Adolescence Development

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Developing

AMERICAN

PSYCHOLOGICAL

ASSOCIATION

AdolescenDeveloping AdolescenA Reference for Professionals


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Development of this document was supported by

Cooperative Agreement No. U93MC00105from the Maternal and Child Health Bureau,

Health Resources and Services Administration,

U.S. Department of Health and Human Services.

Copyright ©2002 by the American Psychological Association. All rights reserved.


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Contents

Acknowledgement s ii

Preface 1

Professional Contexts and Boundaries 1Introduction 3

Recognizing Diversity 4Organization of Developing Adolescents 5

Adolescent Physical Development 7

Puberty and Sexual Development 7Early or Late Sexual Development 8

Physical Appearance and Body Image 8Physical Activity and Weight 8Disordered Eating 9

Adolescent Cognitive Development 11

Moral Development 13Learning Disabilit ies 13

Adolescent Emotional Development 15

Developing a Sense of Identity 15Raising Self-Esteem 16

Emotional Intelligence 17Group Differences in Emotional Development 18

Gender Differences 18

Ethnic Diversity 18Gay, Lesbian, and Bisexual Youth 19

Adolescent Social Development 21

Peer Relationships 21Dating and Sexual Behavior 22

Family Relationships 23School 24Work 25Community 26

The Influence of Neighborhood Characteristics 26Faith Institutions 27The Media 27

Adolescent Behavioral Development 29Reasons for Adolescent Risk Taking 30

When Risk-Taking Behavior Becomes Problem Behavior 31Alcohol and Drug Abuse 31Pregnancy and Sexually Transmitted Diseases 32School Failure and Dropping Out 32Delinquency, Crime, and Violence 32

Protective Factors and Resilience 33Conclusion 3 4

References 35

Developing Adolescents:

A Reference for Professionals

AMERICAN

PSYCHOLOGICAL

ASSOCIATION

750 First Street, NEWashington, DC 20002–4242


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Among the individuals who helped along the way werededicated federal officials from the Maternal and Child HealthBureau: Trina Anglin, MD, Chief of the Office of AdolescentHealth; Audrey Yowell, PhD, Project Officer; Isadora Hare,MSW, formerly an APA colleague and the initiator of theadolescent development project for this association; and the

late Juanita Evans, MSW, who had the vision to create thePIPPAH initiative during her tenure as Chief of the Office of Adolescent Health.

We also appreciate the many individuals who shared theirexpertise with us and provided input throughout this project.Special thanks go to Margaret Schlegel, a science writer whodeveloped the initial organization and an early draft ofthe material.

We offerDevelopi ng Adolescents as an information resourcefor many professionals, including psychologists, as they dealwith adolescents in varied roles—as health professionals,school teachers and administrators, social service staff, juve-nile justice officials, and more.

Jacquelyn H. Gentry, PhDDirector, Public Interest Ini tiatives

Mary CampbellChildren, Youth, & Families Officer

Acknowledgments

Many kinds of expertise are needed to fully address healthissues of adolescents in American society, and many kinds of

expertise went into the development of this document.

We are especially grateful to Andrea Solarz, PhD, Manager of the APA Healthy Adolescents Project. Her leadership andsubstantive expertise are reflected both in the way she hasguided the completion of the overall project and in herexcellent work on this publication. In the development of thisdocument, she refined the basic conceptual frame for themanuscript and maintained the highest standards for the sci-entific integrity of the material. She reviewed literature anddirected the manuscript review process, integrating recentresearch findings as well as experts’ suggestions and com-ments into the text. Her meticulous editing included detailedattention to the nuances of translating specialized scientificreports into material that is accessible to a wide rangeof professionals.

The APA also appreciates the professional support andpractical assistance offered by colleagues in the Partners inProgram Planning for Adolescent Health (PIPPAH), acollaborative project supported by the Office of AdolescentHealth of the Maternal and Child Health Bureau. PIPPAHpartners reviewed drafts of this document and offeredsubstantive comments on its content.The reviewing organizations include:American Academy of Pediatric DentistryAmerican Bar AssociationAmerican Dietetic AssociationAmerican Medical AssociationAmerican Nurses AssociationAmerican School Health AssociationNational Association of Social WorkersOffice on Adolescent Health

Views expressed in th is document have not been approved by the govern ing or poli cy-sett ing bodies of any of the PIPPAH part ners and should not be con- strued as represent ing poli cy of any specifi c organizati on. D

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Preface

The American Psychological Association (APA) is pleasedto offer Developi ng Adolescents: A Reference for Professionals for the many professionals who, because

they work with adolescents, need substantive knowledgeabout the trajectory of youngsters’ lives from lateelementary school ages through high school years.

Developi ng Adolescents is a response to requests bynumerous professionals in various fields for help inunderstanding and working with adolescents. Inpart icular, the organizations involved in the Partnershipin Program Planning for Adolescent Health (PIPPAH),who work together to promote adolescent healthactivities nationally, expressed interest in having adocument to help professionals—physicians, attorneys,nurses, school-based health providers, social workers,dentists, and dieticians, to name a few—understandcrucial aspects of normal adolescent development andrelate more effectively to the adolescents with whomthey work.1

Although an impressive array of literature on adolescentdevelopment exists, much of this information ispublished in specialized journals not easily accessible toprofessionals in other fields. Developing Adolescent s presents, in an accessible way, research findings on thecognitive, physical, social, emotional, and behavioralaspects of “normal” adolescent development to help

guide professionals working with adolescents in manydifferent contexts.

There is currently no standard definition of “adolescent.”Although often captured as an age range, chronologicalage is just one way of defining adolescence. Adolescencecan also be defined in numerous other ways, consideringsuch factors as physical, social, and cognitive develop-ment as well as age. For example, another definition of adolescence might be the period of time from the onsetof puberty until an individual achieves economic inde-pendence. What is most important is to consider

carefully the needs and capabilities of each adolescent.For the purposes of this document, adolescents aregenerally defined as youth ages 10 to 18.2 Using thisdefinition, there were an estimated 36.6 mill ionadolescents in the United States in 2000 (U.S. CensusBureau, 2001a).

Professional Cont exts and Boundari es

A first step in working with youth—and often byextension their families and the social systems withwhich they engage, such as schools—is to understandone’s role and professional boundaries. School socialworkers, for example, are often called on to provideguidance to families or to conduct parenting groups andso may be particularly interested in learning whatpsychological research has discovered about effectiveparenting strategies with adolescents.

Attorneys, on the other hand, may have little need forsuch information and may be stepping outside of theboundaries of their professional role if they makesuggestions to parents about such things as parentingstyles,3 even if they are asked to provide advice onparenting. Physicians, who play an important role in

interpreting normal physical development to teens andparents, are also often the first contact for consultationabout behavioral issues such as substance abuse.

Thus, sections of this publication that refer to parentingwill be more or less relevant depending on one’sprofessional role. The same is true with regard to othertopics—they will be more or less relevant depending onthe reader’s professional context and roles.

Legal statutes govern some behavior of professionals.Medical and mental health professionals and teachers,for example, have specific legal obligations to act upon if they suspect that a young person has been abused.Matters of confidentiality are pertinent to allprofessionals and are generally addressed in law as well

1 PIPPAH is funded by the Office of Adolescent Healt h, a un it of the Maternal and Chil d Healt h Bureau, Healt h Resour ces and Services Admin istr ati on, U.S. Department of Healt h and Human Servi ces. The PIPPAH partners in clude the American Academy of Pediatr ic Dent istry, Ameri can Bar Associat ion , Ameri can Dieteti c Associat ion , Ameri can Medical Associat ion , American Nur ses Associat ion ,American Psychological Associat ion , American School

Health Association, and Nati onal Association ofSocial Workers.

2 There is no standard age range for defin ing adolescence.Individuals can begin adolescence earl ier t han age 10, just as some aspects of adolescent development often cont inue past t he age of 18. Alt hough t he upper age boundar y is sometimes defined as older t han 18 (e.g., age 21 or 25),th ere is widespread agreement that t hose in the age range of 10 to 18 should be considered adolescent s. That being said, professionals who work wit h young adul ts over age 18 may stil l fi nd the information contained in this report t o be relevant for understanding t heir cl ients.

3 Although t he term “parents” is used th roughout th is report for pur poses of readabili ty and flow, it is recognized that the information presented here is also often relevant to

guardians or other caring adult s in t he li ves of adolescents.

