Understanding the Teen Brain (M Richards 2005)

Paper 26
The Teen Brain: What's Going On In There?

Martyn Richards, OPERA Research

Conference Papers

Dealing with the decase of anxiety
Paper 26 David Blackburn, Corporate Edge

Martyn Richards, OPERA Research

"I would there were no age between ten and three-and-twenty, or that
youth would sleep out the rest, for there is nothing in the between but
getting wenches with child, wronging the ancientry, stealing, fighting--
Hark you now! Would any but these boiled brains of nineteen and two-
and-twenty
hunt this weather?"
Shepherd, The Winter's Tale (Shakespeare)

INTRODUCTION

Remember Harry Enfield's Kevin?

How we laughed at his moaning to, and shouting at, his parents… at his
gaucheness at dealing with girls… at his inability to get the car cleaned in less
than twelve hours? We laughed because we recognized this stereotype to be
true, perhaps not of all teenagers, all of the time, but of very many at some
point in their development.

This is an opportune time to be looking at teenagers. The current generation
are more troublesome than any before them:

"Today's teenagers are much more likely to lie, steal or defy authority
than previous generations. They also have more chance of
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experiencing bullying, fighting and suicide attempts. The collapse in
standards of behaviour over the past 25 years is identified in a study
comparing today's 15 and 16 year-olds to those from the 1970s and
1980s… In fact, the percentage of troubled teenagers has more than
doubled since the 1970s."
(Daily Mail, September 2004)

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Shakespeare's shepherd in The Winter's Tale reminds us, however,Corporate
David Blackburn, that the Edge
issue is not new; it is just that extra pressures on today's teens exacerbate a
natural phenomenon.

There has thus been an imperative to understand what lies behind teenagers'
behaviour, in order that we may know what influences are contextual or
environmental, and what, if any, are biological: the old 'nature/nurture debate'.

It is not the function of this paper to cover the whole spectrum of influences on
young people; it is worth reminding ourselves, however, that a lot is going on:

! puberty kicks in, hitting different kids at different ages, and lasting
several years; once again to make things worse, the onset of puberty
has become earlier, declining rapidly during the 20th Century as health
and nutrition improved;
! modern teens are well and truly in a consumer age, which can lead to
many stresses in terms of owning and wearing the 'right' things – media
images only encourage this;
! pressures emerge, especially at school, college and university, to
succeed academically – often, for many young people, beyond their
capability;
! pressures include much that belongs to the modern age - taking drugs,
driving in fast cars – which carry their own risks and dangers.

For the purposes of this paper, the 'nurture' aspects of understanding human
behaviour are ignored: not because they are unimportant, but because they
are covered extensively elsewhere. In his paper at last year's MRS
Conference, Mark Oldridge quoted Sean Brierley thus…

"The reductionist assumption that we are merely machine, a collection
of chemical impulses and buttons. Stimulus – response models of
human behaviour take no account of environment or culture."
(Brierley, 2003)

… and said himself:

"There is the inherent trap in a purely behaviourist perspective, that the
pendulum goes full swing and the notion of the individual becomes
ignored."

Nonetheless, the concentration in this paper is on the 'nature' side. It is widely
accepted these days that we all are results of both influences on our
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behaviours; the real 'news' in respect of teenage behaviour and development
however, resides in neuroscience.

Recently, I emailed a friend in South Africa to explain why I had been
incommunicative, and pointed him to the MRS web pages. His reply was:

"Just had a look at the web site and I see your talk is entitled 'The Teen
Brain: What's Going On In There?' When you find out, please let me
know!"

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His reaction is typical of many people who have experienced the joyCorporate
David Blackburn, of Edge
watching their offspring turn from angelic children into teenage demons, then
possibly return to some form of normality as adulthood replaces adolescence.
A number of people reading this will recognize many of the behaviours
referred to in this paper. Invariably, as I have told parents of teenagers of the
subject matter of this paper, they have regaled me with stories of their own. At
the end of moderating some groups one night during the course of collecting
background material, and discussing this with the recruiter, she told me about
her son. He had appeared to be as much 'on the rails' as his older sister, and
certainly brighter; he suddenly left his studies and decided to become a car
mechanic. He then very quickly got into trouble with the police, having never
been in any sort of trouble before. The recruiter had desperately tried to
explain his changed behaviour, but was mystified. He had had the same
upbringing as his sister: where had she gone wrong? She hadn't: whilst it is
likely that environmental issues came into play, we can now look to changes
in the brain as responsible for the shift. This is seen time and time again,
whether it happens at 14, 15 or even 18. The recruiter's son is now 'OK'. The
vast majority are – they get through it. There are some who go completely 'off
the rails', or suffer severe problems – these are not the subject of this paper;
what we are concerned with is the broad range of experience that falls within
what may be described as 'normal'.

Rather than depend on anecdote, this paper includes two elements which
help underline the issues that exist in today's society. Firstly, a series of
statistics about teenagers is included. Secondly, OPERA have conducted a
number of interviews as illustration. These are "Immersion Interviews" – a
term used to describe interviews which are qualitative in nature, typically
longer than 'standard depth interviews', but are essentially differentiated in
that respondents are presented as individuals. Subjects were selected,
through personal contacts amongst OPERA staff, as essentially 'normal'
teenagers. There is no intention to be representative. Closer to case studies,
Immersion interviewees are shown to the reader through photographs of
themselves and their homes, to help bring each to life, though names are
changed to protect confidentiality. Individuals will be introduced at appropriate
times through the paper1.
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1 Restricted space in this paper means that these interviews will be presented simply as 'snapshots',
centring on the most appropriate elements of each, rather than the more fulsome approach that they
would get in a live project.

