Alienation and the Failure to Cope

Feelings of alienation are common in adolescence. These can be triggered by pubertal changes, identity issues, and feelings of cultural estrangement.
Key Terms: alienation

Runaways: Many alienated adolescents are runaways. These youths are frequently abused or neglected. As a group they suffer from low self-esteem, depression, poor interpersonal skills, insecurity, anxiousness, impulsiveness, and lack of a sense of personal control over their lives. Home life for most is chaotic and characterized by violence.

Support for Adolescent Runaways and Parents: The availability of immediate support for runaways varies from one community to the next. Nearly all urban centers have federally and privately funded shelters. Most of these offer short-term help (e.g., 30 days) in the form of meals and a place to stay; some also offer diagnostic and counseling services. Longer term interventions can take the form of counseling and parenting classes, offered by many communities through full-service schools. The Internet is also a valuable tool for finding shelters and one with which most adolescents are familiar.

Maltreatment: Abuse and Neglect: Three home-life patterns distinguish adolescents who are maltreated. The abuse may be a continuation of abusive patterns that started in childhood, it may reflect a change in the type of discipline used when they reach adolescence, or it may be occasioned by the onset of adolescence itself. Factors that, in combination, characterize maltreating parents include difficulty coping with stress; a negative, defensive worldview; inappropriate expectations of adolescents; less supportive and more aggressive partners; and poverty.
Key Terms: maltreatment, parentified

Problem Behavior

Externalizing Problems: When adolescents turn their problems outward, it shows up in a variety of ways: antisocial behavior, delinquency, participating in gangs, and violence. The type of delinquent act varies with age. There is little evidence suggesting that minor forms of delinquency predict a later shift to more serious crime. The pattern instead suggests a small subgroup of delinquents who start early and account for a relatively large proportion of criminal activity. Gender, ethnic, and social class differences exist in adolescent delinquency. Females are less likely to engage in delinquent activities than are males and are less likely to commit violent crimes. Some ethnic groups are much more likely to enter the juvenile justice system, and although social class differences may be at play, these disparities strongly suggest bias within the juvenile justice system.
Key Terms: externalized problems, undercontrolled, internalized problems, overcontrolled, comorbid

Today, juvenile gangs are more likely to be linked to organized crime than in the past and are associated with more violent crimes and the sale of narcotics. Teenagers are nearly twice as likely to be victims of violent crime as are young adults. Homicide is the second leading cause of death for all young people, and most are killed with a firearm.
Key Terms: life-course persistent antisocial behavior, adolescence-limited antisocial behavior, juvenile delinquency, index offenses, status offenses

Internalizing Problems: When adolescents turn their problems inward, they may become depressed, suicidal, or develop an eating disorder. Adolescents who suffer from depression have feelings of low self-esteem, sadness, hopelessness, and helplessness. Suicide is the third most common cause of death among adolescents. Some of its warning signs include sudden changes in behavior, changes in sleeping or eating patterns, loss of interest in usual activities, withdrawal from others, or talk of suicide. Factors that place adolescents at risk of suicide are depression, a prior suicide attempt, substance abuse, life stresses, and chaotic family lives. The most effective treatment programs work with the family as well as the suicidal adolescent.
Key Terms: affective disorders, depression, major depressive disorder, masked depression

Bulimia and anorexia are closely related eating disorders, and are more likely to occur in adolescents who come from families characterized by enmeshment, overprotectiveness, rigidity, and inadequate conflict resolution. Standards for female attractiveness show thinner models today than in past generations; this trend is problematic in that eating disorders are more common among females. Overweight adolescents are likely to have parents who are overweight. They also eat irregularly, eat food that is denser in calories, and are more inactive than adolescents of average weight. Effective treatments include exercise and involve the family.
Key Terms: bulimia, anorexia, overweight

Adolescents and Drugs

What Is Dependence?: Physical drug dependence occurs with psychoactive substances when they control behavior so that the individual cannot easily discontinue their use. Drug dependence can interfere with school, work, and relationships.
Key Terms: drug dependence, psychoactive

Alcohol: Alcohol loosens inhibitions and makes individuals feel more spontaneous. As blood-alcohol level rises, activities controlled by the central nervous system are increasingly affected. Most high school seniors have tried alcohol and many do so with some regularity.
Key Terms: alcohol

Cigarettes: Cigarettes are the only substance that a sizable number of adolescents use on a daily basis. Because of this, cigarettes pose one of the most serious, if not the most serious, health risks of all drugs to adolescents. Most adolescents who smoke start before they reach high school, and most adolescents who start to smoke have tried unsuccessfully to stop. The use of cigarettes and alcohol is associated with the use of other, illicit substances.
Key Terms: nicotine

Marijuana: Marijuana is a mild hallucinogen that affects thought, perception, reaction time, and coordination. Long-term heavy use carries a number of potential health risks. Of all illicit drugs, marijuana is the most frequently used by adolescents.
Key Terms: marijuana

Age, Ethnicity, and Gender: There are significant age trends with respect to the use of alcohol, cigarettes, and marijuana, with the use of all three increasing with age. There are ethnic differences as well, with African American adolescents being less likely to drink alcohol or smoke cigarettes than European American or Hispanic adolescents. With respect to gender, early adolescent females drink more than males their age; overall, females are as likely to smoke cigarettes but less likely to have used marijuana.

Patterns of Drug Use: There is a pattern to the order in which adolescents experiment with drugs; typically, alcohol is the first drug used, which is followed by cigarettes, which, in turn, is followed by marijuana. Though an adolescent may use a certain drug, progression to the next stage isn’t inevitable. A better predictor of whether or not an adolescent will progress down the drug pathway is the extent to which they become involved in a drug’s use.
Key Terms: gateway hypothesis

Risk and Protective Factors: Factors that place adolescents at risk for substance abuse are being less well adjusted and impulsive, having low self-esteem, doing poorly in school, having problematic relations with peers, and having friends who use drugs. Adolescents who abuse drugs are likely to have less nurturing parents, to have parents who abuse substances themselves, to live in more violent communities, and to have drugs more available. Protective factors include high self-esteem, good social skills, involvement in religion, friends who do not abuse drugs, and doing well in school. Also important are parents who are warm, communicate well, and monitor their children’s activities.

Prevention Programs: Efforts to prevent drug abuse include controlling access to drugs, media campaigns, and school-based educational programs organized around social cognitive principles. Programs using a combination of these approaches are the most effective. Most adolescents will experiment with some drugs before they reach adulthood; most will also not use them frequently. Even casual experimentation with some substances carries substantial risks. Candid discussions that acknowledge the pleasurable effects of drugs as well as their potential dangers promise to be the most effective ways of providing help to adolescents.