Problem & Resilience (SC)

Because learning changes everything.
Adolescence
18th Edition
John W. Santrock
Chapter 13—Problems in
Adolescence and Emerging
Adulthood
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
The Biopsychosocial Approach 1
The biopsychosocial approach to understanding human
problems emphasizes that biological, psychological, and
social factors interact to produce the problems experienced
by people of all ages.
Biological factors: genes, puberty, hormones, and the brain
may be causes of problems
Psychological factors: identity, personality traits, decision
making, and self-control are all important influences
Social factors: factors that have especially been highlighted
as contributors to problems are the social contexts of
family, peers, schools, socioeconomic status, poverty, and
neighborhoods
© McGraw Hill LLC 2

FIGURE 1
THE BIOPSYCHOSOCIAL APPROACH

The Developmental Psychopathology
Approach 1
The developmental psychopathology approach
focuses on describing and exploring the developmental
pathways of problems.
• Many researchers seek to establish links between early
precursors (such as risk factors and early experiences) and
outcomes (such as substance abuse, delinquency, and
depression).
• A developmental pathway describes continuities and
transformations in factors that influence outcomes.

Approach 3
Recently, there has been considerable interest in
developmental cascades, which involve connections
across domains over time to influence developmental
pathways and outcomes.
Developmental cascades can encompass connections

between a wide range of biological, cognitive, and
social processes, including many social contexts.

Approach 4
The identification of risk factors might suggest avenues
for both prevention and treatment.
• Example: Parents who suffer from depression, an anxiety
disorder, or substance abuse are more likely to have
adolescents who experience depression.
Problems can be categorized as:

• Internalizing problems that occur when individuals turn their
problems inward (e.g., depression and anxiety).
• Externalizing problems that occur when individuals turn their
problems outward (e.g., juvenile delinquency).

Characteristics of Adolescent and
Emerging Adult Problems 2
Findings of one large-scale investigation (Achenbach &
Edelbrock, 1981):
• Adolescents from a lower SES background were more likely to
have problems than those from a middle-SES background.
• Most of the problems for adolescents from a lower SES
background were undercontrolled, externalizing behaviors.
• Undercontrolled, externalizing behaviors were most
characteristic of boys.
• Overcontrolled and internalizing behaviors were more likely
for middle-SES adolescents and girls.
• Behavioral problems most likely to lead to referral to a clinic
for mental health treatment were feelings of unhappiness,
sadness, or depression, and poor school performance.

Another investigation found that lower SES children
and adolescents had more problems and fewer
competencies than did their higher SES counterparts
(Achenbach et al., 1991).
Many studies have shown that factors such as poverty,

ineffective parenting, and mental disorders in parents
predict adolescent problems (Gold, 2020; Tornay et al.,
2020).
• Predictors of problems are risk factors—factors which indicate
an elevated probability of a problematic outcome in groups of
people who have that factor.
Some researchers argue that conceptualizing problems in
terms of risk factors creates a perception that is too negative.
Instead, they highlight the developmental assets of youth.
In research by the Search Institute, adolescents with more
developmental assets engaged in fewer risk-taking behaviors
such as alcohol and tobacco use, sexual intercourse, and
violence.
• Four internal assets: academic engagement, positive identity,
positive values, and social competencies.
• Four external assets: support, mattering and belonging,
boundaries, and extracurricular participation.

Stress and Coping
Although the effect has sometimes been
overdramatized, many adolescents and emerging adults
today do experience stressful circumstances that can
affect their development.
Stress: the response of individuals to stressors, which

are circumstances and events that threaten them and
tax their coping abilities
• Some stressors are acute: sudden events or stimuli.
• Some stressors are chronic: long-lasting stressors.
• Stressors can be physical, emotional, or psychosocial.

Stress: Life Events and Daily Hassles 2
When some stressors are simultaneously experienced,
the effects may be compounded.
• One study found people besieged by two chronic life
stressors were four times more likely to need psychological
services.
• Another study linked negative life events to increased
adolescent depression.
• Protective factors in the studies included social support,
family cohesion, higher quality parent and peer
relationships.