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STATISTICS David Blackburn, Corporate Edge
There is strong evidence to suggest that teenagers are at risk in society, from
themselves as much as anyone else. Risk was a constant theme in the
research for this paper:

"Smart kids do stupid things. It's a simple fact of life. No one makes it
through the teenage years unscathed. Even the meekest, smartest,
most obedient, and sensible teenager will, at one point or another, find
himself or herself facing the angry, disbelieving face of an adult who
shouts, 'What were you thinking?'"
(Walsh, 2004)

Teens and Road Accidents

One aspect of this is road safety. The following table demonstrates this:

Table 1: Pedestrian fatalities/injuries
Rate per 100,00 population
Pedestrians: 0-4 5-7 8 - 11 12 - 15 16 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 +
(by age)

Killed 0.4 0.5 0.6 1.2 2.0 1.4 0.8 1.0 1.1 1.1 2.6 5.6
KSI* 8 19 26 32 22 15 9 9 7 9 14 21
(* Killed or seriously injured) (Office of National Statistics, 2003)

The danger of being a old person is much easier to understand than the
'bump' in the figures for teenagers: a peak amongst 16-19s in terms of
fatalities, and a peak at 12-15 in terms of serious injuries. It cannot just be put
down to a lack of awareness or maturity, otherwise why aren't the figures
relatively higher for younger children? Even the fact that young children are
more likely to walk with parents does not fully answer this.

Transport for London have recognized this issue by launching a TV
advertising campaign aiming to reduce the number of teenagers killed or
seriously injured on London's roads, and as it's not due to being on unfamiliar
territory, it must be a simple lack of concentration:

"Analysis shows, that in London, boys aged 11-14 are at most risk from
being hit by a vehicle when crossing roads… Approximately a quarter
of all teenage pedestrian casualties occur on the way to or from
school."
(Transport for London, 2004)

Teenagers are also particularly vulnerable as car passengers, suggesting a
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degree of bad decision-making:

Table 2: Passenger fatalities/injuries
Rate per 100,00 population
Passengers: 0-4 5-7 8 - 11 12 - 15 16 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 +
(by age)

Killed 0.5 0.2 0.3 1.3 4.5 2.3 0.6 0.4 0.3 0.8 1.1 1.5
KSI* 5.7 5.4 6 13 47 21 7 5.2 4.7 6 8 9
(* Killed or seriously injured)

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David Blackburn, Corporate Edge
Boys are particularly at risk in terms of road injuries. In 2003, 4,100 under-16s
were either killed or seriously injured of whom 66% were boys and 34% were
girls.

As for driving itself, it will come as no surprise that young drivers are
particularly at risk, due to their relative inexperience. There are suggestions
that other factors add to the likelihood of serious injury however:

"Immaturity is a contributing factor to the high rate of auto crashes and
deaths among teenagers. For instance, tailgating and not using safety
belts are misjudgements teens make more than older drivers."
(Drive Home Safe, 2004)
Self-harming

As well as accidental deaths, teenagers are at high risk of suicide:

"Suicide accounts for 20 per cent of all deaths amongst young people
aged 15-24 and is the second most common cause of death amongst
young people after accidental death. Around 19,000 young people
attempt suicide every year and about 700 of these die as a result."
(MIND, 2004)

Again, while there are, of course, numerous contextual, social and
environmental influences which lead to suicide in teenagers, these are
perhaps triggers which force a young person over the edge, where there is
already a predisposition to self-harm caused by an inability to deal with
circumstances.

Whilst boys are at more risk in teenage years on the roads, it is girls who are
more likely to self-harm:

"The Samaritans commissioned a study of teenage self-harm,
conducted by the Centre for Suicide Research at Oxford University.
After quizzing 6,000 teenagers it concluded that more than one in 10
adolescents has deliberately cut themselves at some time. Girls were
almost four times as likely as boys to do so."
(Guardian, 2004)
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David Blackburn, Corporate
Of the age cohort mentioned above it is again the older teenagers who Edge
present the biggest risk group:

200

150 Males
Females

100

50

0
< 15 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 -49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 +

Mental Health

In the UK, psychosocial disorders affecting young people have risen
substantially over the last 50 years (Rutter and Smith, 1995). A more recent
study showed a substantial increase "in adolescent conduct problems over
the 25-year study period that has affected males and females, all social
classes and all family types. There was also evidence for a recent rise in
emotional problems" (Collishaw et al, 2004).

A study in New Zealand (Fergusson and Horwood, 2001) showed 'Anxiety
Disorders' at just under 20% for 15 year-old girls, rising to 22% for 18 year-old
girls, 26% of whom also reported 'Mood Disorders'. Figures aren't available
for the UK for this age cohort, but 'Anxiety Disorders' are already at around
6% for girls aged 11-15 years (Office of National Statistics, 1999).
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Sexual Health David Blackburn, Corporate Edge
Frighteningly, the prevalence of sexually transmitted infections has shot up in
recent years (National Statistics on - line, 2004).

As can be seen from Chart 2, chlamydia rates are now above one per
hundred girls aged 16-19.
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Conception rates have remained fairly consistent over the last decade, Edge
despite numerous campaigns and activities to reduce them:

Drug-use, Smoking & Drinking

Reported use of drugs is falling in the UK: around 55% of boys said they had
'ever used' drugs in 1998, falling to around 43% in 2000 (Ramsay & Baker,
2001). Boys are more likely to take drugs, and likelihood increases with age.
This is not to deny it as a serious problem. In a report on young people and
communities, the Institute for Public Policy Research identified fairly worrying
attitudes to drugs in the area of Coventry they chose to use as illustration:

"There appeared to be rules governing what was acceptable and
unacceptable. For example even those using drugs felt that younger
teenagers shouldn't be doing the same… Another rule appeared to be
that cannabis was not a problem drug but one that was taken for
granted as something that young people would use and talk openly
about. For some ecstasy and other pills were not considered
particularly dangerous or serious either. Some felt that it was only 'hard
drugs' like heroin and crack that should remain illegal and be the focus
of police attention."
(Edwards & Hatch, 2003)
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Young girls, however, are more likely to smoke. In 2000, 12% of girls aged 11- Edge
15 smoked regularly, compared with 9% of boys. 29% of 16-19 year-olds were
smokers, with little gender difference.

If drug use appears to be falling, and smoking remaining consistent, the worry
has to be the increase in alcohol consumption.

In England, the proportion of 11-15 year-olds drinking alcohol increased from
21% in 1990 to 27% in 1996, falling back to 24% in 2000. Over 50% of boys,
and around 46% of girls, aged 15 had drunk alcohol in the last week. The key
finding, however, is that consumption has increased dramatically. In 1990, an
average of between 5 and 6 units of alcohol were being drunk a week by 11-
15 year-olds. In 2000 this had risen to almost 12 units for boys and over 9
units for girls (Office for National Statistics, 2004).

