Adolescence is a time for developing independence. Typically, adolescents exercise their independence by questioning or challenging, and sometimes breaking, rules. Parents and doctors must distinguish occasional errors of judgment, which are typical and expected of this age group, from a pattern of misbehavior that requires professional intervention. The severity and frequency of infractions are guides. For example, regular drinking, frequent episodes of fighting, absenteeism from school without permission (truancy), and theft are much more significant than isolated episodes of the same activities. Other warning signs of a possible behavioral disorder include deterioration of performance at school and running away from home. Of particular concern are adolescents who cause serious injury to themselves or others or who use a weapon in a fight.
Because adolescents are much more independent and mobile than they were as children, they are often out of the direct physical control of adults. In these circumstances, adolescents' behavior is determined by their own decision-making, which is not yet mature. Parents guide rather than directly control their adolescents' actions. Adolescents who feel warmth and support from their parents and whose parents convey clear expectations regarding their children’s behavior and show consistent limit setting and monitoring are less likely to develop serious problems.
Authoritative parenting is a parenting style in which children participate in establishing family expectations and rules. This style of parenting involves limit setting, which is important for healthy adolescent development. Authoritative parenting, as opposed to authoritarian-style parenting (in which parents make decisions with minimal input from their children) or permissive parenting (in which parents set few limits) is most likely to promote mature behaviors.
Authoritative parenting uses a system of graduated privileges, in which adolescents initially are given small bits of responsibility, such as caring for a pet, doing household chores, purchasing clothing, decorating their room, or managing an allowance. If adolescents handle a responsibility or privilege well over a period of time, more responsibilities and more privileges, such as going out with friends without parents and driving, are granted. By contrast, poor judgment or lack of responsibility leads to loss of privileges. Each new privilege requires close monitoring by parents to make sure adolescents comply with the agreed-upon rules.
Some parents and their adolescents clash over almost everything. In these situations, the core issue is really control. Adolescents want to feel they can make or contribute to decisions about their lives, and parents are afraid to allow their children to make bad decisions. In these situations, everyone may benefit from the parents picking their battles and focusing their efforts on the adolescent's actions (such as attending school and complying with household responsibilities) rather than on expressions (such as dress, hairstyle, and preferred entertainment).
Adolescents whose behavior is dangerous or otherwise unacceptable despite their parents' best efforts may need professional intervention. Substance use is a common trigger of behavioral problems, and substance use disorders Substance Use in Adolescents Substance use among adolescents ranges from experimentation to severe substance use disorders. All substance use, even experimental use, puts adolescents at risk of short-term problems, such... read more require specific treatment. Behavioral problems also may be symptoms of learning disabilities Learning Disorders Learning disorders involve an inability to acquire, retain, or broadly use specific skills or information, resulting from deficiencies in attention, memory, or reasoning and affecting academic... read more , depression Depression and Mood Dysregulation Disorder in Children and Adolescents Depression includes a feeling of sadness (or, in children and adolescents, irritability), and/or loss of interest in activities. In major depression, these symptoms last 2 weeks or more and... read more , or other mental health disorders Overview of Mental Health Disorders in Children The treatment section for bipolar disorder has been extensively revised with separate treatment sections for mania and for depression. In addition, information has been added throughout to address... read more . Such disorders typically require counseling, and adolescents who have mental health disorders may benefit from treatment with drugs. If parents are not able to limit an adolescent’s dangerous behavior, they may request help from the court system and be assigned to a probation officer who can help enforce reasonable household rules.
(See also Introduction to Problems in Adolescents Introduction to Problems in Adolescents For most children, adolescence is a period of good physical health. The most common problems during adolescence relate to Growth and development School Childhood illnesses that continue into... read more .)
Specific Behavioral Disorders
Disruptive behavioral disorders are common during adolescence.
Attention-deficit/hyperactivity disorder Attention-Deficit/Hyperactivity Disorder (ADHD) Attention-deficit/hyperactivity disorder (ADHD) is poor or short attention span and/or excessive activity and impulsiveness inappropriate for the child’s age that interferes with functioning... read more (ADHD) is the most common mental health disorder of childhood and often persists into adolescence and adulthood. However, adolescents who have difficulty paying attention may instead have another disorder, such as depression Depression and Mood Dysregulation Disorder in Children and Adolescents Depression includes a feeling of sadness (or, in children and adolescents, irritability), and/or loss of interest in activities. In major depression, these symptoms last 2 weeks or more and... read more or a learning disability Learning Disorders Learning disorders involve an inability to acquire, retain, or broadly use specific skills or information, resulting from deficiencies in attention, memory, or reasoning and affecting academic... read more . Although ADHD is often treated with stimulant drugs (such as amphetamine or methylphenidate), which can potentially be misused, such treatment does not appear to increase the risk of developing a substance use disorder and may even decrease the risk. On the other hand, some adolescents complain of symptoms of inattention in an attempt to obtain a prescription for stimulants, either to be used as a study aid or recreationally.
Other common disruptive behaviors of childhood include oppositional defiant disorder Oppositional Defiant Disorder Oppositional defiant disorder is a recurring pattern of negative, defiant, and disobedient behavior, often directed at authority figures. Children with oppositional defiant disorder are stubborn... read more and conduct disorder Conduct Disorder A conduct disorder involves a repetitive pattern of behavior that violates the basic rights of others. Children with a conduct disorder are selfish and insensitive to the feelings of others... read more . These disorders are typically treated with psychotherapy for the child and advice and support for parents.
Violence and Gang Membership
Children occasionally engage in physical confrontation and bullying Bullying Many children and adolescents occasionally have physical confrontations with others, but most children and adolescents do not continue violent behavior or engage in violent crime. However, children... read more , including cyberbullying. During adolescence, the frequency and severity of violent interactions may increase. Although episodes of violence at school are highly publicized, adolescents are much more likely to be involved in violent episodes (or more often the threat of violence) at home and outside of school. Many factors contribute to an increased risk of violence for adolescents, including
Intense corporal punishment (such as punching or beating) inflicted on the child
Caregivers with substance use disorders
Access to firearms
There is little evidence to suggest a relationship between violence and genetic defects or chromosomal abnormalities.
Gang membership has been linked with violent behavior. Youth gangs are self-formed associations made up of 3 or more members, typically ranging in age from 13 to 24. Gangs usually adopt a name and identifying symbols, such as a particular style of clothing, the use of certain hand signs, certain tattoos, or graffiti. Some gangs require prospective members to perform random acts of violence before membership is granted.
Increasing youth gang violence has been blamed at least in part on gang involvement in drug distribution and drug use. Firearms and other weapons are frequent features of gang violence.
Violence prevention begins in early childhood with violence-free discipline. Limiting exposure to violence through media and video games may also help because exposure to these violent images has been shown to desensitize children to violence and cause children to accept violence as part of their life. School-age children should have access to a safe school environment. Older children and adolescents should not have access to weapons and should be taught to avoid high-risk situations (such as places or settings where others have weapons or are using alcohol or drugs) and to use strategies to defuse tense situations.
All victims of violence should be encouraged to talk to parents, teachers, and even their doctor about problems they are having.