Pathologizing & “Risk Behaviors”
Part 1 – Pathologizing
Most of what I’ve learned has come from a mix of Harmful to Minors: The Perils of Protecting Children From Sex by Judith Levine, and The Scapegoat Generation: America’s War on Adolescents, by Mike A. Males. Excerpts I include will come from the latter. I recommend reading it yourself if you’re curious. I’ll also include some accompanying references for the excerpts I do share. Partly so that I can easily find and go over them myself later.
Where did American social scientists get the idea that adolescents are intrinsically perilous? They defined it that way. As Robert Hill and J. Dennis Fortenberry, of the Department of Pediatrics at the University of Oklahoma Health Sciences Center, explain:
By creating adolescence as a developmental period defined by its problems, “adolescent health” becomes an oxymoron… “medicalized” into a condition that is inherently pathological… Adolescence per se is seen as the inevitable “risk” factor for these widespread problems as if the origin of these problems were innate to adolescents, rather than complex interactions of individual biology, personality, cultural preference, political expediency and social dysfunction.2
If adolescence is defined as a disease state, it must be cured. The major impetus for the development of psychological techniques in the late 1800s and early 1900s, writes historian Joseph Kett, was the “testing,” “treating,” and “controlling” of teenagers.3
The views of the psychological industry are cited constantly by the media as “objective” commentary on adolescents […] Several studies have documented the biases, many extreme, held by most mental and medical professionals against teenagers. In repeated studies, psychologists and doctors, when asked to project how normal adolescents would respond to a battery of tests for various neuroses, predicted levels of anxiety, hostility, depression, vulnerability, and other indicators of mental disturbance that were two to three times higher than not only normal, but disturbed, violent, and disabled teenagers rated themselves on the same tests!4 5
Like all psychology it started with assumptions, and these assumptions haven’t been corrected in the mainstream. We trust the “experts” rather than question them, and this leads to a field of psychology that produces more of what it wants to see for profiting purposes. I’m sure starting over when you’ve built careers off of being wrong probably isn’t a pleasant idea.
“Adolescence” was first coined by G. Stanley Hall in 1904, who also viewed masturbation as immoral and believed adolescent boys had to go through a “conversion” period in which they became less sexual and the “sins” of their ancestors were resolved. His opinions on adolescents were largely based on his own experiences growing up. Alongside Sigmund and Anna Freud, the idea was instilled that the period of adolescence was inherently rife with internal struggle and “risk behaviors,” which included sexual expression. Adolescent sexuality was pathologized, because adolescence itself was considered a pathology of aging. This was also clearly influenced by the Puritan values surrounding sex at that time.
Where prejudice exists among scientists, as Stephen Jay Gould points out in The Mismeasure of Man, criteria are selected and evidence assembled to support it. Theories of ‘innate’ teenage instability and recklessness derive from a fundamental mistake in psychological research: The tendency of clinicians to make unwarranted assertions about all adolescents by generalizing from clinical or institutionalized populations. ‘Even though normal teenagers were not studied by clinical investigators,’ psychiatrist Daniel Offer and colleagues write of the earlier studies in which these stereotypes were fostered, all teens were simply assumed ‘to have the same basic conflicts as psychiatric patients or juvenile delinquents’ that the researchers had captive to study.7
Yet the view of roiling teenage biology determining reckless teenage destiny clearly remains the mainstream view of the social and health scientists providing commentary to the media and to political authorities. It is the chief surviving atavism of biological determinism, a 19th century pseudo-science that sought to classify nonwhite racial and ethnic groups and women as innately inferior under precisely the same criteria now applied to adolescents. Modern psychology and human behavior disciplines have resurrected, when convenient, the extreme Sturm und Drang notions of adolescents asserted by early-1900s psychologist G. Stanley Hall. Wrote Hall in 1904 on teenagehood:
The momentum of heredity often seems insufficient to enable the child to achieve this great revolution and come to complete maturity, so that every step of the upward way is strewn with wreckage of body, mind, and morals. There is not only arrest, but perversion, at every stage, and hoodlumism, juvenile crime, and secret vice… Home, school, church fail to recognize its nature and needs and, perhaps most of all, its perils.
This depiction of puberty as soul debilitation was based on the twisted adolescence of G. Stanley Hall, infused with mental and physical abuses by his father, more than any objective study of growing up. Similarly traditional psychodynamic theory viewed adolescence as a period of “disturbances of varying seriousness and crippling effects, transient or permanent.” Anna Freud wrote, “the upholding of a steady equilibrium during the adolescent process is itself abnormal.”