Again, the work in Coventry identified relaxed attitudes to alcohol amongst
teenagers, with high levels of usage amongst older teenagers still below the
legal age:

"As with drugs there seemed to be a form of self regulation taking
place, whereby the older teenagers would not give alcohol to those
considered too young (this appeared to be those under about 13)."
(Edwards & Hatch, 2003)
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The danger is that many parents, scared by drugs, consider alcohol safer,
when, in fact, it is extremely dangerous to the teenage brain.

"Substances like Morphine have specific receptor sites within the
brain… Alcohol is different. It has no receptor sites of its own within the
brain. Its molecules are electrically uncharged which means that they
are attracted to similarly uncharged regions within the brain – such as

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those that exist within the membranes of our neurons. As a result, Edge
alcohol has the potential to disrupt pretty much every brain function."
(Winston, 2003)

Linking this element to that of road safety, a very recent government report in
the States showed that one in five American teens aged 16 to 20 drove under
the influence of drugs or alcohol (CBS News, 2004).

In order to 'humanize' elements of these statistics, our first case study
interview is included here:

Immersion interview #1 – Chloe

Chloe is 13. She lives in a detached house on the outskirts of a country town, with
her mum, dad, 8 year - old sister and two brothers aged 10 and 12.
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Chloe started puberty early, at 9 years - old; although she is only just a teenager,
there are frictions at home, especially between her and her mother.

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These will often be clashes of desire: Chloe wants to go out, to a particular place, at Edge
a particular time, with particular friends, and mum has a problem with one or more
of these. Each sees the other as unreasonable.

Chloe and her mum have begun to have arguments, during which Chloe can 'lose it'.
Her ability to control the situation, or her anger, is inhibited by her emotional
response:

"I just completely lost it. I don't know what was wrong with me… my anger is really
bad and I don't know how to stop it."

Chloe's inability to handle her emotional impulses can lead to danger for those
around her:

"Once, when we were walking to school, my brother was really irritating, 'cause he
was throwing berries at me, and I pushed him into the road… I felt really bad, but I
didn't think about it, I just did it."

A likeable girl, Chloe believes she has some real problems. She is no different,
however, from so many other teenagers.
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BACKGROUND SCIENCE

Back to that moment when Kevin becomes a teenager. Remember when this
'nice young lad' morphed into a slouching, grunting curmudgeon simply
because it was his 13th birthday?

His father says:

"Look! He's losing the power of rational thought!" (Enfield, 2000)

Harry Enfield's observation is brilliant, as this is, in a sense, exactly what
happens in the teenage years.

To understand both what goes on, and how we know about it, some history of
brain science is required.

Phineas Gage (see Macmillan, 2002), is famous in the world of neuroscience
for a very strange reason, having survived a most horrific accident many years
ago. Phineas, a young man in his twenties, was involved in "tamkin": the
process of setting explosions within rock, as part of opening up the railroads in
America in the mid-19th century. His job was to pack explosive charge into a
drilled hole, then pack in over that, sand to contain the blast. A "tamping iron"
was used: Gage's was three feet, seven inches long, one-and-a-quarter
inches in diameter at the business end, tapering over about twelve inches to a
point one-quarter of an inch at the 'held' end. On the 13th September, 1848, in
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the late afternoon, Phineas rammed his iron into a hole where his assistant
had yet to add sand – a mistake that Phineas needed like a hole in the head.
The explosive charge ignited and sent the iron backwards, through Gage's
head, taking a substantial amount of bone and brain with it. Entrance to the
skull was through the left cheek; exit was at the top of the head, towards the
front. Shortly after, Gage was speaking rationally to his men, and managed to
walk to a cart which took him to a doctor. Not only did Phineas survive - an
incredible fact in itself – he lived for another eleven-and-a-half years. But the

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reason for his inclusion here is the observation by those around himCorporate
David Blackburn, at the Edge
time, that his personality altered. Variously, he is described as: "a
psychopathic personality who lied and could not be trusted to honor his
commitments"; "makes elaborate plans that he then cancels and swears
profusely… loses control of much of what is called decorum, becomes like a
child, and has fits of temper when he doesn't get his own way." Specifically,
and reported wherever this story is rehearsed, one of his workmates
commented: "He is no longer Gage."

Whilst there is some caution to be taken in reading too much into the Gage
story, one fact is unassailable: that it is possible to lose large areas of brain
matter and survive, indeed live a 'normal' life. The use of the word
'psychopathic' above should not be taken too literally. Phineas not only
survived more than a decade, he held done a number of jobs. After exhibiting
himself as a freak at Barnum's Museum in New York, he worked in a livery
stable, then as coach driver, then finally as a farm labourer. The inference is
that the area of the brain damaged in Gage's case, the prefrontal cortex, is not
responsible for any of our basic functions, such as movement, speech, or
indeed many of the functions that make us human, but provides, for want of a
better expression, 'good decision-making', and, when 'disabled', leads to 'bad
behaviour'. It was the discovery of this that led directly to the lobotomies, or
'leucotomies' which were so prevalent during the middle of the last century.
Susan Greenfield (2003) reports that:

"Between 1936 and 1978, some 35,000 people in the United States
underwent the surgical procedure… During their heyday, leucotomies
were claimed to result in few side-effects. It gradually became
apparent, however, that there was no net arguable therapeutic benefit
and indeed that the side-effects were severe. As with Phineas, these
patients became changed characters, lacking in foresight and
emotionally unresponsive."

What we now learn, is that the prefrontal cortex of teenagers is still a work-in-
progress. This is the key fact that answers my South African friend's earlier
question. To understand how we learnt this fact, we need to return to an
invention of the late 1970s.
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MRI SCANNING David Blackburn, Corporate Edge
The first MRI2 scan took place on July 3rd 1977. Then it took five hours to
produce one image. There are now thousands of MRI scanners in the United
States, around three hundred in the UK, with many paid for by lottery cash
(see Zoe Gough, 2004), and simple scans take seconds.

Patients tend to enter scanners lying down, a little like entering a tunnel.