Stress: Life Events and Daily Hassles 3
Some psychologists conclude that information about
daily hassles and daily uplifts provide better clues
about the effects of stressors than life events.
• Relationship stress is especially common for adolescents and
felt most keenly by adolescent girls.
• The biggest hassles for college students include wasting time,
being lonely, and worrying about meeting high achievement
standards.
Critics of the daily hassles approach argue it suffers

from the same weaknesses as life events scales.

Stress: Sociocultural Factors 1
Sociocultural factors help to determine which stressors
individuals are likely to encounter, whether they are
likely to perceive events as stressful or not, and how
they believe stressors should be confronted.
• Shelley Taylor: Females are less likely to respond to stressful
and threatening situations with a fight-or-flight response than
males.
• One study revealed no differences in the stress that adolescent
girls and boys reported experiencing in relation to school,
parents, self-related problems, leisure, and their future.
• Girls reported more stress in peer relations and using more
active strategies to cope with stress.
Stress: Sociocultural Factors 2
Acculturative stress: the negative consequences that
result from contact between two distinctive cultural
groups
• Many individuals who have immigrated to the United States
have experienced acculturative stress.
Poverty can cause considerable stress for individuals

and families.

Coping 1
Adolescents and emerging adults respond to stress in
different ways.
Coping: managing taxing circumstances, expending

effort to solve life’s problems, and seeking to master or
reduce stress
• Success in coping has been linked to a sense of personal
control, positive emotions, and personal resources.
• Success in coping also depends on the strategies used, as well
as on the context.

Coping 2
A research review concluded that two types of age
trends occur from childhood through adolescence in
coping:
• An increase in coping capacities, reflected in more
self-reliance and less reliance on adults; greater use of planful
problem solving; and greater reliance on cognitive strategies.
• An improvement in the deployment of different coping
strategies, depending on which ones are more effective in
dealing with certain types of stressors.

Coping: Problem-Focused and
Emotion-Focused 1
Richard Lazarus has proposed two types of coping
strategies:
• Problem-focused coping: the strategy of squarely facing one’s
troubles and trying to solve them.
• Emotion-focused coping: responding to stress in an emotional
manner, especially by using defense mechanisms.

Coping: Problem-Focused and
Emotion-Focused 2
Sometimes emotion-focused coping is adaptive; at
other times it is maladaptive.
Avoidant coping is a harmful strategy that involves

ignoring a problem and hoping it will just go away.
• A longitudinal study revealed that adolescents’ avoidant
coping preceded an increase in anxiety symptoms and
disordered eating.
• Depressive symptoms predicted later increases in
maladaptive coping.

Coping: Thinking Positively
Thinking positively and avoiding negative thoughts are
good strategies for coping with stress in just about any
circumstance.
• A positive mood improves the ability to process information
efficiently and enhances self-esteem.
• Thinking positively reflects the positive psychology
movement—increased emphasis on positive individual
traits, hope, and optimism.
• A recent study that explored how emerging adults were
coping during the COVID-19 pandemic revealed that the
most frequently used coping strategies were maintaining
positivity and staying connected.

Coping: Support
Support from others is an important aspect of being
able to cope with stress.
• Individuals who provide support can recommend specific
actions and plans to help an adolescent or emerging adult
cope more effectively with stressful circumstances.
• Knowing that others care allows adolescents and emerging
adults to cope with stress with greater assurance.
• When adolescents experience severe stressors, it is
important for them to reach out for support and to share
their feelings with others.

Contexts and Coping
Strategies for coping need to be evaluated in the
specific context in which they occur.
• A certain strategy may be effective in one situation but not
another, depending on the extent to which the situation is
controllable.
• Coping flexibility: the ability to modify coping strategies to
match the demands of the situation.

Resilience 1
Despite being faced with challenges, some adolescents
and emerging adults triumph over adversity through
resilience.
Resilient adolescents are characterized by a number of

factors:
• Individual factors.
• Family factors.
• Extrafamilial factors.

Resilience 2
Being resilient in adolescence is linked to ongoing
resilience in emerging adulthood, but resilience can
instead develop in emerging adulthood.
• During emerging adulthood, some individuals become
motivated to better their lives and develop an improved
ability to plan and make more effective decisions.
• In some instances, a specific person may influence an
emerging adult in very positive ways.