Were social scientists’ declarations of “biological determinism”—the innate disadvantages of nonwhites and women […]—issued in a spirit of hostility? Not of the overt kind. It was with compassion and caring that the white man’s burden to exercise greater control over impetuous, childlike, nonwhite races was invoked. Wrote one early-century scientist:
Modern science [has] shown that races develop in the course of centuries as individuals do in years, and that an undeveloped race, which is incapable of self- government is like… an undeveloped child who is incapable of self-government.
For those who emerged from hermetic theorism to study teenagers as they actually lived and breathed, Hall’s dirisms were easily refuted. Despite ‘the widespread myth that every child is a changeling who at puberty comes forth as a different personality,’ psychologist Leta Hollingworth wrote in The Psychology of the Adolescent in 1928, adolescent development is characterized by a ‘gradualness’ in which social mores played a far bigger role than biology.12 Wrote anthropologist Margaret Mead in Coming of Age in Samoa that same year: “The stress is in [American] civilization, not in the physical changes through which our children pass.”
Gould’s 1981 treatise, The Mismeasure of Man, explores the fallacies of labeling blacks and women as grownup “children” or “adolescents” subject to the control of innately superior white northern European men. This concept applies in equal and opposite fashion to today’s efforts to resurrect the same stereotypes once inflicted on minorities and females to apply them against teenagers.
Yet modem pop science ignores the preponderance of literature findings on adolescence, such as the following exhaustive textbook review of dozens of studies:
A few adolescents experience identity crises that are traumatic and totally preoccupying. However… for most, identity formation proceeds in very gradual, uneventful way… For most people, adolescence is not a period of intense emotional upheaval that brings with it an increased risk of adjustment difficulties, although it has often been thought of in this way. In fact, the incidence of serious psychological disturbance increases only slightly from childhood to adolescence (by about 2 percent), at which time the rate is about the same as it is in the adult population.15
Daniel Offer’s studies of 30,000 youths from the 1960s through the 1980s reported “no support for adolescent turmoil” or instability theories. Three decades of surveys of a wide variety of adolescents found 85 percent were healthy and confident, 90 percent were concerned with the future and work, and 90 percent held attitudes and values similar to those of their parents.16 From a cognitive, developmental, maturity, or behavior standpoint, there is no reason to view 16-year-olds as different from adults, Offer’s lengthy studies concluded.17
“Few ideas in adolescent psychology are as accepted by researchers with such unanimity as the notion that parent-adolescent relations basically are not stressful,” another 1980s review found.18 The study authors emphasized “researchers” since the modem cult of pop psychologists and media mythmaking tends toward fear profiteering. Entire books, documentaries, news features, and talk show formats have geared themselves to terrifying parents of berserk and savage teenhood.
Currently the state of research on adolescents is a bit better. Many professionals seem to recognize the notion of “sturm and drang” is not sound science. But despite this we haven’t abandoned the zeitgeist of “risk behaviors,” and the culture has not adopted the relatively new scientific understanding—probably because many professionals haven’t entirely let go of the use of “risk behaviors” yet either, which is a way to play on the fears of parents and gain clientele.
The Scapegoat Generation and Harmful to Minors both go further into the psychiatric industry than I plan to go into here, but it’s a common practice to play on the fears of parents to fill up their psychiatric correctional facilities with young people who may not have any real psychological problem (like in the case of Operational Deviance Disorder—which implies young people are innately subordinate and that challenging authority is disordered). Once the insurance runs out, then the youth is miraculously “cured.”
Defending its members’ admissions policies as based on “appropriate assessment” and “fully implemented quality assurance,” the National Association of Private Psychiatric Hospitals assured Congress that profiteering was not the reason for the rising juvenile clientele:
Child and adolescent admissions to psychiatric facilities are increasing because more of them are seriously psychologically disturbed. The most recent President’s Commission on Mental Health Report (1979), estimated that 1.4 to 2.0 million adolescents have severe psychological problems. More current objective studies confirm these figures. Tragically, these severe psychological problems often manifest themselves in suicide. An American teenager takes his or her own life once every 90 minutes, and this year, an estimated two million young people between 15 and 19 will attempt suicide. Suicide is now the third leading cause of death among young Americans.
Fortunately, the American public is becoming increasingly aware of the problem and increasingly accepting of the need for appropriate treatment. Public education campaigns have contributed to this heightened awareness of the growing numbers of troubled youth.
[…] NAPPH’s claim that a teenager commits suicide “every 90 minutes” yields an annual toll of 5,840, three times the true annual toll (1,849 in 1985). The estimate that “two million young people between 15 and 19 will attempt suicide” per year is four to eight times that predicted by even the highest survey estimates. NAPPH’s claim that adolescent psychological problems “often manifest themselves in suicide” is dubious: By their own figures, only one in 1,000 adolescents with ‘severe psychological problems’ takes his or her own life.