"In conjunction with radio wave pulses of energy, the MRI scanner can
pick out a very small point inside the patient's body and ask it,
essentially: "What type of tissue are you?"
(Gould, 2004)

MRI scans were thus able to inform neuroscientists about brain development
in a way never achievable before. An added bonus came in terms of also
being able to examine activity in the brain through 'functional' MRI scans:

"Using CT3 or MRI is like looking at the floor plan and seating
arrangement of a theatre: they may provide you with an idea of where
you'd like to sit, but they don't enable you to see the play or hear the
actors… A variant of MRI called functional MRI (fMRI) provides you
with the equivalent of the movement and dialogue of the actors in the
play. This imaging technique takes advantage of the fact that the
magnetic properties of blood change according to the amount of
oxygen carried in the blood." (Restak, 2001)

THE WORK OF JAY GIEDD (AND OTHERS)

The Prefrontal Cortex

MRI scanning allows medical scientists and researchers to conduct research
in vivo – to look at live brains; until recent times, brain research was
essentially limited to dead animals and people. With relatively few young
people dying, the opportunities were simply not there for detailed analyses of
significantly large samples.

Scientists believed that the brain was a finished article, in terms of its
potential, while children were still young. Famously, this led Rob Reiner in the
States to champion the cause of devoting attention to initial years of children's
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lives, in order to maximise the chance of educating them well, and preventing
them from following 'bad' paths in their teens and later years. This is from an
address to the National Governors' Association in 1997:

2 Magnetic Resonance Imaging
3 computerized axial tomogram

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"We now know through science that David three years of life is the
the first Blackburn, Corporate Edge
most critical time period. It is the time period when the brain develops
at a greater rate than at any time during the course of a person's life…
But by age 10 your brain is cooked and there's nothing much you can
do." (Bruer, 1999)

This quote is sourced from The Myth of the First Three Years, which does much
to set Reiner's thoughts in context, but was written before the work with MRI
scans became known.

At the National Institute of Mental Health in the United States, a team of
neuroscientists began using MRI to investigate the development of certain
childhood mental ailments such as ADHD4 and autism.

What the team led by Jay Giedd realized was that, in order to understand
potential dysfunction, they needed to understand how the brain functions in
'normal' children and teenagers. A longitudinal study was thus set up, taking
images of youngsters' brains:

"At least 1 scan was obtained from each of 145 healthy subjects (89
male). Of these, 65 had at least 2 scans, 30 had at least 3 scans, 2 had
at least 4 scans and 1 had 5 scans, acquired at approximately two-year
intervals. The age range was from 4.2 to 21.6 years. There were no
significant sex differences for age, Tanner stage, ethnicity,
socioeconomic status, height, weight or handedness."
(Giedd, 1999)

As a result of this study, Giedd's team discovered a "a second wave of
overproduction of gray matter" just prior to puberty. Before this, accepted
medical belief was that the brain overproduced grey matter ("the thinking part
of the brain") in the womb and for about the first 18 months of life, followed by
a period of 'pruning'. This is when the brain reinforces neurons that are well-
used (through a process called myelination, when neural connections –
synapses - are covered in a protective layer which dramatically speeds up
transmission between neurons) and allows others to become inactive. Giedd
refers to this process as "use it or lose it".

Thus another period of pruning occurs throughout the teenage years. Further,
Giedd discovered that the spate of overproduction "predominates in the frontal
lobe" – so, it is that 'policing' area of the brain which gains the most new
matter. The key finding though, is the one most relevant to this paper: that the
pruning which then follows takes all of the teenage years, and in many cases
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years beyond, into the early 20s; also, that the pruning starts at the back of
the brain and works its way forwards, so that the all-important prefrontal
cortex is in fact the last area to mature.

The annals of the New York Academy of Sciences contain the following
quotation from Jay Giedd, which leads us in the direction of forming
conclusions from this finding:

4 Attention Deficit Hyperactivity Disorder

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"The relatively late development of the DLPFC (dorsolateral prefrontal
cortex), not reaching adult levels until the 20s, is intriguing in light of the
behavioural data presented elsewhere in this volume. The DLPFC is
linked to the ability to inhibit impulses, weigh consequences of
decisions, prioritize, and strategize. Speculatively, the DLPFC is still
"under construction" for a decade after the throes of puberty and
therefore may be related to some of the behavioural manifestations of
the teen years." (Giedd, 2004a)

Giedd does not, however, allow direct conclusions to be drawn, though his
use of the expression "may be related" above, suggests that these
conclusions will eventually be drawn, once enough data have been collected.
Recently, however, the National Institute of Mental Health, Giedd's employer,
felt confident enough to put together the following press release:

"The brain's center of reasoning and problem solving is among the last
to mature, a new study graphically reveals. The decade-long magnetic
resonance imaging (MRI) study of normal brain development, from
ages 4 to 21, by researchers at NIH's National Institute of Mental
Health (NIMH) and University of California Los Angeles (UCLA) shows
that such "higher-order" brain centers, such as the prefrontal cortex,
don't fully develop until young adulthood… Areas performing more
basic functions mature earlier; areas for higher order functions mature
later. The prefrontal cortex, which handles reasoning and other
"executive" functions, emerged late in evolution and is among the last
to mature." (NIMH, 2004)

Inference can thus be drawn from the now-known link between development
of the prefrontal cortex, from the learning of what happened to Phineas Gage,
through the experiments with MRI scanners, to what is known about
teenagers:

"People with damage to their frontal lobes – such as, of course,
Phineas Gage – often have difficulty in controlling their anger. MRI
scans of people with antisocial personality disorder, characterized often
by aggressive, destructive behaviour, also show low activity in the
frontal lobe region. In normal individuals, the frontal lobes act as the
policemen of the emotional mind – in particular, the area called the
ventromedial cortex. They receive information from the lower cortex
pertaining to urges, impulses and responses, but they inhibit it, and
form careful plans of action to address it. For instance, if I feel hunger
as I walk through a restaurant to the table I have been allotted by the
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waiter, I do not grab a few chips from the other diners' tables as I pass
by. My frontal lobes are effectively saying to my lower brain: 'I see that
there is hunger. But we wait. I won't cause a scene."
(Winston, 2003)

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The teenage brain, with its undeveloped prefrontal cortex, does not always Edge
respond so maturely. Hence we see teenagers making decisions and
judgements which exasperate adults with their apparent lack of common
sense. That leads us into our second case study:

Immersion interview #2 – Nick

Nick is 18. He lives in a small semi - detached house in a close on the edge of the city,
with his mum, dad and sister, 20.

