Adolescence is usually a wonderful time, perhaps better for current generations than for any earlier cohort. Nonetheless, troubles plague about 20 percent of youths. For instance, one specific survey of over ten thousand 13- to 17-year-olds in the United States using the categories of the DSM-IV found that 23 percent had a disorder in the past month (Kessler et al., 2012). Most disorders are comorbid, with several problems occurring at once. Distinguishing between pathology and normal moodiness, between behavior that is seriously troubled versus merely unsettling, is complex.

It is typical for an adolescent to be momentarily less happy and more angry than younger children, but teen emotions often change quickly (Neumann et al., 2011). For a few, however, negative emotions cloud every moment, becoming intense, chronic, even deadly.

The general emotional trend from childhood to early adolescence is toward less confidence and higher rates of depression, and then, gradually, self-esteem increases. A dip in self-esteem at puberty is found for children of every ethnicity and gender (Fredricks & Eccles, 2002; Greene & Way, 2005; Kutob et al., 2010; Zeiders et al., 2013). Often, self-esteem rises in high school (especially for African American girls and European American boys), but reports vary, and every study finds notable individual differences.

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Universal trends, as well as family effects, are apparent. A report from China also finds a dip in self-esteem at seventh grade (when many Chinese experience puberty) and then a gradual rise. Recent cohorts of Chinese teenagers have lower self-esteem than earlier cohorts. The authors ascribe this to reduced social connections: Many youth have no siblings or cousins, many parents are employed far from their children, and divorce has become more common (Liu & Xin, 2014).

On average, self-esteem in adolescence is higher in boys than girls, higher in African Americans than European Americans, who themselves have higher self-esteem than Asian Americans. It is also higher in older adolescents than younger ones (Bachman et al., 2011).

These generalities regarding depression apply to most disorders (Kessler et al., 2012). All studies find notable variability among people the same age, yet continuity within each person. Severe depression may lift but rarely disappears (Huang, 2010).

Context matters. One cultural norm is familism—the belief that family members should sacrifice personal freedom and success to care for one another. For immigrant Latino youth, self-esteem and ethnic pride are higher than for most other groups, and a rise over the years of adolescence is common. When compared to the high rates of depression among European American girls, the Latina rise in self-esteem is particularly notable (Zeiders et al., 2013). Perhaps familism is the reason: Latinas become increasingly helpful at home, which makes their parents appreciative and them proud, unlike other U.S. teenage girls.

Some adolescents sink into clinical depression, a deep sadness and hopelessness that disrupts all normal activities. The causes, including genes and early care, predate adolescence. Then the onset of puberty—with its myriad physical and emotional ups and downs—pushes some vulnerable children, especially girls, into despair. The rate of clinical depression more than doubles during this time, to an estimated 15 percent, affecting about 1 in 5 girls and 1 in 10 boys.

Hormones are probably part of the reason for these gender differences, but girls also experience social pressures from their families, peers, and cultures that boys do not (Naninck et al., 2011). Perhaps the combination of biological and psychosocial stresses causes some to slide into depression.

Differential susceptibility is apparent. One study found that the short allele of the serotonin transporter promoter gene (5-HTTLPR) increased the rate of depression among girls everywhere but increased depression among boys only if they lived in low-SES communities (Uddin et al., 2010). It is not surprising that vulnerability to depression is partly genetic, but why does neighborhood affect boys more than girls? Perhaps cultural factors depress females everywhere, but boys may be protected unless jobs, successful adult men, and encouragement within their community are scarce.

A cognitive explanation for gender differences in depression focuses on rumination—talking about, brooding over, and mentally replaying past experiences. Girls ruminate much more than boys, and rumination often leads to depression (Michl et al., 2013). For that reason, close mother–daughter relationships may be depressing if the pair ruminate about the mother’s problems (Waller & Rose, 2010). On the other hand, when rumination occurs with a close friend after a stressful event, the friend’s support may be helpful (Rose et al., 2014). Differential susceptibility again.

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Serious, distressing thoughts about killing oneself (called suicidal ideation) are most common at about age 15. The 2013 Youth Risk Behavior Survey revealed that more than one-third (35 percent) of U.S. high school girls felt so hopeless that they stopped doing some usual activities for two weeks or more in the previous year (an indication of depression), and more than one-fifth (22.4 percent) seriously thought about suicide. The corresponding rates for boys were 20 percent and 11.6 percent (MMWR, June 13, 2014).