Further, questioning our view of young people and their supposed incompetence and helplessness would up-end society as we know it. Everything would need to change in order to give respect to a whole class of people that have been systematically oppressed—That would be very costly and very inconvenient. It would also challenge the “parental rights” that many abusive parents rely on to keep control (ownership) over their children.
In the 1940s and 1950s, a reaction to perpetuation of the extreme views of Hall and his followers had set in. A minority of social scientists affirmed teenhood as a dynamic antidote to the sterility of an increasingly regimented adult world. The famous Swiss psychologist Jean Piaget, whose revolutionary studies of child development found youths beginning at around age 11 were fully capable of the mature ‘formal operational’ thinking of adulthood, declared that it is the “duty of the modem adolescent… to revolt against all imposed truth and to build up his intellectual and moral ideas as freely as he can.”21 The problem with teenagers was that they were not rebellious enough.
Similarly, sociologist Edgar Z. Friedenberg found in adolescence the salvation of an increasingly regimented, conforming, corporate-dominated society. America is “a society which has no purposes,” he wrote in a series of essays including The Vanishing Adolescent (1959) and The Dignity of Youth and Other Atavisms (1964). Adults deploy high schools and psychologists in “sedative programs of guidance… to keep young hearts and minds in custody until they are without passion.” The struggle between generations is like that between classes, with adults striving to prevent teenagers from defining themselves through conflict with society.
Friedenberg correctly predicted the increasing anger against teenagers of coming decades. “Fear of disorder, and loss of control; fear of aging, and envy of the life not yet squandered—these lie at the root of much adult hostility to adolescence.”22 The society of facelifts, Grecian formula, and Rogaine evidences one that oppresses teenagers to mask its contempt for the old. Modern America seeks to “infantilize adolescence”23 by exploiting teenagers as a projective device for adult inadequacies:”
Adults read their own hopes and fears into the actions of adolescents, and project onto them their own conflicts, values, and anxieties. They take desperate measures to protect the young from imaginary menaces, which are in fact their own fantasies, and to guide them to imagined success, which is in fact surrender.24
That last quote from Friedenberg is probably one of my favorites now. I don’t think its intentionally malicious, but it still perpetuates the same oppression we’ve all experienced. I think in some ways it’s an attempt for adults to convince themselves they’ve chosen the right path in life. To consider things differently would mean reconsidering their entire life up to the present, whether they made the right choice or sacrificed their freedom to conformation.
Once conformation as a lifestyle sets in, time is lost to it. Whole lives are spent in the stagnation of conforming to a rather pre-determined path. Questioning the foundations on which our own lives and society are built becomes a greater and greater ask. It’s easier to push youth in the direction we’ve been pushed than it is to question, “Is everything we’re doing wrong? Have I wasted large chunks of my life to something profoundly unfair?”
I think there’s some unrecognized fear of the potential for things to be different. Because then wasn’t everything a waste of time and potential happiness? A relinquish of freedom?
Part 2 – “Risk Behaviors” and Innate Incompetency
In the past I’ve spread the idea myself that teenagers are more prone to taking risks, because some evidence suggests that, but I’ve learned it’s mostly poor evidence. Along with correcting it I also want to share what I’ve learned. It’s an important subject because the belief that teenager’s are inherently more prone to risk is hand-in-hand with the belief that they are by nature incapable of making wise decisions—which is the basis for youth oppression as a whole.
I’ll start this with modern data, but later I’ll share some of what’s documented in The Scapegoat Generation. I think witnessing how the same trends have been reported over time is interesting. Also, Miles makes some great points.
General findings are that in each area listed, adults score higher in the risky/destructive behavior. Of course, there are also more adults than minors (that’s why it’s called a minority age group), but still the numbers are mostly low, especially compared to adult samples. And when you consider a larger amount of youths are poor than adults, the risk behaviors likely have more to do with socioeconomic status than age.
Diet and Exercise
“Risk behaviors” are all about judging how prone to risky behaviors someone is, right? It’s in the name. Normally we think of impulsivity, but still, a self-destructive diet which is clearly a poor choice counts. And yet, 30% of adults in America are overweight. 1 in 3 adults is overweight, and 1 in 6 children and adolescents are.
Of course gaining weight takes time which is a factor to consider, but if these habits start in childhood or adolescence (as they often do) and persist into adulthood, that shows that age itself doesn’t have determine how likely someone is to engage this particular risk. People can stop at any time, hard as it is, and many do! Yet many more adults maintain the same lifestyle while knowing in the long-term it will harm them. They have the capability to make a better choice, but they often don’t, because adults are not instinctively wise or responsible.
When it comes to exercise, youth aren’t much better, particularly after starting adolescence. However, as someone ages they become less active, which is still definitely risky to long-term health. Young people are, on the whole, physically healthier than adults, but probably not by much. I think this makes sense, given their role models.
