Psychosocial disturbances: Let's take a closer look at the beast

Book Review Psychosocial Disturbances: Let's Take a Closer Look at the Beast RuI"rER, M. (Ed.)

Psychosocial Disturbances in Young People: Challenges for Prevention New York: Cambridge University Press; 1997 425 pp. ISBN (hardback) 0-521-46187-1, $45.95; ISBN (paper) 0-521-59873-7, $24.95 Reviewed by: Cynthia Lightfoot,* D e p a r t m e n t of H u m a n Development and Family Studies, Pennsylvania State University-Delaware County Guns and drugs in our elementary schools. Youth violence encroaching on our neighborhoods. Delinquency and vandalism roosting on our doorsteps. There is a certain panic to the newspaper headlines and the network news stories. There is a sense that we are caught in the maw of a monster. But before we succumb to the panic and squeeze shut our eyes in anticipation of the last, fatal shake of the head, let's take a closer look at the beast. Just how big is it, anyway? Is it growing and, if so, how fast? What can we do to diminish its hold? For that matter, can we ever get loose of it, or does it really have us by the throat? In attempting to answer these questions, contributors to Michael Rutter's edited volume, Psychosocial Disturbances in Young People: Challenges for Prevention, suggest that the trouble of youth is huge and getting huger, an indiscriminate scavenger of whatever social ills it happens upon. Adding to the general sense that our world is becoming increasingly chaotic and uncertain, the contributors describe a veritable banquet of social ills that continue to place our youth at psychosocial risk. More than that, youth's very own fledgling states and statuses would seem to menace their well-being. The authors implicate as stressful the physiological and morphological processes associated with puberty, as well as the psychosocial complexities of emerging identity, autonomy, individuation, and role definition. The volume is saturated with social and developmental factors that have been found, in one study or another, to affect the social and psychological health of adolescents. When we are pressed into considering all reasonable combinations that could be brought to bear on accounts of why certain children fare better or worse than others (poverty, bad school, positive ethnic identity; poverty, good school, bad parents; bad school, puberty, poor body image; puberty, high self-esteem, identity diffusion), * Direct all correspondence to: CynthiaLightfoot, Department of Human Development and Family Studies, Pennsylvania State University-Delaware County, 25 Yearsley Mill Rd., Media, PA 19063. E-mail: . Journal of AppliedDevelopmentalPsychology20(1): 181-187 Copyright© 1999 Elsevier Science Inc. ISSN: 0193-3973 All rights of reproduction in any form reserved. 181

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we become quickly entangled in an enormous snarl of possibilities that would take a score of hands a hundred years to unravel. A challenge for prevention? You bet. All the more so given that our very best current interventions are only very modestly effective. Beyond that, the psychosocial disturbances of young people present a challenge to theory, which would seem to be in short supply in this book and elsewhere. I am encouraged, however, by the suggestion percolating throughout the volume that the time is ripe for moving beyond the minutiae of variable-centered research and problem focused interventions toward something more developmental and ecological. With that caution in mind, I want to emphasize that ! found the book to be a worthwhile read and I'm glad to have it on my shelf. The Foreword is by Klaus Jacobs, Founder and Chairman of the Board of the Johann Jacobs Foundation which sponsored production of the book. We learn that the work is an outcome of an international conference convened in 1992 in Germany, and that it is meant to serve two main goals. One is to discover "why psychosocial disorders in young people are increasing in frequency and what can be done to prevent such disorders or reduce their adverse impact" (p. vii). The other is to place the implications of research into the hands of counselors, educators, policymakers, business leaders, field-workers, and any one else with leverage enough to facilitate the healthy development of adolescents and youth. The two goals are broad-minded, programmatic, and extend well beyond the reach of a single undertaking, as they should. They are not, however, served equally well by the volume; and this is perhaps as good a reason as any for why similar, future projects are needed to move forward Jacobs's worthy agenda. The book is organized into two major sections. The first, more than twice the size of the second, is more empirically focused. Six chapters present competent reviews of research addressing a variety of adolescent diffficulties--from crime and substance abuse to depression and suicide. These contributors push hard to convince us that adolescents, compared to individuals of other age groups, are particularly vulnerable to certain psychosocial disturbances and, moreover, that their problems, viewed historically, are on the rise. Working against them is a hodgepodge of inconvenient data suggesting that the most disturbed adolescents were disturbed as children, and continue on this path into adulthood; that certain "adolescent" problems are in fact more typical of older people--suicide being a noteworthy example (worldwide, males 75 years of age and older are nearly five times more likely to commit suicide than are males between 15 and 24 years of age (Travis, 1990); and that both historical and cross-national data are plagued by a variety of sampling, measurement, and report biases that complicate interpretations, to say the least. There is more than a little defensiveness regarding all of the ambiguity. For example, in accounting for the recent decline in officially recorded juvenile offending in many countries, including the U n i t e d States, David Smith notes that it may not be a "true reflection of changes in juvenile behavior" but rather a reflection of "changes in policy for dealing with juvenile offenders" (p. 193). Likewise, after touring a number of significant problems in the definition and measurement of depression, suicidal ideation, and parasuieide, Ren6 Diekstra argues that in the

