5
What Next for Research on Adolescence?

The September 2005 workshop demonstrated that many fields are actively contributing to and expanding the knowledge base regarding adolescent health and development. Research findings are emerging in multiple fields, many of which were represented in the workshop—including psychology and human development, psychiatry, biological psychiatry, behavioral and brain development, neuroscience, pediatrics and internal medicine, adolescent medicine, community medicine, epidemiology and statistics, infectious disease and immunology, sociology, education, and the law. The participants identified many opportunities to link these fields within a developmental framework and to apply this knowledge base to policy and practice. They were also mindful of the many areas of research that could not be represented during the short workshop but that are equally relevant.

The key objective for the workshop was to consider the question of whether the time is right for a comprehensive synthesis of the diverse array of research findings that are contributing to an understanding of adolescence. The principal questions to be considered, as Trina Anglin suggested in her opening remarks, were whether there is an adequate, cumulative knowledge base, and whether an effort to synthesize this base would help researchers and policy makers take stock of what has been established, plan future directions, and inform policy and practice.

The five objectives for the workshop (listed in Chapter 1) provided a framework for consideration of this issue. The workshop sessions high-



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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary 5 What Next for Research on Adolescence? The September 2005 workshop demonstrated that many fields are actively contributing to and expanding the knowledge base regarding adolescent health and development. Research findings are emerging in multiple fields, many of which were represented in the workshop—including psychology and human development, psychiatry, biological psychiatry, behavioral and brain development, neuroscience, pediatrics and internal medicine, adolescent medicine, community medicine, epidemiology and statistics, infectious disease and immunology, sociology, education, and the law. The participants identified many opportunities to link these fields within a developmental framework and to apply this knowledge base to policy and practice. They were also mindful of the many areas of research that could not be represented during the short workshop but that are equally relevant. The key objective for the workshop was to consider the question of whether the time is right for a comprehensive synthesis of the diverse array of research findings that are contributing to an understanding of adolescence. The principal questions to be considered, as Trina Anglin suggested in her opening remarks, were whether there is an adequate, cumulative knowledge base, and whether an effort to synthesize this base would help researchers and policy makers take stock of what has been established, plan future directions, and inform policy and practice. The five objectives for the workshop (listed in Chapter 1) provided a framework for consideration of this issue. The workshop sessions high-

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary lighted several emerging fields of research and identified a number of promising areas for further study. Participants also explored the differences among the theoretical and developmental frameworks that govern different kinds of research—and these differences were identified as a key impediment to the kinds of synthesis and cross-fertilization that are needed. In several contexts participants noted that connections between research and the needs of practitioners and others who work with teens are insufficient, yet badly needed. Each of these points contributed to a shared sense of the urgent importance of finding ways to synthesize and apply existing and developing knowledge. Many speakers recognized the formidable challenge that was inherent in producing a synthesis of the diverse body of research on adolescent health and development, if only because of the significant variations in the theoretical models that characterize these fields. Dennis Bier spoke, for example, about the gaps between the conceptual approaches characteristic of biological and social sciences, using evident contrasts among some of the models that were presented. For example, models that are descriptive and qualitative may capture important but poorly understood complex processes, whereas models that are quantifiable and can be described mathematically offer a basis for experimental tests. He noted that some of the descriptive models presented at the workshop were quite complex and did not readily lend themselves to experimentation with the scientific methods characteristic of his own field, isotope kinetic modeling. In many cases, he pointed out, researchers in different fields may not even use common terms or understand commonly used terms in the same way. Bier suggested that the possibilities for linking behavior, biology, and social context are intriguing and promising. Nevertheless, he pointed to what might be viewed as the two ends of a continuum that ranges from qualitative research focused on such concepts as competence and connectedness to quantitative research, such as that done in molecular biology, with its breakthroughs regarding inaccessible regions of the brain, hormonal processes, and the use of techniques such as functional magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning. His concern was with the absence of an overarching framework that would help reconcile very different methodological approaches and standards of evidence. Ron Dahl, in contrast, pointed out that the study of adolescence has been interdisciplinary from the start, as the title of the foundational 1904 text by G. Stanley Hall demonstrates: Adolescence: Its Psychology and Its

