The Adolescent Brain and Substance Use

Adolescence is a time of profound brain growth and change. It has been shown that the brain of an early adolescent compared to that of a late adolescent is different in the areas of anatomy, biochemistry, and physiology. As the adolescent brain moves toward adulthood it becomes faster and more efficient at processing information. One area in particular that becomes more efficient is the frontal lobes. The frontal lobes are involved with reasoning, planning, parts of speech, movement, emotions, and problem solving. There is mounting evidence that neuronal circuitry in the frontal lobes is shaped and fine tuned during adolescence, and that experience plays a prominent role in these changes. An important part of the frontal lobe is the prefrontal cortex (PFC). The PFC is responsible for such skills as setting priorities, organizing plans and ideas, forming strategies, controlling impulses, and allocating attention.

Because the adolescent brain is a work in progress, substance use during adolescence has been associated with alterations in brain structure, function, and neurocognition. Alcohol and drug use can have seriously negative effects damaging long and short-term growth processes. In some cases the damage done during adolescence can even be irreversible.

Short-term or moderate drinking impairs learning and memory far more in youth than adults. Research has identified subtle but important brain changes that occur among adolescents who abuse alcohol resulting in a decreased ability in problem solving, verbal and non-verbal retrieval, visuo-spatial skills, and working memory. For example adolescent drinkers scored worse than non-users on vocabulary, general information, memory, and memory retrieval tests than non users. In a study comparing alcohol dependent and healthy control adolescents, it was found that drinkers recalled 10% less verbal and nonverbal information than controls, even after three weeks of monitored abstinence. A similar degree of reduction was found on attentional and speeded information processing tasks as well as deficits in language competence and academic achievement. Deficits in executive functioning, specifically in future planning, abstract reasoning strategies, and generation of new solutions to problems, have also been found.

The association between antisocial behavior during adolescence and alcoholism may be explained by abnormalities in the frontal limbic system, which appears to cause “blunted emotional reactivity.” This can negatively affect self control, decision making, and behavior regulation.

Blackouts, or alcohol induced amnesia in which a person does not remember events or behavior, are also common among adolescent drinkers. This is due in part to the effect of alcohol on neural plasticity in the hippocampus. The hippocampus is involved in the formation of new memories, and it can be disrupted by excessive drinking. As heavy drinking continues, the brain becomes less able to compensate for the disruptions caused by the effects of alcohol. Thus, the more a teen drinks, the higher the chances for developing permanent neuronal damage.

Marijuana use in adolescence has an adverse impact on brain development, leading to poorer performance on thinking tasks as compared to non-drug using peers. Marijuana users also have slower psychomotor speeds, poorer complex attention, weaker verbal memory, and impaired planning abilities. Although studies suggest that verbal memory function can be partially recovered within three weeks of discontinuing marijuana use, complex attention skills continued to be affected.

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Parenting Tip – Notice the Positives!

How many times a day do you, as a parent, have to correct your teen’s misbehavior with statements such as “Stop that,” “clean up your room,” or “how many times am I going to have to ask you to put the video game away?” I am guessing that it feels like an infinite number of times.

As parents, we have many jobs: working, cleaning the house, making dinner, walking the dogs and when you add our most important job to the mix – raising our children, it can become overwhelming.  Unfortunately, at times we may forget about our child until he or she does something to catch our attention – which often happens when they have done something wrong.

It is extremely important to avoid or break the cycle of ONLY paying attention to your child when he or she misbehaves.  It is critical to catch your children doing the right thing.  When a parent notices their child doing the right thing and praises that behavior, it will most likely increase the positive behavior.

So, for the next week try to catch your teen doing the right thing every day.

  • If your teen tends to disrupt you a lot when you are busy, try to find a moment when he or she has not and thank them for not disturbing you.
  • If your teen voluntarily does something like taking out the trash be sure to thank him or her for doing that, letting them know what it meant to you.
  • If your teen does what you ask without you having to ask 10 times, be sure to notice that and let them know you appreciate it.

