The Moddle School Marathon
Like most children, Luke Voss would sometimes complain about
ali the work he had to do. But it wasn’t until he reached middle school that
his mother, Gisela, realized he actually had something to complain about.
“He was at school from 8 to 3, and with soccer practi ce he
wouldn’t be done until 5,” Gisela explained. “If we all ate dinner together—and
it’s important to me that we do—he wouldn’t even start cracking the books until
7. He missed out on sleep, and his anxiety stressed everybody else out. Wed
rush through the meal knowing that he had hours of work ahead of him, and he’d
start begging for help even before he left the table.”
Luke eventually grew more accustomed to the rigors of middle
school. But this did not change the fundamentals of the situation, for Luke or
for his mother: too much work; too many fwnily and extracurricular
responsibilites, and only so many hours in the day. This is an insane way for
families to live,” Gisela admitted. (Mohler, 2009).
Like Luke, many adolescents struggle to meet society’s—and
their own—demands as they traverse the challenges of the teenage years. These
challenges extend far beyond managing an overstuffed schedule. With bodies that
are conspicuously changing; temptations of sex, alcohol, and other drugs;
cognitive advances that make the world seem increasingly complex; social
networks that are in constant flux; and careening emotions, adolescents find
themselves in a period of life that evokes excitement, anxiety glee, and
despair, sometimes in equal measure.
Adolescence is the developmental stage between childhood and
adulthood. It is generally
said to start just before the teenage years, and end just
after them. Considered neither children
nor adults, adolescents are in a transitional stage marked by
considerable growth.
This module focuses on physical growth during adolescence. We
first consider the extraordinary physical maturation that occurs during
adolescence, triggered by the onset of puberty; We then discuss the consequences
of early and late maturation and how they differ for males and females. We also
:onsider nutrition. After examining the causes—and consequences—of obesity; we
discuss eating dinrdcrs, which are surprisingly common at this stage.
The module concludes witi a discussion of several major
threats to adolescents’ wellbeing—drugs, alcohol, tobacco, and sexually
transmitted infections.
Physical Maturation
L01 What physical changes do adolescents experience?
L02 What are the consequences of early and late maturation?
L03 What are the nutritional needs and concerns of adolescents?
Thr young males of the
Awa tribe, adolescence begins with an elaborate and—to Western eyes—gnesome
ceremony to maik the passage fivm chikliiood to adulthood. The boys are whipped
for2 or3 d with sticks and priddy brandies. Through the whipping the boys atone
ftr their previous infractions and honor tribesmen who re killed in iairfiire.
We are no doubt grateful we were spared such physical trials
when we entered adolescence. But members of Western cultures have their own
rites of passage, admittedly less fearsome, such as bar mitzvahs and bat
mitzvahs at age 13 for Jewish boys and girls, and confirmation ceremonies in
many Christian denominations (Herdt, 1998; Eccles, Templeton, & Barber,
2003; Hoffman, 2003).
J From
an aducator`s perspective: Why do you think many cultures regard the
passage to adolescence as a significant transition that calls for unique
ceremonies?
Regardless of their nature, the
underlying purpose of these ceremonies tends to be the
same across cultures: symbolically
celebrating the physical changes that transform a child’s body into an adult
body capable of reproduction.
Growth During
Adolescence: The Rapid Pace of Physical and Sexual Maturation
In only a few months, adolescents can grow several inches as
they are transformed, at least physically, from children to young adults.
During such a growth spurt—a period of very rapid growth in height and
weight—boys, on average, grow 4.1 inches a year and girls 3.5 inches. Some
adolescents grow as much as 5 inches in a single year (Tanner, 1972; Caino et
al., 2904).
Boys’ and girls’ growth spurts begin
at different ages. As you can see in Figure 6-1, girls’ spurts begin around age
10, while boys start around age 12. [)unng the 2-year period from age 11, girls
tend to be taller than boys. But by 13, boys, on average, are taller than
girls—a state that persists for the remainder of the life span.
Puberty: The Start of
Sexual Maturation
Puberty, the period when the sexual organs mature, begins
when the pituitary gland in the brain signals other glands to begin producing
the sex hormones, androgens (male hormones) or estrogens (female hormones), at
adult levels. (Males and females produce both types of sex hormones, but males
have higher levels of androgens and females, of estrogens.) The pituitary gland
also signals the body to produce more growth hormones. These interact with the
sex hormones to cause the growth spurt and puberty. The hormone leptin also appears
to play a role in the onset of puberty
Like the growth spurt, puberty begins earlier for girls,
starting at around age 11 or 12, whereas boys begin at about age 13 or 14.
However, this varies widely. Some girls begin pubertyasearlyas7or8 oraslate as
age 16.
Puberty in Girls. Mthough it is not clear why puberty begins
wb.m it does, environmental and cultural factors play a role. For example
menarche, the onset of menstruation and probably the most obvious sign of
puberty in girls, varies greatly arond the world. In poorer, developing
countries, :nenstruation begins later than in more conomically advantaged …
FIGURE 6-1 Growth
Patterns
Patterns of growth are depicted in two ways. The first figure
shows height at a given age, while the second shows the height increase that
occurs from birth through the end of adolescence. Notice that girls begin their
growth spurt around age 10, while boys begin their growth spurt at about age
12. Howaver, by the age of 13, boys tend to be taller than girls. What are the
social consequences of being taller or shorter than average for boys and girls?
Souroe: Adapted from cratt 1986.