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case of suicide proper, even though we can expect cultural variations in willingness to certify deaths as "suicide," certain epidemiological regularities--including adolescents' rising suicidal risk over the past 30 years--are discernible, and to miss them is "surely a failure of vision" (p. 220). Given the intended audience of counselors, educators, policymakers, and so forth, as opposed to epidemiologists and other research scientist types, Lee Robins is right to point out in the conclusion to the volume that the chapters are anyway "haunted" by "the feeling that the status of youth is changing in the direction of greater stress and less confidence in the future" (p. 367). Robins does an admirable job of sifting though the chapters in search of telling evidence that "there have indeed been secular and sociocultural changes in the place of youth in modern society that give substance to the concerns." The vision is less than clear, but part of this may well be due to the nature of the beast. Psychosocial disturbances in young people are multiply determined, as is emphasized throughout the first section of the book. The section opens with a chapter by Anne Petersen and Nancy Leffert, who tackle the issue of adolescent vulnerability. Noting that adolescents are simultaneously coping with major developmental transitions in both the biological and social spheres (e.g., puberty, maturational timing, identity, relationships, and so on), the authors note that much adolescent problem behavior is really quite normative, and not particular problematic. They cite research indicating that mild delinquency is associated with high selfesteem (Silbereisen & Noack, 1988), a conclusion consistent with Shedler and Block's (1990) longitudinal study in which it was found that adolescents who had experimented with drugs, in contrast to those who were frequent users, or those who had never touched the stuff, were the best-adjusted in the sample. Trajectories are highlighted throughout the chapter--tracks into adulthood, and the consequences of being put off track. Adolescents caught up in unhealthy patterns of behavior, the authors argue, bypass important developmental opportunities afforded by their attendance in school, their interactions with peers, their time spent with family. To be off track is to be isolated and disconnected from health-promoting contexts of experience. The implied policy and program goal is to create environments that "have the greatest likelihood of facilitating positive development" (p. 27). Francois Alsaker's concern is with the possible effects of pubertal maturation on behavior and psychosocial adjustment. "Regrettably," she writes, "one of the rare areas of consensus in the pubertal literature is the lack of consistency across studies" (p. 68). Thus, studies of the relationship between hormones and behavior yield ambiguous results, as do studies of the relationship between hormones and cognition. What is truly helpful about the chapter begins to see the light of day in Alsaker's discussion of cultural values and attitudes toward maturation and mature body forms, and adolescents' attitudes toward their changing bodies. For example, she presents research showing that one's own perception of pubertal timing (i.e., whether or not one believes oneself to be early, on time, or late compared to one's peers) is of greater significance to such variables as self-esteem and satisfaction than is the timing itself (i.e., whether or not one is really early, on time, or late). In the same vein, other's perceptions of changes may carry more weight than the changes themselves. Implicitly, Alsaker urges us to consider how much of the