Source Characteristic
Individual Good intellectual functioning

Appealing, sociable, easygoing disposition
Self-confidence, high self-esteem
Talents
Faith
Family Close relationship to caring parent figure

Authoritative parenting: warmth,
structure, high expectations
Socioeconomic advantages
Connections to extended supportive
family networks
Extrafamilial Bonds to caring adults outside the family

Context Connections to positive organizations
Attending effective schools
FIGURE 3
CHARACTERISTICS OF RESILIENT CHILDREN AND ADOLESCENTS

Problems and Disorders
Major problems and disorders in adolescence and
emerging adulthood include:
• Drug use.
• Juvenile delinquency.
• Depression and suicide.
• Eating disorders.

Alcohol Use in Adolescence
Adolescent alcohol use has declined.
Binge drinking has also fallen.

• Binge drinking by high school seniors declined from 26.8% in
2010 to 19.8% in 2020.
• Binge drinking by eighth graders and 10th graders has also
dropped in recent years.
• Males continue to engage in binge drinking more than females.

Drinking and Driving in Adolescence
A special concern is adolescents who drive while they
are under the influence of alcohol or other substances.
• In a recent study, 12th grade binge drinking was linked to
driving while impaired, riding with an impaired driver,
blackouts, and riskier driving up to 4 years later.
• One in four 12th graders report consuming alcohol mixed with
energy drinks in the last 12 months, and this combination is
linked to unsafe driving.

Alcohol Use in Emerging Adulthood 2
Getting intoxicated or drunk before going out
(pregaming) has become common among college
students.
Drinking games, in which the goal is intoxication, have

also become common on college campuses.
Higher levels of alcohol use have been consistently

linked to higher rates of sexual risk-taking, such as
engaging in casual sex, sex without contraceptives, and
sexual assaults.

Hallucinogens 1
Hallucinogens: drugs that modify an individual’s
perceptual experiences and produce hallucinations;
also called psychedelic (mind-altering) drugs
Lysergic acid diethylamide, or LSD:

• LSD’s popularity in the 1960s and 1970s was followed by a
reduction in use by the mid-1970s as its unpredictable effects
became publicized.
• Adolescents’ use of LSD increased in the 1990s but has since
declined.

Hallucinogens 2
Marijuana:
Because marijuana can impair attention and memory,

it is not conducive to optimal school performance.
Marijuana use by adolescents decreased in the 1980s

but has increased in recent years.
• In 2020, 21.1% of U.S. 12th graders reported having smoked
marijuana in the last 30 days.
• Decreased perceptions of danger associated with its use.
• Increased ease of access, particularly in states where its use
is legal for adults.

Stimulants 1
Stimulants: drugs that increase the activity of the
central nervous system
• Caffeine, nicotine, amphetamines, and cocaine.
Cigarette smoking is decreasing among U.S.

adolescents, but rates of e-cigarette smoking (vaping)
far surpass rates of regular cigarette smoking.

Stimulants 2
The devastating effects of early smoking were
demonstrated by a research study that found:
• Smoking in the adolescent years causes permanent genetic
changes in the lungs and forever increases the risk of lung
cancer, even if the smoker quits.
The peer group plays an important role in smoking.

• Risk of smoking has been linked to having peer networks,
friends, and siblings who smoke.
Researchers have developed strategies for

interrupting behavioral patterns that lead to smoking.

Depressants 1
Depressants: drugs that slow down the central nervous
system, bodily functions, and behavior
• Among the most widely used depressants is alcohol.
• Though used less frequently than other depressants, the
opiates are especially dangerous.
Barbiturates are depressant drugs that induce sleep or

reduce anxiety.
• Since the initial surveys in 1975, use of depressants by high
school seniors has decreased.

Depressants 2
Opiates, which consist of opium and its derivatives,
depress the activity of the central nervous system.
• Commonly known as narcotics.
• Many drugs have been produced from the opium poppy—
among them, morphine and heroin.
• The opiates are among the most physically addictive drugs.
• The rates of heroin use among adolescents are quite low.

