The Adolescent Brain

Q&A

The following Q&A with Laurence Steinberg, PhD, highlights his newest book, Age of Opportunity: Lessons from the New Science of Adolescence (New York; Houghton Mifflin Harcourt Publishing Company; 2014). Dr Steinberg offers insights into the malleable adolescent brain, providing invaluable guidance to parents hoping to better understand adolescents.

Bringing new ideas to the table, the author additionally provides health care providers with innovative techniques for working with this population, by emphasizing programs that stimulate self-regulation, teach mindfulness, and improve executive functioning. Further, the author delineates public policy changes that can be used to support and protect adolescents during a time of increased risk-taking. Dr Steinberg is the Distinguished University Professor and Laura H. Carnell Professor of Psychology at Temple University, Philadelphia.

Holly Briklin, MD (HB): What motivated you to write this book?

Laurence Steinberg, PhD (LS): I came to feel that mental health professionals and the public needed some sort of corrective to our view of adolescence. Too much of what was written portrayed adolescence as something to be survived or endured-by parents or by young people. I see adolescence as a time when people can thrive, if we are able to take advantage of the opportunity that adolescence affords us.

HB: If someone stopped you on the street and you had 30 seconds to tell them what they will learn by reading your book, what would you say?

LS: It’s hard to do this in 30 seconds, because the book covers so much territory! They will familiarize themselves with the adolescent brain and discover how and why adolescence has been turned into a 15-year stage of life. Readers will learn about the implications of these developments for how we parent, educate, work with, and treat young people in society.

HB: You write that because the adolescent brain is malleable, adolescence is a period of both tremendous opportunity and risk. Can you expand upon this?

LS: When the brain is malleable, or “plastic,” as neuroscientists say, it is more easily influenced by experience. But the brain cannot tell the difference between experiences that are harmful and those that are beneficial. The same malleability that makes adolescence a time of opportunity for positive change makes it a time of vulnerability to the potential effects of toxic experiences.

HB: You characterize adolescence as a period from ages 10 to 25 years. Can you share why you have expanded the definition beyond the common standard?

LS: Adolescence is usually defined as beginning in biology-puberty-and ending in culture-the transition of people into the conventional roles of adulthood. Today, individuals go through puberty at around 12 (earlier for girls, later for boys), but they do not typically become adults until their late 20s. So adolescence has been stretched at both ends into a stage that is at least 15 years in duration.

HB: Who will most benefit from your book?

LS: The book is written for a general audience, which includes parents, educators, practitioners, and policymakers. People who employ adolescents would benefit from reading it too. So would young people themselves.

HB: In your chapter on brain plasticity, you catalog a number of mental health disorders (eg, mood and most anxiety disorders, eating disorders, schizophrenia, impulse control disorders) that first come to clinical attention in adolescence. Do you have any theories on changes in brain development during adolescence that are the potential precipitants to the development of such mental health disorders?

LS: Many mental health disorders are disorders of self-regulation. Because brain systems that govern self-regulation are relatively slow to develop, there is a gap between the arousal of brain systems that are easily aroused by emotional, social, and appetitive stimuli and those that govern self-control. This gap creates a vulnerability to mental health problems.

HB: In your section on why early puberty matters, you detail the consequences of a society whose adolescents are becoming physically mature at younger ages than generations before them. Do you have any recommendations on how clinicians/society can best help guide emotionally immature adolescents through such a transition?

LS: I think the most important thing is to make sure that we don’t treat adolescents who go through puberty earlier as if they are maturing earlier emotionally, too. Earlier puberty creates a longer gap between when the “engines” of adolescence are aroused and when the “braking system” is completely functional. This means that early maturing adolescents need special supports and protections.

HB: You have written many successful books about adolescence. What's next in your writing career?

LS: I have to say that, having worked on Age of Opportunity for so long, the last thing on my mind at the moment is another book! My colleagues and I have recently finished a study of more than 5000 adolescents and young adults in 12 different countries. I need to turn my attention toward writing up the findings of this research.

Disclosures:

Dr Briklin is a resident in the Department of Psychiatry at Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York. She completed her medical school training at Robert Wood Johnson Medical School, New Brunswick, New Jersey. Her interests include child and adolescent psychiatry with a particular focus on the treatment of gender identity disorders.