Nick's mum had much to say about teenagers:

"Even with other people's children, you know exactly when they turn 15 because they
don't even say Hi anymore."

For her part, she considers herself lucky when compared to other mums around her,
whose sons have got into trouble for stealing cars and so forth, but he tends to do
'stupid things' like leaving a chip pan on, or leaving his father's bike outside the front
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door, despite having been told off about that very same thing several times before.

"You think they should make the right decision because they are a lot bigger and
older, but I've noticed that they can't make a decision and therefore you are making
them for them."

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Perhaps what has held Nick together has been his music – he loves mixing, and has
his own decks. The application shown to this however, is not reflected in his attitude
to work. He was unlucky to have lost his course at college through no fault of his
own, but managed to throw away a job, by not turning up, and then getting his
mother to call in sick for him.

What is going on in our brains is a reaction to a number of signals or
impulses. As an example, emotional responses can be triggered from the
amygdala, the almond-shaped part of the brain at its base. This is where 'gut
responses' emanate. In Robert Winston's 'chips' example, his amygdala may
well have taken impulses from his senses and sent out a message saying
'Grab them!' Other areas of the brain will process relevant information, such
as what muscles will be required to take the chips, or what other factors are
involved, such as other people watching, whether the chips will be hot, and so
on. Then it is the prefrontal cortex which takes the decision – No, don't take
the chips.

The Corpus Callosum and the Cerebellum

It is interesting, before moving on to look at the implications of this research,
to take into account further discoveries which have emerged. One of these
affects our understanding within the nature/nurture debate. We have already
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agreed that both environment and genes make us who we are. What Giedd's
research shows is that different areas of the brain impact in different ways. By
examining the brains of twins, he has discovered an interesting fact about the
corpus callosum, which lies between the left and right sides of the brain. This
thick cable of nerves which connects the two halves of the brain is involved in
creativity and higher type of thinking; it too changes throughout childhood and
adolescence. However, it is essentially similar between twins, so "surprisingly
under the control of genes". On the other hand, the cerebellum, which

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changes a lot during teen years, and is responsible for both muscle Corporate
David Blackburn, co- Edge
ordination and some cognitive processes, is the reverse, no more likely to be
similar in twins than any other pair of young people. So, this area is
considered to be more susceptible to the environment. This is especially
important to developing teenagers in terms of the 'use it or lose it'
phenomenon:

"We think that the "Use it or lose it" principle holds for the cerebellum
as well. If the cerebellum is exercised and used, both for physical
activity but also for cognitive activities, that will enhance its
development." (Giedd, 2004b)

Giedd says that the cerebellum is not essential for any particular activity, but
nonetheless improves many activities' effectiveness. He includes in these
activities, those areas which he terms "higher thought – mathematics, music,
philosophy, decision-making, social skills".

That teenagers' brains are still developing in an area which governs decision-
making and social skills will come as no surprise to parents. Again we are
reminded of Harry Enfield's Kevin, metamorphosing from an articulate young
boy into a grunting teenager incapable of holding 'normal' conversations with
those around him.

Risk

Our statistics earlier showed the teenage years to be dangerous times, with
much risk-taking occurring, whether it be stealing, accepting a lift in a friend's
car when they are over the limit, crossing a road badly or substance abuse.
The BBC's web site, in its Science & Nature section, links the new research to
the area of risk:

"Scientists have used advanced scanning methods to study the
changes that occur in the adolescent brain. Much to their surprise, they
have discovered that the brain continues to develop and grow well into
the teenage years. This might explain a teenager's risk-taking
behaviour. It has emerged that the emotional region of the brain
develops to maturity ahead of the part of the brain that controls rational
thought. In other words, teenagers have well-developed emotions and
feelings but have still not acquired the ability to think things through."
(BBC web site, 2004)

This can lead the most well-adjusted teenager into doing impulsive things,
perhaps even committing crimes, as our next case study illustrates:
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Immersion interview #3 – Samantha

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Samantha is 15. She lives in a detached house in a village, with her mum and dad
and two older brothers, 17 and 20.

Samantha is doing her GCSEs, and if her mocks are anything to go by, will do well.
She travels into the nearby city to a catholic high school, having been to the catholic
primary school before that.

There are few arguments; Samantha's mum sets rules about times to get in and they
are adhered to. Partly this is because getting - in times are fairly liberal – they still
have to be stuck to, but they are reasonably late. Samantha's mum seemed fairly
relaxed about certain things that other mums get wound up about – for instance
having a tidy bedroom:
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Last year, however, when 14, Samantha shoplifted from Boots, and got caught. She
was arrested and cautioned. It was a shock, to both her and the rest of the family.
She was on her own – it wasn't done as a crowd - pleaser - and she easily had the
money to pay for what she took. It was a moment of madness: "I don't really know
(why I did it). It was just like, I actually really don't know. It was a stupid thing that
you do and then you think afterwards, What was the point in that?"

Samantha had no idea why she did what she did. This may well be because
the decision-making area of her brain is in flux. Asking teenagers why they did
things can be a fruitless exercise, often resulting in no more than a shrug of
the shoulders, which many adults interpret as insolence. Michael Bradley, who
spends his life helping teenagers and their parents cope with life's problems,
lists amongst 'Common Adolescent Disorders' "The Shepherdus Germanus
Seizure Syndrome" which reflects the 'shrug' referred to above excellently.

"When asked 'why', both children seizured in the manner you've likely
seen by now with your own adolescent. Eyes wide open, head slightly
tilted, tongue hanging out, and slow drooling with nonresponsiveness.
This is very much like the look you get asking your German Shepherd
puppy, 'Why?'"
(Bradley, 2003)

Recognizing Expressions
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Another interesting area of research, again using MRI, was carried out by
Deborah Yurgelun-Todd, who conducted experiments at McLean Hospital,
Belmont, Massachusetts. Volunteers were shown a series of pictures which
showed facial expressions. When shown a particular face, all adult volunteers
identified the emotion behind the expression as fear. Around half of the
teenagers shown the face interpreted it differently however, seeing sadness,

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confusion, shock or anger. When the brain David Blackburn, Corporate
scans were examined, it emerged Edge
that teenagers were using a different part of their brain for reading the images.

