The following study examines the three main categories of psychological problems in adolescence, namely substance abuse, externalizing and internalizing disorders. It focuses on the above mentioned problems by giving their definition, prevalence and main causes. In addition, the study suggests ways of treatment for the different psychological problems. Furthermore, it explains the co-morbid (co-occurrence) for each of the psychological problems observed in adolescence.
- Introduction
Regardless of the negative attitude stereotype of the psychological problems in adolescence, many statements are just myths. Some of those myths are connected with the origin and continuation of the psychological problems. Even though some adolescents develop psychological problems, it is commonly unlikely to persist with those in the adulthood. Furthermore, it is important to mention that not all psychological problems begin in adolescence, neither are they biologically rooted.
- Categories of Psychological problems
- Substance abuse
Substance abuse is characterized with the maladaptive use of legal (alcohol and nicotine), illegal (marijuana and cocaine) and prescription drugs (stimulants and sedatives).
Amongst the most commonly used substances in the United States and New Zealand are nicotine and alcohol. According to the National Service of Healh and Wellness in NZ, 2007 almost all teens have used alcohol. The same study shows that slight proportion of teenagers who have tried smoking is smoking on a weekly basis. A recent study of the National Service of Health and Wellness in NZ shows that actual use has declined with 16 000 in 2012 as compared to 2007, due to higher cigarette taxes. Interesting to be noted is that the smoking ratio of females: males is positive. Regarding the illegal drugs, there is no significant gender difference in rates of use. However, while most of the male ascendants have tried cocaine, stimulants or narcotics, females are pointed to have tried more of glue and ecstasy. Among the common causes for substance abuse in adolescence are believed to be conflicts in the family, friend’s influences and society with no defined rules. Even though many treatments have been tried against substance abuse, only few have worked. Amongst the main ones are educating about danger of drugs, social skills trainings and adolescent self-esteem.
- Externalizing disorders
Externalizing disorder occurs when problems are turned outwards and turned into behavioral problems (e.g. delinquency and antisocial aggression). There are three main categories of externalizing disorder, namely Conduct/anti-social disorder, Juvenile Offending, and Aggression.
Conduct/Anti-social Disorders
This is anti-social behavior that violates the rights of others and leads to problems in school or social relationships. This disorder requires clinical diagnoses and could be divided into four sub-categories: oppositional-defiant disorder, childhood disorder (excessive anger but no aggression), anti-social personality disorder and adulthood disorder (antisocial behavior and disregards of rules).
Juvenile Offending
The Juvenile Offending is externalizing problem that includes criminal behavior. It is divided into two sub-groups, namely delinquency and criminal behavior.
Aggression
The disorder of aggression occurs when there are intentional acts to hurt somebody. It is divided into two sub-groups, namely instrumental (planned) or reactive (unplanned).
The prevalence shows clear gender difference, correlation with poverty and neglecting of inappropriate behavior. The main causes of externalizing problems are claimed to be pathology of childhood-onset delinquents, family factors (ineffective parenthood, mistreated children), violent character and others. Best treatment program would involve early family intervention.
- Internalizing disorders
Internalizing disorders occur when problems are turned inwards and expressed in emotional and cognitive distress. There are two main categories of internalizing disorders, namely Depression and Suicide.
Depression
Depression is a psychological disturbance, shown via the low self-esteem, decreased motivation or sadness. It occurs when individuals, predisposed to internalizing problems are exposed to stress from academic difficulties, family problems, breaking-ups and others. Higher prevalence in NZ is observed for females than for males. In fact, before adolescence, more males are likely to have depression, but afterwards the the ratio females: males is almost doubled. The most common treatment approaches are biolocigal therapies, psycho and family- therapies.
Suicide
Suicide disorder is characterized with the desire of adolescents to attempt to kill themselves. According to a study of the Ministry of Health, performed in 2012, even though suicides have declined for the last couple of decades, the prevalence of suicide in NZ remains relatively high (78 youth males and 35 youth females). The main factors for this high numbers are psychiatric problems and family history.
- Co-morbid problems/disorders
Co-morbid disorders appear at the same time with the same individuals. Studies show that they are more common for females than males. There are different types for the different categories of psychological problems.
- Co-morbid problems of externalizing problems
Problem behavior syndromes- trait driven
The problem behavior syndrome represents unusualness in personality and social environment (e.g. liberal point of view, poor connection to educational and religious institutions, and tolerance of deviance).
Problem clusters- behavioral
The problem cluster co-morbid problem is a cascading effect. It occurs when the involvement in one problem leads to the involvement in another problem.
Social Control theory- social
The social control theory links criminal behavior to absence of strong bonds between individuals and the social institutions around them. This co-occurrence is more common for females than for males
- Co-morbid problems of internalizing problems
The Co-morbid of internalizing problems is less extensively studied than of externalizing problems, though may occur when an individual becomes easily distressed.
References
Liu, J.. (2004). Childhood Externalizing Behavior: Theory and Implications. National Institute of Health . 17 (3), p93-103.
Ministry of Health New Zealand (2007). Suicide Facts. Deaths and Intentional self-harm hospitalisation. 1 (1), p1-21.
Saisan, J (2013). Substance Abuse & Mental Health. Available: http://www.helpguide.org/mental/dual_diagnosis.htm. Last accessed 2nd June 2013.
