Adolescence is a dangerous time. Some of the most life-threatening risks that people take--drunk driving, binge drinking, smoking, having unprotected sex--are especially common during the teenage years. The following statistics illustrate the enormous toll in human suffering caused by adolescent risk taking:
- Both males and females between the ages of 16 and 20 are at least twice as likely to be in car accidents than drivers between the ages of 20 and 50 are. Auto accidents are the leading cause of death among 15- to 20-year-olds, and 31 percent of young drivers killed in motor vehicle crashes in 2003 had been drinking.
- Three million adolescents contract sexually transmitted diseases every year.
- More than half of all new cases of HIV infection occur in people younger than 25, making AIDS the seventh leading cause of death among 13- to 24-year-olds. Two young people in the U.S. are infected with HIV every hour.
- Forty percent of adult alcoholics report having their first drinking problems between the ages of 15 and 19.
- Evidence of pathological or problem gambling is found in 10 to 14 percent of adolescents, and gambling typically begins by age 12.
In addition to the immediate consequences of risk taking--both for adolescents and for those who suffer from their actions--many behaviors that affect adult health begin and become entrenched during adolescence. So risky activities such as heavy drinking and drug use, which begin as voluntary experimentation, can be perpetuated by addiction. And whereas most teen drinkers, for example, do not progress to alcoholism, virtually all alcoholics started drinking in adolescence.
Preventing risky behavior while it is still a matter of deliberate choice is crucially important--not just for protecting troubled teens but also for society. An obvious answer is early intervention, which is both more successful and less costly than efforts to deal with established addictions later.
Strategies that help to postpone sexual activity, binge drinking and other risky behaviors also have the virtue of giving the forebrain and other neurological structures time to mature. As studies are now showing, the immature adolescent brain may be responsible for much of the risky business that young people engage in.
Over the past two decades, studies using magnetic resonance imaging (MRI) and other imaging techniques have shown that the human brain undergoes major remodeling during childhood and throughout the teen years--anatomical changes that may account for the risk taking, novelty seeking and impulsivity that characterize adolescent behavior. Gray matter in the brain, for example, begins thinning early in childhood--a sequential maturation process that begins at the back of the brain. Not until early adulthood does this wave of gray-matter thinning finally reach the forebrain areas where planning, reasoning and impulse control occur.
This growing evidence that risk taking may be hardwired into the adolescent brain has influenced the way that we and other psychologists now view troubled teenagers and the standard intervention programs aimed at preventing their risky behavior.
Why Programs Fail
Traditional intervention programs emphasize the importance of giving teens information about risks and allowing them the freedom to decide for themselves what to do. These programs encourage teens to trade off potentially deadly risks against often transient benefits and assume that they will see the light: just tell them the risks of HIV infection and unwanted pregnancy, these programs assume, and teens will not engage in unprotected sex.
Such programs are based on a collection of theories of decision making with names like "the behavioral decision framework" and "the theory of reasoned action." As their names imply, these theories expect that teenagers will weigh risks against benefits and come to the "rational" conclusion about their actions.