… countries. Even within wealthier countries, more affluent
girls begin to menstruate earlier than less affluent girls.
It appears that girls who are better nourished and healthier
tend to start menstruation earlier than those suffering from malnutrition or
chronic disease. Some studies have suggested that weight or the proportion of
fat to musde in the body play a key role in the onset of menarche. For example,
in the United States, athletes with alow percentage of body fat may start
menstruating later than less active girls. Conversely, obesity—which increases
the secretion of leptin, a hormone related to the onset of menstruation—leads
to earlier puberty (Richards, 1996; Vizmanos & Marti-Henneberg, 2000;
Woelfie, Hart, & Roth, 2007; Oswal & Yeo, 20 10).
Other factors can affect the timing of menarche. For example,
environmental stress from parental divorce or intense family conflict can
effect an early onset (Kaltiala-Heino, Kosunen, & Rimpela, 2003; Effis,
2004; Belsky et aL, 2007).
Over the past century or so, girls in the United States and
other cultures have been entering puberty at earlier ages. In the late
nineteenth century; menstruation began, on average, around age 14 or 15,
compared with today’s 11 or 12. The average age for other indicators of
puberty, such as the attaining of adult height and sexual maturity; has also
dropped, probably due to reduced disease and improved nutrition (Hughes,-2007;
McDowell, Brody, & Hughes, 2007; Harris, Prior, & Koehoorn, 2008).
The earlier start of puberty is an example of a significant secular trend. Secular trends occur
when a physical characteristic changes over the course of several generations,
such as earlier onset of menstruation or increased height resulting from better
nutrition over the centuries.
Menstruation is one of several changes in puberty related to
the development of primary md secondary ccx charateristics. Primary se characteristics are
associated with the development of the organs and body structures related
directly to reproduction. S’condary sex haracterlstlcs are ±e ksible signs of
sexual maturity that do not iavolve the sex or ins
directly.
Note the changes that have occurred in just a few years in
these pre- and post-puberty photos of the same boy.
In girls, developing primary sex characteristics involves
changes in the vagina and uterus. Secondary sex characteristics include the
development of breasts and pubic hair. Breasts begin to grow around age 10, and
pubic hair appears at about age 11. Underarm hair appears about 2 years later.
For some girls, signs of puberty start unusually early. One
out of seven Caucasian girls develops breasts or pubic hair by age 8. For
African American girls, the figure is one out of two. The reasons for this
earlier onset are unclear, and what defines normal and abnormal onset is a
controversy among specialists (Lemonick, 2000; The Endocrine Society, 2001;
Ritzen, 2003).
Puberty in Boys. Boys’ sexual maturation follows a
somewhat different course. Growth of the penis and scrotum accelerates around
age 12, reaching adult size about 3 or 4 years later. As boys’ penises enlarge,
other primary sex characteristics develop. The prostate gland and seminal
vesicles, which produce semen (the fluid that carries sperm), enlarge. A boy’s
first ejaculation, known as spermarche, usually occurs around age 13, more than
a year after the body begins producing sperm. At first, the semen contains
relatively few sperm, but the sperm count increases significantly with age.
Secondary sex characteristics are also developing. Pubic hair begins to grow
around age 12, followed by the growth of underarm and facial hair. Finally,
boys’ voices deepen as the vocal cords become longer and the larynx larger.
(Figure 6-2 summarizes the changes that occur in sexual maturation during early
adolescence.)
The surge in hormones that triggers puberty also may lead to
rapid mood swings. Boys may have feelings of anger and annoyance associated
with higher hormone levels. In girls, higher levels of hormones are associated
with depression as well as anger (Buchanan, Eccles, & Becker, 1992).
Body Image: Reactions
to Physical Changes in Adolescence. Unlike infants, who also undergo rapid growth, adolescents
are aware of what is happening to their bodies, and they may react with horror
or joy. Few, though, are neutral about the changes they are witnessing.
Some of the changes of adolescence carry psychological weight
In the past, girls tended to view menarche with anxiety because Western society
emphasized the negative aspects of menstruation, its cramps and messiness.
Today, however, society views menstruation more positively, in p.rt because
more o.eri discussion has demystifled it; for example, television commercials
fo tampois are conAnonplace. As a result, menarche now typically increases…
FIGURE 6-2 Sexual Maturation
The changes in sexual matuiation
that occur for males and females during early adolescence.
Source: Mapted from Tanner, 1978.
… self-esteem, enhances status, and provides greater
self-awareness, as girls see themselves as young adults (Johnson, Roberts,
& Worell, 1999; Matlin, 2003).
A boy’s first ejaculation is roughly equivalent to menarche.
However, while girls generally tell their mothers about the onset of
menstruation, boys rarely mention their first ejaculation to their parents or
even their friends (Stein & Reiser, 1994). Why? One reason is that mothers
provide the tampons or sanitary napkins girls need. For boys, the first
ejaculation may be seen as a sign of their budding sexuality an area they feel
both uncertain about and reluctant to discuss with others.
Menstruation and ejaculations occur privately, but changes in
body shape and size are quite public. Teenagers frequently are embarrassed by
these changes. Girls, in particular, are often unhappy with their new bodies.
Western ideals of beauty call for an extreme thinness at odds with the actual
shape of most women. Puberty considerably increases the amount of fatty tissue,
and enlarges the hips and buttocks—a far cry from the pencil-thin body society
seems to demand (Unger & Crawford, 2004; McCabe & Ricciardelli, 2006;
Cotrufo et aL, 2007).