In following this advice, it is important that you don’t look only for your teen being extra good, just catch them doing right things.  Also, do not go overboard trying to catch everything.

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Video Games and Violence

Video games are becoming more violent and increasingly realistic as technology improves. In 2008 it was reported that 97% of young people ages 12-17 played some type of video game, and that two-thirds of them played games that contained violent content. In addition, a separate study found that more than half of all video games contained violence. Because of this reality, parents, teachers and mental health professionals are beginning to ask questions about the impact that violent video games will have on today’s youth.

Researchers are divided on whether or not violent video games actually increase aggression among children and teens. Many organizations, such as the American Academy of Pediatrics (AAP) and the American Academy of Child & Adolescent vente parcours obstacle gonflable Psychiatry (AACAP) imply that children learn from observing, mimicking, and adopting behaviors, therefore are concerned that exposure to violent video games may cause many problems. For example, they state that over time exposure to violent video games will numb emotions, cause sleep problems, academic impairments and most importantly contribute to real-life violent behavior. On the other hand, many researchers have questioned this stance and argue that the majority of youth are not affected by violent video games and remain convinced that playing these types of games may be a part of normal development.

Clearly, there are many uncertainties and questions about the influence that violent video games may have on children. The good news is there are a few simple things that parents can do to protect their children from potential harm. These precautions may help:

  1. Limit the amount of time children spend playing video games. The AAP recommends two hours or less of total “screen” time per day (including television, computers, and video games).
  2. Put TV’s and computers in common areas- not in children’s bedrooms.
  3. Play video games with children to better understand the content and how they react.
  4. Check ratings.
  5. Encourage participation in sports and school activities.
  6. Pay attention to “red-flags” such as, anger, depression, impulsivity and isolation.

When it comes to video games, moderation is the key. The most important thing is to help children find a healthy, happy, balance in their lives.

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Parent Tip – Helping your child make friends.

Research shows that parents play an important role in teaching their children how to make friends. The most popular kids are pro-social and are able to demonstrate caring, sharing, and helpful traits. They also know how to control their selfish or aggressive impulses behaviors. Most of all, popular children are good at interpersonal skills: empathy, perspective-taking, and moral reasoning (Slaughter et al 2002; Dekovic and Gerris 1994).  Parents play an important role in helping their children develop these skills.

Research has revealed important things you can do to help your child make friends. First, offer your child empathetic support by being an Authoritative Parent.  Authoritative parents believe in developing a close and nurturing relationship with their children while also upholding and maintaining a reasonably high level of expectations and rules. Authoritative parents develop clear and fair behavioral guidelines for their children.  Studies show that authoritative parents tend to have kids who are less aggressive, more self-reliant, more self-controlled, and better-liked by peers (Brotman et al 2009; Sheehan and Watson 2008; Hastings et al 2007). Teach your child to be part of the conversation, not dominate it.  A number of studies have shown that unpopular kids improve their status with peers after they’ve been trained in “active listening” (e.g., Bierman 1986). An active listener is someone who makes it clear he is paying attention–by making appropriate eye contact, orienting the body in the direction of the speaker, remaining quiet, and making relevant verbal responses. Several studies suggest that children get along better when they are engaged in cooperative activities—i.e., activities in which kids work toward a common goal (Roseth et al 2008) versus being competitive.  It is important to be aware of your child’ social life including where they hang out and who they hang out with.  Various studies suggest that children are better off when their parents monitor their social activities (Parke et al 2002).  Finally it is important to teach your child about cultural differences.

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Prescription: Exercise

Dear Petrus Psychology, Is exercise important for people who have ADHD?

Significant changes take place in the brain during physical activity.  Afternoon sluggishness can often be treated with a quick jog around the neighborhood.  During exercise, the brain’s dopamine and serotonin levels are increased.  These levels are responsible for gains in alertness, attention, motor and cognitive performance.