"In an adult… the prefrontal part of the brain carries out a lot of
executive functions, or what we call more thinking functions: planning,
goal-directed behaviour, judgement, insight. And we think that that
particular part of the brain influences this more emotional or gut part of
the brain… The adolescent will have more of an emotional response.
The part of the brain that has more of that gut reaction will respond to a
greater extent than the adult brain will. And we think that that is due to
the fact that this frontal region is not interacting with the emotional
region in the same way… It was surprising to us that most fairly
sophisticated adolescents did not correctly identify fear. The frontal
lobe, that part of the executive region that we studied, is not always
functioning fully in teenagers… That would suggest that therefore
teenagers aren't thinking through the consequences of their behaviors."
(Yurgelun-Todd, 2004)

Adding to this research is work done by Robert McGivern at San Diego State
University, who found that as children enter puberty, their ability to recognize
quickly, other people's emotions, plummets. It then does not return to 'normal'
until around 18 years old. McGivern's take on this was that it explains why so
many teenagers consider life 'unfair', being less able to understand social
situations.

"During adolescence, social interactions become the dominant
influence on our behaviour, says McGivern. But just at the time
teenagers are being exposed to a greater variety of social situations,
their brains are going through a temporary 'remodelling', he says. As a
result, they can find emotional situations more confusing, leading to the
petulant, huffy behaviour for which adolescents are notorious."
(New Scientist web site, 2002)

Hormones

Adding to the chaos in the teenage brain are, of course, hormones. This is an
area we mostly knew about. The exciting findings which have emerged from
MRI scans instruct us in ways we had no idea about before the late 90s, but
they don't negate what is known about hormones. Puberty is not something
which occurs overnight: it takes a number of years. Gonadal hormones begin
to be released – testosterone in boys, oestrogen in girls – during the second
phase of puberty which ranges across early- to mid-adolescence. One fact
which adds to the exacerbation of all these issues for modern teenagers is
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that the age of puberty has fallen dramatically, due essentially to better health
and diet:

"Puberty is happening at an earlier stage than ever, largely due to the
amount of fat and high-calorie food in the diet. Girls, on average, now
start their periods at the age of 12 years and 10 months, eight months
earlier than 30 years ago."
(Revill, 2003)

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It is likely that the age of puberty has fallen David two years over the last
around Blackburn, Corporate Edge
century.

Certain studies have shown important links between hormones in teenagers
and emotions. In particular is the work of Allan Mazur of Syracuse University,
who, with others, conducted a piece of work which linked aggression in
teenage boys with testosterone levels (Mazur, 1997).

However, shortly before Jay Giedd started sharing his research relating to
adolescent brain development with the world, other work conducted by
Elizabeth Susman, who was one of the contributors to the Mazur paper, was
disseminated in a press release, which very much plays down the links
between hormones and behaviour:

""There are many environmental factors that are at work that can affect
an adolescent. Influences from family, peers and school are likely so
significant that hormones changes are too weak to overcome such
strong social influences," says Elizabeth Susman, Ph.D., the Shibley
Professor of Biobehavioral Health in Penn State's College of Health
and Human Development.

"We spent a number of years on this project and most of us were a bit
surprised that hormones were not more influential on behavior," says
Howard Kulin, M.D., professor of pediatrics in Penn State's College of
Medicine and principal investigator of the project.

The paper, "The Effect Of Sex Hormone Replacement Therapy On
Behavior Problems And Moods In Adolescents With Delayed Puberty,"
was published in the October issue of the journal Pediatrics. Susman,
who adds she was a bit surprised with the results, says that hormones
and biological changes are not as powerful modulators of behavior as
previously thought. Parents should not expect their child to become
more negative, or more anxious or more aggressive just because they
are entering puberty, she says."
(Penn State Population Research Institute, 1998)

Melatonin and sleep

One final area of information on teenage brain development to be included
here concerns sleep patterns. Once again we recognize a facet of the
stereotype teen – hidden under the duvet until lunchtime or beyond. And once
again we find that changes during adolescence are to blame.
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We all need sleep to 'recharge the batteries': certain key functions are
happening in our brains, while our bodies are inert. This is especially true for
teenagers, where hormones connected with growth and sexual development
are released during sleep. Indeed, it is a hormone called melatonin, secreted
from the pineal gland, which tells us it's time to go to sleep in the first place.

Sleep researcher Mary Carskadon, based at Brown University School of
Medicine in Rhode Island, has found through two key surveys that teenagers

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need more sleep than most of us believe, and certainly more than most get; Edge
yet during these years, their melatonin release doesn't happen until later in
the evening. Thus they need to catch up at the weekends.

"Eight to nine year-olds sleep perfectly. The melatonin in the brain
kicks in at 9pm, so they can sleep for ten hours before it is time to get
up for school. In adolescents, however, the melatonin doesn't kick in
until 10.30, the same as for adults, and yet they still need 10 hours'
sleep."
(Daily Telegraph, 2002)

Carskadon has also been quoted criticizing school hours which begin early in
the day:

"The eyes are open, but the brains are asleep… This is not a time of
day when teenagers can be reasonably expected to participate in
class."
(Carskadon, 2004)

Her work does not go as far as identifying a direct link between sleep
deprivation and school grades, but the clues are definitely there. A study she
conducted with Amy Wolfson (1998), of the College of the Holy Cross, found
that students who reported that they were getting Cs or lower at school
obtained about 25 minutes less sleep and went to bed about 40 minutes later
than students who reported they were getting As and Bs.

Three years ago, an experiment in the States provided some evidence that
later starts for schools would be beneficial:

"Researchers at the University of Minnesota reported the results of a
study of more than 7,000 high-school students whose school district
had switched in 1997 from a 7:15am start time to an 8:40am start time.
Compared with students whose schools maintained earlier start times,
students with later starts reported getting more sleep on school nights,
being less sleepy during the day, getting slightly higher grades and
experiencing fewer depressive feelings and behaviours."
(Carpenter, 2001)
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WHAT THIS ALL MEANS David Blackburn, Corporate Edge
To summarize the key points:

! the teenage brain was considered until fairly recently to be essentially
fully-grown;
! research now tells us that a considerable stage of development occurs,
beginning with a period of growth, then a phase of pruning throughout
the teenage years;
! thus teenagers are faced with a 'use it or lose it' scenario, where key
skills may be lost forever;
! the development process begins at the back of the brain and ends with
the front – the prefrontal cortex, which we know is responsible for our
rational decision-making;
! so teenagers are immature, and many of their behaviours can be
understood;
! whilst the facts are true of all adolescents over the years,
environmental factors have made the current generation more
susceptible than ever before.

