Understanding the Teen Brain (M Richards 2005)


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Martyn Richards of OPERA Research reviews what we know about the teenage brain - and what implications this has for cultural marketers. Paper presented at Audiences Europe Network Barcelona Conference 2005. www.audienceseurope.net

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Understanding the Teen Brain (M Richards 2005)

  1. 1. Paper 26 The Teen Brain: Whats Going On In There? Martyn Richards, OPERA ResearchConference Papers
  2. 2. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety Paper 26 David Blackburn, Corporate Edge The Teen Brain: Whats Going On In There? Martyn Richards, OPERA Research "I would there were no age between ten and three-and-twenty, or that youth would sleep out the rest, for there is nothing in the between but getting wenches with child, wronging the ancientry, stealing, fighting-- Hark you now! Would any but these boiled brains of nineteen and two- and-twenty hunt this weather?" Shepherd, The Winters Tale (Shakespeare) INTRODUCTION Remember Harry Enfields Kevin? How we laughed at his moaning to, and shouting at, his parents… at his gaucheness at dealing with girls… at his inability to get the car cleaned in less than twelve hours? We laughed because we recognized this stereotype to be true, perhaps not of all teenagers, all of the time, but of very many at some point in their development. This is an opportune time to be looking at teenagers. The current generation are more troublesome than any before them: "Todays teenagers are much more likely to lie, steal or defy authority than previous generations. They also have more chance ofConference Papers experiencing bullying, fighting and suicide attempts. The collapse in standards of behaviour over the past 25 years is identified in a study comparing todays 15 and 16 year-olds to those from the 1970s and 1980s… In fact, the percentage of troubled teenagers has more than doubled since the 1970s." (Daily Mail, September 2004) Page 2Page 1 of 8 of 38
  3. 3. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety Shakespeares shepherd in The Winters Tale reminds us, however,Corporate David Blackburn, that the Edge issue is not new; it is just that extra pressures on todays teens exacerbate a natural phenomenon. There has thus been an imperative to understand what lies behind teenagers behaviour, in order that we may know what influences are contextual or environmental, and what, if any, are biological: the old nature/nurture debate. It is not the function of this paper to cover the whole spectrum of influences on young people; it is worth reminding ourselves, however, that a lot is going on: ! puberty kicks in, hitting different kids at different ages, and lasting several years; once again to make things worse, the onset of puberty has become earlier, declining rapidly during the 20th Century as health and nutrition improved; ! modern teens are well and truly in a consumer age, which can lead to many stresses in terms of owning and wearing the right things – media images only encourage this; ! pressures emerge, especially at school, college and university, to succeed academically – often, for many young people, beyond their capability; ! pressures include much that belongs to the modern age - taking drugs, driving in fast cars – which carry their own risks and dangers. For the purposes of this paper, the nurture aspects of understanding human behaviour are ignored: not because they are unimportant, but because they are covered extensively elsewhere. In his paper at last years MRS Conference, Mark Oldridge quoted Sean Brierley thus… "The reductionist assumption that we are merely machine, a collection of chemical impulses and buttons. Stimulus – response models of human behaviour take no account of environment or culture." (Brierley, 2003) … and said himself: "There is the inherent trap in a purely behaviourist perspective, that the pendulum goes full swing and the notion of the individual becomes ignored." Nonetheless, the concentration in this paper is on the nature side. It is widely accepted these days that we all are results of both influences on ourConference Papers behaviours; the real news in respect of teenage behaviour and development however, resides in neuroscience. Recently, I emailed a friend in South Africa to explain why I had been incommunicative, and pointed him to the MRS web pages. His reply was: "Just had a look at the web site and I see your talk is entitled The Teen Brain: Whats Going On In There? When you find out, please let me know!" Page 3Page 1 of 8 of 38
  4. 4. