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High-Risk Behaviors Among Youth

The status of high-risk behaviors among youth today are defined and discussed, and suggestions offered for strategies to promote healthy behavioral choices for youth.


Maria R. de Guzman, Extension Adolescent Specialist; and Kathy R. Bosch, Extension Family Life Specialist


Introduction: What Are Risk Behaviors?

High-risk behaviors are those that can have adverse effects on the overall development and well-being of youth, or that might prevent them from future successes and development. This includes behaviors that cause immediate physical injury (e.g., fighting), as well as behaviors with cumulative negative effects (e.g., substance use). Risk behaviors also can affect youth by disrupting their normal development or prevent them from participating in ‘typical’ experiences for their age group. For example, teen pregnancy can preclude youth from experiencing typical adolescent events such as graduating from school or from developing close friendships with peers.

Because high-risk behaviors can significantly impact the lives of youth and those around them, it is essential that parents, educators and other concerned adults become aware of the prevalence of these behaviors, the factors that increase their likelihood, and what can be done to abate or prevent those risks.

Types And Prevalence Of High-Risk Behaviors

Several high-risk behaviors have been of particular interest to professionals because of their prevalence in youth today. Many of these behaviors cause a large number of deaths and injury among teens, or have negative impacts on society.

Self-injurious Behaviors, Violence And Suicide

Among teens, many of the most self-injurious behaviors are related to driving. Obtaining a driver’s license is considered as one of the most exciting milestones of the teen years but unfortunately, car accidents comprise the leading cause of death among teens. Many injuries are exacerbated (and deaths are caused) by the failure to wear seatbelts. Approximately 30 percent of youth nationwide, and 16 percent of youth in Nebraska report that they rarely or never wear seatbelts.

The combination of alcohol use and driving also contributes to deaths among teens from car crashes. About 10 percent of teens report driving after drinking, and 36 percent admit riding in a car where the driver had been drinking. In Nebraska, these numbers are even higher. Among ninth to 12th graders surveyed, 17 percent said that they had driven after drinking, and 36 percent said that they rode in a car after the driver drank alcohol. The good news is that the prevalence of driving-related risk behaviors has steadily decreased over the last four years. Nonetheless, driving-related risk behaviors continue to be a serious problem during the teen years.

Fighting and aggression comprise another group of self-injurious behaviors. It is second to vehicular accidents as the leading cause of death among those 15-34 years of age. Nationally, 36 percent of teens report having been involved in physical fighting over the last year (29 percent of Nebraska teens), with males (43 percent) outnumbering females (28 percent) dramatically. Similarly, both males and females reported carrying a weapon or a gun (19 percent nationally, 18 percent in Nebraska), however males (29 percent) outnumbered females (7 percent) significantly.

Finally, suicide is one of the highest risk behaviors among youth today. Close to 17 percent (almost one out of every five) of youth report having considered suicide within the past year and 13 percent actually planned it (national and state numbers are similar). Among teens, 8.4 percent attempt suicide every year. Suicide now is the third leading cause of death among those ages 15-24, with 86 percent of those deaths from males, and 14 percent from females.

Substance Use

Substance use is another group of behaviors that contribute to immediate as well as long-term damage. Drinking and drug use have been linked to motor vehicle accidents, fighting/violence, problematic relationships and social interactions, and various diseases. Drinking and cigarette smoking are among the most common in this group of behaviors. Unfortunately, a higher number of Nebraska teens actually engage in these behaviors compared to nationwide numbers. Over 43 percent of youth nationwide and 43 percent of youth in Nebraska report that they drink alcohol, and 26 percent of youth nationwide and 30 percent of Nebraska teens admit to heavy drinking (five or more drinks in a row). Approximately 23 percent of teens admit to being cigarette smokers (22 percent among Nebraska teens), with 9.4 percent being frequent cigarette users (smoked on 20 of last 30 days). Like self-injurious behaviors, the prevalence of alcohol and cigarette use has decreased over the last few years, but nonetheless continues to be serious risks to adolescent health.

