Dangerous Journeys

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Dangerous Journeys

• A metaphor for passage through the teen years
• Marvin Krank

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How can we help youth get through these perilous
times
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Mixed messages
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Justsay no!
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Project on Adolescent Trajectories and Health
(PATH) social context, cognition, risk-taking
behaviour, and health outcomes

• Three-year longitudinal study
• Funded by the SSHRC and CIHR
• Partnership with SD23

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Overview of theoretical approach

• Social factors modify cognitions about risky
  behaviors
• Cognitions affect transitions to risk-taking
  behavior
• Risk-taking behaviors impact on health outcomes

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Life style choices begin in adolescence

• Drug and alcohol use begin in the early teens
• Many smokers begin before age 14
• Risky choices have long-term consequences for
  youth
• early pregnancy
• accidents
• unhealthy lifestyles
• lost opportunities

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Grades 7-10 are a time of significant transitions
in drug and alcohol use
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Different patterns in use of marijuana
Experimentation with marijuana occurs during the
study period
Regular use of marijuana also occurs during the
study period
Source Krank and Johnson (1999a,b)
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A small, but significant percentage of these
youth used drugs and alcohol in the past week
Male Male Male Female Female Female
Eight Nine Ten Eight Nine Ten
Alcohol 20 33 36 18 25 29
Drunkenness 10 16 21 8 19 20
Cigarettes 4 4 9 5 12 13
Marijuana 7 13 20 7 17 20
Hallucinogens 4 2 2 3 3 3
Inhalants 5 4 4 4 5 2
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Why weshould care
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Adolescent risk is based on what they do

• Unsafe sex in youth leads to teen pregnancy, low
  birth weight babies, and STDs including HIV
• Drug and alcohol use increase unintentional
  injuries, the leading cause of death in youth

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Early and heavy alcohol use is correlated with
many negative outcomes

• Health
• Aches and pains
• Accidents
• Hospitalization
• Violence
• Victim
• Perpetrator
• Various kinds
• Bullying
• Assault
• Sex
• Early sex
• Regretted sex
• Sexual assault

• Problem behaviours
• Skipped school
• Stayed out all night without parent permission
• Damaged property
• Warned or detained by police
• School detention
• Stole something outside of home
• Stole at home
• Suspended out of school
• Suspended in school
• Ran away from home
• Carrying weapons

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High risk behaviours tend to co-exist

• Drug and alcohol use, early and unsafe sexual
  activity, and violence tend to co-occur
• For example, heavier drug and alcohol use is
  linked to being both a victim and a perpetrator
  of sexual assault.

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Drug and alcohol use are highly correlated
Used alcohol Percent used marijuana
No 2.8
Yes 44.9
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General Bullying - Past Year Percent of Students
Involved
Male Female
Victim 56.4 46.3
Aggressor 60.3 38.2
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Past year as victim of bullying or violence
Male Female
Physically harmed 34.7 21.7
Threatened 45.9 32.9
Witness 81.7 77.6
Will be bullied 37.6 33.3
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Aggressor violence is related to alcohol use
Drank alcohol Drank alcohol
Never In the Past Week
Bullied 1.09 2.34
Physically harmed 0.59 1.70
Threatened harm 0.69 1.99
Internet 0.26 1.00
Verbal 1.24 2.48
Excluded 1.41 2.26
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Dating and sex

• 1/3 of grade eleven students have had sex
• 2/3 of females had sex under influence of alcohol
• 43 of the girls have given oral sex
• ½ of the girls regretted having sex
• 14 of grade 9-11 girls have been physically
  harmed by their dating partner
• 26 of drinkers and 28 of marijuana users have
  been physically harmed by their partner.

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General problems and alcohol use
Alcohol Use Never In the Past Week
Skipped school 11 62
Stayed out all night without parent permission 3 49
Damaged property 14 53
Warned or detained by police 3 29
School detention 11 49
Stole something outside of home 4 39
Stole at home 5 31
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Weapon carrying
Drank alcohol Drank alcohol
Never In the Past Week
In school 4 18
Out of school 4 28
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The social and cultural roots of these cognitions

• Parents
• Peers
• Personality
• Pop Culture

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The effects of advertising

• 1Billion/yr
• 70 on TV
• 22 magazines
• 50 on Saturday and Sunday
• 33 between 8-11 pm

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Tuborg
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Crying
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Thoughts lead to actions

• Social factors modify cognitions about risky
  behaviors
• Cognitions affect transitions to risk-taking
  behavior

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What do you expect to happen if you drank a
moderate amount of alcohol

• Write down three or four things that would happen
  to you.

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Thoughts precede actions
Cognitive changes occur during these years.
These changes predict who will take risks.
Changes in expectancies occur before changes in
behaviors
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Modern Risk Prevention Programs

• Discuss social influences
• Offer skills training alternative behaviours
• Correct misperceptions about norms
• Focus on changing false expectations

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Contemporary Evidence-based Methods

• Less confrontational empathetic and roll with
  resistance
• Motivate change encourage discrepancies by
  realistic feedback
• Meet individuals where they are Age and Stage
  appropriate
• Non-users
• Experimenters
• Users
• Brief interventions

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Cognitive Expectancy challenge
Positive Expectancy So whats wrong with that? What else could you do?
Have fun Artificial high Replace safer and healthier choices for having fun
Feel sexier Not how others see you Bad judgement embarrassment Regret actions
Relax Replace more effective ways of relaxing Actually makes things worse
Talk more easily Say stupid things that you will regret Fail to listen
More is less is a general point What else could
you do is an exercise for the youth, ask
questions, but be ready to help answer with
healthy alternatives that they would like.
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What can you do?

• Goal is to change or prevent risky expectancies
• Parents can and do make a difference

The problem is how do you do that?
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When to talk to them

• Quiet times when the opportunity arises
• Away from friends and siblings
• In the car
• Watching TV e.g. TV commercials

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Try to speak their language
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How to talk to your kids

• Listening first
• Four principles
• Be understanding and try to see things from their
  perspective That must be difficult
• Present facts contrary to what their long term
  goals Smoking marijuana interferes with learning
  and memory. I wonder how that might influence
  getting into university?
• Dont confront or challenge work around the issue
• Be supportive and positive about your child You
  can do it
• Be prepared and tell the truth
  www.ouc.bc.ca/path

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Conclusion

• The real war on drugs is the battle for the
  hearts and minds of our youth
• We dont want to prevent them from taking the
  journey, but we do want them prepared for
  challenges along the way.