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Wisconsin Council on Children Families Inc Defining Adolescence

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  • pg 1
									 Wisconsin Council on Children &
          Families, Inc.
                16 N. Carroll St. #600
                 Madison, WI 53703

                      1/877-23BRAIN

                          608/222-1798

                     nbrien@wccf.org                               Sponsored by:
                      www.wccf.org                                 Southern Child
                                                                   Welfare Training
                                                                   Partnership
                             Nan Brien
                Wisconsin Council on Children and Families, Inc.




        Defining Adolescence
That awkward period between sexual maturation
  and the attainment of adult roles and
  responsibilities.
  • The transition from:
          “child” status (requires adult monitoring)
                               to
          “adult” status (self-responsibility for behavior).
  • The developmental interval that encompasses the
    body and brain changes of puberty.

                Wisconsin Council on Children and Families, Inc.




     Pragmatic Problems: The Health
         Paradox of Adolescence
• Measures of most abilities indicate adolescence
  is the healthiest and most resilient period of the
  lifespan
• From Childhood to Adolescence:
   – Improvements in strength, speed, reaction time,
     mental reasoning abilities, immune function …
   – Increased resistance to cold, heat, hunger,
     dehydration, and most types of injury …
• Yet: overall morbidity and mortality rates
  increase 200-300% from childhood to late
  adolescence
                Wisconsin Council on Children and Families, Inc.
       Sources of Morbidity and
       Mortality in Adolescence
• Primary causes of death/disability are related
  to problems with control of behavior and
  emotion.
• Increasing rates of accidents, suicide, homicide,
  depression, alcohol & substance use, violence,
  reckless behaviors, eating disorders, health
  problems related to risky sexual behaviors…
• Increase in risk-taking, sensation-seeking, and
  erratic (emotionally-influenced) behavior.

                 Wisconsin Council on Children and Families, Inc.




     Adolescence in traditional
  societies: interval between child
           and adult status
• End of childhood usually marked by puberty
  (ritual)
• Onset of adult status in traditional societies
   –    marriage
   –   work roles (e.g. hunting)
   –   owning property
   –   becoming a parent
   –   independence (absence of monitoring)
• Interval between puberty & marriage as an index
                 Wisconsin Council on Children and Families, Inc.




  Puberty, Marriage, and Adult
  Roles in Contemporary Society
          (United States)
   • Average age of menarche is now age 12;
     average age of first marriage for females is 26.
   • Recent changes reflect this pattern:
        – In 1970 timing of first marriage in the U.S:
           • age 21 for women
           • age 23 for men
        – By the 2000 census this had changed:
           • age 26 for women
           • age 27 for men.

                 Wisconsin Council on Children and Families, Inc.
     Puberty, Marriage, and Adult
     Roles in Contemporary Society
• Many adult social roles—starting careers, owning a
  home, choosing to become parents—are now
  occurring a decade or more after puberty.
• These changes have advantages (especially academic
  and economic opportunities).
• These changes have costs (and create vulnerabilities).
• ADOLESCENCE HAS EXPANDED from a 2-4 year
  interval in traditional societies to an 8-15 year
  interval in contemporary society.
                   Wisconsin Council on Children and Families, Inc.




         Historical Changes in
             Adolescence:
   Implications Regarding the Brain
   • The dramatic expansion of the adolescent
     interval raises critical questions about
     brain development
   • Evidence suggests that some brain
     changes are linked closely to puberty
     while other aspects of maturation are
     dependent on age/experience

                   Wisconsin Council on Children and Families, Inc.




     Biology of Brain Development
                    Major Concepts

   • Progressive Development of the Brain
      brain cells migrate from the brainstem to the cortex

   • Critical Windows
      associated with the migration of brain cells

   • Nature vs Nurture: genetics vs environment
               Nurture
      nature (48%): life systems
      nurture (52%): thinking and emotion

                         WI Council on Children & Families
                                 Brain: Side View

     limbic                                                                                           cortex
     system
midbrain                                                                                        cerebellum



                                       brainstem


                                         Wisconsin Council on Children and Families, Inc.




