The reason, based on a functional MRI study from Dr J Wang of the University of Pennsylvania, is that men have an increased blood flow to the orbitofrontal cortex, and when under similar stress levels, women has an increased blood flow instead to the limbic system.

This is absolutely fascinating, and if future research maintains this finding, it adds to how and why dissimilar reactions to response may occur. Overlaying this concept to the adolescent brain brings up many other points. The boy may have an over-activation of the fight or flight response that is not yet mitigated by experience and other learned control elements. The same overlaying in a girl may be that they appear to be so quickly emotional. Men and women have different brain activation patterns when faced with certain levels of needed decision making.

We don’t know at what age these differing blood flow patterns first develop. But many of our responses, for both sexes and at all ages, depend on how we interrupt the stress and the degree of any anticipated associated danger or loss. So we need these blood flow differences to the list of plausible reasons why the sexes react differently to stress, and why a still developing brain may be more likely to choose  one type of reaction over another.

But the question remains – what benefit is there from learning and maturity? The older brain, or perhaps just the more life-experienced brain with a healthier or more pragmatic mental constitution, appears to be less reactive to negative issues. The older brain appears to be less reactive to criticisms and better able to access and prioritize distractions. A study by Monchi and Martins from the University of Montreal suggested that a younger brain, when it makes a mistake or is accused of making a mistake, activates the middle of a task; the older brain will not activate until a new task is started.  Apparently the older brain makes adjustments only when necessary and not as impulsively. This observation may indicate that the blood flow differences mentioned above become less powerful with maturity. Or it may be that with maturity, we learn to ignore the pressures of blood flow differences.

These findings contribute to what we need to know and learn about, and how to approach, the developing adolescent brain. It also loudly speaks to the need to give the developing brain the time it needs to biologically mature, but to also give it the best available education and role models.

PBS did a 9 minute special on women who made a difference. It’s important that teenagers — and all young women entering the adult world in the work force,  and as partners and as mothers — to have a sense of where their world came from.

This brief video is a great introduction to this piece of women’s history.

Hopefully the richest role model will be from within their own families.

This broadcast will also help expand an appreciation of the history that preceded their own lives, and give them a peek into the world in which their mothers, grandmothers, teachers and other leaders lived.

Click on the link: The  PBS Show   This same video  is also on YouTube

Young girls need to be assisted and encouraged to find a goal and passion, then be given a package of realistic tools to achieve those ends,  the package should also come with balanced and proper criticisms when needed, and then finally they need to be allowed the freedom to work towards the goals.  The key is to have a role model or two to learn from when things are rough, seemingly immobile, or frustrating.

We help the adolescent brain develop by exposing it too all sorts of good food. It would be an especially good meal if both mother and daughter sat at the same table to watch this.

The promised posting on marijuana needs to be postponed. Recent data on alcohol binge drinking needs to be discussed.

A recent study suggests that female teenagers, more so than males, could be exceptionally vulnerable to the negative effects of binge drinking. Heavy alcohol use during adolescence could interrupt normal brain cell growth, especially in the frontal brain regions. This could interfere with the ability to perform in school, and could even have long lasting effects. In particular, a soon (October 2011) to be published study in Alcoholism: Clinical and Experimental Research, found that female teenage binge drinkers showed less brain activation that nondrinking adolescents when doing the same task. The binge drinking rate as studied was relatively common for teenagers their age – perhaps four or five drinks at a party on the weekend but not using any alcohol for weeks thereafter.

The study looked at spatial working memory. This is the ability to perceive the space around someone, and then work and remember using this information. This can be part of driving an automobile, understanding geometry, remembering sports plays, using a map, and so on. The study authors are concerned that binge drinking can have long-lasting effects, even after the teenager stopped using the alcohol.

This problem may be related to strong suggestions that alcohol use during puberty permanently alters the system by which our bodies produce appropriate stress reactions. The question has been raised if exposing young people to alcohol permanently disrupts the connections, usually formed during puberty and adolescence, that are necessary to the development of a healthy, adult level, brain function.