How children react to the onset of puberty depends in part on
when it happens. Girls and boys who mature either much earlier or later than
most of their peers are especially affected.
The Timing of Puberty: The Consequences of ErIy and Late
Maturation.
There are social consequences for early or late maturation. And these social
consequences are very important to adolescents.
Early Maturation. For boys, early maturation is largely a
plus. Early-maturing boys tend to be more successful athletes, presumably
because of their larger size. They also tend to be more popular and to have a
more positive self-concept.
Early maturation in boys, though, does have a downside. Boys
who mature early are more apt to have difficulties in school, and to become
involved in delinquency and substance abuse. Being larger in size, they are
more likely to seek the company of older boys and become involved in
age-inappropriate activities. Early-maturers are also more conforming and
lacking in humor although they are more responsible and cooperative in
adulthood. Overall, though, early maturation is positive for boys (Taga,
Markey, & Friedman, 2006; Costello et aL, 2007; Lynne et aL, 2007).
The story is a bit different for early-maturing girls. For
them, the obvious changes in their bodies—such as the development of
breasts—may lead them to feel uncomfortable and different from their peers.
Moreover, because girls, in general, mature earlier than oys, early maturation
tends to come at a very young age in the girl’s life. Early-maturing girls may
have to endure ridicule from their less mature classmates (Franko &
Striegel-l’voore, 2(02; Olivardia & Pope, 2002; Mendle, Thrkheimer, &
Emery, 2007). ®-[Watch on mydevelop
,cntlab,com,
Early maturation, though, is not a completely negative
experience for girls. hose who mature earlier are more often sought as dates,
and their p.pularit, may enhance their self-concept This can be psychologically
challenging, however. Early-maturers may not be socially ready for the kind of
one-on-one dating situations that most girls deal with at a later age.
Moreover, their obvious deviance from their later-maturing peers may produce
anxiety, unhappiness, and depression (Kaltiala-Heino et al., 2003).
Consequently, unless a young girl who has developed secondary
sex characteristics early can handle the disapproval she may encounter when she
conspicuously displays her growing sexuality, the outcome of early maturation
may be negative. In countries in which attitudes about sexuality are more
liberal, the results of early maturation maybe more positive. For example, in
Germany, which has a more open view of sex, early-maturing girls have higher
self-esteem than such girls in the United States. Furthermore, the consequences
of early maturation vary even within the United States, depending on the views
of girls’ peer groups and on prevailing community standards regarding sex
(Petersen, 2000; Gure,Uçanok, & Sayil, 2006).
Late Maturation. As with early-maturers, the situation for
late-maturers is mixed, although here boys fare worse than girls. Boys who are
smaller and lighter tend to be considered less attractive. Being small, they
are at a disadvantage in sports activities. They may also suffer socially as
boys are expected to be taller than their dates. If these difficulties diminish
a boy’s self-concept, the disadvantages of late maturation could extend well
into adulthood. Coping with the challenges of late maturation may actually help
males, however. Late-maturing boys grow up to be assertive and insightful, and
are more creatively playful than early maturers (Livson & Peskin, 1980;
Kaltiala-Heino et aL, 2003).
The picture for late-maturing girls is quite positive even
though they may be overlooked in dating and other mixed-sex activities during
junior high and middle school, and may have relatively low social status (Apter
et a!., 1981; Clarke-Stewart & Friedxnan, 1987), In fact, late- maturing
girls may suffer fewer emotional problems. Before they reach 10th grade and
have begun to mature visibly, they are more apt to fIt the slender, “leggy”
body type society idealizes than their early-maturing peers, who tend to look
heavier in comparison (Petersen, 1988; Kaminaga, 2007; Leen-Feldner, Reardon,
& Hayward, 2008).
The reactions to early and late maturation paint a complex
picture. As we have seen, an individual’s development is affected by a
constellation of factors. Some developmentalists suggest that changes in peer
groups, family dynamics, and particularly schools and other societal
institutions may determine an adolescent’s behavior more than age of
maturation, and the effects of puberty in general (Dorn, Susman, &
Ponirakis, 2003; Stice, 2003; Mendle, Turkheimer, & Emery, 2007; Spear,
2010).
Nutrition, Food, And
Eating Disorders: Fueling the Growth of Adolescence
A rice cake in the
afternoon, an apple for dinner. That was Heather Rhodes’s typical diet her
freshman year at St. Joseph’s College in Rensselaer, Indiana, when she began to
nurture a frar (exacerbated, she says. by the sudden death of afriend) that she
was gaining weight. But when Heather, now 20, returned home to Joliet,
illinois, jbr summer vacation a year and a half ago, her family thought she was
melting away.... Her 5’7”frame held a mere 85 pounds—down 22 pounds from her
senior year in high school.... “[Butj when I looked in the mirror,” she says,
“[thought my stomach was still huge and my face was fat.” (SandIer, 1994, p.
56)
Heather’s problem: a severe eating disorder, anorexia
nervosa. As we have seen, the cultural ideal of slim and fit favors
late-developing girls. But when development does occur, how do girls, and
increasingly, boys, cope with an image in the mirror that deviates from the
popular media ideal?