                                                     Cortex
                                                                                               Parietal
              Frontal
                                                                                                    Occipital




     Occipital -vision
     Parietal - touch
     Temporal - language                                  Temporal
     Frontal - thought,
     logic, reason                       Wisconsin Council on Children and Families, Inc.




                Cortical =12                     Normal                                     Cortical = 10


                   Limbic = 8                       20             Neglect                   Limbic = 6        16
   Midbrain = 6                                                             Midbrain = 6
                                                    10                       Brainstem = 4                     10
    Brainstem = 4
                                                   2.0                                                         1.6

               Cortical = 12                                                            Cortical = 10
                                             Trauma
                                                                                             Limbic = 6        16
                   Limbic = 8                     20
                 Midbrain = 8                                                               Midbrain = 8
                                                                                             Brainstem = 6     14
                Brainstem = 6                      14
                                                                          Neglect & Trauma                     1.1
Wisconsin Council on Children & Families, Inc.    1.4
     Adolescence: Behavioral
             Change
• Strongest link to pubertal change:
  romantic motivation, sexual interest,
  emotional intensity, sleep/arousal
  regulation, appetite, and affective disorders

• A general increase: risk-taking, novelty-
  seeking, sensation-seeking (reward-
  seeking).
             Wisconsin Council on Children and Families, Inc.




  Developmental Framework
• Early activation and maturation of new
  emotional and motivational tendencies
  (“igniting passions”)
• Gradual and prolonged maturation of
  self-regulatory skills and judgment
• Contemporary adolescent social contexts
  filled with complex, ambiguous, and
  emotionally arousing situations
             Wisconsin Council on Children and Families, Inc.




         Puberty and Brain
           Development
• Some brain changes precede pubertal
  increase in hormones and body changes
• Some brain changes appear to be the
  consequence of some pubertal processes
• Some adolescent brain maturation
  appears to be independent of pubertal
  processes
• Potential for creating internal havoc

             Wisconsin Council on Children and Families, Inc.
  Brain Changes: Pre-Puberty

Turning on of brain regions that lead to:
  • Production of estrogen (girls) and
    testosterone (boys)
  • Development of secondary sexual
    characteristics
  • Changes in growth-hormone secretions and
    rapid physical growth


            Wisconsin Council on Children and Families, Inc.




     Brain Changes: Puberty

• Functional maturation of the amygdala
  and to some degree in ventral prefrontal
  cortex (perhaps) – gut feelings
• Changes in emotion – intensity and
  reactivity
• Sleep/arousal patterns

            Wisconsin Council on Children and Families, Inc.




  Behavioral Impact: Puberty

• Romantic motivation, sexual interest,
  emotional intensity (igniting passions),
  sleep/arousal regulation, appetite (growth),
  and affective disorders

• Risk-taking, novelty-seeking, sensation-
  seeking, reward-seeking (hot cognition)


            Wisconsin Council on Children and Families, Inc.
               Brain Changes: Age-Related
         Cognitive changes

                • Dorsolateral prefrontal cortex (DLPFC) –
                  control of emotional behavior includes a
                  cognitive process that is abstract or in the
                  temporal domain (such as weighing the
                  possibility of future consequences)



                            Wisconsin Council on Children and Families, Inc.




       Prefrontal Lobe and Amygdala




Drevets et al. 2000

Davidson et al. 2000




                            Wisconsin Council on Children and Families, Inc.




                       Behavioral Impact: Age-
                              Related
         • Weighing long-term consequences of
           behavior
         • Navigating complex social situations in
           the face of strong emotions and/or
           conflicting feelings
         • Self-control and planning: affect
           regulation

                            Wisconsin Council on Children and Families, Inc.
        Adult Affect Regulation

 A combination of cognitive skills (using
   learned rules, strategies, and plans in the
   pursuit of long-term goals) and emotional
   self-regulation (ability to navigate strong
   feelings, desires, and competing
   motivations) that fosters mature judgment,
   social skills, the attainment of one’s goals,
   and behavioral/emotional health.
                 Wisconsin Council on Children and Families, Inc.




