Teenage attitudes

Teens are an important group in which attitudesthose held by the teen as well as those held by the
health care providerplay a large role in contraceptive success.
The latest National Survey of Family Growth (NSFG) data reports that about 47 percent of female
teens (4.6 million) and about 46 percent of male teens (4.7 million) had engaged in sexual intercourse
at least once.9 When initiating their first sexual intercourse, many teens will not have consulted with a
health professional about contraception.10Many of these teens will either not use a contraceptive at all
or will use a contraceptive
ineffectively. In addition, among
Table 1: Common Teen Attitudes10,15
males ages 15 to 19, between
Partner issues
I didnt know him well enough to ask him
10 percent and 14 percent have
had oral sex but not vaginal
to use a condom or I would have used
contraceptives if the guy werent so
intercourse. Approximately 11
percent of females ages 15 to
opposed to it.
17 have had oral sex but not
Media influences
intercourse.11 Although they
largely avoid the risks of
Sex just happens, and in the movies they
unintended pregnancy with oral
never stop to put on a condom.
sex, many teens are exposing
themselves to sexually
transmitted infections (STIs)
Ambivalence
I really didnt think it was right for me to
such as human papillomavirus
about their
be having sex, so I never thought about
(HPV), chlamydia,
actions
contraception until it was too late.
trichomoniasis, and herpes
Fear and
I didnt talk to my doctor about
simplex.12
misconceptions
contraception because I didnt want to
have a pelvic exam or My friends say
Adults often believe that teens
that birth control pills arent safe.
view themselves as invulnerable
and that teens are incapable of
Confidentiality
If I talk to the doctor, shell have to tell
rationally weighing risks and
concerns
my mom and dad, and theyd kill me.
benefits. Research by Valerie
Reyna, a professor at Cornell
Health care
I didnt know where to go, I didnt have
University, and Frank Farley, a
access
any way to get to the clinic, or I couldnt
professor at Temple University,
challenges
get an after-school appointment.
may contradict these strongly
Health care
I never had a doctor ever tell me anything
held assumptions about teens.
delivery
about any type of birth control, never even
In 2006, Reyna and Farley
challenges
asked me if I was having sex; or They
published research suggesting
wait until youre already knocked up to
that teens do rationally weigh
throw it at you. Get on birth control, get
benefits and risk. However, they
on birth control, get on birth control.
often go ahead with the risk
because they see the benefits
Personal
I wanted to become pregnant.
as outweighing the risks.13
attitudes
Neuroscientists who study the development of the teenage brain have found that the brain undergoes
major remodeling during adolescence. Brain scans have shown that during certain tasks, teens tend to
have much more diffuse activity in the frontal regions of the braipnthose regions involved in
planning and executing actionsthan adults. Bea Luna, a neuroscientist at the University of Pittsburgh
Medical Center, notes, The adolescent brain is acting like an adult brain doing something much more
difficult. An adolescent can look so much like an adult, but cognitively, they are not really there yet.
B.J. Casey, from the Weill Medical College of Cornell University, notes, A reward center in overdrive
coupled with planning regions not yet fully functional could make an adolescent an entirely different
creature to an adult when it comes to seeking pleasure.15

Reyna and Farley use the example of Russian roulette to illustrate how teens and adults think
differently. Would you play Russian roulette for a million dollars? A teen will try to logically weigh the
benefit of having a million dollarsa fortune that lasts a lifetimeagainst a 1 in 6 risk of dying and
may decide that the benefit is worth the risk. An adult would likely reach a different conclusion. Reyna
and Farley explain that as people gain more life experiences, they become more intuitive and base
decisions on gist, the overall sense of what makes the best course of action. Gist helps adults see
the forest through the trees, get to the bottom line more quickly, and reduce risky behavior. Gistbased thinking bypasses the details of weighing the number of bullets against the amount of money
and leads the adult to the conclusion that no amount of money is worth putting a gun to your head. 13
Likewise, teens may conclude that the benefits of having sex outweigh the risk of getting pregnant or
even the risks of seeking out and using contraception. As shown in Table 1, there are numerous
attitudes and issues that health care providers need to be aware of and work with when talking to
teens about contraception.
Reyna developed a gist-based approach to risk prevention that helps adolescents develop gist and
make better decisions. To help resist spontaneous, unprotected sex, girls practice ways to say no
and not worry about losing their boyfriends. A 15-year-old who had already had one unintended
pregnancy had this to say when asked if the intervention made her feel more in control of her life:
Yes, because in talking about all the different ways to say no, Ive actually used them, which makes
me feel much more comfortable. And I feel confident. I dont feel stupid saying no. And even if people
think Im stupid, thats their problem.13
Research by Reyna and colleagues has shown that even brief exposure to positive or negative
experiences contributes to developing good or bad gist. Practicing realistic examples of potentially
risky situations helps adolescents automatically access the gist of the situation and avoid risky
behaviors.15 Reyna also suggests that teens can develop positive and negative gists through visual
depictions, films, novels, serial dramas, and other emotionally evocative media. 13 It is important to
note that this approach differs from some traditional approaches that emphasize reflection,
deliberation, and details at the time of the decision. Reynas research has shown that risk taking
increases when adolescents engage in such traditional rational weighing of costs and benefits. 16
Brianna. Brianna is 14 years old. You see her today because she sprained her ankle at cheerleading
practice. During your discussion, you ask her about sexual activity, and she tells you that she has a
boyfriend and they are getting pretty serious. You ask her about contraceptive methods. She tells
you that her friend wears some kind of sticker-like thing on her back so she wont get pregnant, and
she wonders how that works.
First, answer Briannas question about the sticker by explaining that her friend is most likely using a
contraceptive patch. Briefly explain how it works and tell her it is very effective. Ask her if she wants a
prescription for a contraceptive to get started on now and give her a prescription for emergency
contraception. Health care providers may also want to talk to Brianna about HPV immunization as well
as the risks of sexually transmitted infections and the use of condoms. Suggest that she discuss
contraceptive methods with her boyfriend, if hes open to that. You may even suggest that she and her
boyfriend come to the office or clinic for a confidential discussion of contraceptive methods with a
staff
Author:
Jessor R; Jessor SL
Source:
New York, New York, Academic Press, 1977. xv, 281 p.
Abstract:

