Defining Adolescence

1. Brian’s Brain Can current brain research help us understand adolescent behavior?Sandy PowellAdolescent and School Health ProgramAlabama Department of Public Health

2. Defining Adolescence • That awkward period between sexual maturation and the attainment of adult roles and responsibilities • Transition from “child” status (requiring adult monitoring) to “adult” status (self responsibility for behavior • Developmental stage includes the body and brain changes of puberty • Adolescents today are categorized as 10-24 year olds

5. Stages of Adolescent Development • Early Adolescence • Females: 9 - 13 yo • Males: 11 – 15 yo • Middle Adolescence • Females: 13 – 16 yo • Males: 14 – 17 yo • Late Adolescence • Females: 16 – 21 yo • Males: 17 –21 yo

6. Early Adolescence • Adjusting to body/pubertal changes “Am I normal?” • Concern with body image and privacy • Begin separation from family, increased parent-child conflict • Self preoccupation and fantasy • Moody! • Same-sex friends and group activities • Concentration of relationships with peers • Concrete thinking but beginning to explore new ability to abstract - focused on the present

7. Middle Adolescence • Extremely concerned with looks- “Am I attractive?” • Increased independence from family-(vacation dilemmas) • Increased importance of peer group (Everyone’s doing it) • Experimentation with relationships & sexual behaviors • Movement towards forming sexual orientation / identity • Increased abstract thinking ability • Development of ideals & selection of role models • The altruistic idealist

8. Late Adolescence • Autonomy nearly secured-not mean totally • Body image & gender role definition nearly secured • Thinking beyond themselvesworld view • Attainment of abstract thinking & useful insight • Greater emotional stability • Greater intimacy skills • Sexual orientation nearly secured • Ability to express ideas in words • Concern for future • Transition to adult roles-school, work

9. Tasks of Adolescence • Body matures to sexual adult-Rapid Physical Growth • Cognitively-brain develops moves from concrete thinking to abstract thinking skills • Morally, the teen identifies meaningful moral /social standards, values and belief systems • Identity formed– gender, sexual, cultural • Teen defines an adult role with responsibilities- Brain changes are linked to each component Source: A. Rae Simpson, PhD, Parenting of Adolescents Center, Harvard School of Public Health

10. ADOLESCENCE…heated by Nature as drunken men to wine I would (wish) that there were no age between ten and twenty three… for there is nothing in between but getting wenches with child, wronging the ancientry, stealing, fighting… Shakespeare (The Winter’s Tale; Act III)

11. And yet …. • Considered to be the healthiest and most resilient period of the lifespan • Experiencing ultimate strength, speed, reaction time, mental reasoning abilities, immune function, resistance to cold, heat, hunger, dehydration and most injuries • HOWEVER morbidity and mortality rates increase 200-300% between middle childhood and early adulthood • Onset of nicotine dependence, alcohol and substance use, poor health habits will show up as adult mortality • Many adult onset problems such as depression can be traced to early adolescent episodes

12. Highlights in Brain Research Epilepsyis a “disturbance of the brain.” The brain is the “seat of all intelligence” -HIPPOCRATES 460-379 BC -PLATO agrees 363 BC Hydrocephalus described for the first time 1550 AD Optic nerves were discovered to be originated from the brain

13. Highlights in Brain ResearchPHRENOLOGY 1820s to 1840s The brain is the organ of the mind. The mind is composed of multiple distinct, innate faculties. Because they are distinct, each faculty must have a separate seat or "organ" in the brain. The shape of the brain is determined by the development of the various organs. As the skull takes its shape from the brain, the surface of the skull can be read as an accurate index of psychological aptitudes and tendencies

14. Phineas Gage • Crucial evidence of the relation between personality and the function of the front part of the brain- • 1848 Phineas Gage, Railway foreman working in Cavedish, Vermont • 3’ 7” tamping iron entered his skull in an accidental explosion

15. Phineas Gage • Entered under his left cheekbone and came out the top of his head landing 25-30 yards behind him • After hospital treatment for 10 weeks friends commented he was “no longer Gage” unable to keep a job • Died in 1860, body exhumed in 1867 and studied, tamping iron on display at the Medical Collage of Harvard University