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as in professional ethical codes regarding such practices.Each professional must keep abreast of changes in codesand laws pertaining to his or her professional conductwith adolescents and their families. These codes andlaws, which sometimes vary from state to state and canapply differently in different settings, always supersedeguidance provided in this or similar publications.

Although this publication presents a substantial amountof research on topics related to behavioral and mentalhealth, its aim is not to train professionals to dopsychological counseling. Rather, it is intended todescribe the characteristics of adolescents and aspects of the contexts in which they live that make a difference inpromoting healthy adolescent development.Psychotherapy or counseling, whether provided by alicensed psychologist, psychiatrist, social worker, nurse,or other trained mental health professional, requiresmany years of specialized graduate education andsupervised experience. Professionals who areknowledgeable about normal adolescent development

are in a good position to know when an adolescent needsthis kind of professional psychological help.


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4By age 17, it is estimated that about 25% of all adolescents have taken part in activit ies that can be considered to be harm ful eit her to themselves or others (e.g., gett ing pr eg- nant , taking drugs, faili ng school; Hamburg, 1997).

Much has been written, both in the lay press and thescientific literature, about adolescents’ mental healthproblems—such as depression, suicide, and drugabuse—and about the serious problems that someadolescents experience.4 The purpose of Developing Adolescents, however, is not to describe these problemsor the therapeutic strategies to address them, but toaddress them in the context of adolescent development,with a focus on preventing these problems and

enhancing positive outcomes even under adversecircumstances. Efforts are made to move to a new way of understanding and working with adolescents in thecontext of larger systems (Lerner & Galambos, 1998);although working with adolescents and families iscritical, systemic change is sometimes needed tosafeguard adolescent health.

Also at the heart of Developing Adolescents is the themethat today’s adolescent needs one thing that adults seemto have the least surplus of—time. It takes time to listenand relate to an adolescent. In a report by the U.S.

Council of Economic Advisers, teens rated “not havingenough time together” with their parents as one of theirtop problems. This report also indicates that adolescentswhose parents are more involved in their lives (as meas-ured by the frequency of eating meals together regularly,a simple measure of parental involvement) have signifi-cantly lower rates of “problem behaviors” such as smok-ing, alcohol or marijuana use, lying to parents, fighting,initiation of sexual activity, and suicidal thoughts andattempts (U.S. Council of Economic Advisors, 2000).

A crosscutting theme, regardless of one’s professionalrole, is the need to communicate effectively with youth.Adolescents will not simply “open up” to adults ondemand. Effective communication requires that anemotional bond form, however briefly, between theprofessional and the adolescent. Professionals must find away to relate comfortably to adolescents, and be flexibleenough to accommodate the wide range of adolescentsthey are likely to encounter. And, professionals mustrecognize that developing effective communication withthe adolescents with whom they work requires effort ontheir part. It may take a number of sessions ofnonjudgmental listening to establish the trust needed fora particular adolescent to share with an adult what he or

she is thinking and feeling. It may take even longerbefore an adolescent feels comfortable asking an adult forhelp with an important decision. Discussing options forusing birth control with a physician or tell ing a schoolpsychologist or social worker that one is feelingdepressed or sad generally requires both time and trust.

Introduction

Media portrayals of adolescents often seem to emphasizethe problems that can be a part of adolescence. Gangviolence, school shootings, alcohol-related accidents,drug abuse, and suicides involving teens are all toofrequently reflected in newspaper headlines and movieplots. In the professional literature, too, adolescence isfrequently portrayed as a negative stage of life—a period

of storm and stress to be survived or endured (Arnett,1999). So, it may not be surprising that a 1999 survey of the general public by Public Agenda reported that for71% of those polled, negative terms, such as “rude,”“wild,” and “irresponsible,” first came to mind whenthey were asked what they thought about Americanteenagers (Public Agenda, 1999). Many other negativeattitudes were also expressed by those surveyed. At thesame time, however, the survey found that 89% of therespondents believed that “almost all teenagers can getback on track” with the right kind of guidance andattention. In fact, most adults agree about the kinds of

things that are important for adults to do with youngpeople—encourage success in school, set boundaries,teach shared values, teach respect for culturaldifferences, guide decision making, give financialguidance, and so on (Scales, Benson, & Roehlkepartain,2001). However, fewer actually act on these beliefs togive young people the kind of support they need.

Despite the negative portrayals that sometimes seem soprevalent—and the negative attitudes about adolescentsthat they support—the picture of adolescents today islargely a very positive one. Most adolescents in factsucceed in school, are attached to their families andtheir communities, and emerge from their teen yearswithout experiencing serious problems such assubstance abuse or involvement with violence. With allof the attention given to negative images of adolescents,however, the positive aspects of adolescents can beoverlooked. Professionals can play an important role inshifting perceptions of adolescents to the positive. Thetruth is that adolescents, despite occasional ornumerous protests, need adults and want them to bepart of their lives, recognizing that they can nurture,teach, guide, and protect them on the journey toadulthood. Directing the courage and creativity of

normal adolescents into healthy pursuits is part of whatsuccessfully counseling, teaching, or mentoring anadolescent is all about.

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Professionals may find that the strategies they use toprovide information and offer services to adults justdon’t work as well with adolescents. Young people needadults who wil l listen to them—understand andappreciate their perspective—and then coach ormotivate them to use information or services offered inthe interest of their own health (Hamburg, 1997).Simply presenting information on the negativeconsequences of high-risk behaviors is not enough.

Having an understanding of normal adolescentdevelopment can help professionals be effectivecommunicators with young people.

Recognizi ng Diversity

It is critical that professionals educate themselves aboutthe different cultural and ethnic groups with whom theywork in order to provide competent services and torelate effectively one-on-one with adolescents. Thepopulation of adolescents in the United States is

becoming increasingly racially and ethnically diverse,with 37% of adolescents ages 10 to 19 today beingHispanic or members of non-White racial groups (seetable on page 5). This population diversity is projected toincrease in the decades ahead.

5 To put th is in a larger histori cal context, at the beginni ng

of the 20th centur y, approximately 15% of the U.S. populati on was foreign-born, a result of the large-scale migrati on from Europe during that period. This percentage declined steadily un ti l i t began to climb again aft er 1970 (U.S.Census Bureau, 2002).

6 Those wit h Hi spanic or Lati no identit y may be of any r ace.

7 One important excepti on is the National LongitudinalStudy on Adolescent Health (also known as the Add Health study), a lar ge-scale cross-secti onal sampl e of 12,000 “normal” adolescents from 80 juni or h igh and high schools,their parents, and their schools. Data are conti nual ly being analyzed, and new findings are emerging regularl y about various aspects of adolescent healt h and mental healt h.The study is parti cularl y important in t hat i t i s based on a large noncli ni cal sample of normal adolescents and

in cludes an ethni cally diverse lar ge sampl e.

4

A growing number of households in the United Statesinclude individuals who were born in other countries.Immigrants enter the United States for diverse reasons;some may be escaping a war-torn country, just as othersare in the country to pursue an advanced education.They vary in their English proficiency andeducational levels and in their cultural practices andbeliefs. The number of foreign-born in the United Statesgrew 44% between 1990 and the 2000. People born in

other countries now constitute 10% of the U.S. popula-tion, the highest rate since the 1930 census (U.S. CensusBureau, 2002).5 Half of those from othercountries are from Latin American countries—overall,about 15% of adolescents ages 10 to 19 are of Hispanicor Latino origin (U.S. Census Bureau, 2001a). 6

Unfortunately, many of the studies of adolescentsreported in the scientific literature have looked only atWhite middle-class adolescents (Lerner & Galambos,1998; Ohye and Daniel, 1999). Thus, research on mostareas of normal adolescent development for minority

youth is still lacking; so caution should be used in gen-eralizing the more global findings reported here toall adolescents.7


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Organizati on of Developing Adolescents: AReference for Professionals

The physical changes that herald adolescence—thedevelopment of breasts and first menstrual periods forgirls, the deepened voices and broadened shoulders forboys—are the most visible and striking markers of thisstage. However, these physical changes represent just afraction of the developmental processes that adolescents

experience. Their developing brains bring new cognitiveskills that enhance their ability to reason and to thinkabstractly. They develop emotionally, establishing a newsense of who they are and who they want to become.Their social development involves relating in new waysboth to peers and adults. And, they begin to experimentwith new behaviors as they transition from childhood toadulthood. In Developi ng Adolescents, we thus discussadolescent development with reference to physical,cognitive, emotional, social, and behavioral develop-ment. Each section presents basic information aboutwhat is known about that aspect of adolescentdevelopment and suggests roles professionals can play to

help support adolescents.

