tag:theconversation.com,2011:/uk/topics/teen-health-17277/articlesTeen health – The Conversation2023-10-04T19:04:49Ztag:theconversation.com,2011:article/2067022023-10-04T19:04:49Z2023-10-04T19:04:49ZI think my teen is depressed. How can I get them help and what are the treatment options?<figure><img src="https://images.theconversation.com/files/544471/original/file-20230824-29-js41sa.jpg?ixlib=rb-1.1.0&rect=29%2C0%2C4891%2C3260&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Unsplash</span></span></figcaption></figure><p>Moody, withdrawn, down. These words are often used by parents of teens. And young people may say they feel so “depressed” about upcoming exams, or that the world is “just so depressing” these days.</p>
<p>But how do you know if your teen is experiencing what health professionals call “major depression”? And when should you seek help? </p>
<p>First, let’s understand what is meant by this term. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">Major depression</a> is characterised by persistent low mood and/or irritability and loss of interest or pleasure in usual activities for at least two weeks. It also includes physical symptoms, such as sleep disturbance and fatigue, and cognitive symptoms, such as negative thoughts about themselves and the future, difficulty concentrating or making decisions. </p>
<p>Major depression is more than brief sadness, or an expected reaction to loss or a stressful event. </p>
<p>While the diagnosis is the same for adolescents and adults, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">teens may be more likely</a> to present with irritability and mood changes rather than the low mood typical of adults. </p>
<h2>Increasing over time</h2>
<p>There is evidence depression is increasing among young people, with an <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782796">international study in 2021</a> estimating 25% of children and adolescents experienced elevated depression symptoms – double pre-pandemic levels. While Australia was not included in this study, a recent Australian study showed psychological distress have <a href="https://doi.org/10.1016/j.psychres.2023.115356">spiked</a> in Australian millennials (born between the early 1980s and late 1990s) and Gen-Z Australians (born late 1990s to early 2010s). </p>
<p>While the cause of this increase is unclear, it is likely due to <a href="https://mentalhealththinktank.org.au/wp-content/uploads/2023/08/Mental_Health_Recovery_Package_Australias-Mental-Health-Think-Tank.pdf">multiple factors</a>, such as financial pressures, social isolation, and climate change, and made worse by the <a href="https://pubmed.ncbi.nlm.nih.gov/36970258/">COVID pandemic</a>. </p>
<p>Given the understandable distress experienced by many young people, how can parents or carers know when to seek help? </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-parents-can-play-a-key-role-in-the-prevention-and-treatment-of-teen-mental-health-problems-192927">How parents can play a key role in the prevention and treatment of teen mental health problems</a>
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<h2>Listen up</h2>
<p>Begin by talking to your child. Let them know you have noticed some changes and you are concerned about them. If your child opens up about their difficulties, listen carefully and validate their feelings. Being able to talk about difficulties, and knowing support is there if they need may be enough for some teens. </p>
<p><a href="https://parents.au.reachout.com/common-concerns/mental-health/depression-and-teenagers">Read up on depression</a> from <a href="https://headspace.org.au/explore-topics/supporting-a-young-person/depression/">reputable sources</a>, so you are better equipped to understand and support a young person. </p>
<p>Try not to dismiss a teen’s feelings or punish irritable behaviour. It can be tempting to remind them of positives or offer solutions – but this can often backfire, leaving them feeling misunderstood. While it might be difficult or uncomfortable to talk openly with your teen about their mental health, it is often a <a href="https://aifs.gov.au/media/most-teenagers-turn-parents-and-friends-help">huge relief</a> for them. </p>
<p>Professional help may be needed if they are highly distressed, or if their difficulties are having a significant impact on their usual activities and relationships (this may include withdrawing from many activities, avoiding school, or avoiding friends and family most of the time). </p>
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<h2>Start with a GP</h2>
<p>The good news is, effective treatments are available. </p>
<p>The first step to finding appropriate treatment will likely be supporting your teen to see a GP. Again, simply talking through their concerns with the doctor may be very helpful. Your young person might prefer to discuss this with the GP without you.</p>
<p>The GP may <a href="https://www.health.gov.au/our-work/better-access-initiative">refer them to a mental health professional</a>, such as a <a href="https://psychology.org.au/psychology/about-psychology/seeing-a-psychologist-faqs">psychologist</a> or <a href="https://www.healthdirect.gov.au/psychiatrists-and-psychologists">psychiatrist</a>. </p>
<p>Teens can also go directly to an organisation like <a href="https://headspace.org.au">Headspace</a>, which provides information, support and services to young people aged 12 to 25 and their families and friends via centres across Australia.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-first-sleep-health-program-for-first-nations-adolescents-could-change-lives-206286">The first sleep health program for First Nations adolescents could change lives</a>
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<h2>What does depression treatment look like?</h2>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">recent review</a> on recognising and managing teen depression examined clinical practice guidelines from Canada, Australia, the United Kingdom, the United States and New Zealand found a comprehensive treatment approach is typically used. </p>
<p>Treatment can include:</p>
<ul>
<li><p>education about depression and its treatment</p></li>
<li><p>lifestyle interventions (such as improving sleep, diet and exercise)</p></li>
<li><p>psychological therapy (often focused on understanding and changing unhelpful thinking patterns)</p></li>
<li><p>prescription of antidepressants when needed. </p></li>
</ul>
<p>Whether to start a teen on <a href="https://australianprescriber.tg.org.au/articles/antidepressants-in-adolescence.html">antidepressant medication</a> can be a difficult decision. It should be a collaborative decision involving the teen, their parents and health professionals. </p>
<p>Like all medication, antidepressants have side effects and potential risks. They are typically used in cases of severe depression, or if psychological treatments have been unsuccessful. Suicidal thoughts or behaviour are a <a href="https://www.aacap.org/aacap/medical_students_and_residents/mentorship_matters/developmentor/Do_Antidepressants_Increase_the_Risk_of_Suicide_in_Children_and_Adolescents.aspx">possible side effect of antidepressants</a> for a small proportion of adolescents and should be carefully monitored. However, untreated depression is also a risk factor for suicide, so the potential benefits and risks of antidepressant use by teens needs to be carefully considered. </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CxAZ5ZTBrhe/?img_index=1","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<h2>Assessing risk</h2>
<p>Suicidal thoughts and self-harm are common in depression but can be effectively treated. </p>
<p>Suicide risk assessment is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">critical part</a> of any treatment for depression, and should include the development of a <a href="https://au.reachout.com/articles/how-to-make-a-safety-plan">safety plan</a> with the teen and their parents or carers. Safety plans can be very helpful in times of distress, listing helpful coping strategies and contact details for family, friends and health professionals.</p>
<p>If you are concerned your teen <a href="https://parents.au.reachout.com/common-concerns/mental-health/suicide-and-teenagers">might be at risk of suicide</a>, take it seriously. Ask them direct questions, such as “Are you thinking about suicide?”. Get professional support as soon as possible and take the young person to the nearest emergency department or call 000 if you are worried about their immediate safety. You can also contact Kids Helpline 24 hours a day 1800 55 1800.</p>
<p>Importantly, look after yourself. Supporting a teen with depression can take a toll and lead to significant tension in a household. </p>
<p>Find someone (other than your child) you can confide in. Make sure you’re getting rest, nutrition and exercise. Seek professional support if you find yourself struggling. Taking care of yourself means you are better equipped to support your child. </p>
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<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14 or <a href="https://kidshelpline.com.au/">Kids Helpline</a> on 1800 55 1800.</em></p><img src="https://counter.theconversation.com/content/206702/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Louise Birrell receives funding from the National Health and Medical Research Council, the Australian government and Australian Rotary Health. </span></em></p><p class="fine-print"><em><span>Andrew Baillie is employed by the University of Sydney in a position half funded by Sydney Local Health District and he receives funding from the National Health and Medical Research Council and the Medical Research Future Fund. </span></em></p><p class="fine-print"><em><span>Maree Teesson is Chair of Australia's Mental Health Think Tank which is funded by the BHP Foundation. She is Director of The Matilda Centre, The University of Sydney. She is chair of the Million Minds Mission. She receives funding from the National Health and Medical Research Council, the Australian Government, BHP Foundation, Paul Ramsay Foundation and other research organisations. She is co-director of OurFutures Institute a not-for-profit company established to distribute evidence resources to education organisations. </span></em></p><p class="fine-print"><em><span>Erin Kelly does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Teen depression is on the rise but effective help is available. We look at what parents can do to support their teen.Louise Birrell, Researcher at The Matilda Centre for Research in Mental Health and Substance Use, University of SydneyAndrew Baillie, Professor of Allied Health, University of SydneyErin Kelly, Research Fellow and Clinical psychologistMaree Teesson, Professor & Director of The Matilda Centre. Chair, Australia's Mental Health Think Tank, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2008932023-03-27T12:23:01Z2023-03-27T12:23:01ZExtra food assistance cushioned the early pandemic’s blow on kids’ mental health<figure><img src="https://images.theconversation.com/files/516734/original/file-20230321-20-u5z17m.jpg?ixlib=rb-1.1.0&rect=51%2C25%2C5668%2C3782&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The pandemic-era expansion of SNAP benefits ended in all U.S. states by March 2023.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/asian-woman-wearing-protective-face-mask-hold-paper-royalty-free-image/1253665535?adppopup=true">aogreatkim/iStock/Getty Images Plus via Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>Despite the <a href="https://theconversation.com/snap-benefits-cost-a-total-of-85-6b-in-the-2020-fiscal-year-amid-heightened-us-poverty-and-unemployment-148077">heightened poverty and unemployment</a> seen when the COVID-19 pandemic got underway, many low-income U.S. children <a href="https://doi.org/10.1016/j.ypmed.2023.107456">did not experience a decline in their emotional and mental health</a>, we found in a new study. </p>
<p>We looked specifically at kids whose families were participating in the <a href="https://theconversation.com/how-snap-can-help-people-during-hard-economic-times-like-these-133664">Supplemental Nutrition Assistance Program</a> – commonly known as SNAP – the government program that helps low-income Americans afford food. </p>
<p>The government began to boost SNAP benefits in early 2020 to help offset pandemic-driven food insecurity for participating families, which now <a href="https://theconversation.com/extra-snap-benefits-are-ending-as-us-lawmakers-resume-battle-over-program-that-helps-low-income-americans-buy-food-199929">number around 41 million</a>.</p>
<p>As a result, <a href="https://www.fns.usda.gov/snap/covid-19-emergency-allotments-guidance">families got an extra US$95</a> or more per month for groceries to <a href="https://www.ers.usda.gov/webdocs/publications/100820/ap-089.pdf?v=5555.5">replace the meals children were missing</a> at schools that had closed. <a href="https://healthyeatingresearch.org/research/snap-waivers-and-adaptations-during-the-covid-19-pandemic-a-survey-of-state-agency-perspectives-in-2020/">Some eligibility rules were loosened</a> to expand the program’s reach, and for the first time, <a href="https://www.usda.gov/media/press-releases/2019/04/18/usda-launches-snap-online-purchasing-pilot">people could buy groceries online</a> with their SNAP benefits.</p>
<p>To learn whether these extra benefits affected children’s mental and emotional health, we analyzed five years of data collected by the <a href="https://www.nschdata.org/">National Survey of Children’s Health</a> on 30,748 low-income families with children aged 6 to 17 years. The data, which included both families who were and were not getting SNAP benefits, covered the four years prior to the pandemic, as well as 2020. </p>
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<p>Among the 8,680 families getting SNAP benefits during this period, 38% had at least one child with problems such as doctor-diagnosed mental, emotional, developmental or behavioral health issues – including anxiety and depression.</p>
<p>To assess whether the temporarily expanded benefits had an impact on these children, we conducted a “<a href="https://www.sciencedirect.com/topics/economics-econometrics-and-finance/difference-in-differences">difference in differences</a>” analysis: We compared data regarding children whose families enrolled in the SNAP program over time with children whose families didn’t get those benefits. In addition, we considered the potential influence of several factors that could play a role, such as parents’ mental health.</p>
<p>We found that children in families getting SNAP benefits in 2020 did not generally experience any change in their mental or emotional health compared to prior years, despite the heavy stress of the pandemic.</p>
<h2>Why it matters</h2>
<p>Typically, <a href="https://www.apa.org/topics/socioeconomic-status/poverty-hunger-homelessness-children">low-income children are more at risk</a> of developing mental health or emotional problems, compared with high-income children. Our study adds to earlier evidence that SNAP benefits can lower that risk by <a href="https://dx.doi.org/10.2105/AJPH.2014.302480">reducing psychological distress and improving food security</a>.</p>
<p>While 2020’s extra SNAP benefits protected children’s mental and emotional health, they did not improve it. This suggests that actually reducing food insecurity for low-income families would have required additional steps. </p>
<p>In March 2023, <a href="https://theconversation.com/extra-snap-benefits-are-ending-as-us-lawmakers-resume-battle-over-program-that-helps-low-income-americans-buy-food-19992">the federal government ended</a> the pandemic-era SNAP expansions in 35 states and territories that hadn’t yet rolled them back. With inflation driving the <a href="https://www.ers.usda.gov/data-products/food-price-outlook/summary-findings/">cost of groceries up 11.4%</a> in 2022, we believe that <a href="https://www.cbpp.org/research/food-assistance/temporary-pandemic-snap-benefits-will-end-in-remaining-35-states-in-march#_ftn2">losing these benefits</a> threatens the well-being of millions of families.</p>
<h2>What’s next</h2>
<p>We are now studying the <a href="https://texaswic.org/">effects of pandemic-related changes</a> to the Special Supplemental Nutrition Program for Women, Infants and Children, better known as WIC. </p>
<p>We are looking at, for example, how expanding WIC benefits to cover canned, frozen and dried fruits and vegetables in addition to fresh produce has affected the low-income families’ purchasing behavior. Our team for this research also includes public health and nutrition scholars <a href="https://scholar.google.com/citations?user=d4_yu0YAAAAJ&hl=en&oi=ao">Alexandra MacMillan Uribe</a> and <a href="https://scholar.google.com/citations?hl=en&user=UKvdw94AAAAJ">Elizabeth Racine</a>, </p>
<h2>What is not known</h2>
<p>When we did our study, data from the years after 2020 wasn’t yet available, so we couldn’t investigate the potential impact of subsequent pandemic-related changes to SNAP benefits. Notably, in 2021, the federal government increased maximum benefit levels by 15% and <a href="https://www.cbpp.org/research/food-assistance/temporary-pandemic-snap-benefits-will-end-in-remaining-35-states-in-march">extended the extra $95 or more</a> in monthly food assistance for the lowest-income households.</p><img src="https://counter.theconversation.com/content/200893/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Grace Melo's research related for this article was supported by funding from the Texas A&M AgriLife Institute for Advancing Health Through Agriculture.</span></em></p><p class="fine-print"><em><span>Pourya Valizadeh receives funding from the U.S. Department of Agriculture's Economic Research Service. </span></em></p><p class="fine-print"><em><span>Rodolfo M. Nayga Jr. receives funding from U.S. Department of Agriculture.</span></em></p>Expanding SNAP helped shield low-income children from some of the harm caused by economic upheaval when the COVID-19 pandemic began.Grace Melo, ACES Faculty Fellow, Texas A&M UniversityPourya Valizadeh, Research Assistant Professor of Agricultural Economics, Texas A&M UniversityRodolfo M. Nayga Jr., Professor of Agricultural Economics, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1906692022-09-26T20:02:29Z2022-09-26T20:02:29ZWe asked over 700 teens where they bought their vapes. Here’s what they said<figure><img src="https://images.theconversation.com/files/486212/original/file-20220923-49066-sikp9n.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1917%2C1276&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/a-man-young-man-sitting-on-a-chair-with-a-vape-on-hand-10951435/">Mushtaq Hussain/Pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Teen vaping has been in the news, with reports of <a href="https://www.smh.com.au/national/nsw/number-of-young-people-vaping-doubles-in-a-year-as-smoking-rates-drop-20220531-p5apur.html">rapidly increasing use</a> and <a href="https://www.smh.com.au/world/asia/from-bootcamps-in-china-to-australian-schools-how-vapes-hook-children-on-nicotine-20210830-p58n6w.html">illegal sales</a> of e-cigarettes.</p>