Diet and lack of exercise together contributes to the leading causes of death for adults, cardiovascular disease and cancer. Did you know processed meat is a Group 1 carcinogen? As one ages, the longer they keep the same lifestyle, the more risk increases. And yet many adults keep taking those same risks even knowing the dangers.
Age itself does not grant the wisdom to act responsibly.
Drug and Alcohol Use
According to the 2023 NSDUH, 1.8 million youth ages 12 to 17 (6.9% in this age group) reported that they drank in the past month. 132.9 million adults ages 18 and older (51.6% in this age group) reported that they drank in the past month.
Of course availability is a part of that, it’s easier to get alcohol as an adult. That said, alcohol is still bad for your liver, and is therefor risky to long-term health. In this area adults score much higher than youths. Being an adult doesn’t remove the risks associated with alcohol, though it may be riskier for younger people. It’s still a “risk behavior” regardless.
For illicit drug use, almost all users are over 18. Given the nature of the drugs being illegal, availability may still be greater for adults, as they likely have more money to pay for it—but it’s not necessarily easy to access for either group. And again, this is a significant display of risky behaviors by adults, yet we don’t diminish adult decision making capabilities.
This has some more impressive numbers, but primarily for alcohol and weed use among teenagers in grade 12. And on that note, I think there’s a negative side-effect to this idea we have of teenagers being especially reckless and prone to making poor decisions. That in itself encourages those behaviors. If you’re being told you’re at a time in your life where you’re prone to recklessness, rebellion, and risk—and that as you get older, you will have to “grow up” and always be responsible, then naturally people are going to exploit the opportunity to explore what we may deem “reckless” or “risky” when they’re in the age group its deemed “appropriate.” For instance, teenagers may think that it’s their only chance to experience these things now, and that it’s only natural to do so—everybody is saying it is!
Even still, the statistics are lower than for adults. In this study, 16.9% of people aged 12-17 drank alcohol in the past year, compared to 67% of people over 18.
Sex and Condom Use
Everything I’ve found suggests that teenagers have less sex and use condoms more frequently when they do have sex. Interestingly, in the Youth Behavior Survey (2013-2023), “ever having sex” is considered a risk factor for STIs, HIV and pregnancy. Which, obviously! But we don’t call it that when we talk about adult sex, despite adult’s actually being less likely to use condoms! The presentation of this survey implies “no sex would be perfect,” but why does sex get special treatment? The leading cause of death for teens are accidents, particularly motor vehicle accidents. This is likely less to do with recklessness than it is inexperience. Despite this high risk (much greater than an STI!) we allow teenagers to drive. Teens are also allowed to play in body-contact sports, which are also known to be risky!
I’m not suggesting we should take those rights away, instead I think we should stop treating sex as something exceptionally risky when other forms of risk are acceptable. The only way to actually prevent risk would be to lock young people away all day, and that, in turn, would lead to more risk—They would be even less able to escape abusive situations!
The best way of dealing with risk isn’t to try and control someone from ever living life and gaining experiences, it’s to make support more widely available.
Anyway, onto sex and condom use:
This study on men and women aged 15-44 found that the percentage of people who used a condom “every time” they had intercourse decreased with older age.
Of course there are a few important factors here. Someone who’s younger is less likely to have an established long-term partner. However, this same study finds that when women’s last sexual partner was someone they had just met, 47.2 percent did not use a condom. Considering the study also found adolescents had less sex than adults, and were more likely to use condoms when they did have sex, this could indicate that even in risky situations adults are less likely to use condoms.
Either way, I think that the higher percentages of youths who use condoms, as compared to youth who don’t, shows that young people are not necessarily “prone to risk” in this area.
This study found that even homeless youth pretty consistently use condoms.
This study focused on people aged 12-25 found use of the dual method of protection (both condoms and other contraceptives) increased in teenage years and decreased with age.
Crime and Homicide
The vast majority of people who commit homicide are over 18, most being 30 or older. In 2022, only 9.9% of arrests for all violent crime in the U.S. were juveniles. Most victims of homicide that are youths are killed by adults.
Seems like adults make a lot of risky bad decisions to me, but we recognize lifestyle factors and mental health are bigger impacts in committing those crimes. Why would it be any different for youth, when research has found them capable of reasoning, risk evaluation, and informed decision making? We generalize based on what our biased perspectives of youth.
Suicide
While any suicide rate is too high, this finds that people over 25 are more likely to commit suicide than teens are. Also, the elderly are the most likely to commit suicide. Rather than claiming that’s due to a lack of mental faculties, I think most people would assume that people who have lived a long time may eventually tire of the struggles of life. Adults of all ages score higher than teens as well, but we’ll probably recognize that as unhappiness with life, not age or innate mental capabilities.