Of course, no adolescent can truly be understood inseparate parts—an adolescent is a “package deal.”Change in one area of development typically leads to, oroccurs in conjunction with, changes in other areas.Furthermore, no adolescent can be fully understoodoutside the context of his or her family, neighborhood,school, workplace, or community or without consideringsuch factors as gender, race, sexual orientation, disabilityor chronic illness, and religious beliefs. Thus, theseissues are also touched on throughout.

Developi ng Adolescents: A Reference for Professional s isnot intended to solve all of the mysteries of relating toadolescents, but it will provide scientifically sound,up-to-date information on what is known about today’syouth. Hopefully, this will make it just a bit easier andmore comfortable for professionals to relate to adoles-cents in the context of their particular professions.

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P opulation of Adolescent sAges 10-19 by Race: 2000 8

Race Percent of total

White only 70*

Black only 15

Asian/Pacific Islander only 4

American Indian/Alaska Native only 1

Some other race only 7

Two or more races 3

*White race, not H ispanic or Lati no,

represents 63% of t he populati on of adolescents.

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Derived from data in U.S. Census Bureau (2001b).


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nonclinical samples to confirm that this is the case forgirls in general. Relatively little research has examineddifferences in the course of puberty among differentethnic groups; this is clearly an area that deservesadditional attention (Lerner & Galambos, 1998).Professionals who work with children and their familiescan alert parents to the need to prepare their childrenearly for the changes of adolescence. Professionals canalso offer helpful advice to parents and other adults

about how to discuss puberty with younger adolescents.

Research findings suggest that adolescent girls who areunprepared for the physical and emotional changes of puberty may have the most difficulty with menstruation(Koff & Rierdan, 1995; Stubbs, Rierdan, & Koff, 1989).When 157 ninth grade girls were asked to suggest howyounger girls should be prepared for menstruation, theyrecommended that mothers provide emotional supportand assurance, emphasize the pragmatics of menstrualhygiene, and provide information about how it willactually feel, emphasizing posit ively their own first

experiences with menstruation (Koff & Rierdan, 1995).The girls also recommended that fathers not commenton their daughters’ physical changes, and that mothersnot discuss these changes with fathers in front of theadolescent, even when they become evident.

Although research on boys’ first experiences of sexualmaturation is limited, some evidence suggests that boys,too, are more comfortable with the physical changes of adolescence when adults prepare them. For example,young adolescent boys who were not prepared for thesechanges have reported feeling “somewhat perplexed”upon experiencing their first ejaculations of semenduring dreaming or masturbation (Stein & Reiser, 1994).The implication of these findings is that adolescentsshould be prepared for the upcoming changes early, atabout 9 or 10 years of age, so they will not be caught off guard when the changes occur.

AdolescentPhysicalDevelopment

Entering puberty heralds the physical changes ofadolescence: a growth spurt and sexual maturation.Professionals who work with adolescents need to knowwhat is normative and what represents early or late

physical development in order to help prepare theadolescent for the myriad changes that take place duringthis time of life. Even in schools where sex education istaught, many girls and boys still feel unprepared for thechanges of puberty, suggesting that these importanttopics are not being dealt with in ways that are mostuseful to adolescents (Coleman & Hendry, 1999).

Puber ty and Sexual Development

Although it sometimes seems that adolescents’ bodieschange overnight, the process of sexual maturationactually occurs over a period of several years. Thesequence of physical changes is largely predictable, butthere is great variability in the age of onset of pubertyand the pace at which changes occur (Kipke, 1999).There are numerous factors that affect the onset andprogression of puberty, including genetic and biologicalinfluences, stressful life events, socioeconomic status,nutrition and diet, amount of body fat, and the presenceof a chronic illness. The growth spurt, which involvesrapid skeletal growth, usually begins at about ages 10 to12 in girls and 12 to 14 in boys and is complete ataround age 17 to 19 in girls and 20 in boys (Hofmann &

Greydanus, 1997). For most adolescents, sexualmaturation involves achieving fertility and the physicalchanges that support fertility. For girls, these changesinvolve breast budding, which may begin around age 10or earlier, and menstruation, which typically begins atage 12 or 13.9 For boys, the onset of puberty involvesenlargement of the testes at around age 11 or 12 andfirst ejaculation, which typically occurs between the agesof 12 and 14. The development of secondary sexualcharacteristics, such as body hair and (for boys) voicechanges, occurs later in puberty.10

Many adults may still believe that the magic age of 13 isthe time to talk about puberty, but for many boys andgirls, this is years too late. A recent study of 17,000healthy girls ages 3 through 12 visiting pediatricians’offices found that 6.7% of White girls and 27.2% of African American girls were showing some signs of puberty by age 7 (i.e., breast and/or pubic hairdevelopment) (Herman-Giddens et al., 1997; Kaplowitzand Oberfield, 1999). The findings of this study suggestthat onset of puberty may be occurring about 1 yearearlier in White girls and 2 years earlier in AfricanAmerican girls than had previously been thought.11

However, studies have not yet been completed on

9 African American gir ls begin menstr uati ng an average 6 months earli er than Whit e gir ls, possibly due to genetic or dietar y differences (Archi bald, Graber, & Brooks-Gunn,1999; Dounchis, Hayden, & Wilfl ey, 2001; Herman- Giddens, Slora, & Wasserman, 1999).

10 Healt h care professionals and researchers refer t o the 5- point Tanner scale, which descri bes the external physical changes that take place dur ing adolescence (e.g., the stages of development of breasts and pubic hai r i n gir ls and of geni tal ia and pubic hai r i n boys), to assess progr es- sion t hrough pubert y. Others, including parents and non- medical pr ofessionals, can also learn t o use thi s scale (Archi bald, Graber, & Brooks-Gunn, 1999; Marshall & Tanner, 1969, 1970).

11 Several r easons have been proposed for th is early onset of puberty i n gir ls, including increased body weight , genetics,exposure to hormones in meat or mi lk , and increased exposure to sexual images in the media. For a r ecent dis- cussion i n the popular press of why some girl s are reaching puberty at earl ier ages, see the Timemagazine cover story,

October 30, 2000.


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development, and not to the level of physicaldevelopment, whether early, on time, or late. Forexample, 13-year-olds should be given earlier curfewsand be more closely supervised than older teens, even if they physically appear to be much older. Likewise, anadolescent whose physical maturity is behind his or herpeers may still be ready for increased independence.

Physical Appearance and Body I mage

Regardless of the timing of the physical changes thattake place during adolescence, this is a period in whichphysical appearance commonly assumes paramountimportance. Both girls and boys are known to spendhours concerned about their appearance, particularly inorder to “fit in” with the norms of the group with whomthey most identify. At the same time, they wish to havetheir own unique style, and they may spend hours in thebathroom or in front of the mirror trying to achievethis goal.

Adults should take adolescents seriously when theyexpress concerns about aspects of their appearance, suchas acne, eyeglasses, weight, or facial features. If anadolescent is concerned, for example, that he isoverweight, it is important to spend the time to listen,rather than dismissing the comment with thereassurance that “you look fine.” Perhaps a peer made acomment about his appearance at a time when he hadbeen wondering about the same thing. Adults need tounderstand the meaning and context of the adolescent’sconcern and to keep the lines of communication open.

Otherwise, the adolescent may have a difficult timekeeping the problem (and potential solutions) inperspective or be less likely to express concernsin the future.

Physical Activi ty and Weight

Approximately 14% of adolescents aged 12 to 19 yearsare overweight—nearly 3 times as many as in 1980(USDHHS, 2001). Overweight adolescents are at greaterrisk for type II diabetes, high blood lipids, andhypertension and have a 70% chance of becomingoverweight or obese adults. In addition, they may sufferfrom social discrimination, particularly from their peers,which can contribute to feelings of depression or lowself-esteem. Diseases directly related to lack of exercise,such as obesity and diabetes, have been reported to bemore prevalent among ethnic minority teens (Ross,2000). For example, type II diabetes is particularly preva-

Earl y or Late Sexual Development

It is important for adults to be especially alert for signsof early and late physically maturing adolescents—particularly early maturing girls and late maturingboys—because these adolescents appear to be atincreased risk for a number of problems, includingdepression (Graber, Lewinsohn, Seeley, & Brooks-Gunn,1997; Perry, 2000). For example, early maturing girls

have been found to be at higher risk for depression,substance abuse, disruptive behaviors, and eatingdisorders (Ge, Conger, & Elder, 2001; Graber et al., 1997;Striegel-Moore & Cachelin, 1999).12 Likewise, there isgrowing evidence that boys whose physical developmentis out of synch with their peers are at increased risk forproblems. Early maturing boys have been found to bemore likely to be involved in high-risk behaviors such assexual activity, smoking, or delinquency (Flannery et al.,1993; Harrell, Bangdiwala, Deng, Webb, & Bradley,1998). Although early physical maturation does notappear to pose as many problems for boys as it does forgirls, late maturation seems to place boys at greater risk

for depression, conflict with parents, and schoolproblems (Graber et al., 1997). Because of their smallerstature, late maturing boys may also be at higher risk forbeing bullied (Pollack & Shuster, 2000).