<p>As a Four Corners <a href="https://www.abc.net.au/4corners/vape-haze:-the-new-addiction-of-vaping/13948226">documentary</a> on ABC TV earlier this year showed, parents and schools are struggling to manage this swift rise in vaping, with fears children are addicted and harming their health.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1539762788876181505"}"></div></p>
<p>In contrast, very limited research about Australian teen vaping has been published, until today.</p>
<p>We have <a href="https://onlinelibrary.wiley.com/doi/10.1111/1753-6405.13316">published</a> in the Australian and New Zealand Journal of Public Health the first results from the <a href="https://www.cancercouncil.com.au/cancer-prevention/smoking/electronic-cigarettes/generation-vape/">Generation Vape</a> study. The study aims to to track teenagers’ knowledge, attitudes, beliefs and behaviours about using vapes (e-cigarettes). </p>
<p>Here’s what we found about where teenagers were accessing vapes and what types of products they use.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-damning-review-of-e-cigarettes-shows-vaping-leads-to-smoking-the-opposite-of-what-supporters-claim-180675">A damning review of e-cigarettes shows vaping leads to smoking, the opposite of what supporters claim</a>
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<h2>Vaping common, especially in non-smokers</h2>
<p>We surveyed more than 700 teenagers 14-17 years old from New South Wales. The sample was closely representative of the population, with key characteristics such as age, gender, location and education monitored throughout data collection.</p>
<p>We found teenagers are readily accessing and using illegal, flavoured, disposable vaping products that contain nicotine. </p>
<p>Among the teens surveyed, 32% had ever vaped, at least a few puffs. Of these, more than half (54%) had never previously smoked.</p>
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<p>
<em>
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Read more:
<a href="https://theconversation.com/a-parents-guide-to-why-teens-make-bad-decisions-88246">A parent's guide to why teens make bad decisions</a>
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</em>
</p>
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<h2>Where are teens getting vapes from?</h2>
<p>We found most teens (70%) didn’t directly buy the last vape they used. The vast majority (80%) of these got it from their friends. </p>
<p>However, for the 30% who did buy their own vape, close to half (49%) bought it from a friend or another individual, and 31% bought it from a retailer such as a petrol station, tobacconist or convenience store.</p>
<p>Teens also said they bought vapes through social media, at vape stores and via websites.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-can-we-reverse-the-vaping-crisis-among-young-australians-enforce-the-rules-185867">How can we reverse the vaping crisis among young Australians? Enforce the rules</a>
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<h2>What products are teens using, and why?</h2>
<p>Of the teens who had ever vaped and reported the type of device they used, 86% had used a disposable vape. This confirms anecdotal reports.</p>
<p>These devices appeal to young people and are easy to use. They do not require refilling (unlike tank-style vaping products) and are activated by inhaling on the mouthpiece. </p>
<p>Disposable vapes can contain hundreds, or even thousands of puffs, and are inexpensive, with illicit vapes from retail stores costing between <a href="https://www.smh.com.au/world/asia/from-bootcamps-in-china-to-australian-schools-how-vapes-hook-children-on-nicotine-20210830-p58n6w.html">$20-$30, or as little as $5 online</a>.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=968&fit=crop&dpr=1 600w, https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=968&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=968&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1217&fit=crop&dpr=1 754w, https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1217&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/485511/original/file-20220920-3640-p8l88p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1217&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This ‘Juicy Fruity’ disposable vape resembles Juicy Fruit chewing gum.</span>
<span class="attribution"><span class="source">Author provided</span></span>
</figcaption>
</figure>
<p>There is an enormous range of vape flavours likely to appeal to children – from chewing gum to fruit and soft drink, even desserts. So it is unsurprising teens rated “flavourings and taste” as the most important characteristic of vapes they used.</p>
<p>Disposable vapes often contain very <a href="https://www.health.nsw.gov.au/tobacco/Pages/vaping-evidence-summary.aspx#nicotine">high concentrations of nicotine</a>, even those claiming to be nicotine-free. The way these products <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/pdfs/ecigarette-or-vaping-products-visual-dictionary-508.pdf">are made</a> (using nicotine salts rather than the free-base nicotine you’d find in cigarettes) allows manufacturers to increase the nicotine concentration without causing throat irritation. </p>
<p>In our study, over half (53%) of the teens who had ever vaped said they had used a vape containing nicotine. Many, however, were unsure whether they had used a vape containing nicotine (27%). </p>
<p>All vaping products, irrespective of nicotine content, <a href="https://www.health.gov.au/health-topics/smoking-and-tobacco/about-smoking-and-tobacco/smoking-and-tobacco-laws-in-australia#ecigarette-laws">are illegal</a> to sell to under 18s in Australia.</p>
<p>Today, disposable vapes containing nicotine can only be legally sold in Australia by pharmacies to adult users with a valid prescription.</p>
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<strong>
Read more:
<a href="https://theconversation.com/many-e-cigarette-vaping-liquids-contain-toxic-chemicals-new-australian-research-169615">Many e-cigarette vaping liquids contain toxic chemicals: new Australian research</a>
</strong>
</em>
</p>
<hr>
<h2>We need to end illegal imports and sales</h2>
<p>Our results emphasise that teen vaping is increasingly normalised, and the most popular devices are designed to be highly appealing to young people. This is despite product manufacturers and proponents claiming they are <a href="https://theconversation.com/twelve-myths-about-e-cigarettes-that-failed-to-impress-the-tga-72408">smoking cessation aids</a> only for adult smokers who are struggling to quit. </p>
<p>Turning the tide on teen vaping requires strong and immediate policy action, including ending the illicit importation and sale of vaping products.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Hand reach for vape and vape products on store shelf" src="https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=480&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=480&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=480&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=603&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=603&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486211/original/file-20220923-23143-107ras.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=603&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">We need to clamp down on the illegal sale of e-cigarettes.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/8RN9UZeL-fo">E-Liquids UK/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p><a href="https://www.health.nsw.gov.au/vaping">Education</a> is often the default first action to address unhealthy behaviours in young people. However, unless this is coupled with strong, supportive policy action, this approach is unlikely to have any measurable impact. Education campaigns cannot protect young people from an industry that so freely disregards laws meant to protect health.</p>
<p>We have <a href="https://openresearch-repository.anu.edu.au/bitstream/1885/262914/1/Electronic%20cigarettes%20health%20outcomes%20review_2022_WCAG.pdf">strong evidence</a> that vaping leads to harms such as poisoning, injuries, burns, toxicity, addiction and lung injury. The odds of becoming a smoker is more than three times higher for never-smokers who vape than for never-smokers who don’t vape.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/making-it-harder-to-import-e-cigarettes-is-good-news-for-our-health-especially-young-peoples-141986">Making it harder to import e-cigarettes is good news for our health, especially young people's</a>
</strong>
</em>
</p>
<hr>
<h2>What’s next?</h2>
<p>This study uses data from the first wave of the Generation Vape research project, a three-year study with Australian teenagers, young adults, parents and guardians of teenagers, and secondary school teachers. </p>
<p>It is funded by the Cancer Council NSW, federal Department of Health and Ageing, NSW Ministry of Health, Cancer Institute NSW and the Minderoo Foundation.</p>
<p>Future waves of this repeat cross-sectional study, coupled with in-depth interviews, will allow us to track and monitor changes to adolescent, young adult, teacher, and parent attitudes, perceptions, and knowledge of vaping over time. </p>
<p>Vaping is a rapidly evolving public health crisis in Australia. Our research provides evidence for concerted policy action to prevent young people from accessing harmful and addictive products. </p>
<p>Failure to act will see a whole new generation of Australians addicted to dangerous products.</p><img src="https://counter.theconversation.com/content/190669/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christina Watts has received funding from the Australian Government Department of Health and Aged Care, NSW Ministry of Health, Cancer Council NSW, Cancer Institute NSW and the Minderoo Foundation.</span></em></p><p class="fine-print"><em><span>Becky Freeman has received funding from Healthway WA, NSW Health, Australian Government of Health, Cancer Institute NSW, Ian Potter Foundation, Mindaroo Foundation, NHMRC, WHO, Cancer Council, Cancer Council NSW, Cancer Council WA, and Heart Foundation NSW. She was an expert member of the NHMRC Electronic Cigarettes Working Committee (2020-2022). She is an expert advisor to the National Tobacco Issues Committee. </span></em></p><p class="fine-print"><em><span>Sam Egger has received funding from the Australian Government Department of Health and Aged Care, NSW Ministry of Health, Cancer Council NSW, Cancer Institute NSW and the Minderoo Foundation.</span></em></p>Most teens got their vape from their friends. But of those who bought their own, one-third bought it at the servo, tobacconist or convenience store.Christina Watts, Research fellow, tobacco control, University of SydneyBecky Freeman, Associate Professor, School of Public Health, University of SydneySam Egger, Biostatistician, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1791782022-09-16T12:18:30Z2022-09-16T12:18:30ZSchool start times and screen time late in the evening exacerbate sleep deprivation in US teenagers<figure><img src="https://images.theconversation.com/files/480610/original/file-20220823-14-84rrxh.jpg?ixlib=rb-1.1.0&rect=9%2C9%2C5997%2C3998&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Less than 30% of teenagers are getting the sleep they need.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/portrait-of-teenage-boy-in-the-library-royalty-free-image/1155169520?adppopup=true">Mayur Kakade/Moment via Getty Images</a></span></figcaption></figure><p>With the school year underway around the U.S., parents and caregivers are once again faced with the age-old struggle of wrangling groggy kids out of bed in the morning. For parents of preteens and teenagers, it can be particularly challenging.</p>
<p>Sometimes this gets chalked up to laziness in teens. But the main reason why a healthy person is unable to naturally wake up without an alarm is that they are not getting the sleep their brain and body need. </p>
<p>That’s because studies show that <a href="https://doi.org/10.1093/sleep/zsy011">adolescents need more than nine hours of daily sleep</a> to be physically and mentally healthy. </p>
<p>But the likelihood that you know a teenager who gets enough sleep is rather slim. In the U.S., <a href="https://www.cdc.gov/mmwr/volumes/67/wr/mm6703a1.htm?s_cid=mm6703a1_w">less than 30% of high school students</a> – or those in grades 9 through 12 – sleep the recommended amount, according to the Centers for Disease Control and Prevention. Among middle schoolers in grades 6-8, nearly 60% do not get enough sleep at night. </p>
<p>Yet my laboratory’s research suggests that a much higher percentage of teens are getting too little sleep.</p>
<p>I am a <a href="https://www.biology.washington.edu/people/profile/horacio-de-la-iglesia">professor of biology</a> and have been <a href="https://scholar.google.com/citations?user=I-8qCAYAAAAJ&hl=en">studying sleep and circadian rhythms for more than 30 years</a>. For the past seven years, my laboratory at the University of Washington has been doing research on sleep in Seattle-area teenagers. Our research has found that, just as in other areas of the U.S., <a href="https://doi.org/10.1126/sciadv.aau6200">high schoolers</a> in Seattle are not getting the amount of sleep they need. Our study objectively measured sleep in 182 high school sophomores and seniors and found only two that slept at least nine hours at night during school days. </p>
<p>Our studies and those of others indicate that three important factors lie behind this lack-of-sleep epidemic: a physiological regulation of sleep that leads to a delayed sleep timing in teens and that is not aligned with early <a href="https://doi.org/10.1177%2F0748730419892118">school start times</a>, a <a href="https://doi.org/10.1177%2F0748730419892111">lack of morning exposure to daylight</a> and <a href="https://doi.org/10.1177%2F0748730419892111">excessive exposure to bright electric light and screens</a> late in the evening. </p>
<h2>Teen sleep biology</h2>
<p>The time people go to bed, fall asleep and wake up is governed by <a href="https://doi.org/10.1111/jsr.12371">two main factors in the brain</a>. The first is a so-called “wakefulness tracker,” a physiological timer that increases our need to sleep the longer we stay awake. This is in part the consequence of the accumulation of chemical signals released by neurons, <a href="https://doi.org/10.1111/jsr.13597">such as adenosine</a>.</p>
<p>Adenosine accumulates in the brain when we are awake, leading to increased sleepiness as the day wears on. If, for instance, a person wakes up at 7 a.m., these chemical signals will accumulate throughout the day until the levels are high enough that the person will fall asleep, typically in the late evening.</p>
<p>The second factor that drives the sleep/wake cycle is a 24-hour biological clock that tells our brain what times of the day we should be awake and what times we should be sleeping. <a href="https://theconversation.com/your-body-has-an-internal-clock-that-dictates-when-you-eat-sleep-and-might-have-a-heart-attack-all-based-on-time-of-day-178601">This biological clock </a> is located in an area of the brain called the hypothalamus. The clock is composed of neurons that coordinate the brain areas regulating sleep and wakefulness to a 24-hour sleep/wake cycle.</p>
<p>These two regulators operate with relative independence from each other. But under typical conditions, they are coordinated so that a person with access to electric-powered light would fall asleep in the late evening – between about 10 p.m. to 11 p.m., and wake up in the early morning, around 6 a.m. to 7 a.m. </p>
<p>So why do teenagers often want to go to bed later and wake up later than their parents? </p>
<p>It turns out that during adolescence, both the wakefulness tracker and the biological clock conspire to delay the timing of sleep. First, adolescents can be awake until later hours before their wakefulness tracker <a href="https://doi.org/10.1093/sleep/28.11.1446">makes them feel sleepy enough to fall sleep</a>.</p>
<p>Second, the <a href="https://doi.org/10.1016/j.adolescence.2018.06.001">biological clock of teenagers is delayed</a> because in some cases it appears to run at a slower pace, and because it responds differently to light cues that reset the clock daily. This combination leads to a sleep cycle that operates a couple of hours later than in an older adult – if an older adult feels the signals to fall asleep around 10 p.m. or 11 p.m., this won’t happen until midnight or later in a teenager. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/Ng1i8KuOqVc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Sufficient sleep is key to teen health, but many things prevent adolescents from getting enough of it.</span></figcaption>
</figure>
<h2>How school start times contribute</h2>
<p>To help find more hours of sleep for teens, one measure that some <a href="https://www.theatlantic.com/family/archive/2022/06/american-high-school-later-start-time/661211/">school districts around the country have taken</a> is to delay the school start time for middle schools and high schools. The American Academy of Pediatrics recommends that <a href="https://doi.org/10.1542/peds.2014-1697">schools for this age group should not start before 8:30 a.m.</a>. Yet the majority of <a href="https://nces.ed.gov/pubs2020/2020006/index.asp">high schools in the U.S start at 8 a.m. or earlier</a>.</p>
<p>Based on the recommendation of sleep experts, the Seattle school district, beginning with the 2016-2017 school year, delayed middle school and high school start times by nearly an hour, from 7:50 a.m. to 8:45 a.m. In a study our team conducted after the district enacted the plan, we found that <a href="https://doi.org/10.1126/sciadv.aau6200">students gained 34 minutes of daily sleep</a> – a huge gain by sleep medicine standards. In addition, student attendance and punctuality improved, and median grades went up by 4.5%. </p>