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adolescent experience depends on the meanings of pubertal events for those who experience both pubertal changes in themselves, and changes in how others treat them as a consequence of their sexual maturity. Two chapters address youth antisocial and criminal behavior. David Farrington dwells on the temporal continuity of antisocial behaviors. Problem children very likely become problem adolescents who, in their turn, become problem adults. Trouble begets trouble, it would seem. Nevertheless, there is a peak in offending during the adolescent years, and Farrington discusses the risk and protective factors (e.g., intelligence, SES, peer behavior, family relationships) that influence an adolescent's involvement in antisocial behavior, and the importance of keeping straight the separate developmental processes of onset, persistence, escalation, and desistance. David Smith covers some of the same ground in his account of the "age-crime curve" (i.e., the adolescent peak), which shows remarkable constancy across time, place, and social group, as does the gender difference. He also takes on the issues of cross-national crime rates, and the increase in rates since World War II, and overviews several theories that have been advanced to account for patterns of criminal conduct. It is noteworthy that none of them are developmental. The two chapters remaining (and oddly shuffled with Farrington's and Smith's rather than grouped together topically) deal with the subjects of depression and suicide. Kathleen Rerikangas and Jules Angst describe the methodological inconsistencies in research on depressive disorders that make it difficult to generalize across studies. Their discussion of familial factors is particular well done, highlighting parental psychopathology as the most powerful predictor of the development of depression in offspring. They alert the reader to two significant consequences of adolescent depression--one is suicide, the other is "the interruption of the completion of developmental tasks in the educational, social, and psychological spheres" (p. 137). Once again one is given a sense of how certain maladjustments have the effect of putting the adolescent off the normative developmental track, isolating her from growth-promoting contexts. Ren6 Diekstra takes a more narrow and focused epidemiological approach, looking for signs of a secular increase in depressive disorders and suicidal behaviors. Data are presented which suggest that adolescents and young adults, especially males, are accounting for increasing proportions of total suicides worldwide. Diekstra's presentation of the cross-national data is particularly interesting. Large national differences are apparent in the amount of change in suicide rates over a 15-year period for males and females of different age categories. Ireland, for example, shows increases of 200% to 400% in both sexes across all age categories. Japan, in contrast, shows a slight increase for males aged 15 to 29, a 100% increase for males aged 30 to 59, and decreases for females of all age categories. It is not always clear what to make of these data, but they do invite speculation and encourage some sort of grounding in a broader sociocultural context. Indeed, this need for grounding applies to pretty much all of the chapters in the book's first section. We are inundated with data, variables, factors, measures, operational definitions. The fact that they are so important--that they show remarkable historical stability, or systematic cultural variation, or link reliably with each

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other, or with age or gender--makes the absence of an interpretive frame all the more frustrating. The second and much shorter part of the volume consists of four chapters addressed to the topic of intervention strategies. On this score, it is perhaps of greater service to the intended audience. Bruce Compas provides a useful typology of adolescent stress and coping. He describes for us three types of stress: (1) generic (e.g., the daily hassles, school transitions, and so forth, affecting all adolescents); (2) acute (e.g., illness, injury, divorce) and (3) chronic (e.g., poverty, racism, parental psychopathology). He then argues that program strategies to facilitate coping skills ought to be articulated to the three different forms of stress that adolescents might experience. A hierarchical, comprehensive model of coping intervention is outlined, part of which is intended for all youths (as all must cope with daily hassles), and part of which is intended for only a small segment of youth (those experiencing acute or chronic forms of stress). Two chapters address community and institutional influences on adolescent behavior, and ask us to take a closer look at the sociocultural ecology in which adolescents live. Peter Mortimore discusses how attendance patterns, students' attitudes, and scholastic attainment vary considerably from one school to another, and how the "ethos of the school"--leadership, achievement expectations, parental involvement, and the degree to which student progress is monitored--may cohere with the portrait of its students. Albert Reiss examines broader community influences, including patterns of organization and disorganization, the latter associated with the presence of conflicting values, counterculture, and population instability. His argument regarding the reciprocal influences of troubled youth and troubled communities is well made; his remarks on the dearth of studies devoted to how communities foster prosocial behavior in young people are well taken. Jane Quinn's chapter on youth organizations moves in circles foreign to the problem-centered focus and deficit model driving all of the other chapters in the book. The reactive and remediational approach to adolescent behavior is not only a bias of this volume, it is a bias of our culture--and our policies and programs. Quinn notes that current services ignore youth development and focus instead on coping with such problems as substance abuse, delinquency, school failure, and teen pregnancy. She quotes Michael Sherraden, who undertook an international study of youth programs, to press the point that the United States provides virtually no funding--public or private--for studies of youth development programs: "It would be difficult to overstate the problem. A researcher working in an urban area, for example, can moreeasily obtain a million dollars to study youth purse snatching than a thousand dollars to study youth theater and dance groups" (Sherraden, 1991, quoted by Quinn, p. 300). Cross-nationally, in contrast, youth programs are "developmental, broadly based, inclusive, and participatory" (p. 299). In the UK, Australia, Germany, Sweden, and Norway, for example, local youth boards are charged with overseeing youth programs and providing financial support. After a thoughtful and well-integrated discussion of theory and research focused on community programs and what they provide for youth, Quinn outlines in fairly concrete terms what good community programs ought to look like. She apologizes for the fact that some of her argument