16. Brain Basics • All babies are born with approximately 100 billion neurons • At birth 17% of neurons are wired • By the end of adolescence brain has over 10 billion neurons and another 100 billion support cells forming over 100 trillion connections- more than all the internet connections in the world • Prior to 1992 brain development was thought to be complete by puberty

17. Adolescent Neurons….Connections that receive the most neurochemical juice surviveUse itor lose it

18. Brain Basics • Neurons that fire together, wire together some connections are strengthened, otherseliminated • Blossoming- just prior to puberty and during puberty a stage of increased connections between cells • Pruning Sequence • Window of opportunity, window of sensitivity

19. Brain Basics • Hormones are neurotransmitters that oil communication between neurons • 50 different hormones are highly charged during adolescence, including estrogen, progesterone and testosterone • Testosterone levels increase 1000x during adolescence, approximately 7 surges a day causes male adolescence preoccupation with sex, increased competitiveness, risk taking

20. Brain Basics • Spike in estrogen & progesterone impacts mood stability, risk of depression, causes emotional amplification • Brain development begins in the back and moves forward • Advances in MRI technology has allowed activity areas of the brain to be charted as never before

21. Brain CEO-Prefrontal Cortex (frontal lobes) Behavioral & Cognitive functions • Plans, Organizes • Considers Consequences • Reflects, Insight • Impulse Control • Sets Priorities • Forms strategies • Allocates attention • Stop, Look, Listen

22. Youth Behavior…. • Lack of planning • Rarely fully consider consequences • Emotional outbursts, mood instability • Difficulty inhibiting inappropriate behavior • Not good decision makers • Easily distracted Leading to….. • Increased risk behavior, recklessness and sensation-seeking • Increased conflicts with parents (intensity) • Mood volatility (and increased negative mood)

23. The Amygdala is the emotional center of the brain, produces “gut” reactions While the prefrontal cortex is still under construction behavior is frequently controlled through the amygdala Almond shaped wad of cells in the center of the brain PARENTS MUST BE SURROGATE PREFRONTAL CORTEX Behavior detour….

24. Driving fast with no brakes… • The amygdala does not reason • Sensation seeking portion of the brain • Fight or flight response • Filled with testosterone receptors- • Competitiveness • Aggression • Risk taking

27. Adolescent Brain Development Research Reinforces the effectiveness of Positive/Healthy Youth Development • What is Positive Youth Development (PYD)? • Recognizes adolescence as a time of significant change and transition • Acknowledges adolescent developmental stages • Believes in the capacity and the potential of all youth people and that all youth need developmental opportunities • Emphasizes providing services and opportunities to support all young people in developing a sense of competence, usefulness, belonging, and empowerment • Is BOTH prevention and intervention .

28. Healthy Youth DevelopmentRisk Factors ProtectiveFactors

29. Protective Factors in Adolescence • Parental/family connectedness • Connectedness to a significant adult • School engagement & success • Not working, or working < 20 hours/wk • Being “in-sync” with peers re: physical dev • Perceived importance of religion and prayer • Participation in organized activities

30. Researchers on Healthy Youth Development • Marti Erickson • 3 C’s • Connection • Competence • Contribution

31. Youth need the opportunity to: • Participate as citizens, as members of a household, as workers, and as responsible members of society • Gain experience in decision making • Interact with peers, and acquire a sense of belonging • Reflect on self, in relation to others, and to discover self by looking outward as well as inward

32. Youth need the opportunity to: • Discuss conflicting values and formulate one’s own value system • Experiment with one’s own identity, with relationships to other people, with ideas; to try out various roles without having to commit oneself irrevocably • Develop a feeling of accountability in the context of a relationship among equals • Cultivate a capacity to enjoy life • Find expression through the creative arts

33. Conclusion: Why Invest in Adolescent Health? • Annually, an estimated $700 billion is spent on preventable adolescent health problems. • This estimate considers only the direct and long term medical and social costs associated with 6 common health problems: • Adolescent pregnancy • Sexually transmitted infections • Motor vehicle injuries • Alcohol & other drug problems • Other unintentional injuries • Mental health problems

34. Questions?www.adph.org/schoolhealth