Risk of
Drug Medical Short-term Physical/Psychological
Classification Uses Effects Overdose Health Risks Dependence
Alcohol Pain relief Relaxation, Disorientation, Accidents, brain Physical: moderate;
depressed brain loss of damage, liver psychological:
activity, slowed consciousness, disease, heart moderate
behavior, reduced even death at disease, ulcers,
inhibitions high blood-alcohol birth defects
levels
Barbiturates Sleeping pill Relaxation, sleep Breathing Accidents, coma, Physical and
difficulty, coma, possible death psychological:
possible death moderate to high
Tranquilizers Anxiety Relaxation, Breathing Accidents, coma, Physical: low to
reduction slowed behavior difficulty, coma, possible death moderate;
possible death psychological:
moderate to high
Opiates Pain relief Euphoric feelings, Convulsions, Accidents, Physical: high;
(narcotics) drowsiness, coma, possible infectious psychological:
nausea death diseases such as moderate to high
AIDS (when the
drug is injected)
FIGURE 4
PSYCHOACTIVE DRUGS: DEPRESSANTS
Risk of
Stimulant Drug Medical Physical/Psychological
Classification Uses Short-term Effects Overdose Health Risks Dependence
Amphetamines Weight Increased Extreme Insomnia, Physical: possible;
control alertness, irritability, feelings hypertension, psychological:
excitability; of persecution, malnutrition, moderate to high
decreased fatigue, convulsions possible death
irritability
Cocaine Local Increased Extreme Insomnia, Physical: possible;
anesthetic alertness, irritability, feelings hypertension, psychological:
excitability, of persecution, malnutrition, moderate (oral) to
euphoric feelings; convulsions, possible death very high (injected
decreased fatigue, cardiac arrest, or smoked)
irritability possible death
Hallucinogen Risk of
Drug Medical Short-term Physical/Psychological
Classification Uses Effects Overdose Health Risks Dependence
LSD None Strong Severe mental Accidents Physical: none;
hallucinations, disturbance, loss psychological: low
distorted time of contact with
perception reality
FIGURE 4
PSYCHOACTIVE DRUGS: STIMULANTS AND HALLUCINOGENS
Anabolic Steroids 1
Anabolic steroids: drugs derived from the
male sex hormone testosterone that
promote muscle growth and increase lean
body mass
Nonmedical uses of these drugs carry a
number of physical and psychological
health risks.
Both males and females who take

large doses usually experience:
• Changes in sexual characteristics.
• Psychological effects including
irritability, uncontrollable bursts of
anger, severe mood swings, impaired
judgment, and paranoid jealousy.
Inhalants
Inhalants: ordinary household products that are
inhaled or sniffed to get high
• Inhalants include model airplane glue, nail polish remover,
and cleaning fluids.
• Short-term use can cause intoxicating effects; long-term use
can lead to heart failure and even death.

Factors in Adolescent and
Emerging Adult Drug Use 3
The following sequence of factors is linked with the
likelihood of taking drugs by 12 years of age:
• Being born into a high-risk family.
• Experiencing an increase in harsh parenting in childhood.
• Having conduct problems in school and getting rejected by
peers in childhood.
• Experiencing increased conflict with parents in early
adolescence.
• Having low parental monitoring.
• Hanging out with deviant peers in early adolescence and
engaging in increased substance use.

What Is Juvenile Delinquency?
Juvenile delinquency refers to a
broad range of behaviors, from
socially unacceptable behavior (such
as acting out in school) to status
offenses (such as running away) to
criminal acts (such as burglary).
40
© McGraw Hill LLC
What Is Juvenile Delinquency? 2
For legal purposes, a distinction is made between index
offenses and status offenses:
• Index offenses are criminal acts, whether they are committed
by juveniles or adults, including such acts as robbery,
aggravated assault, rape, and homicide.
• Status offenses, such as running away, truancy, underage
drinking, sexual promiscuity, and uncontrollability, are less
serious acts; they are performed by youth under a specified
age, which classifies them as juvenile offenses.

What Is Juvenile Delinquency? 3
States often differ in the age used to classify an
individual as a juvenile or an adult.
One issue in juvenile justice is whether an adolescent

who commits a crime should be tried as an adult.
• Some psychologists have proposed that individuals 12 and
under should not be evaluated under adult criminal laws and
that those 17 and older should be.