For children and adults with ADHD, exercise is one of the most powerful prescribed medications.  Exercise firms up the executive functioning center of the brain- the center responsible for taking in and processing information, storing it into memory, slowing down impulsivity, and allowing us to focus when we need it most.  In some schools, children with ADHD are encouraged to take ten-minute exercise breaks as an alternative to seated time-outs.  This allows them time to increase the cortical pathways that promote sustained focus.

Aside from the increase in brain activity, exercise grants children with behavioral disorders something they often seek out: a sense of personal accomplishment.  Exercise provides the added benefit of giving children something attainable.  Most physical activity has a beginning and an end, which can lead to a sense of personal satisfaction and self-worth.  Whether it is bike riding, a game of kickball, or a basketball game of “around the world,” exercise provides positive treatment benefits for individuals with ADHD.

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Consequence vs. Punishment

Consequences are different from Punishments because consequences teach children to learn from their mistakes rather than making them suffer for their mistake. Consequences guide a child’s behavior and help children learn about the results of their behavior.  When used correctly, consequences encourage good behavior and help to keep the lines of communication open between a parent and child. Consequences are done in a calm tone of voice, with a friendly attitude, and with the focus on teaching.  Consequences do not always have to be aversive.  A parent can give a child an enjoyable consequence.

Punishments impose suffering which actually shifts the focus from the lesson that needs to be learned to “showing” who is in control. In punishment based parenting few words of explanation are given by the parent,  children are left confused and unsure of their behavior, and it is given out of anger or frustration. Punishments are often excessive and the parent is not in control. Parents who use punishment usually do not recognize the difference between mistakes and misbehavior. As a result, punishment focuses on the parent being responsible for controlling a child’s behavior, rather than the child controlling his/her own behavior, which is the focus of a consequence

Pointers for Parents

  • For every rule there is a responsibility and a privilege.
    • When the responsibility isn’t met, take away the privilege.
  • Avoid dealing out consequences when angry.
    • This will help avoid falling into giving a punishment. Wait until you feel calm.
  • Be sure to praise earning privileges.
  • The goal of consequences is to help children learn that they are responsible for their behavior.
    • Harsh or punitive punishment causes the child to feel either fear or anger instead of feeling regret for their mistake.
  • Children who are punished:
    • have hard time trusting
    • react with anger
    • isolate themselves from parents
    • learn to avoid punishment and to fear their parent’s anger.
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Parenting Part 1 – “Does how I parent really matter?”

The type of Parenting Style a parent uses can positively or negatively affect a child’s level of confidence, self-worth, sense of security, interaction with peers and authority figures, and sense of self. Research has shown that Parenting Style has been found to predict a child’s well-being in the following domains:

  • social competence,
  • academic performance,
  • psychosocial development,
  • problem behaviors.

Parenting Style captures two important elements of parenting (Maccoby & Martin, 1983):

  • Parental Responsiveness – (love, warmth, supportiveness): Responsiveness is the extent to which parents respond to their child’s needs in an accepting, supportive manner. The nurturance parents offer helps their children feel loved, secure, and cared about. Parental Responsiveness predicts social competence and psychosocial functioning.
  • Parental Demandingness -(discipline, control) Demandingness is the extent to which a parent expects and demands responsible behavior from children.  This dimension includes both setting and enforcing rules and limits. Rules must be clear, reasonable, developmentally appropriate, fair and just, flexible, and emphasize what to do rather just what not to do. Parental Demandingness is associated with instrumental competence and behavioral control (i.e., academic performance and deviance).

Types of Parenting Styles

Baumrind (1967) suggested that the majority of parents display one of three different Parenting Styles.

  • Parents who are equally responsive and demanding
    are Authoritative.
  • Parents who are demanding but not very responsive
    are Authoritarian.
  • Parents who are responsive but not at all demanding
    are Indulgent.

Further research (Maccoby & Martin, 1983) suggested the addition of a fourth Parenting Style.

  • Parents who are neither demanding nor responsive
    are Unengaged.

