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Lecture 12 Depression, self-harm and suicide
Moods and emotions
Relatively sudden changes in both positively- and negatively valanced affect
The intensity and/or frequency of negative emotion peaks in early adolescence
Young adolescents also experience less positive emotions
Emotions become more complex with a comprehension of mixed emotions
Dramatic changes of mood
The incidence of dysphoric or depressed moods radically increases, especially for girls
Social aspects of emotion expression and regulation become more developed
Increased in the ability to mask emotions
The use of emotion to manage relationships
Yet, emotional expression during early adolescence
The social referencing aspects of emotion become highly attuned
in early adolescence, there is a sharp increase in the awareness of other's perceptions of the self, and therefore shame
More daily fluctuations in self-esteem
Adolescents are more “moody” or variable in their emotions across the course of a day or week
Changes in negative and positive mood in mid-adolescence
Significant drop in positive mood, no change in negative mood
Mood variability across adolescence using daily internet diaries
Three times a year at age 13-18
4 different moods: happiness, sadness, angry, anxiety
Steady decrease across mid- to late adolescence in variability
Anxiety: does not show the same pattern, slight decrease but not an entire decrease
Moodiness decreases across adolescent period
Depression in all its forms
Depression: an enduring period of sadness
Depressed mood: an enduring period of sadness, without any other related symptoms
Depressive syndrome: sadness plus other symptoms such as crying, feelings of worthlessness, and feeling guilty, lonely or worried
Major depressive disorder: depressed mood or loss of interest or pleasure in almost all activities plus 4 of other symptoms (for at least 2 weeks)
Clinical valuation on slide
Gender differences in CDI depression in mid-adolescence
Girls show higher levels of depression than boys
Depression over the lifespan
5-9: boys are more depressed than girls, but as soon as adolescence hit, then girls show higher rates of depressive disorders than boys. Across the lifespan, women show higher levels of depression than men.
But: men also show a significant increase in depression across the lifespan as well.
Self-harm
NSSI: non-suicidal self-injury
What is self harm?
A variety of behaviors in which an individual intentionally inflicts harm to his or her body for purposes not socially recognized or sanctioned and without suicidal intent
Includes: see slide
Prevalence
4% of adults report a history
14% of adolescents
High school populations in the US and Canada consistently show a 13-24% prevalence rate
17% of young adults
Developmental course
Two developmental pathways: early onset and long-lasting, adolescence-limited
Early onset self-injury is common around the age of 7
Most often, however, self-injury behaviors begin in middle adolescence between the ages of 12 and 15
Can last for weeks, months, or years
30-40% of college respondents report initiating self-injury while 17 years old or older and stopped within 5 years
Frequency and other facts
Lifetime frequency varies dramatically – one to 100s of incidents
The number of forms used by an individual varies from 1 to over 10
1 in 5 self-injurious university students indicated that they had hurt themselves more than intended at least once
1 in 10 indicated that they had hurt themselves so badly that they should have been seen by a medical professional
Who self-injures?
Gender
Females are significantly more likely to self-injure than males
Other study: males are equally likely to self-injure as females, particularly among non-clinical samples
Ethnicity
more common among Caucasians
Others showing similarly high rates in minority samples
Is self-harm contagious?
No hard and fast conclusions can be drawn – no good study of this effect
Anecdotal reports from adults working with youth in school settings report a fad quality to the behavior. There could be groups that intend to injure together.
Survey results of secondary school nurses, counselors and social workers suggest that there are groups of youth injuring together or separately as part of a group membership
Media – increasing prevalence of self-injury in movies, books, and news reports may play a role in the spread of self-injury
Why do people self-injure?