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety His reaction is typical of many people who have experienced the joyCorporate David Blackburn, of Edge watching their offspring turn from angelic children into teenage demons, then possibly return to some form of normality as adulthood replaces adolescence. A number of people reading this will recognize many of the behaviours referred to in this paper. Invariably, as I have told parents of teenagers of the subject matter of this paper, they have regaled me with stories of their own. At the end of moderating some groups one night during the course of collecting background material, and discussing this with the recruiter, she told me about her son. He had appeared to be as much on the rails as his older sister, and certainly brighter; he suddenly left his studies and decided to become a car mechanic. He then very quickly got into trouble with the police, having never been in any sort of trouble before. The recruiter had desperately tried to explain his changed behaviour, but was mystified. He had had the same upbringing as his sister: where had she gone wrong? She hadnt: whilst it is likely that environmental issues came into play, we can now look to changes in the brain as responsible for the shift. This is seen time and time again, whether it happens at 14, 15 or even 18. The recruiters son is now OK. The vast majority are – they get through it. There are some who go completely off the rails, or suffer severe problems – these are not the subject of this paper; what we are concerned with is the broad range of experience that falls within what may be described as normal. Rather than depend on anecdote, this paper includes two elements which help underline the issues that exist in todays society. Firstly, a series of statistics about teenagers is included. Secondly, OPERA have conducted a number of interviews as illustration. These are "Immersion Interviews" – a term used to describe interviews which are qualitative in nature, typically longer than standard depth interviews, but are essentially differentiated in that respondents are presented as individuals. Subjects were selected, through personal contacts amongst OPERA staff, as essentially normal teenagers. There is no intention to be representative. Closer to case studies, Immersion interviewees are shown to the reader through photographs of themselves and their homes, to help bring each to life, though names are changed to protect confidentiality. Individuals will be introduced at appropriate times through the paper1.Conference Papers 1 Restricted space in this paper means that these interviews will be presented simply as snapshots, centring on the most appropriate elements of each, rather than the more fulsome approach that they would get in a live project. Page 4Page 1 of 8 of 38
  5. 5. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety STATISTICS David Blackburn, Corporate Edge There is strong evidence to suggest that teenagers are at risk in society, from themselves as much as anyone else. Risk was a constant theme in the research for this paper: "Smart kids do stupid things. Its a simple fact of life. No one makes it through the teenage years unscathed. Even the meekest, smartest, most obedient, and sensible teenager will, at one point or another, find himself or herself facing the angry, disbelieving face of an adult who shouts, What were you thinking?" (Walsh, 2004) Teens and Road Accidents One aspect of this is road safety. The following table demonstrates this: Table 1: Pedestrian fatalities/injuries Rate per 100,00 population Pedestrians: 0-4 5-7 8 - 11 12 - 15 16 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 + (by age) Killed 0.4 0.5 0.6 1.2 2.0 1.4 0.8 1.0 1.1 1.1 2.6 5.6 KSI* 8 19 26 32 22 15 9 9 7 9 14 21 (* Killed or seriously injured) (Office of National Statistics, 2003) The danger of being a old person is much easier to understand than the bump in the figures for teenagers: a peak amongst 16-19s in terms of fatalities, and a peak at 12-15 in terms of serious injuries. It cannot just be put down to a lack of awareness or maturity, otherwise why arent the figures relatively higher for younger children? Even the fact that young children are more likely to walk with parents does not fully answer this. Transport for London have recognized this issue by launching a TV advertising campaign aiming to reduce the number of teenagers killed or seriously injured on Londons roads, and as its not due to being on unfamiliar territory, it must be a simple lack of concentration: "Analysis shows, that in London, boys aged 11-14 are at most risk from being hit by a vehicle when crossing roads… Approximately a quarter of all teenage pedestrian casualties occur on the way to or from school." (Transport for London, 2004) Teenagers are also particularly vulnerable as car passengers, suggesting aConference Papers degree of bad decision-making: Table 2: Passenger fatalities/injuries Rate per 100,00 population Passengers: 0-4 5-7 8 - 11 12 - 15 16 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 + (by age) Killed 0.5 0.2 0.3 1.3 4.5 2.3 0.6 0.4 0.3 0.8 1.1 1.5 KSI* 5.7 5.4 6 13 47 21 7 5.2 4.7 6 8 9 (* Killed or seriously injured) Page 5Page 1 of 8 of 38
  6. 6. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge Boys are particularly at risk in terms of road injuries. In 2003, 4,100 under-16s were either killed or seriously injured of whom 66% were boys and 34% were girls. As for driving itself, it will come as no surprise that young drivers are particularly at risk, due to their relative inexperience. There are suggestions that other factors add to the likelihood of serious injury however: "Immaturity is a contributing factor to the high rate of auto crashes and deaths among teenagers. For instance, tailgating and not using safety belts are misjudgements teens make more than older drivers." (Drive Home Safe, 2004) Self-harming As well as accidental deaths, teenagers are at high risk of suicide: "Suicide accounts for 20 per cent of all deaths amongst young people aged 15-24 and is the second most common cause of death amongst young people after accidental death. Around 19,000 young people attempt suicide every year and about 700 of these die as a result." (MIND, 2004) Again, while there are, of course, numerous contextual, social and environmental influences which lead to suicide in teenagers, these are perhaps triggers which force a young person over the edge, where there is already a predisposition to self-harm caused by an inability to deal with circumstances. Whilst boys are at more risk in teenage years on the roads, it is girls who are more likely to self-harm: "The Samaritans commissioned a study of teenage self-harm, conducted by the Centre for Suicide Research at Oxford University. After quizzing 6,000 teenagers it concluded that more than one in 10 adolescents has deliberately cut themselves at some time. Girls were almost four times as likely as boys to do so." (Guardian, 2004)Conference Papers Page 6Page 1 of 8 of 38
