Risky Behaviors in Adolescence Understanding Teens and their Vulnerabilities Pamela D. Dodge, MSN, RN Magee-Womens Hospital Pittsburgh, PA

A Unique Developmental Stage n Distinct from both childhood and adulthood n A time of physical and emotional changes n A time to test independence from the family n A time for new relationships-peers, partners, parents

Mortality and Morbidity n Injury n Violence n Accidents n Homicides n Suicides

Accidents n Motor vehicles – Drinking and driving – Driving with someone who has been drinking – Not using seatbelts – Riding motorcycles without a helmet

Homicides and Violence n More males than females n Murder with guns n Carrying weapons: guns, knives, clubs

Suicides n Increasing among teens n More males complete the suicidal act n Rate of suicide attempts is unknown – More females attempt suicide – Suicidal ideation is common in adolescents n 25% of high school students have thought about suicide n 17% have made a suicide plan

Tobacco Use n Smoking among teens is on the rise n Ages start of smoking behavior n Girls – Smoke to look cool – To keep from gaining weight n Boys use smokeless tobacco: chew and snuff

Alcohol n Experimentation is common n First use of alcohol often before 13 years old n Regular use of alcohol is prevalent in ages n Daily use and heavy drinking more common in males

Drug Use n Marijuana use is common n Inhalants n Hallucinogens n Use of cocaine and crack cocaine is low n Injecting drugs is not a usual risk behavior

Sexual Behavior n By age 17, 50% of teens have engaged in sexual intercourse n Consistent use of contraception is on the increase n Condom use is up n DepoProvera is a popular method for girls

Sexually Transmitted Diseases n Most common and destructive infections among teens n Chlamydia n Gonorrhea n Syphilis n HIV n AIDS

Exercise, Diet and Weight n At least one physical activity each week – Decreases as teens get older n Most do not eat five or more servings:fruits and vegetables – High fat content: french fries, hot dogs, hamburgers, sweets – Meals are on the run and not planned n 1/3 think they are overweight and are trying to lose weight

Behavioral Links n Behaviors do not occur in isolation – Substance use and sexual behavior n Sexually active more likely to use drugs and alcohol n Unintended pregnancy n Increases in sexually transmitted diseases n Multiple sex partners – Sexually active more likely to ride in a car under the influence of alcohol/drugs – Fatal accidents, homicides and suicides related to alcohol intoxication

Theories n Problem Behavior Theory – Look at behaviors as purposeful, meaningful, goal oriented and functional rather than arbitrary or perverse – Gaining peer acceptance, establishing autonomy from parents – Psychosocial proneness: teens who engage in one type of risk behavior are also likely to engage in other types

Theories n Biopsychosocial Model – Biological:pubertal timing, hormonal effects, genetic predisposition – Psychological:self-esteem, sensation seeking, cognitive and emotional states – Social:how parents, peers and school influence an adolescents life

Behavioral Links – Relationship between smoking and other high risk behaviors: marijuana use – Fatal accidents, homicides and suicides linked