Contents
“The health of young people is of utmost value and is non-negotiable,” states the Budapest Youth Declaration, adopted on 24 June 2004. “Health is a prerequisite for our personal development and happiness… We also need access to information and education on the most effective ways to maintain our health.” Golden words – adults are ready to exclaim. But do young people always feel the value of their own health? What makes many teenagers put it at risk? Doctors Elena Meshkova and Alexander Kulikov discuss this.
The article was created specifically for the joint project PSYCHOLOGIES and the UNESCO Office in Moscow “Territory of TEENS: a guide for parents of adolescents.”
In Europe, Russia and the CIS countries, diseases are spreading due to the risky behavior of young people. Adolescent maximalism, lack of experience, curiosity and desire to try different aspects of “adult life”, pressure from peers or older friends lead to risky behavior.
As a result, many adult problems – drug addiction, alcoholism, sexually transmitted diseases, pregnancy, the choice between childbirth and abortion – now have to be addressed by adolescent doctors. In the future, smoking, stress, infections, the consequences of abortions, sexual dysfunctions with an early onset of sexual activity can lead to infertility: today in Russia, according to the chief obstetrician-gynecologist Leila Adamyan, every sixth married couple is infertile, and 13% of all cases of infertility can be caused by smoking*.
Portrait of a fifteen year old
- In Russia, 15% of boys smoke, in Ukraine, 23% of them.
- In Ukraine, 30% of girls and 44% of boys drink alcohol at least once a week; in Russia, 9% and 13%, respectively; in Armenia, 11% and 27%.
- By this age, up to 45% of boys and up to 27% of girls living in the CIS countries have already had sex.
- In Kazakhstan, about 50% of adolescents had their first sexual experience while under the influence of alcohol or drugs; every fifth suffers from diseases that affect the ability to subsequently have children.
- In the age group of 15–19 years, the number of suicides per 100 adolescents is 16,7 in Belarus, 17,6 in Russia, and 20,3 in Kazakhstan. Russia, Ukraine, Belarus, Kazakhstan are becoming world leaders in the number of teenage pregnancies and abortions, deaths from injuries, poisoning and violent causes*.
* According to the Ministry of Health and Social Development of the Russian Federation, the World Health Organization, UNICEF.
What is risky behavior?
Most often, we refer to risk as behavior that can lead to loss of health or well-being. One gets the impression that risk is always bad. But from another point of view, risk is an action aimed at an attractive or socially approved goal, the achievement of which is associated with an element of danger. Many of the habitual actions that we repeat every day can be called risky behavior: crossing the street, riding in transport, eating in the canteen, going to the forest for mushrooms or berries, swimming in the sea, and other everyday actions. Such risks are called ordinary or inevitable. A completely different concept is the high-risk behavior of adolescents. Often they are not even aware that their behavior is dangerous. Therefore, the task of adults is to minimize the possible negative consequences of such behavior of adolescents. This is not easy to do, also because risk is a tradition in our society, and we ourselves are not ready to live without risk.
In the case of adolescents, the traditions of society are superimposed on the properties of the age when it is necessary to master the adult ability to make choices. And in modern society, the use of alcohol, like smoking, is no longer considered a deviation. At the same time, the real awareness of young people without bad habits about the consequences of risky behavior is low. The knowledge of adolescents with risky behavior is more complete and detailed due to the already existing, including negative, experience and awareness of the need for such information. Only about 10% of teenagers believe that they will never take risks, as this is wrong. Reasonable risk is a valuable experience: this is how young people define and develop their individuality, but they do not always manage to stay within reason.
Elena Meshkova – Candidate of Medical Sciences, pediatrician of the highest category, Honored Doctor of Ukraine, Deputy General Director of the National Children’s Specialized Hospital “OKHMATDET” (Kyiv, Ukraine)
Alexander Kulikov — Doctor of Medical Sciences, Professor of the Department of Pediatrics and Pediatric Cardiology, Northwestern Medical University named after I. I. Mechnikov, Head of the Educational, Methodological and Scientific Center for the Development of Youth-Friendly Clinics (supported by UNICEF) (St. Petersburg, Russia).
What’s the point of taking risks?