Instead we should look at socioeconomic factors, home life, and mental health. Teenagers deal with a lot of pressures from family and compulsory schooling, alongside their sense of identity and their relationships evolving as a natural part of adolescence.
Even where greater percentages of risk-taking is recognized, it’s also now more commonly recognized that this is not because adolescents have poorer reasoning abilities:
Among the widely-held beliefs about adolescent risk-taking that have not been supported empirically are (a) that adolescents are irrational or deficient in their information processing, or that they reason about risk in fundamentally different ways than adults; (b) that adolescents do not perceive risks where adults do, or are more likely to believe that they are invulnerable; and (c) that adolescents are less risk-averse than adults. None of these assertions is correct: The logical reasoning and basic information-processing abilities of 16-year-olds are comparable to those of adults; adolescents are no worse than adults at perceiving risk or estimating their vulnerability to it (and, like adults, overestimate the dangerousness associated with various risky behaviors); and increasing the salience of the risks associated with making a poor or potentially dangerous decision has comparable effects on adolescents and adults (Millstein & Halpern-Felsher, 2002; Reyna & Farley, 2006; Steinberg & Cauffman, 1996; see also Rivers, Reyna, & Mills, this issue). Indeed, most studies find few, if any, age differences in individuals’ evaluations of the risks inherent in a wide range of dangerous behaviors (e.g., driving while drunk, having unprotected sex), in their judgments about the seriousness of the consequences that might result from risky behavior, or in the ways that they evaluate the relative costs and benefits of these activities (Beyth-Marom et al., 1993). In sum, adolescents’ greater involvement than adults in risk-taking does not stem from ignorance, irrationality, delusions of invulnerability, or faulty calculations (Reyna & Farley, 2006).
And I guess I’ll end this part with two studies I’ve linked in the past, that find young people competent for informed consent (the basis for making wise decisions) at 12 and 14.
Here is a more recent paper by Mike A. Males, who researches adolescents, on the idea of adolescents being particularly risk prone.
For supporting work I haven’t read directly yet:
Here’s Jean Piaget’s work that concluded youth aged 11 were competent to make decisions.
Daniel Offer’s studies: 1, 2, 3, 4, 5
Moving on to excerpts from The Scapegoat Generation:
A particularly thorough justification of the “innate risk” theory of adolescence
occurs in the Winter 1990 issue of New Directions in Child Development. In assessing
teenagers’ risk-taking with regard to AIDS, authors William Gardner and Janna
Herman first declare the consensus among social scientists that “there is abundant
evidence that adolescents take serious risks with their health, as compared with
both adults and younger children.” AIDS is one of the most common areas in which to assert “adolescent risk-taking behavior.” But it is a peculiar illustration. As noted in Chapter 2, nearly all sexually-contracted adolescent AIDS appears to result from relations with adults. Except in cases of outright adult exploitation resulting from extreme power differences or rape, this indicates a shared risk-taking behavior. Even ignoring that salient issue and adopting the most extreme view possible—that all AIDS cases diagnosed among persons age 20-29 were acquired as HIV in adolescence, and that teenagers only have sex with other teens—teenagers are still not the most “at risk” group to contract HIV (Table 8.1).
Using the authors’ own example of HIV/AIDS infection, adolescents are not more likely to take health risks than adults.
Still, unlike most who so assert, Gardner and Herman buttress the claim of innate adolescent risk-taking not as an article of faith, but as the product of empirical evidence:
1. “The primary causes of mortality among 15-24-year-olds were accidents (54 per- cent), suicides (14 percent), and homicides (11 percent), events that either result from or are closely related to behavioral choices… Young people also experience more accidents than adults, of which motor vehicle accidents are the best understood because they can be clearly linked to specific risk-taking behaviors.”
2. “Adolescents and young adults are also more likely to participate in and be the victims of violent crimes. Although the level of crime varies as a function of gender, historical period, ethnic group, and many other variables, the overrepresentation of adolescents and young adults is a remarkable constant.”