Conduct Disorder
Conduct disorder is the psychiatric diagnostic category
used when multiple behaviors occur over a 6-month
period.
• Behaviors include truancy, running away, fire setting, cruelty to
animals, breaking and entering, and excessive fighting.
• Most children or adolescents act out, but if these behaviors
result in illegal acts, society labels the offenders as delinquents.
• Up to 10% of children show these problems, described as
externalizing or undercontrolled patterns of behavior.
• Approximately 25% of children and youth diagnosed with
conduct disorder develop antisocial personality disorder,
characterized by a disregard for right and wrong.
Antecedent Association with Delinquency Description
Authority conflict High degree Youth show stubbornness prior to age 12, then become
defiant of authority.
Covert acts Frequent Minor covert acts, such as lying, are followed by property
damage and moderately serious delinquency, then serious
delinquency.
Overt acts of Frequent Minor aggression is followed by fighting and violence.
aggression
Identity Negative identity Erikson argues that delinquency occurs because the
adolescent fails to resolve a role identity.
Cognitive High degree The thinking of delinquents is frequently characterized by a
distortions variety of cognitive distortions (such as egocentric bias,
externalizing of blame, and mislabeling) that contribute to
inappropriate behavior and lack of self-control.
Self-control Low degree Some children and adolescents fail to acquire the essential
controls that others have acquired during the process of
growing up.
Age Early initiation Early appearance of antisocial behavior is associated with
serious offenses later in adolescence. However, not every
child who acts out becomes a delinquent.
FIGURE 5
THE ANTECEDENTS OF JUVENILE DELINQUENCY 1
Antecedent Association With Delinquency Description
Sex Male Boys engage in more antisocial behavior than girls do,
although girls are more likely to run away. Boys engage in
more violent acts.
Expectations for Low expectations and low Adolescents who become delinquents often have low
education and grades educational expectations and low grades. Their verbal
school grades abilities are often weak.
Parental Monitoring (low), support (low), Delinquents often come from families in which parents rarely
influences discipline (ineffective) monitor their adolescents, provide them with little support,
and ineffectively discipline them.
Sibling relations Older delinquent sibling Individuals with an older delinquent sibling are more likely to
become delinquent.
Peer influences Heavy influence, low resistance Having delinquent peers greatly increases the risk of
becoming delinquent.
Socioeconomic Low Serious offenses are committed more frequently by low-
status socioeconomic-status males.
Neighborhood Urban, high crime, high mobility Communities often breed crime. Living in a high-crime area,
quality which also is characterized by poverty and dense living
conditions, increases the probability that a child will become
a delinquent. These communities often have grossly
inadequate schools.
FIGURE 5
THE ANTECEDENTS OF JUVENILE DELINQUENCY 2
Antecedents of Juvenile Delinquency 1
Other factors related to delinquency:
• Erik Erikson notes that adolescents whose development has
restricted their access to acceptable social roles or made them
feel that they cannot measure up to the demands placed on
them may choose a negative identity.
• For Erikson, delinquency is an attempt to establish an identity,
although it is a negative identity.
Parenting factors play a key role in delinquency:

• High levels of coercive parenting and low levels of positive
parenting lead to antisocial behavior in children.

The role of family in the development of delinquency:
• Parents of delinquents are less skilled in discouraging
antisocial behavior and encouraging prosocial behavior.
• Parental monitoring is especially important.
• In a study by Marion Forgatch and colleagues, improved
parenting practices and reduced contact with deviant peers
were linked with lower rates of delinquency.
• Siblings and peers can have a strong influence on delinquency.
• Some characteristics of the low-SES culture might promote
delinquency: neighborhood poverty, maternal stress, adverse
childhood experiences, observing criminal activities of adults.
• Lack of success in school is associated with delinquency.
Cognitive factors, such as low self-control, poor
decision making, ineffective social information
processing, and lack of sustained attention, are also
implicated in delinquency.
Recent research indicates that certain personality traits

are linked to delinquency.
• Having callous-unemotional personality traits predicts an
increased risk that adolescent males will engage in acts of
delinquency.

Depression 1
Adolescent depression is a concern not just in the
United States but around the world.
• In major depressive disorder, an individual experiences a
major depressive episode and depressed characteristics for at
least 2 weeks or longer, and daily functioning becomes
impaired.
• Rates of ever experiencing major depressive disorder range
from 15% to 20% for adolescents.
• In a recent Chinese study, adolescents showed more
depressive symptoms after the appearance of COVID-19, but
engaging in more physical activity helped buffer the
association between the pandemic and depressive symptoms.