Illicit drug use is both a health and public concern because of the obvious negative physical effects it has on users. Effects of illicit drug use include, but are not limited to, brain damage and damage to major physical organs. It also has been linked to a host of other health compromising behaviors such as risky driving, engagement in high-risk sexual behaviors, and violence. Recent estimates suggest that 22 percent of teens use marijuana (18 percent among Nebraska teens), and that 10 percent of teens used marijuana before the age of 13. Approximately 3 percent use cocaine.

In recent years, methamphetamine use has become a serious concern in the United States. The low cost of the drug and the ease at which many youth are able to access this substance have contributed significantly to its rapid spread. The serious, immediate and long-term effects of methamphetamine have made it a top concern for many professionals and policy-makers. Today, approximately 3 percent of eighth graders, and over 4 percent of 10th and 12th graders report having tried or used methamphetamine nationally.

Risky Sexual Behaviors

Engagement in sexual behavior is considered to be another group of high-risk behaviors for youth because of the potential physical (e.g., STDs or sexually transmitted diseases) and socioemotional risks they present. Youth may or may not be ready for the social and emotional implications of sexual activity, and many sexually active youth do not use safe sexual practices. Slightly fewer Nebraska (41 percent) teens engage in sexual intercourse at a young age as compared with 47 percent of youth nationwide.

Among those who report engaging in sex, only 63 percent report having used a condom during their last intercourse and 17 percent report using alternative methods of birth control. Even fewer Nebraska teens (62 percent) reported using a condom. Unprotected sex exacerbates risks because of the potential for developing STDs and the potential for unwanted pregnancy. Approximately half of the 19 million new STD cases diagnosed per year are of youth ages 15-19; and 13 percent of new HIV/AIDS diagnoses are of youth ages 13-24.

Teen pregnancy is both a possible effect of risky behaviors as well as a risk factor in itself. Teen pregnancy has been linked to higher rates of school dropout, as well as other socio-emotional risks. Rates of U.S. teen pregnancy have declined over the last few years. To date, the rate of teen pregnancy is approximately 7.5 percent for girls between the ages of 15 and 19, which is 36 percent lower than in 1990. Nonetheless, this rate remains the highest in all of the other developed countries (e.g., compared to Canada, Germany, Japan) (Gutmacher Institute, 2006).

Behaviors Related To Obesity And Unhealthy Dieting

In recent years, the rate of obesity in the U.S. has reached epidemic levels. For this reason, many professionals have started to consider behaviors leading to being overweight and obesity as risky. Nationally, only 66 percent of youth report engaging in vigorous physical activity at least three times during the past week. This number is slightly higher among Nebraska teens (68 percent).

While an increasing number of youth are overweight or obese, a large number of youth also are engaging in unhealthy dietary behaviors to lose weight. In Nebraska, one in every four teens who are trying to lose weight use risky/unhealthy methods including vomiting, laxatives, unsupervised/non-prescribed diet pills and fasting.

Relationship Between Adolescence and High-Risk Behaviors

Adolescence is a time of rapid change. In a span of just a few years, teens transition dramatically in almost all realms of their lives. Physically, they grow in leaps and bounds and start to appear like mature adults. Cognitively, their thinking becomes more sophisticated. Socially, relationships are renegotiated, and teens develop the capacity to form deep intimate relationships with others. At the same time, the roles that they occupy in society also change. Partly because teens start to look more mature, people surrounding them sometimes begin to treat them like adults — giving them mature responsibilities and adult expectations.

While significant development occurs during the teen years, full maturity is by no means complete. Studies show that neurological development is not complete until the early 20s. Decision-making and future-oriented thinking are not fully developed. Thus, while teens are entering into adult roles and while they may physically appear to be mature, teens might not be fully equipped to deal with these new tasks and challenges.

