Teens in the 2010s

February 28, 2012

Daniel M. Medeiros, MD Chief, Division of Child and Adolescent Psychiatry Director, Child and Family Institute St. Lukes and Roosevelt Hospitals

Transitions in Adolescence

Body changes Sexuality Peers Education Identity Emotional stresses Brain Development

Body Changes

Feeling loss of control over ones body Growth spurt Sexual characteristics development Acne/braces Chronic illnesses/disabilities Obesity

Sexuality

Loss of control over ones body: hormonal surges Possible struggle regarding gender identity Attractions to males/females/both/neither Negotiating dating and sexuality

Peer Issues

Transition from middle school to high school Cliques, need to fit in Bullying Social media: cautions and concerns Exposure to older teens Moving from groups/gangs to pairing up Dating violence

Education

Transition from middle school to high school Transition from high school to college/employment Learning study skills/taking correct courses Stresses of getting into best college/finances College vs employment GED vs drop out Regents exams

Identity Issues

Dependence/Independence Changing feelings towards parents Alternative adult role models Peer influences

Emotional stresses

Anxiety and Depression Eating Disorders ADHD and behavioral disorders Alcohol and Drug issues Adult onset disorders

Brain Development

Concrete reasoning Less future focused, focused on current rewards Impulsivity and mood instability

This results in more interest in experimenting, taking risks, self-harming behaviors such as cutting, unprotected sex, drinking and driving, etc.

Adolescent Mortality

Accidents
Homicide Suicide

www.monitoringthefuture.org Data from 2011 Lifetime Use

Eighth grade Tenth grade Twelfth grade

cigarettes
alcohol Been drunk marijuana Other illegal drugs

18.4%
33.1% 14.8% 16.4% 9.8%

30.4%
56.0% 35.9% 34.5% 15.6%

40.0%
70.0% 51.0% 45.5% 24.9%

www.monitoringthefuture.org Data from 2011 Past 30 Day Use

Eighth grade Tenth grade Twelfth grade

cigarettes
alcohol Been drunk marijuana Other illegal drugs

6.1%
12.7% 4.4% 7.2% 3.4%

11.8%
27.2% 13.7% 17.6% 5.4%

18.7%
40.0% 25.0% 22.6% 8.9%

www.monitoringthefuture.org Data from 2011 Daily Use

Eighth grade
Cigarettes: Any use pack+/day

Tenth grade 5.5% 1.9% 0.8% 0.2%

Twelfth grade 10.3% 4.3% 2.1% 1.3%

2.4% 0.7% 0.4% 0.1%

alcohol Been drunk

5+ drinks in a row in the last 2 weeks

6.4%
1.3%

14.7%
3.6%

21.6%
6.6%

Marijuana

Substance Dependence
Maladaptive pattern of use, leading to impairment or distress, occurring in same 12 month period, at least 3 criteria: 1) Tolerance 2) Withdrawal 3) Substance often taken in larger amounts or over longer period than intended 4) Persistent desire or unsuccessful efforts to cut down/control use 5) Lots of time spent in activities to obtain drug, use the drug, or recover from the drug 6) Important social/occupational/recreational activities given up/reduced because of drug use 7) Use despite knowing physical/psychological problem is caused by/exacerbated by the substance

Substance Abuse

Maladaptive use of substance leading to significant impairment/distress, within 12 month period, at least one:
1) 2) 3)

4)

Recurrent drug use resulting in failure to fulfill major obligations at work, school, or home Recurrent drug use in situations which are physically hazardous Recurrent drug-related legal problems Continued use despite having physical/psychological problem caused by/exacerbated by the substance

Does my teen have a drug problem?

Relationships with family Relationships with peers Dating relationships School performance Job performance Physical effects Emotional effects Issues with the law

Stages of Change

Pre-contemplation Contemplation Determination/Pre-action Action Maintenance Relapse

Spice and K2 Products

Numerous brands

Spice Spice Diamond Spice Gold K2, K2 Blonde XXX Black Box Smoke n Skulls Zombie

Cannabis substitute implied in marketing

Bath Salts Product Overview

Numerous brands, Plant Food, Stain Remover

Cloud 9 Ivory Wave Super Coke Mtv Energy-1 (NRG1) TranQuility White Lightning Charge Plus

Not for human consumption

Stimulant inconsistently implied in marketing

Synthetic Stimulants: Bath Salts

$20-$30 per packet/jar Cathinone derivatives Mephedrone MDPV Methylone Inter/Intra-product variability Other stimulants Lidocaine/benzocaine

Parenting Styles

Authoritarian Authoritative Permissive

http://www.sciencedaily.com/releases/2012/02/120210 105901.htm

Parenting Styles

Authoritarian parents are demanding and highly controlling, but detached and unreceptive to their childrens needs. These parents support unilateral communication where they establish rules and expect them to be obeyed without complaint or question.
Authoritarian parenting produces children who are discontent, withdrawn, and distrustful.

Parenting Styles

Permissive parents are nondemanding and noncontrolling. These parents tend to be warm and receptive to their childrens needs, but place few boundaries on their children. If they do establish rules, they rarely enforce them to any great extent.
These parents tend to produce children who are the least self-reliant, explorative, and self-controlled.

Parenting Styles

Authoritative parents are both demanding and controlling, but they are also warm and receptive to their childrens needs. They are receptive to bidirectional communication in that they explain to their children why they have established rules and also listen to their opinions about those rules. Children of authoritative parents tend to be selfreliant, self-controlled and content.

Parental Stance

Consistency Rewards and consequences Choices, graduated responsibility/freedom Open communication Do as I say AND do Strong anti-drug stance Monitoring friends/social media Family activities: dinner, exercise Safety first: call if there is an emergency

Thank you!