How do adolescents meet their developmental needs? They experiment, assert themselves and explore. Risky behavior is always aimed at mastering the surrounding space and understanding where its limit is. High risk is usually a by-product of heightened cognition. A teenager is experimenting with…
- Know yourself better
- Try different lifestyles
- Show the environment that it is becoming an adult
- Increase the degree of independence: “I can and decide”
- Finally, just because it’s cool, cool, cool …
Of course, there are also dangerous aspects of teenage experiments, which are usually visible only to adults. Firstly, at no other age does a person experiment in so many areas with such a small amount of knowledge and experience, and secondly, the emotional makeup of adolescents is such that they are often unable to stop in time. But instead of elevating the negative aspects of adolescent risk-taking to an absolute, it is better, according to the Belarusian psychologist Natalya Puzyrevich, to get an adequate idea of the specifics of risk and its consequences, and also to recognize it as a kind of criterion for adolescent health. The most important thing is to what extent the freedom of adolescents, due to the implementation of risky behavior, is combined with their ability to observe the border between justified and unjustified risk. The main task is to understand what risk and what degree of it is beneficial and contributes to the development of the individual, and what is a threat to health.
Parents are always, especially if this is their only child, driven by the desire to protect him from dangers and accidents. But how will such behavior of parents affect the fate of their children? It is possible not to cross the street at all either on a green or a red light, because it is always dangerous. Such people tend to avoid risk – and therefore, new situations, new information, new experiences, any new experience …
Hormones and the Brain: The Biology of Risk
Teenagers are not to blame for their often inappropriate behavior, American neuroscientist Laurence Steinberg from Temple University in Philadelphia is sure: the teenage brain is designed in such a way that they feel a biological need to take risks. In youth, two neural networks are activated in the brain. One of them controls the process of cognition, encouraging to make reasonable, informed decisions, when all the pros and cons are weighed and the possible consequences of actions are evaluated, while the other regulates social-emotional behavior. The brain of a teenager is already able to adequately process and perceive large amounts of information, and this provides great opportunities for development and self-knowledge. However, the immaturity of the neural network responsible for the process of evaluating and analyzing the situation explains the difficulty or even impossibility of making informed, reasonable decisions in an emotionally charged situation, especially in the presence of peers. In an experiment at McLean Hospital in Belmont (Massachusetts, USA), patients of different ages were shown photographs of faces expressing different emotions. Adults successfully identified emotions, but only half of the teenagers were able to recognize such an emotion as fear, and the rest called it embarrassment, resentment, shock. The age of 14 is especially conducive to risks: the results of observations showed that adolescents, having carefully weighed all the pros and cons of the decision, unlike children, deliberately took risks, because they received more pleasure from such a situation than participants in other age groups, especially if in the end they were lucky to avoid bad luck. And since teenagers cannot think like adults, they do not always understand the logic of our prohibitions and actions.
The emotional response of the brain of adolescents to stimuli is significantly higher than that of children and adults. Hence, it would seem, causeless explosions of emotions, resentment, demonstrative behavior. Adolescents prefer actions with a high level of emotional stress, are prone to impulsive actions, including experimenting with drugs and alcohol, rarely think about the possible negative consequences of their behavior and are not able to evaluate them. Very important decisions can also be spontaneous, for example, getting married at 15.
Sex hormones have a huge impact on the brain of adolescents. The level of testosterone determines the degree of determination, leadership, activity of a young man, his independence and aggressiveness.
In our time, the gap between the completion of puberty and the achievement of social and psychological maturity is widening. Young people who, by the age of 15, reasonably claim their biological status for adulthood, at the same time remain infantile for longer. If a teenager has not formed a sense of personal responsibility for himself and his life, this usually manifests itself in a lack of purposefulness, conflicts with others, and an inability to get out of stressful situations. The “crisis of growing up” caused by overstrain in the work of the nervous system can cause aggression, suicidal attempts, sexual experiments, alcohol abuse, addiction to drugs, eating disorders, etc. Conversely, bulimia or anorexia, communication problems, neurasthenia and neurotic syndrome, phobias, depressive disorders, sleep disorders make risky behavior more dangerous.
Motives for risky behavior
Ignorance. This is the case when someone crosses the street at a red light, because they do not know that they have to wait for the green one. This is the behavior of those teenagers who do not know that a condom protects against infections, and therefore do not use it. Timely informing can be a good defense against such an act.