Emotional triggers: overwhelming sadness, anxiety, or emotional numbness
A way to manage intolerable feeling or experience some sense of feeling
Used as means of coping with anxiety or other negative feelings and to relieve stress or pressure
To feel in control of their bodies and minds
To express feelings
To reenact a trauma in attempt to resolve it or to protect others from their emotional pain
Two different pathways:
Dealing with stress
Hyperstress: overwhelmed, not able to cope > trigger (images of self-harm etc.) > self-injury > feeling relieved, being in control, being calm
Dealing with dissociation from the world
Feeling numb, lost, alone, disconnected and/or unreal > self-injury > feeling real, alive and/or able to function again
Nock & Prinstein Model (2004)
Reasons for self-injury > two by two table: look at function of self-injury, why do we keep repeating it? (positive reinforcement (positive stimuli) or negative reinforcement (removal of a negative stimulus))
Functions
Automatic: a function towards the self: we want to feel something > positive reinforcement and serving the self. Doing it to stop bad feelings > negative reinforcement + feeling relieved
Social: to get attention, express something to people. Positive reinforcement (to get attention) or negative reinforcement (to avoid punishment from others)
Self-harm cycle
Self-harm is causing the harm to the self. As a result of the pain > release (feeling of relief, wanting to do it again) > shame (to the self for self-harming) > hurt (emotional turmoil) > trigger for self-harm
Psychiatric heterogeneity
12% of adolescent self-injurers do not fit criteria for any mental disorder
Skin cutters report more anxiety
Endorsers of automatic functions (e.g., to stop bad feelings, feel relaxed) - more likely: suicide attempt, feel hopeless, PTSD symptoms
Users of a range of methods and experience less pain – more likely to have a suicide attempt
Is self-injury a suicidal act?
Self-injury is often undertaken as a means of avoiding suicide
Individuals who report self harm are also more likely to have considered or attempted suicide
Nevertheless, the majority of individuals with self-harm history do not report considering suicide
Non-suicidal self-injury may best be understood as a symptom of distress that, if unsuccessfully mitigated, may lead to suicide behavior
What distinguishes NSSI that attempt suicide from those who do not?
Study of Brausch
Self harm behavior questionnaire
Results
Significant differences on anhedonia, negative self-evaluation and negative self-esteem.
Anhedonia: inability to feel pleasure in normally pleasurable activities
Self-injury only: better of in lower levels of anhedonia, lower sense of negative self-evaluation and higher self-esteem
Graph: parent support, peer support and disordered eating
Sign. Difference: parent support. Individuals who self-harmed only had higher levels of parent support
Conclusion:
Cumulative risk: anhedonia, low levels of parent support, negative self-evaluation etc.
Peers not as important as parents at times of distress > family interventions are important
Study BMJ
Aims...
Results
Higher self harm rates in girls 37,4 compared with boys 12,3 per 10000
Higher incidence rates in low SES (deprived) 27,1 compared to higher SES (nondeprived) 19,6
Girls in 13-16 age group showed 68% increase across time from 45,6 in 2011 to 76,9 in 2014
What’s happening? Referred to mental health services?
No referral for 55,8%
12,4% referred for self harm episode (direct)
14,1% referred within a one year afterwards
Those in deprived areas are less likely to be referred
More than a fifth were prescribed antidepressants, with more girls prescribed them than boys
Boys were more likely to be prescribed hypnotics or anxiolytics than girls
Risks to mortality
A total of 43 deaths occurred among young people in the self harm cohort and 176 in the comparison cohort (this group is 20x bigger)
65% (self harm cohort) compared with 26,6% (comparison cohort) were classified as unnatural deaths
Those who self harmed were an estimated nine times more likely to die unnaturally during the follow-up period than their unaffected peers
In the self harm cohort the risk for mortality was increased for:
All causes of mortality and for each cause of death category
Suicide
Fatal acute alcohol or drug poisoning
Accidents
Boys in the self harm cohort had a higher increase in risk of all cause mortality compared to all other groups
Conclusion
Need to investigate reason for increase among 13-16 year-old girls
Primary care important target for identification and early intervention
More work on prevention needed
Intervention
Focus on:
Enhancing awareness of the environmental stressors that trigger self-injury
Helping individuals identify, practice and use more productive and positive means of coping with their emotional states
Overall conclusion: NSSI represents a continuum of self-harm behaviors, where suicide is the final endpoint
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Lecture 1
Part 1
10 risk behaviors
Alcohol
Delinquency
Gambling
Internet
“extreme sports”
Smoking
School
Unsafe sex
Softdrugs
Traffic
When being different becomes the norm: how microaggressions affect Dutch lesbian, gay, bisexual and transgender youth.
Who are adolescents?
Beginning: 10/11 years old children > you see differences in size and how old they look.
The end: physique that is like the adult level. So huge change in physical appearance, but also from being relatively immature to much more mature.
Defining adolescents
The period between the onset of sexual maturation and the attainment of adult roles and responsibilities.
The transition from:
“child” status (requires adult monitoring)
To “adult” status (self-responsibility for behavior)
Adolescents in action 1
Video ‘tieners reageren op Nederland verwelkomt Trump’
The adolescents understand this form of comedy and can reflect on it and can see what other countries think.
