A STUDY OF INTERACTIONS

EMERGING ISSUES IN THE SCIENCE OF ADOLESCENCE

WORKSHOP SUMMARY

Alexandra Beatty and Rosemary Chalk, Rapporteurs

Program Committee for a Workshop on the Synthesis of Research on Adolescent Health and Development

Board on Children, Youth, and Families

Division of Behavioral and Social Sciences and Education

NATIONAL RESEARCH COUNCIL AND INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary A STUDY OF INTERACTIONS EMERGING ISSUES IN THE SCIENCE OF ADOLESCENCE WORKSHOP SUMMARY Alexandra Beatty and Rosemary Chalk, Rapporteurs Program Committee for a Workshop on the Synthesis of Research on Adolescent Health and Development Board on Children, Youth, and Families Division of Behavioral and Social Sciences and Education NATIONAL RESEARCH COUNCIL AND INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract Numbers HHSH25056057 and HHSH24055019 between the National Academy of Sciences and the Health Resources and Services Administration. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-10165-4 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. Cover image: © Corbis Corporation. Copyright 2006 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. Suggested citation: National Research Council and Institute of Medicine. (2006). A Study of Interactions: Emerging Issues in the Science of Adolescence. A. Beatty and R. Chalk, Rapporteurs. Program Committee for a Workshop on the Synthesis of Research on Adolescent Health and Development, Board on Children, Youth, and Families. Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary PROGRAM COMMITTEE FOR A WORKSHOP ON THE SYNTHESIS OF RESEARCH ON ADOLESCENT HEALTH AND DEVELOPMENT DENNIS M. BIER (Chair), Children’s Nutrition Research Center, Baylor College of Medicine WILLIAM RIGBY BEARDSLEE, Department of Psychiatry, Children’s Hospital, Boston ROBERT WM. BLUM, Bloomberg School of Public Health, Johns Hopkins University RICHARD J. BONNIE, Institute of Law, Psychiatry, and Public Policy, University of Virginia RONALD DAHL, University of Pittsburgh Medical Center DEBORAH Y. DELGADO, Annie E. Casey Foundation, Baltimore RONALD E. KLEINMAN, Department of Pediatrics, Massachusetts General Hospital MILBREY W. MCLAUGHLIN, School of Education, Stanford University SUSAN MILLSTEIN, Division of Adolescent Medicine, University of California, San Francisco HEATHER JOHNSTON NICHOLSON, Girls Incorporated, Indianapolis GAIL B. SLAP, Division of Adolescent Medicine, Children’s Hospital Medical Center of Cincinnati LAURENCE D. STEINBERG, Department of Psychology, Temple University ROSEMARY CHALK, Project Director

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary BOARD ON CHILDREN, YOUTH, AND FAMILIES MICHAEL I. COHEN (Chair), Department of Pediatrics, Albert Einstein College of Medicine BARBARA WOLFE (Vice Chair), Department of Economics and Population Health Sciences, University of Wisconsin WILLIAM RIGBY BEARDSLEE, Department of Psychiatry, Children’s Hospital, Boston P. LINDSAY CHASE-LANSDALE, Institute for Policy Research, Northwestern University THOMAS DEWITT, Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center MARY JANE ENGLAND, Office of the President, Regis College, Weston, MA BRENDA ESKENAZI, School of Public Health, University of California, Berkeley CHRISTINE C. FERGUSON, The Children’s Investment Project, Alexandria, VA NEAL HALFON, School of Public Health, University of California, Los Angeles SUSAN MILLSTEIN, Division of Adolescent Medicine, University of California, San Francisco ELENA NIGHTINGALE, Institute of Medicine, The National Academies LAURENCE D. STEINBERG, Department of Psychology, Temple University ELLEN WARTELLA, Office of the Executive Vice Chancellor and Provost, University of California, Riverside ROSEMARY CHALK, Board Director WENDY KEENAN, Program Associate

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary Contents     Preface   ix 1   Introduction   1 2   A Portrait of Adolescence   5      Developmental Changes and Brain Maturation,   6      Interacting Influences,   7      Hormones—Even More Complicated Than You Thought,   11      Changing Conceptual Models,   13 3   A Time of Risk   15      Depression,   16      Substance Abuse,   19      Dysfunctional Relationships,   22      Media Influences—What Are the Risks?,   23      Conclusion,   26 4   A Time of Opportunity   27      Positive Youth Development,   27      A Safety Net for New York City’s Youth,   30      Linking Research to Intervention,   32 5   What Next for Research on Adolescence?   36     References   41     Appendix Workshop Agenda and Participants List   45

