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Psychosocial Problems in
What can go wrong
Prevalence of Substance
Use and Abuse
A large proportion of adolescents have
experimented with alcohol, tobacco, and
marijuana but not with other drugs
 out of high school seniors: 70% have tried alcohol; 46% have
smoked marijuana, and 40% have smoked cigarettes
 only about 9% have used an illicit drug (other than marijuana) in
the last month
Earlier Age of Initiation
Experimentation with drugs is less common
among younger teens than in the past
The chances of becoming addicted to
alcohol or nicotine are increased when use
begins before age 15
 drugs can affect normal maturation of the brain’s dopamine system
The effects of alcohol and nicotine on brain
functioning (especially memory and impulse
control) are worse in adolescence than in
Ethnic Differences in
Substance Use
 American Indian adolescents use the most
 followed by Hispanic and White; then Black and Asian youth
 immigrant paradox
foreign-born and less Americanized
minority youth are less likely to use drugs,
alcohol, and tobacco than their Americanborn counterparts
Risk and Protective Factors For
Substance Abuse
 Adolescents who use alcohol, tobacco, or other drugs
frequently are usually exhibiting symptoms of prior
psychological disturbance
 More maladjusted as children and teenagers
 Major risk factors are:
 Personality – Anger, impulsivity, and inattentiveness
 Family – Distant, hostile, or conflicted relationships
 Socially – Friends who use and tolerate the use of drugs, living in a
context that makes drug use easy
 Major protective factors are:
 Positive mental health, high academic achievement, engagement
in school, close family relationships, and involvement in religious
Prevention and Treatment of
Substance Use and Abuse
 Efforts to prevent abuse target:
 the supply of drugs (most government attention and money
focused here)
 the environment in which teens are exposed to drugs
 characteristics of the potential drug user
 Experts believe it is more realistic to focus
prevention efforts on adolescents’
motivation and environment
Prevention and Treatment of
Substance Use and Abuse
Most encouraging
programs combine some
sort of social
competence training
with a communitywide
intervention (aimed at
the adolescents, peers,
parents, and teachers)
Categories of Externalizing
 Conduct Disorder
 Aggression
 Juvenile Offending
Externalizing Problems:
Conduct Disorder
Conduct Disorder (CD)
 clinical diagnosis
 a pattern of persistent antisocial behavior that routinely
violates the rights of others and leads to problems in social
relationships, school, or work
 related diagnosis is oppositional-defiant disorder (less
If CD persists beyond age 18, may be diagnosed
with antisocial personality disorder, characterized
by a lack of regard for moral standards
Externalizing Problems: Juvenile
“Juvenile offending” is legal term
Violent (e.g., assault, rape, robbery, and murder)
and property crimes (e.g., burglary, theft arson)
 increase in frequency between the preadolescent
and adolescent years
 peak during high school then declines in young
adulthood (the age-crime curve)
Status offenses – behaviors that are not against
the law for adults (truancy, running away,
Two Types of
Adolescent Offenders
 Life-course persistent offenders
 Demonstrate antisocial behavior before
 Are involved in delinquency during
 Are at great risk for continuing criminal
activity in adulthood
 Adolescent-limited offenders
 Engage in antisocial behavior only during
 These two types have very different
causes and consequences
Persistent Offenders
Usually are poor, male, perform poorly in school
From disorganized families with hostile or inept
 Harsh parenting may affect brain chemistry (serotonin)
 Worse behavior elicits more bad parenting, leads to a
vicious cycle
 Have histories of aggression identifiable as early as age
Have problems with self regulation
 More likely than peers to suffer from ADHD
Exhibit hostile attributional bias – interpret
ambiguous interactions with others as
deliberately hostile and retaliate
Adolescent-Limited Offending
Do not usually show signs of psychological
problems or family pathology
Still show more problems than teens who
are not at all delinquent
 More mental health, substance abuse, and
financial problems
Risk factors include:
 Poor parenting (especially poor monitoring)
 Affiliation with antisocial peers
Internalizing Problems and Depression
in Adolescence
 Depression is the most common
psychological disturbance
among adolescents
 Emotional symptoms – dejection,
decreased enjoyment of pleasurable
activities, low self-esteem
 Cognitive symptoms – pessimism and
 Motivational symptoms – apathy,
 Physical symptoms – loss of appetite,
difficulty sleeping, loss of energy
Sex Differences in Depression
Before adolescence, boys
are more likely to exhibit
depressive symptoms
After puberty, females are
more likely to be
depressed, possibly
because of:
 Gender roles – pressure to act
passive, dependant, and
 Greater levels of stress during
early adolescence
 Ruminating more – turning
feelings inward
 Greater sensitivity to others
Adolescent Suicide
~20% of girls and 10% of boys think about killing
themselves every year (suicidal ideation)
 10% girls and 6% boys make attempts serious enough to
require treatment
Some adolescents commit acts of nonsuicidal
self-injury (NSSI)
 such as deliberately burning or cutting oneself
 ~25% of adolescents have done this at least once
Risks for Suicide
Having a psychiatric problem
 especially depression or substance abuse
Having a family history of suicide in
the family
Experiencing extreme family
 parental rejection, family disruption
Being under intense stress
The Diathesis-Stress
Model of Depression
Depression occurs when people with a
predisposition (a diathesis) toward internalizing
problems are exposed to chronic or acute
stressors (a stress)
 those without the diathesis are able to withstand a great
deal of stress without developing psychological problems
The Diathesis-Stress
Model of Depression
The Diathesis
 may be biological in origin (neuroendocrine or genetically
linked), or because of cognitive style
The Stress
 primarily from having a high-conflict and low-cohesion
family, being unpopular, or reporting more chronic and
acute stressors
Stress and Coping
Stress responses vary, so some
adolescents experience:
Internalized disorders (anxiety,
depression, headaches, indigestion,
immune system problems)
Externalized disorders (behavior and
conduct problems)
Drug and alcohol abuse problems
Insert DAL photo
Stress does not always lead to negative
Resilience in the face of adversity
What Explains Stress Vulnerability?
Multiple stressors have a much greater impact
than single stressors (multiplicative)
Adolescents who have internal and external
resources are less likely to be affected by
stress than their peers
internal: high self-esteem, healthy identity
development, high intelligence
external: social support from others
Coping Strategies
Using more effective coping strategies also
buffers the effects of stress
primary control: taking steps to change the source of
stress (usually the best strategy)
secondary control strategies: trying to adapt to the
problem (better when situation is uncontrollable)