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Just Because They Can Doesn’t Mean They Do

Understanding of adolescent decision making has moved beyond simple “age differences in risk perception and reasoning” to include relevant social and emotional factors that directly inform when and how adolescents make decisions about everything from substance use to condom use.[i]

Adolescence is defined as the period between which “physiologically normal puberty” initiates and adulthood begins.[ii] Though adulthood is often culturally defined in legal terms, the World Health Organization defines adolescence as that time in human development characterized by “rapid physical, cognitive and psychosocial growth,” typically occurring between 10 and 19 years of age.[iii] Though most adolescents are considered medically “healthy,” negative outcomes associated with unhealthy risky behavior is the leading cause of death amongst this demographic.[iv]

Adolescents in fact possess the same cognitive abilities to evaluate risky behaviors as do adults. However, their ability to competently evaluate risky-behavior and make decisions in their best interest is directly dependent upon the presence of “neutral circumstances,” i.e., removed of stress, peer pressure and the potential for dopamine gain.[v] Furthermore, adolescents seem to have a “greater tendency to gamble when the outcomes of those decisions are unknown or unfamiliar.[vi] In other words, “just because they can doesn’t mean they do” make the right decisions in large part due to numerous influence factors.

What influences adolescent decision making?

  • Peer Influences
    • Adolescents are more likely to engage in certain risky behaviors when accompanied by others their age than when alone.[i] For example, they are more likely to drive at excessive speeds, try tobacco, marijuana and alcohol, etc. Being friends with others who engage in risky behavior involving substance use directly predicts an adolescent’s subsequent decision making.
  • Short-term vs. Long-term Decision Making
    • Adolescents do not necessarily believe themselves to be invulnerable to harm but rather tend to seek experiences that provide a high dopamine or “feel good” gain.[ii] It’s not that they think they are invincible but rather the reward to or a positively perceived stimuli is “worth it” in the moment. Furthermore, negative outcomes are not necessarily good “learning” opportunities for adolescents. Experiences deemed “positive” and offering high emotional gains, however, do affect subsequent decision making. They are therefore more likely to engage in risky behavior that makes them feel good, than they are to avoid risky behavior with a negative outcome.[iii] If only they could learn from their “mistakes” or losses the same way.
  • Adverse Childhood Experiences (ACEs)
    • ACE’s include physical and emotional neglect, sexual abuse, violence, parental incarceration, household substance use, etc. and put adolescents at greater risk of “impaired self-regulation” due to the negative effects of trauma on both cognitive and social-emotional development.[iv] Research shows that ACE’s influence age of first sexual encounter and substance use.
  • Parental Engagement
    • Parent communication and parenting styles affect adolescent decision making. Secure attachments to primary care-givers (particularly mothers), as well as well-informed families and peer-groups, all help adolescents develop healthy relationships with others and a subsequent decline in risky behavior, particularly regarding sexual behavior and contraceptive use.[v]

As parents and teachers of adolescents, how can you help?

The more informed parents and caregivers are about how adolescents are making decisions, as well as what external and internal motivators influence them, the more effective is their ability to help them make decisions that have positive effects on their health. Programs and healthy risk taking need to be emphasized and structured with these facts in mind.

Designing programs to improve adolescent health should seek opportunities to address the community and social factors that inform adolescent decision making. This can be done in collaboration with community outreach and schools. Potentially, even including target populations in the design of the very programming intended to help them allowing for their authentic perspectives.

Healthy risk taking must be encouraged during adolescence. From physical, emotional, social, intellectual, and spiritual, adolescents need to the opportunities to make “low-stakes” decisions for themselves. Not all risk taking is negative and “healthy risk taking” is a normal part of adolescent development that must learned and nurtured. Examples could include:

Physical

  • Participating in a team sport
  • Trying a new food

Emotional

  • Reaching out for help
  • Apologizing for a mistake

Social

  • Public speaking
  • Asking someone out on a date

Intellectual

  • Enrolling in a challenging course
  • Applying knowledge to a new situation

Spiritual

  • Experimenting with different values systems and identities
  • Volunteering for a good cause

While there have always been a myriad of reasons contributing to an adolescent’s decision-making process, we now find ourselves with more data and information to better navigate the elusive mind of an adolescent. We can develop better programs and have better conversations to help ensure we’re reinforcing healthy practices and dissuading risky activity for our young people. Providing them impactful information so they “do make the right decision” vs. “can make the right decision.”

 

(Source: National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. https://doi.org/10.17226/25552.)

[i] Albert et al., 2013.

[ii] Wolff, J. M., & Crockett, L. J. 2011.

[iii] Reyna, V. F., & Farley, F. (2006). Risk and rationality in adolescent decision making: Implications for theory, practice, and public policy. Psychological Science in the Public Interest, 7(1), 1-44. doi:http://dx.doi.org/10.1111/j.1529-1006.2006.00026.x

[iv] Williams, A. (2020). Early childhood trauma impact on adolescent brain development, decision making abilities, and delinquent behaviors: Policy implications for juveniles tried in adult court systems. Juvenile and Family Court Journal, 71(1), 5–17. https://doi.org/10.1111/jfcj.12157

[v] Commendador, K. (2011). The relationship between maternal parenting style, female adolescent decision making, and contraceptive use. Journal of the American Academy of Nurse Practitioners, 23(10), 561–572. https://doi.org/10.1111/j.1745-7599.2011.00635.x

 

Written by: Helen Baker-Health Educator, Candor Health Education