3. “The typical adolescent will score higher than an adult on personality measures
associated with risk taking, such as the psychopathic deviance score of the Minnesota Multiphasic Personality Inventory or measures of sensation seeking.”Let us take these claims one by one. First, the assertion that violence is the leading cause of death for adolescents, and therefore teens are a “high risk” group, contains a fundamental fallacy. What it really reflects is a positive fact: Teenagers have much lower death rates than adults because they are far less likely to die from major natural causes, especially cancer and heart disease. Further, violence is the leading cause of death for adults age 20-29 (groups with violent death rates higher than those of teens), and trends among teens and adults display an almost identical pattern over the last 40 years (Figure 8.2).28 As has been discussed, the recent rise in teen violent deaths (which still have not reached levels found among Baby Boom adolescents in the Sixties) is due to homicide increases. This trend, in turn, is closely related not to intrinsic youthful violence, but to the unique rise in teenage poverty since the 1970s. The death rates for whites, Hispanics, blacks, and other nonwhites by age and sex for each major cause for adolescent, young adult, and middle-aged adult groups are shown in Table 8.3. Professing that a characteristic is “innate” to a group necessarily entails arguing that it makes members of that group behave more like each other, and less like those outside the group. Under this concept, teens should act more like teens of other races and of the opposite sex, and unlike adults of their own race and gender.
This is not the case. Even when examining the indexes chosen by those who
claim risk-taking is intrinsic to adolescents—suicide, homicide, accidents, and especially motor vehicle accidents—no innate pattern is evident. The variation in teenage behavior is substantial when analyzed separately by sex, race, and cause of death. Overall, adolescents display no more risks than adult age groups. For all types of violent fatality, young adolescents age 10-14 are less at risk than every adult age group, and older adolescents (15-19) are less at risk than adults in their 20s.Race and gender are much more dominant than age in predicting violent death. Asian teens (focusing on 15-19-year-olds), for example, are less at risk than every adult age group regardless of race. White teens are less at risk of violent death than every adult age group of blacks, and o{ all Hispanic adult groups up to age 40. For all races, the risk is less in teen years than at ages 20-24. Teen violent death patterns most resemble those of persons age 25-34 of their respective races. Even for motor vehicle crashes, teenagers of all races rank second in risk behind 20-24-year-olds. Black teenagers are less likely to suffer a fatal motor vehicle accident than black adults under age 40, but white and Asian teens are second only to 20-24-year-olds. Adding in gender makes the situation even more chaotic. White and Asian female teens are riskier drivers than any other female age group of their race, but black females are less at risk than black adult women under age 35. White male teens have fatal crash rates second only to 20-24-year-old white men. Asian male teen drivers are safer than Asian adult males under age 30, and black males are less likely to die in a traffic mishap than black adults males under age 50! This is far from a clear picture of a teenage group at unique and extreme risk.
Note that motor vehicle crashes—the index chosen by most authors to rank
behavior risk by age—happens to be the one least favorable to teenagers and most
favorable to adults over age 25. As pointed out in the last chapter, the high risk of teenagers is an artifact of the high proportion of novice drivers among adolescents;
inexperience, not immaturity or intrinsic recklessness, is the chief culprit.Further evidence for this is that teenagers are much less at risk of other types of
violent death than are adults. A ranking based on all other accidental deaths produces dramatically the opposite result: Teenagers as a group, and of every race, are much less likely to die from mishaps other than traffic accidents than are adults under age 50. For the two largest non-traffic accident causes, falls and drug deaths, teenagers are far less at risk of fatality than are adults in every older age group. Thus, if viewed according to the reasonable standard of drug poisonings or falls, which are mostly self-inflicted deaths reflecting behavioral choice and causing thousands of fatalities annually, adolescents would be judged uniquely invulnerable to premature demise.
A second argument against the “intrinsic risk” theory of adolescent behavior
emerges from the close similarities between the violent death patterns of teens and
of adults of their gender and race. Teenage males are about 3.5 times more likely to
die violently than are teenage females, a ratio similar to that between adult men and
adult women age 20-44. Blacks at all age levels, from 15-19 to 45-49, are about four times more likely to die from violent causes than are Asians, and 1.5 times more
likely to die violently than are whites, of corresponding age groups. In fact, as Table
8.3 shows, adolescents’ deaths appears to conform to the adult mortality patterns of
their race and sex. Arguing that risk is synonymous with adolescence, while popular,
is not supported by the evidence.Finally, note that the numbers involved for all age groups are very small. In 1991, 1,399 of every 1,400 teens age 15-19 did not die from violent means, compared to 1,299 of 1,300 persons in their 20s and 1,549 of 1550 persons in their 30s. Assertions about the characteristics of a group should be based on the behavior of its majority, not what happens to one in a thousand.
[…] the divergences in fatality by age and race, particularly for homicides, turn much more on the factor of poverty than that of adolescent age. Adolescents are greatly overrepresented among poverty populations of all races (Table 8.4).
The same erroneous logic governs interpretation of teenage versus adult responses to standard psychological tests. Teenagers do indeed score higher on risk-taking scales. So, to an even larger degree, do minority men. Black adult men score so high on anti-social personality disorder scales of the MMPI that separate scales for evaluation have been adopted. Are black men, therefore, “intrinsically” prone to unhealthy behaviors? Few social scientists […] would so declare today. Rather, an array of discriminatory social conditions such as racism and poverty are typically cited as reasons for the discrepancy. Yet as a rule, social scientists have been unwilling to accept that teenagers, whose populations are much more heavily nonwhite and whose poverty rates exceed those of adults by 60 percent or more for every racial group, might be displaying attitudes and behaviors related to imposed social conditions rather than “innate” defects.