Part 2
The health paradox of adolescence
Adolescence is the healthiest and most resilient period of the lifespan
From childhood to adolescence:
Increase strength, speed, mental reasoning, immune function
Resistance to cold, heat, hunger, dehydration, and most types of injury
Yet: overall morbidity and rates increase 200-300% from childhood to late adolescence
Sources of morbidity and mortality in adolescence:
Primary causes of death/disability are related to problems of control of behavior and emotion.
Increased rates of accidents, suicides, homicides, depression, alcohol & substance use, violence, reckless behaviors, eating disorders, health problems related to risky sexual behaviors
Increased risk-taking, sensation-seeking, and erratic (emotionally influenced) behavior
Recognized for a long time
Youth are heated by Nature as drunken men by wine – Aristotle
I would 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
Scientific questions (Ronald Dahl)
What is the empirical evidence that adolescents are heated by Nature?
Are these changes based in biology?
In the hormones of puberty?
In specific brain changes that underpin some behavioral and emotional tendencies & problems that emerge in adolescence?
What are the implications for interventions? Should we intervene?
If we don't intervene
Onset of problems such as nicotine dependence, alcohol and drug use, poor health habits, etc. Will show up as mortality in adulthood.
Many adult onset problems such as depression can be traced to early episodes in adolescence.
The father
.....read moreLecture 3
Part 1 – adolescent cognitive development
Conditional reasoning/propositional logic: Classic Modus Ponens (MP) inference: if p then q
What is cognition?
Cognition: aspects of mind related to the acquisition, modification, and manipulation of knowledge in particular contexts
Cognitive development: changes in how an individual thinks, solves problems, and changes in memory, attention and information processing
Two perspectives in text: Piagetian and Information Processing
Piagetian perspective: focuses on what are the changes that we see all people go to
Information processing perspective: how do we process information? How does this change across time? Based on individual differences.
Textbook: adolescent thinking compared to children differ in (at least) 5 ways
Better at thinking about what is possible
Children: focus on here and now
Better at thinking about what is abstract
More often think about the process of thinking – able to think about how they think about things (metacognition)
Thinking is multidimensional (what persons say, how they say it and what they mean)
Able to see things as relative rather than absolute (not black - white)
Cognitive development during adolescence: a Piagetian perspective
Jean Piaget (1896-1980) Swiss cognitive psychologist
Stage Theory of Cognitive Development (individuals in different stages think differently)
How thinking changes in varies stages of adolescence. Piaget believed that children were active instructors of their knowledge (not only teachers/parents).
Stages | Age | Brief Description |
Sensorimotor | 0–2 | Cog. dev. involves learning how to coordinate activities of the senses with motor activities
|
Preoperational | 2–7 | Capable of representing the world symbolically (e.g. language) |
Concrete Operations | 7–11 | Become more adept at using mental operations which leads to a more advanced understanding of the world
|
Formal Operations | 11–15+ | Allows adolescents to reason about more complex tasks and problems involving multiple variables
|
Cognitive development during adolescence: a Piagetian perspective
Formal operations – final stage of cognitive development
Concrete: discuss world as it is
Formal: as it might be/become
Increase in ability for abstraction/abstract thought, speculation about the future
--> Allows an individual to place their lives in a personal and societal perspective
Needed to: achieve identity, form goals, select an occupation
Adolescent cognitive abilities
Understand impact of: past on present, present on future
How one thing relates to another
Greater capacity to evaluate immediate and long-range costs and benefits
World as might be, ought to be
Formal operations: 4 overlapping
.....read moreLecture 4
Morality: right and wrong. How do we know what is right/wrong?
Trolley problem 1
There is a runaway trolley barreling down the railway tracks. Ahead there are 5 people tied to the tracks. You are standing near a level that will switch the trolley to a different track where 1 person is tied.
Should you pull the lever to divert the runaway trolley onto the sidetrack?
Clash between utilitarianism – (actions that maximize happiness and well-being) and deontological ethics – the morality of an action should be based on whether that action itself is right or wrong under a series of rules, rather than based on the consequences of that action…
2 options: do nothing and allow the trolley to kill 5 people, or pull the lever divert the train and kill one?
Trolley problem 2
A trolley is hurtling down a track towards five people. You are on a bridge under which it will pass, and you can stop it by putting something very heavy in front of it. There is a very fat man next to you – your only way to stop the trolley is to push him over the bridge and onto the track, killing him to save five. Should you proceed?
Most people: do nothing, don't push an innocent person.