  7. 7. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Of the age cohort mentioned above it is again the older teenagers who Edge present the biggest risk group: 200 150 Males Females 100 50 0 < 15 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 -49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 + Mental Health In the UK, psychosocial disorders affecting young people have risen substantially over the last 50 years (Rutter and Smith, 1995). A more recent study showed a substantial increase "in adolescent conduct problems over the 25-year study period that has affected males and females, all social classes and all family types. There was also evidence for a recent rise in emotional problems" (Collishaw et al, 2004). A study in New Zealand (Fergusson and Horwood, 2001) showed Anxiety Disorders at just under 20% for 15 year-old girls, rising to 22% for 18 year-old girls, 26% of whom also reported Mood Disorders. Figures arent available for the UK for this age cohort, but Anxiety Disorders are already at around 6% for girls aged 11-15 years (Office of National Statistics, 1999).Conference Papers Page 7Page 1 of 8 of 38
  8. 8. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety Sexual Health David Blackburn, Corporate Edge Frighteningly, the prevalence of sexually transmitted infections has shot up in recent years (National Statistics on - line, 2004). As can be seen from Chart 2, chlamydia rates are now above one per hundred girls aged 16-19.Conference Papers Page 8Page 1 of 8 of 38
  9. 9. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Conception rates have remained fairly consistent over the last decade, Edge despite numerous campaigns and activities to reduce them: Drug-use, Smoking & Drinking Reported use of drugs is falling in the UK: around 55% of boys said they had ever used drugs in 1998, falling to around 43% in 2000 (Ramsay & Baker, 2001). Boys are more likely to take drugs, and likelihood increases with age. This is not to deny it as a serious problem. In a report on young people and communities, the Institute for Public Policy Research identified fairly worrying attitudes to drugs in the area of Coventry they chose to use as illustration: "There appeared to be rules governing what was acceptable and unacceptable. For example even those using drugs felt that younger teenagers shouldnt be doing the same… Another rule appeared to be that cannabis was not a problem drug but one that was taken for granted as something that young people would use and talk openly about. For some ecstasy and other pills were not considered particularly dangerous or serious either. Some felt that it was only hard drugs like heroin and crack that should remain illegal and be the focus of police attention." (Edwards & Hatch, 2003)Conference Papers Page 9Page 1 of 8 of 38
  10. 10. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Young girls, however, are more likely to smoke. In 2000, 12% of girls aged 11- Edge 15 smoked regularly, compared with 9% of boys. 29% of 16-19 year-olds were smokers, with little gender difference. If drug use appears to be falling, and smoking remaining consistent, the worry has to be the increase in alcohol consumption. In England, the proportion of 11-15 year-olds drinking alcohol increased from 21% in 1990 to 27% in 1996, falling back to 24% in 2000. Over 50% of boys, and around 46% of girls, aged 15 had drunk alcohol in the last week. The key finding, however, is that consumption has increased dramatically. In 1990, an average of between 5 and 6 units of alcohol were being drunk a week by 11- 15 year-olds. In 2000 this had risen to almost 12 units for boys and over 9 units for girls (Office for National Statistics, 2004). Again, the work in Coventry identified relaxed attitudes to alcohol amongst teenagers, with high levels of usage amongst older teenagers still below the legal age: "As with drugs there seemed to be a form of self regulation taking place, whereby the older teenagers would not give alcohol to those considered too young (this appeared to be those under about 13)." (Edwards & Hatch, 2003)Conference Papers The danger is that many parents, scared by drugs, consider alcohol safer, when, in fact, it is extremely dangerous to the teenage brain. "Substances like Morphine have specific receptor sites within the brain… Alcohol is different. It has no receptor sites of its own within the brain. Its molecules are electrically uncharged which means that they are attracted to similarly uncharged regions within the brain – such as Page 10Page 1 of 8 of 38