<p>Despite an abundance of research evidence and the advice from virtually all sleep experts in the country, most school districts are still stuck with school start times that promote chronic sleep deprivation in teenagers. The early school starts are further <a href="https://doi.org/10.1177%2F0748730419854197">aggravated by daylight saving time</a> – when clocks are set one hour ahead in the springtime. This time shift – one that <a href="https://www.nbcchicago.com/news/local/permanent-daylight-saving-time-up-in-the-air-as-house-mulls-when-to-consider-bill-2/2934856/">could become permanent in the U.S. in 2023</a> – exposes teenagers to artificially dark mornings, which exacerbates <a href="https://theconversation.com/why-daylight-saving-time-is-unhealthy-a-neurologist-explains-175427">their naturally delayed sleep timing</a>. </p>
<h2>Teaching healthy sleep habits to teens</h2>
<p>School start times aside, kids also need to learn the importance of healthy habits that promote sufficient sleep. </p>
<p>Getting bright daylight exposure, particularly during the morning, pushes our biological clock to an earlier time. This, in turn, will promote an earlier bedtime and a natural early morning wake time. </p>
<p>In contrast, light in the evening – including the light emitted by screens – is highly stimulating to the brain. It inhibits the production of natural signals such as melatonin, a hormone that is produced by the brain’s pineal gland <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">as the night arrives and in response to darkness</a>. But when these cues are inhibited by artificial light in the evening, our biological clocks are delayed, promoting a later bedtime and a later morning wake time. And thus the cycle of having to roust a sleepy, yawning teenager from bed for school begins again.</p>
<p>Yet few schools teach the importance of good daily routines and sleep timing, and parents and teens also do not fully appreciate their importance. <a href="https://www.penguinrandomhouse.com/books/647334/generation-sleepless-by-heather-turgeon-mft-and-julie-wright-mft-foreword-by-daniel-j-siegel/">Chronic sleep deprivation</a> disrupts every physiological process in the body and has been consistently linked to disease, including <a href="https://doi.org/10.1016/j.cpr.2018.05.006">depression and anxiety</a>, <a href="https://doi.org/10.1111/jsr.13162">obesity</a> and <a href="https://doi.org/10.1016/j.neubiorev.2022.104832">addictive behavior</a>. </p>
<p>Conversely, sufficient sleep not only helps to reduce <a href="https://doi.org/10.1146/annurev-psych-010213-115205">physical</a> ailments and improve <a href="https://doi.org/10.1038/s44159-022-00074-8">mental health</a>, but it has also been shown to be <a href="https://www.ted.com/talks/valerie_crabtree_teen_sleep_what_is_it_good_for_absolutely_everything?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare">fundamental for optimal physical and mental performance</a>.</p><img src="https://counter.theconversation.com/content/179178/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Horacio de la Iglesia receives funding from NIH.</span></em></p>Adolescent biology, early morning classes and too much evening screen time are a few of the key drivers behind teen sleep deprivation.Horacio de la Iglesia, Professor of Biology, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1690022021-11-19T13:15:10Z2021-11-19T13:15:10ZMonitor or talk? 5 ways parents can help keep their children safe online<figure><img src="https://images.theconversation.com/files/432663/original/file-20211118-20-t5yhng.jpg?ixlib=rb-1.1.0&rect=60%2C0%2C6649%2C4466&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Communication is key, experts say.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mother-an-son-using-laptop-at-home-royalty-free-image/1033164998?adppopup=true">damircudic/E+ via Getty Images</a></span></figcaption></figure><p>Children have been <a href="https://www.nytimes.com/2021/01/16/health/covid-kids-tech-use.html">spending more time online</a>. A May 2020 study found that U.S. teenagers spent <a href="https://dx.doi.org/10.1001/jamapediatrics.2021.4334">around seven hours a day, on average</a>, using screens. Even before the pandemic, U.S. teens were indicating in surveys that they were “<a href="https://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-2018/#a-growing-share-of-teens-describe-their-internet-use-as-near-constant">almost constantly online</a>.”</p>
<p>As with any venue, parents might be concerned about what dangers lurk on the internet – from <a href="https://cyberbullying.org/bullying-during-the-covid-19-pandemic">cyberbullying</a> to <a href="https://doi.org/10.1542/peds.2018-3183">teen-to-teen sexting</a> – and tempted to use various technological tools to monitor their children’s online activities. </p>
<p>As a researcher who specializes in <a href="https://scholar.google.com/citations?user=N3T-78EAAAAJ&hl=en&oi=ao">how teens operate in online environments</a>, I know that spying on your children’s keystrokes and web browsers isn’t the only or even the best parental practice to employ and may create problems of its own. Here are five tips on how parents can encourage their children to adopt safer online behavior beyond using spyware or computer surveillance.</p>
<h2>1. Don’t just monitor your kids online, talk to them</h2>
<p>Technical measures, such as those that allow parents to monitor <a href="https://www.mspy.com/">every keystroke</a>, can provide parents with an additional way to keep tabs on what their children are doing. However, parental controls should not replace an ongoing conversation with children about their digital media use and what it means to be safe online. </p>
<p>Many parents <a href="https://doi.org/10.1016/j.chb.2017.04.004">value open communication</a> with their children about their internet use. This can be beneficial in keeping them safe. Research on related traditional risk behaviors, such as teenage substance use, has found that children who have open conversations with their parents are less likely to engage in <a href="https://doi.org/10.1080/15267431.2016.1251920">these risky behaviors</a>. Open communication about online experiences may also allow children to stay safer online.</p>
<h2>2. Search for conversation starters</h2>
<p>More and more television series and films have story lines about digital media use that serve as natural conversation starters. For example, in Episode 5 of the first season of Netflix’s “<a href="https://www.netflix.com/title/80197526">Sex Education</a>,” sexting is a central theme as sexually explicit images of a girl are sent to her schoolmates. The main characters of the show try to put a stop this revenge porn. The movie “<a href="https://www.20thcenturystudios.com/movies/love-simon">Love, Simon</a>” portrays the struggles of a gay teenage boy who seeks and finds online support from another closeted gay student in his school through an online confession site, only to be outed through the same online platform. </p>
<p>Alternatively, you could ask your children to teach you how to use some of their favorite apps. This would be an excellent opportunity to discover together all the features as well as the privacy settings that these applications offer.</p>
<h2>3. Assure your children they can turn to you if they run into trouble</h2>
<p>As part of an ongoing conversation about media use, parents should make sure that their children feel they can reach out to them for help when they run into unpleasant online experiences. Research has found that some children are <a href="https://www.igi-global.com/article/adolescents-experiences-of-cyberbullying/173740">afraid to talk</a> to their parents when they face problems such as cyberbullying. They worry that parents may overreact or take away their devices. </p>
<p>Making sure that your child knows that they can reach out for help and that you will try your best to understand their needs can make them less vulnerable to risks like online extortion. If your child does disclose a particular online problem, a good way to respond is to simply ask your child how the problem makes them feel.</p>
<h2>4. Explain why you’re monitoring their online activities</h2>
<p>Parents who do decide to monitor their children’s internet use should always disclose that they are doing so. Most parents already do this, as evidenced in a study that found most parents believe that not telling their children that they are being monitored would <a href="https://doi.org/10.1080/17482798.2020.1744458">violate their child’s sense of privacy and security</a>.</p>
<p>Moreover, when children find out that their internet use has been monitored without their knowledge, it could lead to a <a href="https://www.lse.ac.uk/media-and-communications/assets/documents/research/projects/childrens-privacy-online/Evidence-review-final.pdf">breach of trust</a>. One study found that <a href="https://doi.org/10.1037/dev0000615">intrusive parenting</a>, such as snooping without their children’s knowing, can lead to more negative interactions between parents and children once the children find out and could make some children less likely to communicate with their parents. Consequently, parents will become less informed about their children’s lives. Therefore, it is important for parents to explain the reasons they are monitoring their children’s online behavior.</p>
<h2>5. Tailor monitoring to your child’s maturity and unique situation</h2>
<p>While young children can benefit from a close monitoring of their internet use, research has found that many parents gradually grant more autonomy to their children and <a href="https://doi.org/10.1016/j.chb.2017.04.004">become less restrictive in their monitoring</a><a href="https://doi.org/10.1016/j.adolescence.2010.09.002">as the children get older</a>. As a natural part of growing up, teenagers increasingly value <a href="https://doi.org/10.1016/j.chb.2017.04.004">personal autonomy</a>, especially when it comes to their media use.</p>
<p>Just as parents cannot always monitor their teenage children in the offline world, they could find it useful to grant their children gradual increased autonomy in the online world as they get older. This can encourage children to develop <a href="https://doi.org/10.1007/s10639-020-10342-w">problem-solving skills</a> and teaches them to navigate online risks. What this looks like will differ for each child and depends on their age. Everyone is susceptible in different ways <a href="https://doi.org/10.1002/9781119011071.iemp0122">to media effects and online risks</a>. This is why it is important to adapt the autonomy that you grant your child based on their personality, their maturity and their prior online experiences.</p>
<p>Online monitoring can also have some unintended side effects. For example, parents of LGBTQ teenagers should be aware that sexual and gender minority youths often rely on the internet to find information, explore their identities and connect with the <a href="https://doi.org/10.1080/2005615X.2017.1313482">broader LGBTQ community</a>. Restrictive forms of monitoring may take away youth agency and may severely limit opportunities for them to grow in their identities.</p>
<p>Whether or not parents decide to monitor their children’s internet use, there is still <a href="https://doi.org/10.1177/20501579211012436">much to learn</a> about effective parental mediation in an increasingly complex digital world. While parental monitoring differs for each child, it should primarily start with good communication and a balance between <a href="https://doi.org/10.1007/s10639-020-10342-w">surveillance and autonomy</a>.</p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-likethis">Sign up for The Conversation’s daily newsletter</a>.]</p><img src="https://counter.theconversation.com/content/169002/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joris Van Ouytsel received funding from the Research Foundation - Flanders.</span></em></p>Parents who spy on their children’s online activity run the risk of doing more harm than good, an expert says.Joris Van Ouytsel, Assistant Professor of Interpersonal Communication, Arizona State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1659182021-09-14T18:58:34Z2021-09-14T18:58:34Z8 a.m. high school? Sleep habits of pandemic teens suggest benefits of later start times<figure><img src="https://images.theconversation.com/files/419877/original/file-20210907-7696-1til2op.jpg?ixlib=rb-1.1.0&rect=0%2C129%2C3100%2C1828&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">COVID-19 lockdown periods opened a unique window for observing teen sleep patterns. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/8-a-m--high-school-sleep-habits-of-pandemic-teens-suggest-benefits-of-later-start-times" width="100%" height="400"></iframe>
<p>The return to in-person classrooms this fall may have the unintended consequence of depriving many Canadian high school students of sleep. </p>
<p>Prior to the COVID-19 pandemic, <a href="https://doi.org/10.1016/j.jadohealth.2020.03.013">many teens were chronically sleep-deprived during the week</a>, putting them at <a href="https://doi.org/10.1139/apnm-2015-0627">greater risk of poor health</a> and <a href="https://doi.org/10.1111/jsr.12475">more sleepiness in the classroom</a>. </p>
<p>The pandemic caused an upheaval in schooling, but introduced some flexibilities in scheduling that paradoxically <a href="https://doi.org/10.1016/j.sleep.2021.04.010">allowed some teens to catch up on their sleep</a>. </p>
<p>Could we capitalize on this disruption to make evidence-based changes in education to improve teens’ sleep? Research suggests that doing so would help high school students have healthier and more productive years.</p>
<h2>Damaging effects of sleep deprivation</h2>
<p>Concern about the damaging impacts of sleep deprivation on teens is substantial, especially because teens are still developing. </p>
<p>In pre-pandemic times, international studies suggested only about <a href="https://doi.org/10.1016/j.jadohealth.2020.03.013">two-thirds of Canadian adolescents were getting the eight to 10 hours of sleep on school nights</a> recommended for 12- to 18-year-olds, and there was a worse picture in many European countries and <a href="http://dx.doi.org/10.15585/mmwr.mm6703a1external%20icon">the United States</a>. </p>
<p>Inadequate sleep is linked to a host of negative outcomes in youth, including greater risk <a href="https://doi.org/10.1093/sleep/zsy018">of obesity</a>, <a href="https://link.springer.com/article/10.1007/s11892-020-01373-1">diabetes</a> and <a href="https://doi.org/10.5664/jcsm.6288">hypertension</a> as well as depression, suicidality and substance abuse. It’s also linked to <a href="https://pubmed.ncbi.nlm.nih.gov/22545685/">deficits in attention and memory skills</a>. </p>
<figure class="align-center ">
<img alt="A youth in a face mask has his head laid down on a desk." src="https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/420873/original/file-20210913-15-1jlodya.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Inadequate sleep is linked with a host of negative outcomes in youth.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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</figure>
<p>Importantly, research points to a key role for sleep in academic performance: teens who have <a href="https://doi.org/10.1111/jsr.12373">irregular or poor quality sleep may have worse grades</a> and <a href="https://doi.org/10.1111/josh.12388">be absent or late more often</a>. Chronic sleep deprivation may not only increase a young person’s risk for health challenges down the road but also may potentially affect their career opportunities and future earning potential.</p>
<h2>Ready to wake two hours after adults</h2>
<p>Sleep deprivation, recognized by the <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-adults-getting-enough-sleep-infographic.html">Public Health Agency of Canada</a> and the <a href="https://www.cdc.gov/sleep/about_us.html">Centers for Disease Control</a> as a significant concern for public health, is alarmingly common in teens. </p>
<p>Contributing to teens’ vulnerability to sleep deprivation is a conflict between traditional school start times (<a href="https://doi.org/10.1111/jsr.12475">as early as 8 a.m. in some parts of Canada</a>) and <a href="https://doi.org/10.1016/j.adolescence.2018.06.001">normal developmental changes in the sleep cycle</a> that lead the average teen feeling ready to sleep and wake about two hours later than younger children and adults. </p>
<p>Adding to this mix are other factors like <a href="https://doi.org/10.1371/journal.pone.0112199">teens’ greater independence in choosing their bedtimes</a> and use of light-emitting screens, which, when used in the evening, can <a href="https://pubmed.ncbi.nlm.nih.gov/27802500/">disrupt nighttime sleep and delay the body’s internal clock</a>. </p>
<p>Sleep researcher Mary Carskadon has described this combination of biological, behavioural and social influences as a “<a href="https://doi.org/10.1016/j.adolescence.2018.06.001">perfect storm</a>” that creates prime conditions for teens to accumulate a “sleep debt” during the school week. This makes many of them too sleepy to participate effectively in the classroom and leads to binge sleeping on the weekends. </p>
<p>As a way of calming this storm, some school districts have experimented with later school start times. Overall, these experiments have been largely successful, with <a href="https://doi.org/10.1016/j.sleep.2018.09.020">students reporting more nightly sleep</a> and <a href="https://doi.org/10.1111/jsr.12475">less sleepiness in the classroom</a> with later start times. </p>
<p>In view of this evidence, organizations such as the <a href="https://pediatrics.aappublications.org/content/134/3/642">American Pediatric Society</a> and the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.6558">American Academy of Sleep Medicine</a> recommend that high schools not start class before 8:30 a.m.</p>
<p>Other interventions like introducing sleep health education programs into the classroom have also shown <a href="https://pubmed.ncbi.nlm.nih.gov/27448478/">benefits for children</a> and somewhat <a href="https://doi.org/10.1111/sbr.12016">for teens</a>. For example, one study of Grade 12 students showed that short-term, classroom-based educational programming improved students’ knowledge of the role of sleep in health. These students also spent more time in bed on weeknights compared to students not receiving the programming. However, these benefits of participating in the program did not translate into changes that reduced students’ daytime sleepiness. </p>
<figure class="align-center ">
<img alt="Students in face masks walk to school on the street." src="https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/420869/original/file-20210913-21-l8itto.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Students have reported more nightly sleep and less sleepiness in the classroom with later school start times.</span>
<span class="attribution"><span class="source">(AP Photo/Marta Lavandier)</span></span>
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</figure>
<h2>Pandemic: More sleep, disrupted sleep</h2>