Suicidal ideation can lead to parasuicide, also called attempted suicide or failed suicide. Parasuicide includes any deliberate self-harm that could have been lethal. Parasuicide is the best word to use because “failed” suicide implies that to die is to succeed (!); suicide “attempt” is likewise misleading because, especially in adolescence, the difference between attempt and actual suicide may be luck and prompt treatment, not intent.

As you see in Figure 16.5, parasuicide can be divided according to instances that require medical attention (surgery, pumped stomachs, etc.) and those who do not, but any parasuicide is a warning. If there is a next time, the person may die. Thus parasuicide must be taken very seriously.

One form of psychotherapy that seems to reduce the risk of completed suicide is dialectical behavior therapy, designed to help the adolescent accept their moods, but not act on them (Miller et al., 2007). This seems a promising, although replicated experimental research regarding this therapy is needed (Berk et al., 2014).

Internationally, rates of teenage parasuicide range between 6 and 20 percent. Among U.S. high school students in 2013, 10.6 percent of the girls and 5.4 percent of the boys tried to kill themselves in the previous year (MMWR, June 13, 2014; see Figure 16.5).

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Although suicidal ideation during adolescence is common, completed suicides are rare. The U.S. annual rate of completed suicide for people aged 15 to 19 (in school or not) is less than 8 per 100,000, or 0.008 percent, which is only half the rate for adults aged 20 and older (Parks et al., 2014). This is an important statistic to keep in mind whenever someone claims that adolescent suicide is “epidemic.” It is not. Of course, even one teenage suicide is one too many.

Because they are not logical and analytical, adolescents are particularly affected when they hear about someone’s suicide, either through the media or from peers (Niedzwiedz et al., 2014). That makes them susceptible to cluster suicides, which are several suicides within a group over a brief span of time. For that reason, media portrayal of a tragic suicide may inadvertently trigger more deaths.

In every large nation except China, girls are more likely to attempt suicide, but boys are more likely to complete it. In the United States, adolescent boys kill themselves four times more often than girls (Parks et al., 2014). The reason may be method: Males typically jump from high places or shoot themselves (immediately lethal), whereas females often swallow pills or cut their wrists, which allows time for conversation, intervention, and second thoughts. Given adolescent volatility, second thoughts are protective.

European American youth are three times more likely to commit suicide than African, Hispanic, or Asian Americans. Suicide is one of very few causes of death that increase with SES.

Like low self-esteem and suicidal ideation, bouts of anger are common in adolescence. In fact, a moody adolescent could be both depressed and delinquent because externalizing and internalizing behavior are closely connected during these years (Loeber & Burke, 2011). This may explain suicide in jail: Teenagers jailed for assault (externalizing) are higher suicide risks (internalizing) than adult prisoners.

Externalizing actions are obvious. Many adolescents slam doors, curse parents, and tell friends exactly how badly other teenagers (or siblings or teachers) have behaved. Some teenagers—particularly boys—”act out” by breaking laws. They steal, damage property, or injure others.

One issue is whether teenage anger is not only common but also necessary for normal development. That is what Anna Freud (Sigmund’s daughter, herself a prominent psychoanalyst) thought. She wrote that adolescent resistance to parental authority was “welcome … beneficial … inevitable.” She explained:

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We all know individual children who as late as the ages of fourteen, fifteen or sixteen, show no such outer evidence of inner unrest. They remain, as they have been during the latency period, “good” children, wrapped up in their family relationships, considerate sons of their mothers, submissive to their fathers, in accord with the atmosphere, ideas and ideals of their childhood background. Convenient as this may be, it signifies a delay of their normal development and is, as such, a sign to be taken seriously.

[A. Freud, 2000, p. 263]

However, most contemporary psychologists, teachers, and parents are quite happy with well-behaved, considerate teenagers, who often grow up to be happy adults. The 30-year Dunedin, New Zealand study first mentioned in Chapter 1 found that adults who had never been arrested usually earned degrees, “held high-status jobs, and expressed optimism about their own futures” (Moffitt, 2003, p. 61).

Some psychologists suggest that adolescent rebellion is a social construction. It might be an idea created and endorsed by many Western adults but not expected or usual in Asian nations (Russell et al., 2010).