I’ve often heard skeptics of such studies say that they know plenty of people who drank a lot during their adolescence, and “they all turned out okay.” But the real question is what is meant by “okay,” and how much better than “okay” would they have been in adulthood had they not exposed their brains to so much alcohol during adolescence.

Alcohol and drug exposure during adolescence clearly alters the body’s ability to produce stress hormones. But it is also involved in the development of the psychological skills to manage stress. So alterations in psychological skill development, mixed with the biochemical alterations, can result in a total person’s impairment of how to deal with stress in adulthood.

The challenge is that we are just now learning how these drugs and alcohol impact the developing brain. We know there is a factual influence, but what we do not yet know is exactly how much drug or alcohol exposure is needed to reach that critical level of irrecoverable damage. The task is complicated because people are all so different and they will react so differently to different exposures. How much chance do we take?

We also know that it would silly to tell people to stop drinking entirely. That is not realistic; people won’t stop.  But we cannot, by the same token, turn away from this developing science, and we cannot dismiss alcohol as blanketly socially acceptable and benign.  To do so is to give into our powerful psychological needs which are often asked to rationalize ill-timed or irresponsible alcohol use.

Next post – an even closer look at marijuana and the developing brain

One of the others is cannabinoid – this is the substance found in marijuana. Ingesting marijuana causes the CB1 (cannabinoid) receptor to fire, and this causes modulation of dopamine. (You may see publications disagreeing with this, but on close review, the cannabinoids (and other abused drugs)  activate the mesocorticorticolimbic dopamine systems.)  Dopamine is used widely throughout the body -  it can affect blood pressure as well as produce psychological pleasure. But when there is too much, it can cause psychosis.  And when too low, it can cause depression.  Many consider dopamine seeking to be the basis of addiction.

The brain develops by intricate and always changing biochemical feedback circuits. At any time, the brain operates based on the ratios of natural neurohormones to organize experiences, induce pruning, repair itself, learn, set down memories, manage emotions, etc. The natural brain system is not designed for outside materials to push up or reduce down inborn hormonal levels. So when someone takes marijuana, they are giving non-natural signals to release dopamine. Two things happen. First, the brain learns based on an artificial stimulation – there is no learning from using marijuana. (How many people don’t really remember what they studied when they crammed the night before a test, using caffeine or other stimulants to ‘stay up.’) Then, secondly, the brain doesn’t have a real experience to learn and figure something out based on its own, native biochemistry. We want our brains to biologically develop by themselves. Consider the philosophy of Alcohol Anonymous. They focus on getting our brains to work without outside biochemical influences. Repeated exposures to artificial stimulations confuses, confounds and impedes.  A good example is considering the brain as an orchestra – at rehearsal everyone thinks the drum player is learning his part, but in fact the drummer is drumming because of marijuana, not real practice. So when the time comes for a real performance, the drummer without the presence of marijuana will not be up to par with the rest of orchestra.  

I’ve heard teenagers discredit drug using performers, but I’ve more than once gotten a feeling that the more emotionally immature or insecure adolescent secretly wonders if drug use will help them find success or take away the pain of failure.

The argument is made that many medications also increase dopamine release. That is true. Some popular performers claim to be be high when on stage;  this may also be true, but this is an exceptionally dangerous rationalization because most people are not exceptions.  The performer may have so much talent that even impeded, they have more talent then the average person, and yet many of them eventually get into trouble for their drug use. It’s risky to assume that “I am like that singer when I am high!”

Unlike street marijuana, properly used medications are monitored, pure substances, and they are being used for the correct diagnosis. Marijuana is often used for social or psychological reasons, not truly ‘chemical imbalance’ reasons. No physician would give a stimulant to a kid who was primarily socially nervous about asking a girl to dance – his brain doesn’t need extra dopamine release, it needs guidance and mentoring.  The psychological success will produce a repeatable and natural dopamine release.

