Chapter 14
Adolescent Problems
and Disturbances
A. What constitutes abnormality?
1. deviance from the cultural norms
2. maladaptive
3. personally distressful or distressful to significant others
B. What causes adolescent abnormality?
1. biological, genetic, and inherited factors
2. psychological problems involving thinking, feeling, and
behaving
3. familial problems
4. social and cultural factors (poverty, discrimination)
5. some combination of above factors
C. At a simple level, disorders of childhood and adolescence
can be characterized as externalizing
disorders (acting out, fighting, violence) and internalizing disorders (anxiety, unhappiness, depression).
D. Often, one can see the roots of adolescent disorders in the
behaviors of earlier developmental stages
1.
The more serious disorders
(depression, drug use, eating disorders) typically are shown by older
adolescents
2.
Externalizing
behaviors are most characteristic of males,
those from lower SES families, and those from single parent families
3.
Most children who
receive treatment have either depression or sadness, or school problems
4.
Seriously emotionally
disturbed (SED) vs. socially maladjusted (SM)
a. IDEA mandates criteria for placement in special education
and differentiates the two categories
b. Typically, the SED student will have an early developmental
pattern of behavior disorder, typically internalizing (anxiety and depression),
and poor social relations. By contrast,
SM appears to originate in adolescence and appears to involve externalizing
disorders (antisocial and defiant), little remorse, and peer influence.
5.
Assets to prevent
problems
The Search Institute
in Minneapolis described 40 developmental assets that are related to positive behavioral outcomes. These include
Clear rules and
boundaries at home and in school
Positive peer
influences
Constructive use of
time
Active engagement in
organized youth activities
High achievement
motivation
Interpersonal skills
High self-esteem
Positive values
E. Alcohol, drug use, and smoking
1. There are some similar reasons for their use. These include reducing tension and anxiety;
escape from reality; curiosity and experimentation; desire for maturity;
lowering social inhibition; fitting in and peer pressure; as part of sexual
behavior.
2. Most adolescents use some drug at some point during the
adolescent period
3. Generally, for nearly all drugs, the prevalence rates
increase from early to late adolescence with the exception of inhalant drugs
4. The most widely used drug is alcohol.
5. There are approximately 13M adult alcoholics. The pattern is established during the
adolescent years.
6. Alcohol intoxication is a major factor in accidents (car,
boat, swimming, etc), sexual violence, and violence against persons and
property.
7. While alcohol use is decreasing, the rates still remain
high.
8. Alcohol risk factors
Most of the substance
abuse models stress positive parental models and peer models as major factors
in the avoidance of drugs. The risk
factors are:
a. family dysfunction and/or family sanctioning
b. peer group use and acceptance
c. personal stress and poor self-image
d. genetic predisposition
9. Cigarette smoking
a. nicotine is the drug most widely used on a daily basis
b. smoking habits usually begin in middle school; by 8th
grade almost half the eighth graders have tried cigarettes
c. during the adolescent years there is an increase from about
1/5 to 1/3 students smoking.
d. The younger one starts to smoke, the heavier they smoke and
the harder is it to break the habit; the younger one starts the greater is the
physical damage
e. Adolescent smokers
typically come from smoking families, particularly the mother
f.
most school-based
prevention programs do a good job of educating around smoking risks but not
preventing smoking behavior
g. some of the best programs emphasize not only the negative
effects of smoking but the positive effects of a health life style.
10.Other drug prevalence rates
a. decreasing prevalence for amphetamines
b. decreasing prevalence for cocaine
c. decreasing use of tranquilizers
d. increasing use of marijuana and LSD
e. increasing use of heroin
f.
increasing use of
anabolic steroids
F. Alcohol, Drug, Smoking Intervention
1. Programs have taken a wide variety of forms
and have dealt both with reducing access (enforcement, raising of legal
drinking age) and the accompanying psychological issues (employing school-based
and family programs)
2. School intervention
a. programs deal both with the dangers of drugs, and resisting
peer pressure and teaching social skills
b. program should start before
the adolescent experiments with drugs
c. most effective programs usually include peer facilitators
and involve members of the community (community-wide programs)
d. evaluations: usually
compare those in program to similar control students who are not in the
program; usually need to include delayed as well as immediate posttest measures
G. Delinquency and violence
1. About 10% of adolescents are arrested each year for a
juvenile delinquency offense. The
male-female ratio is about 3:1.
2. index offenses and
status offenses
a. status offenses are less serious acts and comprise juvenile
offenses; typically, these would not be acts that an adult would be charged
with (e.g., running away, truancy, defiance of parents)
3. conduct disorder: a
psychiatric term for the occurrence of multiple delinquent activities over a
sixth month period; behaviors include truancy, running away, fire setting,
cruelty to animals, excessive fighting, and others.
4. what are the predictors of delinquency?
(1)
negative
self-identity
(2)
lack of self-control
(3)
early initiation of
delinquent acts
(4)
male gender
(5)
low expectations for
academic success
(6)
poor school grades,
especially in earlier years
(7)
negative peer
influence
(8)
low SES
(9)
poor parenting,
management, and poor family support
(10) living in high crime environment
5. There was a significant and serious increase in youth
violence between 1983 and 1993. This
was primarily a function of an increase in acts involving minority males and
the use of firearms.
Serious
violence includes murder, rape, robbery, violence with a weapon
10%
of all schools experience at least one incident of violence each year
What
is associated with youth violence?
1)early
involvement with drugs and alcohol
2)
access to weapons, especially lethal weapons
3)
association with antisocial peers
4)
pervasive exposure to media violence
What
appears to stem the increase in youth violence?
1) effective early identification and prevention programs
2) conflict resolution programs in which all students are
trained how to avoid violence as an option, and learn how to mediate conflicts
H. Depression and suicide
1. Depression is a serious problem that increases during
adolescence and often carries over into adulthood; however, it often goes
undiagnosed. It is far more common in
females than males.
2. Depression has both genetic and
environmental causes. Factors include parent(s) with depression history, family
conflicts, economic problems, and poor peer relationships. Thus, it is usually treated with drugs and
psychotherapy, primarily cognitive therapy.
3. A number of symptoms, usually five or more,
define depression. These include
a. depressed mood
b. disinterest in activities
c. changes in appetite
d. changes in sleeping patterns
e. psychomotor agitation
f.
loss of energy
g. excessive feelings of worthlessness
h. problems in thinking and making decisions
i.
recurrent thoughts of
death and suicide
4. Suicide is a leading cause of adolescent death and can be
triggered by both longstanding causes (genes, family conflict, lack of family
support and warmth) and more immediate causes (school failure, ending
relationships, peer conflicts, pregnancy, incarceration). Hopelessness, low self-esteem, and high
self-blame are associated with suicide.
Suicide rates have risen markedly in the last 50 years. About 10,000 college students attempt
suicide each year. Estimates suggest
that approximately 18%-28% of adolescents seriously consider suicide.
I.
Eating
disorders: the most common are obesity,
anorexia nervosa, and bulimia
1. Obesity affects 25% of adolescents, and obese adolescents
tend to be obese adults
2. The causal factors are both genetic (constitutional,
biochemical) and environmental (poor eating and lowered physical activity)
3. Anorexia and bulimia primarily affect females, and both
involve rapid and unhealthy weight loss to achieve thinness
4. Anorexics choose starvation and have a distorted body
image. The causal dynamics, although
unknown, appear to involve controlling families that push for high achievement
5. Bulimics follow a binge and purge
(self-induced, laxatives, etc.) pattern.
Bulimics cannot control their eating and often are depressed as
well. It appears to affect about 5% of
college females