Issues in Human Services (HMNS 10085)

Module 2: Issues Pertaining to Youth

What is Youth?

• Adolescence - the years of 10 to 18• Teenage years - 13-18 years• Period of time between when puberty begins and

when adulthood is reached– Menarche– Semenarche– Time of rapid growth

• Emerging adulthood 18 to 2 years

The Emergence of Adolescence as a Stage of Childhood

• Adolescence - recent stage of childhood– Emerged in 1890s– Time period when attending school– This has increased over time

• Cultures vary by expectations on adolescents- may be based on gender

Issues for Youth

• High Risk Behaviours - aggression/ “delinquent behaviour”, gang activity– Bullying– Substance Use

• Mental Health Issues - depression, anxiety, eating disorders, self-harm/suicide

• Lesbian/Gay/Bisexual/Transgender/Queer Youth

Classification of Problems

• Externalizing problems:– Directed towards others

• Internalizing problems:– Directed inward

Externalizing Problems: “Delinquent” Behaviour & Violence:• Criminal activity and violence attract a lot

of attention.• Youth do commit a disproportionate

number of violent crimes• Youth - 7% of the overall, general

population• Youth are 4 times more likely to be victims

of crime - female more than male.

“Delinquent” Behaviour & Violence:

• Problem-solving cognition

• Judgement

• Connection to disruptive peers

• Early maturation (girls)

• Values

• Witnessing or experiencing violence

Contributors to “Delinquent” Behaviour & Violence:

• Youth “act out” for a reason

• Conditions within the youth

• Past or present abuse, neglect or chaotic environments (due to substance abuse)

• Structural risk factors– Living in poverty > food insecurity,

specifically.

How School Experience May Contribute

• Teacher insensitivity to a youth’s individuality

• Rigid discipline

• Continuous negative interactions

• Failing to assess the strengths of youth

• Lack of funding for special education resources that help promote school success.

Gang Activity: Types of Gangs

• Groups of friends

• Spontaneous Criminal Activity Gang

• Purposive Gang

• Youth Street Gang

• Structure Criminal Organization

Myths about gangs:

• Cultural or ethnic groups form gangs composed of individuals from their own cultural or racial groups

• Newcomers to Canada frequently form gangs

• Criminal gangs are composed of youth

What do gangs provide youth?

• Respect• A sense of making a contribution• Potential for leadership• Relief from boredom• Acknowledgement of the youth as a unique

individual• A feeling of membership, belonging• A feeling of empowerment

Why gangs tend to form:

• Living in poverty

• Unemployment

• Racism

• Family-oriented difficulties

• Not succeeding in school/low attachment to school

• Chaos in community

Interventions for Youth Involved in Gangs:

• Structural approach:– Mobilize a community to take action– Provide educational, recreational and

employment opportunities– Social intervention (eg. housing)

Bullying

• Bullying is defined as, “…a way of attaining power through

aggression.”

• There is intentionality

• Tends to be repetitive in nature

Bullying Behaviour & Types of Bullying

• Bullying Behaviour:– Physical– Verbal– Social– Used electronically– Being a bystander

• Types: Racial, religious, sexual & disability

How Often Does it Happen?

• 20% of children & youth report being bullied.

• Increases in early adolescence• Decreases in later adolescence• Boys are bullied more using physical

behaviours• Girls - more use of exclusion, gossip

behaviours.

Who is particularly at risk:

• Large body type

• Not fitting in with peer group

• Students who have disabilities &/or use special education services

• Students who are lesbian, gay, bisexual, transgender, or queer (LGBTQ)

Impact of being bullied:

• Anxious and lonely

• School avoidance

• Illness - depression and suicidal thoughts

• Poor academic performance

Who tends to bully?

• Anyone

• Do not possess effective social problem-solving skills

• Considered attractive, popular & leaders in their school communities

Measures to combat bullying:

• School-based awareness campaigns

• Directed to the whole school body

• “Norm”

• Research evidence - mixed

• Raising awareness of the bystander role

Substance Use

• It becomes problematic when:– habitual– involves street or illegal drugs– Interferes with daily life & functioning

How many youth use substances?

