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| Developing Resilience in Children and Adolescents |
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| Feature Articles - Adolescents | ||||||||||
| Monday, 31 May 1999 16:00 | ||||||||||
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Children and adolescents growing up in our fast-paced society face many difficulties. For children who experience the constant and chronic exposure to chemical dependence in the home and in their communities, the journey to adulthood can be fraught with danger and lifelong developmental difficulties. The use of illicit substances has increased steadily over the past twenty-five years. Clinicians and therapists are encountering rapidly growing numbers of children and adolescents who report drug abuse as a result of modeling and/or experimentation. Researchers have hypothesized that substance use may serve as a major focal point for social interaction and may provide adolescents with a sense of group identity. Data from the National Institute on Drug Abuse (1988) National Household Survey on Drug Abuse (1990), the National Institute of Justice (1988), and Drug Use Forecasting Annual Report (1990) may put the problem in perspective. The 1990 report suggests that, nationwide, 25 percent of youths, age 12 – 17, have had experiences with illicit drugs (including marijuana, hallucinogens, inhalants, cocaine, heroin, or prescription type psychotherapeutic drugs, such as stimulants, sedatives, tranquilizers, and analgesics) for nonmedical purposes.The National Institute of Justice’s data is reported on a selected city basis and provides no national aggregates. Another reliable source on the epidemiology of adolescent substance use is the National School Survey (University of Michigan Institute for Social Research, 1992). According to this survey: 88 percent of teens have tried alcohol by senior year, 36.7 percent of high school seniors have tried marijuana followed by:
Etiologic factors Much of the early information concerning the background of substance use was based on retrospective studies. The extant literature indicates that the initiation and early stages of substance use are promoted by a complex array of cognitive, psychological, attitudinal, social, personality, pharmacological and developmental factors, as well as knowledge and normative expectations. Many theories have been formulated in an effort to explore the causes of substance abuse. Research results lead to the inescapable conclusion that there is a multitude of interrelated causes, with no single factors, necessary for the initiation of substance use. Social-learning theory According to social-learning theory, individuals learn how to behave through a process of modeling and reinforcement. Basically, individuals assimilate and mirror behaviors by observing the actions of others and the consequences of their actions. Repeated exposure to successful high-status role models who use substances, whether these role models are figures in the media, peers or older siblings, is likely to influence children and adolescents. Similarly, the perception that smoking, drinking or drug use is standard practice among peers also serves to promote substance use. These influences may suggest to adolescents that substance use is socially acceptable, and perhaps even necessary, if a child or adolescent is to be known as being “down with it,” or “tough.” This perceived social payoff for substance use is likely to increase adolescent susceptibility to peer pressure.
Adolescents who have goals for the future that are inconsistent with substance use and who are aware of the negative consequences of substance use would be expected to be less likely to smoke, drink or use drugs. It would appear that susceptibility to social influences generally, and some influences promoting substance use in particular, are related to low self-esteem, low self-satisfaction, low self-confidence, greater need for social approval, low level of assertiveness and impatience to assume adult roles or to appear grown up. Problem-behavior therapy
Problem-behavior therapy focuses specifically on
problems occurring during adolescence, such as substance use, precocious sexual
behavior, delinquency and truancy. Problem-behavior therapy derives from a
social psychological framework and recognizes the complex interaction of
personal factors (cognition, attitudes, beliefs), physiological-genetic factors
and perceived environ- A problem behavior is one that is identified as problematic within the context of a particular value system. The problem typically elicits a social response designed to control it. The social response may be informal and merely induce disapproval, or like incarceration it may be both formal and substantial. According to problem-behavior therapy, the reason adolescents engage in such problem behavior as substance use and premature sexual initiation:
These behaviors may also help them achieve some personal goal such as admission to a particular peer group. A closer analysis of problem behavior strongly suggests that vulnerability to engage in substance use is greater for children and adolescents who have fewer effective coping strategies in their repertoire, few skills for handling social situations and greater anxiety about social situations. The discomfort in interpersonal situations experienced by these children and adolescents prompts them to take action to alleviate this discomfort.
Risk factors for children and adolescent drug
abusers
Recent research on the effects of laws on alcohol consumption has focused on three legal interventions (a) taxation; (b) laws stating to whom alcohol may be sold; and (c) laws regarding how alcohol is to be sold. Studies examining the relationship of minimum drinking age and adolescents and driving have generally shown that lowering the drinking age increases teen drinking and driving and teen traffic fatalities. Conversely, raising the minimum drinking age decreases teen driving while intoxicated.
Availability is dependent in part on laws and norms of society. However, availability is a separable factor. Whether or not particular substances are legal, their availability may vary and is associated with use. Research further indicates that when alcohol is more available, the prevalence of drinking, the amount of alcohol consumed, and the heavy use of alcohol all increase.
Indications of socioeconomic disadvantages such as poverty, overcrowding and inadequate housing have been shown to be associated with an increased risk of childhood conduct problems and delinquency. However, research on social class and drug use has not always confirmed popular stereotypes. In contrast, Robins and Ratcliff (1979), found that extreme poverty, though not lower-class status, was one of the three factors that increased the risk of adult antisocial behavior, including alcoholism and illegal drug use among children who were highly antisocial in childhood. Wherever there appears to be a negative relationship between socioeconomic status and delinquency, a similar relationship has not been found for the use of drugs by adolescents. Only when poverty is extreme and occurs in conjunction with childhood behavior problems, has it been shown to increase risk for later alcoholism and drug problems.