Adults, including parents, may not be aware of the risksof early maturation for girls and be unprepared to helpthese adolescents deal with the emotional and socialdemands that may be placed on them (Graber et al.,1997). For example, older boys—and even adult men—may be attracted to early maturing girls at a time whenthe girls do not yet have the social maturity to handle

these advances, placing them at risk for unwanted preg-nancies and sexually transmitted diseases (Flannery,Rowe, & Gulley, 1993).

Professionals can talk openly with early maturing youthand their parents about the likelihood that they willconfront peer pressure to engage in activities that theyare not yet emotionally ready to handle, such as datingand sexual activity. For most teens, telling them to “justsay no” does not help them to deal with sexually stress-ful interpersonal situations in which they are anxious tobe liked. Instead, professionals can help the adolescent

identify and practice strategies in advance for dealingwith or avoiding these situations.

Parents may need guidance to understand thatadolescent autonomy should be linked to the teen’schronological age and social and emotional

12 Early matur ati on may increase the ri sk for eati ng disorders in par t because the weight gain associated wit h the physical changes of adolescence can lead to negati ve body

image (Str iegel-Moore and Cachelin , 1999).


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Professionals can help adolescents and their parentsunderstand the importance of physical activity and goodnutrition for maintaining health and suggest healthyoptions. In doing so, it is important to keep in mind thefamily’s resources, such as the family’s ability to pay fororganized athletic activities, and its cultural background,which may, for example, influence its diet.13

Disordered Eati ng

Puberty, by its very nature, is associated with weightgain, and many adolescents experience dissatisfactionwith their changing bodies. In a culture that glorifiesbeing thin, some adolescents—mostly girls—becomeoverly preoccupied with their physical appearance and,in an effort to achieve or maintain a thin body, begin todiet obsessively. A minority of these adolescentseventually develops an eating disorder such as anorexianervosa or bulimia (Archibald, Graber, & Brooks-Gunn,1999; Str iegel-Moore & Cachelin, 1999).14 Theconsequences of eating disorders are potentially very

serious, resulting in death in the most extreme cases.

Between 0.5% and 1% of all females ages 12 to 18 in theUnited States are anorexic, and 1% to 3% are bulimic,with perhaps 20% engaging in less extreme but stillunhealthy dieting behaviors (Dounchis, Hayden, Wilfley,2001). Although boys can also have these eatingdisorders, the large majority are female (over 90%).Symptoms of eating disorders usually first becomeevident early in adolescence. Factors that appear to placegirls at increased risk for anorexia or bulimia includelow self-esteem, poor coping skills, childhood physical orsexual abuse, early sexual maturation, andperfectionism. Daughters of women with eatingdisorders are at particular risk for developing an eatingdisorder themselves (Striegel-Moore & Cachelin, 1999).

lent among Native American and Alaska Native adoles-cents, and obesity is more frequent among AfricanAmerican teenage girls than among White teenage girls(Ross, 2000).

Several factors contribute to the increased prevalence of overweight among teens. One factor is that levels of physical activity tend to decline as adolescents get older.For example, a 1999 national survey found that over athird of 9th through 12th graders do not participateregularly in vigorous physical activity (USDHHS, 2000).Furthermore, enrollment in physical education dropsfrom 79% in 9th grade to 37% in 12th grade; in factsome of the decline in activity is due to feweropportunities to participate in physical education classesand to reduced activity time in physical educationclasses. Lastly, many teens do not have nutritionallysound diets: Three-quarters of adolescents eat fewer thanthe recommended servings of fruits and vegetables perday (MMWR, 2000).

Participation in sports, which has important directhealth benefits, is one socially sanctioned arena in whichadolescents’ physical energies can be positivelychanneled. Other activities in which physical energy canbe channeled include dance, theatre, carpentry,cheerleading, hiking, skiing, skateboarding, andpart-time jobs that involve physical demands. Theseactivities provide adolescents with opportunities forgetting exercise, making friends, gaining competenceand confidence, learning about teamwork, taking risks,and building character and self-discipline(Boyd & Yin, 1996).

Despite the considerable rewards of sports and otherextracurricular activities, many adolescents do notparticipate in them. Barriers to participation inorganized sports activities include costs, lack oftransportation, competing time commitments,competitive pressures in the sport, and lack of parentalpermission to participate (Hultsman, 1992). Otherbarriers can include lack of access to safe facilities, suchas recreation centers or parks, part icularly in inner cityor rural areas. Some youth may also have otherimportant obligations, such as working or caring foryounger siblings, that prevent their part icipation. Youth

with disabilities or special health needs may especiallyexperience difficulty identifying recreationalopportunities that accommodate their particular needs(Hergenroeder, 2002). Professionals should examineeach of these impediments to determine how toovercome them to reduce barriers to participation.

13 The March 2002 Supplement to the Journal of theAmerican Dietetic Association (Volume 102, Number 3),Adolescent Nut ri ti on: A Springboard for Healt h, focuses on nut ri ti onal i ssues for adolescents, str ategies for nut ri ti on professionals who work wi th adolescent s, and programs designed to improve the nu tr it ional stat us of adolescents.

14 Anorexia nervosa is charact erized by body image distur- bance (e.g., seeing oneself as fat even though emaciated) and refusal to maint ain a min imal body weight; bulim ia is characterized by binge eati ng, drastic weight control measur es (such as vomi ti ng) to compensate for bi nge eating episodes, and body image distu rbance (Str iegel-Moore

& Cachelin , 1999).


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Information is limited about the prevalence of eatingdisorders among different ethnic groups, although thereis some evidence to suggest that patterns of disorderedeating differ. For example, dieting appears to occur mostfrequently in Hispanic females and least frequently inBlack females, and binge eating may be more frequent inBlack females (Dounchis et al., 2001). Although anorexiaand bulimia appear to occur much more frequently inWhite girls as compared to ethnic minority girls, there is

also evidence that the prevalence of eating disorders ismore common than has been reported among ethnicminorities. Thus, it is important that professionals notassume that only White girls are at risk. Although muchmore research is needed (particularly with regard toethnic minority adolescents), some strategieshypothesized to protect adolescents in general fromdeveloping an eating disorder or an obsession withweight include:

• Promoting the acceptance of a broad rangeof appearances;

• Protecting adolescents from abusive experiences;

• Promoting positive self-image and body image;• Educating adolescents and their famil ies about thedetrimental consequences of a negative focus onweight; and

• Promoting a positive focus on sources of self-esteemother than physical appearance, such as academic,art isti c, or athletic accomplishments (Str iegel-Moore& Cachelin, 1999).


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Box 1Yes...

It ’s Normal for Adolescents To...

•Argue for the sake of argui ng. Adolescents often go off on tangents, seeming to argue side issues for no apparent r eason; this can be highlyfrustrati ng to many adults (Walker & Taylor,1991). Keep in mind that, for adolescents,exercising their new reasoning capabil it ies canbe exhilarat ing, and they need the opportunit y to experiment wi th these new ski ll s.

•Jump to conclusi ons. Adolescents, even wi th their newfound capacit ies for logical thinki ng,sometimes jump to start li ng conclusions (Jaffe,1998). However, an adolescent may be taking a

ri sk in staking out a posit ion verball y, and what may seem brash may actual ly be bravado to cover his or her anxiety. I nstead of correcting their reasoning, give adolescents the floor and simply l isten. You buil d trust by being a goodli stener. All ow an adolescent to save face by not correcting or arguing wit h faulty logic at every tur n. Try t o find what is realistically posit ive in what i s being said and reinforce that; you may someday find yourself enjoying t he int ell ectual stimulat ion of the debates.