  11. 11. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate those that exist within the membranes of our neurons. As a result, Edge alcohol has the potential to disrupt pretty much every brain function." (Winston, 2003) Linking this element to that of road safety, a very recent government report in the States showed that one in five American teens aged 16 to 20 drove under the influence of drugs or alcohol (CBS News, 2004). In order to humanize elements of these statistics, our first case study interview is included here: Immersion interview #1 – Chloe Chloe is 13. She lives in a detached house on the outskirts of a country town, with her mum, dad, 8 year - old sister and two brothers aged 10 and 12.Conference Papers Chloe started puberty early, at 9 years - old; although she is only just a teenager, there are frictions at home, especially between her and her mother. Page 11Page 1 of 8 of 38
  12. 12. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate These will often be clashes of desire: Chloe wants to go out, to a particular place, at Edge a particular time, with particular friends, and mum has a problem with one or more of these. Each sees the other as unreasonable. Chloe and her mum have begun to have arguments, during which Chloe can lose it. Her ability to control the situation, or her anger, is inhibited by her emotional response: "I just completely lost it. I dont know what was wrong with me… my anger is really bad and I dont know how to stop it." Chloes inability to handle her emotional impulses can lead to danger for those around her: "Once, when we were walking to school, my brother was really irritating, cause he was throwing berries at me, and I pushed him into the road… I felt really bad, but I didnt think about it, I just did it." A likeable girl, Chloe believes she has some real problems. She is no different, however, from so many other teenagers.Conference Papers Page 12Page 1 of 8 of 38
  13. 13. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge BACKGROUND SCIENCE Back to that moment when Kevin becomes a teenager. Remember when this nice young lad morphed into a slouching, grunting curmudgeon simply because it was his 13th birthday? His father says: "Look! Hes losing the power of rational thought!" (Enfield, 2000) Harry Enfields observation is brilliant, as this is, in a sense, exactly what happens in the teenage years. To understand both what goes on, and how we know about it, some history of brain science is required. Phineas Gage (see Macmillan, 2002), is famous in the world of neuroscience for a very strange reason, having survived a most horrific accident many years ago. Phineas, a young man in his twenties, was involved in "tamkin": the process of setting explosions within rock, as part of opening up the railroads in America in the mid-19th century. His job was to pack explosive charge into a drilled hole, then pack in over that, sand to contain the blast. A "tamping iron" was used: Gages was three feet, seven inches long, one-and-a-quarter inches in diameter at the business end, tapering over about twelve inches to a point one-quarter of an inch at the held end. On the 13th September, 1848, inConference Papers the late afternoon, Phineas rammed his iron into a hole where his assistant had yet to add sand – a mistake that Phineas needed like a hole in the head. The explosive charge ignited and sent the iron backwards, through Gages head, taking a substantial amount of bone and brain with it. Entrance to the skull was through the left cheek; exit was at the top of the head, towards the front. Shortly after, Gage was speaking rationally to his men, and managed to walk to a cart which took him to a doctor. Not only did Phineas survive - an incredible fact in itself – he lived for another eleven-and-a-half years. But the Page 13Page 1 of 8 of 38
  14. 14. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety reason for his inclusion here is the observation by those around himCorporate David Blackburn, at the Edge time, that his personality altered. Variously, he is described as: "a psychopathic personality who lied and could not be trusted to honor his commitments"; "makes elaborate plans that he then cancels and swears profusely… loses control of much of what is called decorum, becomes like a child, and has fits of temper when he doesnt get his own way." Specifically, and reported wherever this story is rehearsed, one of his workmates commented: "He is no longer Gage." Whilst there is some caution to be taken in reading too much into the Gage story, one fact is unassailable: that it is possible to lose large areas of brain matter and survive, indeed live a normal life. The use of the word psychopathic above should not be taken too literally. Phineas not only survived more than a decade, he held done a number of jobs. After exhibiting himself as a freak at Barnums Museum in New York, he worked in a livery stable, then as coach driver, then finally as a farm labourer. The inference is that the area of the brain damaged in Gages case, the prefrontal cortex, is not responsible for any of our basic functions, such as movement, speech, or indeed many of the functions that make us human, but provides, for want of a better expression, good decision-making, and, when disabled, leads to bad behaviour. It was the discovery of this that led directly to the lobotomies, or leucotomies which were so prevalent during the middle of the last century. Susan Greenfield (2003) reports that: "Between 1936 and 1978, some 35,000 people in the United States underwent the surgical procedure… During their heyday, leucotomies were claimed to result in few side-effects. It gradually became apparent, however, that there was no net arguable therapeutic benefit and indeed that the side-effects were severe. As with Phineas, these patients became changed characters, lacking in foresight and emotionally unresponsive." What we now learn, is that the prefrontal cortex of teenagers is still a work-in- progress. This is the key fact that answers my South African friends earlier question. To understand how we learnt this fact, we need to return to an invention of the late 1970s.Conference Papers Page 14Page 1 of 8 of 38