For these various reasons, the teen years can be an especially stressful and fragile time, making adolescents more susceptible to engaging in risky behaviors and be unable to weigh their risks and benefits.

Risk Factors

Scholars have identified several factors that predispose youth to risk behaviors. At the individual level, youth who have low self-esteem, who have negative peer groups, and low school engagement or educational aspirations are more likely to engage in risky behaviors. Familial factors include poor parent-child communication, low parental monitoring (e.g., parents are unaware of youth’s whereabouts), and a lack of family support. Not surprisingly, when parents themselves engage in risky behaviors, teens also are more likely to do so. Finally, extra-familial variables also play a role in the risk behaviors of youth. Negative school climate, poor neighborhood quality and low socioeconomic status, and poor (or no) relationships with non-parental adults also are at more risk for negative behaviors.

Helping Strategies for Parents

Researchers suggest that despite the stereotype of adolescence as a period of ‘storm and stress,’ teens actually tend to maintain a close relationship with their family during these years. For many, what actually happens during adolescence is that relationships are renegotiated rather than broken. This means that while changes occur in the relationship, most parents and teens continue to maintain a close relationship during these years. This renegotiation and transition in the parent-child relationship is only natural as the teen is growing up and is having an increased capacity for reasoning, self-discipline and independence.

As parents start to experience this ‘renegotiation,’ it is important to remember that parents continue to be the most important relationship in their teens’ lives. And while conflict and resistance might arise when parents show concern or try to discipline their teens, parents should know that this is all part of the natural progression of relationships as their children grow.

Here are several parenting strategies that parents might find helpful:

