Transcript Teen Brain. iroquois ridge

Jean M Clinton B.Mus MD FRCP(C)
McMaster University and Children’s Hospital
Offord Centre for Child Studies
Council for Early Child Development
Disclaimer… No drug company sponsorship
03-013
THE BRAIN FAIRY
The Hostage Brain , Bruce S. McEwen and Harold M. Schmeck, Jr., 1994.
Kids Today
"The children now love luxury; they have bad
manners, contempt for authority; they show
disrespect for elders and love chatter in place
of exercise. Children are now tyrants, not the
servants of their households. They no longer
rise when elders enter the room. They
contradict their parents, chatter before company,
gobble up dainties at the table, cross their legs,
and tyrannize their teachers."
Adolescents: Why DO they do the things they do?
Defining Adolescence
• That awkward period between sexual
maturation and the attainment of adult
roles and responsibilities.
• The transition from: “child” status
(requires adult monitoring) to “adult”
status (self-responsibility for behavior).
• The developmental interval that
encompasses the body and brain changes
of puberty.
Emerging Science:
Teen Brains Are Still
“Under Construction”
New insights about:
• Risk taking by teenagers
• How teenagers may be highly
vulnerable to drug abuse
Why do we care about brain?
YOU ARE YOUR BRAIN.
• BUT- Your brain is not just produced by
your genes
• Your brain is sculpted by a lifetime of
experiences.
Dr Robin Gibb U of Lethbridge
Nature/ Nurture
• No longer a debate
• Environment leaves its mark on our genome
•
and can modulate future gene expression in a
sometimes heritable fashion
The study of how environment leaves its
footprint on the genome falls into the domain
of Epigenetics
Dr Robin Gibb U of Lethbridge
Connections
are
formed and
altered
by experience
But, not
done until
at least age
20 years…
10
04039
Two Neurons
Axon
RECIPIENT
NEURON
Synapse
SIGNALSENDING
NEURON
Dendrite
Founders Network
SYNAPSE
What Have We Learnt?
•
Adolescence is a period of profound brain
maturation.
•
We thought brain development was complete by
adolescence
•
We now know… maturation is not complete until
about age 25!
Source: Giedd, 2004.
Rate of Change
Brain Development
Source: Tapert & Schweinsburg, 2005
Brain Development
When the pruning is complete, the brain is faster and
more efficient.
But… during the pruning process, the brain is not
functioning optimally.
Source: Giedd, 2004.
Brain Development
Maturation Occurs from Back to Front
of the Brain
Images of Brain Development in
Healthy Youth (Ages 5 – 20)
Blue represents maturing of brain
areas
Source: Gogtay, Giedd, et al., 2004.
Copyright © 2004 The National Academy of Sciences, USA
Gogtay, N., Giedd, J.N., et al. (2004)
Dynamic mapping of human cortical development during childhood through early adulthood
Proceedings of the National Academy of Sciences, 101 (21), 8174 – 8179
Implications of Arrested Development:
Adolescent Behaviour
Earlier development of the back of
the brain and later development of
the front of the brain …
The Frontal Lobes
“Executive Functions”
Governing emotions
 Judgment
 Planning
 Organization
 Problem Solving
 Impulse Inhibition
 Abstraction
 Analysis/synthesis
 Self-awareness*
 Self-concept*
 Identity
and
 Spirituality

*Self- “everything”
Williamsgroup, 2003: Please credit Protecting You/Protecting Me (PY/PM)
UNDER CONSTRUCTION
• Back of brain matures before to
the front of the brain…
• sensory and physical activities
favored over complex, cognitivedemanding activities
• propensity toward risky, impulsive
behaviors
• group setting may promote risk taking
• poor planning and judgment
• Minimal consideration of negative
consequences
UNDER CONSTRUCTION
• Neurodevelopment likely
contributes to….
• > risk taking (particularly in
groups)
• > propensity toward low effort high excitement activities
• > interest in novel stimuli
• < capacity for good judgment &
weighing consequences
21
22
The Brain Bonsai
Overproduction and Exuberance
Pruning
02-066
The Fear Response
Visual Thalamus
Visual
Cortex
Amygdala
Scientific American
The Hidden Mind, 2002, Volume 12, Number 1
03-002
Emotional
Stimulus
Amygdala
+
+
Hippocampus
Hypothalamus
-
-
PVN
Cortisol
Cortisol
CRF
PIT
ACTH
Adrenal
Cortex
LeDoux, Synaptic Self
Amygdala and Hippocampus
What emotion do you see?
WHAT YOU SEE IS WHAT YOU GET!