  15. 15. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety MRI SCANNING David Blackburn, Corporate Edge The first MRI2 scan took place on July 3rd 1977. Then it took five hours to produce one image. There are now thousands of MRI scanners in the United States, around three hundred in the UK, with many paid for by lottery cash (see Zoe Gough, 2004), and simple scans take seconds. Patients tend to enter scanners lying down, a little like entering a tunnel. "In conjunction with radio wave pulses of energy, the MRI scanner can pick out a very small point inside the patients body and ask it, essentially: "What type of tissue are you?" (Gould, 2004) MRI scans were thus able to inform neuroscientists about brain development in a way never achievable before. An added bonus came in terms of also being able to examine activity in the brain through functional MRI scans: "Using CT3 or MRI is like looking at the floor plan and seating arrangement of a theatre: they may provide you with an idea of where youd like to sit, but they dont enable you to see the play or hear the actors… A variant of MRI called functional MRI (fMRI) provides you with the equivalent of the movement and dialogue of the actors in the play. This imaging technique takes advantage of the fact that the magnetic properties of blood change according to the amount of oxygen carried in the blood." (Restak, 2001) THE WORK OF JAY GIEDD (AND OTHERS) The Prefrontal Cortex MRI scanning allows medical scientists and researchers to conduct research in vivo – to look at live brains; until recent times, brain research was essentially limited to dead animals and people. With relatively few young people dying, the opportunities were simply not there for detailed analyses of significantly large samples. Scientists believed that the brain was a finished article, in terms of its potential, while children were still young. Famously, this led Rob Reiner in the States to champion the cause of devoting attention to initial years of childrensConference Papers lives, in order to maximise the chance of educating them well, and preventing them from following bad paths in their teens and later years. This is from an address to the National Governors Association in 1997: 2 Magnetic Resonance Imaging 3 computerized axial tomogram Page 15Page 1 of 8 of 38
  16. 16. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety "We now know through science that David three years of life is the the first Blackburn, Corporate Edge most critical time period. It is the time period when the brain develops at a greater rate than at any time during the course of a persons life… But by age 10 your brain is cooked and theres nothing much you can do." (Bruer, 1999) This quote is sourced from The Myth of the First Three Years, which does much to set Reiners thoughts in context, but was written before the work with MRI scans became known. At the National Institute of Mental Health in the United States, a team of neuroscientists began using MRI to investigate the development of certain childhood mental ailments such as ADHD4 and autism. What the team led by Jay Giedd realized was that, in order to understand potential dysfunction, they needed to understand how the brain functions in normal children and teenagers. A longitudinal study was thus set up, taking images of youngsters brains: "At least 1 scan was obtained from each of 145 healthy subjects (89 male). Of these, 65 had at least 2 scans, 30 had at least 3 scans, 2 had at least 4 scans and 1 had 5 scans, acquired at approximately two-year intervals. The age range was from 4.2 to 21.6 years. There were no significant sex differences for age, Tanner stage, ethnicity, socioeconomic status, height, weight or handedness." (Giedd, 1999) As a result of this study, Giedds team discovered a "a second wave of overproduction of gray matter" just prior to puberty. Before this, accepted medical belief was that the brain overproduced grey matter ("the thinking part of the brain") in the womb and for about the first 18 months of life, followed by a period of pruning. This is when the brain reinforces neurons that are well- used (through a process called myelination, when neural connections – synapses - are covered in a protective layer which dramatically speeds up transmission between neurons) and allows others to become inactive. Giedd refers to this process as "use it or lose it". Thus another period of pruning occurs throughout the teenage years. Further, Giedd discovered that the spate of overproduction "predominates in the frontal lobe" – so, it is that policing area of the brain which gains the most new matter. The key finding though, is the one most relevant to this paper: that the pruning which then follows takes all of the teenage years, and in many casesConference Papers years beyond, into the early 20s; also, that the pruning starts at the back of the brain and works its way forwards, so that the all-important prefrontal cortex is in fact the last area to mature. The annals of the New York Academy of Sciences contain the following quotation from Jay Giedd, which leads us in the direction of forming conclusions from this finding: 4 Attention Deficit Hyperactivity Disorder Page 16Page 1 of 8 of 38