Many inferences will already have been drawn. Statistics were included earlier
which link the teen years to certain issues, and what is now known about
teenage brain development may certainly be a factor. Other inferences are
also drawn; the following article links teenage brain development and
smoking. Edward Levin, of the Duke University Medical Center in North
Carolina, conducted an experiment with teenage rats (it not being ethical to
conduct smoking research of this kind with young people):

"The results indicate that early nicotine exposure can leave a lasting
imprint on the brain. The brain continues to develop throughout the
teenage years. Early nicotine use may cause the wiring of the brain to
[develop] inappropriately."
(Bhattacharya, 2003)

This predisposition to nicotine addiction can apply to drugs also; we know that
environmental issues and pressures will tempt many teenagers to experiment;
now we also learn that they are more likely to get hooked. Dr Andrew
Chambers, of Yale School of Medicine, analysed over 140 studies and
reported the following:

"“Several lines of evidence suggest that socio-cultural aspects
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particular to adolescent life alone do not fully account for greater drug
intake,” said lead author Dr Andrew Chambers in the American Journal
of Psychiatry. The team’s review suggests that particular sets of brain
circuits involved in the development of addictions are the same as
those that rapidly undergo change during the teenage years. “Normally
these processes cause adolescents to be more driven than children or
adults to have new experiences,” he said. “But these conditions also
reflect a less mature neurological system of inhibition, which leads to

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impulsive actions and risky behaviours, including experimentation and Edge
abuse of addictive drugs.”
(Healthy Pages web site, 2003)

This theme is continued by Professor Michelle Ehrlich, of Thomas Jefferson
University in Philadelphia, who claims, in an article in the Journal of
Neuroscience, that the teenage brain is more predisposed to drug-taking than
either children's or adults' brains (Roger Highfield, 2002).
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In one of our Immersion interviews, a young teenager made it clear that he Edge
knew he was vulnerable to the temptation to try drugs:

Immersion interview #4 – Harry

Harry is 13. He lives in a terraced house in the city, with his mum, dad, sister aged
15 and brother aged 18.

Harry's brother has had severe problems with depression through his teenage years,
and is only just coming out of it. Harry appears mostly unaffected – a confident boy
who enjoys badminton and playing the drums. He gets into trouble at school – but all
minor stuff – arguing with teachers and so on.

He has always had a high disposition towards risk, scaling high gates and walls as a
child. The danger is that this now moves away from climbing walls into
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experimenting with substances:

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"There are some people at my school who do drugs, but Blackburn, Corporate
David not any of my friends, so I Edge
am not really tempted… I would feel pressurized into taking them, because if (my
friends) think it's OK, then I should do it as well. But they all think it's quite stupid
and I think it is."

Jay Giedd himself adds to this area:

"It's also a particularly cruel irony of nature, I think, that right at this time when
the brain is most vulnerable is also the time when teens are most likely to
experiment with drugs or alcohol." (Giedd, 2004b)

Clearly this leads to advice as to how parents should, and shouldn't, behave
with their teenage children, if they want to remain sane; many books have
appeared on the shelves addressing this very issue; a personal favourite is
titled Get Out Of My Life (But First Take Me And Alex Into Town) (Tony Wolf &
Suzanne Franks, 2002).

However, Judith Harris tells us that parents have little influence on their
children, in terms of how they behave outside the home, especially by the time
they are teenagers:

"It is true that if you ask kids who influences them more – what they'd do if
their parents and their friends gave conflicting advice – younger children are
more likely to say they'd listen to their parents. But they are asked this
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question out of context and the one who's asking is a grown-up. They may
interpret the question as meaning 'Whom do you love more?' and of course
they love their parents more than they love their friends. The question has
been answered by the relationship department of their mind but it is the group
department that will, in the long run, determine how they will behave when
they're not at home… Adolescence is when the choices get made. When they
sort themselves into groups, teenagers are defining themselves."
(Harris, 1998)

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Harris' thesis is that 'nurture', to the extent that it shares influence with
'nature', is essentially about peer influence, rather than parental influence. So
perhaps reading books about how parents should manage teenagers is not an
answer. This is not to suggest that because teenagers are more influenced by
their peers that adults should give up on them. Indeed, the area of
Information, Advice and Guidance which the new Connexions service has
taken on is hugely important. It is because adolescents are poor at making
decisions, that they need help, even if their outward appearance seems to
reject it:

"When children are small, we patiently teach them how to read and
write, how to count or tie their shoelaces because we know that these
are essential skills. Yet when our children reach adolescence, we often
withdraw and offer less guidance because they are so much more
capable physically of doing things for themselves."
(Figes, 2002)

One important area of life which is taking notice of the new research findings
is that of teenage culpability. This is critical in the States, where a teenager
can be put to death for committing a murder.

The American Bar Association published a paper summarizing the discoveries
of Jay Giedd and others, and came to the following conclusion:

"These discoveries support the assertion that adolescents are less
morally culpable for their actions than competent adults and are more
capable of change and rehabilitation. The ultimate punishment for
minors is contrary to the idea of fairness in our justice system, which
accords the greatest punishments to the most blameworthy.

This fresh understanding of adolescence does not excuse juvenile
offenders from punishment for violent crime, but it clearly lessens their
culpability."
(Juvenile Justice Center, 2004)

The Supreme Court in the States is, at the time of writing, considering a case
which will determine the constitutionality of the juvenile death penalty (due for
announcement in February 2005). In a polemical piece published recently
(David Fassler, 2004), the author argues the case for listening to the recent
research using MRI to inform this decision. Indeed, he tells us that an 'amicus
brief' has been filed by the American Medical Association, the American
Psychiatric Association, The American Academy of Child and Adolescent
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Psychiatry and the American Academy of Psychiatry of the Law stating
opposition to the execution of juvenile offenders, triggered by the new findings
about the teenage brain.

