Diseases & Conditions


Behavioral Problems

Adolescence is a time for developing independence. Typically, adolescents exercise their independence by questioning their parents' rules, which at times leads to rule breaking. Parents and doctors must distinguish occasional errors of judgment from a degree of misbehavior that requires professional intervention. The severity and frequency of infractions are guides. For example, drinking habitually, fighting often, frequent truancy and theft are much more significant than isolated episodes of the same activities. Other warning signs include deterioration of performance at school and running away from home.

Children occasionally engage in physical confrontation. However, during adolescence, the frequency and severity of violent interactions increase. Although episodes of violence at school are highly publicized, adolescents are much more likely to be involved with violence (or more often the threat of violence) at home and outside of school. Many factors, including developmental issues, gang membership, access to firearms, substance use, and poverty, contribute to an increased risk of violence for adolescents. Of particular concern are adolescents who, in an altercation, cause serious injury or use a weapon.

Because adolescents are much more independent and mobile than they were as children, they are often out of the direct physical control of adults. In these circumstances, adolescents' behavior is determined by their own moral and behavioral code. The parents guide rather than directly control the adolescents' actions. Adolescents who feel warmth and support from their parents are less likely to engage in risky behaviors. Also, parents who convey clear expectations regarding their adolescents' behavior and who demonstrate consistent limit setting and monitoring are less likely to have adolescents who engage in risky behaviors. Authoritative parenting, as opposed to harsh or permissive parenting, is most likely to promote mature behaviors.

Authoritative parents typically use a system of graduated privileges, in which the adolescent is initially given small bits of responsibility and freedom (such as caring for a pet, doing household chores, picking out clothing, or decorating his room). If the adolescent handles this responsibility appropriately over a period of time, freedom is increased. Abuses of freedom are dealt with by taking away privileges. Each increase in freedom requires close attention by parents to make sure the adolescent is where and with whom he is supposed to be, returns at the proper time, and so forth.

Some parents and their adolescents clash over almost everything. In these situations, the core issue is really control—adolescents want to feel in control of their lives and parents want adolescents to know they still make the rules. In these situations, everyone may benefit from the parents focusing their efforts on the adolescents' actions (attending school, complying with household responsibilities) rather than on expressions (dress, hairstyle, preferred entertainment).

Adolescents whose behavior is still dangerous or otherwise unacceptable despite their parents' best efforts may need professional intervention. Substance abuse is a common trigger of behavioral problems and often requires specific therapy. Behavioral problems may be the first sign of depression or other mental health disorders. Such disorders typically require treatment with drugs as well as counseling. In extreme cases, some adolescents may also need legal intervention in the form of probation.

Last full review/revision February 2003

Source: The Merck Manual Home Edition