  17. 17. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge "The relatively late development of the DLPFC (dorsolateral prefrontal cortex), not reaching adult levels until the 20s, is intriguing in light of the behavioural data presented elsewhere in this volume. The DLPFC is linked to the ability to inhibit impulses, weigh consequences of decisions, prioritize, and strategize. Speculatively, the DLPFC is still "under construction" for a decade after the throes of puberty and therefore may be related to some of the behavioural manifestations of the teen years." (Giedd, 2004a) Giedd does not, however, allow direct conclusions to be drawn, though his use of the expression "may be related" above, suggests that these conclusions will eventually be drawn, once enough data have been collected. Recently, however, the National Institute of Mental Health, Giedds employer, felt confident enough to put together the following press release: "The brains center of reasoning and problem solving is among the last to mature, a new study graphically reveals. The decade-long magnetic resonance imaging (MRI) study of normal brain development, from ages 4 to 21, by researchers at NIHs National Institute of Mental Health (NIMH) and University of California Los Angeles (UCLA) shows that such "higher-order" brain centers, such as the prefrontal cortex, dont fully develop until young adulthood… Areas performing more basic functions mature earlier; areas for higher order functions mature later. The prefrontal cortex, which handles reasoning and other "executive" functions, emerged late in evolution and is among the last to mature." (NIMH, 2004) Inference can thus be drawn from the now-known link between development of the prefrontal cortex, from the learning of what happened to Phineas Gage, through the experiments with MRI scanners, to what is known about teenagers: "People with damage to their frontal lobes – such as, of course, Phineas Gage – often have difficulty in controlling their anger. MRI scans of people with antisocial personality disorder, characterized often by aggressive, destructive behaviour, also show low activity in the frontal lobe region. In normal individuals, the frontal lobes act as the policemen of the emotional mind – in particular, the area called the ventromedial cortex. They receive information from the lower cortex pertaining to urges, impulses and responses, but they inhibit it, and form careful plans of action to address it. For instance, if I feel hunger as I walk through a restaurant to the table I have been allotted by theConference Papers waiter, I do not grab a few chips from the other diners tables as I pass by. My frontal lobes are effectively saying to my lower brain: I see that there is hunger. But we wait. I wont cause a scene." (Winston, 2003) Page 17Page 1 of 8 of 38
  18. 18. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate The teenage brain, with its undeveloped prefrontal cortex, does not always Edge respond so maturely. Hence we see teenagers making decisions and judgements which exasperate adults with their apparent lack of common sense. That leads us into our second case study: Immersion interview #2 – Nick Nick is 18. He lives in a small semi - detached house in a close on the edge of the city, with his mum, dad and sister, 20. Nicks mum had much to say about teenagers: "Even with other peoples children, you know exactly when they turn 15 because they dont even say Hi anymore." For her part, she considers herself lucky when compared to other mums around her, whose sons have got into trouble for stealing cars and so forth, but he tends to do stupid things like leaving a chip pan on, or leaving his fathers bike outside the frontConference Papers door, despite having been told off about that very same thing several times before. "You think they should make the right decision because they are a lot bigger and older, but Ive noticed that they cant make a decision and therefore you are making them for them." Page 18Page 1 of 8 of 38
  19. 19. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge Perhaps what has held Nick together has been his music – he loves mixing, and has his own decks. The application shown to this however, is not reflected in his attitude to work. He was unlucky to have lost his course at college through no fault of his own, but managed to throw away a job, by not turning up, and then getting his mother to call in sick for him. What is going on in our brains is a reaction to a number of signals or impulses. As an example, emotional responses can be triggered from the amygdala, the almond-shaped part of the brain at its base. This is where gut responses emanate. In Robert Winstons chips example, his amygdala may well have taken impulses from his senses and sent out a message saying Grab them! Other areas of the brain will process relevant information, such as what muscles will be required to take the chips, or what other factors are involved, such as other people watching, whether the chips will be