The above researchers provide the following definitions and outcomes:

  • Authoritative parents nurture, discipline, and respect their children in equal measure.  They set high standards and expectations, consistently enforce rules, and encourage independence. Open communication and the ability to listen are key.  Their parenting is said to be “positive.” Their disciplinary methods are supportive, rather than punitive.
    • In general, children do better in life if they come from a home in which there is Authoritative parenting. Children from authoritative homes have good self-esteem and self-confidence, and have lower levels of anxiety and depression. They function better socially, academically, and in the work world, and have few, if any, behavioral problems. They tend to become respectful and responsible adults.
  • Authoritarian parents, on the other hand are highly Demanding and directive, but not Responsive. They punish their child(ren) but don’t tend to nurture or respect them. They value obedience and discourage independence. They set strict rules, enforce them harshly and do not like to have their authority questioned.  These parents are often described as “dominating”.
    • Children from Authoritarian homes have both low self-esteem and self-confidence, high levels of anxiety and depression, and tend to have problems interacting with others. Their academic achievement is usually average and they have some behavioral problems. They also have persistent problems with authority.
  • Indulgent parents tend to nurture their children but don’t engage in effective discipline and don’t model or expect respectful behavior.  Although they show love and give attention, they make few demands and set no guidelines or structure for their child(ren).  They are nontraditional and lenient, do not require mature behavior, allow considerable self-regulation, and avoid confrontation
    • Children from Indulgent homes have higher self-esteem and self-confidence, and reduced levels of anxiety and depression, but they tend to do poorly at school, show a lot of behavioral problems, and lack respect and responsibility.
  • Uninvolved (Unengaged) parents don’t discipline, nurture, or respect their children. They are generally uninvolved and disinterested in parenting, interacting only minimally with their child(ren).
    • Children from Uninvolved homes in have the worst outcomes as adults. They tend to have low self-esteem and self-confidence, high levels of depression and anxiety, and have poor social skills. They have a lot of behavioral problems, do poorly in school, have little respect for themselves or others, and lack responsibility.

As a parent it is important to expect responsible behavior from your child, set appropriate limits, nurture you child through affection and support, and give your child the opportunity to express his or her thoughts, feelings and beliefs.  For more information on parenting please sign up for our newsletter or check back with our blog site in the near future.

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Executive Functioning

Executive function is a term used to describe the many tasks our brains perform that are necessary to think, act, and solve problems. Executive functioning includes tasks that help us learn new information, remember and retrieve information we’ve learned in the past, and use this information to solve problems of everyday life.  Specifically executive functioning refers to the role of the brain’s frontal lobes in:

  • organizing,
  • developing initiatives,
  • controlling impulses,
  • making appropriate decisions,
  • learning from mistakes,
  • monitoring and changing behavior as needed,
  • planning future behavior when faced with novel tasks and situations,
  • initiating and stopping actions,
  • assessing risks,
  • and adapting to changing situations.

The term “executive function” comes from the business world where the top executive organizes, decides, adjusts, and supervises the activities of the business. As the name implies, executive functions are high-level abilities that influence more basic abilities like attention, memory, and motor skills.  Executive functions allow people to figure out the task demanded through trial and error, and change strategies as needed. The abilities to form concepts and think abstractly are considered components of executive function.

Executive function deficits are associated with a number of psychiatric and developmental disorders, including but not limited to obsessive-compulsive disorder, Tourette’s syndrome, depression, conduct disorder, anxiety, oppositional defiant disorder, schizophrenia, attention-deficit/hyperactivity disorder, autism, Asperger’s syndrome, fetal alcohol syndrome and pre-natal drug exposure. Chronic heavy substance users show impairments on tests of executive function.  Some of these deficits appear to result from heavy substance use, but there is also evidence suggesting that problems with executive functions may contribute to the development of substance use disorders.

