adolescent problem solving behavior

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Behavioral Problems in Adolescents

• Specific Behavioral Disorders |
• Violence and Gang Membership |

Adolescence is a time for developing independence. Typically, adolescents exercise their independence by questioning or challenging, and sometimes breaking, rules. Parents and doctors must distinguish occasional errors of judgment, which are typical and expected of this age group, from a pattern of misbehavior that requires professional intervention. The severity and frequency of infractions are guides. For example, regular drinking, frequent episodes of fighting, absenteeism from school without permission (truancy), and theft are much more significant than isolated episodes of the same activities. Other warning signs of a possible behavioral disorder include deterioration of performance at school and running away from home. Of particular concern are adolescents who cause serious injury to themselves or others or who use a weapon in a fight.

Because adolescents are much more independent and mobile than they were as children, they are often out of the direct physical control of adults. In these circumstances, adolescents' behavior is determined by their own decision-making, which is not yet mature. Parents guide rather than directly control their adolescents' actions. Adolescents who feel warmth and support from their parents and whose parents convey clear expectations regarding their children’s behavior and show consistent limit setting and monitoring are less likely to develop serious problems.

Authoritative parenting is a parenting style in which children participate in establishing family expectations and rules. This style of parenting involves limit setting, which is important for healthy adolescent development. Authoritative parenting, as opposed to authoritarian-style parenting (in which parents make decisions with minimal input from their children) or permissive parenting (in which parents set few limits) is most likely to promote mature behaviors.

Authoritative parenting uses a system of graduated privileges, in which adolescents initially are given small bits of responsibility, such as caring for a pet, doing household chores, purchasing clothing, decorating their room, or managing an allowance. If adolescents handle a responsibility or privilege well over a period of time, more responsibilities and more privileges, such as going out with friends without parents and driving, are granted. By contrast, poor judgment or lack of responsibility leads to loss of privileges. Each new privilege requires close monitoring by parents to make sure adolescents comply with the agreed-upon rules.

Some parents and their adolescents clash over almost everything. In these situations, the core issue is really control. Adolescents want to feel they can make or contribute to decisions about their lives, and parents are afraid to allow their children to make bad decisions. In these situations, everyone may benefit from the parents picking their battles and focusing their efforts on the adolescent's actions (such as attending school and complying with household responsibilities) rather than on expressions (such as dress, hairstyle, and preferred entertainment).

Adolescents whose behavior is dangerous or otherwise unacceptable despite their parents' best efforts may need professional intervention. Substance use is a common trigger of behavioral problems, and substance use disorders require specific treatment. Behavioral problems also may be symptoms of learning disabilities , depression , or other mental health disorders . Such disorders typically require counseling, and adolescents who have mental health disorders may benefit from treatment with drugs. If parents are not able to limit an adolescent’s dangerous behavior, they may request help from the court system and be assigned to a probation officer who can help enforce reasonable household rules.

(See also Introduction to Problems in Adolescents .)

Specific Behavioral Disorders

Disruptive behavioral disorders are common during adolescence.

Attention-deficit/hyperactivity disorder (ADHD) is the most common mental health disorder of childhood and often persists into adolescence and adulthood. However, adolescents who have difficulty paying attention may instead have another disorder, such as depression or a learning disability

Other common disruptive behaviors of childhood include oppositional defiant disorder and conduct disorder . These disorders are typically treated with psychotherapy for the child and advice and support for parents.

Violence and Gang Membership

Children occasionally engage in physical confrontation and bullying , including cyberbullying. During adolescence, the frequency and severity of violent interactions may increase. Although episodes of violence at school are highly publicized, adolescents are much more likely to be involved in violent episodes (or more often the threat of violence) at home and outside of school. Many factors contribute to an increased risk of violence for adolescents, including

Developmental problems

Intense corporal punishment (such as punching or beating) inflicted on the child

Caregivers with substance use disorders

Gang membership

Access to firearms

Substance use

There is little evidence to suggest a relationship between violence and genetic defects or chromosomal abnormalities.

Gang membership has been linked with violent behavior. Youth gangs are self-formed associations made up of 3 or more members, typically ranging in age from 13 to 24. Gangs usually adopt a name and identifying symbols, such as a particular style of clothing, the use of certain hand signs, certain tattoos, or graffiti. Some gangs require prospective members to perform random acts of violence before membership is granted.

Increasing youth gang violence has been blamed at least in part on gang involvement in drug distribution and drug use. Firearms and other weapons are frequent features of gang violence.

Violence prevention begins in early childhood with violence-free discipline. Limiting exposure to violence through media and video games may also help because exposure to these violent images has been shown to desensitize children to violence and cause children to accept violence as part of their life. School-age children should have access to a safe school environment. Older children and adolescents should not have access to weapons and should be taught to avoid high-risk situations (such as places or settings where others have weapons or are using alcohol or drugs) and to use strategies to defuse tense situations.

All victims of violence should be encouraged to talk to parents, teachers, and even their doctor about problems they are having.

Copyright © 2024 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

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Mental health of adolescents

• Globally, one in seven 10-19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group.
• Depression, anxiety and behavioural disorders are among the leading causes of illness and disability among adolescents.
• Suicide is the fourth leading cause of death among 15-29 year-olds.
• The consequences of failing to address adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults.

Introduction

One in six people are aged 10–19 years. Adolescence is a unique and formative time. Physical, emotional and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems. Protecting adolescents from adversity, promoting socio-emotional learning and psychological well-being, and ensuring access to mental health care are critical for their health and well-being during adolescence and adulthood.

Globally, it is estimated that 1 in 7 (14%) 10–19 year-olds experience mental health conditions (1) , yet these remain largely unrecognized and untreated.

Adolescents with mental health conditions are particularly vulnerable to social exclusion, discrimination, stigma (affecting readiness to seek help), educational difficulties, risk-taking behaviours, physical ill-health and human rights violations.

Mental health determinants

Adolescence is a crucial period for developing social and emotional habits important for mental well-being. These include adopting healthy sleep patterns; exercising regularly; developing coping, problem-solving, and interpersonal skills; and learning to manage emotions. Protective and supportive environments in the family, at school and in the wider community are important.

Multiple factors affect mental health. The more risk factors adolescents are exposed to, the greater the potential impact on their mental health. Factors that can contribute to stress during adolescence include exposure to adversity, pressure to conform with peers and exploration of identity. Media influence and gender norms can exacerbate the disparity between an adolescent’s lived reality and their perceptions or aspirations for the future. Other important determinants include the quality of their home life and relationships with peers. Violence (especially sexual violence and bullying), harsh parenting and severe and socioeconomic problems are recognized risks to mental health.

Some adolescents are at greater risk of mental health conditions due to their living conditions, stigma, discrimination or exclusion, or lack of access to quality support and services. These include adolescents living in humanitarian and fragile settings; adolescents with chronic illness, autism spectrum disorder, an intellectual disability or other neurological condition; pregnant adolescents, adolescent parents, or those in early or forced marriages; orphans; and adolescents from minority ethnic or sexual backgrounds or other discriminated groups.

Emotional disorders

Emotional disorders are common among adolescents. Anxiety disorders (which may involve panic or excessive worry) are the most prevalent in this age group and are more common among older than among younger adolescents. It is estimated that 3.6% of 10–14-year-olds and 4.6% of 15–19-year-olds experience an anxiety disorder. Depression is estimated to occur among 1.1% of adolescents aged 10–14 years, and 2.8% of 15–19-year-olds. Depression and anxiety share some of the same symptoms, including rapid and unexpected changes in mood.

Anxiety and depressive disorders can profoundly affect school attendance and schoolwork. Social withdrawal can exacerbate isolation and loneliness. Depression can lead to suicide.

Behavioural disorders

Behavioural disorders are more common among younger adolescents than older adolescents. Attention deficit hyperactivity disorder (ADHD), characterized by difficulty paying attention, excessive activity and acting without regard to consequences, occurs among 3.1% of 10–14-year-olds and 2.4% of 15–19-year-olds (1) . Conduct disorder (involving symptoms of destructive or challenging behaviour) occurs among 3.6% of 10–14-year-olds and 2.4% of 15–19-year-olds (1) . Behavioural disorders can affect adolescents’ education and conduct disorder may result in criminal behaviour.

Eating disorders

Eating disorders, such as anorexia nervosa and bulimia nervosa, commonly emerge during adolescence and young adulthood. Eating disorders involve abnormal eating behaviour and preoccupation with food, accompanied in most instances by concerns about body weight and shape. Anorexia nervosa can lead to premature death, often due to medical complications or suicide, and has higher mortality than any other mental disorder.

Conditions that include symptoms of psychosis most commonly emerge in late adolescence or early adulthood. Symptoms can include hallucinations or delusions. These experiences can impair an adolescent’s ability to participate in daily life and education and often lead to stigma or human rights violations.

Suicide and self-harm

Suicide is the fourth leading cause of death in older adolescents (15–19 years) (2) . Risk factors for suicide are multifaceted, and include harmful use of alcohol, abuse in childhood, stigma against help-seeking, barriers to accessing care and access to means of suicide. Digital media, like any other media, can play a significant role in either enhancing or weakening suicide prevention efforts.

Risk-taking behaviours

Many risk-taking behaviours for health, such as substance use or sexual risk-taking, start during adolescence. Risk-taking behaviours can be an unhelpful strategy to cope with emotional difficulties and can severely impact an adolescent’s mental and physical well-being.

Worldwide, the prevalence of heavy episodic drinking among adolescents aged 15­–19 years was 13.6% in 2016, with males most at risk (3) .

The use of tobacco and cannabis are additional concerns. Many adult smokers had their first cigarette prior to the age of 18 years. Cannabis is the most widely used drug among young people with about 4.7% of 15–16-years-olds using it at least once in 2018 (4) .

Perpetration of violence is a risk-taking behaviour that can increase the likelihood of low educational attainment, injury, involvement with crime or death. Interpersonal violence was ranked among the leading causes of death of older adolescent boys in 2019 (5) .

Promotion and prevention

Mental health promotion and prevention interventions aim to   strengthen an individual's capacity to regulate emotions, enhance alternatives to risk-taking behaviours, build resilience for managing difficult situations and adversity, and promote supportive social environments and social networks.

These programmes require a multi-level approach with varied delivery platforms –   for example, digital media, health or social care settings, schools or the community – and varied strategies to reach adolescents, particularly the most vulnerable.

Early detection and treatment

It is crucial to address the needs of adolescents with mental health conditions. Avoiding institutionalization and over-medicalization, prioritizing non-pharmacological approaches, and respecting the rights of children in line with the United Nations Convention on the Rights of the Child and other human rights instruments are key for adolescents’ mental health.

WHO response

WHO works on strategies, programmes and tools to assist governments in responding to the health needs of adolescents.

For example, the Helping Adolescents Thrive (HAT) Initiative is a joint WHO-UNICEF effort to strengthen policies and programmes for the mental health of adolescents. More specifically, the efforts made through the Initiative are to promote mental health and prevent mental health conditions. They are also intended to help prevent self-harm and other risk behaviours, such as harmful use of alcohol and drugs, that have a negative impact on the mental  ̶  and physical  ̶  health of young people.

WHO has also developed a module on Child and Adolescent Mental and Behavioural Disorders as part of the mhGAP Intervention Guide 2.0. This Guide  provides evidence-based clinical protocols for the assessment and management of a range of mental health conditions in non-specialized care settings.

Furthermore, WHO is developing and testing scalable psychological interventions to address emotional disorders of adolescents, and guidance on mental health services for adolescents.

WHO’s Regional Office for the Eastern Mediterranean has developed a mental health training package for educators for improved understanding of the importance of mental health in the school setting and to guide the implementation of strategies to promote, protect and restore mental health among their students. It includes training manuals and materials to help scale up the number of schools promoting mental health.

(1)  Institute of health Metrics and Evaluation. Global Health Data Exchange (GHDx)

(2) WHO Global Health Estimates 2000-2019

(3) Global status report on alcohol and health 2018

(4) World Drug Report 2020  

(5) 2019 Global Health Estimates (GHE), WHO, 2020

Comprehensive Mental Health Action Plan 2013-2030 

Guidelines on promotive and preventative mental health interventions for adolescents

Mental Health Gap Action Programme (mhGAP) Intervention Guide 2.0

LIVE LIFE: an implementation guide for suicide prevention in countries

Mental health in schools: a manual 

Global Strategy for Women’s, Children’s and Adolescents’ Health 2016–2030

Improving the mental and brain health of children and adolescents

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Why Interventions to Influence Adolescent Behavior Often Fail but Could Succeed

David s. yeager.

University of Texas at Austin

Ronald E. Dahl

University of California, Berkeley

Carol S. Dweck

Stanford University

This paper provides a developmental science-based perspective on two related issues: (1) why traditional preventative school-based interventions work reasonably well for children, but less so for middle adolescents, and (2) why some alternative intervention approaches show promise for middle adolescents. The authors propose the hypothesis that traditional interventions fail when they do not align with adolescents’ enhanced desire to feel respected and be accorded status ; however, interventions that do align with this desire can motivate internalized, positive behavior change. The paper reviews examples of promising interventions that (1) directly harness the desire for status and respect, (2) provide adolescents with more respectful treatment from adults, or (3) lessen the negative influence of threats to status and respect. These examples are in the domains of unhealthy snacking, middle school discipline, and high school aggression. Discussion centers on implications for basic developmental science and for improvements to youth policy and practice.