hot, and so on. Then it is the prefrontal cortex which takes the decision – No, dont take the chips. The Corpus Callosum and the Cerebellum It is interesting, before moving on to look at the implications of this research, to take into account further discoveries which have emerged. One of these affects our understanding within the nature/nurture debate. We have alreadyConference Papers agreed that both environment and genes make us who we are. What Giedds research shows is that different areas of the brain impact in different ways. By examining the brains of twins, he has discovered an interesting fact about the corpus callosum, which lies between the left and right sides of the brain. This thick cable of nerves which connects the two halves of the brain is involved in creativity and higher type of thinking; it too changes throughout childhood and adolescence. However, it is essentially similar between twins, so "surprisingly under the control of genes". On the other hand, the cerebellum, which Page 19Page 1 of 8 of 38
  20. 20. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety changes a lot during teen years, and is responsible for both muscle Corporate David Blackburn, co- Edge ordination and some cognitive processes, is the reverse, no more likely to be similar in twins than any other pair of young people. So, this area is considered to be more susceptible to the environment. This is especially important to developing teenagers in terms of the use it or lose it phenomenon: "We think that the "Use it or lose it" principle holds for the cerebellum as well. If the cerebellum is exercised and used, both for physical activity but also for cognitive activities, that will enhance its development." (Giedd, 2004b) Giedd says that the cerebellum is not essential for any particular activity, but nonetheless improves many activities effectiveness. He includes in these activities, those areas which he terms "higher thought – mathematics, music, philosophy, decision-making, social skills". That teenagers brains are still developing in an area which governs decision- making and social skills will come as no surprise to parents. Again we are reminded of Harry Enfields Kevin, metamorphosing from an articulate young boy into a grunting teenager incapable of holding normal conversations with those around him. Risk Our statistics earlier showed the teenage years to be dangerous times, with much risk-taking occurring, whether it be stealing, accepting a lift in a friends car when they are over the limit, crossing a road badly or substance abuse. The BBCs web site, in its Science & Nature section, links the new research to the area of risk: "Scientists have used advanced scanning methods to study the changes that occur in the adolescent brain. Much to their surprise, they have discovered that the brain continues to develop and grow well into the teenage years. This might explain a teenagers risk-taking behaviour. It has emerged that the emotional region of the brain develops to maturity ahead of the part of the brain that controls rational thought. In other words, teenagers have well-developed emotions and feelings but have still not acquired the ability to think things through." (BBC web site, 2004) This can lead the most well-adjusted teenager into doing impulsive things, perhaps even committing crimes, as our next case study illustrates:Conference Papers Immersion interview #3 – Samantha Page 20Page 1 of 8 of 38
  21. 21. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge Samantha is 15. She lives in a detached house in a village, with her mum and dad and two older brothers, 17 and 20. Samantha is doing her GCSEs, and if her mocks are anything to go by, will do well. She travels into the nearby city to a catholic high school, having been to the catholic primary school before that. There are few arguments; Samanthas mum sets rules about times to get in and they are adhered to. Partly this is because getting - in times are fairly liberal – they still have to be stuck to, but they are reasonably late. Samanthas mum seemed fairly relaxed about certain things that other mums get wound up about – for instance having a tidy bedroom:Conference Papers Page 21Page 1 of 8 of 38
  22. 22. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge Last year, however, when 14, Samantha shoplifted from Boots, and got caught. She was arrested and cautioned. It was a shock, to both her and the rest of the family. She was on her own – it wasnt done as a crowd - pleaser - and she easily had the money to pay for what she took. It was a moment of madness: "I dont really know (why I did it). It was just like, I actually really dont know. It was a stupid thing that you do and then you think afterwards, What was the point in that?" Samantha had no idea why she did what she did. This may well be because the decision-making area of her brain is in flux. Asking teenagers why they did things can be a fruitless exercise, often resulting in no more than a shrug of the shoulders, which many adults interpret as insolence. Michael Bradley, who spends his life helping teenagers and their parents cope with lifes problems, lists amongst Common Adolescent Disorders "The Shepherdus Germanus Seizure Syndrome" which reflects the shrug referred to above excellently. "When asked why, both children seizured in the manner youve likely seen by now with your own adolescent. Eyes wide open, head slightly tilted, tongue hanging out, and slow drooling with nonresponsiveness. This is very much like the look you get asking your German Shepherd puppy, Why?" (Bradley, 2003) Recognizing ExpressionsConference Papers Another interesting area of research, again using MRI, was carried out by Deborah Yurgelun-Todd, who conducted experiments at McLean Hospital, Belmont, Massachusetts. Volunteers were shown a series of pictures which showed facial expressions. When shown a particular face, all adult volunteers identified the emotion behind the expression as fear. Around half of the teenagers shown the face interpreted it differently however, seeing sadness, Page 22Page 1 of 8 of 38