The rapid physical growth of adolescence
is fueled by an increase in food consumption. Particularly during the growth
spurt, adolescents eat substantial quantities of food, increasing thei: intake
of calories rather dramatically. During the teenage years, the average girl
requires some 2,2)0 calories a day, and the average boy requires 2,800. Of
course, not just any calories .ourish this growth. Several nutrients are
essential, particulari’ calcium and iron. Milk ai certain regetables provide
calcium for bone growth, and calcium may prevent the…
Obesity has become the most common nutritional concern during
adolescence. In addition to issues of health, what are some psychological
concerns about obesity in adolescence?
… osteoporosis—the thinning of bones—that affects 25 percent
of women in later life. Iron is also necessary, as iron-deficiency anemia is
not tin- common among teenagers.
For most adolescents, the rnor issue is eating a sufficient
balance of nutritious foods. Two extremes of nutrition concern a substantial
minor.. ity and can create real threats to health: obesity and eating disorders
like the one afflicting Heather Rhodes.
Obesity. The most common nutritional concern in adolescence is
obesity One in 5 adolescents is overweight, and I in 20 can be classified as
obese (snore than 20 percent above average body weight). The proportion of
females who are classified as obese increases over the course of adolescence
(Brook & Tepper, 1997; Critser, 2003; Kiman et aL, 2003).
Adolescents are obese for the same reasons as younger
children, but special concerns with body image may have severe psychological
consequences at this age. The potential health consequences of obesity during
adolescence are also problematic. Obesity taxes the circulatory system,
increasing the risk of high blood pressure and diabetes. Obese adolescents also
have an 80 percent chance of becoming obese adults (Blame, Rodman, &
Newman, 2007; Goble, 2008; Wang et aL, 2008).
Lack of exercise is a major culprit. One survey found that by
the end of the teenage years, few females get much exercise outside of
schoolphysical education classes. In fact, the older they get, the less they
exercise. This is espedaily true for older Black female adolescents, more than
half of whom report no physical exercise outside of school, compared with about
a third of White adolescents (Deforche, Dc Bourdeaudhuij, & Tanghe, 2006;
Delva, O’Malley, & Johnston, 2006; Reichert et aL, 2009; Liou, Liou, &
Chang, 2010).
Additional reasons for the high rate of obesity during
adolescence include the easy availability of fast foods, which deliver large
portions of high-calorie, high-fat cuisine at prices adolescents can afford.
Furthermore, many adolescents spend a significant proportion of their leisure
time inside their homes watching television, playing video gaines, and surfing
the Web. Such sedentary activities not only keep adolescents from exercising,
but they often are accompanied by snacks of junk foods (Rideout, Vandewater,
& Wartella, 2003; Delmas et aL, 2007; Krebs et aL, 2007; Bray, 2008).
Anorexia Nervosa and Bulitnia. Fear of fat and of growing obese
can create its own problems—for example, Heather Rhodes suffered from anorexia nervosa, a severe eating
disorder in which individuals refuse to eat. A troubled body image leads some
adolescents to deny that their behavior and appearance, which may become
skeletal, are out of the ordinary
Anorexia is a dangerous psychological disorder; some 15 to 20
percent of its victims starve themselves to death. It primarily afflicts women
between the ages of 12 and 40; inteffigent, successful, and attractive White
adolescent girls from affluent homes are the most susceptible. Anorexia is also
becoming a problem for boys; about 10 percent of victims are male. This
percentage is rising and is often associated with the use of steroids (Jacobi
et al., 2004; Ricciardelli & McCabe, 2004; Crisp et a!., 2006).
Though they eat little, anorexics tend to focus on food. They
may shop often, collect cookbooks, talk about food, or cook huge meals for
others. They may be incredibly thin but their body images are so distorted that
they see themselves as disgustingly fat and try to lose more weight. Even when
they grow skeletal, they cannot see what they have become.
Builmia, another eating disorder, is
characterized by binge eating; consuming large amounts of food, followed by
purging through vomiting or thE use of laxatives. Bulimics may eat art entire
gallon of ice cream or a whole package of tortilla chips, but then feel such
powerful guilt and depression that they intentionally rid then selves of the
food. The disorder poses real risks. Though:’ bulimia sufferer’s weight remains
fairly nnrmal, the constant vomiting and diarrhea of the binge-aoL -purge
cycles may prode a chemical imbalance that triggers heart failure.
Why eating disorders occur is not deai but several factors
maybe at work Dieting often precedes the onset of eating disorders, as society
exhorts even normal-weight individuals to be ever thinner. Losing weight may
lead to feelings of control and success that encourage more dieting. Girls who
mature early and have a higher level of body fat are more susceptible to eating
disorders in later adolescence as they try to trim their mature bodies to fit
the cultural ideal of a thin, boyish physique. Clinically depressed adolescents
are also prone to develop eating disorders later (Gionlana, 2005; Santos,
Richards, & Blecldey, 2007; Courtney, Gamboz, & Johnson, 2008; Rodgers,
Paxton, & Chabrol, 2010).
Some experts suggest that a biological cause may underlie
both anorexia nervosa and bulimia. Twin studies suggest genetic components are
involved. In addition, hormonal imbalances sometimes occur in sufferers (Kump
et at, 2007; Kaye, 2008; Wade et at, 2008; Baker et al., 2009).
Other attempts to explain the eating disorders emphasize
psychological and social factors. For instance, some experts suggest that the
disorders are a result of perfectionistic, overdemanding parents or by-products
of other family difficulties. Culture also plays a role. Anorexia nervosa, for
instance, is found primarily in cultures that idealize slender female bodies.