Adolescence is a maturational period of tremendous learning, exploration, and opportunity (for reviews see Blakemore & Mills, 2014 ; Crone & Dahl, 2012 ; Steinberg, 2014 ; Telzer, 2016 ). It is also a time when behavioral and health problems can emerge or worsen, creating consequences that “stick” long into adulthood (e.g. Paus, Keshavan, & Giedd, 2008 ). For instance, depressive symptoms rise substantially during adolescence ( Andersen & Teicher, 2008 ; Merikangas et al., 2010 ), and most depressed adults suffered their first depressive episode during adolescence (e.g. Pine, Cohen, Gurley, Brook, & Ma, 1998 ). Likewise, school engagement often declines during the transition to high school (see Benner, 2011 ), and students who drop out of high school go on to earn substantially lower wages even if they later earn a GED (see Heckman, Humphries, & Kautz, 2014 )

Educational interventions delivered broadly in schools (i.e., universal preventative interventions ) are commonly implemented with the aim of preventing these and other problems, including bullying, violence, obesity, delinquency, substance abuse, and teen pregnancy (see Steinberg, 2015 for a commentary). The theory of change underlying many of these interventions comes out of behavioral decision-making theories (e.g., Albarracin, Johnson, Fishbein, & Muellerleile, 2001 ; Fischhoff, 2008 ; Fishbein, 2008 ), which propose that increasing knowledge of health risks, skills for achieving health goals, and awareness of societal values regarding healthy behavior will lead to positive behavior change. Traditional interventions based in these theories typically involve classroom presentations that present relevant health information and invite young people to practice implementing skills (via scenarios, skits, or homework), coupled with school-wide assemblies or announcements during which adults publicly endorse the values taught by the program (see descriptions in Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011 ; Stice, Shaw, & Marti, 2006 ; Yeager, Fong, Lee, & Espelage, 2015 ).

Unfortunately, just at the developmental stage when universal prevention programs are perhaps most needed, traditional programs show reduced effectiveness. Indeed, Heckman and Kautz (2013) , after a review of the literature, concluded, “programs that target adolescents have not been established to be as effective as programs that target earlier ages” (p. 35). Going a step further, Steinberg (2015) stated that adolescent “classroom-based health education is an uphill battle against evolution and endocrinology, and it is not a fight we are likely to win” (p. 711).

This pessimism may be justified given the data we review below. However, the limited success of many traditional prevention efforts might say more about the methods they employ than the impossibility of positive behavior change during adolescence.

In the present paper we propose an explanation for why comprehensive and lengthy school-based universal prevention efforts often go from being somewhat effective with children to being mostly ineffective with middle adolescents. Furthermore, the paper explores why some alternative interventions are showing promising effects in middle adolescence, even though they are relatively targeted and efficient ( Cohen & Sherman, 2014 ; Lazowski & Hulleman, 2015 ; Walton, 2014 ; Wilson, 2011 ; Yeager & Walton, 2011 ). Our thesis is that adolescents are more sensitive to whether they are being treated with respect and accorded high status, as compared to children. Traditional programs might work against this sensitivity, but effective adolescent interventions allow young people to make choices that benefit their long-term future while also feeling respected and high status in the short term.

Overview of the paper

In the remainder of this paper, we first review evidence from multiple domains that show age-related declines in the efficacy of traditional adolescent problem-behavior prevention. Second, we offer a preliminary developmental model that could account for this. The model integrates emerging evidence in multiple areas of developmental science, including neuroscience, physiology, and the study of adolescent emotion and behavior. Third, acknowledging that we cannot definitively test this new model based on existing data, we provide evidence from interventions that have shown efficacy in adolescence and that support specific aspects of the model. Fourth, we discuss research ideas for further evaluating and extending the model—and ultimately creating the next generation of improved interventions.

Defining adolescence

Following many past reviews, we define adolescence as the maturational period that begins at the onset of puberty and ends with a transition to an adult-like role in society (e.g., Blakemore & Mills, 2014 ; Crone & Dahl, 2012 ; Steinberg, 2014 ). Thus, adolescence is thought to have a biological onset and a socio-cultural offset.

We focus mainly on “middle adolescence” because this is where the developmental patterns we review here are most striking and where there are plausible developmental mechanisms that could account for them. Middle adolescence is defined as a period after the initial stages of pubertal maturation have begun, but before young people have fully adjusted to the rapid developments in their bodies and before they have been accorded adult-like status by society. In developed nations such as the U.S., the middle adolescent period refers roughly to the ages of 13 or 14 to 17, or grades 7 or 8 to 11.

We acknowledge that chronological age is only a proxy for the relevant developmental processes. The onset of puberty occurs at different chronological ages for different individuals, and maturation can vary substantially across racial, ethnic, or socio-economic groups. Moreover, pubertal maturation involves a series of cascading biological processes (increases in pubertal hormones, and rapid physical changes including body hair, sexual maturation, height velocity, menarche) that can occur in a coordinated fashion, or not (see Mendle, 2014 ). Nonetheless, we describe findings in terms of chronological age or grade level because (a) the existing evidence base primarily reports these, and (b) these co-vary with purported developmental mechanisms. As future intervention studies begin to include measures of pubertal maturation and other developmental processes, greater precision will become possible.

Evidence for Age-Related Declines in Traditional Intervention Efficacy

Effect sizes from meta-analyses of a variety of adolescent interventions suggest that average benefits are weaker among middle adolescents (ages 13 to 17) as compared to young children or children transitioning into adolescence (ages 9–12). This is true for individual studies with large sample sizes (e.g., Karna et al., 2011 ), but below we focus on meta-analyses.

Consider interventions to prevent obesity. A meta-analysis of 64 universal interventions ( Stice et al., 2006 ) found that healthy-eating and exercise-promotion interventions were effective for young children and early adolescents, but not for middle adolescents. For the latter age group, effect sizes clustered around zero and many effect sizes were negative, meaning that adolescents in many programs tended to gain more weight when they received an anti-obesity program compared to when they did not.

In the domain of depression prevention, one meta-analysis ( Horowitz & Garber, 2006 ) reported that universal preventative interventions for middle adolescents had non-significant average effect of d =.02 at follow-up (p. 409), and weaker effects for adolescents compared to adults. Another ( Stice, Shaw, Bohon, Marti, & Rohde, 2009 ) showed non-significant effects of universal interventions at follow-up, r =.07. Furthermore, we conducted a between-study meta-regression of the Stice et al. (2009) results for children and adolescents only (using data reported in Table 4, pp. 496-7) and found a negative correlation between effect size and age, r =−.48, such that middle adolescents showed smaller (and non-significant) effects compared to younger individuals. 1

Or consider social-emotional skill training interventions in general, which teach an array of coping and social skills. Durlak, Weissberg, Dymnicki, Taylor, and Schellinger (2011) meta-analyzed 213 school-based, universal social and emotional interventions delivered from kindergarten to 12 th grade. A between-study analysis of moderators found a negative correlation between age and effect size, r =−.27, such that middle adolescents showed smaller improvements in social-emotional skills relative to younger children.

These results, although informative, are potentially subject to ecological fallacies. Meta-regressions compare different interventions given to children of different ages, and therefore mask the possibility that the same intervention given to different age groups in the same study might show a different moderation pattern (for a commentary see Cooper & Patall, 2009). However, a recent meta-analysis of anti-bullying interventions avoided this ecological fallacy. Yeager et al. (2015) obtained an effect size for separate age groups in a given study (72 effect sizes total) and then estimated within-study age-related trends. This analysis found that traditional anti-bullying interventions were effective from early childhood to early adolescence ( d = .13). When the interventions were delivered to middle adolescents (8 th grade or above), however, there was a decline to a null effect ( d =.01) (see Figure 1 ). That is, the interventions that are available to high schools for purchase have not yet been effective, on average, even though several states in the U.S. have mandated that schools purchase and implement anti-bullying programs ( Bierman, 2010 ).

Moderation of school-based bullying prevention program effects (Cohen’s d ) by grade level in school ( Yeager et al., 2015 ). Estimated values from three-level meta-analysis. Higher values correspond to more beneficial effect sizes. Grade levels on the U.S. scale.

Pessimism about traditional intervention approaches delivered to middle adolescents also comes from meta-analyses of studies conducted only within this age group. Interventions to reduce recidivism for juvenile delinquents were summarized in a meta-analysis of 28 studies and 19,301 youths aged 12 to 16. It found no significant average benefits ( Schwalbe, Gearing, MacKenzie, Brewer, & Ibrahim, 2012 ). There was heterogeneity, however, and one type of intervention, restorative justice, showed benefits (we will return to this later).

In sum, traditional interventions to prevent problematic behavior or health outcomes have shown some promise with children or early adolescents. There is not yet strong evidence that the traditional programs show benefits on average for middle adolescents, which in the U.S. spans the end of middle school and the first few years of high school.

This summary is not the final word, however. First, only one of the meta-analyses we reviewed ( Yeager et al., 2015 ) employed a within-study moderation by age. Second, there was often unexplained heterogeneity in past meta-analyses. We are not saying that no traditional intervention has ever been effective with middle adolescents, or that no traditional intervention ever could be effective. All we can conclude is that traditional interventions that have appeared in meta-analyses have not yet been effective on average for middle adolescents across multiple domains—including obesity prevention, depression prevention, bullying, recidivism, and social-emotional skill-building in general—even though evaluations of the same or similar programs found benefits for younger individuals.

Do the discouraging results of traditional intervention evaluations mean that, by middle adolescence, we have missed our window for creating positive behavior change? That patterns of behavior have become set, like plaster? We do not think so.

Adolescence is a dynamic period of learning and change ( Casey, 2015 ; Steinberg, 2014 ; Telzer, 2016 ), especially, we argue, when what adolescents are learning about or changing is relevant to status and respect in their lives (see Blakemore & Mills, 2014 ; Crone & Dahl, 2012 ). We argue that:

• Compared to younger individuals, middle adolescents show a greater sensitivity to status and respect , resulting from pubertal maturation (e.g. changes in hormones), changes in social context (e.g. school transtions), and social-cognitive developments;
• Traditional interventions do not sufficiently honor this greater sensitivity to status and respect, making the interventions less effective;
• Improved interventions could honor the sensitivity to status and respect and thereby capture adolescent attention and motivation to create behavior change.

Defining the sensitivity to status and respect

We define the sensivity to status and respect as a readiness to align attention, motivation, and behavior with the potentially-rewarding feelings that come from attaining status or being respected. We define aspects of this construct in turn. Status is defined as one’s relative rank in a social hierarchy (see Anderson, Hildreth, & Howland, 2015 ; Maner & Case, 2016 ; Mattan, Kubota, & Cloutier, 2017 ). Individuals discern their status in part based on how others treat them, and in particular whether others treat them with respect ( Anderson et al., 2015 ; Miller, 2001 ). Respect is a complex, gestalt social judgment that hinges on whether one is being granted the rights one expects to be granted in one’s role in society (see Miller, 2001 ; Ruck, Abramovitch, & Keating, 1998 ; also see an analysis of naturalistic respectful language in Voigt et al., 2017 ). Anthropological, evolutionary, and psychological perspectives have noted that individuals feel respected and high status when they are treated as though they are competent, have agency and autonomy, and are of potential value to the group (e.g., when supporting self-determination rights, Ryan & Deci, 2000 ; also see a discussion of “prestige” in Maner & Case, 2016 ). Finally, status and respect-relevant experiences can be highly rewarding (e.g., L. E. Sherman, Payton, Hernandez, Greenfield, & Dapretto, 2016 ); they elicit social emotions such as pride and admiration, making them motivationally salient. Likewise, being disrespected or treated as low status can be painful and elicit social emotions such as shame or humiliation.

1. Compared to younger students, middle adolescents are more sensitive to status and respect

Evidence from three sources shows that middle adolescents have a greater sensitivity to status and respect than younger individuals.

Pubertal hormones

The first source of evidence involves hormones affected by pubertal maturation, such as testosterone, estradiol, cortisol, oxytocin, and dehydroepiandrosterone (DHEA) (e.g., Klapwijk et al., 2013 ; for reviews see Blakemore, Burnett, & Dahl, 2010 ; Peper & Dahl, 2013 ; Sisk & Zehr, 2005 ). We focus mostly on testosterone because more is known about its relevance to status-pursuit and maintenance.

Testosterone increases dramatically after the onset of puberty in both boys and girls (see Figure 6 in Braams, van Duijvenvoorde, Peper, & Crone, 2015 ). Testosterone is often stereotyped as an “aggression” or “sex” hormone ( Eisenegger, Naef, Snozzi, Heinrichs, & Fehr, 2010 ), but a growing line of research in both humans and animals suggests it increases the motivation to search for, learn about, and maintain status in one’s social environment ( De Lorme & Sisk, 2013 ; Eisenegger, Haushofer, & Fehr, 2011 ; Josephs, Sellers, Newman, & Mehta, 2006 ; Mehta & Josephs, 2006 ; for a review see Terburg & van Honk, 2013 ).

At an attentional level, endogeneous levels of testosterone predict greater reactivity to status-relevant emotional stimuli ( Goddings, Burnett Heyes, Bird, Viner, & Blakemore, 2012 ). Demonstrating causality, experimentally administered testosterone has increased adults’ attention to status-relevant stimuli, such as cues of physical dominance ( Goetz et al., 2014 ; Welling, Moreau, Bird, Hansen, & Carré, 2016; for a review see Bos, Panksepp, Bluthé, & van Honk, 2012) .

Behaviorally, testosterone predicts a readiness to learn about the criteria for status and respect in a given context and then behave in ways that satisfy those criteria. In a classic study, adolescent males high in endogeneous testosterone showed greater aggression when they had deviant friends, but greater leadership when they did not have deviant friends ( Rowe, Maughan, Worthman, Costello, & Angold, 2004 ). In a recent study with adults, experimentally-administered testosterone promoted either anti-social or pro-social behavior depending on which type of behavior the experimenter led participants to believe would enhance status the most ( Dreher et al., 2016 ; for a related Syrian hamster study, see De Lorme & Sisk, 2013 ).