•Be self -centered (Jaffe, 1998) . Adolescents can

be very “me-centered.” It takes time to l earn to take others’ perspectives into account; in fact, this is a ski ll that can be learned.

•Constantl y fi nd fault i n the adult’s posit i on (B jorklund & Green, 1992). Adolescents’newfound abili ty to think cri ti cally encourages.them to look for discrepancies, contr adictions, or exceptions in what adults (in part icular) say.Sometimes they wi ll be most openly questi oning or cri ti cal of adults with whom they feelespecial ly safe. This can be qui te a change to adjust to, part icularl y i f you t ake it personally or

the youth ideali zed you in t he past.•Be overl y dramati c (Jaffe, 1998). Everything seems to be a “big deal” to teens. For someadolescents, being overly dramat ic orexaggerati ng their opinions and behaviors simply comes wit h the terr itory. Dramatic t alk is usually best seen as a style of orat ion r ather than anindicator of possible extr eme action, unless an adolescent ’s history indicates otherwise.

AdolescentCognitiveDevelopment

The changes in how adolescents think, reason, andunderstand can be even more dramatic than theirobvious physical changes. From the concrete,black-and-white thinkers they appear to be one day,

rather suddenly it seems, adolescents become able tothink abstractly and in shades of gray. They are now ableto analyze situations logically in terms of cause andeffect and to entertain hypothetical situations and usesymbols, such as in metaphors, imaginatively (Piaget,1950). This higher-level thinking allows them to thinkabout the future, evaluate alternatives, and set personalgoals (Keating, 1990). Although there are markedindividual differences in cognitive development amongyouth, these new capacities allow adolescents to engagein the kind of introspection and mature decision makingthat was previously beyond their cognitive capacity.Cognitive competence includes such things as the ability

to reason effectively, problem solve, think abstractly andreflect, and plan for the future.

Although few significant differences have been identifiedin the cognitive development of adolescent boys andgirls, it appears that adolescent boys and girls do differin their confidence in certain cognitive abilities andskills. Adolescent girls tend to feel more confident abouttheir reading and social skills than boys, and adolescentboys tend to feel more confident about their athletic andmath skills (Eccles, Barber, Jozefowicz et al., 1999). Thisis true even though their abilities in these areas, as a

group, are roughly the same (there are, of course, manyindividual differences within these groups). Conformingto gender stereotypes, rather than differences in abilityper se, appears to be what accounts for these differencein confidence levels (Eccles et al., 1999). Adults can helpto dispel these myths, which can lead adolescents tolimit their choices or opportunities. For example, anadolescent girl might be encouraged to take advancedmath or technology courses, and an adolescent boy toconsider relationship-based volunteer opportunities suchas mentoring—options that they might nototherwise consider.

Despite their rapidly developing capacity for higher-levelthinking, most adolescents still need guidance fromadults to develop their potential for rational decisionmaking. Stereotypes to the contrary, adolescents preferto confer with their parents or other trusted adults inmaking important decisions about such things asattending college, finding a job, or handling finances(Eccles, Midgley, Wigfield et al., 1993). Adults can usethis openness as an opportunity to model effectivedecision making or to guide adolescents as they grapplewith difficult decisions.


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Gardner, these different pathways for learning—whicheveryone possesses and has developed to varyingdegrees—include verbal/linguistic, logical-mathematical,spatial, musical, bodily kinesthetic, intrapersonal,naturalist, and possibly existential intelligence (i.e., thecapacity to tackle fundamental questions about humanexistence). Traditional approaches to learning havefocused primarily on logical—mathematical andverbal/linguistic intelligence. Gardner suggests that the

other forms of intelligence are just as important andthat teaching and learning will be most successful whenmultiple intelligences are engaged. Consequently, adultscan help adolescents develop their multiple intelligencesand not just focus on problems or deficits.

Another theory of intelligence that focuses on multiplestrengths has been proposed by Yale Universitypsychologist Robert Sternberg, who posits that creativityand practical abilities (i.e., common sense), and not justthe analytical abilities and memory skills measured bytraditional intelligence tests, are important components

of intelligence (Sternberg, 1996). In order to besuccessfully intelligent, it is not necessary to be equallyhigh in each of these spheres. Rather, one must findways to exploit effectively whatever pattern of abilitiesone has. For example, Sternberg found in one of hisstudies that when high school students taking apsychology course were placed in sections of the coursethat better matched their particular pattern of analytical,creative, and practical abilities, they outperformedstudents who were more poorly matched (Sternberg,Ferrari, Clinkenbeard, & Grigorenko, 1996). In otherwords, giving young people the opportunity to learn inways that emphasize different types of abilities increases

their chances of success.

Adults can foster the development of adolescents’ senseof competence. Although parents often feel that theyhave little influence during the teen years, research hasfound that feelings of competence in both adolescentboys and girls are directly linked to feeling emotionallyclose and accepted by parents (Ohannessian, Lerner,Lerner, & Eye, 1998). Professionals can educate parentsabout their role in fostering these competencies and inengendering feelings of competence in their children.Parents need to know just how influential they are in

As adolescents develop their cognitive skills, however,some of their behaviors may be confusing to the adultswho interact with them. These characteristics arenormal, though, and should not be taken personally (seeBox 1). In a later section on emotional development,practical strategies for communicating with adolescentswill be discussed; these strategies will be helpful forfostering adolescents’ budding cognitive competencies.

Just as adults sometimes make poordecisions, so do adolescents. This can especially be aproblem when poor decisions lead adolescents to engagein risky behaviors, such as use of alcohol or violence.Immature adolescents are especially likely to choose lessresponsible options. This level of maturity of judgementhas been found to be more important than age inpredicting whether an adolescent will make moreresponsible decisions (Fischoff, Crowell, & Kipke, 1999).It is important to understand that level of maturity of judgement may actually drop during the mid-teen yearsbefore increasing again into young adulthood.

There are a number of ways that adults can helpadolescents to make better decisions. One is to helpthem expand their range of options so they can considermultiple choices (Fischoff et al., 1999). Becauseadolescents who make snap decisions are more likely tobe involved in risky behaviors, adults can helpadolescents to carefully weigh their options and considerconsequences. Because adolescents can be moreinfluenced by what they believe their peers are doing,thus increasing the social pressure they feel to engage inthese activities, it can be helpful to provide them withmore accurate objective information if i t is available.15

Adults can help adolescents to understand howemotions—both positive and negative—can affect theirthinking and behavior. Finally, it is important tounderstand that adolescents may fear potential negativesocial consequences of their choices more than they dopossible health risks. For example, a teen may fear beingostracized from a social group or being made fun of if heor she refuses to drink alcohol at a party more than thepotential negative consequences of consuming alcohol.Thus, it is important for adults to consider andunderstand the context in which adolescents makedecisions about risk behaviors.

Even adolescents who are very skilled or talented insome areas may have weaknesses in others. For example,an adolescent who has trouble with learningmathematical concepts may excel on the basketballcourt or at learning a foreign language. HarvardUniversity psychologist Howard Gardner has developed atheory of multiple intelligences, or ways of approachingproblems and analyzing information that expands thetraditional view of ability (Gardner, 1993). According to

15 For example, there are a number of nat ional surveys that regularl y gather and publish i nformation on such th ings as teen drug use and sexual acti vit y. These include the National Survey of Famil y Growth (www.cdc.gov/nchs/nsfg.htm), the Nati onal Survey on Drug Use and Health (nhsdaweb.rti .org), and the National Health In terview Survey (www.cdc.gov/nchs/nhi s.htm ).Compil ed data on teen sexual acti vit y can also be found on sites such as Chi ld Trends (www.chi ldt rends.org), the Alan Gut tmacher I nstit ute (www.agi-usa.org/), and the Nati onal Campaign to Prevent Teen Pregnancy

(www.teenpregnancy.org).


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may be overlooked and left untreated. Hormonalchanges of adolescence and the increased demands of school can exacerbate learning disabilities thatadolescents were able to manage or mask when theywere younger. Once they reach middle and high school,adolescents with learning disabilities are at increasedrisk of school failure if their problems are notunderstood and addressed. In addition, problems withprocessing verbal information or poor reasoning skills

can make it difficult for some adolescents with learningdisabilities to form positive relationships withtheir peers.

