The Science of Adolescent Risk-Taking Workshop Report (2011) / Chapter Skim
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2 Adolescents and the Risks That Affect Them
2 Adolescents and the Risks That Affect Them
Pages 6-34
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From page 6... ...
adolescents and then takes a close look at a few of the most prevalent risks they take -- sexual risk-taking, substance use, illegal behavior, and risky driving. The chapter closes with a look at the most common emotional disorders that affect them.
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YRBSS data indicate that, in 2005, 17 percent of youth contemplated suicide and 13 percent said that they had made a suicide plan.1 Turning to morbidity, Blum highlighted trends in substance use from the Monitoring the Future survey (http://monitoringthefuture.org)
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However, these declines have reversed in the past 2 years; in 2006, the teen pregnancy rate increased for the first time in more than a decade, rising by 3 percent, and the teen birth rate increased by 4 percent (Guttmacher Institute, 2010)
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RISK-TAKING As the general portrait indicated, a few areas of risk-taking pose the most serious threats to adolescents: sexual risk-taking, substance use, illegal behavior, and risky driving. Each of these behaviors provides an interesting lens through which to examine questions about the influence of environmental and individual factors, so we explore here the preva lence of each of these behaviors among population subgroups and the developmental course typical for each.
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Jaccard suggested that age at first intercourse might be the most important to track because it is predictive of such risks as unintended pregnancy and sexually transmitted disease Several meta-analyses have shown that various sexual behaviors have intercorrelations of approximately .35, which is about the same as the intercorrelation among other risk behaviors, such as alcohol and drug use or smoking. For Jaccard, this suggests that unique determinants exist for each of these behaviors that must be understood.
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Rates of pregnancy, abortion, and birth for this age group are also significantly higher in the United States than in Sweden, France, Canada, or Great Britain, and Figure 2-2 shows that the United States has a significantly higher birth rate for youth under age 20 than 25 other industrialized nations. Historical trend data indicate that most sexual risk behaviors began to decline in the early 1990s and then reached a plateau.
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Developmental Course The prevalence of sexual activity increases by about 10 percent in each year of the adolescent period, with about 12 percent of 7th graders reporting having had sexual intercourse, while the figure is more than 60 percent for 12th graders. The peak age for reported first sexual intercourse is 16.
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Data from the National Longitudinal Study of Adolescent Health (called Add Health) show, for example, that the number of domains in which parents allow their adolescent children to make their own decisions increases steadily from 7th through 12th grade, as parental monitoring decreases (Guilamo-Ramos et al., 2010)
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, the term "disorder" refers to a pattern of use associated with impairment in which the individual continues to use one or more substances despite noteworthy life difficulties, such as getting in trouble at school or getting caught driving under the influence. The term disorder also refers to substance dependence, in which the individual uses the substance compulsively despite loss of control and recurring life problems, may develop a tolerance (i.e., require increasing doses to get the same effects)
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Prevalence A look at some of the data on adolescent substance use provides some context for thinking about these questions. Table 2-1 shows the percentages of young people who have experimented with substances (including alcohol, illicit drugs, and also misuse of prescription drugs)
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. Although researchers have documented demographic variations in substance use, the data can be difficult to interpret, Chassin observed.
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First, children who experience adverse circum stances, such as prenatal exposure to substances, genetic propensity to addiction and disinhibition, and poor parenting, are more likely to have difficulty regulating their behavior, to be impulsive, and to have poor executive functioning. These children are at heightened risk for school failure, are more likely to be excluded from prosocial peer groups, and to associate with deviant groups that promote substance use.
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Available landscape online at http://monitoringthefuture.org/pubs/occpapers/occ61.pdf (accessed November 1, 2008)
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Available Fig 2-7.eps online at http://monitoringthefuture.org/pubs/occpapers/occ61.pdf (accessed November 1, 2008)
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Illegal Behavior As with both sexual behavior and substance use, the illegal behavior adolescents engage in encompasses a wide range of acts, as D Wayne Osgood explained.