When researched directly rather than simply asserted in popular media forums, risk-taking and delusions of immortality are no more features of American adolescents than American adults. University of California at San Francisco psychologist Nancy Adler studied adolescents (average age 15) and their parents (average age 43) and found the two groups expressed very similar perceptions of risk. Society has “overestimated how much adolescents feel invulnerable,” she concluded. Other research found that illusions of invulnerability were “no more pronounced for adolescents than for adults.” In fact, teenagers tended to see themselves as more vulnerable to some risks than their parents.29
“Researchers suggested it may even be a myth that adolescents intentionally take more risks than adults do,” an April 1993 summary of recent findings in the American Psychological Association Monitor concluded. In fact, it may be adults who have more delusions of immortality:
“Although evidence of perceived invulnerability among adolescents is sparse, studies with adults have consistently shown” that adults feel invulnerable, they [researchers] wrote. Adults think they are more likely than other adults to have positive as opposed to negative experiences in many areas, from business transactions to natural disasters to social events.30
A quadrupling in teen suicide since 1950 would represent a change in behavior by approximately 1 in 10,000 teens age 15-19. That is far from a widespread trend sufficient to support the kinds of dire assertions about adolescent mental health that have accompanied it. Further, as will be seen, it is unlikely that teen suicide has increased as claimed.
Puzzlement over why a few teenagers—about one in a sizeable high school of 2,000 students every five or six years—commit suicide has become mired in just such generalized speculations about the mental health of adolescents. When suicidal teens are studied directly, some clear differences emerge. These are not “average” youths. The reasons for their suicidal feelings often are not comfortable for adults to contemplate.
One of the biggest is a history of sexual abuse. In a 1992 study of 276 low income pregnant teenagers, a California pediatrics team found histories of physical and sexual abuse increased the risk of suicide four-fold.35 Similarly, a 1993 survey of 5,000 exemplars by Who’s Who Among American High School Students found that the one in seven girls who had been sexually assaulted were four times more likely to have attempted suicide (17 percent versus 4 percent) than students who had not been assaulted.36 The 1992 Rape in America study of 4,000 women found one-third of rape victims had contemplated suicide and that 13 percent had attempted suicide. In contrast, suicide attempts were practically non-existent (only1 percent reported having tried) among females who had not been raped. 0f those raped, 62 percent had been victimized prior to age 18.37
In addition to sexual abuse, key factors in suicide incidence are maleness, homosexuality, economic stress, childhood neglect and violence, and individual biochemistry.38 Most of these factors cannot be changed by the affected individual, but they can be changed by changes in social environments and attitudes. For example, child abuse and neglect and negative attitudes toward homosexuality can be addressed by changes in policies and attitudes controlled by adults.
Teen suicide is considerably rarer than adult suicide. As Table 8.7 indicates, the puzzling aspect of suicide is not its teenage incidence, but its high rate among young and middle-aged white male adults, who should be experiencing a time of greatest opportunity.
Like other youth behaviors, suicide is patterned after cultural norms. Adult men age 20-44 commit suicide 4-5 times more than women that age; teenage boys
commit suicide 4.5 times more than teenage girls. Young and middle-aged white
adults are 1.6 times more likely to kill themselves than corresponding nonwhite
adults, and white teens are 1.5 times more suicidal than nonwhite teens.
As with the case of drunken driving and drug abuse, when teenage behaviors turn out to be less alarming in reality than officials and programmers want to depict, the measures are changed. It has become standard for psychiatric lobbies (as shown later) and agencies to lump the much higher suicide tolls among 20-24-year-olds with those of teens, produce a total of “5,000 to 6,000 per year,” and then label this exaggerated number as “teenage suicides”—a figure popular in the media as well. And rather than talk about the comparatively low teenage suicide death toll, most discussions of teen suicide have switched the measure to much murkier and uninterpretable self-reported behaviors such as self-reported “suicide ideation” or “suicide attempts.”
“Suicidal ideation” can mean fantasizing about dying without any goal to follow through. “Suicide attempts” can mean cutting oneself without the actual goal of dying. Both of those can be done or reported out of a desire for recognition. Unfortunately, discussion about poor mental health isn’t popular within many families, and it’s definitely not popular in a school setting either. Even if it were, many people don’t have the confidence to open up about their struggles. If talking about it is hard, then the best way to get recognition for your suffering is to display it somehow and hope attention is given as a result.