Illustrating our model, another recent laboratory experiment ( Yeager, Hirschi, & Josephs, 2017 ) randomly assigned adults to be asked to carry out an unpleasant but healthy behavior (i.e., taking “medicine” that was actually a spoonful of Vegemite, a yeast extract). Language was either respectful and honored autonomy and competence (e.g., “you might consider taking the medicine”) or was disrespectful and threatened autonomy and competence (e.g., “just take the medicine” cf. Vansteenkiste, Simons, Lens, Sheldon, & Deci, 2004 )). Respectful language increased adherence—participants consumed 60% more medicine—and sensitivity to respectful language was stronger among those high in endogeneous testosterone (measured via saliva) and also among low-testosterone individuals who were administered testosterone (via nasal spray; Yeager, Hirschi, et al., 2017) . This is direct evidence for a key claim of our model: testosterone—a hormone implicated in pubertal maturation—causes an increased behavioral responsiveness to respectful treatment.

Reactivity to social threat

Second, middle adolescents have shown greater reactivity to experiences that threaten status, at multiple levels of analysis. In one study, middle adolescents (age 15) showed a significant cortisol response when they faced a social threat (i.e. the Trier Social Stress Test (TSST); Kirschbaum, Pirke, & Hellhammer, 1993) , but children and early adolescents (age 9–13) did not ( Gunnar, Wewerka, Frenn, Long, & Griggs, 2009 ). The exception was 13-year-old girls who did show cortisol reactivity. This finding is consistent with the notion that pubertal maturation (which girls experience at earlier ages than boys), and not chronological age, causes a greater sensitivity to status and respect threats. In another study, middle adolescents who suffered a threat to status (i.e. peer rejection) reported greater distress and showed more neural activation in regions associated with social cognition, compared to children or younger adolescents ( Gunther Moor, van Leijenhorst, Rombouts, Crone, & Van der Molen, 2010 ). Furthermore, the simple act of being watched by a peer elicited more embarrassment among middle adolescents compared to younger individuals ( Somerville et al., 2013 ; also see research on the adolescent “imaginary audience” by Elkind & Bowen, 1979 ).

Social-cognitive developments

Third, middle adolescents come to perceive adult authorities’ efforts to influence their behavior, even when seemingly benign, as a sign that they are being disrespected or deprived of adult-like status. Research on self-determination rights ( Ruck et al., 1998 ; Ruck et al., 2002 ; also see Ryan & Deci, 2000 ; Smetana & Villalobos, 2009 ) shows that adolescents, as compared to children, come to disagree with adults’ judgments that they are not ready to display agency and control over personal choices. In one study ( Ruck et al., 1998 ), participants aged 8 to 16 responded to scenarios in which, for example, an adolescent wrote a story for the school paper that was critical of school rules and the principal suppressed it. Only about half of the children and early adolescents (age 8–12) said the adult should have respected the adolescent’s right to exert agency over the situation, but nearly three-fourths of middle adolescents (age 14–16) did (calculations conducted with statistics reported in Table 2 on p. 208 of Ruck et al., 1998 ). More tellingly, eighth grade (roughly age 14) was the grade level with the largest gap between adolescents’ beliefs that adults should respect their right to make their own choices, on the one hand, and adults’ beliefs that adolescents are competent enough to do so, on the other ( Ruck, Peterson-Badali, & Day, 2002 ; also see Ruck et al., 1998 ; for a related perspective on the “maturity gap,” see Moffitt, 1993 ).

School Discipline Interventions

Note: Common features of zero tolerance interventions abridged from published descriptions of programs ( American Psychological Association Zero Tolerance Task Force, 2008; Heitzeg, 2009 )

2. Interventions are less effective when they fail to honor this adolescent sensitivity to status and respect

We argue that many universal school-based preventative interventions, both in what they say and how they say it , insufficiently honor adolescents’ desire to feel respected and accorded status. This can make the interventions less effective.

What the interventions say

What might ineffective interventions be saying that conflicts with adolescents’ desire to feel respected and high status? Traditional interventions often focus on providing knowledge or self-regulation skills with the intent of suppressing short-term desires for the sake of long-term goals. In doing so, these interventions may ignore or fight against the powerful reasons why adolescents are engaging in the “problem” behavior in the first place (for a related argument see Ellis et al., 2012 ).

Recall the ineffective anti-bullying interventions for adolescents ( Yeager et al., 2015 ). Why do adolescents bully? It is not always because they fail to understand aggression hurts others, or because they categorically lack self-control. Although deficits in social and cognitive skills predict greater bullying in childhood, as expected, the same is not true for high school students (for meta-analytic evidence see Cook, Williams, Guerra, Kim, & Sadek, 2010 ). Middle adolescents often bully to gain or demonstrate social status ( Pellegrini & Long, 2002 ). Moderate-to-highly popular youth—who often have sufficient self-regulatory skills and knowledge of societal norms about aggression, but also have the requisite social competence to strategically undermine others’ reputations—often bully the most ( Faris & Felmlee, 2011 ; see Yeager et al., 2015 for a review). Hence traditional interventions that enhance social and cognitive skills among middle adolescents are not always addressing the underlying motivation—a desire to gain or demonstrate social reputation—and may even be increasing the social skills young people need to bully more effectively.

How the interventions say it

How do traditional interventions deliver their messages, and how might these modes of delivery be problematic? Heavy-handed methods of instruction— lectures, assemblies, homework—may backfire even when they are disseminating relevant information. Many adolescents are already aware that risky behaviors are bad for their health (for a review see Reyna & Farley, 2006 ). Imparting information adolescents feel they already have, repeatedly over multiple sessions and in multiple forms, may come across as infantilizing and therefore disrespectful.

We note that research has not definitively shown that how an intervention presents its message—its format or tenor—can threaten status or respect and undermine behavior change. However, research has shown that adult-delivered messages that come across as nagging can affect relevant adolescent brain activity. One study found that maternal nagging activating anger-related regions and reducing activity in regions related to planning how to change behavior ( Lee et al., 2014 ).

Furthermore, skill-building programs that require high school students to risk social status to participate can reduce use of the program—even when adolescents know that the skills are useful for their long-term goals. For instance, one field experiment made an SAT-prep course seem low-status. That decreased signups for the free course, even though students believed te course was helpful and knew that high SAT scores were critical for college admission and long-term success ( Bursztyn & Jensen, 2015 ).

Finally, Allen, Philliber, and Herre (1994) showed that adolescents’ reports that an intervention supported their feelings of autonomy—a key contributor to feelings of respect and status in adolescence—moderated the efficacy of a school-based preventative intervention on outcomes such as course failures, suspensions, and pregnancy. Adolescents benefitted less when they said that they felt “like the facilitator makes all the decisions” and “the facilitator doesn’t listen to things they say,” but stronger benefits when they said that they got “to help decide what the group will do” and that the “facilitator really listens to things they say” ( Allen et al., 1994 ).

3. More effective interventions honor the sensitivity to status and respect and promote attention, motivation, and behavior as a result

Last, we argue that it may be possible to capitalize on adolescents’ sensitivity to status and respect and redirect it toward positive behavior change.

Imagine interventions that make a young person feel that he or she is worthy of respect and is admired by others. Such interventions would treat young people as though they have worthwhile knowledge, as though they have the ability to exercise their agency in life, and as though they have the potential to make a contribution and be of value to the group. Perhaps even time-limited exposures to such feelings of status and respect could, during this sensitized period of adolescence, be enough to start a meaningful change in behavior. In the remainder of the paper, we discuss various methods to move programs closer to achieving this possibility.

Three Case Studies

We present concrete examples of interventions that, in various ways, were sensitive to adolescents’ desire for status and respect. These illustrate three different approaches:

• Harnessing the adolescent desire for status and respect
• Making interactions with adults more respectful
• Lessening the influence of status and respect threats.

This list is illustrative, not exhaustive. Examples come from the domains of unhealthy snacking, school discipline, and aggression. All of the interventions were evaluated with participants who were between the second semester of 7 th grade and the second semester of 10 th grade, which is the age range during which traditional interventions lose effectiveness, on average.

Since these represent relatively new approaches, the interventions are more limited in scope and the data are usually from shorter-term demonstrations of efficacy (sometimes one day to a few weeks). However, each case we present shows initial promise, speaks to the theoretical model proposed here, and includes evidence of mechanisms. Therefore each may serve as a guide for the development or improvement of future interventions.

The examples come primarily from studies that we or our colleagues conducted, because we know them intimately and, more importantly, because they included measures of our proposed mechanisms. However, many other examples could have illustrated similar points, most notably in the domain of academic achievement ( J. M. Aronson, Fried, & Good, 2002 ; Blackwell, Trzesniewski, & Dweck, 2007 ; Cohen, Garcia, Purdie-Vaughns, Apfel, & Brzustoski, 2009 ; Destin & Oyserman, 2009 ; Eskreis-Winkler et al., 2016 ; Gehlbach et al., 2016 ; Good, Aronson, & Inzlicht, 2003 ; Hulleman & Harackiewicz, 2009 ; Paluck & Shepherd, 2012 ; D. K. Sherman et al., 2013 ; Stephens, Fryberg, Markus, Johnson, & Covarrubias, 2012 ; for a review see Wilson, 2011 ).

Finally, each of the interventions reviewed in detail required relatively little time for participants to complete. This does not mean that they took relatively little time to develop ; R&D can last several years and involve thousands of participants (e.g., Yeager, Romero, et al., 2016) . Nor does the brevity of the interventions we highlight mean that longer and more comprehensive interventions cannot be attuned to the adolescent desire for status and respect. We review successful, longer interventions after the three cases.

1. Harnessing the adolescent desire for status and respect: The case of unhealthy snacking

Can the adolescent desire for status and respect be harnessed and put to use in the service of healthy behavior? Bryan, Yeager, and colleagues (2016) recently developed a behavioral approach to reduce junk food snacking among 8 th grade students. Bryan et al. (2016) began with the presumption that, for many adolescents, healthy eating is construed as low status—for instance, adolescents may believe that “healthy eaters are lame nerds who do what their parents tell them .” To combat this, Bryan et al. (2016) sought to re-define what it meant to be a healthy eater so that it had greater social-status appeal, by creating the impression that “ healthy eaters are independent-minded people who make the world a better place .”

What did the intervention say to make healthier eating seem “high-status”? The Bryan et al. intervention took the form of an exposé of industry practices (see the right column in Table 1 ). It used journalistic accounts (e.g., Moss, 2013 ) to describe how food companies pay scientists to make junk food addictive to children’s brains; how companies hired former tobacco executives to use cartoons to market the food to children so they could become addicted; and how food executives themselves will not eat the junk food or let their children eat it, making them hypocrites.

Programs to Promote Healthy Eating

Note: Common features of traditional interventions abridged from descriptions of materials often disseminated in schools ( Let’s Move, 2017 ) or described in past meta-analyses ( Stice et al., 2006 ).

Hence, the intervention led to the conclusion that people who buy junk food are giving money to executives who are disrespecting young people by thinking they will not stand up for themselves. Viewed from this perspective, being the kind of person who stands up to these executives by eschewing junk food is status-enhancing—it allows one to join a social movement and it affords the chance to demonstrate one’s competence and mastery over adult authorities.

The Bryan et al. (2016) approach was inspired in part by the “truth® ” anti-smoking campaign ( Farrelly et al., 2002 ; Farrelly, Davis, Haviland, Messeri, & Healton, 2005 ; Henriksen, Dauphinee, Wang, & Fortmann, 2006 ). In the truth® campaign, television advertisements depicted rebellious, autonomous adolescents flooding the streets, screaming into megaphones at rich, old tobacco executives in high-rise buildings in Manhattan, telling them to “take a day off” from tricking and harming children for the sake of profit. This harnessed the desire for status and respect. In an evaluation study, teens exposed to the truth® campaign said “not smoking is a way to express independence” and disagreed that “smoking makes people your age look cool” ( Farrelly, Davis, Duke, & Messeri, 2009 ). In a policy evaluation study, the truth® campaign was estimated to have prevented 450,000 adolescents from initiating smoking ( Farrelly, Nonnemaker, Davis, & Hussin, 2009 ).

How did the Bryan et al. (2016) intervention convey its message? It used now-common methods for social-psychological interventions, which, in retrospect, appear to offer respect and high status ( Cohen, Garcia, & Goyer, 2017 ; Cohen & Sherman, 2014 ; Walton, 2014 ; Yeager & Walton, 2011 ). These social-psychological intervention methods do not “tell” adolescents what to do and not do, so much as they invite adolescents to “discover” the meaning of the messages for their own lives, honoring adolescents’ expectation that they not be treated as child-like.

For instance, the Bryan et al. (2016) exposé article takes the form of a news article that the food industry does not want you to read—giving it an illicit status. Next, adolescents, after reading the article, read quotes from irate, high-status older adolescents (e.g., high school football players) who previously read the article and vowed not to eat junk food out of protest. This capitalizes on the psychology of descriptive norms —or the notion that individuals may conform to the choices of relevant others when presented with consensus information about their behaviors ( Cialdini, 2003 ). Descriptive norms directly influence adolescents’ willingness to conform to behavior, especially when norms come from high-status peers (see Helms et al., 2014 ).