                 Gray Matter:
            Growth Spurts & Pruning
Gray Matter: dendrites
  • Growth spurt just before puberty (predominately in
    frontal lobe)
  • Loss between ages 12 & 20; striking loss after age 16;
    total loss of 7-10%
Example: caudate (deep in brain) – involved with
  automatic motor movements, i.e., biking, playing
  musical instrument; gymnastics
  • Gray matter increases until ages 8-11; 20% loss by age 13
  • Those who learn early are more facile; more natural

                 Wisconsin Council on Children and Families, Inc.




dendrites
                                                                     Neurons
                                                                    cell body


                                                                    myelin sheath




                                                         axon

                 Wisconsin Council on Children and Families, Inc.
                     Gray Matter:
                   Adolescent Pruning
  Pruning of synapses leads to:
      • Specialization – motor skills, languages
      • Fine-tuning
          o inhibition control
          o working memory
      • Changes in neurotransmitter levels
          o dopamine: higher – adolescents; lower – adults

  “Relative inefficiency in frontal circuitry”
                              Robert McGivern, San Diego State University

  (Adolescents are using their more active/mature limbic region)

                     Wisconsin Council on Children and Families, Inc.




                        Myelination
Myelination increases efficiency of messaging
  • Corpus collosum - more efficient linking of hemispheres
      o verbal & written expression (Wernicke’s area) – better essays (more
        depth, better organization)
      o speech (Broca’s area) – more intellectual communication
      o logic (parietal cortex)
  • Cingulate - integral part of the circuit that connects quick
    reactions to historical context (teens are more apt to go with
    “gut feeling”)
Myelination makes circuits that link emotional and
 intellectual responses more efficient. Brain becomes
 less plastic, however.

                     Wisconsin Council on Children and Families, Inc.




                       Implications

      1. Practice
      2. Guidance

      3. Clear-cut expectations

  Family/Caregiver Influence
                     Wisconsin Council on Children and Families, Inc.
                          Summary
Earlier activation of some biologic maturational
  processes (changes in brains, bodies, and social
  experiences) may create relative asynchronies in
  the development of cognitive-emotional
  integration – particularly in some high-risk
  individuals and in some high-risk social contexts.
Policy implications:
   •   Protecting high-risk youth
   •   Identifying specific risks – affective disorders, drugs
   •   Media
   •   Positive, goal-directed, socially responsible activities

                   Wisconsin Council on Children and Families, Inc.




        Sleep/Arousal Regulation
 • Some developmental changes in sleep
   regulation are biologic and linked to
   puberty
 • Some changes in sleep regulation linked
   to social influences, habits, and patterns
 • Interactions between these domains can
   lead to a negative spiral of consequences
 • Small shift in motivation (tendency to
   stay up later) can lead to dramatic
   changes in behavior
                   Wisconsin Council on Children and Families, Inc.




  Sleep: Learning and Memory

 • Increasing evidence that sleep is
   fundamental to consolidation of learning
   (including procedural learning as well as
   explicit memory)

 • Some compelling hints that these
   processes are even more crucial during
   development
                   Wisconsin Council on Children and Families, Inc.
        Historical Changes in
            Environment
• In a social context, > 100 years ago when it
  became dark, there were limited options for
  stimulating activity:
   – Motivation to stay up later usually balanced
     by motivation (need) for more sleep
   – Limited options for multi-day “sleeping-in”
• Context of modern life alters this balance:
  access to light, stimulation, arousal at night

              Wisconsin Council on Children and Families, Inc.




  Pubertal Influences on Sleep
    and Arousal Regulation
• A pubertal shift in circadian (biologic clock) to
  preferring later bedtimes and rise-times
  (adolescent “owl” tendencies vs. child “lark”
  tendencies)
• Evidence that the need for sleep actually
  increases at puberty
• Greater daytime sleepiness (increased need for
  sleep) even if obtaining as much night sleep as
  prepubertal children
              Wisconsin Council on Children and Families, Inc.