There are, of course, people, even teenagers, who need medications. This is the gift of modern psychopharmacology. Those with brain illnesses can be helped in so many incredible ways. We can help with real depressions and phobias. But the risk is that many adolescents endanger their development if they use outside uncontrolled chemical influences to deal with their psychological pressures and problems.  

There is another argument often made that using a drug brings a person into a group, which in turn makes them feel wanted or gives them a sense of fellowship. The question is how many of them will outgrow the need for the continuing drug use as time goes by?  Will any on-going use of the drug skew the psychosocial development into long-term dangerous choices and patterns? Why can’t someone feel wanted without drug use being the admission ticket? And how will the regular drug use effect the brain’s development – this is a real concern.

People who outgrow drug use may be lucky that their frontal lobes eventually mature before too much neurological marring occurs.  It’s tragic but true – we often speak about kids with psychiatric conditions from drug use as “they took one too many hits of pot, and they stepped over that invisible but oh so real threshold…” 

More people are in treatment for mariana use than for cocaine use. This US White House Office of  Drug Abuse Policy offers good statistics.

The best initial treatment is what comes out of the mouth – talking about it – as opposed to what goes into the mouth – swallowing a drug or medication.  Sometimes, and only when appropriate, are both needed.  But I’ve never seen an adolescent benefit only from medication use. Even kids with straight ADHD can benefit from some counseling. “So what does it mean to you to have ADHD? Do you tell your friends?  Why does your Mom hide your meds from your friends? How different do you now feel?  How do we combine how you feel on meds and going after our goals?” 

There is a biochemistry of talking and teaching. The brain can change by talking!  Many kids know this; but unfortunately not all know how, or never have a chance or do not live in world where they can do it.  A great lesson to teach adolescents is how to change the world they live in; sadly, this can be extremely hard and risky in its own right. But hiding, using marijuana or other drugs, from learning how to change their world never gives them the right experience to help their neurological and psychological worlds to become healthier.

We need to add ‘talking’ and ‘giving them good models to follow’ to the list of neurohormones.

No risk taking is as unhealthy as too much risk taking. We learn from risks. It’s the types and intensity of risks that matter.

Risks refine our relationships with the world. It is the grandest of all experiments, the “what will happen if…” query into cause and effect.

But the risk brought on mostly by emotions – the adolescent risk — is quite different than the considered risk; this latter risk could be considered the adult risk. Anger and feeling inferior or rejected are probably the most common emotional triggers for adolescents. But this will change too, because the 14 year old is not the same as the 21 year old. Yet they both remain incompletely developed. And, which cannot be overlooked, is that a 19 year male may take more defiant risks because he is big and strong enough – aspects that did not exist when he was 13 years old — to take a stand. Being older, perhaps with some money and more independence, gives a stage for his emotions that may have existed when younger. So the risks can take on a different dimension. But the core emotions may not be as mature as his new mobility and body strength.

We assume that the ‘considered risk’ has been evaluated by as mature a frontal lobe as possible, with a database of hopefully good experience and training. (“At your age, you ought to know better…” ) The ‘emotional or adolescent risk’ lacks the same degree of experience, training and a mature frontal lobe. (“She’s too young or immature to babysit…”)

The race car driver speeding into a curve at 125 mpg is a considered risk, while the show off 17 year old,  drag racing on a distant road, is the adolescent risk. Yet the 17 year old may actually develop better driving skills with each drag race, and his grey and white matters will change accordingly.

It’s been said that the risky behavior seen as a result or during a psychotic or manic episode leaves a different learning trail because during the episode, the person can not control the risky decision process. This may apply to panic and anxiety as well. That’s the disease in action. When the psychosis ends, the person may remember the episode, and  may learn from the memory, but there is not always the usual, pruning based, left over learning as such. These episodes short-circuit the decision and learning process.