<p>The conditions during COVID-19 lockdown periods opened a unique window for observing teen sleep patterns when students no longer needed to commute to the classroom. Several studies showed that <a href="https://doi.org/10.1016/j.sleep.2021.04.010">teens were sleeping more because they could sleep later into the mornings</a>, and <a href="https://doi.org/10.1016/j.sleep.2020.09.015">felt more rested and alert during online schooling</a>, suggesting that additional sleep helped them to engage in their studies. </p>
<p>It’s important to note that <a href="https://doi.org/10.1016/j.sleep.2020.06.001">other studies reported more disrupted sleep in some teens</a>, which may have been due in part to anxiety, depressed mood and fewer opportunities to get outside. </p>
<p>However, having the opportunity to rest a little later into the morning could allow teens to offset some effects of a disturbed night of sleep. Taken together, what we’ve learned both about teens sleeping more and teens’ sleep being disrupted during the pandemic adds more evidence in favour of greater flexibility in school scheduling to improve teen sleep health.</p>
<h2>Pandemic schooling shifts</h2>
<p>While some schools have planned schedules to accommodate things like physical distancing and class bubbles, <a href="https://doi.org/10.1016/j.sleep.2020.09.015">could this be an opportunity to test out delayed or flexible school start times</a>? </p>
<p>Staggering school start times across the day, for example, could offer a double benefit of allowing later-rising students to begin their school day a little later and reducing the number of students in school at any one time, thereby promoting physical distancing and perhaps <a href="https://www.startschoollater.net/uploads/9/7/9/6/9796500/brookings_study_on_later_start_times_0911.pdf">better distribution of resources across the day</a>. </p>
<p>School districts in some <a href="https://theconversation.com/more-sleep-less-traffic-heres-what-we-know-about-the-benefits-of-staggered-school-start-and-finish-times-164313">other parts of the world</a> are undertaking this plan, and it will be exciting to see how scheduling changes play out. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/how-much-sleep-do-teenagers-really-need-111797">How much sleep do teenagers really need?</a>
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</em>
</p>
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<p>Policy change is slow, however, so what can be done now to improve teens’ sleep health? Adopting <a href="https://sleeponitcanada.ca/all-about-sleep/age-specific-dos-and-donts/">sleep recommendations</a> can help put healthier sleep routines in place. </p>
<p>Parents can’t go wrong with guiding teens through basics like turning off screens at least an hour before bedtime, encouraging regular periods of activity outside in daylight, limiting daytime caffeine intake (including energy drinks) — and trying to maintain a regular daily bedtime and wake-up time, even on weekends. </p>
<p>Excellent bilingual resources are also available through campaigns such as <a href="https://sleeponitcanada.ca/">“Sleep On It!”</a> (developed by the <a href="https://www.cscnweb.ca/?set_lang=en">Canadian Sleep and Circadian Network</a>), the <a href="https://css-scs.ca/">Canadian Sleep Society</a>, <a href="https://fondationsommeil.com/">Fondation Sommeil</a> and <a href="https://www.wakeupnarcolepsy.org/">Wake Up Narcolepsy Canada</a>.</p><img src="https://counter.theconversation.com/content/165918/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Suzanne Hood does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Could we capitalize on disruption schedules during the pandemic to make evidence-based changes in school start times to improve teens’ sleep?Suzanne Hood, Associate Professor of Psychology, Bishop's UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1442472020-08-20T08:56:35Z2020-08-20T08:56:35ZFitness levels in teenagers linked to where they grow up – new research<figure><img src="https://images.theconversation.com/files/353619/original/file-20200819-43015-1oaor7e.jpg?ixlib=rb-1.1.0&rect=15%2C0%2C5160%2C3453&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Green spaces near schools was also linked to higher fitness levels in teens.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/urban-bicycle-teenage-girl-boy-cycling-603987185">Jacek Chabraszewski/ Shutterstock</a></span></figcaption></figure><p>The places and communities that we live in play an important role in our physical health. What we have access to on our doorstep is important to motivating – or preventing – our physical activity levels. This is especially the case for <a href="http://www.psi.org.uk/docs/7350_PSI_Report_CIM_final.pdf">young people</a>, who are less able to travel outside the community in which they live. Given that being active during our childhood and teenage years can affect our health even in <a href="https://www.theguardian.com/lifeandstyle/2017/aug/28/young-at-heart-why-children-who-exercise-become-healthier-adults">adulthood</a>, it’s important that teens are able to exercise near where they live.</p>
<p>We wanted to understand how where teenagers live influences their activity levels and fitness. We used mapping via <a href="https://www.nationalgeographic.org/encyclopedia/geographic-information-system-gis/#:%7E:text=12th%20Grade-,A%20geographic%20information%20system%20(GIS)%20is%20a%20computer%20system%20for,understand%20spatial%20patterns%20and%20relationships.">Geographic Information Systems (GIS)</a>, and compared it against baseline data on <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4554-7">teenage activity levels</a> to understand how active teens are in different communities. </p>
<p>We also collected data on physical activity with accelerometers (which showed us how many minutes teenagers spent active either at low, medium or high intensities, or being sedentary), fitness levels with the <a href="https://www.verywellfit.com/fitness-test-for-endurance-12-minute-run-3120264">Cooper Run Test</a> (a 12-minute walk/run test when teenagers try and complete as many laps of their school sports hall), and blood pressure levels. We also monitored exercise motivation with a questionnaire. </p>
<p>We explored how the distance from a young person’s home and school to leisure centres or active travel infrastructure (such as footpaths and cycle paths), as well as distance from public transport and natural spaces (including parks and woods) affect activity and fitness levels. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237784">We found</a> that teenagers often need to travel from home to be active and that green space near schools increases activity levels. We also discovered that teens from more deprived neighbourhoods are fitter.</p>
<h2>Physical activity and fitness</h2>
<p>Our research showed that teenagers (especially girls) were more active if their homes were closer to public transport. This might be because those living near transport links may not have a car. It might also indicate teens are willing to travel to <a href="https://theconversation.com/six-ways-to-get-teenagers-more-active-suggested-by-the-teens-themselves-90980">do things they like</a>, or that they get more activity while travelling to school or to see friends. </p>
<p>But being able to travel to physical activities doesn’t lessen the importance of local opportunities. Creating opportunities to be active within a community can improve fitness levels, and may be more accessible to people who might not be able to afford public transport. </p>
<p>We also found that teenagers performed better on the Cooper Run Test if their school was closer to green spaces. Schools near green spaces may be able to provide better, more active PE classes and outdoor breaks for students. Green space may also facilitate outdoor, active learning. All of these may improve overall fitness. </p>
<p>Green spaces near schools may also provide a safe place for young people to cycle, or spend time with friends after school. Schools with better access to natural spaces may also be in less urban areas, thus further away from high traffic areas. Having a safe area to be active is likely to allow young people to be more independent in their community. </p>
<p>Our findings also show that improving activity and improving fitness are not intrinsically linked, in that time spent sitting or lying down increases as physical activity does. This is especially the case with boys. It might be that teens who take part in structured, competitive sports may also have high periods of inactivity outside formal training periods. They perhaps feel they need to rest in between. So being active in this way may not mean that teenagers are fitter. </p>
<figure class="align-center ">
<img alt="Groups of teens playing basketball." src="https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/353620/original/file-20200819-42976-p07tpc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Playing structured or competitive sports didn’t necessarily increase fitness levels.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-teenagers-play-basketball-on-playground-310184831">Sergey Novikov/ Shutterstock</a></span>
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</figure>
<p>This would suggest that we should promote different types of activity (such as walking and yoga), which benefit both <a href="https://link.springer.com/article/10.1186/s12966-017-0601-0">cardiovascular health and fitness</a>, and may get teens moving outside of structured activities. Improving access to a <a href="https://www.ajpmonline.org/article/S0749-3797(19)30447-7/fulltext">variety of activities</a> within the community will promote physical activity and improve health. </p>
<p>Another finding from our study was that teenagers from more deprived areas are more fit – especially teenage girls. Despite being less likely to <a href="https://www.huffingtonpost.co.uk/entry/how-to-encourage-girls-sport_uk_5a704e2ce4b0a52682ff3da0">participate in structured activities</a>, such as competitive sports, it may be that teens from less afluent areas are active out of necessity – such as needing to walk or cycle to school. </p>
<p>With this in mind, communities should focus on promoting and maintaining active travel and infrastructure, such as cycle paths, pavements and car-free zones. Creating affordable opportunities for activity and giving teens a space to spend time with their friends locally may also continue to improve fitness levels.</p>
<p>The key findings of our research are important to consider. Our research shows which activities teens use to keep fit, and which factors influence their fitness levels. These findings might inform communities and help them create more opportunities to be active other than through travel. Creating more places locally for young people to <a href="https://www.tandfonline.com/doi/full/10.1080/23748834.2020.1795386">live, play, and connect</a> with friends and family might be one way communities can create more opportunities for teens to be active. </p>
<p>Our research also revealed the extent to which the school setting affects teenagers’ activity levels. What we found suggests that schools should be used as a hub for the community in order to improve fitness. Currently, school grounds are underused for play and physical activity when the teaching day ends. For teenagers, who are often less physically active, having a space for after-school activities is essential for improving fitness levels.</p>
<p>Being physically active from a young age can create <a href="https://www.gosh.nhs.uk/medical-information/general-health-advice/leading-active-lifestyle/exercise-children-and-young-people">lifelong habits</a> that can prevent against poor health later in life. Creating more opportunities for activity within our communities will improve health for all.</p><img src="https://counter.theconversation.com/content/144247/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michaela James receives funding from the National Centre for Population Health and Wellbeing Research (NCPHWR). This work was funded by the British Heart Foundation. </span></em></p><p class="fine-print"><em><span>Sinead Brophy receives funding from Health Care Research Wales and this work was funded by a grant from the British Heart Foundation.</span></em></p>Living near green spaces, or growing up in a deprived neighbourhood, were both linked to higher fitness levels among teens.Michaela James, Research Assistant in Childhood Physical Activity, Swansea UniversitySinead Brophy, Professor in Public Health Data Science, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1291332020-01-23T13:51:51Z2020-01-23T13:51:51ZIs it OK for teens to drink coffee?<figure><img src="https://images.theconversation.com/files/309310/original/file-20200109-80111-j91cm7.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C7688%2C3118&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Too much caffeine interferes with sleep.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/teenager-girl-dressing-gown-over-pink-1450721138">Luis Molinero/Shutterstock.com</a></span></figcaption></figure><figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/us/topics/curious-kids-us-74795">Curious Kids</a> is a series for children of all ages. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskidsus@theconversation.com">curiouskidsus@theconversation.com</a>.</em></p>
<hr>
<blockquote>
<p><strong>Is it OK for teens to drink coffee? – Lucy G., Arlington, Virginia</strong></p>
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<p>When my daughter was around 14 years old, she began to ask if she could have a <a href="https://theconversation.com/the-biology-of-coffee-129179">cup of coffee</a> in the morning like Mom and Dad. As a scientist who studies the <a href="http://sphhp.buffalo.edu/nutrition-and-health-research.html">effects of caffeine</a> – the ingredient in coffee that helps wake you up – on kids, I had more information available to me to inform my answer than most parents would.</p>
<p>Many kids and teens consume caffeine. The main source of this chemical is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288269/pdf/102.pdf">soda for children under 12</a>. Even colas have <a href="https://cspinet.org/eating-healthy/ingredients-of-concern/caffeine-chart">lower levels of caffeine than tea or coffee</a>. </p>
<p>Kids and teens can also get caffeine from many foods and drinks, including <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288269/pdf/102.pdf">chocolate, chocolate milk and iced tea</a>. What’s more, <a href="https://www.clinicalnutritionjournal.com/article/S0261-5614(18)30134-1/pdf">some over-the-counter medications</a> that kids might take, such as Excedrin, are significant sources of caffeine. But coffee is the main source of caffeine among Americans 12 years and up.</p>
<p>Based on my years of research, I’m confident that one daily cup of coffee won’t harm <a href="https://www.sciencedirect.com/science/article/pii/S0890856718318847?via%3Dihub">kids over the age of 12</a> – as long as they avoid all other sources of caffeine.</p>
<p>That one cup of coffee combined with, say, a can of iced tea or soda, or a chocolate bar, could put kids over the daily limit of <a href="https://healthblog.uofmhealth.org/childrens-health/parents-perk-up-to-dangers-of-caffeine-for-teens">100 milligrams</a> of caffeine doctors recommend. Adults should aim for no more than <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678">400 milligrams of caffeine</a>, which they could get from four cups of coffee.</p>
<p>And since caffeine is in so many different foods and drinks, it’s easy for kids – or grownups – to get more than they should without realizing it.</p>
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<h2>Side effects</h2>
<p>Having too much caffeine can have many negative effects on kids, like putting them in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663646/">bad mood</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359329/">depriving them of sleep</a> and contributing to misbehavior, such as <a href="https://doi.org/10.1177%2F0269881117691568">risk-taking</a> and <a href="https://doi.org/10.1100/tsw.2008.82">aggression</a>.</p>
<p>Coffee can also make some kids feel <a href="https://psycnet.apa.org/record/1997-39117-009">jittery, nervous and anxious or nauseated</a>. It can change their <a href="https://pediatrics.aappublications.org/content/134/1/e112.long">heart rate and blood pressure</a>. In some cases, overcaffeination may make kids feel like they’ve used <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663646/">illicit drugs</a>.</p>
<p>The threat to sleep might not sound like the most serious of all of these side effects to you. But it could be. The National Sleep Foundation, a nonprofit that funds and conducts research on sleep, recommends that <a href="https://www.sciencedirect.com/science/article/pii/S2352721815001606?via%3Dihub">teens get about nine hours of sleep per night</a>. But studies show that on average <a href="https://www.sciencedirect.com/science/article/pii/S1389945708003134">kids get much less sleep than that</a>.</p>
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<h2>Old myths</h2>
<p>Some adults may tell kids that drinking caffeine will stunt their growth.</p>
<p>There are two reasons why some people think that. First, caffeine can <a href="https://doi.org/10.1093/jn/123.9.1611">decrease the amount of calcium in your bones</a>, which people used to think would make you not grow as tall.</p>
<p>Second, caffeine consumed later in the day can reduce sleep. <a href="https://doi.org/10.1203/00006450-198911000-00003">Growth hormone</a>, which makes you grow, is released early in sleep, so the idea was that less sleep would lead to less growth.</p>
<p>It turns out that neither of these concerns was valid. One study that followed 81 adolescents for six years found no connection between <a href="https://doi.org/10.1080/07315724.1998.10718793">caffeine and bone density</a>. Another study found <a href="https://doi.org/10.1002/ajhb.20405">no association between sleep duration and growth</a>. </p>
<p>Based on the best science that is available, I’ve been allowing my three children to have one cup of coffee first thing in the morning once they turn 12. It is important to think about what else they’re getting with their coffee, however. Some of the sweet iced and flavored coffee drinks, such as Starbucks Frappuccinos, that are popular with kids have over <a href="https://www.starbucks.com/menu/product/424/iced?parent=%2Fdrinks%2Ffrappuccino-blended-beverages%2Fcoffee-frappuccino">50 grams of sugar</a>. And consuming <a href="https://theconversation.com/sugar-isnt-just-empty-fattening-calories-its-making-us-sick-49788">too much added sugar</a> can also have negative health consequences.</p>
