NYU youth mental health expert speaks at IOL Grand Rounds session
More than 80 percent of high school students rarely or never wear a bicycle helmet. Twenty percent have texted while driving in the past month. More than 40 percent didn’t use a condom the last time they had sex. And one in four high school seniors have engaged in binge drinking in the past month.
The greatest causes of death among adolescents — accidents, suicide and homicide — are related to behavior that is driven by how they think and feel. So why do adolescents take risks that put them in danger?
It’s often about evolution, said Jess P. Shatkin, MD, MPH, vice chair for education and director of undergraduate studies and child and adolescent mental health studies at NYU College of Arts & Sciences.
During the adolescent years, dopamine helps push people toward activities that will lead to rewards. This function of evolution, designed to tell us what is important for our survival, leads to beneficial activities like reading stimulating books as well as risky activities like having sex.
“There’s a reason adolescents do the crazy things they do. It’s an advantage for human survival,” Dr. Shatkin said. “We need to have some empathy for kids and not be always angry or frustrated with them for doing these stupid things that are really programmed in each of us as necessary tools for survival.”
Hormones emerging in early puberty also play a role in risk taking as the body prepares for reproduction.
“These years are about reproductivity,” Shatkin said. “If we have good genes, and if we’re seen as strong, attractive, smart and capable, then we will be the ones to get the best mates. That’s what’s driving this process.”
Greater exposure to hormone disruptors like light, fatty food and plastics may cause puberty to emerge at an earlier age. As diets change and children spend many more hours each day in front of lit screens, early puberty can lead to adolescents taking even more risks.
The presence of peers also contributes to risk-taking behavior. When an adolescent knows peers are around, they sense an opportunity for competition and are more likely to take risks. On the other hand, the brain experiences pain when an adolescent is left out of social activities. The feeling of left behind is so intense, that children will sometimes do anything to avoid it.
“In moments of ‘cold cognition’ — when adolescents have a calm environment, when they’re not under slept or over caffeinated, or have peers around them — they act pretty well,” Dr. Shatkin said. “By 16, most young people can make decisions just as good as older people as long as they’re in a moment of cold cognition. But put them in a moment of ‘hot cognition’ — where peers are present, they haven’t slept enough, maybe they’re a little bit high or a little bit drunk and showing off — and they make terrible decisions.”
What will keep our adolescents safe? Giving them more information isn’t necessary helpful.
One common misconception is that adolescents take risks because they think they’re invincible. In fact, adolescents often overestimate the likelihood of bad things happening and overthink their choices because they haven’t yet created decision-making shortcuts in their brains. This lack of experience leads to riskier decisions, not the belief that they’re not at risk.
Authoritative parenting can help. Kids have better grades and lower rates of pregnancy, depression, anxiety and dropout when they have parents who are supportive, loving and kind — and set limits. Parents who spend time with their adolescents know much more about their lives and the risks they might face.
Parents can create opportunities for adolescents to take safe risks and teach them very detailed consequences that certain decisions could have for their lives. They can also talk with their children about specific ways to respond to risky situations.
“We want to focus on practice,” Dr. Shatkin said. “Roleplaying, engaging them in anticipating consequences and making things seem as emotionally real to them as possible.”
Dr. Shatkin is the author of Born to Be Wild: Why Teens Take Risks, and How We Can Help Keep Them Safe.