A social neuroscience perspective on adolescent risk-taking
Introduction
It is widely agreed among experts in the study of adolescent health and development that the greatest threats to the well-being of young people in industrialized societies come from preventable and often self-inflicted causes, including automobile and other accidents (which together account for nearly half of all fatalities among American youth), violence, drug and alcohol use, and sexual risk-taking (Blum and Nelson-Mmari, 2004, Williams et al., 2002). Thus, while considerable progress has been made in the prevention and treatment of disease and chronic illness among this age group, similar gains have not been made with respect to reducing the morbidity and mortality that result from risky and reckless behavior (Hein, 1988). Although rates of certain types of adolescent risk-taking, such as driving under the influence of alcohol or having unprotected sex, have dropped, the prevalence of risky behavior among teenagers remains high, and there has been no decline in adolescents’ risk behavior in several years (Centers for Disease Control & Prevention, 2006).
It is also the case that adolescents engage in more risky behavior than adults, although the magnitude of age differences in risk-taking vary as a function of the specific risk in question and the age of the “adolescents” and “adults” used as comparison groups; rates of risk-taking are high among 18- to 21-year-olds, for instance, some of whom may be classified as adolescents and some who may be classified as adults. Nonetheless, as a general rule, adolescents and young adults are more likely than adults over 25 to binge drink, smoke cigarettes, have casual sex partners, engage in violent and other criminal behavior, and have fatal or serious automobile accidents, the majority of which are caused by risky driving or driving under the influence of alcohol. Because many forms of risk behavior initiated in adolescence elevate the risk for the behavior in adulthood (e.g., drug use), and because some forms of risk-taking by adolescents put individuals of other ages at risk (e.g., reckless driving, criminal behavior), public health experts agree that reducing the rate risk-taking by young people would make a substantial improvement in the overall well-being of the population (Steinberg, 2004).
The primary approach to reducing adolescent risk-taking has been through educational programs, most of them school-based. There is reason to be highly skeptical about the effectiveness of this effort, however. According to AddHealth data (Bearman, Jones, & Udry, 1997), virtually all American adolescents have received some form of educational intervention designed to reduce smoking, drinking, drug use, and unprotected sex, but the most recent report of findings from the Youth Risk Behavior Survey, conducted by the Centers for Disease Control and Prevention, indicates that more than one-third of high school students did not use a condom either the first time or even the last time they had sexual intercourse, and that during the year prior to the survey, nearly 30% of adolescents rode in a car driven by someone who had been drinking, more than 25% reported multiple episodes of binge drinking, and nearly 25% were regular cigarette smokers (Centers for Disease Control & Prevention, 2006).
Although it is true, of course, that the situation might be even worse were it not for these educational efforts, most systematic research on health education indicates that even the best programs are far more successful at changing individuals’ knowledge than in altering their behavior (Steinberg, 2004, Steinberg, 2007). Indeed, well over a billion dollars each year are spent educating adolescents about the dangers of smoking, drinking, drug use, unprotected sex, and reckless driving—all with surprisingly little impact. Most taxpayers would be surprised—perhaps shocked—to learn that vast expenditures of public dollars are invested in health, sex, and driver education programs that either do not work, such as D.A.R.E. (Ennett, Tobler, Ringwalt, & Flewelling, 1994), abstinence education (Trenholm et al., 2007), or driver training (National Research Council, 2007), or are at best of unproven or unstudied effectiveness (Steinberg, 2007).