This solution is essentially an application of the doctrine of double effect, which says that you may take action which has bad side effects, but deliberately intending harm (even for good causes) is wrong.
Different rationale for making the same decision.
Trolley problem
A moral dilemma is a conflict in which you have to choose between two or more actions and have moral reasons for choosing each action.
Trolley problem 1:
Utilitarianism (greatest good; 1 person dead is better) vs. Deontological ethics (moral action regardless of consequence; putting the lever gets you involved in a situation > you become in a criminal act)
Trolley problem 2:
Utilitarianism: push the person
Deontological: you don't push the person. Don't get involved.
Nature-nurture debate on moral development
Biological/evolutionary viewpoint
Developmental process of maturation. Morality rises because of this maturation.
Nature of the human being is ‘good’. Something built into us: we recognize who is helpful or not > nature of human is good.
Cultural viewpoint
Developmental process of interiorization/internalization
Nature of the human being is ‘bad’
Teach people to have certain values (not built into us). Teach the child to move the original sin.
Interactionist viewpoint
Nature of the human being is morally neutral, neither good nor bad. It depends on what happens and how they interact and mature
Lecture 5 Self and Identity
Part 1 - Introduction
Video: what kind of elements of identity do you recognize?
Everybody wears a mask
Insecurity, focus on others
Different faces > multiple identities
Showing her true face > search for autonomous identity: being yourself
Social/peer identities, peer groups
Why is identity an adolescent issue?
Biological changes
Puberty
Appearance
Changes on the outside have an impact on how one perceives oneself.
Cognitive changes
More self-conscious
Develop a future orientation
Imagine themselves from the outside, different time, able to consider different types of identities that they may want to adopt.
Social changes
Norms and values
Social choices
Educational choices
What is important for them?
Identity
Who am I?
Personal identity: who am I in terms of sense of self
Central is the process of figuring out who one is
Social identity: who am I in terms of group memberships
Identifying with social group
Central is one's sense of belonging to social groups
These identities may influence ones believes about oneself > self-concept
Mental image that one has about oneself
Views about oneself, including:
Values
Attributes
Goals
Self-esteem
Competence
Self-concept clarity (consistent self-concept)
Identity + self-concept > the self (the totality of me)
Part 2 – personal identity
Erikson's identity development
Adolescence = psychosocial moratorium
Time gap between childhood security and adult autonomy
Adolescents experiment with numerous roles and identities
Sense of insecurity: what is the future? What am I going to do?
Crisis in adolescence
Identity diffusion versus achievement
Identity diffusion: failure to form a stable and secure identity
Identity achievement: establishing a clear and definite sense of who you are and how you fit into the world around you
Erikson: achievement by end of adolescence
Characteristics that can help you to achieve identity achievement:
Mental and emotional capacity (so, not possible before end of adolescence)
Interactions with others (others serve as a mirror)
Exploration (trying out possibilities, only possible in environment that gives you the opportunity to explore)
Commitment (making choices among alternatives. Making decisions: who are you?)
Marcia's 4 stages model (extension of Eriksons model)
4 markers: commitment vs crisis/exploration
Absent/present
Lecture 6 Family relations
Part 1
How and why do (dynamics of) parents-adolescent relationships change during adolescence?
How are adolescents affected by (changing) experiences in the parent-adolescent relationship, and vice versa?
What is family?
Dictionary definition: married, 2-parent, biological offspring
But: different forms and sizes
Definition may be culture-dependent
Structures common ‘historically’ are not as common today
Ruggles:
Fragmentary household (1 parent, divorced etc.): increased
Extended households (multiple generations, family-units): decreased
In white and in non-white. But different slope of decrease and increase
In all societies, the family fulfills similar functions:
Socialization of children/adolescents
Enduring source of (practical/economic & emotional/social) support
Continuity of relationships across the life course = social embedding
The family as a system
Focus traditionally on mother (primary caregiver)-child/adolescent relationship
Family systems theory: an organized whole, consisting of interrelated parts that influence each other
System: set of elements standing in interrelation among themselves and with the environment
Interrelation: not A affects B, but A & B affect each other
Changing, self-organizing, and adapting to (changes in) its members and the outside environment
System is flexible, but strives for stability (= equilibrium: each person a particular role)
Family = cohesive emotional unit (emotional bond)
Three aspects – family system theory
Holism
To understand family, not enough to look at members separately
Roles (e.g., caretaker)
Illustration of depression: mother can't take her role > influences the system > the child takes the ‘mother'-role
‘hierarchy’/structure
Organized into subsystems
By gender or generations
Dyadic relationship
Marital relationship
Parent-child relationship
Sibling relationship
Triadic level
Particular with both her parents
Family level/whole
Boundaries
At every level (subsystems, inside/outside)
Permeability varies across families
Permeability evolves over time
How much what happens when a specific subsystem of the family affects other subsystems or the entire family?