“Perhaps it will carry over!” This is how someone who crosses the road on a red light behaves, knowing that the green light will soon light up. We are talking about a situation where we know about the danger, but still take risks, although this can lead to loss of health and well-being, the formation of addiction, violence. For example, unprotected sex with a new partner is Russian roulette, high risk.
Seeking thrills. These are the cases when pedestrians cross the street in front of oncoming cars just for a dose of adrenaline. Ordinary life with its regularity, duties and routine seems to some teenagers to be terribly boring. The American psychologist Marvin Zuckerman described the behavior of these young people “as a search for new sensations” and proposed a test to identify such adolescents: The Sensation-seeking Scale (SSS). One of the reasons for this behavior may be impaired brain function of a teenager due to an unfavorable course of pregnancy and childbirth in his mother. These young people need higher doses and risks in order to experience the same emotions as their healthy peers.
Protest. In some children and adolescents, the demands of adults that limit their activity, on the contrary, can provoke a sharp protest and a desire to act “in spite”, violating norms and rules, often to their own detriment. Their inherent curiosity and the desire to search turn into a tendency to protest and various forms of risky behavior.
Love and trust. These feelings often lead to risky sexual behavior, because young people are sure that a loved one is healthy or will warn if they are sick. But, unfortunately, many sexually transmitted infections occur without severe symptoms. The infection can be transmitted without knowing it.
group pressure. Self-affirmation among peers and familiarization with an attractive social group often requires a teenager to accept certain “rules”. For example, if a group smokes, uses alcohol and drugs, then such behavior is expected from all its members.
A.K.
Boys and girls: who has it easier?
Gender is a definite risk factor for the development of risky behavior. Risk taking is a typically male trait. The level of testosterone determines the degree of determination, leadership, activity of a young man, independence and aggressiveness. Every young man dreams of becoming a hero; No wonder Napoleon said that teenagers are the most courageous soldiers. Boys are characterized by a higher level of trauma associated with violence, accidents and suicides, while girls are more likely to experience negative consequences of sexual behavior. Perhaps that is why 12,7% of girls and significantly more boys (53,8%) do not see anything wrong with the early onset of sexual activity. However, if there were no negative consequences of sexual activity, then among girls the number of supporters of its early start would increase sharply (up to 71,4%). Thus, girls, unlike boys, are afraid of the negative consequences of sexual life with a very high readiness for it.
Overall, boys of all ages have a 10% higher behavioral health risk. The response to stressful life situations is also different depending on gender. Boys, unlike girls, behave aggressively (both towards themselves and towards others), looking for relaxation in the use of physical force, while taking the position of objecting or ignoring stress/problems. While the girls go deeper into their problem, they try to solve it, turning to a specialist (for example, a psychologist) much more often.
It is noteworthy that many adolescents understand that in order to maintain health it is important not to smoke (girls – 46,0%, boys – 61,5%), to be physically active (girls – 54,0%, boys – 87,2%), not abuse alcohol (girls – 63,5%, boys – 48,7%). However, they behave in exactly the opposite way. Knowledge does not turn into beliefs.
From the point of view of 90,5% of girls, they need health for healthy offspring. Young men are convinced of this less often – 66,7%. Girls also show a higher awareness of sexual infections and their negative consequences, which indicates their higher responsibility in relation to their reproductive health*. It must be borne in mind that the likelihood of transmission of infection during unprotected sexual contact from a man to a woman is higher than from a woman to a man, which is associated with the peculiarities of the structure of the genital organs. The situation is complicated by the fact that in many societies, due to cultural traditions, there are double standards regarding the sexual life of men and women: the sexual experience of a girl before marriage is condemned, while that of a boy is encouraged. A woman often cannot herself refuse sexual relations or offer the use of protective equipment: this is the prerogative of a man.
* Based on the report by A. Kulikov and V. Boeva ”Risk behavior and prevention of STIs in adolescents” (Department of Adolescent Medicine and Valeology, St. Petersburg Medical Academy of Postgraduate Education, 2003)
Sometimes it seems that adults and teenagers live under the same roof, “not intersecting.” Russian children spend their evenings out on average twice as often as their Western European counterparts**. And if young people stay at home, watching TV programs remains a favorite activity for younger teenagers, while Western peers prefer active play and sports. From 45 to 65% of adolescents spend more than two hours daily on the Internet and more than two hours a day playing computer games. This is significantly more than that of Western teenagers. At the same time, boys play computer games one and a half to two times more often than girls. Most adolescents are dissatisfied with their position in the family, and this mainly concerns family relationships, nutrition and housing conditions.