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leans on survey data and parent/adolescent focus groups--studies that may not "conform to commonly valued research standards, such as random assignment to groups." Be that as it may, Quinn's chapter provides the sort of narrative t h r u s t - - a view of how things are and a vision of how they might b e - - t h a t places in the reader's hands certain requisite tools for helping youth construct contexts in which to live well. Our understanding of psychosocial disturbances in young people could profit from a paradigm shift toward something that respects the intentional, reflective, and meaning-laden nature of the actions of adolescents and those myriad of others who fill their lives. Acknowledging that actions are multiply determined need not, however, commit us to an incoherent eclecticism, although it does require that we keep in view the adolescent's cultural-developmental context of action. For example, and as I have argued elsewhere (Lightfoot, 1997), the meanings of adolescent risktaking may be analyzed at several relational levels: interpersonal relationships, peer culture, and broad cultural beliefs and values. Adolescents take risks in groups. Certain risks are taken with acquaintances, others only with close friends. Risks can be vehicles for initiating new friendships, and for consolidating or maintaining existing relationships; they promote cohesion, trust, and closeness. Certain patterns of risk are symbolic of certain personal and social identities. Rednecks drink beer, smoke pot, and like to fight. Preps smoke cigarettes, snort cocaine, and drive fast cars. Risks and reputations can be mutually affirming. Moreover, risks that are deviant within the peer culture isolate adolescents from the larger community of peers, foreclose on potential sources of growth and new patterns of action, and are thereby instruments of social maladjustment and inertia. Risks also have meaning in light of the larger cultural-developmental project of experiencing the world and growing up. Despite our collective railing against all of the things that our teenagers can conceivably do wrong, our cultural narrative of the self is that individuals are active seekers of experience who pursue novelty and risk for the purpose of extending the horizons of their lives. Our young people are in the process of constructing this narrative. There are other recent efforts to explore the troubles of youth from perspectives that are also attentive to cultural-developmental contexts (see Cicchetti, 1990, and Noam, Chandler, and Lalonde, 1995, for reviews). Commenting on the preponderance of epidemiological and psychometric research in the area, and the extent to which it limits our understanding of youth's problems and our ability to intervene on their behalf, Noam and Valiant (1994) advance a synthetic, clinical-developmental theory for framing internalizing and externalizing disorders. Another step in this direction is Levitt and Selman's (1996) recent effort to understand the personal meaning of risk behavior in early adolescence. So, too, is Chandler and Lalonde's (1998) attempt to understand why it is that some Canadian native tribes experience adolescent suicide rates 800 times the national average, whereas for other tribes, the rates are very nearly zero. As it happens (and this will come as no surprise to Reiss or to Quinn) the tribes with low suicide rates engage in collective, community practices oriented toward preserving their cultural heritage in the minds and lives of their children. It would seem that continuity of cultural context can make all the difference for adolescents whose sense of personal continuity--that is, their