Adolescents were next asked to author a letter to a future student (i.e. to engage in self-persuasion ), in which participants explained how they planned on rebelling against the food companies by eating healthy food and avoiding junk food (for a review of self-persuasion see E. Aronson, 1999 ). First, self-persuasion respects a person’s potential for personal agency—the prompts do not say “you have to believe this” but rather “would you mind choosing to write an argument for why someone might want to believe this?” (cf. Vansteenkiste et al., 2004 ). Second, self-persuasion respects a person’s competence—it implies “you have wisdom and experience to share with a peer that we adults may not have,” as opposed to “we know the facts and you do not.” Third, self-persuasion respects a person’s purpose and value to the group, by allowing adolescents to engage in a prosocial act of helping future students learn important information.

Bryan et al. (2016) call the exposé article a “values-harnessing” treatment. It showed efficacy in an initial, double-blind, randomized, behavioral experiment with over 450 8 th grade students ( Bryan et al., 2016 ). The evaluation involved two control conditions: a no-treatment control, and a traditional healthy eating control that used materials from contemporary government anti-obesity efforts (i.e., choosemyplate.org) and appealed to the long-term benefits of eating healthy (See Table 1 ). All conditions included self-administered reading and writing exercises, lasted approximately 30 minutes, were randomized at the student level, and were administered in sealed, individualized packets during class.

The key behavioral outcome was measured the next day. The principal announced that the entire 8 th grade class would get a “snack pack,” and students received a menu that had healthy food options (fruit, nuts, water) and unhealthy food options (Hot Cheetos, Oreos, Coca-Cola), as a reward for good behavior during state testing.

The Bryan et al. (2016) values-harnessing treatment reduced the total sugar content of the selections by 3.6 grams, or 9% ( d =.20) compared to the two control conditions, which did not differ. More importantly for the framework advanced here, a mediational analysis showed that the values-harnessing treatment caused adolescents to construe healthy eating as more aligned with the desire for status and respect. The treatment increased the social-status appeal of the healthy behavior (“I respect healthy eaters more than unhealthy eaters”), and this mediated the effects of the treatment on behavior ( Figure 2 ).

Source: Bryan et al. (2016) . c path above the line is the unconditional direct effect; the path below the line is the c ’ path in a model that accounts for the effect of the mediator.

The Bryan et al. (2016) values-harnessing intervention is, of course, not the whole solution to adolescent obesity. The follow-up was only one day post-intervention, and the intervention would mostly likely need to be coupled with programs to increase the availability of healthy foods, especially in low-income communities. Instead, the Bryan et al. (2016) approach is an early-stage investigation that helps develop theory. It illustrates one way that adolescents’ prioritization of status and respect-relevant learning can be harnessed for positive change. This approach may well prove useful in other domains of health behavior.

2. Making interactions with adults more respectful: The case of race disparities in middle school discipline

The values-harnessing approach tries to make adolescents more aware of how some adults were disrespecting them, and then channel the resulting feelings into positive behavior change. A second approach is to change the environment and reduce adolescents’ experiences of being disrespected by the adults around them, which can engender greater adherence with rules and procedures. Our second case focuses on methods to address discipline infractions, with particular attention to disparities in the rates at which Latina/o or African-American youth are disciplined compared to their white or Asian peers (see Carter, Fine, & Russell, 2014 ; Crenshaw, Ocen, & Nanda, 2015 ; Losen, 2014 ; Okonofua, Walton, & Eberhardt, in press ; Tyler, Goff, & MacCoun, 2015 ).

Intuitively, school discipline problems might be solved by creating strong threats to deter deviant behavior in school (i.e. zero-tolerance policies; see the left column of Table 2 ). This “zero tolerance” approach, however, has produced very few benefits in numerous evaluations. In some cases, zero tolerance has increased racial disparities, perhaps by licensing authorities to rely on stereotypes when doling out harsh punishments ( American Psychological Association Zero Tolerance Task Force, 2008 ; Heitzeg, 2009 ).

An alternative approach stems from the possibility that disparities in discipline infractions are the result, in part, of daily experiences of disrespect that come from being targeted by stigma and stereotypes ( Okonofua et al., in press ). When individuals are disrespected by authorities, they perceive it to be unjust (see Miller, 2001 ). When individuals perceive injustice, it undermines the legitimacy of an institutional authority and erodes a willingness to comply (see Tyler, 1990 ).

A potential method to recuce school discipline problems among adolescents, then, is to make the environment more respectful (for a related argument in criminology, see Tyler, 2006 ). Recall that programs that implement restorative justice —or the tendency to work collaboratively with a young person to repair relationships and reputation after carrying out an offense, such as through conferences or victim-offender mediation. These were among the only traditional programs to reduce recidivism in the juvenile justice system ( Gregory, Clawson, Davis, & Gerewitz, 2014 ; Schwalbe et al., 2012 ). Restorative justice interventions honor young people’s ability to self-govern and they presume their good intentions, perhaps creating an experience of respect and encouraging to rule-following.

In a similar spirit, two studies, reviewed in detail here, illustrate how adults might create respectful environments in schools and how these environments can reduce the prevalence of disciplinary infractions. First, Okonofua, Paunesku, and Walton (2016) evaluated an intervention for middle school that was designed to change teachers’ beliefs about discipline— that discipline should be empathic, not “zero tolerance.” Treated teachers were encouraged to see students’ subjective psychologies—students’ “back-stories” for their misbehavior—and try to find other ways to help students meet their goals of doing well and being happy in school.

The Okonofua et al. (2016) empathy training intervention took roughly 30 minutes for teachers to complete and was evaluated in a randomized trial with roughly 35 teachers and 1,200 students. Official records showed that sudents who took a class with treated teachers showed half as many suspensions in school (from 9% of students to 4.5%), and effects generalized beyond the class with the treated teacher. Supporting the model proposed here, previously-suspended students reported that their classrooms were now more respectful when they had a teacher who completed the empathy intervention. That is, students responded to greater respect by following school rules and meriting fewer suspensions (also see Gregory et al., 2016 ).

Second, Yeager and colleagues (2014 ; 2017) have tested the hypothesis that an intervention to make an academic interaction with a teacher feel more respectful can reduce disciplinary infractions, even without directly targeting students’ misbehavior or teachers’ views of students’ misbehavior. Cohen and colleagues (1999) developed a technique called “wise feedback” (see Goffman, 1963 ), in which an authority figure justifies critical feedback on someone’s work with an appeal to high standards (conveying respect for one’s competence by setting a high bar), accompanied by an assurance of one’s potential to reach the high standards (conveying respect for one’s competence by implying that one can improve and develop) (see Lepper & Woolverton, 2002 ; Treisman, 1992 ; see also research on natural mentors, Hurd, Sánchez, Zimmerman, & Caldwell, 2012) .

Yeager, Purdie-Vaughns, Garcia, and Cohen evaluated wise feedback in late middle school using a small-sample, double-blind field experiment in two consecutive cohorts of white and African-American youth ( Yeager, Purdie-Vaughns, et al., 2014; 2017 ). Students nearing the end of 7 th grade wrote first-draft essays that were critiqued by their social studies teachers, all of whom were white. When essays were returned, they were accompanied by randomly-assigned notes, hand-written in advance by their teachers. Half received a control note (“I’m giving you these comments so that you’ll have feedback on your paper”) and half received a wise feedback note (“I’m giving you these comments because I have very high expectations and I know that you can reach them”).

Yeager et al. (2014) expected that wise feedback would be most effective for African-American youth, who, surveys showed, were more likely to have experienced disrespect as a result of either negative stereotypes and to have been subjected to inequitable discipline, relative to their white peers. The experiment was replicated across two cohorts in the same classrooms. In the first cohort ( N =44), the randomly-assigned wise feedback note, as compared to the control note, increased African-American students’ willingness to revise the essay from 17% to 72% (covariate-adjusted values; Yeager, Purdie-Vaughns, et al., 2014 , Study 1). In the second cohort ( N =44, Study 2), the note increased the scores on the revisions, when everyone was required to revise. In both cohorts, treatment effects were small and non-significant for white students. Supporting our model, the wise feedback note most strongly changed behavior and feelings of being respected by teachers in general among those African-American students who over the previous two years had felt disrespected—i.e., who repeatedly disagreed that “teachers and other adults treat me with respect” ( Yeager et al. 2014 ).

Critically, Yeager et al. (2017) next found that, over a year later, the wise feedback note resulted in a reduction in discipline problems for African-American students, even though students had moved on from the teachers who delivered the wise feedback. That is, averaging across the two cohorts, African-American students in the group who received the wise feedback note in the spring of 7 th grade showed fewer 8 th grade discipline incidents across all classes, halving the discipline gap ( Yeager, Purdie-Vaughns, Hooper, & Cohen, 2017 ). As in the short-term results, there were no benefits for white students, who were also far less likely to be disciplined. See Figure 3 .

Source: Yeager, Purdie-Vaughns, Hooper, & Cohen (2017) .

The Okonofua et al. (2016) and Yeager et al. (2017) studies illustrate a few points about adolescent behavior change. First, it is not always necessary to stoke the fire of reactance to achieve adolescent behavior change, as was done in the values-harnessing healthy eating treatment ( Bryan et al., 2016 ) or the truth® campaign ( Farrelly et al., 2005 ). A credible show of dignity and respect, during a period of status-sensitivity, dampened adolescents’ feelings of being disrespected by authorities.

Second, the research in this section highlights the importance of relationships with adults , not only peers (also see research on natural mentors; Hurd et al., 2012 ). Some research has rightly emphasized adolescents’ heightened concern with peers ( Chein, Albert, O’Brien, Uckert, & Steinberg, 2011 ; Crosnoe & McNeely, 2008 ; Larson & Richards, 1991 ), and adolescents’ tendency to ignore adults’ requests to change behavior ( Lee, Siegle, Dahl, Hooley, & Silk, 2014 ). However, adolescents also value the opinions of respected adults and willingly comply under the right conditions ( Engelmann, Moore, Capra, & Berns, 2012 ). Said another way, going through the peer group is not the only way to improve adolescent behavior. Relationships with valued adults can be transformative for young people as well (also see Allen, Moore, & Kuperminc, 1997 ).

3. Lessening the influence of status and respect threats: The case of high school aggression

Sometimes it will not be possible to use these first two methods (values-harnessing or changing environments), and so a third approach may be useful: lessening the influence of threats to status and respect by changing mindsets. Adolescents should not be oblivious to social threats, of course, but they may benefit from perceiving the threats as less definitive. We illustrate this third approach in the context of high school aggression—an area where, as noted, it has been difficult to identify programs that show average benefits for middle adolescents ( Yeager et al., 2015 ; also see the left column of Table 3 ).

Interventions to Reduce High School Aggression

Note: Common features of traditional interventions abridged from descriptions of programs in past meta-analyses (e.g., Yeager et al., 2015 )

Our analysis starts with the observation that the threat of losing status or being disrespected may be more influential when it feels diagnostic of a lasting future as a lonely, isolated, dominated, or low-status person. From the perspective of a new high school student, being left out of a party or ridiculed on social media might not only be a temporary inconvenience. It could seem to mean that you will have no friends or be ridiculed for the four years of high school and beyond.

Our research has shown that adolescents’ beliefs that people’s socially-relevant traits and labels are fixed and unchangeable—called an entity theory of personality —can predict whether social difficulty makes one feel permanently disrespected (see Yeager, 2017 ; Yeager & Dweck, 2012 ; also see Dweck, Chiu, & Hong, 1995 ; Erdley & Dweck, 1993 ; Heyman & Dweck, 1998 ). For example, studies have found that a survey measure of an entity theory of personality predicts adolescents’ responses to social adversity. Research participants reporting more of an entity theory also reported greater shame and humiliation when they imagined being excluded or made fun of ( Yeager, Trzesniewski, Tirri, Nokelainen, & Dweck, 2011 ).

Fortunately, teaching the belief that traits and labels are malleable and have the potential to change—called an incremental theory of personality —lessens the influence of social conflict ( Yeager, 2017 ; Yeager, Johnson, et al., 2014; Yeager, Miu, Powers, & Dweck, 2013 ; Yeager et al., 2011 ). Incremental theory of personality interventions demonstrate that implicit theories have a causal impact on coping with status and respect threats. Incremental theory interventions teach that people have the potential to change—that, if bad things happen, you are not stuck having a low-status label forever (e.g., as a “loser” or a “victim”). This different worldview can alter the meaning of social events and what emotions social events elicit ( Yeager et al., 2011 ).

Experiments have found that teaching an incremental theory can improve adolescent coping following status and respect threats. An incremental theory of personality intervention has reduced self-reported stress, anxiety, and feelings of threat following negative social evaluation experience that occurred moments after the intervention (e.g. Cyberball exclusion, Yeager, Johnson, et al., 2014 , or the Trier Social Stress Test (TSST), Yeager, Lee, & Jamieson, 2016) . As one example, high school students receiving the incremental theory showed reduced threat-related cardiovascular responses (lower total peripheral resistance, higher stroke volume) and HPA-axis reactivity (lower cortisol) when they were asked to give a speech about what makes teenagers popular, in front of judgmental, older peers (the TSST; Yeager, Lee, et al., 2016) . Similar findings appeared in a study of adolescents with elevated internalizing symptoms ( Schleider & Weisz, 2016 ). Moreover, an incremental theory intervention reduced high school students’ salivary cortisol one week later, especially on days when they reported social-evaluative threats ( Yeager, Lee, et al., 2016 ).

More directly relevant to our model, the incremental theory has reduced aggressive retaliation. In one field experiment, conducted by Yeager et al. (2013) , facilitators taught the incremental theory of personality through six classroom workshops that employed autonomy-supportive language, opportunities for self-persuasion, and capitalizing on descriptive norms (stories from upper classmen who found the messages helpful) (see Walton, 2014 ). In a double-blind field trial conducted in 9 th and 10 th -grade classrooms, the incremental theory intervention was compared to a traditional coping skills intervention that taught the best available content (analogous to interventions meta-analyzed by Durlak et al., 2011 ), and to a no-treatment control.