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary Preface This volume summarizes a two-day workshop convened in September 2005 that reviewed emerging research findings related to the biological, behavioral, psychological, and social processes that occur during adolescence. These complex processes are attracting increased attention because new research now makes it possible to identify certain interactions among brain structures, hormonal changes, other biological and behavioral impulses, and the contextual settings that surround and engage young people. Many researchers believe that such interactions provide important clues and underlying explanations for the solution of serious problems that frequently emerge during adolescence: alcohol and other substance abuse, mental and behavioral disorders, unhealthy sexual conduct, violence, school failure and delinquency, and other social and health disorders. All too often, the confinement of studies of adolescence within certain fields of research impedes cross-disciplinary analysis and recognition of common risk factors and opportunities for positive interventions. In addition, much of the basic research literature, experimental studies, and longitudinal analyses of adolescent health and development are scattered across multiple scientific disciplines and research centers. The workshop was thus intended to provide an opportunity for an interdisciplinary group to explore the current research landscape and to consider links among the disciplines—links that might be useful in both moving the field of adolescent studies forward and helping to translate emerging research findings into

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary policy and practice. The time frame for the workshop was by no means sufficient for a comprehensive overview of even the primary issues related to adolescent health and development. The participants sought instead to identify a few key areas that show promise in advancing the understanding of fundamental processes that occur during adolescence. They were also asked to provide perspectives on the state of study in their own fields and to consider whether transdisciplinary work would help advance these studies. The overarching goal of the workshop was for participants to consider whether a broad synthesis of the emerging research base could help advance understanding of the science of adolescence, and, if so, how such a synthesis might be prepared. The proposed synthesis was viewed as a future companion report to the earlier National Academies study From Neurons to Neighborhoods,1 which examined the broad array of factors that affect early childhood development and argued convincingly that a science base could inform the practices involved in caring for and educating very young children. The initiative for this workshop was first developed by Robert Blum, former chair of the Committee on Adolescent Health and Development of the National Research Council (NRC) and the Institute of Medicine (IOM). The proposal was further reviewed and refined by the NRC-IOM Board on Children, Youth, and Families. The Office of Adolescent Health in the Maternal and Child Health Bureau of the U.S. Department of Health and Human Services subsequently funded an activity that included the formation of a program committee that met once to help plan and convene the workshop. The efforts of the planning committee members and the workshop participants fostered a collaborative effort designed to begin to unravel a challenging and multifaceted area of study. We are particularly grateful for the contributions of the expert presenters who agreed to prepare background papers to inform the workshop deliberations as well as the other speakers and discussants who contributed to the meeting (see the appendix for the workshop agenda and list of participants). Special appreciation also goes to the members of the planning committee, who volunteered their time and intellectual efforts to shape the 1   National Research Council and Institute of Medicine. (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development. Committee on Integrating the Science of Early Childhood Development. Jack Shonkoff and Deborah Phillips, eds. Board on Children, Youth, and Families, Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

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A Study of Interactions: Emerging Issues in the Science of Adolescence - Workshop Summary workshop program and identify themes and contributors. In addition, we give special thanks to Alix Beatty, who prepared a comprehensive draft for the summary report, and Wendy Keenan, who assisted with the production of the final publication. The summary report was prepared by rapporteurs who attended the workshop, but it does not represent findings or recommendations that can be attributed to the planning committee members. This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the NRC. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this report: Nancy Birkhimer, Teen and Young Adult Health Program, Maine Center for Disease Control and Prevention, Maine Department of Health and Human Services; Ronald E. Dahl, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; Charles E. Irwin, Jr., Division of Adolescent Medicine, University of California, San Francisco; Becky Judd, Division of Behavioral Health, Alaska Youth Services; and Michele D. Kipke, Saban Research Institute, University of Southern California Children’s Hospital, Los Angeles. Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the report nor did they see the final draft of the report before its release. The review of this report was overseen by Nan Marie Astone, Department of Population and Family Health Sciences, The Johns Hopkins Bloomberg School of Public Health. Appointed by the NRC, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution. Rosemary Chalk, Director Board on Children, Youth, and Families

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