Because in most places such a standard does not hold, anorexia is not prevalent
outside the United States (Haines & Neumark-Sztainer, 2006; Harrison &
Hefner, 2006; Bennett, 2008).
For example, anorexia is relatively rare in Asia. with the
exceptions of areas in which Western influence is greatest. Furthermore,
anorexia nervosa is a fairly recent disorder. It was not seen in the
seventeenth and eighteenth centuries, when the ideal of the female body was a
plump corpulence. The increasing number of boys with anorexia in the United
States may be related to a growing emphasis.on a muscular male physique that
features little body fat (Mangweth, Hausmaan, & Walch, 2004; Makino et at,
2006; Greenberg, Cwikel, & Mirsky 2007; Pearson, Combs, & Smith, 2010).
Because anorexia nervosa and bulimia have both biological and
environmental causes, treatment typically requires a mix of approaches (e.g.,
both psychological therapy and dietary modifications). In more extreme cases,
hospitalization may be necessary (Wilson, Grilo, & Vitousek, 2007; Keel
& Haedt, 2008; Stein, Latzer, & Merick, 2009).
This young woman suffers from anorexia nervosa, a severe
eating disorder in which people refuse to eat, while denying that their
behavior and appearance are out of the ordinary.
Brain Development and
Thought : Paving the Way for Cignitive Growth
Teenagers tend to assert themselves more as they gain greater
independence. This independence is, in part, the result of changes in the brain
that bring significant advances in cognitive abilities. As the number of
neurons (the cells of the nervous system) continues to grow, and their
interconnections become richer and more complex, adolescent thinking becomes
more sophisticated (Thompson & Nelson, 2001; Toga & Thompson, 2003;
Petanjek et al., 2008).
The brain produces an oversupply of gray matter during
adolescence, which is later pruned back by ito 2 percent each year (see Figure
6-3). Myelination—the process of insulating nerve cells with fat
cells—increases, making the transmission of neural messages more efficient.
Both pruning and increased myelination contribute to the growing cognitive
abilities of adolescents (Sowell et at, 2001; Sowell et at, 2003).
The prefrontal cortex of the brain, which is not fully
developed until the early 20s, undergoes considerable development during
adolescence. The prefrontal cortex allows people to think, evaluate, and make
complex judgments in a uniquely human way. It underlies the increasingly
complex intellectual achievements that are possible during adolescence.
At this stage, the prefrontal cortex becomes increasingly
efficient in communicating with other parts of the brain, creating a
communication system that is more distributed and sophisticated, which permits
the different areas of the brain to process information more effectively
(Scherf, Sweeney, & Luna, 2006; Hare et at, 2008).
The prefrontal cortex also provides impulse control. An
individual with a fully- developed prefrontal cortex is able to inhibit the
desire to act on such emotions as anger or rage. In adolescence, however, the
prefrontal cort is biologically immature; the ability to inhibit impulses is
not fully developed (Wcinbergcr, 2001; St inbcrg & Scott, 2003; Es1el t
aT., 2007).
The prefrontal cortex, the area of the brain responsible for
impulse control, is biologically immature during adolescence, leading to some
of the risky and impulsive behavior associated with the age group.
The Immature Brain
Argument: Too Young for the Death Penalty?
Just after 2a.m. on
September 9, 1993, CM stopher Simmons, 17, and Giai1es Benjamüi, 15, broke into
a thdler south of Fenton, Missouri, just outside of SL Louis. They woke Shirt
eyAnn Crook, a 46year-old truck cfriver who was inside, and proceeded to tie her
up and cover her eyes and mouth with silver duct tape. Theythen put her in the
backof her minivan, drove hertoaraibvad bridge and pushed her into the river
below, where her body was Jbund the next day Simmons and Benjwnin later
confessed to the abduction and murder; which had netted them $6. (Raeburn,
2004, p. 26).
FIGURE 6-3 Pruning
Gray Matter
This three-dimensional view of the brain shows areas of gray
matter that are pruned from the brain betven adolescence and adulthood.
Source: Sowell et al., 1999.
This horrific case sent Benjamin to life in prison, but
Simmons was given the death penalty. Simmons’s lawyers appealed, and ultimately
the U.S. Supreme Court ruled that no one under the age of 18 could be executed,
citing their youth. Among the factors affecting the Court’s decision was
evidence from neuroscientists and child developmentalists that adolescents’
brains were still developing in important ways and thus lacked judgment due to
brain immaturity. This reasoning says adolescents are not fully capable of
making sound decisions because their brains differ from those of adults.
The argument that adolescents may not be as responsible for
their crimes stems from research showing continued brain growth and maturation
during the teenage years, and beyond. For example;iieurons that make up
unnecessary gray matter begin to disappear. The volume of white matter begins
to increase. This change permits more sophisticated, thoughtful cognitive
processing (Beckman, 2004).
When the brain’s frontal lobes contain more white matter,
they are better at rLstraining impulsivity. Teenagers may act impulsively,
responding with emotion rather than reason. Their ability to foresee
consequences may also be hindered by their less mature bra ns.
Are adolescents’ brains so immature that offenders should
receive a lesser punish. rent for their crimes thar adults? The answer to this
difficult questior may come from students of ethics rather than science.
