamide).
– Marijuana, comes from the hemp plant Cannabis
sativa.
– Stimulants are drugs that increase the activity of
the central nervous system.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
30
Problems and Disorders
Trends in Annual Prevalence of Marijuana Use by U.S.
8th-, 10th-, and 12th-Graders
Fig. 13.4
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
31
Problems and Disorders
• Cigarette Smoking
– The active drug is nicotine is one of the most
serious yet preventable health problems (Mathers &
others, 2006).
– Approximately 20 percent of adolescents in more
than 130 countries use a tobacco product (Centers
for Disease Control and Prevention, 2006).
– The peer group especially plays an important role
in smoking (Picotte & others, 2006).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
32
Problems and Disorders
Trends in Cigarette Smoking by U.S. Secondary
School Students
Fig. 13.5
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
33
Problems and Disorders
• Cigarette Smoking (Continued)
– Engaging in risk-taking behavior is also linked to
cigarette smoking in adolescence.
– Smoking in the adolescent years causes permanent
genetic changes in the lungs and forever increases
the risk of lung cancer, even if the smoker quits
(Weineke & others, 1999).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
34
Problems and Disorders
• Cocaine
– A stimulant that comes from the coca plant, native
to Bolivia and Peru.
– Either heated and the fumes inhaled or it is injected
in the form of crystals or powder.
– The effect is a rush of euphoric feelings, which
eventually wear off, followed by depressive
feelings, lethargy, insomnia, and irritability.
– Can have a number of seriously damaging effects
on the body, including heart attacks, strokes, and
brain seizures.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
35
Problems and Disorders
• Amphetamines
– Often called “pep pills” and “uppers.”
– Are widely prescribed stimulants, sometimes
appearing in the form of diet pills.
– Use among high school seniors has decreased
significantly.
– Although use of over-the-counter diet pills has
decreased in recent years, 40 percent of today’s
females have tried using diet pills by the time they
graduate from high school.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
36
Problems and Disorders
• Ecstasy
–
–
–
–
–
–
The street name for the synthetic drug MDMA.
Has stimulant and hallucinogenic effects.
Similar to methamphetamines.
Usually comes in a pill form.
Tolerance builds up rapidly.
Produces euphoric feelings and heightened
sensations (especially touch and sight).
– Users often become hyperactive and sleepless.
– Can lead to dangerous increases in blood pressure,
as well as stroke or a heart attack.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
37
Problems and Disorders
• Depressants
– Drugs that slow down the central nervous system,
bodily functions, and behavior.
– Medically, depressants have been used to reduce
anxiety and to induce sleep.
• Alcohol
• Barbiturates
• Tranquilizers
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
38
Problems and Disorders
Psychoactive Drugs: Depressants, Stimulants, and Hallucinogens
Fig. 13.6
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
39
Problems and Disorders
• Anabolic Steroids
– Drugs derived from the male sex hormone,
testosterone.
– Promote muscle growth and increase lean body
mass.
– Abused by some athletes and others who hope to
improve their sports performance and physical
attractiveness.
– Nonmedical uses of these drugs carry a number of
physical and psychological health risks (National
Clearinghouse for Alcohol and Drug Information, 1999).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
40
Problems and Disorders
• Anabolic Steroids (Continued)
– Users who take large doses of anabolic steroids
usually experience changes in sexual
characteristics.
– In males: a shrinking of the testicles, reduced
sperm count, impotence, premature baldness,
enlargement of the prostate gland, breast
enlargement, and difficulty or pain in urinating.
– In females: can trigger severe acne on the face and
body, a weakening of tendons (which can result in
rupturing or tearing), reduction in HDL (the “good”
cholesterol), and high blood pressure.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
41
Problems and Disorders
• Inhalants
– Ordinary household products that are inhaled or
sniffed by children and adolescents to get high.
• Examples include:
– Model airplane glue
– Nail polish remover
– Cleaning fluid
– Short-term use can cause intoxicating effects.
– Long-term use can lead to heart failure and even
death.
– Use of inhalants is higher among younger than
older adolescents.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
42
Problems and Disorders
•
Factors in Adolescent and Emerging Adult Drug
Abuse
– Being born into a high-risk family (especially a
poor, single, or teenage mother).
– An increase in harsh parenting in childhood.
– Child has conduct problems in school and gets
rejected by peers.
– Increased conflict with parents in early
adolescence.
– Low parental monitoring by parents.