Fear
Contempt
Disgust
Surprise
Sadness
Anger
Happiness
Adolescents use the Amydala (fight or flight response) rather than the
Frontal Cortex (used by older adults) to read emotions
Deborah Yurgelun Todd McLean Hospital Belmont, Mass (2004)
ACC The “Oops Centre”
• Greater motivational drives for novel
experiences, coupled with an immature
inhibitory control system, could predispose to
performance of impulsive actions and risky
behaviors.
• This combination of reduced inhibition, and
increased risk or thrill seeking may be natures
way of promoting exploration of the world, an
eagerness to leave the nest (Ha!) and seek out a
partner.
• However, in a world of fast cars, readily available
drugs and alcohol, this combination simply puts
teens at increased risk.
Putting the brakes on, planning and regulating emotion
develops with the final development of the frontal lobe at
Around 20 -24
A fully pruned and sculpted frontal lobe HELPS (no guarantees) to resist the need to
buy the first clothes you see or impulsively blow up in anger at your parent
Made worse as group adolescent
brains amp-up the levels
The Problem
Frontal Lobe Development
Autonomy
drivers license
Average age of first
sexual encounter in
Canada
The Cognitive Affective Balance
Early Adolescence
Early Adulthood
Ideally!
KEY: Not the overall balance that matters, it is the flexibility to shift when needed
Remember:
the emotional brain
is often in charge
in teens.
SCENARIOS
• What we THINK….
• Affects what we FEEL…
• Affects how we ACT….
 NURTURE by being
Positive Approach... supportive, warm and
encouraging
• DISCIPLINE by
Nurture
Discipline
teaching how to
behave, set and
enforce limits, and
monitor behavior
• RESPECT by
Respect
encouraging teens to
develop their own
opinions and beliefs,
model civility and allow
privacy
Positive Parenting is Ideal
POSITIVE PARENTING
is warm, supportive and encouraging
while being firm, consistent and clear
with limits and boundaries.
“I’m important in my teen’s
life. We have some good times
and some bad times, but I’m
there for the long run.”
 HIGH Nurturance
 HIGH Expectations
 HIGH Respect
PERMISSIVE PARENTING
is inconsistent enforcement of rules, or
no rules at all and a need to be a pal,
more than a parent.
“I really want to enjoy parenting
my teen. It’s important for them
to fit in and have what they want,
and not have too many rules. We
get along better that way.”
 HIGH Nurturance
 LOW Expectations
 MODERATE Respect
DOMINATING PARENTING
is harsh, punitive and rigid.
 LOW Nurturance
 HIGH Expectations
 LOW Respect
“I need to really clamp down
now that he’s a teen..
If you give him an inch,
he’ll take a mile”
UNENGAGED PARENTING
is inconsistent presence in a
child’s life - teens raise
themselves.
 LOW Nurturance
 LOW Expectations
 LOW Respect
“It’s time to let go now that
my child’s grown up. It’s
time to get my needs met. He
can take care of himself.”
When in Conflict Remember….
• Don’t engage in “power struggles” that are about how to think, and
•
•
•
•
•
•
•
who is right.
Focus on the important issues of health and safety.
Model the language and tone of voice you expect from your teen.
Stay calm and remember you are in charge - You are the adult
Avoid conflicts when you are pressed for time - often issues can be
dealt with later and this gives you time to be creative in finding a
win-win approach.
Be realistic about how your teen acts - they simply don’t have the
skills and experience you have in dealing with disagreements.
Find ways to say “YES” as well as “no”. Look for common ground
where you and your teen agree,
Don’t forget your sense of humor - it’s your best tool for putting
issues in perspective.
A Model for Solving Problems
Together
• When preparing to discuss an issue with your teen, think of
the words I CARE, I SEE, LISTEN, I WANT and I WILL… it
will help you organize your thoughts and get to some
healthy resolution.
• I CARE — express warmth and love
• I SEE — state the facts
• I FEEL — share your feelings
• LISTEN — what are your thoughts?
• I WANT — state a plan of action
• I WILL — say what you’ll do to help out
*Center for the Application of
Prevention Technologies (CAPT)
GREATEST OPPORTUNITY…GREATEST VULNERABILITY
As the adolescent brain is reconfigured it is more
susceptible to long lasting damage of drugs, alcohol, and
negative experiences. Unfortunately, the brain is most
vulnerable at a time when they are most inclined to take
risks and to act impulsively…”
(Jay Giedd, NIH 2004)
Alcohol & Other Drugs
 Increase in dopamine which further
encourages risk taking
 Increase in depression and anxiety
 Can wound or damage brain
(more than in adults)
 Hinder brain storage of new
information
Drug use starts early and peaks in
the teen years
First Drug Use (number of initiates)
Evidence from surveys
Infa
nt
Chil
d
Tee
n
Adul
t
Older
Adult
Human Data: Alcohol’s Effects
The hippocampus encodes new information
into memory.