Adolescents with learning disabilities reportedlyexperience severe emotional distress at rates 2 to 3 timeshigher than other adolescents, with girls being morelikely to experience these problems than boys (Svetaz,Ireland, & Blum, 2000). Furthermore, youth withlearning disabilities are significantly more likely thanadolescents in the general population to report havingattempted suicide in the past year or to have been

involved in violence. They are at especially high risk forthese negative outcomes if they are experiencingemotional distress. For adolescents with learningdisabilities, feeling connected to family and school andhaving a religious identity are all factors found to beassociated with lower risk for negative outcomes such asemotional distress, suicide attempts, and involvement inviolence. Thus, families, schools, and other institutionshave important roles to play in protecting these youthfrom negative outcomes (Svetaz et al., 2000).

Because of the higher risk that adolescents with learningdisabil ities have for serious problems, professionalsshould monitor adolescents’ social and emotionalfunctioning, paying particular attention to signs ofanxiety and depression. Conversely, youth experiencinganxiety or depression who have not been identified ashaving a learning disabilit y or emotional disordershould also be evaluated to rule out the presence of these problems.

their adolescent’s life. Professionals can directlyreinforce adolescents’ growing competencies by simplynoticing and commenting on them during routinecontacts. Even passing comments can mean a great dealto a young person, especially one who may be gettinglittle in the way of positive feedback.

Moral Development

Moral development refers to the development of a senseof values and ethical behavior. Adolescents’ cognitivedevelopment, in part, lays the groundwork for moralreasoning, honesty, and prosocial behaviors such ashelping, volunteerism, or caring for others (Eisenberg,Carlo, Murphy, & Van Court, 1995). Adults can helpfacilitate moral development in adolescents by modelingaltruistic and caring behavior toward others and byhelping youth take the perspective of others inconversations. For example, an adult might ask theadolescent, “How would you feel if you were _____?”

Educators and other adults can ensure that issuesinvolving fairness and morality are identified anddiscussed sensitively and in a positive atmosphere whereadolescents are encouraged to express themselves, askquestions, clarify their values, and evaluate theirreasoning (Eisenberg, Carlo, Murphy, & Van Court ,1995; Santilli & Hudson, 1992). This atmosphere shouldreinforce the concept that racism, sexism, homophobia,ageism, and biases against persons with disabilities areinherently destructive to both the individual and society.

Volunteering in the community is an important positiveavenue for youth that can help promote their moraldevelopment. In addition to helping foster a sense of purpose and meaning and enhancing moraldevelopment, volunteering is associated with a numberof positive long-term outcomes. For example, onenational study of girls from 25 schools found that thosewho volunteered in their communities were significantlyless likely to become pregnant or to fail academicallythan girls who did not volunteer (Allen, Philliber,Herrling, & Kuperminc, 1997). Professionals can helpadolescents understand the value of volunteering anddirect them toward valuable volunteer experiences.

Learn ing Disabil it ies

Learning disabilities refer to disorders that affect theability to interpret what one sees and hears or to linkinformation from different parts of the brain (Neuwirth,1993). Individuals with learning disabilities may haveproblems with reading, spoken language, writing,memorizing, arithmetic, or reasoning. Without carefulassessment, some adolescents with learning disabilitiesmay be seen as having behavior problems, and thecognitive problems underlying their behavioral problems


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strongly influence, either positively or negatively, globalself-esteem. This is particularly true in early adolescencewhen physical appearance tops the list of factors thatdetermine global self-esteem, especially for girls (Harter,1990a). Comments by others, particularly parents andpeers, reflect appraisals of the individual that someadolescents may incorporate as part of their identity andfeelings about themselves (Robinson, 1995).

The process by which an adolescent begins to achieve arealistic sense of identity also involves experimentingwith different ways of appearing, sounding, andbehaving. Each adolescent approaches these tasks in hisor her own unique way. So, just as one adolescent willexplore more in one domain (e.g., music), another willexplore more in another (e.g., adopting a certain style orappearance). Professionals whose role involves advisingparents or adolescents can assure them that mostexperimentation is a positive sign that adolescents feelsecure enough to explore the unknown. Adolescents whofail to experiment in any realm are sometimes seen to be

more stable but may, in fact, be experiencing moredifficulty than youth who seem to flit from one interestto another. Adolescence is a time when experimentingwith alternatives is developmentally appropriate, exceptwhen it seriously threatens the youth’s health or life.Although it may seem a simple strategy, professionalscan help adolescents begin to define their identitythrough the simple process of taking time to askquestions and listen without judgment to the answers.Box 2 contains some suggestions that may be helpful forhaving conversations with youth that not only help tobolster their sense of identity but also help to promotetheir cognitive and moral development. 16 It is amazing

how many youth are hungry to discuss these issues witha trusted adult, and how few are offered the opportunity.Discussing these issues can also help adolescents todevelop their new abstract reasoning skills and moralreasoning abilities.

AdolescentEmotionalDevelopment

Emotional development during adolescence involvesestablishing a realistic and coherent sense of identity inthe context of relating to others and learning to copewith stress and manage emotions (Santrock, 2001),

processes that are life-long issues for most people.Identity refers to more than just how adolescents seethemselves right now; it also includes what has beentermed the “possible self”—what individuals mightbecome and who they would like to become (Markus &Nurius, 1986). Establishing a sense of identity hastraditionally been thought of as the central task ofadolescence (Erikson, 1968), although it is nowcommonly accepted that identity formation neitherbegins nor ends during adolescence. Adolescence is thefirst time, however, when individuals have the cognitivecapacity to consciously sort through who they are andwhat makes them unique.

Developi ng a Sense of I dent it y

Identity includes two concepts. First is self-concept: theset of beliefs one has about oneself. This includes beliefsabout one’s att ributes (e.g., tall, intelligent), roles andgoals (e.g., occupation one wants to have when grown),and interests, values, and beliefs (e.g., religious,political). Second is self-esteem, which involvesevaluating how one feels about one’s self-concept.“Global” self-esteem refers to how much we like or

approve of our perceived selves as a whole. “Specific”self-esteem refers to how much we feel about certainparts of ourselves (e.g., as an athlete or student, how onelooks, etc.). Self-esteem develops uniquely for eachadolescent, and there are many different trajectories of self-esteem possible over the course of adolescence.(Zimmerman, Copeland, Shope, & Dielman, 1997).Thus, self-esteem, whether high or low, may remainrelatively stable during adolescence or may steadilyimprove or worsen.

Many of the factors already described in Developing Adolescents influence identity development andself-esteem during adolescence. For example,adolescents’ developing cognitive skills enable them tomake abstract generalizations about the self (Keating,1990). The physical changes they are experiencing can

16 A helpful guide for parents about communicati ng with teens is Helping Your Children Navigate Their TeenageYears: A Guide for Parents,which can be found atwww.mentalhealth .org/publicati ons (Whit e House Council

on Youth Violence, 2000).

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Box 2

Tips forTalking Wit h Adolescents

•Engage adolescents wi th nonthreateningquestions. Choosing only one or two questions ata given time, ask adolescents questi ons that help

them t o define their identit ies. For example, whom do you admire? What is it about t hat person that makes them admirable? What do you l ike to do in your free time? What do you consider to be your strengths? What are your hopes for t he future?What have you done in your l ife that you feelproud of (even if j ust a lit tl e)?

•Listen nonjudgmentall y (and listen more than you speak). This enables the adolescent to realize that you value his or her opin ions, and thus to trustyou more (Forgatch & Patt erson, 1989).

•Ask open-ended questions. Ask questi ons that

require more than a yes or no response; th is helps the adolescent th ink th rough ideas and options(Hi ll & O’Brien, 1999).

•Avoid “why” questions. “Why?” questi ons tend t o put people on the defensive (Plu tch ik , 2000). Tryto r ephrase your questi ons to get at what t headolescent was th inking rather than the reason for something the adolescent has said or done. For example, instead of asking, “Why did you saythat?” say instead: “You seemed to be reall y t ry ingto get across a point when you did that. Can youtell me more about what you meant?”

•Match the adolescent ’s emot ional state, unless it is hostile. I f the adolescent seems enthusiastic orsad, let your responses reflect his or her mood.Reflecti ng someone’s mood helps the indi vidualfeel understood (Forgatch & Patterson, 1989).

•Casuall y model r ational decision-makingstrategies. Discuss how you once arri ved at adecision. Explain, for example, how you (orsomeone you know well ) defined the problem,generated options, ant icipated posit ive andnegative consequences, made the decision, and

evaluated the outcome. Keep in mind that theadolescent has a relat ively short att ention span, so be bri ef. Choose a topic that is relevant toadolescents (e.g., deciding how to deal wi th anint erpersonal conflict , ident ifyi ng str ategies forearning money for college) (Keating, 1990).