  Circadian (Biological Clock)
           Problems
• School/Sleep Squeeze
• During summers, vacations, and weekends,
  adolescent sleep/wake schedules are phase
  delayed (e.g., 3 am - noon)
• Circadian advance requires slow, steady
  changes (students often partially-adapted to
  school schedules)
• Delayed circadian phase contributes to
  difficulty falling asleep, difficulty waking
              Wisconsin Council on Children and Families, Inc.
     Contributing Factors/Vicious
                Cycle
    • “Catch-up” sleep on week-ends pushes
      circadian system to further delay
    • Use of stimulants (caffeine and nicotine) can
      contribute to DFA (difficulty falling asleep)
    • Full time students working more than 20
      hours/week
    • Stress and conflict contribute to emotional
      arousal and further DFA

                   Wisconsin Council on Children and Families, Inc.




      Consequences of Insufficient
     Sleep in Adolescents (behavior
               & emotion)
• Difficulties with focused attention
• Tiredness (decreased motivation)
• Irritability, emotional lability
• Affect Regulation & Cognitive Emotional
  Integration more difficult
• Effects on learning, memory consolidation
• Negative synergy with alcohol
                   Wisconsin Council on Children and Families, Inc.




      A Spiral of Negative Effects?

    • Late night/erratic schedules => Sleep
      Deprivation
          => erodes mood and motivation
          => greater stress and affective problems
          => interferes further w sleep/arousal regulation
          => greater DFA


    • The Balance of Sleep/Arousal Regulation
       – tilted HEAVILY toward chronic arousal

                   Wisconsin Council on Children and Families, Inc.
      Summary Principles of
     Sleep/Arousal Changes at
             Puberty
• Relatively small changes in tendency to want to
  stay up later (motivational shift that has a basis
  in neurobehavioral systems)
• Can, in some social situations, result in a huge
  spiral of effects impacting every aspect of an
  adolescents life.
• Brain/behavior/social-context interactions are
  key to understanding this problem

              Wisconsin Council on Children and Families, Inc.




                           AOD
                                   &
             Adolescence

              Wisconsin Council on Children and Families, Inc.




           Natural Rewards

Survival-associated activities
   • Eating
   • Drinking
   • Sex

Satiation
              Wisconsin Council on Children and Families, Inc.
  Natural Rewards


    • Achievement

              • Success



    Wisconsin Council on Children and Families, Inc.




Anticipation of Reward



 Mimics actual reward




    Wisconsin Council on Children and Families, Inc.




  Reward System




    Wisconsin Council on Children and Families, Inc.
                                                       www.drug abuse.gov
                                                                  Neurons
dendrites
                                                                 cell body


                                                                 myelin sheath




                                                      axon

              Wisconsin Council on Children and Families, Inc.




            Neurotransmitter




              Wisconsin Council on Children and Families, Inc.




            Adolescent Brain

  PFC: more dopamine
      • Novelty
      • Salience


  Nucleus Accumbens: less dopamine
      • Pleasure
      • Anticipation

              Wisconsin Council on Children and Families, Inc.
                                  Results

     • NA – less motivation, less pleasure,
       therefore prone to greater risk-taking



     • PFC – novelty seeking, immediate
       gratification

                      Wisconsin Council on Children and Families, Inc.




       Pleasure-and-Reward Circuit
Adolescent reward system appears to bias choice
 toward excitement, even if that includes risk.
Circuit often becomes “risk-taking” and pleasure.
 Because of lack of full development in
 dorsolateral prefrontal cortex (DLPFC),
 consequences are often not considered.

“Not surprisingly, we’ve evolved to seek rewards that better our
  chances of survival. …many scientists now say, we also take
  certain risks because through our evolutionary history, it, too, has
  enhanced our chances of survival.”                    The Primal Teen
                      Wisconsin Council on Children and Families, Inc.