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We now understand that the brain works on a "use it or lose it" basis while it is Edge
undergoing development. One of these phases of development occurs during
the teenage years. This is when a large proportion of teenagers, especially
boys, spend large amounts of time playing on PlayStations, GameCubes and
Xboxes:

"An incredible 95% of (UK) teenage boys have a games console at
home and half spend over nine hours a week playing on them."
(Holden &
Griffiths, 2004)

There have been a number of studies looking at the effects of such games on
behaviour. Findings are inconclusive, in the sense that some studies report
more aggressive behaviour related to video games-playing (for instance, see
Anderson & Dill, 2000) whilst others do not (for example Wiegman and Van
Shie, 1998). For an excellent summary of research in this area, see Wolock,
2004.

For the purposes of this paper however, there is a strong argument to suggest
that some teenagers will be allowing elements of their brain concerned with
socialization to be 'lost', as they communicate solely with their TV screen or
monitor. To some extent this will be counterbalanced in terms of those who
play in pairs or groups.

The advice, that appears in a number of sources, is that teenagers will benefit
from continuing sport and music. It is fair to say that a number of young
people begin these activities in their childhood, but drop them when the social
pressures of teenage emerge. It is also fair to say that many schools, whilst
prizing their prowess at sport and/or music, nonetheless place greater
emphasis to their students on achievement in academic subjects. Parents
would do well to consider the advice which suggests that continuation of
physical activity and creative arts will have benefits beyond the obvious ones:

"Basal Ganglia: larger in females than in males, this part of the brain
acts like a secretary to the prefrontal cortex by helping it prioritize
information. The basal ganglia and prefrontal cortex are tightly
connected: at nearly the same time, they grow neuron connections and
then prune them. This area of the brain is also active in small and large
motor movements, so it may be important to expose preteens to music
and sports while it is growing."
(Dell, 2004)

Once again Jay Giedd has words on the subject:
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"The pruning-down phase is perhaps even more interesting, because
our leading hypothesis for that is the "Use it or lose it" principle. Those
cells and connections that are used will survive and flourish. Those
cells and connections that are not used will wither and die. So if a teen
is doing music or sports or academics, those are the cells and
connections that will be hard-wired. If they're lying on the couch or

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playing video games or MTV, those are the cells and connections that Edge
are going [to] survive." (Giedd, 2004b)

For this paper, evidence emerged in the Immersion interviews, that where
teenagers were involved in sport or music, or indeed both, there were fewer
problems at home.

Immersion interview #5 – Jake

Jake is 15. He lives in a terraced cottage on the outskirts of the city, with his mum.

Jake lost his dad when he was just one, so has grown up an only child in a single -
parent family. He has stayed well on the rails however: the worst that appears to
have happened at home is when his mum found cigarette butts in his room. This was
just an experimentation with a friend however. Typically, Jake cannot explain why he
did it.
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Otherwise, Jake and his mum only argue about David Blackburn, Corporate
what time he goes to bed. Edge

Jake plays rugby - at full - back for the county – and bass guitar in a band.

The 'use it or lose it' principle is also connected to the issue of drug and
alcohol use amongst teenagers. This is especially dangerous since use of
these substances contributes to the 'lose it' side of the equation:

"From pot to cocaine, from angel dust to Ecstasy to heroin to alcohol,
to nicotine, which is, after all, just another drug, all addictive, mood-
altering drugs behave like terrorists hijacking the brain-reward neural
pathways, giving your brain instant false, temporary rewards and what
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is worse, setting your brain up to need the next jolt. The healthy reward
circuits, unused, are beginning to disappear."

(Carlson, 2004)

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IMPLICATIONS FOR THE MARKET RESEARCH INDUSTRY

How do we deal with this knowledge of teenagers? Parents of teens going
through the changes outlined above often express frustration at the lack of
communication. Remember Michael Bradley (2004) and the image of the
German Shepherd puppy. The average teenager has no more sensible
response to the question "Why?", perhaps in terms of Why they didn't go to
school, or Why they cut up a favourite T-shirt, than the puppy has as to why
he used your favourite carpet as a toilet. And the reason is probably the
same: that they don't know Why.

We need to consider what we as researchers ask of young people whose
brains are undergoing what is major refurbishment, whether it is within a
quantitative questionnaire, or in a qualitative interview or stimulus board.
Deborah Yurgelun-Todd, who did the experiment with fearful faces is quoted
thus:

"We have to think about the idea that they might not be hearing the
words in the ways we intend them."
(Strauch, 2003)

So, not only should we be considering what to ask teenagers, but also,
clearly, how to ask questions, and how to interpret the answers. It is likely that
we are guilty often of providing complex questions, which to the teenage brain
are difficult to decode if they contain an emotional as well as a rational
element to them.

If simplifying the process is the order of the day, then in qualitative research,
perhaps the individual interview will elicit more salient responses than the
group situation, or even pairs, where the complication of the relationship with
the other person may 'confuse' the young person's thinking. We would
normally adopt this protocol for 'sensitive' topics: how can we as adults
perceive what is and what is not sensitive to the developing teenager?

IMPLICATIONS FOR MARKETERS

It is to be hoped that a proportion of the readership for this paper will be those
actually marketing to teenagers. One of my clients swears by What Kids Buy
and Why (Acuff, 1997); whilst this provides an interesting description of the
differing ages and their psychological triggers, its publishing date means that
all references to teenagers and brain development are out-of-date. In her
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introduction to her book, Barbara Strauch (2003) says:

"Indeed, the field is changing so fast, I found myself checking dates on
any scientific study I looked at. 'Oh, 1996, too old'."

The research cited in this paper is relatively new: it is to be hoped that Acuff
updates his book; indeed that other, new books emerge to grapple with what
we have learnt.

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Certainly, and marketer who has a brand with a 'youth' profile needs to think
carefully about how homogeneous their cohort actually is. Anyone seeking to
attract 15-24s will need to consider just how those at the younger end of that
spectrum relate to the world, and therefore how they relate to their brand.
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Understanding the Teen Brain (M Richards 2005)

Understanding the Teen Brain (M Richards 2005)

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