Teens in Balance - Tara Cousineau, PhD

Teen Brains: What were they thinking?

Sometimes a news story crosses your radar and it'€™s hard to shake. Maybe because my last post threw me back 25 years to those NY parties over the state border that we teens went to. Recently, a 17 year old was found dead not 100 feet away from the spot in a meadow where she and her friends partied after a Homecoming game. She told her friends she was leaving and off she went. She called a family member but the call was garbled, chocked up to bad reception. No one heard from her again. It seems she passed out and never woke up.

It was 30 degrees that night. She died from exposure.

It so happened that my best friend from high school called out of the blue. We were talking about our kids -- hers are teens and mine, tweens. I told her about the story of the girl I read about in Monday'€™s paper, and remarked, "She could have been anyone of us; it could happen to our kids.€

"€œI know," my friend lamented. She just allowed her 15 year old to have a Facebook account. We worry about the modern challenges, like kids exposing themselves on the net or being preyed on by cyber freaks, when simple human tragedies happen in our communities every day.

I told my 11 year old about the girl in an effort to talk about the consequences of alcohol use. She immediately went to the emotional, untold part of the story: Her friends must feel soooo bad.

The alcohol part didn'€™t register so much yet. I'm sure it will in a few years, at least the intellectual understanding of it - eventually, the physical understanding of it.

Years ago a professor of mine had shared some research he had done on adolescent risk taking related to drug use. He found that kids who dabbled risky behaviors, the "€œexperimenters"€, faired much better psychologically than the teens on the extremes -- those who abstain from any risk and those who revel in it. Intuitively, that makes sense. Most of us fall in the middle range. Of course, one misjudgment can be deadly.

I recently read The Primal Teen by Barbara Strauch.It'€™s a fascinating and fun summary of the research on adolescent brain development. It's should be required reading for every parent. Strauch spans the brain development of mankind and the role of risk taking in survival of the species; experiments with teen monkeys; and research on human adolescent brains using MRI and other technologies. She writes about the effects of a brain exploding with neuronal development on the cognitive, social and behavioral domains. A wild territory. Basically, the teen'€™s neuronal map is rapidly expanding and then pruning itself back, honing in on "€œexecutive'€ functions like the ability to plan, delay gratification, or take perspective.

I devoured it and my bumpy but basically boring adolescence came into focus: The inexplicable outbursts vs. the otherwise empathic and steady outlook on life; or the distractibility and flakiness, like repeatedly missing the bus with no way to get 5 miles across town to school. This is in contrast to an intense focus on one activity, like my devotion to ballet or scrap booking. And, of course, there was one time I felt devastated by a boy'€™s rejection, made all the worse by a brain marinated in cheap sweet wine, and I walked miles through wooded neighborhoods to arrive home with brambles in my hair and twigs in my sweater.

• Reference: Shedler, J. & Block, J. (1990). Adolescent drug use and psychological health: a longitudinal inquiry. American Psychologist, 45, 5, 612-630.
• For Teens: Inside the the Teen Brain (Frontline)

An Unsavory Tonic: Teens, Texting and Driving

Sometimes I am amazed I survived adolescence. Whenever I see or hear a story of automobile crash involving teens, I do this auto-scan of times I found myself in an accident (twice) or in the car of a drunk peer, bracing myself and praying to God to get us all safely home (too many times). Being stick thin and of slight frame I learned early I could not hold a drink very well; and so I often volunteered to be a designated driver, taking my friends beyond the NY state line where the drinking age was still 18 -- not 21 like the state in which we lived. We called them New York parties, out in some wooded area, bon fires and kegs, fishermen's sweaters, and innocent flirtations with seniors.

The night of my high school graduation one student killed another, just slammed him down while he was getting in his car at the roadside, dragging him underneath the carriage. It was at a house party where the dad collected everyone's keys as some measure of safety. But it didn'€™t matter in the end. It broke the class of '83 and a number of families. The driver committed suicide the following year. The tragedy is still subtly reflected in reunions that seem to happen on an off year, a haphazard attempt to get together from time to time.

Unlike 25 years ago, seat belts are now the norm and the dinging in cars are a nuisanced reminder to buckle up, as part of the modern technology tuned in to broken brake lights and level of wiper fluid. But now there is a new technological danger while driving and it’s something just about every teen has: a cell phone.

A recent report on NPR, Multitasking In the Car: Just like Drunk Driving, hit this new reality home. Apparently, performance while driving using a cell phone “is as poor if you were legally drunk. I guess I need to demand that any sitter driving my kids around not use her phone or else she'€™s out of a job. But what about my own kids? They aren'€™t that many years away from driving -- and they are chatty as it is. They'€™ll both be fluent in text messaging in no time.