Over time, after repeated episodes, the person learns the signs of trouble; like a volcano’s temperature detector, the person becomes aware of the pattens which foretell problems that risky behavior may soon follow and help is needed.  Younger bipolar patients, for example, lack the experience of repeated episodes and, in combination with the less mature brain, are more vulnerable to recurrences.  Older patients tend to be more aware and in more control of recurrences. The younger bipolar patient brain is doubly challenged.

Sometimes an adolescent will repeat a dangerously risky behavior because they are not getting the reward they want. This is a sign of emotional desperation. A more mature brain will give up  or change the effort if it is not working out. But sometimes an adolescent will decide  that  only greater risk taking will produce the results. So they take more drugs, act more defiantly, drive faster, be more promiscuous, etc.

One of the heavily discussed topics is when does a problematic personality disorder first appear. These can greatly influence how or when  a risk or a decision is made. We’ll study this later.

Also, some kids can’t risk getting out of a bad situation. For example, they do not know how to get out of an abusive home or from a gang. They may not be strong or protected enough to ‘risk’ changing their life enough to feel relief or escape from some handicap or social pressure. It is not uncommon that some kids, because of their cultural, shyness, or sexual orientations, etc, never take the step – they never risk — coming forth against those who may bully them. In these cases they suffer a quiet, fearful life., which leaves it’s own learning pattern.  Making their life better is too risky until they grow strong or old enough not to fear the risk. But when they do leap away from the problem, their emotional skills may not be honed and annealed enough to reduce errors, so they make mistakes, over react, etc.

Not all risks produce damage. But they might. And every risk produces experience. The challenge is to find ways to get good learning, success,  and insight in a non-dangerous manner. We all need to learn how to use fear.

“Early and provident fear is the mother of safety.” — Edmund Burk, 1792

This link will offers some additional thoughts of adolescent risk taking. It is worth the visit.

Next: Beginning to bring it all together — Risk, dopamine, and recent studies that marijuana use in adolescence increases the chance of psychosis.

What comes across is the on-going importance of the adults in a teenager’s life. What is sad is what happens to the kids who don’t have this good fortune.

Click here to go to the show at the PBS Frontline site.

I’ll post updates on some of the themes mentioned in the show.

The teenager favors the immediate over delayed gratification. They do not – or in some situations cannot – project ahead to anticipate a decision’s  long term effect. In fact, they often discount the future in favor of the present — this is the temporality at work. This is commonly seen in how they approach sexual encounters, use drugs, accept delays,  solve emotional problems, choose a personal identity, their car driving patterns, etc.

The biological aspect of temporality may be related to the under functioning (in medical terms — hypoactivation) of the part of the frontal lobe known as the lateral prefrontal cortex. This brain area is simply not yet mature enough to be able to compute the safety, outcome, or danger of a decision. This is especially so if the decision is attached to a strong emotional drive.

What’s interesting is how often a group of teenagers will excite a ‘group choice’ to do something risky. But the opposite may happen; they, as a group, may control and regulate themselves away from dangerous risk.

This is a fascinating process to watch because it is the combined efforts of all their frontal lobe skills working like separated, but linked computers, to deal with the questions coming out of their combined drives. Sometimes the group can offset the temporality thinking. Groups vary from the street gang to the school study-group.

Many aspects of how a decision is made reflects what the teenager is taught or what rules they ‘have to follow’ in life, whether or not they agree with the rules. How different this process is when the rules come from a gang leader, a military sergeant, or a Boy’s Club counselor.

People make mistakes in risk assessment when they primarily use their own emotions.

The anterior insula is one area of the brain that integrates and processes emotions.  Adolescents with a greater frequency of high-risk behavior had a lower activation of the frontal lobes (orbitofrontal, prefrontal and cingulate) cortex, so there is less ability to assess and regulate the emotional  inputs from the insula before the inputs are changed into behaviors. The frontal lobes need until the late 20’s to do this, which is so obvious in how we all see how differently emotions will be controlled.