  1. Listen to your teen. The most important thing parents can do for their adolescents is to listen to them. Parents must recognize and respect the value of what they say. Too often parents dismiss or underestimate the significance of the pressure their children feel and the problems they face. Listening and valuing teens’ ideas is what promotes the ability of parents to effectively communicate with them. Listening to a teen does not mean giving advice and attempting to correct or control the situation. Sometimes all a teen might need is for parents to listen or be there for them. It is essential that teens understand that they are being heard.
  2. Act on teachable moments. Talking with teens does not always have to happen on planned one-on-one serious talks. Teachable moments, which are the best times during the day to talk, can emerge at various times of the day, often in the context of doing shared tasks or activities like cooking, driving home or dinner. Issues such as death, sexual behavior or substance abuse can come up anytime. Take advantage of these windows of opportunity, even if they are only 30 seconds long. Parents who are aware and sense that youth need to talk will look toward these teachable moments. They are more important over the long run than giving a long lecture.
  3. Clearly communicate expectations. It is essential that parents pass along a strong sense of values. This is one of the fundamental tasks of being a parent. Teens cannot read their parents’ minds so it is important that parents clearly communicate what their expectations are in terms of behaviors and values. No matter how uncomfortable it may be, parents need to talk to their children about what’s right and wrong — about appropriate and inappropriate behavior. Again, look for those ‘teachable moments.’ For instance, a good time for these discussions might be while parents are driving with their teen. Not only does the parent have a captive audience, but they can also avoid the need for eye contact. This can help teens feel more comfortable.
  4. Focus on what is important. Adolescence is a time of identity seeking and experimentation of different roles. This can be irritating and bewildering to parents. But as painful as it may be to watch, it is one way that teens learn to function on their own without having to consult their parents about every decision. Guiding principle: Do not make a fuss about issues that are reversible or do not directly threaten your child’s or another person’s safety. These issues include unwashed hair, a messy room, torn jeans and so on. Parents should save their concern and action for safety. Safety is a non-negotiable issue. Safety rules need to be stated clearly and enforced consistently. Example: Drinking is not acceptable. If you have a party here, no beer or hard liquor is allowed ... and an adult must be present at any party you attend.
  5. Be willing to be unpopular. Parents need to accept that there will be times when adolescents will disagree with them and possibly even act as if they stop ‘liking’ them. It is essential to remember that parenting (and not being a ‘buddy’) is a parent’s primary role. It is important to resist the urge to win their favor or try too hard to please them.
  6. Avoid useless arguing. This does not mean that parents have to avoid confrontation. Useless arguments are those that simply fuel hostility but have no real purpose. It is important for parents to remember the following:
    1. Do not feel obliged to judge everything their teen says. Parents and teens should be able to agree or disagree.
    2. Avoid trying to reason with someone who is upset as it is futile. It is better to wait until tempers have cooled off before trying to sort out disagreements.
    3. Parents should not try to talk teens out of their feelings. Teens have the right to be hurt, angry and disappointed. Parents can acknowledge their teen’s reaction without condoning it. This type of response often defuses anger.
    4. All this said, parents should not let disagreements dissuade them from talking to their teens. Studies show that parents who talk to their teens (and even disagree) still are closer to their children than those who avoid these types of conversations.
  7. Be respectful. Parents get offended when children treat them discourteously. But they need to be careful that they do not do the same to them. Example: A parent would be very offended if their teen used offensive and hurtful language. Parents should also make sure that they are not verbally assaulting their teens.
  8. Help teens learn from experience. No matter how hard parents try to protect their teens from risky behaviors, they cannot watch their teens 24 hours every day or protect them from every risk. Should negative consequences arise, parents should try to use those situations to help teens learn from experience. Sometimes, dealing with the consequences of their own actions inspires sensible behavior more effectively than any lecture or discussion. Example: A mother went away for the weekend and without permission, her daughter invited a few friends for a party with no adults present. Several other teens crashed the party, drank heavily and threatened to get violent. The girl felt she had lost control in her own house. After her mother calmly talks to her about what happened, the daughter realizes her mother was right in insisting that adults be there.
  9. Encourage participation in positive activities. One effective way of discouraging engagement in negative behaviors is to encourage participation in positive activities. Today, there are many activities that teens can be involved in which encourage the development of various competencies and are enjoyable. If teens develop a sense of competency in acceptable activities, they will feel worthy and accepted. In feeling competent, teens likely will have fun and reduce stress. Parents need to assist youth in finding these opportunities. For instance, finding volunteer opportunities and developing a supportive network of family and friends will help buffer high-risk behaviors.
  10. Help youth make healthy decisions. Parents cannot be there all the time to help their children make healthy choices; thus, it is important to equip teens with the skills needed to make decisions on their own. An important skill in decision-making is assessing benefits and costs. In helping youth do this, one should be honest in helping teens examine the benefits and the costs of various behaviors. For instance, in talking to teens about smoking, parents should be honest about both sides. Positive consequences might be that some people find it enjoyable or even “cool.” Negative consequences include adverse health conditions, financial cost and the fact that it can give unpleasant odors. Similarly, in talking about engaging in sexual behaviors, teens might consider the benefits (e.g., they feel close to someone and want to take the next step), but also consider the risks (e.g., STDs, emotional consequences).

Conclusion

Adolescence is a unique period of the lifespan. It is full of changes and challenges, but also of growth and opportunities. Adolescents are particularly susceptible to high-risk behaviors so parents and other concerned adults need to support youth as they go through this period.

The process surrounding high-risk behaviors can be complex, and often it is not enough just to tell a child to ‘say no’ to engaging in these behaviors. Risk-behavior prevention must cover a wide range of issues that adolescents face in order to be most effective. Parents and community organizations must address issues such as family violence, poverty, psychiatric illness, poor interpersonal skills, learning deficits and the dysfunctional development that might be associated with such behaviors. Parents must clearly express their expectations, and must help equip youth to assess risks, to be assertive, and to have the self-esteem and forbearance to withstand external pressures that might push them toward behaviors that lead to negative outcomes.