Both the prevalence (how widespread) and the incidence (how frequent) of criminal actions are higher during adolescence than earlier or later. Arrest statistics in every nation reflect this fact, with 30 percent of African American males and 22 percent of European American males being arrested at least once before age 18 (Brame et al., 2014).

It would be good to know how many young people have broken the law but not been caught, or caught but not arrested. Confidential self-reports suggest that most adolescents (male or female) break the law at least once before age 20.

However, the actual percentage is unknown, as some adolescents refuse to answer and some might brag (falsely) about skipping school, drinking underage, shoplifting, hurting another person, vandalism, and so on. Others might deny (again falsely) ever having done such a thing. Researchers in the Netherlands found that one-third of those interrogated by the police said that they had no police contact (van Batenburg-Eddes et al., 2012).

Research on confessions to a crime is interesting in this regard. In the United States, about 20 percent of confessions are false: That is, people confess to a crime they did not commit. False confessions are more likely in adolescence, partly because of brain immaturity and partly because young people want to help their family members and please adults—including the police (Feld, 2013; Steinberg, 2009).

Many researchers in delinquency suggest that we need to distinguish two kinds of teenage lawbreakers (Monahan et al., 2013), as first proposed by Terri Moffitt (2001, 2003). Most juvenile delinquents are adolescence-limited offenders, whose criminal activity stops by age 21. They break the law with their friends, facilitated by their chosen antisocial peers. More boys than girls are in this group, but some gangs include both sexes (the gender gap in law-breaking is narrower in late adolescence than earlier or later).

The other delinquents are life-course-persistent offenders, who break the law before and after adolescence as well as during it. Their law-breaking is more often done alone than as part of a gang, and the cause is neurological impairment (either inborn or caused by early experiences). Symptoms include not only childhood defiance but also early problems with language and learning.

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During adolescence, the criminal records of both types may be similar. However, if adolescence-limited delinquents can be protected from various snares (such as quitting school, entering prison, drug addiction, early parenthood), they outgrow their criminal behavior. This is confirmed by other research: Few delinquent youths who are not imprisoned continue to be criminals in early adulthood (Monahan et al., 2009).

One way to reduce adolescent crime is to consider earlier behavior patterns and then stop delinquency before the police become involved. Parents and schools need to develop strong and protective relationships with children, teaching them emotional regulation and prosocial behavior, as explained in earlier chapters. In early adolescence, three pathways to dire consequences can be seen:

Each of these pathways demands a different response. The rebelliousness of the first can be channeled or limited until less impulsive anger prevails with maturation. Those on the second pathway require stronger human relationships and moral education. Those on the third present the most serious problem; their bullying should have been stopped in childhood, as Chapter 10 and Chapter 13 explained. In all cases, early warning signs are present, and intervention is more effective earlier than later (Loeber & Burke, 2011).

Adolescent crime in the United States and many other nations has decreased in the past 20 years. Only half as many juveniles under age 18 are currently arrested for murder than were in 1990. For almost every crime, boys are arrested at least twice as often as girls are.

No explanation for declining rates or gender differences is accepted by all scholars. Regarding gender, it is true that boys are more overtly aggressive and rebellious at every age, but this may be nurture, not nature (Loeber et al., 2013). Some studies find that female aggression is typically limited to family and friends and therefore less likely to lead to an arrest.

Regarding the drop in adolescent crime, many possibilities have been suggested: fewer high school dropouts (more education means less crime); wiser judges (who now have community service as an option); better policing (arrests for misdemeanors are up, which may warn parents); smaller families (parents are more attentive to each of two children than each of twelve); better contraception and legal abortion (wanted children are less likely to become criminals); stricter drug laws (binge drinking and crack use increase crime); more immigrants (who are more law-abiding); less lead in the blood (early lead poisoning reduces brain functioning); and more.

Nonetheless, adolescents remain more likely to break the law than adults. To be specific, the arrest rate for 15- to 17-year-olds is twice that for those over 18. The disproportion is true for almost every crime (fraud, forgery, and embezzlement are exceptions) (FBI, 2013). Jail increases the chance that a temporary rebellion will become a lifetime pattern, but that does not mean that delinquency should be accepted. As with depression, angry adolescents cannot be ignored: They harm themselves as well as others.

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