It makes us wonder if adolescence should be separated from teenagehood. We mistakenly assume the terms are synonymous; they are not. Adolescence suggests a period of development. Teenagehood is just the second decade of life. The common use is to overlap the terms,  but adolescence extends past the age of 19.

Another aspect of temporality is that teenagers overestimate the potential rewards of a decision. Perhaps addictive behaviors start out as an erroneous evaluation of long term risk.  They often seek a group that reflects their emotional needs. They don’t take the time to evaluate the situation because they lack the computing power and software (experience) to “think it through…”  So we, as adults, must equip the working parts of their frontal lobes with values, pacing skills, and rules that they feel obligated to use until their own systems develop.  Of course, those rules may taint and color how these adolescent systems develop, but such is the basis of our traditions and, hopefully, of good parenting.

We should probably rename this blog as ‘the adolescent brain in an adolescent environment’ since their environment is an unprecedented example of emotional temporality – they live in a world of inexpensive instant texting and YouTubing, intense media based suggestions, endless news broadcasts, internet searches, etc. The world itself is too rapid to let our children to have the time to mature. 

People mature earlier or later than others, so exceptions exist. And sadly, some also suffer the burden of psychiatric illnesses or very distorted home lives.  But the overall development theme is constant.

Like Erickson’s and Freud’s ideas, adulthood is the product of necessary developmental stages. The type of adulthood we seek from adolescence may not be possible if the process is incomplete or damaged. 

Next: When and how is adolescent risk taking a good thing?

Many times teenagers take risks to ‘make a point.’ They are emotionally angry or hurt, and their emotional reaction is often a retaliatory over-reaction. The resulting behaviors may endanger others or themselves (or sometimes a mixture of both) though violence or defiance, cutting themselves, sexual or drug use acting out, or even driving irresponsibly, but the behavior carries a message! Good intervention must decipher the message from the behavior. Then the irritant can be removed, or if it cannot be removed, then the goal is give them better and more workable coping skills. This is often hard to do, and usually takes a lot of time and energy.

Teenagers may feel less ‘risk aversion’ because of their youthfulness. They often believe there is plenty of time in their lives to regain something if it is lost. They also tend not to see death as permanent, or they see the goal of their death as saying something like “my death will force you to understand or appreciate me.” Therefore, the prospect of risking death is not as aversive or frightening. This is perhaps because teenagers are more inclined to over-estimate the reward of a risk and not be so afraid of any subsequent discomfort or punishment. For example, the hope of gaining some euphoria, social status , or an object from drug use (usually they seek all three goals) is not outweighed by the possible malaise of a hangover or the risk of pregnancy. 

These behaviors can also be the result of depressions and other psychiatric conditions. This makes the diagnosis so complex. Is it an emotional developmental phase, situational, or psychiatric problem? And how much of the choice to choose a behavior stems from neurological immaturity? Problems get worse with mixtures of psychological and neurological issues.

This then brings us to the second neurologically based reason teenagers take risks. The process seeking the rewards is thought to stem from the over activation of reward centers (such as the nucleus accumbens) while there is also an under activation of regulating brain area ( the frontal lobes). The combination of a strong social or psychological need to express an emotion fails to undergo the necessary regulation of a fully mature frontal cortex.

We could gather all these thoughts under the term of the day by day, ever-changing psycho-neurobiology of decision-making.

A 23-year old looked back at his “wild youth” and told me that “now, in my ripe old years, I can finally stop and say ‘humm, do I really want to do that?’ ”

Let’s now mix in caffeine, alcohol or drugs. We don’t give drugs or alcohol to infants or young children because of what it does to their brain’s development. Can we – or should we — carry that same concern to the teenager and young adult? Will that be too much of a social change? Is it as important to protect the 20-year-old brain as much as the 13-year-old brain?

(Remember to visit our page of Basic Definitions of terms used in these postings. )

Thanks.

Next post: more about for teenage risk taking and information about the immediate versus delayed responses.

Adolescents tend to have less aversion to risk than adults. There are several reasons for this. This entry will focus on one of them, and the other reasons will follow.