•Discuss ethical and moral problems that are in the news. Encourage the adolescent to think throughthe issues out l oud. Without challenging hi s or her point of view, wonder aloud about how othersmight di ffer in their perspective on the issue and what m ight infl uence these differences (Santi ll i & Hudson, 1992).

Raising Self-Esteem

Low self-esteem develops if there is a gap between one’sself-concept and what one believes one “should” be like(Harter, 1990b). How can a professional know whetheran adolescent has low self-esteem? The followingcharacteristics have been identified by differentresearchers as being associated with low self-esteem inadolescents (Jaffe, 1998):

• Feeling depressed• Lacking energy• Disliking one’s appearance and rejecting compliments• Feeling insecure or inadequate most of the time• Having unrealistic expectations of oneself • Having serious doubts about the future• Being excessively shy and rarely expressing one’s own

point of view• Conforming to what others want and assuming a

submissive stance in most situations

Because consistently low self-esteem has been found tobe associated with negative outcomes, such asdepression, eating disorders, delinquency, and otheradjustment problems (Harter & Marold, 1992,Striegel-Moore & Cachelin, 1999), it is important thatprofessionals identify youth who exhibit thesecharacteristics and help them get the extra helpthey need.

How can a professional help an adolescent raise his orher self-esteem? The most important task is to identifythe specific areas that are important to the adolescent.

Trying to improve global self-esteem is difficult, buthelping adolescents to improve their self-concepts inspecific valued areas is both doable and contributes toglobal self-esteem in the long run (Harter, 1990b). Forexample, a professional may find that an adolescent withlow self-esteem is interested in learning to play theguitar. Encouraging the adolescent to explore thatspecific interest and helping to find resources that mightlead to guitar lessons may lead to important gainsin self-esteem.

Professionals can help to enhance adolescents’

self-esteem by helping them face a problem instead of avoiding it. This can involve such activities as teachingthe youth interpersonal or problem-solving skil ls,role-playing a difficult conversation, or providinginformation and resources. Or, it may simply entailproviding ongoing encouragement and support in facingfeared situations, such as taking an exam, breaking upwith a boyfriend, or telling a parent that one has decidedto stop participating in a sport. The professional mustuse his or her skills and knowledge to determine

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whether the youth is in over his or her head and needsmore than coaching and support to handle a particularsituation. For example, if a youth is expressing thoughtsof suicide, this is clearly a situation where professionalpsychological help is needed.

Emotional Int el l i gence

Identity development as well as moral developmentoccurs in the context of relating to others (Jordan,1994). All adolescents must begin to master theemotional skills necessary to manage stress and besensitive and effective in relating to other people. Theseskills have been called “emotional intelligence”(Goleman, 1994). Emotional intelligence involvesself-awareness, but above all, relationship skills—theability to get along well with other people and to makefriends. Professionals who can help adolescents developemotional intelligence provide them with resources thatwill help them succeed as adults in both their personal

and professional lives. However, one does not have tolook to the future for the benefits; youth withoutrelationship skill s are at greater risk than their peerswho have these skills for a number of problems,including dropping out of school (Olweus, 1996).

What follows is a brief description of the most importantskills for adolescents to begin to master as part of theiremotional development.

• Recognizing and managing emot ions. In order to labeltheir feelings accurately, adolescents must learn to pay

conscious attention to them. Without thisself-awareness, they may simply say that they feel“good” or “bad,” “okay”or “uptight.” When adolescentsare able to specify that they feel “anxious” about anupcoming test or “sad” about being rejected by apossible love interest, then they have identified thesource of their feelings, which can lead to discoveringoptions to resolve their problem. For example, theycan set aside time to study or ask for help in preparingfor the test, or they can talk over their feelings aboutbeing rejected by a love interest with a friend or thinkabout a new person in whom to become interested.The important point is that being aware of and being

able to label their feelings helps adolescents identifyoptions and to do something constructive about them.Without this awareness, if the feelings become uncom-fortable enough and the source is undefined, they mayseek to numb their emotions with alcohol or otherdrugs, to overeat, or to withdraw and becomedepressed. Adolescents who feel angry may take outtheir anger on others, hurting them or themselvesinstead of dealing with their anger in constructiveways, if they are not aware of its sourceGoleman, 1994).

• Developing empathy. Recognizing their own emotionslays the groundwork but does not ensure that youthwill recognize that others have feelings and that theyneed to take these feelings into account. Some youthhave particular difficulty “reading” the emotions of others accurately, for example, mistaking neutral com-ments for hostility. Empathy can be taught in variouscontexts, such as helping students to empathize withdifferent groups of immigrants and understand emo-

tionally the negative consequences of prejudice(Aronson, 2000).

• Learn ing to resolve conflict constr ucti vely. Given theunique and differing needs and desires that peoplehave, conflict is inevitable. Tools for managing conflictcan be modeled informally by professionals or, as insome schools, actively taught to adolescents. Conflictresolution programs teach students to define theirobjectives in conflicts, their feelings, and the reasonsfor what they want and feel, and then ask them to takethe perspective of others involved when coming up

with options that might resolve conflicts (Johnson &Johnson, 1991). Although many of these skills aretaught within programs targeting adolescents, theycan also be taught informally with good results.

• Developing a cooperati ve spir it . It is hardly surprisingthat schools mirror the competit ive att itudes presentin our larger society. Yet, in the contemporary workworld, the importance of teams and the ability to workcooperatively with others is increasingly emphasized.

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Even some Nintendo and video games requirecooperation among the players (Santrock, 2001). The“jigsaw classroom” is a teaching technique pioneeredto facilitate the development of cooperation skills(Aronson & Patnoe, 1997). It requires students to relyupon one another to learn a subject, using strategiesthat reduce competition and that elevate the standingof students who are sometimes ignored or ridiculed.The name derives from the fact that each student

becomes part of a small expert group that is aninformational puzzle piece that must be assembledwith others in order to fully understand a subject. Thisapproach has been successful not only in helpingadolescents learn how to work cooperatively towarda group goal, but also in improving theiracademic performance.

Professionals can bring an awareness of the importanceof these skills to their work with youth and can developstrategies for helping youth to build these skills in theireveryday contacts with them.

Group Dif ferences in Em oti onal Development

Emotional development occurs uniquely for eachadolescent, with different patterns emerging for differentgroups of adolescents. Boys and girls can differ in thechallenges they face in their emotional development. Foradolescents from minority cultures in the United States,feeling positi ve about their ethnic identity, sometimes inthe wake of negative stereotypes about their culture, isan important challenge for healthy emotional

development. Youth whose sexual orientation is gay,lesbian, or bisexual and youth who have a physicaldisabilit y or are chronically ill , experience addit ionalchallenges in building a positive self-esteem in a culturewhere the predominant media image of an adolescent isa White, heterosexual, thin, and able-bodied middle-classteen. Adolescents need adults who can model positiveself-esteem, teach them to be proud of their identity, andhelp them cope positively with any prejudice theyencounter in their lives.

Gender Differences

Longitudinal research has shown that feelings ofself-esteem tend to decrease somewhat as girls becomeadolescents, with different patterns emerging fordifferent ethnic groups (Brown et al., 1998). Part icularlyin early adolescence, some studies have shown that boystend to have higher global self-esteem than girls (e.g.,Bolognini, Plancherel, Bettschart, & Halfon, 1996;Chubb, Fertman, & Ross, 1997).

Because of differences in how boys and girls aresocialized in our society, male and female adolescentsmay also differ in their specific needs for help fromprofessionals in promoting identity formation. Forexample, some adolescent girls may need help learningto become more assertive or in expressing anger.Adolescent boys, on the other hand, may need to beencouraged to have cooperative rather than competitiverelationships with other males and helped to understand

that it’s okay to feel and express emotions other thananger (Pollack & Shuster, 2000).

Ethnic Diversity

Developing a sense of ethnic identity is an importanttask for many adolescents, and numerous studies havefound that having a strong ethnic identity contributes tohigh self-esteem among ethnic minority adolescents(e.g., Carlson, Uppal, & Prosser, 2000). Ethnic identityincludes the shared values, traditions, and practices of acultural group. Identifying with the holidays, music,

rituals, clothing, history, and heroic figures associatedwith one’s culture helps build a sense of belonging andpositive identity. For many of these youth, adolescencemay be the first time that they consciously confront andreflect upon their ethnicity (Spencer & Dornbusch,1990). This awareness can involve both positive andnegative experiences.

