What Were You Thinking? Neuroscience of the Teen Brain Stephannee Standefer, LCPC, Program Director, Counseling@Northwestern Carolyn Ball, Graduate Student

Teenagers are known for making bad decisions. They drive at high speeds. They stand around outside parties and guzzle liquor in front of cops. They have unprotected sex. They skip school. They lie to their parents and feel no remorse. Risk-taking among teenagers is striking not only for its boldness but also for its frequency

But not all teen behavior is fun and games – some of it can be quite deadly. When it comes to driving teens are responsible for the vast majority of fatal car crashes

The Stats Teens are 4 times more likely than adults to get in a car crash In fact they crash at 4 times the rate of adults In 2014, 2,270 teens in the United States ages 16–19 were killed and 221,313 were treated in emergency departments for injuries suffered in motor vehicle crashes. That means that six teens ages 16–19 died every day from motor vehicle injuries.

Teens also engage in behavior that’s pretty dangerous Teens also engage in behavior that’s pretty dangerous. So dangerous in fact, teens end up in the hospital for self-inflicted injuries more than any other age group

The Stats Teens are 4 times more likely than adults to get in a car crash Self-Inflicted Injuries peak at age 16 Not only do risky things like skateboard off a roof, they also engage in self-harm A 2014 study conducted by researchers at Queens University found that one in every 10 teenagers has considered self-harming at some point. The National Center for PTSD estimates that 13 to 35 percent of students have injured themselves on purpose at some point.

And then there’s crime. Did you know that teens commit more crimes than adults? Surprising right? Teens also commit more crimes in pairs or groups whereas adults tend to commit crimes alone

The Stats Teens are 4 times more likely than adults to get in a car crash Self-Inflicted Injuries peak at age 16 Teens are 6 times more likely than adults to commit crimes Teens mostly get arrested for petty theft, vandalism, violence, drug and alcohol related issues, BUT Violence toward others also tends to peak in adolescent years, mostly likely to start around age 16, - and people who haven't committed a violent crime by age 19 only rarely start doing it later Juveniles under 18 accounted for 13.7% of all violent crime arrests and 22.5% of all property crime arrests.

This one was surprising to me. Unintentional drowning This one was surprising to me. Unintentional drowning. If you’re like me you thought the most drowning's occur during the toddler years. Turns out, that isn’t so.

The Stats Teens are 4 times more likely than adults to get in a car crash Self-Inflicted Injuries peak at age 16 Teens are 6 times more likely than adults to commit crimes Teens drown at 3 times the rate of toddlers Crazy right? Teens take more risks in natural bodies of water and those risks often lead to death

Ahh, teen love. Teen sex actually Ahh, teen love. Teen sex actually! I’m sure none of you are shocked to learn that teens have sex. In fact by age 15 20% of teens have had oral sex and by age 17 40% of teens have had intercourse, but that’s not all…

The Stats Teens are 4 times more likely than adults to get in a car crash Self-Inflicted Injuries peak at age 16 Teens are 6 times more likely than adults to commit crimes Unintentional drowning peaks at age 17 Teens have 5 times more sexually transmitted diseases than adults Young people, between the ages of 15 to 24, account for 50% of all new STDs, although they represent just 25% of the sexually experienced population 46% of American high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection and other STDs In 2012, gonorrhea rates were highest among adolescents aged 15-18

Which is crazy because the teen years should be the healthiest years of your life! Adolescents that make it out of childhood have lower rates of disease and cancer. So why do teens make crazy decisions that put their lives at risk??

Myths Adolescents are illogical Adolescents underestimate risk Adolescents think they are invincible Adolescents have poor cognitive skills Adolescents are unaware of the danger Most of us have heard (or thought!) that teens just don’t understand the risk. That teens think they are invincible. Or that teens are really just immature intellectually and don’t have the ability to make good decisions.

Turns out that’s not true at all Turns out that’s not true at all. By age 16 we have basically the same cognitive skills as we do at age 25. So if teens are as smart as adults what’s really going on?

So what’s really going on? Heightened risk-taking in adolescents is not due to cognitive deficits Heightened risk-taking is the product of psychosocial rather than intellectual immaturity The adolescent brain engages in a dual systems model of reasoning Ah, so teens are smart but they are psychosocially immature. This is due to the dual systems model of reasoning. The teen brain is intellectually smart, but they lack control.

Dual Systems Model Reward System Sensation seeking Sensitivity to rewards Preference for immediate rewards Cognitive Control Impulse control Strategic planning Anticipation Delayed gratification All of our brains have what is called the dual systems model of reasoning. The reward system is responsible for sensation seeking – or new and novel experiences. This part of the brain is also very sensitive to rewards – it likes new things and also has a preference for immediate rewards. No delayed gratification here! The cognitive control part of the brain is like the braking system for the reward system. This is the parent saying woah, slow down. Cognitive control is responsible for impulse control, planning, anticipating outcomes and delayed gratification. Guess where the teen brain mostly operates – right, in the reward center. While adults have a strong and predominate control center, teens have a strong reward center.