     Alcohol/Drugs and Risk-Taking

   • “Incentive salience” assigned to stimuli,
     including alcohol/drugs
   • Peer-group standards
   • High risk-taking behavior
   • Genetic predisposition

                      Wisconsin Council on Children and Families, Inc.
    Alcohol: Short-term Effects

 Interferes w/learning & memory
    • Impacts hippocampus (LTP)
    • Adolescents more sensitive than adults – just
      two beers


 Intoxication (sedation) & motor coordination
    • Less impact

               Wisconsin Council on Children and Families, Inc.




    Alcohol: Long-term Effects
 Decreased hippocampus size: leads to
  memory-impairment later in life.
    • Cause: binge or repeated heavy drinking
    • Result: cell death
    • Females: more vulnerable

 Alterations in normal brain development
  during adolescence

 Addiction
               Wisconsin Council on Children and Families, Inc.




           Alcohol and Stress
1. High levels of stress can reduce number of
  dopamine receptors, reducing dopamine
  effect, and predisposing to “get more”

2. Stress, specifically cortisol, may also
  activate dopamine transmission in the VTA,
  NA, and PFC to facilitate the pleasurable
  response to alcohol (gender implications)

               Wisconsin Council on Children and Families, Inc.
    Nicotine: Short-term Effects

Pleasure
Increased alertness & wakefulness
Improved learning & memory




              Wisconsin Council on Children and Families, Inc.




     Nicotine: Long-term Effects

 Addiction: twice as many receptors as adults
 Withdrawal: decreased sensitivity to pleasure;
  depression-like symptoms
 Panic Attacks: triggered by respiratory
  problems
 Females: cell death in hippocampus (estrogen)

              Wisconsin Council on Children and Families, Inc.




   Marijuana: Short-term Effects
Increased heart rate, dilated bronchial passages
Blood vessels in eyes expand – bloodshot
Pleasant sensations – euphoria
Colors & sounds – more intense
Time moves slowly
Thirsty, dry mouth
Impaired memory, balance, attention, judgment
Acute toxic psychosis – food & drink
              Wisconsin Council on Children and Families, Inc.
  Marijuana: Long-term Effects

  Short-term memory impairment
  Cell death (hippocampus) w/chronic use

  Addiction possible

  Reduced capacity for self-reinforcement:
   confidence & perseverance

                  Wisconsin Council on Children and Families, Inc.




        Meth: Short-term Effects

Increased attention & decreased fatigue
Increased activity
Decreased appetite
Increased respiration
Hyperthermia

Rush (smoking, injecting)
Longer-lasting high (oral ingestion or snorting)
                  Wisconsin Council on Children and Families, Inc.




        Meth: Long-term Effects

  Dependence & addiction
    •   Paranoia
    •   Hallucinations
    •   Mood disturbances
    •   Violent behavior
    •   Repetitive motor activity
  Destruction of nerve cell endings – dopamine &
   serotonin (50% or more damaged after
   prolonged exposure)
                  Wisconsin Council on Children and Families, Inc.
    Cocaine: Short-term Effects
  Cocaine: injected, inhaled
  Crack: smoked

  Increased energy
  Decreased appetite
  Mental alertness, increased performance
  Increased heart rate & blood pressure
  Constricted blood vessels
  Increased temperature
  Dilated pupils
                 Wisconsin Council on Children and Families, Inc.




    Cocaine: Long-term Effects

  Addiction
  Irritability & mood disturbances
  Restlessness
  Paranoia
  Auditory hallucinations
  Cognitive impairments – constricted
   cerebral blood vessels

                 Wisconsin Council on Children and Families, Inc.




                   Implications
Societal risk-factors
Biological risk-factors
  • revved-up limbic region; underdeveloped cortical
    regions, reward system susceptible to risk, sleep/arousal
  • motivation toward risk-taking
High-risk individuals
  • appropriate interventions
Average kid
  • need for structure and high-level thinking, planning
    activities; parental guidance
  • opportunities for risk-taking: cars, alcohol, drugs, peers,
    adult expectations, technology
                 Wisconsin Council on Children and Families, Inc.

								
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