In the Yeager et al. (2013) experiment, the coping skills control group did not try to lessen the influence of a status or respect threat by changing its meaning. Instead, like many traditional interventions reviewed earlier, the coping skills control emphasized the need to think positively and not over-generalize from one bad event to one’s life in general. These messages were delivered in a respectful way, however—including using descriptive social norms, autonomy-supportive practices, and self-persuasion. The control group’s developmentally-attuned delivery mechanism allowed for an unconfounded test of the impact of the message and its delivery.

At one-month follow-up, adolescents in the Yeager et al. (2013) experiment responded to a peer status/respect threat: exclusion in a Cyberball game ( Williams & Jarvis, 2006 ; Williams, Yeager, Cheung, & Choi, 2012 ). Aggression was measured by allowing participants to allocate unpleasantly spicy hot sauce to a peer who had just excluded them. Adolescent participants (temporarily) believed that the peer disliked hot sauce and would have to consume the entire sample (see Lieberman, Solomon, Greenberg, & McGregor, 1999 ). (Participants were debriefed afterward).

Adolescents who received the traditional coping skills intervention did not allocate any less hot sauce (i.e., were not any less aggressive) compared to the no-treatment control group. See Figure 4 . What adolescents in the coping skills group learned was not relevant to the meaning of a peer status or respect threat, and so it did not change aggressive retaliation (cf. Yeager et al., 2015 ). Inert content, even when delivered in a respectful way, should not change behavior.

Source: Yeager, Trzesniewski, and Dweck (2013) .

Meanwhile, adolescents who received the incremental theory of personality allocated 40% less hot sauce, representing less aggressive retaliation, as compared to the combined coping skills and no-treatment control groups ( Yeager et al., 2013 ). See Figure 4 . The benefits of the intervention for aggressive behavior were confirmed three months post-intervention, when teachers (blind to condition) were more likely to nominate treated students as having improved their behavior, compared to the combined controls ( Yeager et al., 2013 ).

Interventions can change the meaning of status and respect threats by implicit theories of personality and thereby lessen the impact of such threats. This approach can be useful in reducing important and undesirable responses to status threats, such as aggression.

More generally, it is not always necessary or advisable for interventions to only help adolescents “win the status game.” Sometimes it is desirable to help adolescents feel as though they do not have to play the status game so vigorously.

Is Shorter Always Better?

The effective interventions highlighted here usually required less time from participants than traditional interventions. This could be important to their effectiveness. Stice and colleagues found in two meta-analyses that shorter interventions had stronger effects ( Stice et al., 2009 , 2006 ). Perhaps shorter interventions have an easier time maintaining treatment fidelity, or perhaps shorter interventions are less likely to imply to recipients that they are viewed by adults as lacking in competence.

And yet our model does not require that shorter interventions are necessarily preferable. Longer interventions can be attuned to status and respect. For instance, in past studies intervention designers have created multi-session educational workshops that involve a high social status “brand,” endorsed by influential peers, in support of the targeted behavior. This has reduced teen smoking and bullying (compare Biglan, Ary, Smolkowski, Duncan, & Black, 2000 and Gordon, Biglan, & Smolkowski, 2008 ; also see Paluck, Shepherd, & Aronow, 2016 for an example with anti-bullying programs). Programs have also respected adolescents’ autonomy and desire to “matter” to others by wrapping psychoeducational content in a relatively long volunteer service program (i.e. the Teen Outreach Program; Allen, Philliber, Herrling, & Kuperminc, 1997 ). This reduced female teen pregnancy from 9.8% to 4.2%, reduced suspensions from 29% to 13%, and course failure rates from 47% to 27%. (There have been some mixed results from attempts to replicate the Teen Outreach Program, Francis et al., 2016 . In four out of the five replications, the control group received key features of the treatment, and in the one replication where this was not true, the Teen Outreach Program benefits were replicated).

One multi-session intervention reduced youth violence: Becoming a Man (BAM). Instead of being didactic, BAM used a democratic discussion group (cf. Lewin, Lippitt, & White, 1939 ) that focused on finding ways besides violence to maintain high status and peer respect, and did so without adults “tell[ing] youth the ‘right’ thing to do” ( Heller et al., 2015 , p. 6). BAM reduced arrests among youth of color in Chicago, Illinois by 28–35% and violent crime by 45–50%, and increased high school graduation by 12–19% at long-term follow-up ( Heller et al., 2015 ). In sum, longer, comprehensive interventions are capable of honoring the desire for status and respect and can be effective at promoting positive adolescent behavior change.

We have argued that traditional interventions for adolescents often work against adolescents’ prioritization of experiences of status and respect, both in terms of what those interventions say and how they say it ( Tables 1 – 3 ). Yet adolescents’ heightened sensitivity to feelings of status and respect need not thwart adult-delivered interventions. Effective interventions work with those sensitivities and can inspire internalized behavior change.

Our perspective resonates with the Lewinian tension system approach to behavior change ( Lewin, 1952 ). Like Lewin, we emphasize that sometimes it can be easier to achieve behavior change by taking advantage of motives people already have, rather than trying to convince them to have a different source of motivation. In adolescence, effective interventions can make the long-term, healthy choice aligned with short-term feelings of status and respect, rather than trying to make adolescents care about long-term health more than short-term social success.

Our recommendation is consistent with the arguments of many scholars in educational psychology ( Eccles, Lord, & Midgley, 1991 ), developmental neuroscience ( Blakemore & Mills, 2014 ; Crone & Dahl, 2012 ; Steinberg, 2014 ; Telzer, 2016 ), social psychology ( Walton, 2014 ; Wilson, 2011 ), sociology ( Coleman, 1961 ; Crosnoe, 2011 ), evolutionary psychology ( Ellis et al., 2012 ), and community psychology ( Watts & Flanagan, 2007 ), who have emphasized the importance of adolescents’ social success for motivation and behavior change. What the present analysis adds is an integration of the relevant developmental science of adolescence with the behavioral evidence emerging from intervention experiments.

We have limited ourselves to universal, school-based preventative interventions in three problem areas—unhealthy snacking, school discipline, and peer aggression. However, it will be important to test which aspects of our model apply to other domains. Could direct efforts at status and respect enhancement improve academic motivation? Could it enhance adherence with medical treatments? We are excited to find out.

We are not arguing that adult-delivered interventions represent the only method for influencing adolescent behavior. Clearly there is promise in peer networks (e.g., Paluck et al., 2016 ) or “nudges” that bypass intentional deliberation or habit (e.g., Hanks, Just, Smith, & Wansink, 2012 ). Furthermore, in some cases, policies that constrain adolescents’ freedoms—like age-graded driver’s license policies—can prevent death and injury (see Steinberg, 2015 ).

Yet the model we present here suggests it would be premature to give up on adult-delivered, school-based universal prevention. Such interventions can play a role in positive youth development, and the alternatives have limitations of their own. Peer social networks can have unpredictable or even harmful effects when peers encourage deviant behavior (see the positive and negative peer acceleration effects in Valente et al., 2007 ; also see Helms et al. 2014 ). “Nudge” strategies cannot be effective when one cannot control the environment in which the behavior occurs—as is the case for many of the free-choice behaviors discussed here. Laws that take away rights might prevent risk behavior in the short term, but such laws could also deprive youth of opportunities for learning how to be independent and autonomous in the long term, slowing the transition from child-like status to adult-like status in society (for a philosophical discussion of this issue, see Schapiro, 1999 ).

We nevertheless are in agreement with the commentators who have challenged the field’s prevailing intuitions about the traditional education and skills-based approach to intervention. Our hope is that the present model encourages mechanism-focused research on improved means for creating internalized, lasting positive behavior change for adolescents. Next, we outline several ways that developmental science can push the present framework forward.

From Initial Motivation to Sustained Behavior Change

The model presented here has not yet established the feedback loops through which an intervention that honors the adolescent desire for status and respect might translate into sustained, internalized changes in behavior (though see Fig. 1 in both Yeager, 2017 and Yeager, Purdie-Vaughns, et al., 2017) . The question of how time-limited interventions can sustain impact is an emerging topic of investigation in the social and behavioral sciences more generally ( Bailey, Duncan, Odgers, & Yu, 2017 ; Fiske, Frey, & Rogers, 2014 ; Miller, Dannals, & Zlatev, 2017 )

The present analysis can contribute to this discussion in two ways. First, we speculate that feelings of respect and status could serve as a gateway to the self—a view that “I am now the kind of person who does this behavior because it makes me feel the way I want to feel”—and therefore create internalization and maintenance of change (see Gerrard, Gibbons, Houlihan, Stock, & Pomery, 2008 ; also see McAdams & Olson, 2010 ; Oyserman & Destin, 2010 ).

Second, initial behavior changes, if timely, can open channels into different social environments or formal structures (for a related perspective, see Bailey et al., 2017 ; Cohen et al., 2017 ). A seemingly small initial behavior might alter relations with teachers or peers or involvement with extra-curricular activities, which might encourage the behavior further. An initial change in motivation could place one in institutional pathways (like advanced course-taking or out-of-school activities) that create access to adult mentors or other beneficial resources (for an example in sociology, see Frank et al., 2008 ). Extending the model presented here and explicitly testing the processes for sustained change—both within the person and between the person and the affordances in the environment—represents an exciting area for innovation.

Advancing a Developmental Science-Based Perspective on Interventions

Future studies can test developmental mechanisms for the differences in responsiveness to the interventions described here. We have focused on the rough labels of “middle adolescence” or “childhood” and considered chronological age or grade level as predictors of developmental trends, due to the state of the evidence. But, as noted, chronological age is imprecise. In fact, anthropological studies of adolescence largely ignore chronological age and focus instead on the milestones of pubertal maturation and adult role acquisition (e.g. Schlegel & Barry III, 1991) .

A falsifiable prediction that follows from our framework is that pubertal maturation and testosterone levels (or estradiol, or a combination of these and other pubertal hormones) will predict weaker responsiveness to traditional interventions (see Yeager, Hirschi, et al., 2017) . That is, if pubertal maturation causes an increased coupling of motivation to change and status/respect-relevant experiences, then pubertally advanced or higher-testosterone individuals should be more strongly resistant to traditional programs that threaten status or respect. Chronological age, meanwhile, may be a less consistent predictor of variability in treatment impacts, especially during ages with great variability in pubertal timing and tempo.

Our predictions are less clear for status-sensitive interventions. On the one hand, more-mature and higher-testosterone individuals might show greater responsiveness to status-sensitive approaches such as values-harnessing ( a la Yeager, Hirschi, et al., 2017) . On the other hand, early-adolescence (often age 10–13) may prove to be an opportune stage for creating enduring change via status-sensitive interventions. Perhaps early adolescents could be taught the notion that healthy behavior is high-status, and this association might be intensified by pubertal maturation.

Comparisons to Children and Adults

We are not arguing that status and respect only matter to adolescents and do not matter for children or adults. Even young children can be attuned to status ( Rizzo & Killen, 2016 ) and both children and adults are motivated by the opportunity for self-determination (see Ryan & Deci, 2000 ). Instead, we argue that during middle-adolescence, three things come together: a new meaning of taking away choice or undermining competence (that it violates status and respect), the high likelihood of being treated like a child (which violates status and respect), and the motivational prioritization of feelings related to status and respect.

Many of the universal preventative interventions we discuss here may also simply be less relevant at later ages. Problem behaviors have often already begun—or not—by middle adolescence. For instance, almost no one starts smoking for the first time as an adult, and motivating adults to get a GED does not benefit wages like an on-time high school degree does ( Heckman et al., 2014 ). Once the school-to-prison pipeline has given one a criminal record or exposed one to deviant peers, the damage is difficult to undo ( Heitzeg, 2009 ).

Furthermore, universal interventions can be easier to deliver during middle adolescence. Before age 17, young people are required by law to be in school, so societies can give beneficial messages to almost entire cohorts of young people. Hence, even if the psychological processes described here remain present in adulthood, it is still critical to study them among adolescents.

Program Evaluation Research

Last, we see many opportunities for the proposed model to inform program evaluation research. For decades, researchers have focused primarily on whether a program evaluated in a randomized-controlled-trial shows main effects. Yet, as null treatment effects of interventions have become more the rule than the exception, researchers have begun to prioritize the study of treatment heterogeneity, defined as the differential effectiveness of interventions across individuals, contexts, or program implementations ( Bryk, 2009 ; Gelman, 2014 ; Hulleman & Cordray, 2009 ; Weiss, Bloom, & Brock, 2014 ). Might students’ reports of whether or not the program made them feel respected predict heterogeneity in intervention effect sizes? Future evaluations studies could find out.

Our perspective has been that when adults honor adolescents’ sensitivity to feeling high status and respected, we may find that adolescents show far greater self-regulation, ability to think about the future, and capacity to change than we imagined. The present article provides the beginning of a roadmap for tapping into this powerful source of motivation—one that might result in improvements to both developmental science and societal welfare.

Acknowledgments

This paper was supported by the Raikes Foundation, the William T. Grant Foundation, the National Institute of Child Health and Human Development under award number R01HD084772, and a fellowship from the Center for Advanced Study in the Behavioral Sciences (CASBS). The content does not necessarily represent the official view of the National Institutes of Health. This research benefitted from conversations with or feedback from: Kenneth Barron, Christopher Bryan, Charles Carver, Geoffrey Cohen, Robert Crosnoe, Christopher Hulleman, Jenann Ismael, Robert Josephs, Margaret Levi, Todd Rogers, Daniel Schwartz and the Schwartz Lab, Ahna Suleiman, Sander Thomaes, Gregory Walton, Timothy Wilson, Zoe Stemm-Calderon, the Social-Personality and Developmental areas at the University of Texas at Austin, and the Clinical Excellence Research Center at Stanford University.