Neighborhoods with high population density, lack of natural surveillance of public places (C.A. Murray, 1983), high residential mobility, physical deterioration, low levels of attachment to neighborhood (Herting & Guest, 1985) and high rates of adult crime also have high rates of juvenile crime (Wilson & Herrinstein, 1985) and illegal drug trafficking. Neighborhood disorganization has been considered a contributing factor to a deterioration in the ability of families to transmit pro-social values to children. Even though few studies of neighborhood disorganization have explicitly examined its relationship with drug abuse, a deterioration in parental socialization and supervision associated with the neighborhood disorganization could also be expected to produce high rates of drugs.
Research indicates that sensation-seeking and low harm avoidance can predict early onset of alcoholism. Poor impulse control in childhood predicts frequent marijuana use at age 18. Early onset alcoholism that is associated with impulsivity and aggression apparently has a partial foundation in individual physiological characteristics.
Families affect children’s drug use behavior in several ways beyond the genetic transmission of a propensity to alcoholism in males. Family modeling of drug using behavior and parental attitudes toward children’s drug use are family influences specifically related to the risk of alcohol and other drug abuse. Poor parenting practices, high levels of conflict in the family and a low degree of bonding between children and parents appear to increase risk for adolescent problem behaviors generally, including the abuse of alcohol and other drugs.
Children and adolescents are at risk for substance abuse by family management practices that are characterized by unclear expectations for behavior, poor monitoring of behavior, few and inconsistent rewards for positive behavior and excessively severe and inconsistent punishment for unwanted behavior.
Conflict among family members appears more important in the prediction of delinquency than does family structure. Children raised in families high in conflict appear to be at risk for both delinquency and illegal drug use.
Parent-child interaction, characterized by lack of closeness and lack of maternal involvement in activities with children, appears to be related to initiation of drug use. Positive family relationships and involvement and attachment appear to discourage youth initiation into drug use.
The greater the variety, frequency and seriousness of childhood antisocial behavior, the more likely antisocial behavior will persist into adulthood. Children who were irritable, easily distracted, had temper tantrums, fought often with siblings and engaged in pre-delinquent behaviors were more likely to use drugs in adolescence. School misconduct was one of the three most important predictors of alcohol-related problems.
Failure in school is a predictor of adolescent drug abuse. Poor school performance has been found to predict frequency and levels of illegal drugs. What is not clear from the existing research is that developmentally poor school achievement becomes a stable predictor of drug abuse.
Factors such as how much students like school, time spent on homework and perception of the relevance of course work are also related to levels of adolescent drug use. This indicates a negative relationship between commitment to education and frequent drug use among junior and senior high school students.
Peer use of substances has consistently been found to be one of the strongest predictors of substance use among youth.
Alienation from the dominant values of society, low religiosity and rebelliousness has been shown to be positively related to drug use and delinquent behavior.
Studies have shown that drug use initiation is preceded by values favorable to its use.
Early onset of drug use predicts subsequent misuse of drugs. Earlier initiation into drug use also increases the probability of extensive and persistent involvement in the use of more dangerous drugs and the probability of involvement in deviant activities, such as crime and the selling of drugs. Developing Resilience in Children and Adolescents Some children and adolescents who are exposed to multiple risk factors do not become substance abusers, juvenile delinquents, school dropouts or teen parents. It appears their exposure to risk factors has been balanced or countered in some way. A key strategy in balancing or countering risk factors is to support elements of peoples’ lives that engender positive behavior, health, well being and personal success, thereby reducing the impact of risk factors or changing the way the child or adolescent responds to them. (For the purpose of this section, “protective” and “resilience factors” are used interchangeably.) Studies indicate that protective factors fall into three basic categories: 1. Individual Characteristics – Having a resilient temperament or a positive social orientation are protective factors. 2. Bonding – Bonding is another protective or resilience factor that can provide motivation for children and adolescents to not succumb to drugs and alcohol. Lasting motivation comes from strong attachments or relationships, beginning with parents and continued by schools, friends and other caring adults, who hold healthy beliefs and clear standards and who recognize, appreciate and encourage the child’s uniqueness and positive behavior.
3. Clear Beliefs and Standards – When parents teach
— and communities set — clear pro-social standards against delinquent behavior
or alcohol and drug use that are widely and consistently expected, children and
adolescents are likely not to engage in negative behavior. When a young person
is bonded to those who hold healthy beliefs, he or she does not want to threaten
the bond by behaving in ways that would jeopardize these affirming
relationships. Bonding, healthy beliefs and clear standards work together to
protect children and adolescents from the lure of alcohol and drugs. Opportunity Children must be provided with meaningful, useable opportunities to contribute to their families, schools and communities. If faced with opportunities that are beyond them they will be frustrated. (Likewise, if they are presented with opportunities that are too easy they will be bored.) Examples of opportunities that offer protection/resilience in thwarting alcohol and drug use include teachers who provide active roles for children in the classroom. Skills Children must be taught the skills necessary to effectively take advantage of the opportunities offered. Reading and problem solving are skills shown to be protective, as well as the ability to communicate, to be assertive and to ask for support. Recognition
Children must be recognized and acknowledged for
their efforts. Recognition gives them the incentive to continue to contribute
and reinforces their skillful performances. Fred J. Dyer, is a speaker, trainer and consultant to social service agencies, organizations and corporations on the subjects of chemical dependency, violence and other mental health issues, especially as they affect adolescents and their families.
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