– Young adolescent hangs out with deviant peers
and increases substance use.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
43
Problems and Disorders
Binge Drinking in the Transition from Adolescence to Adulthood
Fig. 13.7
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
44
Problems and Disorders
• Juvenile Delinquency
– Refers to a broad range of behaviors, from socially
unacceptable behavior (such as acting out in
school) to status offenses (such as running away)
to criminal acts (such as burglary).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
45
Problems and Disorders
• Juvenile Delinquency (Continued)
– For legal purposes, a distinction is made between
index offenses and status offenses:
• Index offenses are criminal acts, whether they
are committed by juveniles or adults.
– They include such acts as robbery, aggravated assault,
rape, and homicide.
• Status offenses, such as running away, truancy,
underage drinking, sexual promiscuity, and
uncontrollability, are less serious acts.
– They are performed by youth under a specified age,
which classifies them as juvenile offenses.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
46
Problems and Disorders
• Juvenile Delinquency (Continued)
– Conduct disorder is the psychiatric diagnostic
category used when multiple behaviors occur over
a six-month period.
– These behaviors include truancy, running away, fire
setting, cruelty to animals, breaking and entering,
excessive fighting, and others.
– If these behaviors result in illegal acts by juveniles,
society labels them as delinquents.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
47
Problems and Disorders
Number of U.S. Juvenile Court Delinquency Caseloads from 1960 to 2005
Fig. 13.8
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
48
Antecedents of Juvenile Delinquency
Fig. 13.9
McGraw-Hill
(Continued on next slide)
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
49
Antecedents of Juvenile Delinquency
(Continued from previous slide)
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
50
Problems and Disorders
•
Effective Prevention and Intervention Programs
– The most successful programs are those that prevent juvenile
delinquency from occurring in the first place.
• Examples include:
– Home-visiting programs that provide services to
pregnant adolescents and their at-risk infants.
– Quality preschool education that involves home visits
and working with parents.
– Improving family interactions and providing skills to
adults who supervise and train the adolescent.
• The least effective programs for reducing juvenile
delinquency are those that emphasize punishment or
attempt to scare youth.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
51
Problems and Disorders
• Violence and Youth
– An increasing concern is the high rate of
adolescent violence (Specter, 2008).
• Gangs
– It is estimated that there are more than 750,000
gang members in more than 24,000 gangs in the
United States (Egley, 2002).
– Most gang members are 12 to 26 years of age.
– Average age of 17 to 18 years of age.
– More likely to be male than female.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
52
Problems and Disorders
• Gangs (Continued)
– Often composed of adolescents from low-income
and ethnic minority backgrounds.
– It is estimated that approximately one-fourth of U.S.
gang members are made up of non-Latino whites.
– Often engage in violent and criminal activities.
– Criminal activities are used as an indication of gang
identity and loyalty.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
53
Problems and Disorders
• Gangs (Continued)
– Risk factors that increase the likelihood an
adolescent will become a gang member are:
• Disorganized neighborhoods characterized by
economic hardship.
• Having other family members involved in a gang.
• Drug use.
• Lack of family support.
• Peer pressure from gang members to join their
gang (Lauber, Marshall, & Meyers, 2005).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
54
Problems and Disorders
• School Violence and Shootings
– An issue of national concern in the United States.
– A 2005 national survey revealed a decline in
violence-related behaviors in schools.
• From 1991 to 2005 physical fighting declined from 16
percent to 13.6 percent.
• Weapon carrying in schools declined from 12 percent of
students to 6.5 percent.
– The violent youth are overwhelmingly male and
many are driven by feelings of powerlessness.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
55
Problems and Disorders
• School Violence and Shootings (Continued)
– Violence seems to infuse these youth with a sense
of power (Fritzon & Brun, 2005).
– Youth violence is far greater in poverty-infested
areas of inner cities.
– Factors often present in at-risk youths:
• Disorganized neighborhoods characterized by economic
hardship.
• Family members who are involved in a gang.
• Drug use.
• Lack of family support.
• Peer pressure from gang members to join their gang.
(Lauber, Marshall, & Meyers, 2005).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
56
Problems and Disorders
• Depression and Suicide
– The most frequent characteristics of adolescents
referred for psychological treatment is sadness or
depression, especially among girls.