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In sum, prevalence of at least some illegal behav ior is quite common, but frequent and serious illegal behavior is highly concentrated in a small group. Prevalence of involvement in the justice system reflects a major domain of consequences of illegal behavior for young people's lives.
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Osgood suggested that trends for specific behaviors can be subject to idiosyncratic influences, such as burglary becoming more dangerous over time as increasing numbers of householders have acquired burglar alarms and firearms. Moreover, trends for some aspects of illegal behavior, such FIGURE 2-8 Historical trends: Property arrests.
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Osgood noted that self-report data from the National Youth Survey3 about involvement with violent crime show a similar pattern, with the peak slightly higher, at age 17. Describing the developmental course of illegal behavior is complicated for a few reasons, however.
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The important question, for Osgood, is iden tifying processes and experiences that lead some to stop serious illegal behavior when others do not. Rates of illegal behavior (based on arrest reports)
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Osgood also pointed out that the strongest correlates of delinquent behavior are other problem behaviors -- risky sex, dangerous driving, substance use -- especially when they begin early. However, although risk behaviors may tend to cluster together, there are important differences as well.
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Risky Driving The significance of the risks teen drivers pose is apparent in Figure 2-11, which shows the crash rate by age throughout the life span, and Figure 2-12, which shows the learning curve for newly licensed drivers.4 Teen drivers also pose a threat to others: 45 percent of teenagers ages 13 to 19 who die in vehicle crashes caused by teen drivers are passengers, not drivers. Allan Williams opened his presentation by noting that despite these 30 Male 20 Female 10 0 16 17 18 19 20– 25– 30– 35– 40– 45– 50– 55– 60– 65– 70– 75– 80– 85+ Dr iver Ag e FIGURE 2-11 Young driver crash risk, crashes per million miles, by driver age, 2001-2002.
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. alarming statistics, teen driving has not been as thoroughly researched as other risk behaviors.
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The rate of adolescent crashes involving alcohol, however, has gone down 30 Day 20 Night 10 0 16 17 18 19 20– 25– 30– 35– 40– 45– 50– 55– 60– 65– 70+ Dr iver Ag e FIGURE 2-13 Night driving risks, fatal crashes per 100 million miles, by driver age, 2001-2002. Fig 2-13.eps SOURCE: IIHS (Insurance Institute for Highway Safety)
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Williams noted that graduated licensing is unlike training that uses driving simula tors to provide practice in a completely safe environment; rather, it allows learning drivers on the road so they can amass experience with real-world hazards. Research on simulated driving has thus far used only outcomes measured during the simulated situation, Williams noted, so there is no evidence on whether the skills transfer to real-world driving.
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The result has been a focus on scare tactics designed to heighten adolescents' awareness of risks, which, in Williams' view, have not shown marked success in reducing crash rates. MENTAL HEALTH RISKS The mental health status of adolescents relates in various ways to the discussion of each of these risks.
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and other impulsive behaviors, and risky sexual behavior. Major depression is predictive of suicide and suicide attempts and possibly substance abuse as well.
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A related question is how likely mental and emotional disorders are to persist past adolescence, and here, Pine indicated, the picture is mixed. For example, he pointed out that diagnosis rates for anxiety are quite high among adolescents: in one study of adolescent boys, 253 out of 670 study participants had a diagnosed anxiety disorder (Pine et al., 1998)
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SUMMARY The presentations and discussions highlighted key points about the most prevalent adolescent risk behaviors. First is the importance of understanding the interrelationships among the environmental and individual factors that affect adolescent behavior.
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in the way risk behaviors cluster and that various risk behaviors have both common and unique correlates. It seems likely that other variables, such as personality and innate temperament, cultural norms, and brain development, may also play a part in determining how individual adolescents behave, and these fac tors are discussed in the following chapters.
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