THE STORMS OF YOUTH: VIOLENCE, DEPRESSION AND THE NEED FOR  ADOLESCENT RESEARCH

M. Allan Cooperstein, Ph.D.

Published as Cooperstein, M.A. (1999, August).  Pennsylvania Psychologist Quarterly. 

Adolescent Violence: Cultural Enigma or Sign of the Times?

Sturm und Drang (storm and stress), an 18th century German concept of an emotional individual’s struggle against society’s conventions, has been expressed literally in the form of adolescent violence, such as the April, 1999 murders/suicides of 15 in a middle-class Denver high school. Sadly, only one month later, a 15-year-old wounded 6 classmates, then surrendered. (Knapp, 1999; The Washington Post, 1999: www.washingtonpost.com).

In 1997, Donna E. Shalala, Secretary of Health and Human Services, addressed the issue of violence among youth:

Today, violence is the second leading cause of death for Americans between the ages of 15 and 24 - and the leading cause for African Americans in this same age group…The death rate from homicide for teens 15 through 19 doubled between 1970 and 1994 to 20 per 100,000. It has also doubled for children 10 through 14. For African American males, the homicide rate was 136 per 100,000 - nine times that of white males the same age…. Suicide is also a leading cause of death for young people. In 1995, about 24 percent of children in grades 9 through 12 - almost one in four - reported that they seriously considered taking their own lives in the previous year. And almost 10 percent reported actually attempting suicide.

(Julius Richmond Lecture, Harvard University, Boston, Massachusetts, November 21, 1997, italics added)

Arnett (1999) identifies three major areas of difficulty in adolescence: (1) conflict with parents, (2) mood disruptions, and (3) risk behavior. Current evidence indicates that biological changes contribute to adolescent problems, but far too little is known to make definitive statements about their role. Culturally, pubertal changes alone do not make inevitable the stormy aspects of adolescence. Most traditional cultures experience less adolescent stress when compared with the West, although such stresses are not unknown. He concludes that anticipating adolescent stresses may instigate parents and other adults to plan how best to approach possible adolescent problems and be pleasantly surprised if none appear.

Whether homicide or suicide, adolescent violence has forced these problems to our attention, indicating a pervasive problem in our lack of identification, understanding, and treatment of adolescent disorders in the home, the school and the clinic.  

Depression, Violence, and Suicide: Warning Signs

Depression, according to the National Institutes of Health, occurs more frequently among teenagers today than in the past. Many aberrant behaviors remain unidentified, often attributed to "normal adjustment”.  Consequently, many adolescents do not receive necessary help and many believe their problems to be unsolvable. They become so despairing that they attempt suicide…and many succeed.

Although other causes of teen suicide and violence exist, depression is a major factor.  Adolescents often "act out", masking depression (or manic-depressive disorder) with aggression, elopement, substance abuse, or antisocial acts. If these signs are interpreted as “natural” by parents and professionals, disorders go unrecognized and untreated, allowed to worsen.

Exemplified by quickly changing moods and behaviors, careful scrutiny of adolescents is needed to identify differences between developmentally appropriate and extreme behaviors. The vital aspect in recognizing warnings of depressive disorders is that the behavioral change lasts for weeks or longer. Adolescents showing 4 or more symptoms of depression for longer than a few weeks, who do poorly in school, who seem withdrawn, overly impulsive, and uninterested in activities once enjoyed, should be examined for possible depression through screening by qualified professionals.

Depression, based on the DSM-IV (1994), requires that the following signs be observed over a 1-year period in adolescents:

• Chronically depressed mood occurring for most of the day, more days than not.

• Showing or describing their mood as sad.

• This may be  shown as irritability rather than depression.

• Poor appetite or overeating.

• Insomnia or hypersomnia.

• Low energy or fatigue.

• Low self-esteem.  

• Poor concentration or difficulty making decisions.

• Feelings of hopelessness.

• Low interest.

• Self-criticism, with the self-concepts of being uninteresting, incapable, or ineffective.  

Warning signs of violence was provided through a collaboration of APA and MTV, to enable youth to recognize signs in themselves or peers and suggest how to obtain help (http://helping.apa.org/warningsigns/about.html):

• History of violent or aggressive behavior.

• Serious drug or alcohol use.

• Gang membership or strong desire to be in a gang.

• Access to or fascination with weapons, especially guns.

• Threatening others regularly.

• Trouble controlling feelings like anger.

• Withdrawal from friends and usual activities.

• Feeling rejected or alone.

• Having been a victim of bullying.

• Poor school performance.

• History of discipline problems or frequent run-ins with authority.

• Feeling constantly disrespected.

• Failing to acknowledge the feelings or rights of others

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Conclusion: Research and Intervention

In 1990, the National Institute of Mental Health (NIMH) and Bureau of Maternal and Child Health encouraged research on emergency mental health services for children and adolescents. Murray Rosenthal, M.D., Director of Behavioral & Medical Research, reports “While the advances in the opportunities for treatment have clearly expanded, making accurate diagnosis remains for the most part an enigma…The reason for this enigma is manifold, not the least of which is the time required to make a proper diagnosis.…(While) in research facilities, children who have previously been diagnosed with ADHD and go through a full diagnostic panel are often reclassified into such illnesses as generalized anxiety disorder, agitated depression, and incipient bipolar illness” (personal communication, June 17, 1999, italics added).

Dr. Rosenthal correctly identifies the need for more effective clinical diagnostic procedures. This must be complemented, however, by increased sensitization and education of parents, the public at large, and educational systems to potential warning signs. Based upon the rise in teenage homicides and suicides, the need for research that is more intensive and a more critical look at our identification and prevention procedures becomes both mandatory and an obligation to our youth.

References

Arnett, J. J. (1999). Adolescent Storm and Stress, Reconsidered. American Psychologist, 54, 5, 317-326.

Diagnostic and Statistical Manual IV (1994). Washington, DC: American Psychiatric Association.

Knapp, S. (1999, June). Three rules for addressing school violence. The Pennsylvania Psychologist, 1, 7.

National Institutes of Health. 6001 Executive Boulevard, Rm. 8184, MSC 9663, Bethesda, MD 20892-9663.

The Washington Post (1999). www.washingtonpost.com.

Research on Emergency Mental Health Services for Children and Adolescents. (1993, April 16). NIH Guide, 22 (15), PA No. PA-93-075 P.T. 34.

Medical Disclaimer: This website is underwritten completely by Dr. Cooperstein.

 Last updated: June 26, 2011 12:55 PM