Sleep Deprivation. With increasing academic and social demands, adolescents go
to bed later and get up earlier, leaving them sleep-deprived. This deprivation
coincides with a shift in their internal docks. Older adolescents have a need
to go to bed later and to sleep later in the morning, requiring 9 hours of
sleep to feel rested. Yet half of adolescents sleep 7 hours or less each night,
and almost one in five gets less than 6 hours. Because they typically have
early morning dasses but don’t feel sleepy until late at night, they end up
getting far less sleep than their bodies crave (National Sleep Foundation,
2002; Fuligni & Hardway, 2006; Epstein & Mardon, 2007; Loessi et al.,
2008).
Sleep-deprived teens have lower grades. are more depressed,
and have greater difficulty contmlling their moods. They are also at great risk
for auto accidents (Teixeira, Fischer, & Lowden, 2006; Dahl, 2008; Roberts,
Roberts, & Duong, 2009).
Threats to Adolescents`
Well-Being
L04 What are the major
threats to the well-being of adolescents?
L05 What dangers do
adolescent sexual practices present, and how can these dangers be avoided?
Like most parents, Thad
thought of dng use as soniething you wormed about when your kids got to high
schooL Now I loiow that, on the average, dds begin using drugs at 11 or 12, but
at the tune that never crossed our minds. Ryan had just begun attending mixed
parties. He was pkzthig L tile League. In the eighth gude, Ryan started getting
into a hUe ln,uble—one tune he and another fellow stole afire extinguisher but
we thought it was just a prank Then hi grades began to deteriorate. He began
sneakingout at nighL He would become belligerent at the divp of a hat then
sunny and nice again....
It wasn’t intil Ryan fell apart at 14 ‘hat we arted thinking about drugs.
He had just begun McLean High SthooL and to him, it wa !ke goirg to drug ccmp
every day. Back then, everythingwas so available. He began cutting dasse.s, a
common tip-off but we didn’t hear from the school until he was flunking
everything. It turned out that he was going to school for the first period,
getting checked in then leaving and smoking marijuana all day. (Shafer, 2990,
p. 82)
Ryan’s parents learned that marijuana was not the only drug
he was usmg. Ryan was what his friends called a “garbage head. He would try
anything. Despite efforts to curb his drug use, he died at 16, hit by a car
after wandering into the street while on drugs.
Though it rarely ends in such
tragedy, drug use, as well as other kinds of substance use and abuse, is one of
several health threats in adolescence, usually one of the healthiest periods of
life. While the extent of risky behavior is unknown, drugs, alcohol, and
tobacco pose serious threats to adolescents’ health and well-being.
Illegal Drugs
Illegal drug use in adolescence is very common. A recent
survey of nearly 50,000 U.S. students showed that almost 50 percent of high
school seniors and almost 20 percent of eighth graders had used marijuana
within the past yeac Although marijuana usage (and use of other drugs) has
declined in recent years, the data on drug use still shows substantial use by
adolescents (Nanda & Konnur, 2006; Johnston et aL 2009; Tang & Orwin,
2009) (see Figure 6-4).
Adolescents use drugs for many reasons. Some seek the
pleasure they provide. Others hope to escape the pressures of everyday life,
however temporarily. Some adolescents try drugs simply for the thrill of doing
something ifiegaL The drug use of well-known role models, such as movie stars
and athletes, may also be enticing. And peer pressure plays a role: Adolescents
are especially influenced by their peer groups (Urberg, Luo, & Pilgrim,
2003; Nation & Heffinger, 2006; Young et aL, 2006; Pandina, Johnson, &
White, 2010).
The use of illegal drugs poses several dangers. Some drugs
are addictive. Addictive drugs produce a biological or psychological
dependence, leading users to increasingly crave them.
With a biological addiction, the drug’s presence becomes so
common that the body cannot function in its absence. Addiction causes actual
physical—and potentially lingering—changes in the nervous system. The drug may
no longer provide a high,” but may be necessary to maintain the perception of
normalcy (Cami & Farré, 2003; Munzar, Cairn, & Farre, 2003).
Drugs also can produce psychological addiction. People grow
to depend on drugs to cope with everyday stress. If used as an escape, drugs
may prevent adolescents from confronting—and solving—the problems that led to
drug use in the first place. Even casual use of less hazardous drugs can
escalate to dangerous forms of substance abuse.
Whatever the reason for using drugs
in the first place, drug addiction is among the most difficult of all behaviors
to modify Even with extensive treatment, addictive cravings are hard to
suppress (Thobaben, 2010).
FIGURE 6-4 Downward Trend
According to an annual survey, the proportion of students reporting
marijuana use over the past 12 mont is has decreased since 1999 What might
account for the decline in drug use
Source: Jonston et al., 2009.
Alcohol : Use and Abuse
Three-fourths of college students have something in common:
They’ve consumed at least one alcoholic drink during the last 30 days. More
than 40 percent say they’ve had five or more drinks within the past 2 weeks,
and some 16 percent drink 16 or more drinks per week. High school students,
too, are drinkers: Nearly three-quarters of high school seniors report having
consumed alcohol by the end of high school, and about two-fifths have done so
by eighth grade. More than half of twelfth graders and nearly a fifth of eighth
graders say that they have been drunk at least once in their lives (Ford. 2007;
Johnston et aL, 2009).
Binge drinking is a particular problem on college campuses.
Binge drinking is defined for men as drinking five or more drinks in one
sitting; for women, who tend to weigh less and whose bodies absorb alcohol less
effidently, binge drinking is defined as four drinks in one sitting. Surveys
find that almost half of male college students and over 40 percent of female
college students say they participated in binge drinking during the previous
two weeks (Harrell & Karim, 2008; Beets et aL, 2009) (see Figure 6-5).