To appear in Perspectives on Psychological Science

1 The average effect size for universal interventions was not reported in the Stice et al. (2009) paper but we calculated a weighted average using the effect sizes in their Table 4. Stice et al. (2009) also report a between-study meta-regression for age that was not relevant because it combined indicated (i.e., for at-risk youth) and universal interventions; our interest here was in universal interventions. That meta-regression reported a positive effect of age (p. 498), but it is driven by the college student studies, which were only indicated and not universal.

Contributor Information

David S. Yeager, University of Texas at Austin.

Ronald E. Dahl, University of California, Berkeley.

Carol S. Dweck, Stanford University.

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Challenging behaviour – teenagers

As they develop, teenagers will experience a range of emotions and express themselves in many different ways. It’s normal for teenagers to be moody and to show some disrespect and defiance as they go through hormonal changes and a period of brain development during puberty.

Teenagers may also be short-tempered as they naturally begin to seek privacy and independence. They may begin spending more time with their peers or lock themselves in their room away from their parents.

It’s important that you and other caregivers provide support while your teenager is maturing and gaining independence. Guiding your teenager, setting boundaries and forming positive relationships will help them through the challenges of adolescence.

Signs and symptoms   

What one family finds challenging, another family will find acceptable. You and your family will have different ranges of what is acceptable when it comes to behaviour. However, some common issues during adolescence include:

• defiance and being argumentative with parents or siblings
• disrespectful towards others in the family (e.g. talking back, name calling)
• fluctuations in emotions and being moody
• aggressive or violent behaviour. 

Mental health in teenagers  

Although challenging behaviours and changes in mood are a normal part of adolescence, knowing what is normal and recognising signs of concern is important.

Emotional periods and challenging behaviours should not last more than a few days; if feelings of sadness, anxiety or frustration are continual then you should speak to your teenager about your concerns.

It is natural for teenagers to want to disengage from their families and spend more with their friends or participating in extra-curricular activities. However, if you notice that your child is withdrawing from all social interactions and no longer enjoys participating in activities they once enjoyed, this may be of concern.

For more information about mental health concerns in teenagers, see our fact sheet  Mental health – adolescents . 

What causes challenging behaviour?  

As teenagers mature, they are presented with new experiences. The way teenagers’ brains develop means that they may feel emotions very intensely, and they often do not yet have adequate coping tools to deal with their feelings. As a result, teenagers can often be very sensitive, self-conscious, and experience a range of emotions that at times can be overwhelming – these feelings are then often expressed by being argumentative or disrespectful towards others.

The part of the brain involved in self-control, the frontal cortex, isn’t fully developed until people are well into their twenties, which means that teenagers can face challenges in self-management and decision-making.

Sometimes challenging behaviours can also be a result of stressful or worrying events (e.g. a fight with a friend, an upcoming test, feeling that they don’t have the right clothes to wear).

When looking at challenging behaviours in teenagers it is important to consider their current situation and how it may be affecting them. Some other important factors that have an impact on behaviour include: 

• lack of sleep 
• too much screen time 
• mental health. 

Sometimes, ongoing challenging behaviour can indicate other health issues. If you are concerned about your child, see your GP. 

How you can help  

There a number of strategies that can be used to help combat challenging behaviours that emerge during adolescence: 

Positive relationships

Building resilience in teenagers and the development of coping skills will help them to overcome difficult situations. Having strong, positive relationships and spending time with your child is key to building resilience.

You can promote positive behaviours in your teenager by:

• encouraging healthy habits in diet, exercise and adequate sleep
• listening to concerns in a compassionate way and allowing your teenager to speak uninterrupted
• problem-solving together with your teenager and asking them if they would like to hear your opinion or advice before offering it to them
• showing interest in what’s happening in their life and celebrating achievements
• encouraging talking about emotions or problems, and checking-in to make sure there’s nothing they are particularly stressed or worried about
• spending time with your teenagers one-on-one and together as a family.

If you find it difficult to have a positive relationship with your teenager, or there is often tension between you, another adult you trust (e.g. an aunt, family friend or sports coach) may be able to offer their support and be a positive role model for your child.

Try to defuse heated arguments

Arguing with your teenager rarely produces a positive outcome and being angry during a discussion usually ends up in heated argument and produces no or undesired outcomes.

• Avoid starting arguments – ignore little things like shrugs or the rolling of eyes if your teenager is otherwise behaving in an acceptable way.
• Avoid nagging your teenager – they often tune out and stop listening and this generally only increases your frustration.
• If the argument is between siblings, get both children to voice their problems, look at what the conflict is about and encourage them to resolve the argument or compromise on their own before stepping in.
• Defuse heated arguments, rather than provoking or worsening the situation (e.g.  listen to their opinion, allow your teenager to speak uninterrupted and to find a solution or resolution to the problem).
• Try to stay calm even if your child reacts with attitude or talks back.
• Reduce the tension in an argument by using humour to change the tone of an argument, but avoid mocking or sarcastic language.
• If an argument is becoming heated, walk away and come back to continue the discussion when you are both calm. Teenagers are more likely to be reasonable and respond positively in a calm discussion.

If heated arguments happen regularly, and your teenager finds it difficult to control their frustration or anger, it may be helpful for them to seek support from a counsellor, who may offer an independent or unbiased view and recommend new ways to deal with the anger.

Set boundaries and consequences

Teenagers develop their independence by separating themselves more and more from their parents as they get older, and it is important to give them the freedom and space to do this. However, it is also very important to set boundaries.

Most teenagers will try to test the boundaries that have been set as they get older to see how much they can get away with.

• Set clear rules and involve your teenager in this process. Setting rules is important so that your teenager knows what behaviour is expected of them and what the consequences are if they decide to break the rules.
• The most effective boundaries or rules are those that are fair and reasonable, and can be applied consistently.
• Back yourself by being consistent with your approach to consequences and applying them each time rules are broken.
• Avoid reacting when your teenager is teasing, disobeying, back talking or rule breaking. Instead of reacting or exacerbating the problem, remind them that disrespectful behaviours have consequences and respond appropriately.

Violent behaviour and aggression

Sometimes teenagers can struggle with emotions of frustration or anger and become violent or aggressive towards the people around them.

Teenagers need to be made aware that violence and aggression towards anybody is unacceptable. If your teenager is being aggressive towards you, tell them you are walking away and you will return when they have calmed down.

Strategies for dealing with aggressive behaviour in your teenager include to:

• always use non-violent and respectful strategies when interacting with your child
• give your teenager space - remove yourself or the other person who is aggravating the situation and allow them time to calm down before continuing the discussion
• Set appropriate non-violent consequences, and follow through - this will help your teenager to understand that their aggressive behaviour is unacceptable
• talk to your child’s school to find out if their behaviour is consistent with behaviours at home – the school may also be able to offer your child support.

If there is violence or aggression in your family, you feel unsafe, or you or your child is at immediate risk of harm, contact emergency services on 000. 

Why negative discipline can be harmful  

Physical discipline  .

Physical discipline is anything done to cause physical pain or discomfort to a child in response to their behaviour, including smacking, hitting, spanking, slapping, pinching or pulling.

Many studies have found that physical discipline can have long-lasting negative effects on a child or young person, including: 

• increased aggression and antisocial behaviour   
• reinforcing the idea that violence is OK 
• low self-esteem 
• mental health problems 
• a poor relationship between the teenager and parent. 

Shouting or shaming

Shouting or yelling may be an understandable response when parents are extremely frustrated; however, studies have found that harsh verbal discipline like shouting can have similar harmful effects to physical punishments.  

Being shouted at can very stressful for a teenager. Losing control and lashing out verbally at your teenager is not modelling good ways to deal with anger and frustration.

Shouting at, shaming, belittling and humiliating teenagers for their actions can lead to more behavioural problems (e.g. increased aggression), be damaging to their long-term mental health, and is not an effective way to improve their behaviour. 

When to see a doctor  

Sometimes, severe and persistent challenging behaviour can be a sign of a medical condition or a more serious social or emotional problem. A GP can investigate this and refer you to a specialist if needed. You should speak with your GP if you are concerned that your teenager’s behaviour is linked to a mental health problem.

Behavioural challenges can have an ongoing, negative impact on family life. If you are having difficulties managing or coping with your teenager’s behaviour, you can talk to a GP who may refer you on to a specialist in paediatric behaviours. 

Key points to remember

•  It’s normal for teenagers to show challenging behaviours as they go through puberty and develop coping skills. 
• Forming positive relationships with your teenager is important to help with the development of their resilience and problem-solving abilities as they gain independence. 
• Arguing with teenagers is often unproductive – it is best to defuse heated arguments and be calm and clear when speaking to your child.  
• Setting boundaries being consistent with consequences is important.  
• Punishing your teenager with physical discipline, shouting or shaming can be harmful.  

More information  

• Kids Health Info: Challenging behaviour – school-aged children
• Kids Health Info: Challenging behaviour – toddlers and young children
• Positive Parenting Program:  Triple P  
• Raising children network:  Dealing with disrespectful teenage behaviour
• Raising children network:  Behaviour

Common questions our doctors are asked

What effect will too much screen time have on my child? 

Studies have found that being ‘addicted’ to screens, in particular for internet and gaming use, can actually causes changes in the brain that affect emotional processing, decision making and ability to control behaviour. Even for teenagers who are not addicted to their devices, too much screen time can lead to poor quality sleep and mental health problems. These things can all contribute to challenging behaviour. Furthermore, being glued to a screen means less time exercising, getting fresh air and spending time with family and friends, which can also negatively impact on mental and physical wellbeing.  

The American Academy of Pediatrics recommends that for all children aged five to 18 years, screen time should be reduced where possible. Screen time should not replace time needed for sleeping, eating, being active and interacting with family or friends. 

Although there are no specific guidelines in place for teenagers, it is up to parents to make decisions about how much screen time their children have access to and how screens are used (e.g. using a screen for research or homework may not need to be restricted as much as time spent playing video games). 

How do I find the right balance between allowing my teenager the space to develop and setting boundaries and rules?  

As part of the journey to becoming a capable adult, teenagers need to become more independent, try new things, make their own decisions and come up with their own solutions to problems they face. They won’t be able to do this if there are too many rules in place. Of course, your teenager does also need rules and boundaries to keep them safe and to ensure they are responsible and respectful. The rules you set will depend on your family situation and your teenager’s personality and needs, and may need to change over time as your teenager develops and matures. Aim to set clear, fair boundaries but also try to be understanding of your teenager’s needs and feelings.   

Developed by The Royal Children's Hospital Community Information, Department of Adolescent Medicine, and The RCH Child Health Poll. We acknowledge the input of RCH consumers and carers. 

First published October 2018.  

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit  www.rchfoundation.org.au . 

Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.

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Home • Teen • Development

11 Common Problems Of Adolescence, And Their Solutions

Their issues are real. Do lend an ear and hold their hands.

Michelle Bowyer is the founder of Ocean Grace, a center for therapeutic counseling, behavior intervention, and relationship services. She is an accredited social worker with a Masters' in Social Work (MSWQ).With over 20 years of experience in providing support and interventions to children, adults, and families across three different countries, she aims to support parents, teachers, carers, and families to bring their focus back to the most important part of life: relationships. Read full bio of Michelle Bowyer

Sagari was a math graduate and studied counseling psychology in postgraduate college, which she used to understand people better. Her interest in reading about people made her take up articles on kids and their behavior. She was meticulous in her research and gave information that could be of help to parents in times of need. Read full bio of Sagari Gongala

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Read full bio of Swati Patwal

Apoorva is a certified psychological counselor and NLP practitioner. The assistant professor-turned-writer believes that her experience as a teacher, psychologist, and researcher enables her to guide MomJunction readers on child development and mental health. Read full bio of Apoorva K

MomJunction believes in providing reliable, research-backed information to you. As per our strong editorial policy requirements, we base our health articles on references (citations) taken from authority sites, international journals, and research studies. However, if you find any incongruencies, feel free to write to us .

Image: Created with Dall.E

Adolescence is a phase when children go through several changes as they journey from childhood to maturity. It is also a vulnerable time for children since they may experience several problems of adolescence, such as unhealthy behaviors, which may lead to significant problems later in life. Concerns about adolescent behavior are also common during this time, making it difficult for parents to connect with their children.

Continue reading to learn about common adolescent issues and how you can help your children avoid or overcome them.

How To Deal With Common Problems Of Adolescence

Dr. Theodore Kremer, a board-certified pediatrician from St Louis, Missouri, says, “ There are many factors that affect adolescents, including physical, emotional, cognitive, and social changes that occur during puberty. The physical changes often cause curiosity and anxiety, and affect self-esteem. The social factors increase their quest for independence. Changes in the brain’s frontal lobe cause adolescents to think more abstractly and make complex decisions. Adolescents are often emotional due to hormonal changes during puberty. ”

Adolescence is not an easy time for children or parents. The only way to deal with needs and problems at this age is to know about them and be ready to face them. Parent-adolescent conflicts that cause insecure and unstable feelings have a linear association with pubertal maturity. Understanding and dealing with these conflicts positively could help your child be more responsible and social (1) . Here is our list of the most common problems, and their solutions that adolescents have to deal with.

1. Physical changes

Physical changes happen due to changes in the teenager’s hormone levels.

• Development of full breasts in girls can be awkward in the beginning. Girls may start to feel conscious about their figure.
• Change of voice and appearance of facial hair in boys is perhaps the most prominent change that takes place during adolescence.
• Acne is one of the major problems.
• Muscle gain sometimes leads to excessive body weight in teens.
• The growth of pubic hair in girls and boys.
• Body odor becomes evident.
• Girls start their periods.