• Depression
– Major depressive disorder
• An individual experiences lethargy and
hopelessness, for at least two weeks or longer
and daily functioning becomes impaired.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
57
Problems and Disorders
• According to the DSM-IV classification of
mental disorders (American Psychiatric
Association, 1994), nine symptoms define a
major depressive episode.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
58
Problems and Disorders
•
To be classified as having major depressive disorder,
at least five of these must be present during a twoweek period:
1. Depressed mood most of the day.
2. Reduced interest or pleasure in all or most activities.
3. Significant weight loss or gain, or significant decrease or
increase in appetite.
4. Trouble sleeping or sleeping too much.
5. Psychomotor agitation or retardation.
6. Fatigue or loss of energy.
7. Feeling worthless or guilty in an excessive or inappropriate
manner.
8. Problems in thinking, concentrating, or making decisions.
9. Recurrent thoughts of death and suicide.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
59
Problems and Disorders
•
In adolescence, pervasive depressive symptoms
might be manifested in such ways as:
–
–
–
–
–
–
–
–
McGraw-Hill
Tending to dress in black clothes.
Writing poetry with morbid themes.
A preoccupation with music that has depressive themes.
Sleep problems can appear as all-night television watching.
Difficulty in getting up for school.
Sleeping during the day.
Withdrawal from friends.
Adolescent depression also can occur in conjunction with
conduct disorder, substance abuse, or an eating disorder.
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
60
Problems and Disorders
•
How serious a problem is depression in adolescence?
– One-third of adolescents who go to a mental health
clinic suffer from depression (Fleming, Boyle, &
Offord, 1993).
– Depression is more common in the adolescent
years than the elementary school years.
– By about age 15, adolescent females have a rate of
depression that is twice that of adolescent males.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
61
Problems and Disorders
•
How serious a problem is depression in adolescence?
(Continued)
– Some of the reasons for the sex difference that
have been proposed:
• Females tend to ruminate in their depressed mood and
amplify it.
• Females’ self-images, especially their body images, are
more negative than males’.
• Females face more discrimination than males do.
• Hormonal changes alter vulnerability to depression in
adolescence, especially among girls.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
62
Problems and Disorders
•
How serious a problem is depression in adolescence?
(Continued)
•
– Mental health professionals note that depression
often goes undiagnosed in adolescence.
– Family factors are involved in adolescent
depression (Graber & Sontag, 2009).
– Poor peer relationships also are associated with
adolescent depression (Starr & Davila, 2008).
What type of treatment is most likely to reduce
depression in adolescence?
– Adolescents recovered faster when they took an
antidepressant and received cognitive behavior therapy that
involved improving their coping skills (Tads, 2007).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
63
Problems and Disorders
• Suicide
– Depression is linked to an increase in
suicidal ideation and suicide attempts in
adolescence (Werth, 2004).
– Suicide behavior is rare in childhood but
escalates in adolescence and then
increases further in emerging adulthood
(Park & others, 2006).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
64
Problems and Disorders
• Suicide
(Continued)
– Suicide is the third-leading cause of death
in 10- to 19-year-olds today in the United
States (National Center for Health Statistics, 2007).
– A suicide threat should always be taken
seriously.
– Far more adolescents contemplate or
attempt it unsuccessfully than actually
commit it (Miranda & others, 2008).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
65
Problems and Disorders
Percentage of U.S. 9th to 12th-Grade Students Who
Seriously Considered Attempting Suicide in the
Previous 12 Months from 1991 to 2005
Fig. 13.10
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
66
Problems and Disorders
• Suicide
(Continued)
– Females were more likely to attempt suicide
than males, but males were more likely to
succeed in committing suicide.
– Males use more lethal means, such as guns,
in their suicide attempts, whereas
adolescent females are more likely to cut
their wrists or take an overdose of sleeping
pills—methods less likely to result in death.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
67
Problems and Disorders
Suicide Attempts by U.S. Adolescents from Different Ethnic Groups
Fig. 13.11
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
68
Problems and Disorders
• Suicide
(Continued)
– Both early and later experiences may be
involved in suicide attempts.
– The adolescent might have:
• A long-standing history of family instability and
unhappiness.
• Lack of affection and emotional support.
• High control.
• Pressure for achievement by parents during
childhood are likely to show up as factors in
suicide attempts.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
69
Problems and Disorders
• Suicide
(Continued)
– Genetic factors are also associated with
suicide.
– In some instances, suicides in adolescence
occur in clusters.
• “Copycat” suicide
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
70
Problems and Disorders
• What is the psychological profile of the
suicidal adolescent?
– Depressive symptoms.
– Overly self-critical.
– A sense of hopelessness.
– Low self-esteem.
– High self-blame.