Control Center Develops gradually from preadolescence to mid-20s Independent from puberty Linked to structural changes in brain and increased connectivity to cortical and subcortical regions Synaptic Pruning Results in: better impulse control coordination of emotion and regulation better foresight better planning ahead The control center is the last to develop and develops gradually from the early teens to the mid-20s Surprisingly, the control center is not influenced by puberty – it grows at it’s own pace While the control center is developing it goes thru a process of synaptic pruning – if you don’t use it you lose it – this is the times when the brain gets really efficient, It gets rid of stuff it doesn’t need and build strong connection to the cortical and subcortical regions of brain responsible for executive functioning This results in: better impulse control, coordination of emotion, more foresight and planning ahead

Reward Center Most of the activity in a teen brain is in the reward center: Pleasure Risk Reward Dopamine System But for teens the control center is not yet mature so instead the reward center takes over. The reward center is responsible for pleasure, risk reward and most importantly the dopamine system!! If you look back on your teen years with fondness, and feel that those were the best years of life, that’s because your brain was flooded in dopamine. Here’s a takeaway for you – you will never again feel as good as you did as a teen!! All that dopamine felt good!!

Greater Risk = Greater Reward Reward Center That results in a reward system that allows the brain to have a preference for risk over reward This part of the brain IS influences by puberty and all those crazy hormones. During puberty the reward center is developing rapidly making it more sensitive to rewarding stimuli – Drugs! Sex! Rock and Roll! Because the reward center loves novel and exciting stimuli, teens are programmed to make risky and impulsive decisions For teens- The Greater the Risk, the Greater the Reward!! Greater Risk = Greater Reward

Risk Tolerance Teenagers have a very different perception of risk compared to adults They actually OVER-estimate the risk Greater tolerance for uncertainty and ambiguity Discovering the unknown is more pleasant for teens than for adults This makes teens pretty tolerant to risk. In fact, teens have wildly different perception of risk compared to adults. THEY OVERESTIMATE THE RISK! – huh? Teens lack experience in the real world and actually take in more information leading to overestimating risk. However! Teen’s risk taking comes not from immunity to known risks but from their greater tolerance for uncertainly and ambiguity Discovering the unknown is simply more pleasant for teens than for adults

Gist Based Decision Making Teens take longer to make decisions and consider more information than adults do Adults instinctively grasp the gist People make better decisions by processing less information Teens lack of experience in the real world influences their risky decision making in another way – Teens take longer to make decisions than adults do and they also consider more information As it turns out, this may actually lead to worse decision making! While adults have the unique ability to get the GIST of the situation, teens take time to contemplate the risks and benefits People make decisions by processing LESS information and by making clearer distinctions between options Teens don’t have enough life experience to do this well

Peers Play a Big Role Guess what? Teens make riskier decisions and engage in more dangerous behavior when with their friends – no surprise there – but why? Peers provide novelty and therefore reward Kids’ first experiences in life are with their family of origin – that’s where they first learn rules, norms and expectations But as they become teens, they begin to surround themselves primarily with their peers – for the first time in their life they are learning how other people live (what they think and believe) and that’s pretty exciting stuff! In a driving test study done by Lawrence Steinberg and Albert Chein from Temple University, they put teens in front of a computer to play Stoplight – a game in which you earn points for driving across town and getting to the end spot. Teens played the game alone and then in front of their peers. Teens took 50% more risk when their friends where watching – an effect not found in adults That’s why teen driving laws are important. If you want a teen driver to be careful – have them drive alone!

So why would we be made this way – with the reward center more powerful than the control center? Why have your foot on the gas without the braking system complete? Not only is all this crazy behavior normal, it’s also adaptive Novelty and risk help teens leave the nest Teens diversify the gene pool, seek new information and create amazing new things This uniquely human characteristic makes us, as a species, smarter, healthier and more accomplished

Smarter, healthier and more accomplished Not only is all this crazy behavior normal, it’s also adaptive Novelty and risk help teens leave the nest Teens diversify the gene pool, seek new information and create amazing new things This uniquely human characteristic makes us, as a species, smarter, healthier and more accomplished This is how teens are made! Teens go to risk like a fly to honey!! This is their DNA and its what they SHOULD do! Smarter, healthier and more accomplished

Experiential Exercise

How Can We Help?

Mitigating the Risk Help them learn gist based decision-making Let them experiment safely Programs focused on negative consequences fail miserably, instead focus on peer mentality Learn important tasks without peers present As clinicians we must learn to tolerate our own anxiety

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