Adolescent High Risk

Behaviors
Massiel K. Sarmiento
PGY-3
LMMHC
 Introduction

• Young people undergo rapid changes in body structure and

physiologic, psychological, and social functioning between the ages
of approximately 9 to 10 and 20 yr.

Early Adolescence Middle Adolescence Late Adolescence

*Concrete operations *Emergence of abstract thought *Future oriented perspective

*Unable to perceive long *May perceive outcomes, but may not apply to *Peer group/value recede in
term outcomes decision making importance
*Same sex affiliation *Preoccupation with peer culture
 Limbic development preceeding development of
Prefrontal cortex may explain increased potential for risk
taking, recklessness and onset of emotional and
behavioral problems
 Introduction Continued

• Hormones set this developmental agenda together with social

structures designed to foster the transition from childhood to
adulthood.
• Risk-taking is limited in early adolescence, peaks in middle
adolescence; escalation of risk-taking behaviors is
problematic.
The Epidemiology of Adolescent Health Problems
Burstein, Gale R., Nelson Textbook of Pediatrics, Chapter 111, 937-939.e1

Copyright © 2016 Copyright © 2016 by Elsevier, Inc.

Leading cause of Male Female
Death age 15-19
Yr.
#1 Accidents Accidents
(unintentional (unintentional
injuries) injuries)

#2 Assault Intentional self-

(homicide) harm (suicide)

#3 Intentional self- Assault

harm (suicide) (homicide)
* Based on data from Heron M: Deaths: Leading causes for 2009. National vital statistics reports; vol 62. No. 6.
Hyattsville, MD, 2013, National Center for Health Statistics.
Health Risk Behaviors - Trends

Injury-related behavior Tobacco use

Unsafe sexual behavior Alcohol use

Inadequate physical activity Marijuana use

Poor nutritional habits Prescription & OTC use

Violence

Arrows denote trends in prevalence over past decade

Leading Causes of Death in U.S.: Ages
10-19 & Ages 25-44, 2010
Motor Vehicle Accidents
Adolescents Other Unintentional Injuries Adults
Homicide
Suicide
9%
Malignant Neoplasms
22% Heart Disease
24% Other
31%
17%

3%

8% 6%
15%

12% 11%
14%
14%
14%

Source: National Center for Injury Prevention & Control, WISQARS database, 2012
 Behaviors that contribute to
unintentional injury/violence

Not wearing Seatbelt: 7.6%

Helmet: 87.9%. Higher risk in males

DUI: 10%. > Hispanic males. Riding w/driver having

drunk alcohol: 21.9%. > Black females.

Text/Email while driving: 41.4%. >Hispanic males

Cyberbullying
 Link between Media and Risk Taking

• Media has profound influence on cultural norms and an adolescents’ sense of

identity.

• 7 hr/day (e.g., television, Internet).

Fad Behaviors
Dangerous Social Media Challenges

Tide Pod challenge

 “Skitching”

Hanging onto a car while riding a skateboard/bike or

rollerblades.
 “Ghost riding the whip”

* Exiting a moving vehicle, and dancing beside and around it.

https://m.youtube.com/watch?v=7688P
3Tt6RM
 “Car Surfing”

• Riding on the outside of a moving vehicle being driven by another person.

• CDC identified 58 reports of car-surfing deaths. 41 nonfatal injurires (1990-

2008).

• Most cases in Midwest and Southern.

• Males (70%) and youths aged 15–19 (69%).

http://youtu.be/yKk-YPDIqzU
 “Planking”

The activity consists of lying face down — like a board — on any

surface. Participants snap a photo and upload it to the internet,
where planking groups have proliferated to immortalize the most
daring
 “Choking/Fainting game”

• Use of restraints or the assistance of a friend to choke the player.

• Cutoff blood flow to the brain with the goal of inducing temporary syncope and
euphoria.

• Risk for seizures, stroke, injuries.

• More common in 9-16 yo Males.

• Reported deaths of 250-1000/yr. Often mistaken for suicides.

Substance Use
 High Risk Behavior: Drugs

• Alcohol: most commonly used/abused drug. Cause of death

in ~ 4,300/yr.

• 11% consumed in US is by 12-20 yo, >90% binge drinking.

• Inhalants: Glue sniffing, aerosol spray, paint (8.9%).

 “Sizzurp/Purple drink”

OTC drugs: cough syrup with codeine + soft drink

and candy (usually Sprite and Jolly Ranchers) used as
recreational drug.

Made w/ over-the-counter medications like Robitussin

DM, which contains dextromethorphan.
 “Bath Salts/Purple Wave/ Bliss”

• Contain Mephedrone and MDPV, leads to hallucinations/psyc

hosis, sever agitation.

• Smoked, snorted, or injected.

• In 2011, Poison control centers received 3,470 calls about bat

h salts from Jan-June, according to the American Association o
f PCC.
 High Risk Behavior: Sex

• Sexual behaviors that contribute to unintended pregnancy and STIs.

YRBS survey 2013:

• 47% had sexual intercourse.

• 34% sexual intercourse w/i 3 months, 41% did not use a condoms.
• 15% had had sex with four or more people during their life.
• Only 22% of sexually active students had ever been tested for HIV.
10,000 (aged 13-24) dx with HIV in 2013.

Young MSM and bisexual men (aged 13-24) - 19% of all new HIV infections,
72% of youth.

~1/2 of the 20 million new STIs each year - 15 to 24.4 yo

Approximately 273,000 babies were born to teen girls aged 15–19 years in 2013.
• Dating violence: physical, sexual, psychological, or emotional violence
within a dating relationship, including stalking.

• 2011 CDC: survey found 23% of females and 14% of males who ever
experienced rape, physical violence, or stalking by an intimate partner,
first experienced some form of partner violence between 11 and 17
years of age.
*Sexting:

* Twenty percent of students with text-capable cell phone access reported receiving a sext and 5% reported sending a sext.

* Students who text at least 100 times per day were more likely to report both receiving (odds ratio [OR]: 2.4) and sending (OR:
4.5) sexts and to be sexually active (OR: 4.1).
 High Risk Behaviors: Unhealthy
dietary habits

YRBS 2013 survey:

• 47.7% trying to lose weight.

• 13.0% of students had not eaten for 24 or more hours to lose weight
or to keep from gaining weight. > WF

• 5.0% of students had taken diet pills, powders, or liquids without a

doctor’s advice.

• 4.4% of students had vomited or taken laxatives.

Obesity:13.7%. Linear increase from 2011-2013 (10.6-
13.7%)

Overweight: 16.6%. Increase from 2011-2013 (14.1-

16.6%)
Questions?????
Thank You