– A perception of being a burden on others.
– Thwarted belongingness.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
71
Problems and Disorders
What to Do and What Not to Do When You Suspect Someone Is
Likely to Attempt Suicide
Fig. 13.12
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
72
Problems and Disorders
• Eating Disorders
– Eating disorders have become increasingly
common problems in adolescence (Schiff, 2009;
Wardlaw & Smith, 2009).
• What research reveals about adolescent
eating disorders:
Body Image
Adolescence were dissatisfied with their bodies, with
males desiring to increase their upper body and females
wanting to decrease the overall size of their body (Ata,
Luden, & Layyy, 2007).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
73
Problems and Disorders
• What research reveals about adolescent
eating disorders (Continued):
Body Image (Continued)
Girls who felt negatively about their bodies in early
adolescence were more likely to develop eating
disorders two years later than their counterparts who
did not feel negatively about their bodies (Attie & BrooksGunn, 1989).
Adolescent girls with an eating disorder rated their
physical appearance lower and the importance of
physical appearance higher than their adolescent
female counterparts who did not have an eating
disorder (Kirsch & others, 2007).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
74
Problems and Disorders
• What research reveals about adolescent
eating disorders (Continued):
Parenting
Adolescents who reported observing more healthy
eating patterns and exercise by their parents had more
healthy eating patterns and exercised more themselves
(Pakpreo & others, 2005).
Negative parent-adolescent relationships were linked
with increased dieting by girls over a one-year period
(Archibald, Graber, & Brooks-Gunn, 1999).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
75
Problems and Disorders
• What research reveals about adolescent
eating disorders (Continued):
Sexual activity
Girls who were both sexually active with their
boyfriends and in pubertal transition were the most
likely to be dieting or engaging in disordered eating
patterns (Cauffman, 1994).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
76
Problems and Disorders
• What research reveals about adolescent
eating disorders (Continued):
Role models and the media
Girls who were highly motivated to look like same-sex
figures in the media were more likely than their peers to
become very concerned with their weight (Field & others,
2001).
Watching commercials with idealized thin females
images increased adolescent girls’ dissatisfaction with
their bodies (Hargreaves & Tiggemann, 2004).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
77
Problems and Disorders
•
Overweight Adolescents
– The Centers for Disease Control and Prevention (2009) has a
category of obesity for adults but not an obesity category for
children and adolescents because of the stigma the label
obesity may bring.
– Rather, the Centers for Disease Control and Prevention (2009)
does have categories for being overweight or at risk for being
overweight in childhood and adolescence.
– These categories are determined by body mass index (BMI).
– Only children and adolescents at or above the 95th percentile
of BMI are included in the overweight category.
– Children and adolescents at or above the 85th percentile of
BMI are included in the at-risk category.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
78
Problems and Disorders
• Overweight Adolescents
– The percentage of overweight adolescents
has been increasing.
– Being overweight as a child is a strong
predictor for being overweight as an
adolescent.
– An increase in being overweight has also
occurred in emerging adulthood (Park &
others, 2006).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
79
Problems and Disorders
• Overweight Adolescents
– U.S. children and adolescents are more
likely to be overweight or obese than their
counterparts in most other countries.
– A survey by the National Center for Health
Statistics (2002) found that African
American girls and Latino boys have
especially high risks of being overweight
during adolescence.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
80
Problems and Disorders
Percentage of Overweight U.S. Adolescent Boys and Girls in
Different Ethnic Groups
Fig. 13.13
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
81
Problems and Disorders
• Overweight Adolescents
– Eating patterns established in childhood
and adolescence are highly associated with
obesity in adulthood.
– 80 percent of obese adolescents become
obese adults.
– Both heredity and environmental factors are
involved in obesity (Hahn, Payne, & Lucas, 2009).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
82
Problems and Disorders
• Overweight Adolescents
– The dramatic increase in obesity is likely due to
greater availability of food (especially food high in
fat), energy-saving devices, and declining physical
activity.
– Being overweight or obese has negative effects on
adolescent health, in terms of both biological
development and socio-emotional development
(Schiff, 2009).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
83
Problems and Disorders
• What types of interventions have been
successful in reducing overweight in
adolescents?
–
–
–
–
–
A combination of caloric restriction.
Exercise.
Reduction of sedentary activity.
Behavioral therapy.
School-based approaches have been less effective
than the clinically based individual approaches
(Lytle & others, 2004).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
84
Problems and Disorders
• Anorexia Nervosa
– Anorexia nervosa is an eating disorder that
involves the relentless pursuit of thinness through
starvation.