Binge drinking affects even those who don’t drink or drink
very little. Two-thirds of lighter drinkers reported that they have been
disturbed by drunken students while sleeping or studying. Around a third have
been insulted or humiliated by a drunken student, and 25 percent of women said
they have been the target of an unwanted sexual advance by a drunk dassmate
(Wechsler et aL, 2000, 2002, 2003).
There are many reasons adolescents drink. For some—espedally
male athletes, who tend to drink more than their peers—drinking is a way to
prove their prowess. As with drug use, others drink to release inhibitions and
tension, and reduce stress. Many begin because they believe everyone else is
drinking heavil something known as the false consensus effect (Pavis,
Cunningham- Burley, & Amos, 1997; Nelson & Wechsler, 2003; Weitzman,
Nelson, & Wechsler, 2003).
Some adolescents cannot control their alcohol use. Alcoholics learn to depend on alcohol
and are unable to stop drinking. They develop an increasing tolerance for it,
and need to drink ever-larger amounts to get the positive effects they crave.
Some drink throughout the day, while others go on binges.
Why.some adolescents become alcoholics is not fully
understood. Genetics plays a role:
Alcoholism runs in families, though not all alcoholics have
family members with alcohol problems. For adolescents with an alcoholic parent
or family member, alcoholism may be triggered by efforts to deal with the
stress (Berenson, 2005; Clarke et aL, 2008).
Of course, the origins of an adolescents alcohol or drug problems
matter less than getting help. Parents, teachers, and friends can help a
teen—if they realize there is a problem. Some of the telltale signs are
described next.
FIGURE 6-5 Blinge
Drinking Among College Students
For men, binge drinking is defined as consuming five or more
drinks in one sitting; for women, the total is four or more. Why is binge
drinking popular?
Source: Wechsler et al., 2003.
Tobacco:The Dangers of
Smoking
Despite an awareness of the dangers of smoking, many
adolescents indulge in it. Recent figures show that, overall, smoking is
declining among adolescents, but the numbers remain substantial; and within
certain groups the numbers are increasing. Smoking is on the rise among girls,
and in several countries, induding Austria, Norway, and Sweden, the proportion
of girls who smoke is higher than for boys. There are racial differences, too:
White children and those of lower socioeconomic status are more likely to
experiment with cigarettes and to start smoking earlier than African American
children and those of higher socioeconomic status. Also, significantly more
White males of high school age smoke than do their African American male peers,
although the difference is narrowing (Harrell et al., 1998; Stolberg, 1998;
Baker, Brandon, & Chain, 2004; Fergussoñëtal., 2007).
Smoking is becoming a habit that is
harder to maintain because there are growirg social sanctions against it. It’s
beconng more difficult to find a comfortable place to smoke: More place,
including schools and 11aces of business, have become “smoke-free.” Even so, a
good number of adolescents still smoke, despite knowing the dangers of smoking
and of secondhand smoke. Why, then, do adolescents begin to smoke and maintain
the habit?
One reason is that for some
adolescents, smoking is seen as an adolescent rite of passage, a sign of
growing up. In addition, seeing influential models, such as film stars,
parents, and peers smoking increases the chances that an adolescent will take
up the habit. Cigarettes are also very addictive. Nicotine, the active chemical
ingredient of cigarettes. can produce biological and psychological dependency
very quickly Although one or two cigarettes do not usually produce a lifetime
smoker, it takes oniy a little more tn start the habit. In fact, people who
smoke as few as 10 cigarettes early in their lives stand an 80 percent cha; ce
of becoming habitual smokers (Kodi & Mermelstein, 2004; West, Romezv, &
Trinidad, 2007; Tucker et al., 2008; Wills et al, 2008).
Hooked on Drugs or
Alcohol?
Becoming an informed
Consumer of Development
It s not always easy to know if an adolescent Is abusing
drugs or alcohol, but there are signals. Among them:
Identification with the
drug culture
• Drug-related magazines or slogans on clothing
• Conversation and jokes that involve drugs
• Hostility discussing drugs
• Collection of beer cans
Signs of physical
deterioration
• Memory lapses, short attention span, difficulty
concentrating
• Poor physical coordination, slurred or incoherent speech
• Unhealthy appearance, indifference to Lgiene and grooming
• Bloodshot eyes, dilated pupils
Dramatic changes In
school performance
• Marked downturn in grades—not Just from C’s to F’s, but
from A’s to B’s and C’s; assignments not completed
• Increased absenteeism or tardiness
Changes In behavior
• Chronic dishonesty (lying, stealing, cheatin trouble with
the
police
• Changes in friends; evasiveness in talking about new ones
• Possession of large amounts of money
• Increasing and inappropriate anger, hostility Iriitabilitt
secretIveness
• Reduced motivation, energy, self-discipline, self-esteem
• Diminished interest in extracurricular activities and
hobbies (Adapted from Franck & Brownstone, 1991; National Institute on Drug
Abuse, 2007)
If an adolescent—or anyone else—fits any of these
descriptors, help is probably needed. Call the national hotline run by the
National Institute on Drug Abuse at (800) 662-4357 or visit its bsite at
www.nida.nih.gov. You can also find a local listing for Alcoholics Anonymous in
the telephone book.