Adolescents with a history of alcohol use
disorder have a smaller hippocampus volume
(on average, by about 10%).
Source: Tapert & Schweinsburg, 2005
Adolescents and Sleep
 Shift in Circadian (Biological Clock)
to preferring later bedtimes and risetimes
 Need for sleep increases at puberty
 Societal influences push teens
toward sleep delay
 Sleep deprivation common
Provide Guidance and
Opportunities
 Teens need to use their “thinking
brains” for planning, analyzing,
organizing, problem solving, and
making decisions
Keep Communicating
 Listen
 Encourage
 Support
In Closing:
Brain development continues throughout life.
The “emotional” brain shows earlier
development than the “thinking” brain
The “emotional” brain seeks novelty and
stimulation, sometimes met by risky behavior
Risks can be healthy and unhealthy
Adults can and should provide guidance,
opportunities, and environments that
promote development of the “thinking” brain
Take Home for Parents
Promote activities that capitalize on the strengths of the developing brain
Assist your child with challenges that require planning
Reinforce their seeking advice from you and other adults
Educate about risk taking and negative consequences
Never underestimate drug effects on developing brain
Tolerate “oops” behaviors common during the teens
References
Brown, S.A., Tapert, S.F., Granholm, E., & Delis, D.C. (2000). Neurocognitive functioning of
adolescents: Effects of protracted alcohol use. Alcoholism: Clinical and Experimental
Research, 242, 164-171.
Clark, D. B., Kirisci, L., & Tarter, R. E. (1998). Adolescent versus adult onset and the
development of substance use disorders in males. Drug and Alcohol Dependence, 49,
115-121.
Giedd. J. N. (2004). Structural magnetic resonance imaging of the adolescent brain. Annals of
the New York Academy of Sciences, 1021, 77-85.
Gogtay, N., Giedd, J.N., et al. (2004). Dynamic mapping of human cortical development during
childhood through early adulthood. Proceedings of the National Academy of Sciences,
101 (21), 8174 – 8179.
Grant, B.F., Dawson, D., et al. (2004). The 12-month prevalence and trends in DSM-IV alcohol
abuse and dependence: United States, 1991-1992 and 2001-2002. Drug and Alcohol
Dependence, 74, 223-234.
Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (2006). Monitoring the Future national
survey results on drug use, 1975-2005. Bethesda, MD: National Institute on Drug Abuse.
Spear, L. P. (2002). Alcohol’s effects on adolescents. Alcohol Health and Research World,
26(4), 287-291.
Tapert, S. & Schweinsburg, A.D. (2005). The human adolescent brain and alcohol use
disorders (pp 177-197). In M. Galanter (Ed.), Recent developments in alcoholism: Vol
XVII. Washington D.C.: American Psychiatric Press.
Winters, K.C., & Lee, S. (2008). Likelihood of developing an alcohol and cannabis use disorder
during youth: Association with recent use and age. Drug and Alcohol Dependence, 92,
239-247.
Suggested Reading
Dahl, R.E. & Spear, L.P. (Eds.) (2004). Adolescent brain
development: vulnerabilities and opportunities. NY, NY:
Annals of the New York Academy of Sciences, Volume
1021.
Dubuc, B. (n.d.). The brain from top to bottom. Retrieved
September 1, 2004, from McGill University Web site:
http://www.thebrain.mcgill.ca/flash/index_d.html#
Nestler, E. J., & Malenka, R. C. (2004, March). The
addicted brain. Scientific American, 290 (3), 78-85.
Wallis, C. (2004, May 10). What makes teens tick? Time,
163, 57-65.
U.S. News & World Report. (Special Issue, 2005).
Mysteries of the teen years. Author.
Books and Resources
• The Primal Teen: What the new discoveries about the teenage brain tell us
about our kids. Barbara Strauch New York Anchor Books 2003
• “Why do they act that way.” A Survival Guide to the Adolescent Brain for
you and Your Teen . David Walsh PhD New York Free Press 2004
• Teen Brain, Teen Mind. What Parents Need to Know to Survive the
Adolescent Years . Dr Ron Clavier Toronto Key Porter Books 2005
• PBS Frontline (2003). Inside the Teenage Brain. www.pbs.org
• Giedd, J. (1999). Brain development during childhood and adolescence: A
longitudinal MRI study. Nature Neuroscience, 2(10), 861-63
• Carskadon, M. (2000). Adolescent sleep needs and patterns: Research
report and resource guide. Washington, DC: National Sleep Foundation.
www.sleepfoundation.org