<p>Any negative effects of the caffeine they get from that morning jolt wear off long before bedtime. But I don’t let them have any caffeine-containing products after 3 p.m. to protect their sleep.</p>
<hr>
<p><em>Hello, curious kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to <a href="mailto:curiouskidsus@theconversation.com">CuriousKidsUS@theconversation.com</a>. Please tell us your name, age and the city where you live.</em></p>
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<p class="fine-print"><em><span>Jennifer L. Temple receives funding from the National Institutes of Health.</span></em></p>Since caffeine is in so many different foods and drinks, it’s easy for kids – or grownups – to get more than they should without realizing it.Jennifer L. Temple, Associate Professor of Nutrition; Director, Nutrition and Health Research Laboratory, University at BuffaloLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1297322020-01-16T19:27:51Z2020-01-16T19:27:51ZWhy teen depression rates are rising faster for girls than boys<figure><img src="https://images.theconversation.com/files/310063/original/file-20200114-151829-k7iq4s.jpg?ixlib=rb-1.1.0&rect=0%2C460%2C4966%2C3843&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">One-fifth of U.S. teen girls reported experiencing major depression in 2017.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/sad-unhappy-teenage-girl-young-woman-1298221180">Tgraphic/Shutterstock.com</a></span></figcaption></figure><p>We’re in the middle of a teen mental health crisis – and girls are at its epicenter.</p>
<p>Since 2010, depression, self-harm and suicide rates have increased among teen boys. But rates of major depression among teen girls in the U.S. <a href="https://doi.org/10.1037/abn0000410">increased even more</a> – from 12% in 2011 to 20% in 2017. In 2015, <a href="https://jamanetwork.com/journals/jama/fullarticle/2664031">three times</a> as many 10- to 14-year-old girls were admitted to the emergency room after deliberately harming themselves than in 2010. Meanwhile, the suicide rate for adolescent girls <a href="https://www.cdc.gov/mmwr/volumes/66/wr/mm6630a6.htm">has doubled since 2007</a>. </p>
<p>Rates of depression started to tick up just as smartphones became popular, so digital media could be playing a role. The generation of teens born after 1995 – known as <a href="https://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501152016">iGen</a> or Gen Z – were the first to spend their entire adolescence in the age of the smartphone. They’re also the first group of teens to experience social media <a href="https://www.apa.org/pubs/journals/releases/ppm-ppm0000203.pdf">as an indispensable part of social life</a>.</p>
<p>Of course, both boys and girls started using smartphones around the same time. So why are girls experiencing more mental health issues? </p>
<p><a href="https://doi.org/10.1016/j.adolescence.2019.12.018">Mining three surveys of more than 200,000 teens in the U.S. and U.K.</a>, my colleagues and I were able to find some answers.</p>
<h2>The screens we use</h2>
<p>We found that teen boys and girls spend their digital media time in different ways: Boys spend more time gaming, while girls spend more time on their smartphones, texting and using social media. </p>
<p>Gaming involves different forms of communication. Gamers often interact with each other in real time, talking to each other via their headsets. </p>
<p>In contrast, social media often involves messaging via images or text. Yet even something as simple as a brief pause before receiving a response <a href="https://www.vice.com/en_us/article/pavnbb/texting-anxiety">can elicit anxiety</a>.</p>
<p>Then, of course, there’s the way social media creates a hierarchy, with the number of likes and followers wielding social power. Images are curated, personas cultivated, texts crafted, deleted and rewritten. All of this can be stressful, and one study found that simply comparing yourself with others on social media <a href="https://doi.org/10.1521/jscp.2014.33.8.701">made you more likely to be depressed</a>. </p>
<p>And, unlike many gaming systems, smartphones are portable. They <a href="https://doi.org/10.1016/j.jesp.2017.10.007">can interfere with face-to-face social interaction</a> or be brought into bed, two actions that have been found to undermine mental health and <a href="https://doi.org/10.1016/j.sleep.2018.11.009">sleep</a>. </p>
<h2>Are girls more susceptible than boys?</h2>
<p>It’s not just that girls and boys spend their digital media time on different activities. It may also be that social media use has a stronger effect on girls than boys. </p>
<p>Previous research revealed that <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2749480">teens who spend more time on digital media are more likely to be depressed</a> <a href="https://www.doi.org/10.1007/s11126-019-09630-7">and unhappy</a>. In our new paper, we found that this link was stronger for girls than for boys. </p>
<p>Both girls and boys experience an increase in unhappiness the more time they spend on their devices. But for girls, that increase is larger. </p>
<p>Only 15% of girls who spent about 30 minutes a day on social media were unhappy, but 26% of girls who spent six hours a day or more on social media reported being unhappy. For boys, the difference in unhappiness was less noticeable: 11% of those who spent 30 minutes a day on social media said they were unhappy, which ticked up to 18% for those who spent six-plus hours per day doing the same.</p>
<p>Why might girls be more prone to unhappiness when using social media? </p>
<p>Popularity and positive social interactions <a href="https://doi.org/10.1111/j.1467-8624.2010.01521.x">tend to have a more pronounced effect</a> on teen girls’ happiness than boys’ happiness. Social media can be both a cold arbiter of popularity and a platform for bullying, shaming and disputes. </p>
<p>In addition, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6099106/">girls continue to face more pressure about their appearance</a>, which could be <a href="https://doi.org/10.1002/eat.22141">exacerbated by social media</a>. For these reasons and more, social media is a more fraught experience for girls than for boys.</p>
<p>From this data on digital media use and unhappiness, we can’t tell which causes which, although <a href="https://doi.org/10.1037/ppm0000178">several experiments</a> <a href="https://doi.org/10.1521/jscp.2018.37.10.751">suggest that digital media use does cause unhappiness</a>. </p>
<p>If so, digital media use – especially social media – might have a more negative effect on girls’ mental health than on boys’.</p>
<h2>Looking ahead</h2>
<p>What can we do? </p>
<p>First, parents can help children and teens postpone their entry into social media. </p>
<p>It’s actually <a href="https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/childrens-online-privacy-protection-rule">the law that children can’t have a social media account in their own name until they are 13</a>. This law is rarely enforced, but parents can insist that their children stay off social media until they are 13.</p>
<p>Among older teens, the situation is more complex, because social media use is so pervasive. </p>
<p>Still, groups of friends can talk about these challenges. Many are probably aware, on some level, that social media can make them feel anxious or sad. They might agree to call each other more, take breaks or let others know that they’re not always going to respond instantly – and that this doesn’t mean they are angry or upset.</p>
<p>We’re learning more about the ways <a href="https://www.theguardian.com/technology/2017/nov/09/facebook-sean-parker-vulnerability-brain-psychology">social media has been designed to be addictive</a>, with companies making more money the more time users spend on their platforms. </p>
<p>That profit may be at the expense of teen mental health – especially that of girls.</p>
<p>[ <em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://theconversation.com/us/newsletters/weekly-highlights-61?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=weeklysmart">You can get our highlights each weekend</a>. ]</p><img src="https://counter.theconversation.com/content/129732/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jean Twenge has received speaking honoraria from for-profit and non-profit entities for presenting research.</span></em></p>New research finds that the different ways boys and girls use digital technology might explain the discrepancy.Jean Twenge, Professor of Psychology, San Diego State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1267692019-11-24T19:09:22Z2019-11-24T19:09:22ZTeens with at least one close friend can better cope with stress than those without<figure><img src="https://images.theconversation.com/files/302889/original/file-20191121-547-kpe3ae.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Girls reported less resilience in our study than boys.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/ch5QGWmDBFA">Caitlin Venerussi/Unsplash</a></span></figcaption></figure><p>Teenagers who have at least one close friendship are better able to bounce back from stress. This is one of the <a href="https://aifs.gov.au/publications/adolescents-resilience">latest findings</a> from the Growing Up In Australia study.</p>
<p><a href="https://growingupinaustralia.gov.au/">Growing Up in Australia</a> has been following the lives of around 10,000 children since 2004. In 2016, the older children in the study were aged 16–17. We asked them about aspects of their lives including their peers, school environment and mental health.</p>
<p>One aspect of teen well-being we looked at was resilience. This is the ability to bounce back from stressful life events and learn and grow from them. </p>
<p>Stressful life events may include arguments with friends, sporting losses and disappointing test results. A more serious setback may be family breakdown, the illnesses or death of a family member, or being the victim of bullying. </p>
<p>Overall, teens said they displayed characteristics of resilience often, but boys significantly more so than girls. Our findings also show a strong relationship between not having a close friend and a low resilience score. </p>
<h2>Boys more resilient than girls</h2>
<p>Research <a href="https://www.vichealth.vic.gov.au/-/media/ResourceCentre/PublicationsandResources/Research/Youth-resilience_mental-wellbeing_Full-Report.pdf?la=en&hash=5D6C001F0B6BF33C246A967A9D13A6E5D5E22566">suggests a person’s resilience</a> is determined by a variety of factors. These include individual biological and psychological characteristics, relationships with family and peers, and environmental influences such as those in the school and broader community. </p>
<p>Our study asked teens to rate themselves on ten different aspects of resilience including their ability to adapt to change, how well they can achieve goals despite obstacles and how easily they are discouraged by failure. Together these gave a score from 0 to 40 (the higher the score, the higher the resilience).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/combatting-online-bullying-is-different-for-girls-and-boys-heres-why-91837">Combatting online bullying is different for girls and boys: here's why</a>
</strong>
</em>
</p>
<hr>
<p>The average total resilience score for adolescents was 26.5 out of 40. This suggests the “average” 16–17 year old views themselves as displaying resilient
characteristics often. </p>
<p>Boys had significantly higher resilience scores than girls – 27.6 out of 40 for boys compared to 25.5 for girls. For example:</p>
<ul>
<li><p>51% of boys and 37% of girls said they were not easily discouraged by failure</p></li>
<li><p>63% of boys and 45% of girls said they can usually handle unpleasant feelings</p></li>
<li><p>50% of boys and 39% of girls responded “often or nearly always true” to the statement “coping with stress can strengthen me”</p></li>
<li><p>67% of boys and 58% of girls felt they could (often or always) deal with
whatever comes.</p></li>
</ul>
<hr>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=458&fit=crop&dpr=1 600w, https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=458&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=458&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=575&fit=crop&dpr=1 754w, https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=575&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/303039/original/file-20191121-112975-17b61x0.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=575&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Longitudinal Study of Australian Children 2019</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<hr>
<p>It is possible that when answering the survey questions boys may be more likely to want to appear strong in the face of stress than girls. But <a href="https://www.ncbi.nlm.nih.gov/pubmed/19264325">other studies</a> have also shown significantly higher levels of resilience in boys.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-wish-you-were-murdered-some-students-dont-know-the-difference-between-bullying-and-banter-124272">'I wish you were murdered': some students don't know the difference between bullying and banter</a>
</strong>
</em>
</p>
<hr>
<h2>Close relationships make kids stronger</h2>
<p>We also looked at how supportive environments – such as family, school community and friends – affected teens’ resilience. </p>
<p>Of the 16–17 year olds we interviewed, 84% said they had at least one good friend. These teens had average resilience scores of 27, compared to 23 for the 16% who said they did not have a good friend (this is a statistically significant difference).</p>
<p>We also found the nature of the friendship important. Average resilience scores were higher for teenagers who had</p>
<ul>
<li><p>high levels of trust in their friends — average resilience scores were three points higher than for those with low levels of trust</p></li>
<li><p>good communication with their friends — average resilience scores were 3.5 points higher, compared to those who reported poorer communication.</p></li>
</ul>
<hr>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=305&fit=crop&dpr=1 600w, https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=305&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=305&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=383&fit=crop&dpr=1 754w, https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=383&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/303037/original/file-20191121-112990-19dnfmh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=383&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Longitudinal Study of Australian Children 2019</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<hr>
<p>The flipside to having a close friend is being a victim of bullying. The average resilience scores of teens who had been bullied in the previous 12 months were almost two points lower than those who had not. </p>
<p>But even the harmful experience of being bullied is not as damaging to teens’ resilience as not having a close friend to confide in. A good friend raised average resilience scores by four points.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/adolescence-can-be-awkward-heres-how-parents-can-help-their-child-make-and-maintain-good-friendships-107362">Adolescence can be awkward. Here's how parents can help their child make and maintain good friendships</a>
</strong>
</em>
</p>
<hr>
<p>We also found teens who felt close to their parents and other family members had higher resilience. </p>
<p>Around 16% of young people lacked family support consistently through their early adolescent years (10–13 years old) and these teens reported significantly lower resilience levels at age 16–17. </p>
<p>Lacking family support means a teen doesn’t have people in their immediate or extended family who they trust when they want to talk about things that upset or worried them.</p>
<p>The average resilience score at age 16–17 for those who lacked family support in early or mid-adolescence was 25.3, compared to 26.8 for those who had support at one or both ages.</p>
<p>Our findings do not demonstrate a causal relationship between friendship and resilience. Because teens reported on friendships and resilience at the same time, it was not possible to tell whether those who have no close friends were so because they were less resilient, or whether they were less resilient because they had no close friends.</p>
<p>But our findings do highlight the vulnerability of teenagers lacking close relationships.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/poor-kids-hit-puberty-sooner-and-risk-a-lifetime-of-health-problems-78178">Poor kids hit puberty sooner and risk a lifetime of health problems</a>
</strong>
</em>
</p>
<hr>
<p>Resilience <a href="https://www.edcan.ca/wp-content/uploads/EdCan-2009-v49-n3-Masten.pdf">can change</a> as people interact with and respond to other people in their lives and their environments. This creates opportunities to promote resilience in young people in different settings.</p>
<p>For anyone caring for or working with teens, a key finding from our research is that one of the best things you can do to foster resilience in a young person is to help them find and make friends. One good friend can make a big difference.</p><img src="https://counter.theconversation.com/content/126769/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Resilience is the ability to bounce back from stressful life events. Teenagers with at least one close friend and strong family relationships are more resilient than teens without such relationships.Tracy Evans-Whipp, Research Fellow, Australian Institute of Family StudiesConstantine Gasser, Senior Research Officer, Australian Institute of Family StudiesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1261202019-11-01T14:36:14Z2019-11-01T14:36:14ZHeart disease risk starts young – improving teenager health is essential<figure><img src="https://images.theconversation.com/files/299847/original/file-20191101-88399-1obpkps.jpg?ixlib=rb-1.1.0&rect=0%2C28%2C6306%2C4169&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Learning health habits in your teens can help protect you from developing heart disease in adulthood. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/streetball-basketball-game-two-players-teenagers-1310688317?src=ShcKUbEjWFklM7Ys9LiDvg-1-67">VH-studio/ Shutterstock</a></span></figcaption></figure><p>Heart disease causes an <a href="https://www.who.int/health-topics/cardiovascular-diseases/">estimated 31% of all deaths worldwide</a> each year. While the condition is often associated with older adults, rising childhood inactivity and poor fitness levels mean that the risk factors associated with heart disease are more common among teenagers <a href="https://www.acls.net/cardiac-disease-in-the-young.htm">than most people think</a>. </p>