Depression 2
Adolescent females are far more likely to develop
depression than are their male counterparts.
• Why?
Go to www.menti.com and insert the code 4421 9964

Suicide 1
Depression is linked to an increase in suicidal ideation
and suicide attempts in adolescence.
• Rare in childhood but escalates in adolescence and then
increases further in emerging adulthood.
• The third-leading cause of death in in adolescents for a number
of years but recently replaced homicide as the second-leading
cause of death in adolescents.

Suicide 2
The rate of suicide among emerging adults is triple that
of adolescents.
According to a national study, females are more likely to

attempt suicide than males, but males are more likely
to succeed in committing suicide.
• In emerging adulthood, males are six times more likely to
commit suicide as females.
• Males use more lethal means.

Suicide 4
Both early and later experiences may be involved in
suicide attempts.
• These may include a history of family instability and
unhappiness; lack of affection and emotional support, high
control, and pressure for achievement by parents; and
childhood or sexual abuse.
Recent and current stressful circumstances may also

trigger suicide attempts.
• School and romantic difficulties can trigger suicide attempts.
• In a recent analysis, the main factor in adolescent suicidal
deaths was the occurrence of recent stressful life events.

Suicide 5
Family and peer relationships are linked to suicide:
• In recent research, the highest stressor for suicidal ideation
was peer conflict, followed by family circumstances.
• Family conflict and low parental monitoring were linked to
children’s increased suicidal ideation and attempts.
• Most significant risk factors for suicide and bullying are being
a boy, having a previous personal and/or family suicide
attempt, mental health problems, substance abuse, previous
abuse, low SES, single-parent family, underachievement,
family dysfunction, and a violent environment.
In some instances, adolescent suicides occur in clusters.

What to do What not to do
1. Ask direct, straightforward questions in a calm 1. Do not ignore the warning signs.
manner: “Are you thinking about hurting
2. Do not refuse to talk about suicide if a person
yourself?”
approaches you about it.
2. Assess the seriousness of the suicidal intent
by asking questions about feelings, important 3. Do not react with humor, disapproval, or repulsion.
relationships, who else the person has talked with, 4. Do not give false reassurances by saying such things
and the amount of thought given to the means to as “Everything is going to be OK.” Also do not give
be used. If a gun, pills, a rope, or other means have out simple answers or platitudes, such as “You have
been obtained and a precise plan has been everything to be thankful for.”
developed, clearly the situation is dangerous. Stay
with the person until help arrives. 5. Do not abandon the individual after the crisis has
passed or after professional help has commenced.
3. Be a good listener and be very supportive without
being falsely reassuring.
4. Try to persuade the person to obtain professional
help and assist them in getting this help.
FIGURE 7
WHAT TO DO AND WHAT NOT TO DO WHEN YOU
SUSPECT SOMEONE IS LIKELY TO ATTEMPT SUICIDE

Overweight and Obese Adolescents 1
The Centers for Disease Control and Prevention does
not have an obesity category for children and adolescents
because of the stigma the label obesity may bring.
They do have categories for being overweight or at risk of

being overweight, determined by body mass index (BMI).
• Overweight: adolescents at or above the 95th percentile of BMI.
• At risk of overweight: adolescents at or above the 85th
percentile of BMI.

Eating patterns established in childhood and adolescence are
strongly linked to obesity in adulthood.
Both heredity and environmental factors are involved in obesity:

• This increase is likely due to greater availability of food and declining
physical activity.
Having overweight or obesity has negative effects on

adolescent health in terms of both biological and
socioemotional development.
• Biological issues include high blood pressure, hip problems,
pulmonary problems, and type 2 (adult onset) diabetes.
• Socioemotional issues include low self-esteem, mental health
disorders, and problematic relationships with peers.

Dietary changes and regular exercise are key components
of weight reduction in adolescence and early adulthood.
Recommendations for parents about helping children

and adolescents lose weight:
• Work on a healthy project together.
• Be a healthy role model for them.
• Engage in physical activities with them.
• Give them choices about what they want to do to lose weight.
• Eat healthful family meals together on a regular basis.
• Reduce screen time.