Adolescents with a strong ethnic identity tend to havehigher self-esteem than do those who do not identify asstrongly with their ethnic group. Professionals canadvise parents of this fact, encouraging them to discussand practice aspects of their own ethnic identity (e.g.,history, culture, traditions) at home to help their childdevelop a strong ethnic identity (Phinney, Cantu, &Kurtz, 1997; Thornton, Chatters, Taylor, & Allen, 1990).

Quite naturally, the values that parents consider to bemost important to impart to youth vary among ethniccultures. For example, Asian American parents considervaluing the needs and desires of the group over those of the individual and the avoidance of shame to beimportant values to convey to youth (Yeh & Huang,1996). African American families tend to valuespirituality, family, and respect. Values stressed by Latino

parents include cooperation, respect for elders andothers in authority, and the importance of relations withthe extended family (Vasquez & de las Fuentes, 1999).Parents from many Native American Indian cultureshighly value harmony with nature and ties withfamily (Attneave, 1982). And, parents from themainstream White culture may stress independenceand individualism.


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Great diversity exists within each of these ethnic groups.Well-meaning individuals can still fail to recognize thatwithin the Latino community, for example, there arewide cultural differences among those who come fromMexico, Cuba, El Salvador, or Puerto Rico. Blackadolescents may have cultural roots in such varied partsof the world as Africa, the West Indies, Europe, or LatinAmerican countries. Asian Americans from Vietnam,China, and Japan also differ significantly in their

cultural heritage.

Similarly, it can be important to consider whether anadolescent is from a family that has recently immigratedto the United States or from a family whose roots havebeen in America for many generations. Different levels of acculturation, that is, the adoption of behaviors andbeliefs of the dominant culture, are important toconsider in working with adolescents and their families.For example, parents who are not proficient in Englishmay rely on their children to interpret importantinformation for them.

For many in the United States, becoming aware of racism and gaining an understanding of themanifestations of social injustice is an inevitable andimportant part of building a sense of ethnic identity.Professionals who work with ethnic minority youth canhelp them to make sense of the discrimination they mayface and to build the confidence and skills necessary toovercome these obstacles (Boyd-Franklin & Franklin,2000; Oyserman, Gant, & Ager, 1995).17 Professionals canalso help White youth to understand and be awareof racism and discrimination and their impacton people of color.

Gay, Lesbian, and Bisexual Youth

Lesbian, gay, and bisexual (LGB) youth constituteanother minority group for whom identity concerns maybe particularly salient during adolescence. In addition tothe typical identity tasks of any adolescent, these youthsmay also be negotiating the development task ofincorporating a sexual identity in a society thatdiscriminates against homosexuals and a youth culturethat is largely homophobic. Ethnic minority youth, whomust also deal with the stress of racial discrimination,

face the additional challenge of developing an identitythat reflects both their racial or ethnic status and theirsexual identity. The development of a gay, lesbian, orbisexual identity often begins with an awareness of being“different,” of feeling attracted to members of one’s ownsex, and of not sharing peers’ attraction to the oppositesex. An adolescent may find this awareness frightening

and try to deny feelings of attraction to the same sex andto intensify feelings toward the opposite sex. Asupportive environment can help adolescents negotiatethis process and realize their sexual orientation(Fontaine & Hammond, 1996; Ryan & Futterman, 1998;Savin-Williams, 1998). As with heterosexual youth,sexual exploration proceeds with variability, dependingon the individual. Most youth will disclose their sexualorientation to trusted friends first, but may prefer that

their status remain a secret because of the stigmaassociated with differing sexual orientation. When familymembers are told, mothers tend to be told before fathers(Savin-Williams, 1998).

It is important to understand that there are numerousreasons that some adolescents (particularly males) wil lengage in same-sex sexual behavior—they mayself-identify as gay, lesbian, or bisexual; they may bequestioning their sexual identity; or they may simply beexperimenting. Professionals who are privy todisclosures from youth about such experiences should

not necessarily assume that those youth are in theprocess of discovering or developing a gay, lesbian, orbisexual identity—they may or may not be. At the sametime, professionals should be aware that being gay,lesbian, or bisexual could present unique challengesfor teens.

Lesbian, gay, and bisexual youth are at higher risk thantheir heterosexual peers for a number of health-relatedconcerns. These include, for example, substance use,earlier onset of heterosexual intercourse, unintendedpregnancy, HIV infection (especially males), and othersexually transmitted diseases (Blake, Ledsky, Lehman, &Goodenow, 2001; Faulkner & Cranston, 1998; Saewyc,Bearinger, Blum, & Resnick, 1999; Saewyc, Skay,Bearinger, & Blum, 1998). Lesbian, gay, and bisexualyouth have also been reported to be at greater risk forexperiencing verbal and physical violence directedtoward them in a variety of settings (Faulkner &Cranston, 1998; Russell, Franz, and Driscoll, 2001). Inaddition to the danger associated with violence fromothers, there is some evidence that homosexual orbisexual boys are at higher risk for suicide attempts thanheterosexual youth (Remafedi, French, Story, Resnick, &Blum, 1998). This risk of suicide is not related to sexual

orientation per se, but to the intolerable stress createdby the stigma, sexual prejudice, and the pressure toconceal one’s identity and feelings without adequateinterpersonal support (Rotheram-Borus, Rosario, VanRossem, Reid, & Gillis, 1995).

17 Boyd-Frankl in and Frankl in (2000) and Ward (2000) have out li ned some concrete ways parents and professionals

can help adolescent s to deal wi th issues relat ed to racism.


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A challenge for professionals is not just to endeavor toreduce risks for these youth, but to promote resilienceso youth can deal effectively with the challenges thatmay come their way. Youth who are connected to theirfamily, school, and community are more likely to havethe resources necessary to help them cope with thestresses and challenges they face. Professionals whowork with adolescents who are in the process ofdiscovering and accepting their lesbian, gay, or bisexual

identity can do the following:

• Provide accurate information about sexual orientationto dispel stereotypes about gay, lesbian, or bisexualsexuality;

• Avoid communicating disapproval of gay, lesbian, orbisexual sexuality;

• Help the adolescent identify sexual prejudice andreject its messages;

• Refrain from pressuring the adolescent to reacha decision about his or her sexual orientation;

• Provide developmentally appropriate information

about sexual behaviors, including both same-sex andopposite sex behaviors, that can lead to HIV infection,STDs, and unintended pregnancy in a manner that isinclusive of a lesbian, gay, or bisexual sexualorientation;

• Be aware of the heightened risk of suicide for someyouth and make appropriate referrals forpsychotherapeutic help for distressed youth; and

• Acknowledge and address any biases they may haveabout gay, lesbian, or bisexual youth.

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world outside of the family and about themselves(Santrock, 2001). Peer groups also serve as powerfulreinforcers during adolescence as sources of popularity,status, prestige, and acceptance.

Being accepted by peers has important implications foradjustment both during adolescence and into adulthood.One study found, for example, that fifth graders whowere able to make at least one good friend were found tohave higher feelings of self-worth at age 30 whencompared to those who had been friendless (Bagwell,Newcomb, & Bukowski, 1998). Positive peer relationsduring adolescence have been linked to positivepsychosocial adjustment. For example, those who areaccepted by their peers and have mutual friendshipshave been found to have better self-images duringadolescence and to perform better in school (Hansen,Giacoletti, & Nangle, 1995; Savin-Williams & Berndt,1990). On the other hand, social isolation amongpeer-rejected teens has been linked to a variety ofnegative behaviors, such as delinquency (Kupersmidt &

Coie, 1990). In addition, adults who had interpersonalproblems during adolescence appear to be at muchgreater risk for psychosocial difficulties duringadulthood (Hansen et al., 1995).

The nature of adolescents’ involvement with peer groupschanges over the course of adolescence. Youngeradolescents typically have at least one primary peergroup with whom they identify whose members areusually similar in many respects, including sex(Savin-Williams & Berndt, 1990). During this time,involvement with the peer group tends to be mostintense, and conformity and concerns about acceptanceare at their peak. Preoccupation with how their peers seethem can become all consuming to adolescents. Theintense desire to belong to a particular group caninfluence young adolescents to go along with activitiesin which they would otherwise not engage (Mucucci,1998; Santrock, 2001). Adolescents need adults who canhelp them wit

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Adolescence Development

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