<p><a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-764">Research has found</a> young people from lower-income backgrounds are more likely to be unfit and have a family history of obesity, which increases the likelihood of developing heart disease in later life. However, most cases of heart disease can be prevented by <a href="https://www.bhf.org.uk/informationsupport/risk-factors">managing these risk factors</a>. Developing healthy habits as a teenager might be one way of ensuring a healthy heart in later life. </p>
<p><a href="https://openheart.bmj.com/content/6/2/e001147.full">Our study</a> aimed to provide more clarity on what factors can predict the likelihood of developing heart disease in later life – and how we can prevent it. We looked at 234 teenagers aged 13 to 14 from seven secondary schools in deprived areas of South Wales. This was part of a <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4554-7">bigger study</a> looking at the physical activity of young people from lower-income families. </p>
<p>The <a href="https://www.nhs.uk/conditions/coronary-heart-disease/causes/">leading causes</a> of heart problems are stiff arteries, high blood pressure, sedentary lifestyles and being overweight. We measured how stiff participants’ arteries were using a method called <a href="https://www.futuremedicine.com/doi/full/10.1517/14796678.1.1.69">pulse wave analysis</a>. We also looked at their blood pressure and fitness. These were our heart health measures. </p>
<p>We combined our data with information from the <a href="https://saildatabank.com/about-us/overview/">SAIL databank</a>, a database of anonymised health information in Wales. We looked at health data of other 13- to 14-year-olds, including birth information, maternal health, child health examinations, GP visits and hospital admissions. This novel analysis approach allowed us to add to the relatively little research that has previously been done into early life and environmental impacts on young people’s heart health. What we found highlights important areas where we may improve long-term heart health.</p>
<p>Our study found that teenagers attending schools in deprived areas already had stiffer arteries by their early teens compared to pupils attending schools in less deprived areas. This could be down to food choices offered in school (low cost, processed and higher in salt and fat), increased exposure to smoking and <a href="https://www.bbc.co.uk/news/uk-wales-46280208">less time spent doing sport or PE</a>. Arterial stiffness is a major factor in developing heart disease, as stiffer arteries make it harder for blood to flow. Clots may also form in narrowed arteries. </p>
<p>However, we also made a number of surprising discoveries about this group of deprived teens that might help protect them from developing heart disease in the future. Interestingly, we discovered that these teenagers appeared fitter. We tested them using the <a href="https://en.wikipedia.org/wiki/Cooper_test">Cooper Run Test</a>, and found that they were able to run further in a given time.</p>
<p>Although these teenagers were less likely to do physical activity in the form of structured competitive sports clubs, we think they may be more likely to walk to school, making them more fit. This means the environment within the school (including what food is made available) is important, but so are the benefits of less structured, regular activities such as simply walking to school. Fitness does not need be associated with being in a structured, competitive environment but could be facilitated by different types of activity. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=506&fit=crop&dpr=1 754w, https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=506&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/299848/original/file-20191101-88399-1npth22.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=506&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A healthy diet and plenty of exercise contribute to a healthier heart.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/five-running-teenage-athletes-stadium-467789786?src=seX1jLTQuubJ_wCO9Doi4Q-1-11">Sergey Novikov/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Our study also found that children who were first born had even lower blood pressure and were fitter compared to those who were born later. <a href="https://www.sciencedirect.com/science/article/pii/S0160289614001500">There is some evidence</a> that first-borns have greater access to resources and parents’ attention, which might include more access to activity opportunities. This may account for better fitness measures. </p>
<p>We also found that older mothers (in relation to the age they had their child) have fitter children. Again, this could be due to greater access to resources. So providing support to larger, younger families might help give children and teens more chances to be active. Increased activity levels will help improve blood pressure and fitness. </p>
<p>Teenagers in the study whose mothers reported breastfeeding also had lower blood pressure. These findings add to increasing evidence supporting the <a href="https://academic.oup.com/ajcn/article/95/2/498/4576840">beneficial impact of breastfeeding on heart health</a>. So promoting the benefits of breastfeeding to mothers could help prevent poorer heart health for children in the future. </p>
<p><a href="https://academic.oup.com/ajcn/article/95/2/498/4576840">Research has shown</a> that longer duration breastfeeding has a beneficial effect on cardiorespiratory fitness. This is likely because breastfeeding is associated with <a href="https://www.unce.unr.edu/publications/files/hn/2010/fs1011.pdf">lower risk of becoming obese</a>, due to factors such as lower maternal BMI or higher educational levels. </p>
<p>We also found that the boys in our study were significantly fitter (they ran nearly 400m further than girls in the testing), despite the number of programmes targeting girls’ activity and fitness in recent years. Boys generally have a <a href="https://www.tandfonline.com/doi/abs/10.1080/09751270.2010.11885146">higher amount of lean body mass at this age</a>, which could contribute to better fitness levels. </p>
<p>This study provides further evidence that improving health in early life could improve teenagers’ heart health in later life. The school environment also has an important influence on adolescent health. This means that improving support for families and providing physical activity opportunities (particularly for girls) are key to improving heart health. Developing healthy habits as a teenager is essential for lifelong improvements in health.</p><img src="https://counter.theconversation.com/content/126120/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michaela James receives funding from the National Centre for Population Health and Wellbeing Research (NCPHWR). </span></em></p><p class="fine-print"><em><span>Sinead Brophy receives funding from Welsh Assembly Government, Medical Research Council, British Heart Foundation and the Economic and Social Research Council. </span></em></p>We found that 13- and 14-year-old teens from deprived areas already showed signs of developing heart disease – but also made some surprising discoveries about what factors can lead to a healthy heart.Michaela James, Research Assistant in Childhood Physical Activity, Swansea UniversitySinead Brophy, Professor in Public Health Data Science, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1117442019-02-17T19:00:09Z2019-02-17T19:00:09Z‘Is it normal to get sore down there after sex?’<figure><img src="https://images.theconversation.com/files/258949/original/file-20190214-1758-xx87dr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Sex should never hurt.</span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p><em><a href="https://theconversation.com/just-so-you-know-the-conversation-launches-a-qanda-service-for-teens-103432">I Need to Know</a> is an ongoing series for teens in search of reliable, confidential advice about life’s tricky questions.</em></p>
<hr>
<blockquote>
<p>Hi! I only recently have gotten a boyfriend and have started having regular sex. After 2 or more days, it starts to get a bit sore down there. Is that normal? I just assumed it was pain from friction, but I don’t know if that’s right and I’ve never sought help because it’s a bit embarrassing! </p>
<p>Sandra, 17, in Sydney</p>
</blockquote>
<h2>Key points</h2>
<ul>
<li>Sex should never hurt</li>
<li>if it does, tell the person to stop</li>
<li>get checked out by a GP or sexual health clinic to make sure it’s not something that needs to be treated – better safe than sorry.</li>
</ul>
<p>Hi, and thanks for your question! You’re not alone in finding that sex isn’t always straightforward. By sex, I assume you mean intercourse. What I’m not sure about is where you mean by “down there”. In a woman’s body, down there is lots of places!</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/259355/original/file-20190216-56215-1jr6979.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<hr>
<p>To start with, sex shouldn’t hurt, and if it does, a good tip is to say “stop”, no matter what! The aftermath of sex also shouldn’t hurt – whether it’s two minutes, two hours or two days later. </p>
<p>Even very vigorous intercourse where there’s lots of friction should not actually hurt. It can happen if there’s not enough natural (or artificial) lubrication or if there’s some muscle tension in the vagina. Both of these can be signs of not being fully aroused (turned on) beforehand or during sex, or being a bit anxious about having sex.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/female-sexual-dysfunction-or-not-knowing-how-to-ask-for-what-feels-good-34651">Female sexual dysfunction or not knowing how to ask for what feels good?</a>
</strong>
</em>
</p>
<hr>
<p>A new partner or relationship can bring some anxiety for each person. It can affect the way a woman’s body (or a man’s) gets aroused and how comfortable sex feels. Good communication with your partner about what feels good is really helpful. </p>
<p>If you have background worry about <a href="https://playsafe.health.nsw.gov.au/">sexually transmitted infections</a> (STIs) or pregnancy, that can definitely affect enjoyment of sex. Getting armed with <a href="https://www.fpnsw.org.au/health-information/individuals/under-25s">knowledge</a> and equipment to prevent any unwanted consequences of sex should be a routine part of getting into a relationship for both parties.</p>
<p>The cause of your pain also depends on where it is – is it at the opening of the vagina, or other parts of the vulva? Is it related to peeing, and is it always in the same place? </p>
<p>Inflammation (redness and soreness) can cause pain – this could be from inside the vagina such as with a thrush infection (which is not sexually transmitted) or from the skin in the vulva (which could be from dermatitis or a skin condition). </p>
<p>Some STIs cause pain in the genital area, for example herpes (caused by the cold sore virus), but you would be likely to notice the sores as well. A common STI such as chlamydia often has no symptoms, but could cause pain higher up in the pelvic area or when you wee. A condition known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014358/">vulvodynia</a> causes chronic pain, not just from having sex – it can also be triggered by the conditions mentioned above.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-controls-our-sex-drive-when-and-why-do-we-feel-like-sex-61159">Health Check: what controls our sex drive? When and why do we feel like sex?</a>
</strong>
</em>
</p>
<hr>
<p>You deserve to be enjoying a happy and healthy sex life, and not feeling embarrassed about one of the most natural experiences in the world – even if it’s not always going right. It’s important you do get personal advice, since this could be something that needs treatment. It would be good to have a doctor or sexual health clinic check up, and this can all be done completely confidentially.</p><img src="https://counter.theconversation.com/content/111744/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Melissa Kang does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sex isn’t always straightforward – especially not when you first start ‘doing it’. If you experience pain ‘down there’ after sex, you may need to have a medical checkup.Melissa Kang, Associate professor, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/993422018-07-17T10:47:10Z2018-07-17T10:47:10ZHow a positive outlook on the future may protect teens from violence<figure><img src="https://images.theconversation.com/files/227860/original/file-20180716-44088-wnb7qr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Hope and goals for the future, such as graduating from college, can help protect teens from turning to violence.</span> <span class="attribution"><span class="source">Georgia State University</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Youth violence is pervasive and has serious consequences for teens’ health and well-being. Based on a recent <a href="https://www.cdc.gov/healthyyouth/data/yrbs/index.htm">Centers for Disease Control and Prevention survey</a> of ninth to 12th graders in the U.S., 1 in 6 youth report carrying a weapon in the past 30 days, and 1 in 4 report being in a physical fight in the past year. Each year, over 200,000 youth seek care in emergency departments across the U.S. for <a href="https://www.cdc.gov/injury/">assault-related injuries</a>. Male teens in lower resource urban settings bear the highest burden of exposure to violence. </p>
<p>As an adolescent medicine doctor and researcher, I study how we can protect teens from violence. Most research has focused on factors that increase risks for violence, yet we know much less about factors that protect teens. According to new research my colleagues and I published in <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2685842">JAMA Pediatrics</a>, having a positive outlook on the future may protect male teens from violence perpetration. </p>
<h2>Future orientation and violence</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/227848/original/file-20180716-44100-1pgz25h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Teens who have hope and a future goal, such as going to college or being involved in their communities, are less likely to commit violence, a study suggests.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/school-bus-smiling-teen-student-others-199612325?src=_clOY-DdzKKFiO5kXutjFA-1-67">Sean Locke Photography/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Positive future orientation means having high hopes and plans for the future. This could include a broad range of ideas, such as plans to go to college, to pursue a certain career path, to excel in extracurricular activities, or to be engaged in improving one’s community. Previous studies <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827712/">have linked positive future orientation</a> to many important positive outcomes for youth, including doing well in school, avoiding illicit substances, and being less likely to engage in risky sexual behavior. This motivated our team to ask, “Can a positive outlook on the future protect teens from violence?” </p>
<p>To study links between future orientation and violence perpetration, we surveyed 866 male teens between the ages of 13 and 19 in lower resource neighborhoods in Pittsburgh. All of the teens were part of a community-based sexual violence prevention study. We asked them a series of questions before they started the intervention program about their aspirations, goals and contributions, as well as about their involvement in violence. For example, teens answered, “I trust my future will turn out well” and “It is important to me that I reach my goals.”</p>
<p>In the past nine months, two-thirds, or 66 percent, had been in a fight. More than one-fourth, or 29 percent, had threatened someone with a weapon, and 1 in 7, or 15 percent, had injured someone with a weapon.</p>
<p>Just over half, or 58 percent, of teens in the study had positive future orientation based on their answers to seven survey items. They answered that survey items such as, “My life will make a positive difference in the world,” were “a lot like me” or “exactly like me.”</p>
<p>We found that youth with positive future orientation were significantly less likely to report threatening someone with a weapon or injuring someone with a weapon in the past nine months. Teens with positive future orientation were 0.7 times less likely to report threatening someone with a weapon and 0.6 times less likely to report injuring someone with a weapon. </p>
<h2>What do the findings mean?</h2>
<p>Future orientation may help protect male teens in lower resource urban neighborhoods from violence. Many excellent programs, such as <a href="http://yes.sph.umich.edu/">Youth Empowerment Solutions</a>, are already working with youth in lower resource communities to reduce violence. Expanding programs that foster positive future orientation may be an important part of comprehensive youth violence prevention interventions. </p>
<p>It is important to consider how we can help youth develop positive future orientation and provide skills and opportunities for them to achieve their goals. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827712/">Family members and mentors are likely to play key roles</a> in supporting positive future orientation and reducing violence involvement. </p>
<p><a href="https://cdpsdocs.state.co.us/safeschools/Resources/CDC%20Centers%20for%20Disease%20Control%20Prevention/CDC%20Preventing%20Youth%20Violence%20one%20page%20summary%20sheet.pdf">A public health approach to youth violence prevention</a> requires thoughtful and sustained investment in communities and community-based interventions that recognize and support existing strengths. Investing in community infrastructure, building safe spaces where teens can spend time together, and creating career opportunities go hand in hand with promoting future orientation. I believe our findings, together with the work of other researchers and practitioners, show that it is essential to combine interventions that strengthen future orientation with meaningful opportunities for youth to engage in their communities and achieve their identified goals. In doing so, we can provide all teens with the opportunity to thrive.</p><img src="https://counter.theconversation.com/content/99342/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alison Culyba receives funding from the National Institutes of Health and the Academic Pediatric Association.