References

Centers for Disease Control (2006). Healthy youth! YRBSS Youth on-line: Comprehensive results. Accessed Oct. 11, 2006, http://apps.nccd.cdc.gov/yrbss.

Eaton, D. K. Kann, L., Kinchen, S. Ross, R., Hawkins, J., Harris, W. A., Lowry, R., McManus, T., Chyen, D., Shanklin, S., Lim, C., Grunbaum, J. A., Wechsler, H. (2006). Youth Risk Behavior Surveillance ? United States, 2005. Morbidity & Mortality Weekly Report, 55(SS-5):1—108.

Nebraska Health and Human Services System. 2005. Nebraska Adolescents: The Results of the Youth Risk Behavior Survey of Nebraska Public High School Students (Grades 9-12). http://www.hhs.state.ne.us/srd/05_yrbs.pdf

Perkins, D. F. & Borden, L. M. (2003). Positive behaviors, problem behaviors, and resiliency in adolescence. In R. M. Lerner, M. A. Easterbrooks, and J. Mistry (Vol. Eds.) and I. B. Weiner (Series Ed.). Handbook of Psychology, Vol. 6: Developmental Psychology (pp. 373-394).

Pollack, W. S. (2004). Parent-child connections: The essential component for positive youth development and mental health, safe communities, and academic achievement. New Directions for Youth Development, 103, 17-30.

Acknowledgments

The authors would like to acknowledge the work of the late Herbert G. Lingren, Extension Family Scientist and author of the previous edition of this publication.

Identifying Assets in the Adolescent Environment

The worksheet below was developed by the Search Institute. It is designed for adolescents and parents to identify and discuss the assets or strengths, available or lacking, in the adolescent environment. Complete the checklist separately, and then discuss resopnses. Do not get into an argument about whether the asset is available. What is important is to discuss how to create or enhance an asset in the teen’s life if parent/teen thinks it is lacking.

Instructions: Print two copies of the following sheets. Parents and teens should fill out the sheets separately, and then come together to compare results. Place a check on the items that you believe accurately describe the teen’s situation.

Discuss any disparities in responses and use this as a take-off point for discussion. Also discuss which assets might be insufficient and need to be improved. Discuss how you might try to improve in those areas.

Teens’ External Assets 16. Teen spends at least one hour each week attending religious activities.
Support
Internal Assets
1. Teen receives lots of love and support from his/her family. Educational Commitment
2. Teen sees parent(s) as accessible resources for advice and support. 17. Teen is motivated to do well in school.
3. Teen has frequent in-depth conversations with parent(s). 18. Teen aspires to continue schooling after high school.
4. Teen has access to non-parent adults for advice and support. 19. Teen’s school performance is above average.
5. Teen has frequent in-depth conversations with non-parent adults. 20. Teen does at least six hours of homework each week.
6. Parent(s) are involved in helping teen succeed in school. Positive Values
7. School provides a caring, encouraging environment. 21. Teen places a high value on helping other people.
Boundaries 22. Teen is interested in reducing world suffering.
8. Parent(s) have set standards for appropriate conduct. 23. Teen cares about other people’s feelings.
9. Parent(s) discipline teen when rules are violated. 24. Teen thinks it’s important not to be sexually active.
10. Parent(s) keep track of where teen is and who teen is with. Social Competence
11. Teen goes out for fun and recreation three or less nights each week. 25. Teen can stand up for what he/she believes in.
12. Teen’s best friends model responsible behavior. 26. Teen is good at making appropriate decisions.
Structured Time Use 27. Teen is good at making friends.
13. Teen spends at least three hours each week in music or drama. 28. Teen is good at planning ahead.
14. Teen spends at least one hour each week in school sports, clubs or organizations. 29. Teen has high self-esteem.
15. Teen spends at least one hour each week in organizations and clubs outside of school. 30. Teen is optimistic about his/her personal future.



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Index: Families
Adolescence & Youth
Issued July 2007

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