A colleague of mine created a CD-ROM for teens called Crash Site, funded by the National Institutes of Health. It was ingenious. It started out with the sounds of a car screeching and then the screen going black. The user would have to find out if he or she were the drunk driver, a passenger, the paramedic, or a lawyer. During the process the teen player would learn about blood alcohol levels, affects of alcohol on the brain, not to mention the emotional and legal consequences. Now we have cell phones to consider in the mix as well.

Of course, the most obvious role models are parents. I know I'€™m a queen of multitasking. But it seems to me banning the use of cell phone use in cars, short of an emergency, is the obvious next step.

Here's a listing of which states have taken a lead on cell phone driving laws (and it's only a minority): Governor€™'s Highway Safety Association.

A good read may lead to healthy lifestyle changes in overweight girls

I love behavioral health research with a creative design so I was pleasantly surprised when I was tipped off to Tara Parker-Pope'€™s piece in the New York Times this week, Healthful Messages Wrapped in Fiction.She reported on a Duke University study that basically had overweight tween girls (ages 9-13) in a obesity prevention program split into three groups: (1) one group read a Beacon Street Girls Series novel focused on the classic middle school angst around weight, feeling fat, being teased, and ways the character coped, (2) another group read an installment of the same series around self-esteem only, and (3) a third group did not receive anything.

The interesting results: Girls in the first group who read about the girl with the weight issues changed their behavior around eating and physical activity to be more healthy and thoughtful â€" resulting in a slightly lower BMI -- which, if apparently sustained for these girls, could mean growing into teenagers with a healthier weight. The second group also showed positive gains in healthy lifestyle habits although not as great; and the reading-deprived group showed a slight increase in BMI.

Of course, there is the question of whether statistical significance translates into clinical significance. But to me the important points were that fiction may a viable way to communicate to kids about healthy choices in scenarios that readers can connect to (rather than us grown ups and health educators stammering over and over again about eating your fruits and veggies). And, also that small changes -- early enough in one'€™s development -- could lead to sustained healthy habits to carry through life. Time will tell if the researchers follow these girls long enough.

(The study was originally presented earlier this month at the Obesity Society'€™s annual conference, lead author: Alexandra C. Russell, medical student, Duke University School of Medicine, Durham, N.C.)

The second reason I was delighted to read the story is that I used to live on Beacon Street and when this series came out I was still living in Brookline, MA. The story hit the local press at the time and the shelves of Brookline Booksmith, the neighbor bookseller with the best guest writer talks in Boston area. I was impressed with the mission of B*tween Productions who created the Beacon Street Girls series. At the time I thought the books series was a brilliant idea. Now, with a daughter about to turn 11, this is a great reminder to start her on this book series (if she could stop reading the Harry Potter series again -- this time in reverse order).

Teens: A World of Extremes

This blog is my space for my own commentary about teens, health, and consumerism; it'€™s in parallel to a project I have going to create an online teen health program. I figure it is best to keep my own thoughts and biases separate from the project, which has a cool team of people and teens to keep it on track.

I suppose it is timely to begin this week, when the US economy is in a bit of a tailspin, and along with lean times supposedly comes leaner waistlines. It will be interesting to see what our epidemiologists and social economists will report about this phase after looking at health and economic data 5 years down the line.

This is the 4th blog I'€™ve started and it'€™s the one I'€™m going to stick with for 2 reasons: I'm immersed in eHealth prevention programming for teens related to nutrition, physical activity and body image, and I have two daughters rapidly approaching the tween/teen years - so I am going to be swept up with the teen tide no matter what.

It's a world of extremes.

Here's some sobering facts about our teens today -- and they are a bit all over the place, because so are adolescents in general:

• Over the past 25 years the prevalence of childhood obesity has quadrupled in the US. Processed and high caloric foods predominate meal choices for children. Many public schools have decreased or eliminate physical education and recess. Only 15% of kids walk or bike to school.
• Today, about 16%  are overweight or obese. Another 9 million are at risk for becoming fat. Boys and girls of all ethnicities and race are affected.
• The health consequences include asthma, type II diabetes, hypertension and heart problems, orthopedic complications and sleep apnea. Overweight girls experience earlier onset of menstruation. The emotional consequences for teens include low self-esteem and depression.
• The health care costs associated with obesity threaten to cripple our health care system.
• While more kids play sports today than 30 years ago, competitive sports in youth start earlier. Pressure has increased on pre teens and teens to excel and play year round sports with no off- season.High school athletes account for an estimated 2 million injuries each year.
• More teens report attempting to diet and 70-80% are dissatisfied with their bodies.
• The prevalence in eating disorders has increased with 5-10 million girls/women and 1 million boys/men suffering from anorexic or bulimic disorders. The number of pro anorexic websites increased by 470% since 2006.
• The access to anabolic steroids to increase muscle mass among youth has skyrocketed.

And it'€™s not just in the US. All these problems affect other industrial and developing nations.

Needless to say, there is a lot to do.

Sources:

American College of Sports Medicine;

Centers for Disease Control