The best way you can help your teenager get through the stage is to make them aware of these changes.

• Explain that it is normal for the body to change as every teenager goes through it!
• Help them adapt to these changes – acknowledge the change and help them accept it.
• Enable them to stay healthy and fit through a nutritious diet and exercise.

2. Emotional changes and problems

Hormones affect your teenager not only physically but also emotionally.

• Adolescence is the age between adulthood and childhood. Teenagers are often confused about their role and are torn between their responsibilities as growing adults and their desires as children . It is a time when young people may experience an identity crisis as they grapple with questions about who they are, who they want to be, and how they fit into the world around them.
• They tend to feel overly emotional (blame it on the hormones). Just about anything and everything can make them happy, excited, mad or angry.
• Adolescent girls are vulnerable to crying.
• Mood swings are common among teenage boys and girls.
• Bodily changes result in self-consciousness.
• Children who hit puberty early may even feel weird.
• Feelings of inferiority or superiority may arise at this time.
• Adolescence is the age when sexual feelings arise in youngsters. Feelings and thoughts about sex can trigger a sense of guilt.

Puberty can be an emotional roller-coaster ride. And it is normal. Here is how you can help your kid deal with these emotional problems of adolescence.

• Assist them to take care of themselves. Tell your teenagers that it is okay to feel the way they are feeling.
• Encourage them to exercise as physical activity helps keep the serotonin i A chemical that conveys messages throughout the body and influences bodily processes, including nausea, digestion, mood, and sleep (creates good feelings and happiness) levels up.
• Let them talk. Listen to them without judging and avoid giving them advice when they are not ready for it.
• Share your experiences of puberty or let them talk to an older sibling who has gone through the same. It will emphasize that it is okay to feel the way they do.
• Indulging in a creative activity can help them channelize their emotions.

Sharing his thoughts on bonding with his teenagers, Tim Dahi, a father, remarks, “I have set some technology boundaries like device-free meal times, which they, of course, resisted, but the tradition gradually took hold. I did other things, too, like familiarizing myself with some of their interests to get a better understanding of their lives. I’ve found new conversation starters, but some discussions remain strained due to the generation gap ( ⅰ ).’’

3. Behavioral changes

Overwhelming emotions can lead to impulsive behavior, which can be harmful to your child as well as others. Mostly, it is just teen behavior that will last as long as their adolescence.

• Adolescence is the time when children develop and exercise their independence, which can sometimes lead to rebellion. This can give rise to questioning the parents’ rules (seen as argumentative) and standing up for what they believe is right (seen as stubbornness).
• Significant developmental change in the brain makes teens moody, tired and difficult to deal with.
• The raging hormones in teenage boys can even push them to get into physical confrontations. They would also want to listen to loud music.
• As a part of their new-found independence, adolescents may also want to try new things and take risks, resulting in careless behavior.
• Sometimes, peer pressure and the need to ‘fit in’ can make them behave in a certain way or develop certain habits that are hard to break.
• Your teen’s dressing, hairstyle, and sense of fashion also change, mostly to something that you may not approve of.
• The most troubling behavior is perhaps your teen hanging out with problem children and adapting to a dangerous lifestyle.
• Lying is one of the common teen behavioral issues. Teens may lie to avoid confrontation with parents or out of fear.
• Behavioral problems in adolescence can make life difficult for parents. But remember that it is a passing phase, and is entirely normal.
• Gaining your child’s trust is important if you want to help them with behavioral issues. Talk to them and listen to what they have to say. Do not judge or criticize them, as it could worsen their behavior.
• Let them know that you love them just as they are. Encourage them to be true to themselves and not take on a personality just to please others.
• Remember that your adolescent child is not completely independent in dealing with their emotions and needs your support. Help them by telling them what you do when you feel sad, angry, jealous, etc. They can try those solutions to come out of their own emotional issues.
• You will have to intervene if you see them falling into bad company. Remember that adolescents are sensitive and may not take criticism well.

4. Substance Use and Abuse

Teenagers are vulnerable and can be easily swayed to the wrong side. Substance abuse is one of the biggest problems that parents of adolescents around the world have to deal with.

• Peer influence is one of the significant factors that drive adolescents to take up smoking and drinking or to do drugs.
• The tendency to take risk encourages most teens to try smoking or drinking even before they are of legal age.
• What may start as a ‘thrill’, can become a habit if it remains unchecked.
• If there is somebody who smokes or drinks at home, they can become your teen’s role models.
• Poor self-esteem and the need to be ‘cool’ can push adolescents to smoke or drink.
• Easy access to substances like cigarettes, alcohol, drugs, and anabolic steroids i Synthetic forms of the male sex hormone testosterone used to treat hormonal issues and delayed puberty may increase the temptation to try illicit substances.

The 2019 statistics, as per The Centers for Disease Control and Prevention , report 29.2% alcohol use, 21.7% marijuana use, 13.7% binge drinking, and 7.2% prescription opioid misuse. These figures highlight the need for expansion of prevention programs and practices to effectively address teenage substance abuse.

• Keep an eye on your child’s behavior. Look for erratic behavior and change in their appetite, sleep patterns, and moods.
• Do not spy on them or accuse them of any wrongdoing. Encourage them to talk and be honest. Tell them what your concerns are and discuss the problem with them.
• If your child is not willing to talk to you, the doctors can ask confidential questions to know if they are abusing any substances. Avoid going as far as a drug test, as that may come across as confrontational and threaten the child.
• If necessary, get your adolescent the appropriate treatment.

5. Educational challenges

High school is not all about fashion, friends, and parties. Children also have a lot of educational activities on their plate. Dr. Kremer opines, “ Adolescents often find academics challenging due to their struggle for independence during a critical time of brain development. Adolescents often want to be independent and do not want parents to remind them about completing their assignments. Their brain is changing in a way that allows them to go from concrete to abstract thinking, which can often cause them to make poor academic choices. Adolescents often develop their set of values and unfortunately, some adolescents don’t make academics a priority. ”

• Academic pressure to excel in their studies and secure a spot in college can be a significant source of stress for teenagers, often leading to moodiness.
• Juggling school work, extra-curricular activities (must for college admissions) and chores at home can be tiring.
• Distractions at school can result in poor academic performance, which will add to the pressure.
• Support your child’s aspirations for college education as what they need is the encouragement to do well.
• You could cut down their household chores to enable them to focus on their school projects when needed.
• Nutrition and exercise can help them get the strength and endurance they need to get through the hectic high school period.
• If you notice that your child is experiencing academic stress and feeling overwhelmed with their daily activities, it may be helpful to reduce the number of tasks they are expected to complete. Adolescents have not yet fully developed their lung capacity, and therefore may tire more quickly than adults.

6. Health problems

Adolescents are vulnerable emotionally and physically. Without proper nutrition and healthcare, they are susceptible to illnesses. According to a 2015 WHO report, 1.3 million adolescents died in 2015, a majority of them had preventable diseases.

• Teenagers have a hectic schedule as they hop from one activity to another with little time to eat or rest properly. Unhealthy eating habits prevent them from getting the nutrition they need.
• Consciousness about their body can lead to eating disorders, especially in girls. Adolescent girls who worry about their weight and appearance can develop disorders like anorexia i An eating disorder characterized by severe food restriction and an intense fear of putting on weight or bulimia i An eating disorder that allows you to quickly overeat and purge the food by vomiting or using laxatives .
• Stress can also lead to loss of appetite and sleeplessness in young children.
• Unhealthy eating habits and a less active lifestyle could also lead to obesity – this is often the case when your child consumes a lot of empty calories through fast food and sodas.

Parental guidance can help abate health problems in adolescence to maintain a healthy lifestyle. Lead by example and encourage your children to eat healthy food, exercise right and sleep on time.

• Ensure they get nutrition through their meals. Give them a balanced diet.
• Be there for them emotionally and physically as this will help them deal with any possible disorders.

7. Psychological problems

Research has revealed that around 50% of mental health disorders that adults have, begin at the age of 14. In fact, one-third of adolescent deaths are suicides triggered by depression (4) . If your child is overly moody and is not eating or sleeping at all, it is imperative you get professional help for them.

Anxiety and depression are prevalent among youth. Many children exhibit signs and symptoms of depression early on, and their friends and peers may be the first to notice it. A study suggests that 70% of teens reported that their peers suffer from psychological problems such as anxiety and depression (8)

US teenagers report anxiety and depression as major problems in their peers

The most common mental health disorders observed during adolescence are anxiety and mood disorders. Social phobias and panic disorders are common among this age group. Girls may tend to have more vulnerability to develop depressive disorders than boys (5) .

• Teenagers may have self-esteem or confidence issues. The feelings of inferiority or superiority often arise from their appearance, and acceptance of their body – skin color, beauty, and figure.
• Poor performance in academics and low IQ can also demotivate them. They develop the ‘I’m not good enough’ attitude towards life.
• Depression is one of the common psychological problems associated with adolescence.
• The stress and pressure of adolescence can create anxiety related issues, while mood swings can lead to conduct disorder or oppositional defiant disorder.
• Eating disorders are also psychosomatic i The onset of physical symptoms without a known medical reason or influenced by psychological factors as they start with the adolescent having a poor self-image and the need to change the way they look by any means.

While moodiness and temper tantrums are normal in teenage girls and boys, they may not always be what they seem. Identifying symptoms of psychological problems in adolescence is not easy and needs the eye of an expert.

• Most of the time, talking about the problems and maintaining a healthy lifestyle can prevent the onset of depression.
• If your child is overly moody and cynical, it is time to intervene and seek professional help if necessary.
• Sometimes, your teenage girl or boy may be unhappy only at home, and doing fine outside. Talk to the child’s teachers and friends to know if they are moody and disoriented at school as well. If they are, then it is a cause for concern.
• Do not brush away their feelings, as that can make things worse.
• Encourage them to communicate with you. For this, you need to talk to them. If you think your child would not take it easy, talk to them in the car where the chances of confrontation are fewer as you are not face-to-face.

8. Social problems – dating and relationships

Attraction to the opposite sex begins during puberty, and for some teens, this can trigger feelings of social anxiety. Adolescence is the time when their sexual or reproductive organs start developing. At such a vulnerable time, it is but natural for teens to feel awkward in social situations.

• Teenagers want to have an identity of their own. They tend to look up to role models at home or outside.
• Adolescents also start thinking about what is ‘right’ and ‘wrong’ and question your take on certain things.
• They need time to understand and get comfortable with their sexuality. Girls and boys start experiencing ‘weird’ feelings towards the other sex and may not know what to do about it.
• For certain adolescents, their sexual identity can cause confusion, anxiety, and discrimination. Due to their sexual orientation or gender identity, they may face harassment or ostracism, which can be incredibly challenging to navigate.
• This is the time they start dating. Your adolescent may not be comfortable talking to you about it and may go with little information or misinformation they have about it.
• Competition is another important aspect of a teenager’s social life. Your child may compete with her peers in anything and everything. Their spirit of competition speaks a lot about their perception of self – whether they have a positive self-esteem or a negative one.
• Sexual feelings and thoughts of sex may seem wrong to an adolescent, because of which they may feel guilty.
• Their social circle expands during this time as they seem occupied interacting with friends on social media sites, through their phone and outside.

Here is how you can deal with social problems of adolescence –

• Dating, romance, and sex are delicate issues that your teenager may not be comfortable talking about. Don’t make it more awkward for your child. Be confident and rational when discussing the subject.
• Your child may seem to spend more time outside than with you. Accept that your adolescents are discovering a whole new world. Just let them know you are there when they need you.
• Sharing your dating and social life experiences in school can put them at ease sometimes.

9. Sexual health – unplanned pregnancy and STIs

The development of secondary sexual characteristics during adolescence gives rise to new feelings in teenagers and pushes them to experiment with their bodies.

• Adolescence is the time when teens experience their first kiss, the intimate dance with their ‘boyfriend’ or ‘girlfriend’ and secret make out sessions.
• Without proper guidance, teenagers may become sexually active before they are ready. This could result in unwanted pregnancies. Unwanted pregnancy is the biggest risk that adolescent girls face.
• Unprotected sex can also lead to sexually transmitted diseases like HIV.
• Have ‘the talk’ with your child as they may already be learning about sexual health and reproduction at school. Your duty as a parent is to ensure that they understand the importance of safe sex.
• The hormonal changes in teenagers may make them act impulsively. Your teen may not like it but it is important that you talk to them about the consequences of unprotected sex and how it can change their life.
• Awareness is the only way to prevent early pregnancies and sexually transmitted infections (STIs) in adolescents.

10. Addiction to cyberspace

The advent of social media has changed the way we interact with each other. It has affected teenage lifestyles the most.

• Your teen may seem to spend hours on phone, texting, talking or simply playing.
• Adolescents addicted to the internet tend to have fewer friends and a less active social life. They lead solitary lives and are happy browsing the internet for hours. (6)
• Addiction to cyberspace also cuts short their physical activities, resulting in an unhealthy and sedentary lifestyle.
• Internet addiction adversely impacts academic performance.
• Do not assume that your child is addicted to the internet just because he or she spends a lot of time in front of the computer. They could be doing more productive things on the system other than surfing the net.
• Do not say ‘no’ to the Internet. That will only make them adamant. Instead, talk about your concerns and help them work on other things that do not require a computer.
• You could use parental controls , but that may not be taken well by your teen – remember that they are not kids anymore. At the same time, they may also not have the judgment to make the right choices. So guide them as a parent, but never decide for them.
• Enroll them in activities that encourage them to interact with others. Have family activities that will make them want to spend less time at the computer.
• Have some cyber rules and boundaries for everybody at home. Limit the use of the mobile phone to a few hours in a day, and avoid bringing the phone to the bedroom as it is likely to affect a person’s sleep.