Personally, I experienced a lot of suicidal ideation growing up. I never followed through, because I didn’t really want death or pain—What I wanted was for my pain and difficult circumstance to be recognized and addressed. I once starved myself for a few weeks for that reason. There’s nothing wrong with people who are struggling needing attention, and if we destigmatized that, maybe suicidal ideation and “attempts” would become less common.
As a society we might posture that we care so much about preventing protecting young people, but the factors that lead young people to considering suicide to begin with are continually overlooked. Gay teens are more likely to be suicidal or commit suicide than straight teens, and yet many conservatives still want the subject of LGBTQ+ to be wiped from schools entirely, even though this may aid in supporting some of those young people—especially those with prejudiced or outright abusive families.
Compulsory education, and all the suffering that causes, is never addressed either. Nor are “parental rights” which are really just “ownership rights.” And all of this is based on the idea that young people need to be controlled, because they are incompetent at decision making and prone to taking risks. Both of which are false generalizations.
As exemplified in the next excerpt, the idea of youthful susceptibility and risk-behaviors can be comforting to parents who probably aren’t doing a good job, and want something else to blame for their child’s struggling or otherwise upsetting behavior:
Parents can sue Judas Priest for marketing albums they claim “caused” teenage suicides, insisting that four-minute rock songs are more important than their kids’ backgrounds of beatings and abandonment by alcohol-abusing parents, and win accolades and mass media attention. But youths do not kill themselves because of rock songs. There is, in reality, no such distinct phenomenon as “teen suicide.” Its only distinguishing characteristic is that it is significantly lower than suicide among adults. In all other respects, it is as tragic and baffling as suicide among apparently healthy grownups.
As we have seen, teenagers commit suicide in the same patterns, by the same methods, and under the same circumstances as adults of their gender, era, and socioeconomic background.
2. Hill RF, Fortenberry JD (1992). Adolescence as a culture-bound syndrome. Social Science & Medicine 35, p 73.
3. Kett JE (1977). Rites of passage: Adolescence in America, 1790 to the present. New York: Basic Books, pp 238. 241.
4. Holmbeck GN. Hill JP (1988). Storm and stress beliefs about adolescence: Prevalence, self-reported antecedents, and effects of an undergraduate course. Journal of Youth and Adolescence 17. 285-306.
5. Lavigne JV (1977). The pediatric staffs knowledge of normal adolescence development. Journal of Pediatric Psychology 2, 98-100
7. Offer D. Ostrov E. Howard Kl ( 1981 ). The adolescent: A psychological self-portrait. New York: Basic Books, p 5.
12. Hollingworth LS (1928). The psychology of the adolescent. New York: Appleton-Century. p 17
15. Berk L ( 1991 ). Child development. Boston: Allyn &. Bacon, p 445.
16. Offer et al ( 1981 ). op cit. pp 2-4. 63, 65.
17. Offer D (1987). in defense of adolescents. Journal of the American Medical Association 257, 3407-3408.
18. Montemayor R (1983). Parents and adolescents in conflict: All families some of the time and some families most of the time. Journal of Early Adolescence 3. 85.
21. Piaget J ( 1967). Six psychological studies. New York: Vintage Books.
22. Friedenberg EZ (1964). The vanishing adolescent. Boston: Beacon Press, pp 15, 118.
23. Friedenberg EZ (1963). The dignity of youth and other atavisms. Boston: Beacon Press, p 94.
24. Friedenberg EZ( 1964). op cit, pp 114-115.
28. “For the mathematically inclined, the correlation between teen (age 15-19) and adult (age 20-44) violent death rates from 1955-1991 is very high: r = .91 1, 35 degrees of freedom, p < .0001. More than 80 percent of the change in teenage violent deaths is explained by the same factors that cause changes in adult violent death.”
29. AdlerT (1993, April). Sense of invulnerability doesn’t drive teen risks. APA Monitor, p 15
30. Ibid.
35. Bayatpour M, Wells RD. Holford S (1992). Physical and sexual abuse as predictors of substance use and suicide among pregnant teenagers. Journal of Adolescent Health 13, 128-132.
36. Shogren E (1993. 20 October). Survey of top students reveals sex assaults, suicide attempts. The Los Angeles Times, p A22.
37. National Victim Center (1992, 23 April). Rape in America. Arlington, VA: NVC, Table 7.
38. Dooley D et al (1989, Winter). Economic stress and suicide: Multilevel analysis. Suicide & Life-Threatening Behavior 19, 321; Stanley M, Stanley B (1989, Spring). Biochemical studies in suicide victims: Current findings and future implications. Suicide & Life -Threatening Behavior 19, 30; Green A (1978). Self-destructive behavior in battered children. American Journal of Psychiatry 13, 579-582.