</span></em></p>Teens who have high hopes for the future were less likely to threaten or injure someone with a weapon, a recent study reports. Could helping youth build dreams for the future also curb violence?Alison Culyba, UPMC Children's Hospital; Assistant professor of pediatrics, University of PittsburghLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/702112016-12-15T19:21:40Z2016-12-15T19:21:40ZHow to be a healthy user of social media<figure><img src="https://images.theconversation.com/files/150049/original/image-20161214-18895-vfz4rn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Around half of young people are heavy social media users, with one in four teen users constantly connected. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/garryknight/8331105136/in/photolist-o9dz4K-dGc6iJ-duZ1b4-pQXWNX-ibbj7D-roLS89-fYWDir-59h4nh-7p1vwD-euYoS-7fJfcX-nRspxb-5Lfy7t-5eC9kP-4CArm6-bCUWtR-9sanNx-5M3JV4-59ywqw-bmBGag-drYR8E-7SLQGz-eCh5jy-8ZE6bh-8AZdSA-4dFcED-4dJwrs-FoGnm-qZuGev-BQHdGn-CgW4iP-CmUZTQ-u319iw-uZhPiR-Nok8gG-K6GLBz-czA9Gf-5SBvdW-9vfdi3-4MYA8z-8MbfM4-2qsT5-8HbrLk-qyeZmZ-qmcFYA-weKCqg">garryknight/flickr </a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>We can learn a lot about people through how they use social media. For example, Twitter language can be used to predict the <a href="http://newsroom.melbourne.edu/news/twitter-can-predict-hot-spots-coronary-heart-disease">risk of dying from heart disease</a>. </p>
<p>Analyses of Facebook updates show <a href="https://pursuit.unimelb.edu.au/articles/how-gender-shapes-our-facebook-chats">women tend to be warmer than men, but just as assertive</a>, and <a href="https://www.ncbi.nlm.nih.gov/pubmed/24322010">people high in extraversion</a> tend to express positive emotions, whereas those with neurotic tendencies are more likely to write about being lonely and depressed. </p>
<p>Concerns exist about the negative effects social media can have on mental health, <a href="http://pediatrics.aappublications.org/content/127/4/800.short">especially for young people</a>. </p>
<p>The incidence of <a href="http://theconversation.com/online-bullying-on-the-rise-in-australia-30213">cyberbullying</a>, <a href="http://theconversation.com/how-sexting-is-creating-a-safe-space-for-curious-millennials-56453">sexting</a> and <a href="http://theconversation.com/domestic-violence-and-facebook-harassment-takes-new-forms-in-the-social-media-age-50855">victimisation</a> has risen. People manage their profiles, presenting an image of a perfect life, while hiding real struggles they might have. Despite having thousands of “friends”, some people still <a href="http://www.sciencedirect.com/science/article/pii/S0747563216302552">feel completely alone</a>. </p>
<p>The potential for social media to be used to detect signs of mental illness is reflected in Facebook’s implementation of a <a href="https://www.facebook.com/help/contact/305410456169423">suicide watch program</a>. </p>
<h2>What to look for in your use of social media</h2>
<p>Is there a way to tell if your use of social media is healthy or reflective of underlying mental health conditions? </p>
<p>With my colleagues, PhD student Liz Seabrook and <a href="http://med.monash.edu/psych/school/staff/rickard.html">Dr Nikki Rickard</a>, we recently conducted <a href="http://mental.jmir.org/2016/4/e50/">a systematic review</a> of 70 different studies that linked social media use to depression, anxiety and mental well being. Turns out, <a href="https://pursuit.unimelb.edu.au/articles/is-social-media-good-for-you">social media is not all good, nor all bad</a>. It’s more about how you use it. </p>
<p>If you are concerned about your own social media use or that of a family member, here are some aspects to look out for. </p>
<h3>1. Content and tone</h3>
<p>One of the main things that distinguished users who reported high well-being versus those with depression or anxiety was what they wrote about and how they wrote it. </p>
<p>Depressed people used a lot more negative language, reflecting on things that were going wrong, or complaining about life or other people. They posted angry thoughts and emotions. </p>
<p>After writing a post, take a moment to read through it. What is the tone? Consider ways you can focus on some of the good things that happen in your life, not just the negative. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Social media users with depression behave differently online than those with good mental health.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/wentongg/2717345676/in/photolist-5987cw-dy1PDy-95nfYB-dP8PNB-f9Umke-eSzteS-nNyy6o-eSobAc-f9UmcB-ifE4Fq-7D7PPY-aahCHb-7erzYD-ifEpKT-66StMg-7sDr81-66WKbA-66StRH-66StQz-qfLgUa-8trz3H-jBdAco-8trz3p-7SsMXZ-gSMMUE-7SsMY2-7RFxr1-dPeqMb-81bVNH-7SsMXX-gSMN3W-aUDbS2-ERR39-7SsMXR-dt9Kj4-oSEczD-9UjV8m-gSNHBi-7YJNNo-poZma8-7QDAVM-5U8YVj-5U4C4H-6TeQEB-5U4Cj6-ke5x8P-ke5wU2-ke68en-BaDhoq-NZJ4uX">wentongg/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h3>2. Quality</h3>
<p>After a conversation with a friend, sometimes I feel really good about the conversation. Other times I don’t. </p>
<p>Similarly, we found the quality of interactions on social media made a big difference. Depression related to negative interactions with other people, being more critical, cutting others down or feeling criticised by others, and hostility. </p>
<p>In contrast, by supporting and encouraging others and feeling supported by them, it can help you feel good.</p>
<h3>3. Time online</h3>
<p><a href="https://www.psychology.org.au/psychologyweek/survey/results-fomo/">A recent Australian survey</a> found adults spend over two hours a day using social media. It also found more than 50% of young people are heavy social media users, with one quarter reporting being constantly connected. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1067&fit=crop&dpr=1 600w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1067&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1067&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1340&fit=crop&dpr=1 754w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1340&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1340&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Comparing yourself to Rebecca Judd may not support good mental health.</span>
<span class="attribution"><span class="source">Instagram/becjudd Dec 14 2016</span></span>
</figcaption>
</figure>
<p>In our review, some studies found depressed users spent more time online while other studies were inconclusive. </p>
<p>Notably, no study found spending more time online was a good thing. </p>
<p>This is something to keep on the radar as people spend more and more time connected to their devices. Many young people have a <a href="http://psychcentral.com/blog/archives/2015/10/12/fear-of-missing-out/">fear of missing out (FOMO)</a>, and thus stay constantly connected. Indeed, in our review we found feeling addicted to social media was associated with higher levels of depression. </p>
<p>We see growing evidence that <a href="https://www.youtube.com/watch?v=3gEZSD-2RIk">simplifying life</a>, including spending time offline, has health and well-being benefits. </p>
<p>If you feel concerned about how much time passes by while you are online, consider stepping away from social media for a few days. </p>
<h3>4. Passive versus active use</h3>
<p>Some people post many updates, providing blow-by-blow descriptions of their lives. Others read through news feeds, liking posts and passing interesting tidbits on to others. </p>
<p>In our review, simply reading posts and browsing news feeds did not positively or negatively impact well-being. </p>
<p>The difference was for active users: those who posted their thoughts and feelings and responded to others. People who were depressed posted a lot of negative content. Those who were happy actively engaged with other users, sharing their lives.</p>
<h3>5. Social comparisons</h3>
<p>Social media provides opportunities to compare ourselves with others, for better or for worse. </p>
<p>Social media can provide support groups that can help spur you on towards reaching a specific goal. For example, <a href="http://www.huffingtonpost.com/dan-collinson/are-you-up-to-the-strengths-challenge_b_9096378.html">the Strengths Challenge</a> used social networks to encourage people to look for good things about themselves and their co-workers, resulting in higher levels of well-being. </p>
<p>But comparing yourselves with others can also be quite destructive. Depressed individuals were more likely to see others as better than them. Envy plays a particularly destructive role. </p>
<p>If you find yourself jealous of friends and others in your network, it might be a good time to disconnect and find other sources to build up your self esteem. </p>
<h3>6. Motivation</h3>
<p>Why do you use social media? People who used social media to connect with friends felt it contributed to their well-being. </p>
<p>In contrast, those who were depressed sought out social support on social media, but felt like their friends were letting them down. </p>
<p>If you are feeling lonely and trying to fill a void through social media, it could be doing more harm than good. </p>
<h2>Take a good look at yourself</h2>
<p>Social media is here to stay. It offers a great way to connect with others, but can also exacerbate social anxieties that exist in the offline world. </p>
<p>So how do you best use social media? Take a few minutes to think about how social media makes you or your family and friends feel. Is it a positive addition to your life, or does it make you feel bad, consuming time and energy you could use in other ways? </p>
<p>By taking stock of your social media habits, it can help you choose ways – and encourage others – to use it in a manner that keeps you healthy.</p><img src="https://counter.theconversation.com/content/70211/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peggy Kern does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How you use social media can provide warning signs of depression or anxiety.Peggy Kern, Senior Lecturer in Positive Psychology, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/462252015-08-20T05:32:34Z2015-08-20T05:32:34ZWhen it comes to mental health, parents shouldn’t worry who their children are friends with<figure><img src="https://images.theconversation.com/files/92309/original/image-20150818-12433-11bwxzl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The only bad influence was on the kids' fashion sense.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/narisa/3412995806/">Narisa/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>When you’re a teenager, what your friends say and do really matter. Even for the most nonconformist adolescents, the clothes you wear, the music you listen to, whether or not you drink or take drugs, and even your attitudes and opinions about the world are often hugely influenced by your peers.</p>
<p>But does this effect extend to your mental health? Social factors such as living alone or experiencing abuse in childhood play a large role in whether someone becomes depressed. On the other side, <a href="http://bjp.rcpsych.org/content/196/2/96">social support</a> (having people to talk to) is important for recovery from depression. So can the social impact of being friends with people who are depressed drag you down as well? And does having a positive mood keep those around you in high spirits? </p>
<p>To answer these questions, my colleagues and I studied data on <a href="http://www.cpc.unc.edu/projects/addhealth">more than 2,000 adolescents</a> in a network of US high school students to see how their mood influenced each other. This involved modelling the spread of mood using similar methods to those used to track the spread of infectious diseases. </p>
<p>The difficulty with this method was the existence of examples that indicate something has spread when in reality it hasn’t (a false positive). In this case, a possible cause of false positives is the tendency for people to have friends who are like themselves. For example, if a group of friends all drink large amounts of alcohol and several become depressed it may be the alcohol rather than the friendships that cause the depression.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=481&fit=crop&dpr=1 600w, https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=481&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=481&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=604&fit=crop&dpr=1 754w, https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=604&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/92397/original/image-20150819-10873-1fk8wh7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=604&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Friendship protection.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>To deal with this issue, our analysis used longitudinal data (information recorded repeatedly over time). This allowed us to directly model changes in mood by noting each individual’s depression at one time point and whether or not this has changed at a second time point. This meant it did not matter what the other characteristics of the people were. </p>
<p>We found that depression does not “spread” between friends. But, on the other hand, having five or more friends with a healthy mood can halve the probability of developing depression over a six-to-12 month period. And having ten healthy-mood friends doubles the probability of recovering from depression compared to those who have just three such friends.</p>
<h2>“Spreading” moods</h2>
<p>It’s important to note that we don’t believe a healthy mood literally “spreads” like a disease but rather that it emerges from the behaviour of a complex social system. This behaviour is possible through a number of mechanisms. Research has shown people who are, or tend to be, depressed are <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0075655">less able to maintain a positive outlook</a> from moment to moment. For these individuals, having sufficient exposure and interaction with healthy friends could address this issue. This can keep their own mood healthy or aid their recovery.</p>
<p>Additionally, depression has been <a href="http://www.researchgate.net/publication/254078829_Misery_Does_Not_Love_Company_Network_Selection_Mechanisms_and_Depression_Homophily">associated with social withdrawal</a>, meaning that depressed individuals would be expected to exert less social influence than adolescents exhibiting a healthy mood. This offers a possible explanation for why we found that depression didn’t spread. </p>
<p>These findings show that when it comes to mental health, parents shouldn’t be worried about who their teenagers are friends with. Having depressed friends does not put them at risk, but having healthy friends is both protective and curative. What’s more, the research supports the idea that depression should be a public health issue rather than an individual one and should be used to help counter the stigma attached to the condition.</p>
<p>It also suggests that one cheap, low-risk way to tackle depression among young people would be to simply encourage friendships, for example by providing youth clubs. If every teenager had more friends it could go some way to providing them with a protective effect against mental health problems.</p><img src="https://counter.theconversation.com/content/46225/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Edward Hill receives funding from EPSRC.</span></em></p>New research shows that depression doesn’t spread between teenagers but having mentally healthy friends can protect you.Edward Hill, PhD candidate in mathematical epidemiology & complexity science, University of WarwickLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/442002015-07-06T05:14:40Z2015-07-06T05:14:40ZThe latest statistics on teenage births are missing a vital ingredient: fathers<figure><img src="https://images.theconversation.com/files/87359/original/image-20150703-20481-1gtp5fe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Out of the picture</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Teenage births are declining across <a href="http://www.bbc.co.uk/news/magazine-30275449">much of the developed world</a>. For example, the <a href="http://www.nisra.gov.uk/archive/demography/publications/annual_reports/2014/Table3.10_2014.xls">latest statistics</a> show teenage births in Northern Ireland, as in the rest of the UK, are experiencing a steady downward trend: from 1,791 in 1999 to 839 in 2014.</p>