11. Aggression and violence

Aggression is especially a concern with adolescent boys. Young boys start to develop muscles, grow tall and have a coarser, manly voice. In addition to that, they are moody and vulnerable and can let others get under their skin.

• Adolescent boys can get into fights at school.
• Worse, they could start bullying others, which is a major problem that adolescent boys and girls have to deal with.
• Boys may fall into bad company and be drawn to acts of violence, vandalism, and aggression. They could be easily swayed to own or use a firearm or a weapon too.
• Impulse acts of violence can lead to serious consequences, including death. According to the WHO report, interpersonal violence causes around 180 adolescent deaths around the world.
• Teenage girls are likely to suffer violence or aggression by a partner.

Children tend to imitate what they see at home. The following remedies for problems of adolescence will help abate aggression, violence and related issues.

• Teach your children to be kind and considerate. Nurturing relationships at home can help them become less aggressive.
• Prevent access to firearms and alcohol early to prevent violence.
• Teach them life skills and the importance of compassion. Lead them by being their model.
• Avoid exposing them to violent stories, games or movies at an age when they cannot differentiate between what is right and wrong.
• Make them try alternative ways, such as going for a run, doing yoga or using a punch bag, for venting out their anger. This way, they understand that it is alright to be angry but how they deal with it makes all the difference.

When You Know, You Can Help

Parents play an important role in adolescents’ behavior development (7) . Educating your teen about possible problems and their solutions can have a positive impact. Understanding their feelings and giving suggestions could reduce family conflicts than being judgmental or rude to them.

Setting up clear rules on bad behaviors and drug use may help your teen stay away from it. Establishing good and friendly communication with your child can encourage them to speak up about their issues to you and seek your help.

Frequently Asked Questions

1. How can parents help their adolescent children deal with identity issues?

Parents may help adolescents improve their self-awareness by identifying their likes, dislikes, negative past experiences, feelings about themselves, and strengths. They may also help children identify their emotions (sadness, frustration, confusion, or anger) and let them know that venting their feelings is okay (8) .

2. What are some common communication problems between parents and adolescents?

Parental criticism worsens communication, and it is advisable to reach conclusions together after a thorough discussion with children. Another communication problem is that adolescents may find it difficult to freely express feelings and perspectives, causing them to engage in autonomous behaviors without their parent’s approval (9) . In such cases, it is essential to interact with the adolescent calmly without being judgemental.

Infographic: How To Deal With Common Problems Of Adolescence

Illustration: Momjunction Design Team

Key Pointers

• The course of change during adolescence can have negative impacts on mental health, leading to anxiety, depression, and self-harm.
• Do not brush away their problems but talk to them.
• Puberty can lead to physical complexities and low self-esteem for adolescents.
• Explain about the physical changes and tell them how natural they are.
• Adolescents also face new social challenges, such as making friends, fitting in, and forming romantic relationships.
• Address the delicate subject of relationships and dating at the appropriate time with the right examples from your own life.

You may have been a teenager yourself. But once you become a parent to a teen, you seem clueless. Think about it – your adolescent is at an age that you have already been through. Be empathetic and try to understand what your child is going through. That makes dealing with their problems easier.

Personal Experience: Source

MomJunction articles include first-hand experiences to provide you with better insights through real-life narratives. Here are the sources of personal accounts referenced in this article.

1. Brett Laursen, et al.; Reconsidering Changes in Parent-Child Conflict across Adolescence: A Meta-Analysis ; The United States National Library of Medicine 2. 13.3: Physical Changes in Adolescence 3. Use of Tobacco Products, Alcohol, and Other Substances Among High School Students During the COVID-19 Pandemic — Adolescent Behaviors and Experiences Survey, United States, January–June 2021 4. Adolescents: health risks and solutions ; The World Health Organization 5. Susan J Bradley; Anxiety and mood disorders in children and adolescents : A practice update; The United States National Library of Medicine 6. Hing Keung Ma; Internet Addiction and Antisocial Internet Behavior of Adolescents ; The United States National Library of Medicine 7. Parents play an important role in shaping adolescent’s behavior ; Kansas State University 8. Identity Issues ; AppState 7. Teenagers and Communication ; Better Health Channel 8. Most U.S. Teens See Anxiety and Depression as a Major Problem Among Their Peers ; Pew Research Center

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Behavioral Problems in Adolescents

• Specific Behavioral Disorders |
• Violence and Gang Membership |

Adolescence is a time for developing independence. Typically, adolescents exercise their independence by questioning or challenging, and sometimes breaking, rules. Parents and doctors must distinguish occasional errors of judgment, which are typical and expected of this age group, from a pattern of misbehavior that requires professional intervention. The severity and frequency of infractions are guides. For example, regular drinking, frequent episodes of fighting, absenteeism from school without permission (truancy), and theft are much more significant than isolated episodes of the same activities. Other warning signs of a possible behavioral disorder include deterioration of performance at school and running away from home. Of particular concern are adolescents who cause serious injury to themselves or others or who use a weapon in a fight.

Because adolescents are much more independent and mobile than they were as children, they are often out of the direct physical control of adults. In these circumstances, adolescents' behavior is determined by their own decision-making, which is not yet mature. Parents guide rather than directly control their adolescents' actions. Adolescents who feel warmth and support from their parents and whose parents convey clear expectations regarding their children’s behavior and show consistent limit setting and monitoring are less likely to develop serious problems.

Authoritative parenting is a parenting style in which children participate in establishing family expectations and rules. This style of parenting involves limit setting, which is important for healthy adolescent development. Authoritative parenting, as opposed to authoritarian-style parenting (in which parents make decisions with minimal input from their children) or permissive parenting (in which parents set few limits) is most likely to promote mature behaviors.

Authoritative parenting uses a system of graduated privileges, in which adolescents initially are given small bits of responsibility, such as caring for a pet, doing household chores, purchasing clothing, decorating their room, or managing an allowance. If adolescents handle a responsibility or privilege well over a period of time, more responsibilities and more privileges, such as going out with friends without parents and driving, are granted. By contrast, poor judgment or lack of responsibility leads to loss of privileges. Each new privilege requires close monitoring by parents to make sure adolescents comply with the agreed-upon rules.

Some parents and their adolescents clash over almost everything. In these situations, the core issue is really control. Adolescents want to feel they can make or contribute to decisions about their lives, and parents are afraid to allow their children to make bad decisions. In these situations, everyone may benefit from the parents picking their battles and focusing their efforts on the adolescent's actions (such as attending school and complying with household responsibilities) rather than on expressions (such as dress, hairstyle, and preferred entertainment).

Adolescents whose behavior is dangerous or otherwise unacceptable despite their parents' best efforts may need professional intervention. Substance use is a common trigger of behavioral problems, and substance use disorders require specific treatment. Behavioral problems also may be symptoms of learning disabilities , depression , or other mental health disorders . Such disorders typically require counseling, and adolescents who have mental health disorders may benefit from treatment with drugs. If parents are not able to limit an adolescent’s dangerous behavior, they may request help from the court system and be assigned to a probation officer who can help enforce reasonable household rules.

(See also Introduction to Problems in Adolescents .)

Specific Behavioral Disorders

Disruptive behavioral disorders are common during adolescence.

Attention-deficit/hyperactivity disorder (ADHD) is the most common mental health disorder of childhood and often persists into adolescence and adulthood. However, adolescents who have difficulty paying attention may instead have another disorder, such as depression or a learning disability

Other common disruptive behaviors of childhood include oppositional defiant disorder and conduct disorder . These disorders are typically treated with psychotherapy for the child and advice and support for parents.

Violence and Gang Membership

Children occasionally engage in physical confrontation and bullying , including cyberbullying. During adolescence, the frequency and severity of violent interactions may increase. Although episodes of violence at school are highly publicized, adolescents are much more likely to be involved in violent episodes (or more often the threat of violence) at home and outside of school. Many factors contribute to an increased risk of violence for adolescents, including

Developmental problems

Intense corporal punishment (such as punching or beating) inflicted on the child

Caregivers with substance use disorders

Gang membership

Access to firearms

Substance use

There is little evidence to suggest a relationship between violence and genetic defects or chromosomal abnormalities.

Gang membership has been linked with violent behavior. Youth gangs are self-formed associations made up of 3 or more members, typically ranging in age from 13 to 24. Gangs usually adopt a name and identifying symbols, such as a particular style of clothing, the use of certain hand signs, certain tattoos, or graffiti. Some gangs require prospective members to perform random acts of violence before membership is granted.

Increasing youth gang violence has been blamed at least in part on gang involvement in drug distribution and drug use. Firearms and other weapons are frequent features of gang violence.

Violence prevention begins in early childhood with violence-free discipline. Limiting exposure to violence through media and video games may also help because exposure to these violent images has been shown to desensitize children to violence and cause children to accept violence as part of their life. School-age children should have access to a safe school environment. Older children and adolescents should not have access to weapons and should be taught to avoid high-risk situations (such as places or settings where others have weapons or are using alcohol or drugs) and to use strategies to defuse tense situations.

All victims of violence should be encouraged to talk to parents, teachers, and even their doctor about problems they are having.

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Social problem solving among depressed adolescents is enhanced by structured psychotherapies

Affiliations.

• 1 Western Psychiatric Institute and Clinic, University of Pittsburgh.
• 2 Research Institute at Nationwide Children's Hospital.
• 3 Family Practice Center.
• PMID: 24491077
• PMCID: PMC3966937
• DOI: 10.1037/a0035718

Objective: Changes in adolescent interpersonal behavior before and after an acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescents' interpersonal behavior.

Method: Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% White) engaged in videotaped interactions with their mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST) and after 12-16 weeks of treatment. Adolescent involvement, problem solving, and dyadic conflict were examined.

Results: Improvements in adolescent problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on adolescents' problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive symptoms. Improvements in adolescents' problem solving were associated with higher rates of remission across treatment conditions, but there were no significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low.

Conclusions: Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and suggest one pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT.

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Social stress, problem-solving deficits contribute to suicide risk for teen girls

• Women and Girls

Adolescents who have trouble solving interpersonal problems and experience greater interpersonal stress may be at elevated risk for suicidal behavior, study suggests

Read the journal article

• Social Problem-Solving and Suicidal Behavior in Adolescent Girls (PDF, 338KB)

Washington — Teen girls who have greater difficulty effectively solving interpersonal problems when they experience social stress, and who experience more interpersonal stress in their lives, are at greater risk of suicidal behavior, suggests research published by the American Psychological Association.

Suicide is the second-leading cause of death among teens, and rates of suicidal behavior are particularly high among girls. Previous research has found that interpersonal stressors—such as conflict with peers, friends and family—are related to suicidal behavior. Some theories of suicidal behavior suggest that poor social problem-solving skills may contribute to the link, possibly because teens with poorer social problem-solving skills are more likely to see suicide as a viable solution to their distress when they feel they’ve exhausted other options.

The current study aimed to test these associations by considering both experimentally simulated and real-world measures of social stress. The research was published in the Journal of Psychopathology and Clinical Science .

“The findings provide empirical support for cognitive and behavioral theories of suicide that suggest that deficits in abilities to effectively manage and solve interpersonal problems may be related to suicidal behavior,” said study lead author Olivia Pollak, MA, of The University of North Carolina at Chapel Hill. “Clinically, this is notable, as problem-solving features prominently in several treatments for suicidal or self-harming behaviors.”

Participants were 185 girls ages 12 to 17 who had experienced some mental health concerns in the past two years. At the beginning of the study, participants completed surveys or interviews about their mental health symptoms and suicidal behaviors. Participants also completed a task assessing their social problem-solving skills, which involved responding to scenarios involving interpersonal conflicts or challenges with other people, such as peers, friends, family members and romantic partners. The teens were then asked to perform a task that has been shown in previous studies to induce social stress—they had to prepare and deliver a three-minute speech before what they thought was an audience of peers watching via video link. Immediately after the stressful task, they again completed the social problem-solving task to see whether experiencing social stress led to declines in their problem-solving ability.

The researchers also followed the girls for nine months, checking in every three months, to ask them about the stressors they were experiencing in interpersonal domains, such as with peers, friends and family members, as well as about suicidal behaviors.

Overall, the researchers found that girls who showed greater declines in problem-solving effectiveness in the lab, and who also experienced higher levels of interpersonal stress over the nine-month follow-up period, were more likely to exhibit suicidal behavior over the nine-month follow-up period.

“Importantly, problem-solving deficits under distress may increase risk for future suicidal behavior only in combination with greater cumulative interpersonal stress in real life,” Pollak said. “Risk for suicidal behavior was higher among adolescents who showed greater declines in effectiveness and who experienced high levels of interpersonal stress over nine-month follow-up, consistent with robust evidence for links between interpersonal life stress and suicidal behavior.”

Article: “Social Problem-Solving and Suicidal Behavior in Adolescent Girls: A Prospective Examination of Proximal and Distal Social Stress-Related Risk Factors,” by Olivia Pollak, MA, and Mitchell J. Prinstein, PhD, The University of North Carolina Chapel Hill; Shayna M. Cheek, PhD, Duke University; Karen D. Rudolph, PhD, University of Illinois Urbana-Champaign; Paul D. Hastings, PhD, University of California Davis; and Matthew K. Nock, PhD, Harvard University. Journal of Psychopathology and Clinical Science , published online May 25, 2023.

Olivia Pollak can be reached via email .

Lea Winerman

(202) 336-6143

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