Executive functioning deficits affect a person’s ability to plan, organize and manage time and space. People with executive functioning deficits may also show weakness with working memory.  Parents of children and teens with executive function deficits may notice their child having difficulty:

  • making plans,
  • keeping track of time,
  • keeping track of more than one thing at a time,
  • engaging in group dynamics,
  • evaluating ideas,
  • reflecting on work,
  • organizing work
  • planning and finishing work on time,
  • asking for help when needed,
  • making mid-course corrections while thinking, reading and writing,
  • figuring out the amount of time needed to complete a project,
  • finishing work on time,
  • waiting to speak until called on,
  • seeking information when needed,
  • communicating details in an organized, sequential manner, with important details and minimal irrelevant details,
  • initiating activities or tasks, or generating ideas independently,
  • retaining information while doing something with it.

The primary key to successful interventions for executive function difficulties in children and teens is to properly describe the problem. Do not attribute the difficulties to laziness, lack of motivation, or irresponsibility.  Do not assume that change occurs because a child/teen wants to.  A child/teen has to learn the necessary skills that will enable him/her to make change.  It also important that the youth understand that change is possible. If you are concerned that your child/teen might have executive functioning difficulties consult with your pediatrician, school psychologist or other mental health professional to find out how to best help your child/teen.

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My Teen is Growing Up

Adolescence is considered to be one of the most important phases in the developmental theory and developmental progress.  It is the time when a child emerges from the latency period, pre-pubescence, where they are trying to figure out who they are and where they belong.  The adolescent phase marks an intense quest for identity.  During this stage, the teen takes on various tasks that aid in his or her developmental maturing.  These tasks include: separation from the family as the teen begins to learn new ways of being outside the family; accepting body image changes and secondary sex changes; development of new more functional cognitive abilities; and the development of healthy coping mechanisms to handle these and other changes.

From 11 years of age through 13 years teens become more preoccupied with how they look.  Rapid body changes have a lot of social significance among peers and affect the teens self image.  The adolescent peer group influence begins to increase as the adolescent seeks out the approval for their changing identity.  Teens tend to want to avoid ridicule so they conform to their peer groups ideas and actions.  During this period it is extremely important that parents continue to provide structure and offer a safe environment for their child(ren) to express themselves. During this period teens are susceptible to deviant behavior by their peers. 

From 14 years of age through 16 years most boys and girls have grown into their adult bodies and begin to feel more confident about themselves.  Sexual urges increase and peer groups change as dating increases.  Teens begin to move away from their family as they begin to self examine.  During this time many teens learn to cope with social rejection, consider factors that will allow for better decision making, and will develop skills to better deal with frustrations and stressors.   Yet others who do not, may become self destructive, angry, and oppositional. 

From 17 years of age through 19 years the adolescent begins to think more like an adult.  They become more self reliant and more sure about themselves.  Peer group influence begins to diminish and the need for independence increases.  During this time parents begin to yield control and encourage their young adult to begin to accept more responsibilities.

As a child navigates through adolescence parent(s) need to provide both emotional support and structure.  Parents need to continue to be consistent with limits and expectations.  For example: monitoring peer groups and social life, maintaining curfew, providing responsibilities such as chores, and maintaining expectations with school and extra curricular activities.  As a teen progresses through this phase, if expectations and responsibilities are appropriately met and dealt, with parents should allow their teen increased decision making opportunities and independence.

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Family Dinners

Have a dinner as a family and enjoy the benefits of your child’s healthier adolescent development.  Families that eat together have teens that are less likely of smoking, drinking, using drugs, getting depressed, developing an eating disorder, delay having sex, are more likely to do well in school, and less likely to consider suicide.

The National Center on Addiction and Substance Abuse at Columbia University (CASA) reported that compared to teens who eat dinner frequently with their families (five or more family dinners per week), those who have infrequent family dinners (fewer than three per week) are:

  • three and a half times likelier to have abused prescription drugs.
  • three and a half times likelier to have used an illegal drug other than marijuana or prescription drugs.
  • three times likelier to have used marijuana.
  • more than two and a half times likelier to have used tobacco.
  • one and a half times likelier to have used alcohol
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