In addition to the lack of communication and loss of contact with parents, such mutual isolation leads to the fact that parents do not know how their children spend their time, what and how they eat, which does not have the best effect on health. The level of physical activity of Russian teenagers is one of the lowest in the world.
A good relationship with teachers is essential to the well-being of adolescents. Conflicts and mutual misunderstanding with adults at school provoke protest behavior in adolescents.
A special place in the life of adolescents is occupied by friendships: they help shape personality, develop social skills and independence, and increase self-esteem. Mutual support is also a protective factor against feelings of depression and isolation. Those who do not have friends do not value themselves, are dissatisfied with their lives, more often complain of depression. One way to compensate for the lack of real friends is the Internet.
Teenagers today “live” in the world of the Internet and digital technologies: they communicate on blogs and social networks, exchange information, play online games. The obvious impact of the computer on the health of adolescents is the lack of physical activity, deterioration of vision, fatigue. But there is also the threat of Internet addiction and a number of problems associated with the process of socialization of adolescents on the Internet. Among them are unreliable and intrusive information, the problem of isolation and loss of the “I”, the decline in the cultural level, the displacement and restriction of traditional forms of communication, dangerous acquaintances. Teenagers are especially attracted to social networks on the Internet. Almost 90% of schoolchildren visit VKontakte. Three-quarters of users post their last name, photo, exact or inflated age, school number, 20% – and their exact address online.
At the same time, parents’ awareness is extremely low – no more than 12% of Russian parents know how dangerous the Internet is for their children. The older Russian schoolchildren are, the less often their parents control them. In addition, in Russia, twice as often as in Europe, children use mobile communications to access the Internet almost without parental control. And this significantly increases the likelihood of a collision with risks.
According to the study “Children of Russia Online”, conducted by the Internet Development Fund and the Faculty of Psychology of Moscow State University. M.V. Lomonosov, 40% of girls aged 14–16 are interested in sites advertising ways to lose weight, 13% of 13–16-year-olds are interested in drugs and methods of their preparation.
When listening through headphones to sound waves of a certain length, you can experience sensations and emotions similar to the effect of drugs. Younger teenagers aged 10-13 do not know how to block potentially dangerous information. One of the main dangers of children’s communication in networks is bullying, repeated deliberate aggressive behavior, both physical and verbal, directed against a weaker peer in order to humiliate his dignity. This is reported by 20-35% of Russian network users. Usually, the victim’s page is hacked and posted humiliating content. This problem is especially relevant for children 10-12 years old.
The Internet, in comparison with television, magazines, books, leads in the sexual education of children. More than 40% of Russian Internet users speak about this. One in six sees sexual images on a daily basis. One in three teenagers encounter sexual images on social networking sites.
Everything is interconnected
What happens? Social factors cause psychological trauma to a teenager and contribute to the formation of an unfavorable psychological climate, both in the family and at school, which leads to the use of psychoactive substances, and this, in turn, leads to a violation of somatic and psychological health. All types of health risks we are talking about are interconnected and interdependent: mental illness and alcohol, conflicts and traumas, stress and smoking, emotional instability and sexual experiments. And yet, let us recall that “the development of childhood is objectively connected with the knowledge of the world around us by experience, which inevitably leads to children falling into risk situations … The task of education in this case is not to isolate the child from risks, but to equip him with the ability to overcome them.
* takzdorovo.ru/deti/grudnye-deti/kurenie-i-reproduktivnoe-zdorove
** Here and below: Health Behavior in School-aged Children (HBSC): International Survey Report 2009–2010, WHO, 2012.
*** I. F. Dementieva “Risk Factors of Modern Childhood”. Sociological Research, 2011, No. 10.
The article was created specifically for the joint project PSYCHOLOGIES and the UNESCO Office in Moscow “Territory of TEENS: a guide for parents of adolescents.”
The information and materials contained in this publication do not necessarily reflect the views of UNESCO. The authors are responsible for the information provided.