• >65% of students had used alcohol (25.3% had been binge-drinking)

• 29.8% had used cannabis• >23% smoked tobacco• 6% used ecstasy• No substance use > 27.4%• At least 4 different drugs - 14% of all students• 5.6% of students - could not stop using

Trends in Youth Substance Use:

• Alcohol & using drugs increasing since the 90s.– Some increase in use of most substances

– Highest increase - marijuana

– Increase in alcohol

– Increase in designer drugs or rave drugs (Ecstasy)

• Use of tobacco decreased since 90s.– Except it has increased in young women

– Highest smoking rate in country

Associated Problems in Substance Use:

• Use of alcohol, marijuana, cocaine & amphetamines linked to violent behaviour

• More likely to gamble

• Substance use (alcohol use especially) is linked to depression

• ADHD diagnoses

Factors Thought to Contribute to Substance Use:

• Influenced by peers• Have mothers • Move frequently/school adjustment• Have lower parent supervision & support in single

parent families• Have parents who are more authoritative &

directing• Come from households where parents are religious

Individual Characteristics/Resources that decrease likelihood of substance use in

youth:• Good self-concept

• Religious beliefs/values

• Authoritative parenting

• Social support

Mental Health Issues in Youth:

• Externalizing Disorders:– Conduct Disorder– Oppositional Defiance Disorder

• Internalizing Disorders:– Depression– Self-injury– Suicide– Anxiety– Eating disorders

• ~20% of youth have a mental health disorder

Depression:

• Symptoms:– Low mood– Feelings of sadness– Crying easily– Loss of interest in activities previously enjoyed– Sleep disturbances– Appetite disturbances– Low energy– Stomach aches or headaches– Diminished memory & ability to concentrate– Youth > irritability

• Interferes with functioning in daily life

Depression: How many youth does it affect?

• 3.5% of children and youth experience depression

• Tends to increase in adolescence

• Girls more affected than boys

• Can be difficult to detect

Anxiety

• Anxiety - level is such that it interferes with functioning in daily life

• Often occurs with depression.• Impacts ~6% of children & youth• Types of anxiety disorders:

– Generalized Anxiety-many worries & fears– Specific Phobia - anxiety response specific to 1 thing > highly

avoidant– Social Phobia - excessive worry about social situations– Panic Disorder - physical panic response > “attack”– Obsessive-Compulsive Disorder - uncontrollable & unreasonable

thoughts (obsessions) & routines/rituals (compulsions)

Factors Contributing to Depression & Anxiety:

• Genetic - runs in family• Early life stress - trauma• Attachment issues• Psychological controlling by parents• Economic problems in household• Low marital happiness in parents• Parental hostility towards you• Reaction to a stressful life event

Self-injurious Behaviour

• “…any deliberate, repetitive attempt to harm one’s own bodily tissue without a conscious desire to commit suicide.” (Nock & Prinstein, 2005, in Martin, 2011).

• Most frequent - cutting legs and arms with razor blade, burning one’s self.

Prevalence of Self-injurious Behaviour

• Adolescents are at higher risk for self-injuring than adults

• 39% of adolescents have self-inflicted injury at some point in their lifetime

• Female youth self-injure at a much higher rate.

Causes of Self-injuring Behaviour

• Causes are unclear

• Associated with:– Eating Disorders– Depression– Anxiety– Physical, sexual or severe emotional abuse– Being a perfectionist

Reasons for Self-injury

• It allows youth to feel something when they otherwise feel emotionally numb

• Allows youth to numb psychic pain

• Internal expression of rage or intense anger

• Self-punishment

• Means of getting attention

Eating Disorders

• A group of disorders characterized by a distorted body image in which eating behaviours are severely restricted or unhealthy, to alter body weight & shape– See themselves as fat when dangerously thin

• Primary onset- tends to be adolescence• Risk for medical problems such as:

– Infertility– Tooth damage– Heart & kidney problems– Bone loss– Anemia – Premature death– Growth may be halted

Types of Eating Disorders

• Anorexia Nervosa - refusal to maintain expected body weight (< 85% of normal body weight) through starvation, excessive exercise, use of diuretics, laxatives. Use of excessive calorie counting, lack of satisfaction with weight loss, intense fear of gaining weight. Part of diagnosis - absence of menstrual cycle for 3 months.

• Bulimia Nervosa - binge eating followed by purging (vomiting, using laxatives). Youth feels no control over the eating behavior.

• Binge-eating Disorder - Eats excessively to point of being uncomfortable. Feels highly guilty which can lead to other binges.