Anorexia Nervosa 1
Anorexia nervosa: an eating disorder that involves the
relentless pursuit of thinness through starvation
• It is a serious disorder than can lead to death.
Three main characteristics of anorexia:

• A clinically significant level of being underweight.
• An intense fear of gaining weight that does not decrease with
weight loss.
• A distorted image of their body shape.

Anorexia Nervosa 2
Anorexia typically begins in the early to middle
adolescent years, often following an episode of dieting
and some type of life stress.
• It is about 10 times more likely in females than males.
Most individuals with anorexia are non-Latinx white

adolescents or young adults from well-educated,
middle- and upper income families that are competitive
and high-achieving.
• Problems in family functioning are increasingly being found to
be linked to the appearance of anorexia in adolescent girls.
• Family therapy is often recommended as a treatment.
Anorexia Nervosa 3
Biology and culture are involved in anorexia nervosa.
• Genes play an important role in the development of the
disorder.
The fashion image in U.S. culture likely contributes to

the incidence of anorexia nervosa.
• The media portray thin as beautiful.
• A recent study found that having an increase in Facebook
friends across 2 years was linked to intensified motivation to
be thin.

Bulimia Nervosa 1
Bulimia nervosa: an eating disorder in which the
individual consistently follows a binge-and-purge eating
pattern
• As in anorexia nervosa, most individuals with bulimia are
preoccupied with food, have a strong fear of becoming
overweight, and are depressed or anxious.
• Unlike anorexia nervosa, people who binge and purge typically
fall within a normal weight range.

Bulimia Nervosa 2
Bulimia typically begins in late adolescence or early
adulthood.
• About 90% of cases are women.
• About 1%–2% of women are estimated to develop bulimia.
• One study found that increased dieting, pressure to be thin,
exaggerated attention on appearance, body dissatisfaction,
depression symptoms, low self-esteem, and low social
support predicted binge eating 2 years later.
• Drug therapy and psychotherapy have been effective in
treatment of bulimia nervosa.

Binge Eating Disorder (BED) 1
Binge eating disorder (BED) involves frequent binge
eating but without compensatory behavior like purging.
• Individuals with BED frequently have overweight.
Researchers are examining the role of biological and

environmental factors in BED:
• Genes play a role, as does dopamine, the neurotransmitter
related to reward pathways in the brain.
• Adolescents with BED are more likely to live in families with
less effective family functioning, especially in the area of
emotional involvement.

Binge Eating Disorder (BED) 2
A research review indicated that the two best predictors
that differentiated BED from other eating disorders were
eating in secret and feeling disgust after the episode.
Adolescents and young adults revealed that dieters were

two to three times more likely than nondieters to
develop binge eating problems.
• Depressive symptoms and low self-esteem predicted binge
eating onset beyond the influence of dieting alone.
Cognitive behavior and interpersonal therapy are the

most strongly supported interventions.
Adolescents With Multiple Problems 1
The four problems that affect the largest number of
adolescents are:
• Drug abuse.
• Juvenile delinquency.
• Sexual problems.
• School-related problems.

Because learning changes everything. ®
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Because learning changes everything.

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Developmental cascades can encompass connections

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Problems can be categorized as:

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Many studies have shown that factors such as poverty,

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Stress: the response of individuals to stressors, which

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Critics of the daily hassles approach argue it suffers

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Poverty can cause considerable stress for individuals

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Coping: managing taxing circumstances, expending

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Avoidant coping is a harmful strategy that involves

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Resilient adolescents are characterized by a number of

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Individual Good intellectual functioning

Family Close relationship to caring parent figure

Extrafamilial Bonds to caring adults outside the family

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Binge drinking has also fallen.

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Drinking games, in which the goal is intoxication, have

Higher levels of alcohol use have been consistently

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Lysergic acid diethylamide, or LSD:

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Because marijuana can impair attention and memory,

Marijuana use by adolescents decreased in the 1980s

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Cigarette smoking is decreasing among U.S.

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The peer group plays an important role in smoking.

Researchers have developed strategies for

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Barbiturates are depressant drugs that induce sleep or

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Both males and females who take

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One issue in juvenile justice is whether an adolescent

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Parenting factors play a key role in delinquency:

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Recent research indicates that certain personality traits

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Problem & Resilience (SC)

Problem & Resilience (SC)