Transcript RISKY BUSINESS: Why Teens Do What they Do

+
RISKY BUSINESS:
Why Teens Do What
they Do
Caryl Oris, MD
+
Public Health Context
 Adolescence
is generally considered a time of
good health and little disease
 Accidents
account for half of all deaths in
teens, and motor vehicle accidents account for
73% of all unintentional injuries.
 The
majority of teen deaths are due to
accidents, homicide, and suicide, considered
preventable. This makes this a public health
problem.
+
QUIZ TIME!
 Teenagers
generally see themselves as more
invincible, or invulnerable, than other age groups.
 Teenagers
have poor decision making skills
 Teenagers
generally do not consider the
consequences of their actions
 Teen
 The
behavior is due to raging hormones
teenage brain is essentially fully formed
before adolescence
+
The Reality
 Reasoning
age of 15.
ability is fully developed by the
 Adolescents
are just as adept as adults in
their ability to logically assess whether
something is dangerous, and to use logical
thinking.
 During
adolescence, the brain goes
through enormous changes which can
affect teen behavior
+
Death Rate for Teens 12-19:
Rate per 100,000. CDC statistics
+
Leading Causes of Death in Teens
+
Other Reasons for Teen Mortality
 Crime
rates increase through adolescence
and peak at the age of 18.
 Adolescents
drown more often than any
other time of life
+
Suicide Attempts and Self-Harm
+
Unintentional Drowning
+
So Why Do Teens Do What they
Do?
 It’s
all about their brains!
 The
emotional center of the brain, and the
reward center, develop earlier than the
control center (PFC). It develops around
puberty, while PFC development is not
complete until late adolescence or early
adulthood
 This
makes the ages of 14-17 the most
vulnerable for risk taking behavior.
+
The Brain
+
How the Brain Grows

Built over time, from back to front and from inside out

The brain of the young child is soaking up knowledge,
growing neurons.

The two most important spurts of brain growth:


0-18 months

10-13 years
Adolescence is a Unique Period of Development:

Pruning: USE IT OR LOSE IT

Myelination: Faster, more efficient connections. The brain is
becoming more specialized.
+
So Why Do Teens Take Risks?

First, it is important to point out that teenagers are just as adept as adults
to assess danger and to think logically.

Teenage thinking is affected more by other factors than at any other
stage of life:







The limbic system (emotion, memory and motivation) more sensitive and
easily triggered
The teen brain craves more reward and gratification: Hyperrational Thinking:
the reward or excitement outweighs the negative.
The chief predictor of teen behavior is not the perception of the risk, but the
anticipation of the reward DESPITE the risk.
Gratification is at the heart of their impulsivity: a teen will continue to engage
in risky behavior if they did not have any negative consequence in order to get
that gratification.
Less prefrontal cortex control
Influence of Peers: the need to belong
Increased release of DOPAMINE
+
DOPAMINE!!
 Increase
activity of dopamine in the teen brain,
and increased release in response to pleasure.
 Leads
teens to focus on the positive reward of
an activity, while placing less value on the
potential risk and danger. They put more
weight on the excitement and thrill.
 Gratification
is at the heart of their impulsivity:
if you engage in risky behavior and never had
a negative consequence, you will keep
repeating the risky behavior: drug use, sex
+
Addiction in Teens

Addiction is rooted in adolescence: Most adult addictions start in adolescence


Try a drug before age 18: 25% chance of addiction
Try a drug after age 18: 4% chance of addiction

The teenage brain is changing rapidly, and is more vulnerable. Addiction develops
faster and stronger.

The earlier the age of onset, the more severe the addiction.

Addiction is a form of memory and learning. The teen brain is primed to learn.,
Anything that is learned that stimulates dopamine release is construed as a reward, so
the brain craves more of that learning. When the drug wears off, dopamine plummets,
and you need to use more of the drug to get your dopamine to surge again.

Remember that dopamine can surge even when thinking about the drug, or with friends
that you used the drug with.