Spillover vs. Compensation
Associations between dyadic relationships within the whole family
When there are loose boundaries between subsystems
Spillover: do we see that what happens in a systems, affects what happens in other systems?
Compensation: do we see that what happens in a particular system, is compensated in another system?
Compartmentalization: systems are quite independent from each other
Sherill:
Interparental conflict >
Lecture 7 Peers
Book ‘The nurture assumption’: peers play a big role in development of youth (instead of (only) the parents)
Part 1 - Importance of peers across adolescence
Higher in needs fulfillment when you fulfilled the lower needs (survival needs) > belongingness and love needs and esteem needs. These are psychological needs.
Importance also visible in the brain: social relationships. Example: exclusion from playing a game: social pain when excluded (analogous in its neurocognitive function to physical pain).
Peers become more central in adolescence
Time spent with family decreases
Time spent with peers increases
Peers compared to parents in adolescence
Differences between the two relationships
Parents = vertical (parents are more powerful), peers = horizontal relationship
Being equal in experiences, characteristics etc.
Shift from parents to friends as main source of support and happiness
Discuss with friends for romantic issues, emotional issues;
Discuss with parents for career/education issues;
Thus: relationships are different and friends become more important
Peers vs friends
Peers
Large network of same-age peers
Friends
People you know, like and with whom you develop a valued, mutual relationship (broad definition)
More specifically:
Mutual liking
Emotional closeness
Loyalty
Reciprocal validation of self-worth
General support
Time spent together
Childhood vs adolescence
From shared activities (childhood) to intimacy: trust, loyalty, self-disclosure > relying on each other
Why? It requires a certain role-play: perspective-taking, keep their own views and other's views in mind at the same time (that's complex to do)
Social competences therefore increasingly important (conflict management, perspective-taking etc.)
From same-sex to mixed-sex
And “friends with benefits”
From dyads (2) and small groups (3-4) to cliques (5-6) or larger crowds (these are larger to contain)
“Subcultures” used to form identity > understand who you are
Selection vs influence
Friends are often similar to each other
Is this due to selection or influence?
Research:
On the one hand: due to selection. Principles of interpersonal attraction:
Proximity (being close by)
Homophily/similarity (in values, interests, characteristics)
Adolescents: orientation toward school, leisure activity, SES, ethnicity (perhaps due to attitudes/prejudice)
Reciprocity
So: selection plays a role > “birds of a feather flock together”
But, parents also play a role in this selection process
Expressing disapproval
Type of school
Neighborhood
Extra-curricular activities
Adolescent personality & behavior
Lecture 8
Part 1 – adolescents in school
Schools:
Educate young people: prepare them for adulthood
Define young persons’ social world
Context in which they spend most of their waking hours
Shape their psychosocial development
Classroom factors:
Classroom climate
Teachers' expectations
Instructional quality
Emphasis on performance vs learning (grades)
Friends' engagement
Peer norms
Social organizations of schools
School transition at age 12
Educational tracks
Select school
Admission by lottery
School size
Part 2 – Dutch school system
NL: freedom of education
Guiding principle in educational governance is article 23 of the Constitution:
Education shall be the constant concern of the Government
All persons shall be free to provide education (start their own school), without prejudice to the authorities’ right of supervision
Then: protestants vs Catholics
Now: many different school types
Based on religion
Based on teaching philosophy
Relatively easy to change teaching principles as long as it meets the quality criteria
Consequences of freedom of education for classroom climate
Diversity educational approaches
Relatively large differences in learning outcomes in different schools
Consistency values home & school
Segregation: similar peers
“free-market system” (popularity of schools varies > competition between schools)
NL: early educational tracking
Level on which they receive their teaching
Red countries: single school for both primary and lower secondary education
Pink: transition between primary and lower secondary education, but still with common core curriculum for students
Blue: differentiated branches/tracks
Decrease in combined educational tracks in the 1st year of secondary school
E.g., havo-vwo
Consequences of early educational tracking for classroom climate
Instruction adapted to level of understanding > teaching is more efficiently
Similar performing classmates
Achievement constrained by level of instruction
Less contact between different social groups
Lower status of vocational pathways
Selection based on?