This study is the 2nd phase of a long-term program of research on problem behavior. The approach to
theory testing involves a longitudinal design. The study plots trajectories of change over time in
personality, social environment, and behavior, and uses the theory to forecast important transitions-beginning to drink, starting to use marijuana, and becoming a nonvirgin. The book has 4 main
sections: 1) an introductory chapter and a chapter describing problem-behavior theory and research
design and method, 2) the cross-sectional findings and their bearing on the theory, 3) the longitudinal
findings, and 4) studies of socialization and conclusions. Using adolescents and youths in American
society in the late 1960s and early 1970s, this research represents a logical continuation of a long
term interest in problem behavior and a recognition that what was going on among youth and in the
student movement can be viewed from a problem-behavior perspective. This high school study began
in the spring of 1969 with grades 7, 8, and 9; by the end of the study in 1972, these participants had
all made the transition from junior to senior high school of grades 10, 11, and 12. Each year, each
participant completed a 50 page questionnaire inquiring about their drug use, sexual behavior, alcohol
drinking, and the problem behavior associated with excessive use of alcohol. Some of the major
findings suggest that: 1) the prevalence of problem behaviors is substantial at the college level, and
while much lower, sizable at the high school level; 2) personal controls appear to be most influential in
relation to the set of problem behaviors, motivational-instigations are next, and personal beliefs are
least; 3) the adolescent who is less likely to engage in problem behavior is one who values academic
achievement and expects to do well academically; 4) within the distal structure, the variables that
indicate whether a youth is parent-oriented or peer-oriented are the most significant; and 5) the
developmental changes most often measured in connection with growth trends are growth of
independence, decline in traditional ideology related to achievement value and society as a whole,
assumption of a more relativistic and tolerant morality, attenuation of conventional norms and
religious beliefs, increase in peer influence, and increase in problem behavior itself. Overall, it would
be an important step forward for prevention and control if problem behavior in youth came to be seen
as part of the dialectic of growth.
The variable of parental authority and discipline in the home environment and its correlates in the
child's attitudes and social behavior are investigated by a number of methods including questionnaire
and interview reports from both parents and children, ratings of personal-social behavior by teachers,
and tests, experimental situations and projective techniques on the children. The subjects were 43
nursery school and kindergarten children, averaging 4 years 8 months in age, from urban homes
representing a select social, economic, and educational sample of the population. Data collected by
the various methods are related under various "atmosphere" and behavior combinations. Results
"extend our knowledge in this field by obtaining a description of the nature of discipline and authority
patterns in one stratum of our culture, by determining changes that have occurred from the preceding
to the present generation, by pointing out the young child's clear perception of complex social
relationships within the home and by investigating the role of the home in the social behavior of the
child." Interview methods with the young child yielded significant data, and there is partial
confirmation of the value of projective picture and doll play techniques in locating critical areas in the
child's home relations and getting his reactions to known home situations. (PsycINFO Database Record
(c) 2016 APA, all rights reserved)
Media Influences
Between TV, the movies, online videos and all of the other media sources out there, it's no wonder
that these societal influences can shape your teen's behavior for good or for ill. The American
Academy of Pediatrics' Healthy Children website notes that parents should watch for media influences
that include acts of violence, sexual situations, statements about body image, alcohol and drug use,
and gender or cultural stereotypes. Although your teen might seem immune to what he the media is
saying, some messages can slowly begin to sink in and make risky behaviors such as underage
drinking or unprotected sex seem attractive.
Advertisements
Advertising can influence a teen's behavior in multiple ways, including how the child acts as well as
her spending habits. For example, the child development experts at the Healthy Children website note

that cigarette ads can negatively influence a teen's ideas and thoughts when it comes to smoking.
Without adequate adult guidance, ads that feature young, attractive people smoking can make this
unhealthful habit seem acceptable or even appealing. Aside from glorifying, or selling, risky behaviors,
advertising can also alter the way a teen chooses to spend money. Whether it is mom and dad's cash
or an after-school job paycheck, enticing ads in magazines, billboards, TV or in-store displays can
make teens think it's acceptable to spend hard-earned money on pricey or unnecessary items such as
designer label jeans.
School
The schools, and subsequent social environments, are parts of society that exert a communal
influence on teens. Every junior and senior high school setting is different in some way, creating a
community that accepts or disregards certain behaviors. This could mean that a child who had certain
values or beliefs before entering junior or senior high school might make changes due to the
predominant school views. For example, if the popular crowd believes that cool girls shouldn't get
good grades, your daughter might start to take up behaviors that lead to poor grades.
Society and Laws
Some aspects of society can have a positive influence. As children grow into the teen years, they
become more aware of legal issues and society's laws. Although a younger child might know that
stealing money can result in jail time, adolescents have the ability to understand legalities in a more
abstract way. This knowledge might help teens to think twice before engaging in risky or illegal
activities such as underage drinking, drug use or drinking and driving. This isn't to say that teens
aren't going to experiment with illegal substances just because the societal laws say "no," but instead
they might think harder about their choices in light of the consequences.
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