Once a teen is addicted, it is much harder to overcome the addiction than if you become
addicted later in life.
+
The Power of Peers

Teens have a drive to feel rewarded and they crave novelty,
and intense social engagement is a key part of adolescence.

Move away more from parent figures and towards peers. But
teens still need important adult figures in their lives for
advice and for guidance.

Risky behaviors increase in company of peers: driving alone
vs driving with friends
+
DRIVING:
Alone vs with Peers
+
Teens Face Many Challenges

Normal separation from parents

Establish an identity of their own

Acceptance by peers

Responsibility and autonomy

Digital world and social media: FOMO, peer pressure, lack of
sleep


Study of 467 teens age 11-17: Nighttime social media and emotional
investment related to poorer quality of sleep, lower self-esteem and
increase in anxiety and depression. Pressure to be available 24/7.
Most girls who are worried or anxious seek solace from social media
rather than talking to parents.
+
Stress

During adolescence, more than any other time, emotions
rule.

Half of all psychiatric conditions begin by the age of 14.

Because of delayed maturation of frontal lobes, teens cannot
inhibit and manage emotions well. And adolescent brain is
firing neurons more intensely than in adult brain.

Stress inhibits learning. Stress leads to increased levels of
cortisol, How do most teenagers handle stress?
.
+

WHAT PARENTS NEED TO DO:
Share your PFC!!!
IMPORTANCE OF PARENTAL INVOLVEMENT: they need our PFC!!!






Practice decision making skills
Help with planning, time management. Write notes, use calendars.
Set clear limits and boundaries
Being connected to an adult is linked to decreased stress, anxiety, depression,
self-harm, substance use and teen pregnancy.
Sleep, good nutrition
Since the teenage brain is WIRED FOR RISK, we have an obligation to
steer teens to taking POSITIVE RISKS. Give them the opportunities to
take risks in healthy ways:




Try a new skill or sport
Volunteer work
Audition for a part in the school play
Summer employment
+
What Should Parents Say?

Remember that teenagers pay less attention to danger and risks: BEST
TO STEER AWAY

Limit their opportunities to use immature judgment:



Parties
Driving
Talk to them about:



THEIR BRAINS!!
How to avoid negative peer pressure: give them scenarios
Help them manage stress:
 Organization
 Schedules
 Time management
 SLEEP!!!
 Be available to LISTEN!!!!
+
Learning: What it means for the
teen

This is the time to invest in strengths and emerging talents

This is the time when remediation and extra help can give best
results

IQ can actually increase (or decrease) in teenage years

Just as their brains are able to learn better and faster, however,
they are also overwhelmed by the emotional center of the brain.
So we need to:





Stay calm when talking to them: avoid anger. Take a time out.
Use as little criticism as possible
Don’t judge
Help them examine different points of view, role play scenarios
Validate their emotions
+
Let’s Try to Change our Thinking
 Not
helpful to think teens have “raging
hormones” or “immature brains” or “this is
just a bad time that will pass”
 Adolescence
is not just a stage to “get
over’, but is an important developmental
stage that has implications for the rest of
one’s life
 Acknowledge
the teen brain
and respect the changes in
+
What Parents Can Do
 Acknowledge
the need for teens to crave rewards
and thrills. This can be healthy.
 Encourage
new skills, new adventures that are not
harmful. Help teens channel their need for thrills
in safe, creative ways.
 “Don’t
Do It!” doesn’t do it! Promote positive,
healthy activities.
 Communicate
with your teen about this brain
science. Help them understand the changes their
brains are experiencing.
+
“This will be the only phone you ever
own!!”
+
The ESSENCE of Adolescence

Dr. Daniel Siegel: “Brainstorm”:

Emotional Spark

Social Engagement

Novelty

Creative Exploration

Give teens opportunities

Have adults lost these qualities? Are we jealous of our kids?

Perhaps we need to recognize the adolescent in all of us.
+
Thank you!
Questions, Comments!