But first a bit of background.

The brain is only about 80% developed in adolescence. It is not complete until the late 20’s.

The brain also develops from the back to the front, and the last section to mature is the frontal lobe, where reasoning, planning, and judgment take place. Girls begin this process between 12 and 14 years of age, and boys start about 2 years later. (Which every parent and teacher knows!)

Learning takes place as the brain cells develop more robust synapses – that is, connections – that follow robust and repeated stimulations. This is called ‘long term potentiation,’ and it is this massive growth and pruning that allow teenagers to learn more easily than adults. But this growing process is also under the brutal attack of the sex hormones. So there the frontal lobes sit, faced with the challenge of making decisions beyond their level of maturity and experience. The early teenage frontal lobes also lack the needed connections going back to other parts of the brain – which may be more mature – that help make a proper decision. That is the turmoil of adolescence. So a ‘risk’ toa teenager is not processed or viewed in the same manner as an equal risk may be evaluated by an older adult.

The other factor is that kids are going into puberty at even younger ages, and so they may being doing so with even less mature brains. We’ll explore this too.

The first of the reasons for taking greater risk is that there is less ‘risk aversion,’ and this has been linked to an under activation of two parts of the brain: (1) the anterior insula, which is involved in emotions such as fear and disgust, and (2) to parts of the still under mature prefrontal cortex that monitors for conflict and error detection. So the effect is that the younger teenager’s logic doesn’t ‘see the danger’ the same way an older person may see it. This is why it is so important for the teenager to have external values and models that literally ‘dictate’ a model behavior. Some teenage risk taking is inevitable, and often can be beneficial, but some risks are riskier than others. They may not fully understand or agree with the adult reasoning regarding the extent of a particular risk, but because of their environment, they know when it is safer and prudent for them to follow the adults’ choice making procedure. This process of respecting the adult’s feelings about such things proceeds adolescence and should speak to the entirety of the child’s life.

The growth producing effect of this process has two parts. It teaches the importance of resisting an impulse, and of learning to live with delayed gratification and frustration. This is laid down in the neurons as a memory with a good outcome, and it leaves the teenager a step more mature both in a psychological and biological way. What follows is a reward for not doing something, and in that comes a piece of psychological strength. It may also get applause from the adult.

It’s not hard, sadly, to see the opposite happening if trustworthy adults are not around to give good advice and offer good models. The brain will biologically mature in and of itself, but the tools it learns as it matures is the product of what tools are made available to it during all of the childhood and across all the different stages of the maturing process.

A blast has two elements that clearly overlap. The ‘wind from the blast’ might throw people around and against walls, etc., which can toss the brain about within the skull. The actual ‘blast’ can be an explosion or a physical push, such as a hard football tackle, a fall, assault, or an auto injury. This is known as cranial shock-wave injury, and it can cause a concussion or other damages.  The second element involves the physics of a shock wave – an energy pulse and the resulting tissue disruption – as the pulse passes through the body. Tissues are also disrupted as the energy is displaced within the body. The brain is squeezed, the openings into and out of the brain might temporarily shift, and so on. Some blasts can also result in brain swelling, bleeding, vascular spasms, etc.

Medicine often refers to an injury as an insult. Our interest in this topic is because teenagers often suffer these types of insults. Young adults also are commonly first in battle. And since neurologically their brains have not been fully developed, they risk interfering with their brain’s ability to do so. For years it was nearly impossible to find structural changes in the brain after these insults. This was in part because of a lack of sophisticated enough neuroimaging tools.  Traditional CT and MRI scans identified no problems. But now diffusion tensor imaging (DT) can detect problems of axonal disruption. This is the topic of much discussion.

Each of us knows of people who were in battle, had football related head injuries, etc., who seem to be fine. With time, therefore, the statistical perspectives of these observations will be better established. So now there remain more questions than answers. But we must be aware of these new questions about how such insults might effect brain neurological and cognitive development and accept that these questions do not yet come packaged with answers.