The high rate of risky behavior among adolescents relative to adults, despite massive, ongoing, and costly efforts to educate teenagers about its potentially harmful consequences, has been the focus of much theorizing and empirical research by developmental scientists for at least 25 years. Most of this work has been informative, but in an unexpected way. In general, where investigators have looked to find differences between adolescents and adults that would explain the more frequent risky behavior of youth, they have come up empty handed. Among the widely-held beliefs about adolescent risk-taking that have not been supported empirically are (a) that adolescents are irrational or deficient in their information processing, or that they reason about risk in fundamentally different ways than adults; (b) that adolescents do not perceive risks where adults do, or are more likely to believe that they are invulnerable; and (c) that adolescents are less risk-averse than adults. None of these assertions is correct: The logical reasoning and basic information-processing abilities of 16-year-olds are comparable to those of adults; adolescents are no worse than adults at perceiving risk or estimating their vulnerability to it (and, like adults, overestimate the dangerousness associated with various risky behaviors); and increasing the salience of the risks associated with making a poor or potentially dangerous decision has comparable effects on adolescents and adults (Millstein & Halpern-Felsher, 2002; Reyna & Farley, 2006; Steinberg & Cauffman, 1996; see also Rivers, Reyna, & Mills, 2008, this issue). Indeed, most studies find few, if any, age differences in individuals’ evaluations of the risks inherent in a wide range of dangerous behaviors (e.g., driving while drunk, having unprotected sex), in their judgments about the seriousness of the consequences that might result from risky behavior, or in the ways that they evaluate the relative costs and benefits of these activities (Beyth-Marom, Austin, Fischoff, Palmgren, & Jacobs-Quadrel, 1993). In sum, adolescents’ greater involvement than adults in risk-taking does not stem from ignorance, irrationality, delusions of invulnerability, or faulty calculations (Reyna & Farley, 2006).
The fact that adolescents are knowledgeable, logical, reality-based, and accurate in the ways in which they think about risky activity—or, at least, as knowledgeable, logical, reality-based, and accurate as their elders—but engage in higher rates of risky behavior than adults raises important considerations for both scientists and practitioners. For the former, this observation pushes us to think differently about the factors that may contribute to age differences in risky behavior and to ask what it is that changes between adolescence and adulthood that might account for these differences. For the latter, it helps explain why educational interventions have been so limited in their success, suggests that providing adolescents with information and decision-making skills may be a misguided strategy, and argues that we need a new approach to public health interventions aimed at reducing adolescent risk-taking if it is adolescents’ actual behavior that we wish to change.
These sets of scientific and practical considerations form the basis for this article. In it, I argue that the factors that lead adolescents to engage in risky activity are social and emotional, not cognitive; that the field’s emerging understanding of brain development in adolescence suggests that immaturity in these realms may have a strong maturational and perhaps unalterable basis; and that efforts to prevent or minimize adolescent risk-taking should therefore focus on changing the context in which risky activity takes place rather than mainly attempting, as current practice does, to change what adolescents know and the ways they think.
Section snippets
Advances in the developmental neuroscience of adolescence
The last decade has been one of enormous and sustained interest in patterns of brain development during adolescence and young adulthood. Enabled by the growing accessibility and declining cost of structural and functional Magnetic Resonance Imaging (MRI) and other imaging techniques, such as Diffusion Tensor Imaging (DTI), an expanding network of scientists have begun to map out the course of changes in brain structure between childhood and adulthood, describe age differences in brain activity
Why does risk-taking increase between childhood and adolescence?
In my view, the increase in risk-taking between childhood and adolescence is due primarily to increases in sensation seeking that are linked to changes in patterns of dopaminergic activity around the time of puberty. Interestingly, however, as I shall explain, although this increase in sensation-seeking is coincident with puberty, it is not entirely caused by the increase in gonadal hormones that takes place at this time, as is widely assumed. Nonetheless, there is some evidence that the
Why does risk-taking decline between adolescence and adulthood?
There are two plausible neurobiological processes that may help account for the decline in risky behavior that occurs between adolescence and adulthood. The first, which has received only scant attention, is that further changes in the dopaminergic system, or in reward processing that is mediated by some other neurotransmitter, take place in late adolescence that alter reward sensitivity, and, in turn, diminish reward-seeking. Little is known about changes in reward seeking after adolescence,
Implications for prevention and intervention
In many respects, then, risk-taking during adolescence can be understood and explained as the product of an interaction between the socio-emotional and cognitive control networks (Drevets & Raichle, 1998), and adolescence is a period in which the former abruptly becomes more assertive at puberty while the latter gains strength only gradually, over a longer period of time. It is important to note, however, that the socio-emotional network is not in a state of constantly high activation, even
Acknowledgments
Preparation of this article was supported by funding from the John D. and Catherine T. MacArthur Foundation Research Network on Adolescent Development and Juvenile Justice and by the National Institute on Drug Abuse (1R21DA022546-01). The content of this paper, however, is solely the responsibility of the author and does not necessarily represent the official views of these organizations. I am grateful to Network members Marie Banich, Elizabeth Cauffman, Sandra Graham, and Jennifer Woolard for
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