Test scores standardized achievement test
Also based on achievement motivation and work ethic of the student
Lower level advised to students with low SES parents > unequal opportunities
But: reading level at age 15 overlaps (PISA)
Maybe students become different because we put them in different tracks
How is the Dutch system doing?
PISA scores 2018: Netherlands score average on performance, but in regard to variation, there is more variance in comparison with other countries
Conclusion: the way a society organizes a school system shapes the experiences of adolescents in the classroom.
Part 3 – school transition
School transition involves many changes
Lecture 9 Media use
Adolescents are heavy users of media.
How does this media use impact the development? (2)
How does adolescent development influence media use? (1)
Moderate discrepancy hypothesis (MDH)
Children and adolescents are predominantly attracted to entertainment that deviates only moderately from the things they know, understand, and are capable of.
Children and adolescents are not or less interested in entertainment that deviates too much from their existing framework and experiences.
Developmental approach: Hypothesis is a viable explanation of why media preferences differ so much among different age groups. As children develop, they learn and understand more, so what attracts them in media also changes.
Children and adolescents like to be challenged, but not too much. It has to relate to the things they know.
Media can be used to gratify certain needs. Individuals select media to gratify needs that they have (e.g., needs to lift your mood (> choose a happy song))
Needs are determined by developmental level
Depends on different situational and individual factors, including development
Five main developmental characteristics that inform needs and gratifications
Identity exploration
Autonomy and self-efficacy
Peer orientation (and romantic partners)
Emotionality and sensation seeking
Physical development (hormonal changes)
Changes in appearance
Interest in sex (curious and questions)
Impact on mood (moody, fluctuations in mood)
Link to media
Needs in media preferences
Adolescents have a need for information: insecure about bodies, interest in sex > what should a body look like? What is attractive?
Media can used to seek advice about these topics
Risky consequence: e.g., boys asking girls for nude selfies, difficult to oversee the consequences
Physical development
Pruning: decline grey matter > more efficient processing
Cell bodies and synapses
‘Use it or lose it’
Explains why after this process of pruning, it becomes much harder to learn new things
Cognitive development
Formal operational thinking: logical, abstract hypothetical, problem-solving, interest in future
Only completely in place at the end of adolescence
Adolescents will switch between concrete and formal operational thinking
Disadvantages:
Egocentrism is on overdrive. They imagine this audience: what would other people think about what I’m doing?
This all has implications for media use
Media implications
More complexity in story lines
More complex characters
Topic that deal with big world issues > war movies, science fiction
Fast-pace media which stimulates problem-solving skills
Multiple levels: not easily get bored
Lecture 10 Love and sex
Part 1 &2 – Adolescent romance
Not only being in a romantic relationship, but also:
Daydreaming about the person in front of you in class with whom you have never spoken
Claims to have a boyfriend, but denied by the boy
Talk on phone everyday (or texting), but never seen in public together for fear of being ridiculed
Going together but only spend time together with other members of their crowd
Going steady for 3 years (the “real” thing)
Fantasies to interactions to relationships = romantic experiences
Romance
Love or romance is central theme in 68% of pop music
One of top 5 script themes for adolescent characters on TV
Adolescent girls attribute 34% of their strong emotions to real or fantasized heterosexual relationships
Adolescent boys 25%
Substantially higher than any other topic
Organizing principles of peer culture
Focal topic of conversation in leisure time
Romantic relationship
Romantic Relationship = mutually acknowledged ongoing voluntary interactions.
Compared to other peer relationships, romantic ones typically have a distinctive intensity, commonly marked by expressions of affection and current or anticipated sexual behavior.
Applies to same-gender, as well as mixed-gender, relationships.
Romantic experiences
Refers to activities and processes that include romantic relationships and also behavioral, cognitive, and emotional phenomena that do not involve direct experiences with a romantic partner.
Includes:
fantasies and one-sided attractions (“crushes”),
interactions with potential romantic partners (including flirting) and
Brief, nonromantic sexual encounters (e.g., “hooking up,” or casual involvement in activities usually thought to take place with romantic partners, from “making out” to intercourse)
Adolescent romance
Romantic relationships support the development of interpersonal skills and promote a sense of identity.
Experiment with romantic relations
may facilitate healthy relations in adulthood.
Opportunities to gain skills in the expression and regulation of emotions, empathy and intimacy.