– Anorexia nervosa is a serious disorder that can
lead to death.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
85
Problems and Disorders
•
Anorexia Nervosa (Continued)
– Three main characteristics of anorexia nervosa are:
• Weighing less than 85 percent of what is considered
normal for age and height.
• Having an intense fear of gaining weight. The fear does not
decrease with weight loss.
• Having a distorted image of body shape (Stice, 2002).
• Even when they are extremely thin, anorexics see
themselves as too fat. They never think they are thin
enough, especially in the abdomen, buttocks, and thighs.
• They usually weigh themselves frequently, often take their
body measurements, and gaze critically at themselves in
mirrors (Seidenfeld, Sosin, & Rickert, 2004).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
86
Problems and Disorders
• Anorexia Nervosa (Continued)
– Begins in the early to middle teenage years.
– 10 times more likely to characterize females than
males.
– Most anorexics are non-Latino white adolescents
from well-educated, middle- and upper-income
families that are competitive and high-achieving.
– “Thin is beautiful” contributes to the incidence of
anorexia nervosa.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
87
Problems and Disorders
• Bulimia Nervosa
– An eating disorder in which the individual
consistently follows a binge-and-purge eating
pattern.
– To have a serious bulimic disorder the episodes
must occur at least twice a week for three months.
– Most bulimics are preoccupied with food, have a
strong fear of becoming overweight, and are
depressed or anxious (Speranza & others, 2005).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
88
Problems and Disorders
• Bulimia Nervosa (Continued)
– Unlike anorexics, people who binge and purge
typically fall within a normal weight range, which
makes bulimia more difficult to detect.
– Typically begins in late adolescence or early
adulthood.
– About 90 percent of the cases are women.
– About 70 percent of individuals who develop
bulimia nervosa eventually recover from the
disorder (Agras & others, 2004).
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
89
Interrelation of Problems and
Prevention/Intervention
• Adolescents with Multiple Problems
– The four problems that affect most adolescents are:
(1) Drug abuse
(2) Juvenile delinquency
(3) Sexual problems
(4) School-related problems
(Dryfoos, 1990; Dryfoos & Barkin, 2006).
– The adolescents most at risk have more than one of
the problems listed above.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
90
Interrelation of Problems and
Prevention/Intervention
• Prevention and Intervention
– Programs that have been successful in preventing
or reducing adolescent problems:
• Intensive individualized attention
• Community-wide, multi-agency collaborative
approaches
• Early identification and intervention
– High Scope
– Fast Track
– National Longitudinal Study on Adolescent Health
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
91
RESOURCES FOR IMPROVING THE LIVES OF ADOLESCENTS
Adolescence by Joy Dryfoos and Carol Barkin. (2006).
New York: Oxford University Press.
An outstanding book on adolescent problems and the
programs and strategies that can successfully prevent and
intervene in these problems.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
92
RESOURCES FOR IMPROVING THE LIVES OF ADOLESCENTS
Developmental Psychopathology edited by Dante
Cicchetti and Donald Cohen. (2006). New York: Wiley.
This up-to-date three-volume set provides extensive
information about many aspects of developmental
psychopathology.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
93
RESOURCES FOR IMPROVING THE LIVES OF ADOLESCENTS
The Future of Children, Vol. 18, No. 2 (2008)
Up-to-date coverage of many aspects of juvenile
delinquency, including effective prevention and intervention
programs.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
94
RESOURCES FOR IMPROVING THE LIVES OF ADOLESCENTS
National Adolescent Suicide Hotline
800–621–4000
This hotline can be used 24 hours a day by teenagers
contemplating suicide, as well as by their parents.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
95
RESOURCES FOR IMPROVING THE LIVES OF ADOLESCENTS
National Clearinghouse for Alcohol Information
www.health.org
This clearinghouse provides information about a wide
variety of issues related to drinking problems, including
adolescent drinking.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
96
RESOURCES FOR IMPROVING THE LIVES OF ADOLESCENTS
Reducing Adolescent Risk edited by Daniel Romer.
(2003). Thousand Oaks, CA: Sage.
A number of experts analyze ways to reduce adolescent risk
in a number of problem areas.
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.
97
E-LEARNING TOOLS
To help you master the material in this
chapter, visit the Online Learning Center
for Adolescence, 13th edition at:
http://www.mhhe.com/santrocka13e
McGraw-Hill
Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved.