Adolescent/Young Adult
Brain Development
And Drugs
Dean Blumberg, PhD, LMFT, CADC
Kaiser CDRP, San Francisco
dean.blumberg@kp.org
1
OBJECTIVES
Review:




Adolescent brain development
Gender differences
Effects of substance abuse and chemical
dependency on adolescent development
Substance abuse prevention for parents
2
THE JOURNEY
Storm and Stress:
Not always
(Offer and Offer, 1975)
3
3 Pathways (rides) through
adolescence (Caviola & Kane- Caviola, 1989,) :
(1) The Kiddy Roller Coaster – continuous
growth group (23%) - well-adjusted teens
who meet the demands of this stage.
(2) Go For a Ride or 2 on the Big Roller Coaster surgent growth group (35%) comprised of
reasonably well-adjusted youngsters, who may
have difficulty coping with unexpected
4
trauma.
3 Pathways (rides) through
adolescence (Caviola & Kane- Caviola, 1989,) :
(3) Go For the Biggest,
Scariest Roller
Coaster You Can
Find - tumultuous
growth group (42%)
characteristic of the
adolescent turmoil
hypothesized by the
‘storm and stress’
theorists.
5
Which One?
(1) The Kiddy Roller Coaster
(2) Go For a Ride or 2 on
the Big Roller Coaster
(3) Go For the Biggest,
Scariest Roller Coaster
6
THE TASKS
Individuation and Separation
7
Identity Development
EXPLORATION
“Sex, Drugs and Rock ‘n Roll”
Hip Hop”
“Teenagers define their identity
through risk-taking . . .”
- Shedler and Block
“. . . balance exploration with
commitment to formulate a sense of
8
identity.” (Trad, 1994)
Identity Development
Exploration –
Oppositional as a Transitional Step

“not trusting adults”

to develop identity

When CD: pseudoindividuation (Haley)
9
Identity Development
EXPLORATION –
Neurological Basis


The reward/pleasure system.
Dopamine (DA) is the final
neurotransmitter.
10
Identity Development
EXPLORATION –
Neurological Basis
Dopamine (DA) is depleted in teens’ reward
system.
Because DA has migrated to help develop the
prefrontal cortex
11
Identity Development
EXPLORATION –
Neurological Basis

Teens often need more stimulating activities to
get the same kick as adults get.
• DA increases w/high risk-taking in the nucleus
accumbens (NAc).
(Strauch,97; Galvin, et. al., 2006)
12
Identity Development
EXPLORATION –
Neurological Basis

NAc Activity in response to rewards
:
(Galvan, A., et
al., 2005 and Galvan, A., et al., 2006)
• Adults: Corresponds to level of reward.
• Children: The same despite level of reward.
“. . . Kids were happy to play the game . . .”
• Teens: All-or-Nothing - High to high
rewards. Low to moderate and low
rewards.
13
Identity Development
EXPLORATION –
Neurological Basis

Evolutionary basis:
• Explorers for the tribe
• Broaden the gene pool?

One Consequence: More susceptible to
substance abuse & chemical dependence.
14
Neurological Development
Phases of Growth

DEVELOPING POTENTIAL

DEVELOPING ABILITIES

BECOMING CONSISTENT & EFFICIENT
(childhood – 11/12 y.o.)
(puberty – 19 y.o.)
(19 –
26 y.o.)
15
Neurological Development
Developing Potential –
Childhood - Prepuberty

Brain thickening – Dendrite
Growth
• Grey matter over-production until
11 y.o.- girls & 12 y.o. boys
• 4 million dendrites/neuron

Brain highly receptive to new
information & skills

Primed to acquire new skills
16
Neurological Development
Developing abilities Puberty – 19 y.o.

Pruning and Shaping
• Developing abilities
17
Neurological Development
Developing abilities 
Puberty – 19 y.o.
“Use It or Lose It”

“You are hard-wiring your brain in
adolescence. Do you want to hard-wire it
for sports and playing music and doing
math . . .

or for lying on the couch in front of the TV?”

Jay Giedd, MD, NIMH
18
Neurological Development
Developing abilities  “Use It or Lose It”
15 – 19 y.o.
19
Neurological Development
Phases of Growth

19 – 26 y.o.: Myelination
• Becoming consistent and efficient
20
Neurological Development
Becoming consistent & efficient –
19 – 23 -> 26 y.o.

Electrical charge travels 100x times
faster on a myelinated axon than on
unmyelinated one.

Speeds and smoothes signals
• Less jumping to unintended neuron

> 200 miles per hour
21
Neurological Development
Intelligence & Skills

Don’t use it, you lose it =
• less dendrites.
• less myelination SO messages travel
slower
=
22
Neurological Development
Intelligence & Skills

More dendrites/connections + Thicker
myelination/faster message travels =
INTELLIGENCE!
23
Neurological Development
Direction of Growth
Growth begins at the back and moves to
the front of the brain.
24
25
Neurological Development
Growth
26
Neurological Development
Frontal lobes

The brain’s so-called chief executive.

Fully developed frontal lobes =
grown-up.

Executive functioning: planning,
organization, decision making, emotional
processing, response inhibition
27
Neurological Development
Frontal lobe

The brain’s chief executive.

The human frontal lobe
comprises:
30%
28
Neurological Development
Frontal lobe

Dogs?
7%
29
Neurological Development
Frontal lobe

Cats?
3%
30
Neurological Development
Executive Functioning

Onset of puberty begins remodeling.
• DA migrates to frontal lobes as part of
development

DA involved in ability to recognize when something
is important and take action
31
Neurological Development
Executive Functioning

This growth spurt and pruning of
synapses leads to relative inefficiency
in circuitry. For ex.:
• Speed can identify emotions drops by as
much as 20%.
• Returns to normal levels only at age 18 or
older. (McGivern, 2002)
32
Neurological Development
Executive Functioning

Younger teens use the more crocodile like
amygdala part of their brain to process emotions.
(Yurgelun-Todd, 1999)
33
Neurological Development
Executive Functioning

Often misread facial expressions.
• For ex., frequently mislabel
fear as anger.
34
Neurological Development
PreFrontal Cortex

Impulse Control-The Brain’s Police
35
Neurological Development
Amygdala


Lots of connections between amygdala and
prefrontal cortex (PC)
“Do something part of the brain”
36
Neurological Development
PreFrontal Cortex

Amygdala: Robust @ 9 weeks old
• Neg. emotions have a more powerful and longer
impact than positive emotions so can survive.
37
Neurological Development
Amygdala

Hormonal Influence



Due to surge in hormones: amygdala
hyperactive
Hyperactive amygdala + not-fully developed
prefrontal cortex = “the roller coaster”
Not uncommon for early adolescents to experiment with SDB
like cutting as part of general exploration, to get some temp.
pain relief and increase DA in reward pathway.
38
TMI?
Too Much Information?
39
Neurological Development
The Low Road

The amygdala, reward pathway and other
emotional centers along w/the “reptilian,”
automatic brain responses comprise the
FAST MOVING, LOW-ROAD
of the
brain.

The
“GO”
part of the brain.
40
Neurological Development
The High Road

The cortex, particularly the frontal
cortex, is the “thinking brain” that is
SLOW MOVING, HIGHROAD of the brain.
the
41
Neurological Development
PreFrontal Cortex

The
“STOP” part of the brain:
42
Neurological Development
PreFrontal Cortex

15 y.o. brain does not have the biological
machinery to inhibit impulses in the service
of long-range planning.
• One reason teens can “flip out” @ a moments
notice

“Adolescents make a lot of decisions that
the average 9 yr. old would say [were] a
dumb thing to do.”
Ronald E. Dahl, MD, Univ. of Pittsburgh Medical Center, NYAS Magazine 2003
43
Neurological Development
Phineas Gage Syndrome

1848-Phineas Gage first taught us about the frontal lobes: impulse control and
personality.

He was a foreman of a railroad construction crew laying tracks in Vermont.

He was honest, reliable, hardworking, smart and respectful, a very likeable guy.

Tamping down a dynamite charge when it exploded.

It launched a 13 lb., 4 ½ foot tamping rod through his left cheek and out the
top of his head.

It didn't kill him. He remained conscious.

Phineas became a belligerent, cursing, dishonest schemer.

Sometimes, teens PFCs stop working . . .
44
Neurological Development
PreFrontal Cortex

Immortality and Omnipotence
• Rates of mortality in youth ages 10–24,
by cause:

Motor vehicle accidents - 32%

Unintentional injuries - 12%

Homicide - 15%


Suicide - 12%
All other causes - 29%
45
Neurological Development
PreFrontal Cortex
Adolescent dilemma:
“ . . . want to be adults and
they’re exposed to a semiadult culture, but they don’t
have the prefrontal cortex
to regulate those adult behaviors.” (Giedd,
MD)
46
Neurological Development
PreFrontal Cortex
Adolescent dilemma:
“They have the passion and
the strength but no brakes
and . . . may not get good
brakes until . . . twentyfive.” (Giedd, MD)
47
Neurological Development
PreFrontal Cortex
Parents, teachers and therapists task:
“Sometimes need to act as though they
are their teenagers’ “frontal cortex . . .
talking through possibilities and options.
They have to function like a surrogate
set of frontal lobes, an auxiliary
problem solver.”
48
Neurological Development
Sleep effects
• Sleep cycle-circadian rhythm
 Night owls to guard the cave,
keep the fire going?
• Too little sleep impairs a teenager’s
thinking ability and can cause a
variety of problems . . .
• Teenagers are most sleep-deprived
segment of pop.
49
Neurological Development
Sleep effects
•Most adol. need to sleep ~9 hours.
• Dendrites grow during sleep, if you get enough sleep.
• Get enough sleep, all neurons fire and rehearse
learning.
 Also, can’t learn if tried to learn too much the day
before.
50
Cognitive Development
Formal Operations

Use of logic



hypothesis development and validation through
experimentation (Brisbon & Chambers).
“Capacity to engage in propositional thinking, go
beyond the here and now to understand abstract
concepts . . .” (Caviola & Kane- Caviola, 1989, 17)
Ex. of hypothesis testing looking for honesty:
– Teen who called in early AM 12 step members who didn’t
seem sincere re/giving their #’s.
51
Cognitive Development
Formal Operations
Decision making/problem solving

Predicting the probable outcomes of
behavior

Weighing options and selecting
alternatives
52
Cognitive Development
Formal Operations



Females: 14 -16 y. o.
Males: 16 – 18 y. o.
Full ethical/moral:
~ 24 – 26 y.o.
53
Cognitive Development
Formal Operations
Abstraction/Ideals



Teen hypocrisy: “To an adolescent expressing an
ideal is equal to living up to it.” (Caviola & KaneCaviola, 1989, 18)
“Hypercritical of parents, . . . able to imagine the
perfect parents or perfect family and now realizing
that yours is not perfect makes for a critical,
argumentative adolescent.” (Caviola & KaneCaviola, 1989, 17)
“At a certain point, many teenagers start a rash of
lying, . . . a way of solving problems and could
again point back to the development of the frontal
54
lobes.” 119
Hormonal Changes


Hormones with feet.
Terrible 2's in big bodies.- Lack of impulse
control.
• Puberty is developing 2 yrs. earlier in girls-and
somewhat earlier, in boys than 100 yrs. ago.
 Speculation that puberty/menses is starting
earlier in girls due to hormones in food.
• Increase in thrill-seeking behavior . . . “an
engine w/o a driver.” (Strauch, 96)
55
Hormonal Changes

Poor parental relations:





High testosterone sons - more likely to engage in risky
behavior, e.g., skipping school, sex, lying, drinking, and
stealing.
Low testosterone sons - more likely depressed.
Low testosterone daughters - who had poor relations
with their mothers - more likely to do risky things.
Low testosterone daughters who had bad relations
with their fathers - more likely depressed.
(Strauch,142)
With good relationships, high and low testosterone
levels don’t matter at all.
56
Gender Differences
80% of women and 20% of men have
similar brain architecture:
Better better designed for info. processing,
language development and relational
skills.
57
Gender Differences
80% of men and 20% of women have
similar brain architecture:
Built for action, motor
skills, spatial reasoning,
problem solving.
58
Gender Differences
Boys Are From Pluto Uranus

Boys are ‘‘wired’’ to act on their emotions
rather than work through them with
language.

Boys have more Cerebrospinal fluid (CSF):
The main purpose of CSF appears to be to
cushion the brain in the case of trauma to the
cranium
59
Gender Differences
The Hemispheres

The brains of men consistently show
more hemispheric asymmetry than
women
• Men’s left hemisphere ‘‘looks’’ different
from the right; function more
independently.
• Women’s two hemispheres are essentially
indistinguishable either by MRI or at
60
autopsy
Gender Differences
Connecting the Hemispheres

Corpus Collusum (CC): Use both hemispheres
for abstract thinking, communication, writing,
multitasking.
• Women’s CC: Freeway
• Men’s CC: Dirt road
61
Gender Differences
Stress

Women under stress: release Oxytocin,
cuts off connection to amygdala.
• One reason can have a child again; doesn’t
let burn into the HC.

Oxytocin: female more susceptible to
caring, nurturing, and connection/
bonding
62
Gender Differences
Stress

Men under stress produce testosterone
= ACTION!
• Boys are nearly twice as likely to report
having been in a physical fight and nearly
5x as likely to have carried a weapon.
63
Gender Differences
Stress
When do male brains produce “the cuddle
hormone,” Oxytocin?
64
Gender Differences
Stress
Under sexual conditions.
65
Gender Differences
Two recommendations for boys

Give an adolescent male some time to get
ready to discuss how he is feeling.
• For example, if a parent needs to talk to a boy
about his poor report card, it is better to say to
him, ‘‘I’d like to talk to you about your report card
when you are ready,’’ rather than confront him
without warning.

Boys also may have an easier time
‘‘unlocking’’ their emotions if they are allowed
to move around.
• Taking a walk or shooting baskets while discussing
tough issues is likely to be more rewarding than
66
sitting him down on the couch.
Gender Differences



Middle-school girls who ate with their
families at least 5x/week were much
less likely to use alcohol, tobacco or
marijuana 5 years later.
Boys: No association between family
meals and substance-using behavior.
Girls could be picking up on subtle
reinforcing messages from family
members — signals that boys may tend
to miss.
Journal of Adolescent Health , August 2008, Pages 151-156
67
Gender Differences
RISK TAKING & SELF-ESTEEM
•
Risk taking - correlated to high selfesteem
•
Boy’s brain: produces testosterone
•
•
Primed to take risks w/little thought,
Girl’s brain: produce oxytocin
•
Help girls take a risk by putting into a
relationship/caring context
68
Risk of Developing Chemical
Dependency

Due to brain development, adolescent
brain is very susceptible to CD:
• Increased receptor sites


50% more receptors for nicotine
Adol. rats given typical nicotine of daily smoker
produced 2x the nicotine receptors in VTA
(craving)
69
Risk of Developing Chemical
Dependency

Decreased DA in reward pathway

Poor impulse control (prefrontal cortex)

Psychological stress


Stress can reduce DA receptor sites
Lower susceptibility to negative side effects:
sedation, motor problems, hangovers, etc.,
70
71
Alcohol Dependence Onset
Past-year DSM-IV Alcohol Dependence by Age in the United States
Source: NIAAA 2001-2002 NESARC data (18-60+ years of age) and SAMHSA 2003 NSDUH
(12-17 years of age)
Drug Dependence Onset
Hazard rates for age at onset of DSM-IV drug abuse and dependence
Compton, W. M. et al. Arch Gen Psychiatry 2007;64:566-576.
Copyright restrictions may apply.
Chemical Dependency: Risks
 Inherited predisposition (genetics)
 Childhood trauma or abuse*
 Unwanted sexual involvement before age 13*
 Mental Illness: depression, anxiety, personality disorder
(teen or other family member)*
 Attention Deficit Hyperactive Disorder (ADHD)
 Learning disabilities/school failure
 Parental discord or divorce*
 Parental substance abuse*








*
Subjected to teasing, bullying
Acne and/or obesity
Other than heterosexual orientation
Social rejection
Onset of drug use before age 16
Enabling environment
Ignorance
Using energy drinks
Rothman, Emily F., Edwards, Erika M., Heeren, Timothy, Hingson, Ralph W. Adverse Childhood Experiences Predict Earlier Age of Drinking
Onset: Results From a Representative US Sample of Current or Former Drinkers Pediatrics 2008 122: e298-e304
74
FIGURE 6 Association of age of initiation of alcohol use and
lifetime dependence (meeting Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, criteria for dependence at some point in one's life)
Masten, A. S. et al. Pediatrics 2008;121:S235-S251
Data source: 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions.7
Copyright ©2008 American Academy of Pediatrics
Chemical Dependency: Resilience
Factors
 No family history of addiction
 Good mental health
 Academic competence
 Positive relationship with an adult
 Family eats dinner together 5 days/wk
 Positive peer group participation
 Participation in sports
 Participation in music, drama or dance
 Involvement in faith-based activities
 Taking care of pets
 Volunteer activities
 Social acceptance
 Environment disapproves of drug use
 Immediate, appropriate scaled consequences for alcohol/drug use.
76
 Early intervention for alcohol/drug use
Impact of Chemical Dependency

Teens who drink avg of 2 drinks/day for 2
yrs. or weekend binge drinking for 1 yr.:
10% smaller HC and recall 10% less
• = to at least one grade lower

Adult rats need 2x as much beer as an
adol. rat for equivalent amt. of HC damage
(Strauch, 177)
77
Impact of Chemical Dependency

MARIJUANA:
16 y.o.
2 year history of daily abuse
Normal
underside surface view of prefrontal and temporal
lobe activity
© 2006 Amen Clinics Inc
78
Neurogenic Denial

MARIJUANA:
18 y.o.
3 year history of 4x/week
Normal
underside surface view of prefrontal and temporal
lobe
activity
© 2006 Amen Clinics Inc
79
The Need to Deny Chemical
Dependency

The PET-scan images to show the brain’s response to the avalanche of dopamine in the nucleus accumbens of
people with dependencies. To relieve the chronic stimulation of its neurons, the nucleus accumbens simply
reduces the number of dopamine receptors that they have.

In these images of the brain, the red areas indicate large numbers of dopamine receptors. These images
show that people who are alcoholic, obese, or cocaine-dependent have fewer dopamine receptors than
normal people do.
80
Impact of Chemical Dependency

MARIJUANA & Memory:
16 y.o.
2 year history of daily abuse
underside surface view of prefrontal and temporal
lobe activity
© 2006 Amen Clinics Inc
81
Impact of Chemical Dependency
MARIJUANA & Virtual Novelty


Instant Interest & Fun, BUT . . .
Leads to More Boredom



So, want to use more
Memory & learning problems
Slower Reactions

Pilots 24 hrs. later
82
Marijuana & Cancer
70% increased risk of testicular cancer*
associated with current marijuana use
 The risk is particularly elevated for:
 Current, at least weekly use
or
Use that began in adolescence.
* approx
1 in 36,266 or 7,500 people in USA/yr.
Rate increasing 3 – 6%/yr for past ~ 50 yrs.
83
5-HT levels in monkey after MDMA (two 5 mg/kg daily for 4 days)
• Result:
-long-term
loss of 5HT
fibers in
monkeys
2 weeks
7 years
(caudate nucleus)
(Hatzidimitriou et al., J. Neurosci. 19 [1999] 5092)
-some
recovery
Image courtesy of Dr. GA Ricaurte, Johns Hopkins University Bloomberg School of Medicine
Impact of Chemical Dependency
Teen heavy smokers:

4x more likely to develop depression
with in a year.

15x greater risk of developing panic
attacks as adults.
• Anxiety levels were no higher than others
to begin with . . .

Possibly due to respiratory prob. which can trigger panic attacks. After a few years
of smoking , lung capacity is reduced, smokers take in less oxygen, and exhale
less carbon dioxide. Carbon dioxide in the blood stimulates breathing and too
much of it sends a signal to the brain that it’s suffocating, setting off a false alarm
and a panic attack. (Strauch,184)
86
Impact of Chemical Dependency

Delayed or Arrested Development
• The phenomena of early stage physical symptoms
with middle and late stage emotional impairment.
• Liquid Courage

Ex.: Empathy Difficulties - Rely on drugs for
coping so delayed development of
relationship coping skills.
• Difficulty understanding other’s point of view.
• Narcissism?
87
Impact of Chemical Dependency

Use drugs or drink:

Short term gain, long term pain

Don't go for the easy, quick high:

Short term pain, long term gain!
88
Prevention Goals
I. Education
II. Commitment to not drink/use drugs and
drive or ride with others who are
intoxicated
III. Support primary objective of no ATOD
use under 21
89
Parents’ Perceptions of Teen Alcohol Use
Drank alcohol at least 1x in past yr.
Source: Pride Surveys National Summary for Parents, 2004-05
90
Parents’ Perceptions of Teen Drug Use
Used a drug at least 1x in past yr.
Source: Pride Surveys National Summary for Parents, 2004-05
91
Prevention


LOVE, LIMITS & LISTENING
Don’t:
• Lecture
• Nag
• Preach or
• Give unwanted advice

Don’t Inflict Help!
92
Prevention

LISTEN, LISTEN, LISTEN
• Bite your tongue
• They need you to hold up the mirror . . .
• Adolescence: Learner’s permit on life
• Mistakes are an opportunity to learn
93
Prevention
LISTEN, LISTEN, LISTEN CONT’D:

Teens need you to respect their
“No’s,” before they will give you a
“Yes.”

DON’T INFLICT HELP!

Earn the right to ask 1 time:
• “Would you like to know what I think?,
Would you like a suggestion?,” etc.
94
Prevention
LISTEN, LISTEN, LISTEN CONT’D:
If don’t want your advice/opinion:
• “You’ve got a good head on your
shoulders, I’m sure you’ll figure it out . .
.”
• “I trust you to know when to ask for
help when you need it . . .”
• “I have faith in you . . .”
95
Prevention
LISTEN, LISTEN, LISTEN CONT’D:

Positive One on One Time**
–
Break the coercion “log jam.”
–
Spend positive time with your teen first.
–
Take a sabbatical from teaching, judging, lecturing,
directing, correcting, etc.
–
15-20 min. 3-4x per week.
–
Let your teen choose something enjoyable
or

Notice when your teen is doing a fun
activity, approach, make positive
comments, and stick around
** From “Your Defiant Teen,” Barkley, Robin, & Benton, 2007
96
Prevention

LIMITS:
• + and – consequences
• Written down


They need “No's” to develop selfdiscipline
No limits =
DDD
•Discipline Deficit Disorder
D. Walsh, PhD
97
August 4, 2008
Vol. 17, Issue 31
Percentage of South Dakota Students Reporting Heavy Drinking in 9th and 11th Grades,
by Permissiveness of Household
Permissive Household
Nonpermissive
(n=313)Household (
100%
74%
80% 76%
60%
40%
27%
20%
8%
0%
Heavy Drinking
Heavy
in 9th
Drinking
Grade in 11th Gr
*Data are from a sample of 3,687 7th grade students recruited from 48 South Dakota schools in 1997-1998, with follow-up assessments conducted in grades 8, 9, 10,
and 11. Nonpermissive households (n=397, 10.3% weighted) were defined as parents being “very upset” to know that their child drank alcohol or used
marijuana, knowing “all of the time” where to find their child, and telling the child “all of the time” what time to be home. Permissive households (n=313,
10.2% weighted) were defined as having at least three of these four characteristics: parents being “not at all” or “a little” upset to know that their child drank
alcohol or used marijuana, knowing “sometimes” or less often their child’s whereabouts, and telling the child “sometimes” or less often what time to be
home. The remaining 79.5% (n=2,977) of the sample were from households that fell in between these two extremes in terms of permissiveness and were not
analyzed.
SOURCE: Adapted by CESAR from Tucker, J.S., Ellickson, P.L., and Klein, D.J., “Growing Up In a Permissive Household: What Deters At-Risk Adolescents
from Heavy Drinking?,” Journal of Studies on Alcohol and Drugs 69(4):528-534,2008. For more information, contact Dr. Joan S. Tucker at joan_tucker@rand.org.
Prevention


LIMITS:
When angry, don’t act, take a break,
and think about what you want to do.
• “When you feel like taking the wind out of his
sails . . . take your sails out of his wind.”
• Mirror neurons

Apologize when you make a mistake

Let them get the last word
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Prevention

Giving Effective Commands
– Make sure you mean it
– Make it simple, direct, in a business like tone, not
a question (there is no choice)
– Tell what to do rather than what not to do
– Make sure you have teen’s full attention
– If giving time limit, give teen a timer to use.
– Give limited choices.

** Start off w/things you know
they’ll do: go to the mall, have
another dessert
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Prevention

If can only do one of the 3 L’s:
LOVE
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Selected References
The Primal Teen, Barbara Strauch
Marijuana: What’s a Parent to Believe?,
Timmen Cermak
Why Do They Act That Way? A Survival
Guide to the Adolescent Brain for You
and Your Teen, David Walsh
Inside the Teenage Brainhttp://www.pbs.org/wgbh/pages/frontline/shows/teenbrain/i
nterviews/giedd.html
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Don't panic. You can do this.
http://timetoact.drugfree.org/
103
Safe Drinking Guidelines for
Adults
Moderate Drinking is…
For Men: no more than 2/day, 14/week
or 5 drink tolerance
For Women/Elderly: no more than
1/day, 7/week or 4 drink tolerance
(M) 2 - 14 - 5
(W) 1 - 7 - 4
(NIAAA, 2000)
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Prevention
105
Neurological Development
Direction of Growth

Occipital, parietal and temporal lobes largely
mature in older adolescents.
• Parietal – logic and spatial reasoning.
• Temporal – language.
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