Richard G. Petty, MD

Risk-taking in Teenagers

The study of adolescence is in an intersting state of flux.

The expectation that teenagers are rebellious by nature is probably not correct. After all, it is nly recently that adolescence, which more or less corresponds to the teen years, has been recognized at all. As recently as the early 1960, most young people went straight from school to employment, and wore the same clothes as everyone else at work. And of course that is still the pattern in many parts of the world, with the exception of school, which is sadly unavailable to so many. In most cultures teenage rebellion is not recognized at all.

Two years ago Professor Philip Graham, author of an excellent book published by Oxford University Press called ‘The End of Adolescence’ and a leading child and adolescent psychiatrist, challenged the myth that teenagers are trouble. He believes that the social attitudes towards the ‘adolescent stereotype’ that prevail in Western society have significant negative effects on the mental health of young people.

This stereotyping can cause some real problems:

  • Low expectations of behaviour are often shared by teenagers themselves, leading to low self-esteem
  • at least some of the frustration shown by young people in secondary schools can be attributed to the fact that they are ‘disempowered’ in relation to their intellectual and emotional competence
  • The legal position of young people, for instance in relation to the age of criminal responsibility, voting age and the consumption of drugs and alcohol, is wildly inconsistent, and results both in injustice and in inadequate preparation for adult life
  • The organisation of mental health services often fails to take into account the need to recognise the ‘young adult’ status of this age group.

The other side of this research is the risky behavior of many young people.

There is an excellent review in this month’s issue of Current Directions in Psychological Science by Laurence Steinberg, Distinguished University Professor and the Laura H. Carnell Professor of Psychology at Temple University in Philadelphia. He is also the Director of the John D. and Catherine T. MacArthur Foundation Research Network on Adolescent Development and Juvenile Justice.

The review points out that over the past 10 years there has been a great deal of new research on adolescent brain development that sheds light on why yonug peple engage in risky and dangerous behavior. And also answer the question about why the educational programs or interventions that have been developed have not been especially effective. According to Steinberg, heightened risk taking in adolescence is the result of competition between two very different brain systems, the “socioemotional” and cognitive-control networks. Both are undergoing maturation during adolescence, but along very different timetables. During the adolescence, the socioemotional system becomes more assertive during puberty, while the cognitive-control system gains strength only gradually and over a longer period of time.

The “socioemotional” system processes social and emotional information, and it becomes very active during puberty, allowing adolescents to become more easily aroused and experience more intense emotion. They also become more sensitive to social influence.

On the other side, the cognitive-control system is the part of the brain that regulates behavior and makes the ultimate decisions, but it is still maturing during adolescence and into a person’s mid-20s and perhaps beyond.

The socioemotional system is not always going full bore. When the system is not highly activated, for example, when individuals are not emotionally excited or they are alone, the cognitive-control network is strong enough to impose regulatory control over impulsive and risky behavior, even in early adolescence.

In the presence of peers, or in situations where emotions run high, the socioemotional network becomes sufficiently activated to diminish the regulatory effectiveness of the cognitive-control network.

Steinberg cites a study in which the presence of peers more than doubled the number of risks teenagers took in a video driving game.

As he says,

“In adolescence, not only is more merrier — it is also riskier.”

“There is a window of vulnerability in teens between puberty and mid-to-late adolescence in which kids have already started to experience the increased arousal of the socioemotional system, but they don’t yet have a fully mature cognitive control system,” he says. “Because their cognitive-control system is still not fully mature, it is more easily disrupted, especially when the socioemotional system is quite excited. And it gets excited by the presence of other people.”

“I don’t want people to think that education should not continue, I just think that it alone is not going to make much of a difference in deterring risky behavior. Some things just take time to develop, and, like it or not, mature judgment is probably one of them.”

Steinberg advocates stricter laws and policies that would limit opportunities for immature judgment that often have harmful consequences. For example, strategies such as raising the price of cigarettes, more vigilantly enforcing laws governing the sale of alcohol, expanding adolescents’ access to mental-health and contraceptive services, or raising the driving age would likely be more effective than education in limiting adolescent smoking, substance abuse, pregnancy, and automobile fatalities.

This is controversial stuff, but is also an illustration of a way in which science can help us make better decisions about how best to help young people to avoid auto-destruction.

Neurologically, teenagers are not just small adults, they are still large children. The problem is heightened because so many young people are constantly multi-tasking and children are being exposed to risky behaviors at ever younger ages, when their brains are least able to handle complex decisions about things that may have long-term consequences for them.

Chiropractic Treatment in Children with Learning Disorder and Dyslexia

I spend a lot of time scanning, reading and analyzing scientific and medical journals that might have anything in them that are relevant to our themes of Health, Integrated Medicine, Meaning and Purpose.

And as I discussed recently, those that are helpful and accessible may find their way onto the “Journals” resource panel on the left-hand side of this blog. I don’t want any of us to get overwhelmed with information, so I check several issues before any of them make the final cut.

Many readers have been kind enough to make suggestion, all of which I have checked on your behalf. So I have just added a journal – Journal of Vertebral Subluxation Research – that I have only discovered in the last month or so, though I’ve now had a look at all the past issues.

There was a particular article that caught my attention. The paper suggests that chiropractic care may offer significant benefits to children suffering from learning disabilities and dyslexia.

The research was a literature review by the Swiss chiropractor Yannick Pauli, who is President of the Swiss Chiropractic Pediatric Association and who specializes in the care of children suffering from learning and behavioral disorders.

Learning disorders and dyslexia affect anywheere between three and ten percent of school-aged children in the United Sates. The numbers vary depending on the exact criteria that we use. And it is certainly true that individuals with these disorders often suffer from low self-esteem, low levels of motivation, loss of interest in school, academic difficulties and often have problems in social functioning.

Dr. Pauli suggest that any positive effects on learning disabilities and dyslexia may have something to do with improving function in the cerebellum. Most books will tell you that the cerebellum is simply involved in motor corodination, posture and balance. But that has long been known to be a limited view: amongst mammlas, humans have the largest cerebellum relative to the rest of the brain, and it is involved in coordinating not just motor functions, but also sensation, language, emotion and social functions.

According to Pauli, “The only source of constant stimulation to the brain comes from the spine and the postural muscles constantly adjusting to the force of gravity…. If the daily physical stresses of life cause misalignments in the spine — called vertebral subluxations by chiropractors — the brain is not adequately stimulated. This can cause problems throughout the body.”

This work is preliminary and skeptcs will imediately ask why it was not done by independent scholars? The answer is that they will rarely touch a topic like this unless someone has done some preliminary work to show that it might be worth their attention. This is exactly what happened a number of years ago when several friends of mine – all eminent researchers – decided to examine chiropractic manipulation in low back pain. The research was only done because some British chiropractor had already produced some pilot data. Then the full resources of a major research team swung into action.

I also have some personal observations that lead me to think that the results of this small Swiss study will have traction. Tough not everyone gets better, I have seen several children with neurodevelopmental problems and traumatic brain injuries helped greatly by chiropractic and Ayurvedic forms of manipulation. One of the most striking was a young South Indian girl whose family lived in Germany. She had a form of cerebral palsy, and at the age of 5 was in a bad way. I saw her after a dozen manipulative treatments in London, and the change was stunning.

That is why research is so important. Not just to see if a thing works, but to try and work out in whom it might work. And then to see if we can make the treatment yet better.

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