Prevalence

• Anorexia - half to 1% of youth

• Bulimia - 1 to 3% of youth

• Females much more likely to have an eating disorder

Causes

• Interplay of cultural, genetic & psychological causes

• Cultural -related to unrealistic body image ideals• Genetic - predisposition to mental disorders• Psychological - may have anxiety disorder earlier

in childhood. Low self-esteem, trying to be “perfect”; family interaction patterns– Control

Suicide

• The most extreme internalizing disorder

• Adolescents - high risk, females higher suicidal ideation

• Rate is higher for adolescents than adults

• Rate is growing

Types of Suicidal Behaviour

• Gestures - cry for help vs. attempt with intent to kill oneself

• Attempts/Completed

• Females - 85% of those who attempt but are unsuccessful

• Males - 80% of those who complete suicide

Risk Factors for Suicide:

• Youth feeling hopeless, with little social support, having feelings of hostility & negative self-esteem > greatest risk

• Strongly linked to family disruption & divorce• Having a friend commit suicide.• Having a gun (for males)• High level of school involvement > associated

with a decreased risk for suicide

Schizophrenia

• Most often diagnosed in late adolescence or emerging adulthood

• Thought Disorder• Symptoms:

– Unclear or illogical thinking – Delusions– Hallucinations– Cognitive impairment– Inability to express emotions

Early Signs

• 30 times more likely to commit suicide

• Increased social isolation - especially from peers

• Declining cognitive functioning - confusing thoughts

• Indications of hallucinations

Treatment of Mental Health Disorders:

• Prevention

• Medical treatment

• Cognitive Behavioural Therapy - for depression, anxiety & eating disorders

• Family therapy

Lesbian, Gay, Bisexual, Transgender/Transexual, Queer

(LGBTQ) Youth• Often the victims of bullying - 75% of gay youth in one

study reported being verbally abused at school & 14% reported physical abuse

• 85% of LGBTQ youth reported being victimized by bullying - 60% report having been assaulted

• Male youth were abused more than female youth• School climate in which there is heterosexist, homophobic

language used > increased anxiety & depression amongst LGBTQ youth– 39.4% heard such remarks from adults in their schools

• High rate of suicide - 30% reported attempting

How to make communities safe & inclusive for LGBTQ Youth

• Address the harassment - provide education to school personnel to begin with

• Policies that do not condone harassment based on LGBTQ status > “Zero Tolerance” policies

• Focus on sexuality as part of youth’s personhood - not the sole defining factor of a human being

• Teach students to respect the dignity of all persons

Readings:• Centre For Addiction & Mental Health (2002). Alcohol, tobacco, and other drug use among Ontario Students. Youth

Scoop, Vol 2. Toronto: Centre For Addiction & Mental Health.

• Retrieved from: http://www.camh.net/education/Resources_teachers_alcdruguse.pdf.

• Centre For Addiction & Mental Health (2002). Youth violence: what’s the story? . Youth Scoop, Vol 3. Toronto: Centre For Addiction & Mental Health.

• Retrieved from: http://www.camh.net/education/Resources_teachers_schools/Youth%20Scoop/youth_scoop_violence_youth.pdf

• Centre For Addiction & Mental Health (2009). Hear me, understand me, support me: what young women want you to know about depression. Toronto: Centre For Mental Health & Addiction.

• Retrieved from: http://www.camh.net/Publications/Resources_for_Professionals/Validity/validity_sizism.html

• Hamilton Wentworth District School Board (____). Bullying: Information for parents and students. In Safe and Caring Schools #3.

• Retrieved from: http://www.hwdsb.on.ca/programs/safeschools/bullying/pdfs/bullying_booklet_english.pdf.

Readings continued…• Offord Centre For Child Studies (2007). Eating problems in children and adolescence. Hamilton, ON: Centre of

Knowledge on Healthy Child Development.

• Retrieved from: http://knowledge.offordcentre.com/images/stories/offord/pamphlets/EatingDisorder_en.pdf.

• Offord Centre For Child Studies (2007). Mood problems in children and adolescents. Hamilton, ON:Centre of Knowledge on Healthy Child Development.

•Retrieved from: http://knowledge.offordcentre.com/images/stories/offord/pamphlets/Mood%20B&W.pdf .