Cultural Dimentions
Selling Death: Pushing Smoking to the less Advantaged
In Dresden, Germany, three women in miniskirts offer
passers-by a pack of Lucky Strikes and a leaflet that reads You just got hold
of a nice piece of America . Says a local doctor, Adolescents time and again
receive cigarettes at such promotions.’
A Jeep decorated with the Camel logo pulls up to a high
school In Buenos Aires. A woman begins handing out free cigarettes to 15- and
16-year-olds during their lunch recess.
At a video arcade in raipel, free American cigarettes are
strewn atop each game. At a disco filled with high school students, free packs
of Salems are on each table. (Ecenbarger, 1993, p. 50)
U.S. cigarette companies have sought new markets among the
least advantaged people, both at home and abroad. In the early 1990s, the R.J.
Reynolds tobacco company designed a brand of cigarettes t named Uptown.’ The
advertising made clear who the target was: African Americans living in urban
areas (Quinn, 1990). Subsequent protests caused the company to withdraw
‘Uptown’ from the market (Quinn, 1990; Brown, 2009).
In addition to seeking new converts at home, tobacco
companies aggressively recruit adolescent smokers abroad. In many developing
countries the number of smokers is still low. Tobacco companies are using
marketing strategies sucji as free samples to increase this number. In
countries where American culture and products enjoy high esteem, advertising
suggests cigarette smoking is an Anierican—and consequently prestigious——habit
(Sesser, 1993).
The strategy is effective. In some Latin American cities as
many as 50 percent of teenagers smoke. According to the World Health
Organization, smoking will prematurely kill some 200 million of the world’s
children and adolescents. Overall, 10 percent of the world’s population will
die from smoking (Ecenbarger, 1993; Picard, 2008).
Sexually Transmitted
Infections
One out of four adolescents contracts a sexually transmitted infection (STI) before graduating from high
schooL Overall, around 2.5 million teenagers contract an STI each year (Centers
for
Disease Control, 2009) (see Figure 6-6).
The most common STI is hwnan papilloina virus (HPV). HPV can
be transmitted through genital contact without intercourse. Most infections do
not have symptoms, but HPV can produce genital warts and in some cases lead to
cervical cancer. A vaccine that protects against some kinds of HPV is now available.
The US. Centers for Disease Control and Prevention recommends it be routinely
administered to girls 11 to 12 years of age—a recommendation that has provoked
considerable political reaction (Kahn, 2007; Casper & Carpenter, 2008;
Caskey, Lindau, & Caleb, 2009).
Another common STI is triclwmonlasis, an infection in the
vagina or penis, which is caused by a parasite. Initially without symptoms, it
can eventually cause a painful discharge. Chiamydia, a bacterial infection,
starts with few symptoms, but later causes burning urination and a discharge
from the penis or vagina. It can lead to pelvic inflammation and even to
sterility. Chlamydia can be treated with antibiotics (Nockels & Oakshott,
1999; Fayers et aL, 2003).
Genital herpes is a virus not unlike the cold sores that
appear around the mouth. Its first symptoms are often small blisters or sores
around the genitals, which may break open and become quite painfuL Although the
sores may heal after a few weeks, the infection often recurs and the cycle repeats
itselL When the sores reappear, this incurable infection is contagious.
Gonorrhea and syphilis are the oldest known STIs, with cases
recorded by ancient historians. Both infections were deadly before antibiotics,
but can now be treated effectively.
Acquired
immunodeficiency syndrome or AIDS, is the deadliest of sexually transmitted diseases and a
leading cause of death among young people. AIDS has no cure, but treatments
have improved greatly in recent years and AIDS is no longer the sure death
sentence that it used to be. Although it began as a problem that primarily
affected homosexuals, it has spread to other populations, induding
heterosexuals and intravenous drug users. Minorities have been particularly
hard hit African Americans and Hispanics account for some 40 percent of AIDS
cases, although they make up only 18 percent of the population. Already, 25
million people have died from AIDS, and people living with the disease number
33 million worldwide (Quinn & Overbaugh, 2005; UNAIDS, 2009).
J From
a health care provider’s perspectIve : Why do adolescents’ increased cognitive
abilities, including the ability to reason and to think experimentally, fail to
deter them from drug and alcohol abuse, tobacco use, and sexually transmitted
infections? How might you use these abilities to design a progrom to prevent
these problems?
FIGURE 6-6 Sexually
Transmitted Infections (ST1s) Among AdoIescents
Why are adolescents in particular in danger of contracting an
STI?
Snjrces: Asn Guttmacher ns’itute, 2004; Weinstock, Berman,
& Cates, 2006.
Table 6-1 Safer sex
practices
Avoiding STIs
Short of abstinence, there is no certain way to avoid STh.
However, there are ways to make sex safer; these are listed in Table 6-1.
Even with substantial sex education, the use of safer sex
practices is far from universal. Teenagers believe their chances of contracting
STIs are minimaL This is particularly true when they view their partner as
“safe”—someone they know well and with whom they have had a relatively
long-term relationship (Lefkowitz, Sigman, & Kit-fong Au, 2000 Lees,
&Sumartojo, 2004).
Unfortunatel unless one knows a partner’s complete sexual
history and STE status, unprotected sex remains a risk. And that information is
difficult to get. Not only is it embarrassing to ask, partners may not be
accurate reporters, whether from ignorance of their own exposure,
embarrassment, forgetfulness, or a sense of privacy As a result, STh remain a
significant problem.