<p>However, these figures only tell us about teenage births not teenage pregnancies. We don’t know how many teenagers in Northern Ireland have abortions. Retrictions mean most women who wish to terminate a pregnancy travel to other parts of the UK or Europe to do so or obtain “<a href="http://www.belfasttelegraph.co.uk/news/northern-ireland/belfast-woman-will-go-on-trial-for-helping-her-daughter-to-have-a-medical-abortion-31314912.html">abortion pills</a>” over the internet, leaving an incomplete picture of teenage pregnancies.</p>
<p>We do know that the rest of the UK still has one of the <a href="http://www.ons.gov.uk/ons/rel/vsob1/births-by-area-of-usual-residence-of-mother--england-and-wales/2012/sty-international-comparisons-of-teenage-pregnancy.html">highest rates of teenage pregnancy</a> in Europe, despite <a href="http://www.bbc.co.uk/news/health-31602417">recent falls</a>. Just under <a href="http://www.ons.gov.uk/ons/rel/vsob1/conception-statistics--england-and-wales/2013/stb-conceptions-in-england-and-wales-2013.html">25,000 women</a> under the age of 18 became pregnant in England and Wales in 2013 and approximately half of these opted for legal abortion. So it is likely that the rate of teenage pregnancy in Northern Ireland is quite a lot higher than the rate of teenage births.</p>
<p>However, the latest figures on births also tell us little about the fathers. Teenage pregnancy is often considered to be a woman’s problem, or a problem for women and children – or even society more broadly – but teenage men are rarely part of this picture.</p>
<h2>Counting the costs</h2>
<p>Of course, not all teenage pregnancies are unintended or unwanted. They can be a welcome and fulfilling aspect of many teenage women’s lives. Yet, when we do count the negatives, we only count these in terms of the adverse medical, educational and economic outcomes for teenage mothers and their children.</p>
<p>Also, when we count the costs, it is always in terms of the costs of “teenage mothers” to the exchequer. For example, we know that every year in England <a href="http://dera.ioe.ac.uk/6334/">approximately £26m</a> is paid in benefits to teenage mothers on income support. The Northern Ireland government has pinned the cost to the economy of each teenage mum at <a href="http://www.dhsspsni.gov.uk/dhssps_sexual_health_plan_front_cvr.pdf">£20,000 a year</a> based on income support plus tax revenue foregone with an approximate annual cost to the Exchequer of £25m.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/87360/original/image-20150703-20487-vgsn9k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sharing responsibility.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>But most births to teenage women are also births to teenage men. Teenage boys have a vital but neglected role in preventing unintended pregnancy and standing up to the responsibility of dealing with a teenage birth. <a href="http://www.qub.ac.uk/sites/media/Media,358434,en.pdf">Research shows</a> children with fathers who are involved in their lives do better in education, are happier (have higher self-esteem and life satisfaction) and have better relationships with childhood friends as well as relationships in adulthood. The children of involved fathers are also less likely to show problem behaviours such as delinquency and other criminal behaviours.</p>
<p>But to help men plan for parenthood in their lives we need to start educating young men at an earlier age. Boys are <a href="http://www.sciencedirect.com/science/article/pii/S0883035514000792">less likely</a> to receive relationship and sexuality education in schools in general and especially in relation to teenage pregnancy. The lack of resources for teaching boys about teenage pregnancy has prompted the World Health Organisation among others to <a href="http://www.euro.who.int/__data/assets/pdf_file/0008/158093/316637_WHO_brochure_226x226_5-AdolecentPregnancy.pdf">call for action</a>. And <a href="http://www.sciencedirect.com/science/article/pii/S088303551400079">research shows</a> that parents are much less likely to talk to their sons than their daughters about avoiding a teenage pregnancy. </p>
<p>The rates of teenage births are also thought to be <a href="http://www.childtrends.org/wp-content/uploads/2013/03/Child_Trends-2012_06_01_RB_TeenFathers.pdf;%20http://www.children1st.org.uk/media/69930/spr-pub-031.pdf">much greater</a> for boys and young men who might be most in need of support. Approximately <a href="http://www.parentingacrossscotland.org/publications/essays-about-parenting/some-practice-examples/young-fathers-in-prison-helping-them-parent.aspx">one in four</a> young men in young offenders’ institutes are thought to be or about to become fathers.</p>
<h2>Part of the solution</h2>
<p>It’s time to engage teenage men not just as part of the problem of unintended pregnancy in teenagers’ lives but as part of the solution. To do this, we should ensure that teenage fathers are <a href="http://www.fatherhoodinstitute.org/2012/fi-joins-david-lammy-mp-to-call-for-joint-birth-registration">always registered</a> as fathers at the birth of their children. We can also provide boys with better relationship and sexuality education, which includes them in the reproductive equation and educates them that as they become sexually active they also become reproductively active too.</p>
<p>Recognising this need, my colleagues and I are studying the effectiveness of a new educational resource entitled “<a href="http://www.nets.nihr.ac.uk/news/all/2014/new-study-addressing-unintended-teenage-pregnancy">If I were Jack…</a>”. This is designed to help young boys aged 14 to 16 years as well as girls imagine the consequences of an unintended pregnancy and to develop the skills to avoid one.</p>
<p>Teenage pregnancy and teenage births are not all about the girl – and forgetting that comes with costs both for our society and for thousands of children. It’s time to share the responsibility with young men, from pregnancy to birth to fatherhood.</p><img src="https://counter.theconversation.com/content/44200/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Maria Lohan is chief investigator of the Jack Trial, a RCT feasibility study of a new educational intervention designed to increase boys’ as well as girls’ intentions to avoid an unintended teenage pregnancy, which is delivered in second level schools. The Jack Trial was funded by the National Institute for Health Research Public Health Research (NIHR PHR) Programme (project number 12/153/26)”. PHR Protocol - project ref: 12/153/26. The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of the NIHR PHR Programme or the Department of Health.</span></em></p><p class="fine-print"><em><span>Dr Áine Aventin is lead Research Fellow on the The Jack Trial. Funding details of the study are as above under Dr Maria Lohan <a href="http://www.qub.ac.uk/sites/IfIWereJack/">http://www.qub.ac.uk/sites/IfIWereJack/</a> </span></em></p>Young men are being forgotten when it comes to teenage pregnancy but helping them share responsibility could have a big impact.Maria Lohan, Senior Lecturer in Nursing and Midwifery, Queen's University BelfastÁine Aventin, Research Fellow in Nursing & Midwifery, Queen's University BelfastLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/397412015-05-26T13:26:10Z2015-05-26T13:26:10ZFeelings are as important as grades to teenagers. Can schools help?<figure><img src="https://images.theconversation.com/files/81930/original/image-20150515-25417-1ojhepb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Teens need help not only with school work, but with their emotions as well.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&search_tracking_id=dkce4jxS_8IMju9caQ-mJA&searchterm=depressed%20teens&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=264524723">Girl Image via www.shutterstock.com</a></span></figcaption></figure><p>A recent <a href="http://www.who.int/mediacentre/news/releases/2014/focus-adolescent-health/en/">World Health Organization report</a> points to depression as the leading cause of illness and disability worldwide in 10- to 19-year-olds. Suicide by teens is ranked as the third leading cause of death in this age group. </p>
<p>A question that comes up time and again is whether <a href="http://www.apa.org/monitor/2009/01/school-clinics.aspx">schools</a> should be involved in screening adolescents. But many parents and students find schools’ involvement in mental health to be a violation of their privacy. </p>
<p>As a University of Texas Arlington professor and a pediatric nurse practitioner in private practice, I have found that teens do not consider “prying” questions to be a violation of their privacy. In fact, they want us to ask about their mental health. Teens believe their feelings and emotions are just as important as their grades, diet or physical activity. </p>
<h2>Ask questions</h2>
<p>The fact is that these teens could easily be helped if signs of depression were identified early enough. Most times, symptoms of depression in teens are overlooked by parents and health care providers as “<a href="http://www.mentalhealthamerica.net/conditions/depression-teens">just a phase</a>” or dismissed as a normal part of puberty. </p>
<p>Almost all of these teens have been seen by a healthcare provider who could have easily identified symptoms of depression. But most teens are never asked about how they are feeling - whether they are <a href="http://www.nimh.nih.gov/health/publications/depression-and-high-school-students/index.shtml">happy or sad</a>, tearful or angry and irritable.</p>
<p>In the rushed 10- to 15-minute standard office visit, there’s hardly enough time to handle mental health concerns. Most providers do want to ask, but they are afraid the teen may reveal something they do not know how to handle. </p>
<p>The school environment seems to be a great place to pick up those teens at risk; however, parents and students may feel it is a <a href="http://www.latimes.com/health/la-hew-depression-screening-pro-con3-2009aug03-story.html#page=1">violation of their privacy </a>. <a href="http://www2.nami.org/Content/ContentGroups/CAAC/MH_Screening_in_Schools.pdf">Mental health</a> officials support widespread <a href="http://time.com/3479351/mental-health-schools/">screenings in school</a> as a way to identify at-risk teens. </p>
<p>The goal of screening in schools is to provide early identification and early treatment to help decrease the number of teen suicides. <a href="http://www.mindfreedom.org/kb/mfi-usa-campaign/us-teenager-s-parents-sue-school-over-depression-screening-test">But some</a> argue that school is no place to discuss mental health; and that in fact, screening may lead to an incorrect conclusion or diagnosis and a “labeling” of the teen in question. </p>
<p><a href="http://www.psychsearch.net/teenscreen-news/232005.pdf">Attorneys</a> have also argued that screenings in schools violate the constitutional rights of the parents, especially when screenings are conducted without parental consent. </p>
<p>Because of the backlash from parents and teens, the <a href="http://www.uspreventiveservicestaskforce.org/Page/Document/final-research-plan15/depression-in-children-and-adolescents-screening1">US Preventive Services Task Force (USPSTF)</a> released an update this year, stating screenings should take place in the healthcare provider’s office and not schools.</p>
<h2>Teens want to share</h2>
<p>So, screening for depression and other mental health problems is slowly being implemented in emergency rooms and doctors’ offices. </p>
<p>In 2009, the <a href="http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/depression-in-children-and-adolescents-screening">USPSTF</a> recommended screening adolescents for depression when services for confirmation of the diagnosis are available as well as treatment options. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/81931/original/image-20150515-25432-crhpee.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Teenagers do not view questions as invasion of their privacy.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&search_tracking_id=dkce4jxS_8IMju9caQ-mJA&searchterm=depressed%20teens&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=184855025">Girl image via www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>In my descriptive study conducted in a private practice setting in a suburb of the Dallas-Fort Worth metroplex in 2011, I screened teens (12 to 18 years of age) for depression, using a simple 15-item [screening tool](Center for Epidemiological Studies
Depression Scale for Children (CES-DC), and found that not only could teens at risk be identified easily, but that they also wanted to share their concerns. </p>
<p>Teens may not want to respond if they are directly asked but may feel more comfortable completing a paper-and-pencil questionnaire privately. I found teens’ symptoms of depression can be identified much sooner with this scientific screening tool. Positive results mean further evaluation of these symptoms is warranted. </p>
<p>More often than not, teens want someone to ask about their feelings. Teens did not consider asking these questions an invasion of their <a href="http://npwomenshealthcare.com/use-of-screening-tools-for-depression-vol2-no2/">privacy</a>. Often, parents tend to overlook the symptoms of their teens. </p>
<p>In my practice working with teens, I have discovered teens want their opinions to be heard and their feelings to be validated. For example, a young male patient was angry over his parents’ divorce. </p>
<p>He was hiding his feelings because he did not think he was supposed to be angry with his parents. Once this was discovered and he was told it was ok to feel this way, his symptoms of depression began to go away. </p>
<p>With a few counseling sessions, he was able to work through his anger and be a happy 12-year-old boy again. There were similar other such cases.</p>
<h2>Early detection is important</h2>
<p>Are teens more at risk because of puberty and <a href="http://depression.about.com/od/teenchild/a/depression-during-puberty.htm">changes in the brain</a>? Is there something about starting high school, or do they realize as they grow up they have more responsibilities? </p>
<p>Is there <a href="http://www.mentalhealthamerica.net/conditions/depression-teens">societal pressure</a> to grow up too fast? Are teens wondering if they can handle the pressures of adult life? </p>
<p>These questions are yet to be answered, but they do stress the importance of using a screening tool to look for depression or other mental health illnesses. </p>
<p>The key to successful treatment of mental health illness is to identify symptoms early and start treatment. Many times, counseling may be all that is needed, but if a problem is not identified early enough, longer, more extensive counseling, medication, or even hospitalization may be needed. </p>
<p>But before beginning this process, <a href="http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/depression-in-children-and-adolescents-screening">appropriate services</a> for counseling, inpatient or outpatient care, and follow-up services must be in place. </p>
<p>If screening is completed in the school setting, resources must be made available for appropriate evaluation and follow-up. </p>
<p>Many <a href="http://www.integration.samhsa.gov/clinical-practice/screening-tools">screening tools</a> are available online, free of charge, and simple to administer and score. </p>
<p>If mental health issues can be detected early, treatment can be started much sooner. With earlier identification and treatment, we hope to lessen the burden of long term mental health issues. </p>
<p>Ask your teens about their mental health today!</p><img src="https://counter.theconversation.com/content/39741/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sharolyn Kay Dihigo does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There is lot on the minds of teens other than school, grades and friends. Research shows being asked “prying” questions could make a real difference to their mental health.Sharolyn Kay Dihigo, Clinical Assistant Professor College of Nursing and Health Innovation, University of Texas at ArlingtonLicensed as Creative Commons – attribution, no derivatives.