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary Relations to Physiology, Anthropology, Sociology, Sex, Crime, Religion, and Education. Today, Dahl argued, despite persistent efforts to establish transdisciplinary links, numerous disciplines continue to publish in different journals and operate within different frameworks, creating a fragmented and piecemeal clinical picture for adolescents, their families, and those who care for them. A child with attention deficit hyperactivity disorder, depression, or a sleep problem, for example, might go to a pediatrician, a developmental pediatrician, a behavioral pediatrician, an adolescent medical specialist, a neurologist, or a child psychiatrist, to name just some of the possibilities. Depending on which kind of practitioner the child sees, the treatment response might vary significantly. The fragmentation is evident at other levels as well. It can be detected in the kinds of empirical support that are mustered for various interventions, the performance standards used to evaluate selected programs, and the processes through which researchers apply for grant funding to support their work. Dahl argued that this fragmentation is counterproductive because few structures are available that encourage and enable researchers to stay informed about developments in other fields that might offer important implications for their own work. Dahl and others highlighted the opportunities that could emerge from developing connections among multiple research fields, both those that already exist and those that need to be developed and fostered. To that end, a comprehensive research synthesis that examines some primary existing lines of research—the contributions they are making and the actual and potential links among them—could help stimulate the research agenda in ways that will make it more valuable to practitioners, policy makers, and researchers. From Dahl’s perspective, adolescence requires a transdisciplinary framework because it begins in biology (the physical changes associated with puberty) but it really ends in social context (the assumption of adult roles). While a detailed discussion of the feasibility and design of any particular study approach was beyond the scope of the workshop, many participants cautioned against attempting to cover the whole waterfront at once. A comprehensive study that tried to look across all the possible dimensions might be overwhelming, while a focused study that addressed unique problems and opportunities to intervene with adolescents could bring coherence to a scattered array of relevant research studies. These types of integrated snapshots could help the field make an important move forward. A more focused study might also provide a model for integrating selected fields that could be applied in other contexts. For example, Dahl noted that

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary discussions throughout the workshop touched on processes related to inhibitory control, social monitoring, and regulatory capacities that adolescents lack. Neural development, social development, skill development, and other processes all relate to these functions, and many types of research can contribute to a fundamental understanding of the nature and expression of these interactions. Thus, developing a synthesis of just the work relevant to this field alone might pose a manageable challenge. The influence of media on diets, learning processes, social relationships, and other behaviors is another area about which complex questions can be asked in a variety of domains—and which could also serve as the focus of a study that explored the possibilities for transdisciplinary research. In closing remarks, Robert Blum reiterated a view expressed in different ways throughout the workshop—that new conceptual models are needed to explain the boundaries and frontiers of adolescence and to offer opportunities to strengthen scientific investigations of underlying processes. He suggested that such models could help establish parameters that would enable researchers from different traditions to communicate and improve opportunities for collaboration. An integrated model of adolescence—a definition of the subject of study—that was able to incorporate the contextual, social influences on young people as well as neuroscience, cognitive, and behavioral research and other experimental research might also reduce some of the obstacles that now limit the explanatory power and applicability of findings. At the same time, he cautioned that because funding streams tend to focus on problem behaviors, those fields of study are likely to continue to dominate the study of adolescence until more powerful theoretical and developmental frameworks emerge. While some participants pointed out that an integrative model that encompasses this entire terrain may be too ambitious, a synthesis that could systematically identify areas in which congruence is possible could nevertheless be of real importance. Gail Slap drew on two comments that seemed worlds apart—one about the importance of religiosity and spirituality in adolescents’ lives and another about hormones—to make the point that the challenge is to think about how religiosity might interact with neurohormonal effects and to develop a framework in which such questions are likely to be asked. Taking that point another step, Dennis Bier observed that the classical study of hormones has given way to a realization that “every organ knows what every other organ is doing, because they each have a series of hormones.” Thus, the chemical and biological connections used by the brain

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary to process biological functions, environmental influences, emotional and sensory impulses, and other stimuli are just now being recognized as far more complex than had been realized. Any phenomenon—sleep, decision making, diet, or appetite, for example—could be studied as a way of illustrating these complex connections. Participants offered a variety of candidate topics that could serve as the focus for a synthesis study, if it were tackled in steps, rather than as an effort to integrate the entire universe of research relevant to adolescence. At the same time, however, few were willing to abandon the hope of a basis for improved coordination and integration among multiple fields. The point was made repeatedly, in different ways, that research-based conclusions are most useful in practice when they reflect an integrated understanding of what is going on with teenagers, those at risk or engaged in risky or problem behaviors as well as those who are resilient in resolving or avoiding such behaviors.