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sense of self as c o n t i n u o u s and abiding t h r o u g h t i m e - - i s d e v e l o p m e n t a l l y o n the skids. It is p e r h a p s for the same reasons that a culture's sense of itself can have implications for a child's e m e r g i n g identity that s o m e o f o u r best protective factors are early childhood p r o g r a m s (such as H e a d Start) that were i n t e n d e d originally not to diminish risk for adolescent problems, but to p r o m o t e overall c o m p e t e n c e in a variety of social d o m a i n s (Zigler, Taussig, & Black, 1992). All of this m a y be seen to c o n v e r g e on the possibility that involving children in culturally meaningful practices has significant, long t e r m c o n s e q u e n c e s for their psychosocial well-being. Providing children with avenues for i n v o l v e m e n t certainly will foster the developm e n t of i m p o r t a n t skills and c o m p e t e n c i e s required for s o m e d e g r e e of functional success in the culture. Sustaining a trajectory that takes its bearing on doing well in school, learning an instrument or a sport, o r assuming a role in a club or church very likely defines a track r u n n i n g o r t h o g o n a l to a lot of behaviors that routinely get adolescents into trouble. M o r e than that, it seems reasonable to suppose that inclusion, participation, and sharing in culturally relevant activities nurtures the d e v e l o p m e n t of c o m m i t m e n t s and fidelities to m e m b e r s of o n e ' s c o m m u n i t y and to o n e ' s o w n current and future self as a p e r s o n of c o n s e q u e n c e ; c o m m i t m e n t s and fidelities that are incompatible with guns and drugs in o u r e l e m e n t a r y schools, with y o u t h violence in o u r n e i g h b o r h o o d s , with delinquency and vandalism o n our doorsteps; c o m m i t m e n t s and fidelities that used to define character.

REFERENCES Chandler, M.J., & Lalonde, C.E. (1998). Cultural continuity as a hedge against suicide in Canada's First Nations. Transcultural Psychiatry, 35, 193-211. Cicchetti, D. (1990). A historical perspective of developmental psychopathology. In A. Rolf, D. Cicchetti, K. Neuchterlein, & S. Weintraub (Eds.), Risk and protective factors in the development of psychopathology. New York: Cambridge University Press. Levitt, M., & Selman, R. (1996). The personal meaning of risk behavior: A developmental perspective on friendship and fighting in early adolescence. In G. Noam & K. Fischer (Eds.), Development and vulnerability in close relationships. Mahwah, NJ: Erlbaum. Lightfoot, C. (1997). The culture of adolescent risk-taking. New York: Guilford Press. Noam, G., Chandler, M., & Lalonde, C. (1995). Clinical-developmental psychology: Constructivism and social cognition in the study of psychological dysfunctions. In D. Cicchetti & D. Cohen (Eds.), Developmental psychopathology. Volume 1. Theory and methods. New York: Wiley. Noam, G., & Valiant, G. (1994). Clinical-developmental psychology in developmental psychopathology: Theory and research of an emerging perspective. In D. Cicchetti & S. Toch (Eds.), Rochester symposium on developmental psychopathology: Disorders and dysfunctions of the self. New York: University of Rochester Press. Shedler, J., & Block, J. (1990). Adolescent drug use and psychological health. American Psychologist, 45, 612--630. Silbereisen, R. K., & Noack, P. (1988). On the constructive role of problem behavior in adolescence. In N. Bolger, A. Caspi, G. Downey, & M. Moorehouse (Eds.), Person in conflict: Developmental processes (pp. 152-180). Cambridge, MA: Cambridge University Press. Travis, R. (1990). Suicide in cross-cultural perspective. International Journal of Comparative Sociology, 31,237-248.

Zigler, E., Taussig, C., & Black, K. (1992). Early childhood intervention: A promising preventative for juvenile delinquency. American Psychologist, 47, 997-1006.