Developmental progression of romantic and sexual interest and behavior
8-11 (Pre and early puberty) adrenarche
First crush
Sexual attraction
Sexual arousal
More awareness of social rules
12-17 Mid and late puberty
Gender intensification
Gender binary
conformity increases and then subsides
Romantic relationships
Duration longer
More intense
Some life-long partners
Sexual Experiences increase
Not until adolescence do truly intimate relationships first emerge
Characteristics of true intimacy:
Openness, honesty, self-disclosure, and trust
Intimacy becomes an important concern due to changes of
Puberty
Cognitive changes
Lecture 11 Alcohol use and delinquency
Intro
Under the influence of alcohol, youth are at higher risk to be involved in aggressive behavior and violent behaviors.
Part 1 – alcohol use and delinquency
Do the Dutch drink?
Underage drinking
13 years old > monthly drinking = 8.8%
15 year old drinkers > binge drinking = 70.8%
Are they delinquent?
Self-reported criminal behavior (at least one delinquent act in the last 12 months):
12-17 year
2010: 38%
2015: 35%
10/11 year old
2010/2015: 20%
Most prevalent delinquent acts:
Violence acts
Threatening
Vandalism
Registered minor suspects:
50% fewer registered minor suspects in 10 year
Part 2 – Similarities and differences between alcohol use and delinquency
Shared similarities
Interrelated
Correlated and co-occurrence
Table: number of offenses and prevalence rate of different drinking behaviors. Those adolescents who were not involved in any offense, half of them had drunk alcohol at least once in their life. Number of kids that had been involved in lifetime drinking, increases in amount of offenses
Longitudinal predictions: most studies find no predictive effect of alcohol use on delinquency, whereas delinquency mostly is a significant predictor of alcohol use
Peak in adolescence
Predictor of other risk behaviors (e.g., drug use, risky sex)
Shared underlying mechanisms (e.g., self-control, peers)
Importance of parental control and warmth
Decline in recent years
decline started from 2006/2007 onwards
Registered minor suspects: also a decline starting from 2006/2007
What is going on there?
Differences
Development
Alcohol use: increases up to at least 25 years
Delinquency: decline 18 year onwards
Across gender
Alcohol use: hardly any differences between boys and girls
Delinquency: boys are more likely to be involved in delinquent behavior than girls
Representation ethnic minorities
Alcohol use: less likely to drink
Delinquency: more likely to be involved
Behavior-specific vs general parenting
Age restriction
Alcohol-specific rules/communication
Delinquency: general parenting
No age restriction
Level of control and support are important in both parenting behaviors
Four different parenting styles
Neglectful: these kids are most likely to drink and engage in risky behaviors
Balance between control and support – alcohol use
Most of the parents in authoritative/average authoritative group
Lecture 12 Depression, self-harm and suicide
Moods and emotions
Relatively sudden changes in both positively- and negatively valanced affect
The intensity and/or frequency of negative emotion peaks in early adolescence
Young adolescents also experience less positive emotions
Emotions become more complex with a comprehension of mixed emotions
Dramatic changes of mood
The incidence of dysphoric or depressed moods radically increases, especially for girls
Social aspects of emotion expression and regulation become more developed
Increased in the ability to mask emotions
The use of emotion to manage relationships
Yet, emotional expression during early adolescence
The social referencing aspects of emotion become highly attuned
in early adolescence, there is a sharp increase in the awareness of other's perceptions of the self, and therefore shame
More daily fluctuations in self-esteem
Adolescents are more “moody” or variable in their emotions across the course of a day or week
Changes in negative and positive mood in mid-adolescence
Significant drop in positive mood, no change in negative mood
Mood variability across adolescence using daily internet diaries
Three times a year at age 13-18
4 different moods: happiness, sadness, angry, anxiety
Steady decrease across mid- to late adolescence in variability
Anxiety: does not show the same pattern, slight decrease but not an entire decrease
Moodiness decreases across adolescent period
Depression in all its forms
Depression: an enduring period of sadness
Depressed mood: an enduring period of sadness, without any other related symptoms
Depressive syndrome: sadness plus other symptoms such as crying, feelings of worthlessness, and feeling guilty, lonely or worried
Major depressive disorder: depressed mood or loss of interest or pleasure in almost all activities plus 4 of other symptoms (for at least 2 weeks)
Clinical valuation on slide
Gender differences in CDI depression in mid-adolescence
Girls show higher levels of depression than boys
Depression over the lifespan
5-9: boys are more depressed than girls, but as soon as adolescence hit, then girls show higher rates of depressive disorders than boys. Across the lifespan, women show higher levels of depression than men.
