1. Risk Management with Teens Mark E. Crawford, Ph.D.

2. Overview 1 ) Why do students take more risks as they enter adolescence? 2) What are the things we need to be particularly vigilant about during these years? 3) What are some effective strategies for parents to help protect our kids?

3. This is NOT a “good kid” vs. “bad kid” issue…. Good kids make BAD decisions…. The teenage brain: – Is bad at risk assessment – Seeks novelty and stimulation – Does not anticipate consequences effectively

4. Teen brain development from ages 5 – 20 years:

6. Executive skills: planning ahead making informed judgments and weighing the potential costs, benefits, and risks of making various decisions (anticipating consequences) Drawing on past experience in the moment of decision making organizing tasks prioritizing activities deciding when to initiate or start a task in order to allow sufficient time to complete that activity

7. Executive skills: inhibiting impulses controlling the expression of powerful emotions such as anger, anxiety, and frustration in order to prevent these feelings from exerting too much influence on judgment and decision making (emotional highjacking)

8. The Three R’s RESPECTRESPONSIBILITY RISK Privileges

9. The Three R’s RESPECTRESPONSIBILITY RISK

10. The Third R: Risk Substance Abuse Sexual Behavior Technology

11. Percentage of students who drank at least one drink in the last 30 days: Grade 931.5% Grade 1040.6% Grade 1145.7% Grade 1251.7% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

12. Percentage of students who had 5 or more drinks in a row within 2 hours in the last 30 days: Grade 915.3% Grade 1022.3% Grade 1128.3% Grade 1233.5% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

13. Percentage of students who have tried marijuana at least once: Grade 926.4% Grade 1035.5% Grade 1142% Grade 1245.6% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

14. Percentage of students who have smoked marijuana at least once in the last 30 days: Grade 915.5% Grade 1021.1% Grade 1123.2% Grade 1224.6% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

15. Percentage of students who have abused prescription drugs (without a doctor’s prescription): Grade 915.4% Grade 1018.2% Grade 1122.7% Grade 1225.8% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

16. Percentage of students who have tried marijuana before the age of 13 years: Grade 99.1% Grade 108.3% Grade 116.5% Grade 125.2% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

17. Percentage of students who rode in a car driven by someone who had been drinking alcohol at least once in the last 30 days: Grade 927.5% Grade 1028% Grade 1129.4% Grade 1228.2% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

18. Percentage of students who drove a vehicle when they had been drinking alcohol at least once in the last 30 days: Grade 95% Grade 108.3% Grade 1111.4% Grade 1215.4% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

19. Teen vs. Adult Rats and the effects of alcohol: Adolescent rats are less sensitive to the sedative and motor impairment effects of intoxication Adolescent rats are more sensitive to the social disinhibition induced by alcohol use Adolescent drunk rats perform worse on memory tasks than adult drunk rats

20. Implications… Teens may drink more than adults before they are sedated and have poor motor skills = potential alcohol poisoning Teens portion of the brain that allows them to be inhibited is more sensitive = riskier behavior In short: Teenagers can drink far more than adults before they get sleepy enough to stop, but along the way they're impairing their cognitive functions and judgment much more powerfully

21. Anatomy of an addiction: Immediate use of a drug increases production of Dopamine Continued use results in the brain decreasing it’s own production of Dopamine The brain begins to believe that the thing that produced the Dopamine has survival value The brain begins to seek the substance Craving occurs, use increases, dependency follows

22. WHAT ABOUT SEX?

23. Percentage of students who have had sexual intercourse: Grade 931.6% Grade 1040.9% Grade 1153% Grade 1262.3% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

24. Percentage of students who had sexual intercourse for the first time before the age of 13 years: Grade 97.7% Grade 106.5% Grade 114.3% Grade 124.4% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

25. Percentage of students who are currently sexually active: Grade 921.4% Grade 1029.1% Grade 1140.3% Grade 1249.1% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

26. Percentage of students who have had sexual intercourse with 4 or more partners: Grade 98.8% Grade 1011.7% Grade 1115.2% Grade 1220.9% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

27. Percentage of students who used a condom during last sexual intercourse: Grade 964% Grade 1067.8% Grade 1161.4% Grade 1255% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

28. Percentage of teens who DID NOT use a condom during last sexual intercourse: Grade 936% Grade 1032.2% Grade 1138.6% Grade 1245% Centers for Disease Control and Prevention. YRBSS. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5)

29. Concerns Pregnancy STD’s Emotional consequences

30. Technology and Teens Posting information that is self-incriminating “Cyber-bullying” “Sexting” Conversations are different when not face-to-face Unrealistic perception of others’ lives (chronic feeling of “missing out” - FOMO) Failure to develop and fine tune skills needed for one-to-one human interaction

31. What can you do?? You have influence with your teen… use it! Have clear expectations about what your family values and expectations are around sexual activity, substance use, and the use of technology Appreciate the value of dialogue (many conversations vs. “the talk”) Understand the teen brain and appreciate the unique vulnerability teens have in high risk situations

32. Have some limits and decide how you will monitor and enforce them Identify the highest risk situations

33. Risk taking (alone v. with friends) Gardner & Steinberg (2004)

34. Understand and help your kids understand their unique risk factors – Family history – Ever gotten in trouble – History of blackouts – Continued use when being monitored

35. Be the adult Your kids need for you to be a parent – not a friend – Present and active in their lives – Providing reliable information – Teaching a value system to help them make decisions – Providing supervision and monitoring them (Don’t be the “cool parent” – Talk to other parents (share information) – Saying “no” for them when they lack the life experience and wisdom to do so for themselves

36. Questions??