But: men also show a significant increase in depression across the lifespan as well.
Self-harm
NSSI: non-suicidal self-injury
What is self harm?
A variety of behaviors in which an individual intentionally inflicts harm to his or her body for purposes not socially recognized or sanctioned and without suicidal intent
Includes: see slide
Prevalence
4% of adults report a history
14% of adolescents
High
Lecture 12a suicide and related problems in adolescence
Suicide in the Netherlands
1% of all deaths
Males commit suicide 2 times more than females
Cause of death of young people in NL
10-25 years
Traffic accidents
Suicide
25-40 years
Suicide
40-60 years
Health related causes
Suicide
Methods of suicide
men: violent method: 50% hanging, 1 in 9 jump in front of train (more often among youth)
Women: less violent: 33% hanging, 25% medication overdose, 1 in 9 jump in front of train (more often in youth)
Leading cause of death US youth
Second cause of death
Also a high homicide rate
Across various ages:
Suiciding is the leading cause of death among individuals between 1 and 65 years of age
Suicide methods US: children and others
Availability of guns > firearms is the leading methods, then suffocation/hanging, ingestion, CO poisoning, jumping from a height, cutting, other causes
Suicide rates by race/ethnicity
Males are more likely to attempt suicide
Rural areas
Frequency of suicidal ideation and attempts
Thinking of suicide > ideation > attempt > suicide
Once one attempts suicide, they are more likely to do it again (15-fold)
Most common diagnoses in teen suicides:
Depression
Antisocial
Substance abuse
Anxiety
Despite the high rates of depression, among those who commit suicide, 24% who have completed suicide, were prescribed antidepressants, but zero found at autopsy: lack of using antidepressants > increases changes of suicide
Why do males complete more suicides than females, even though females are more likely to attempt suicide?
Gender paradox of suicidal behavior:
Areas with lower prescription rates (antidepressants), the rates of suicide are higher
If males are not going into doctors to get treatment, then this could be a potential explanation for why we see more suicides completions among males
Factors that predispose to suicide
Personal characteristics
Psychopathology
History of prior suicide attempt
Cognitive and personality (hopelessness & poor interpersonal problem-solving)
Homosexuality
Biological factors
Family characteristics
Family history of suicidal behavior
Higher rates of parental psychopathology
Non-intact families
Impaired parent-child relationships
Adverse life circumstances
Stressful life events
Childhood physical abuse
Sexual abuse
Contextual factors
Lecture 12b the end of adolescence
When does adolescence end?
In the past – criteria that have been used to mark entry into adulthood include:
Events such as marriage, child-bearing
Important responsibilities to provide, protect, and procreate – duties towards others
Gender-specific criteria
Average age of marriage in the Netherlands 1950-2018
Shift in percentage who marry + older ages
Average age of the mother at the birth of a child in NL in 2018
29,9. Age of marriage: 35
Shift in society to say that we don't need to marry first to have children
Demographic distinctions
Median age of marriage and child birth is now much later than it was in the past
Young people attend school and college longer than in the past
In addition, more young people are going to college before starting work
From jobs to career
Arnett's theory of emerging adulthood
Influenced by theories of
Erikson: prolonged adolescence
Love, work, worldviews
Levinson: novice phase 17-33
Keniston: youth (role exploration)
What is emerging adulthood?
In Western cultures, could last from about 18 until the mid 20's
A life period which is typically characterized by an ongoing exploration of, and experimentation with possible life directions
Young people have left the dependency of childhood and adolescence, but have not entered the enduring responsibilities of adulthood
Emerging: it is a process of becoming an adult
In Western cultures
Young people no longer consider marriage and other events (such as finishing school, getting a job, etc.) as criteria for adulthood
They emphasize the capacity of the individual to stand alone as a self-sufficient person as the criterion for adulthood
Top 3 criteria defining adulthood
Responsible behavior, accept one's responsibility
Autonomous, independent decision making
Financial independence
Individualistic qualities of character
Criteria like chronological age and role transitions ranked very low
5 aspects of emerging adulthood
Age of identity exploration
Trying out various possibilities, especially in love and work
Difference between US and European educational system
Us: university level: orientation where you can study different areas before you make a choice of your major
European: more specialized, stronger connection to the work that you will be doing
Difference between US and Southern Europe versus Nothern Europe in cohabitation (become smaller)
Cohabitation more common in Northern Europe
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