  23. 23. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety confusion, shock or anger. When the brain David Blackburn, Corporate scans were examined, it emerged Edge that teenagers were using a different part of their brain for reading the images. "In an adult… the prefrontal part of the brain carries out a lot of executive functions, or what we call more thinking functions: planning, goal-directed behaviour, judgement, insight. And we think that that particular part of the brain influences this more emotional or gut part of the brain… The adolescent will have more of an emotional response. The part of the brain that has more of that gut reaction will respond to a greater extent than the adult brain will. And we think that that is due to the fact that this frontal region is not interacting with the emotional region in the same way… It was surprising to us that most fairly sophisticated adolescents did not correctly identify fear. The frontal lobe, that part of the executive region that we studied, is not always functioning fully in teenagers… That would suggest that therefore teenagers arent thinking through the consequences of their behaviors." (Yurgelun-Todd, 2004) Adding to this research is work done by Robert McGivern at San Diego State University, who found that as children enter puberty, their ability to recognize quickly, other peoples emotions, plummets. It then does not return to normal until around 18 years old. McGiverns take on this was that it explains why so many teenagers consider life unfair, being less able to understand social situations. "During adolescence, social interactions become the dominant influence on our behaviour, says McGivern. But just at the time teenagers are being exposed to a greater variety of social situations, their brains are going through a temporary remodelling, he says. As a result, they can find emotional situations more confusing, leading to the petulant, huffy behaviour for which adolescents are notorious." (New Scientist web site, 2002) Hormones Adding to the chaos in the teenage brain are, of course, hormones. This is an area we mostly knew about. The exciting findings which have emerged from MRI scans instruct us in ways we had no idea about before the late 90s, but they dont negate what is known about hormones. Puberty is not something which occurs overnight: it takes a number of years. Gonadal hormones begin to be released – testosterone in boys, oestrogen in girls – during the second phase of puberty which ranges across early- to mid-adolescence. One fact which adds to the exacerbation of all these issues for modern teenagers isConference Papers that the age of puberty has fallen dramatically, due essentially to better health and diet: "Puberty is happening at an earlier stage than ever, largely due to the amount of fat and high-calorie food in the diet. Girls, on average, now start their periods at the age of 12 years and 10 months, eight months earlier than 30 years ago." (Revill, 2003) Page 23Page 1 of 8 of 38
  24. 24. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety It is likely that the age of puberty has fallen David two years over the last around Blackburn, Corporate Edge century. Certain studies have shown important links between hormones in teenagers and emotions. In particular is the work of Allan Mazur of Syracuse University, who, with others, conducted a piece of work which linked aggression in teenage boys with testosterone levels (Mazur, 1997). However, shortly before Jay Giedd started sharing his research relating to adolescent brain development with the world, other work conducted by Elizabeth Susman, who was one of the contributors to the Mazur paper, was disseminated in a press release, which very much plays down the links between hormones and behaviour: ""There are many environmental factors that are at work that can affect an adolescent. Influences from family, peers and school are likely so significant that hormones changes are too weak to overcome such strong social influences," says Elizabeth Susman, Ph.D., the Shibley Professor of Biobehavioral Health in Penn States College of Health and Human Development. "We spent a number of years on this project and most of us were a bit surprised that hormones were not more influential on behavior," says Howard Kulin, M.D., professor of pediatrics in Penn States College of Medicine and principal investigator of the project. The paper, "The Effect Of Sex Hormone Replacement Therapy On Behavior Problems And Moods In Adolescents With Delayed Puberty," was published in the October issue of the journal Pediatrics. Susman, who adds she was a bit surprised with the results, says that hormones and biological changes are not as powerful modulators of behavior as previously thought. Parents should not expect their child to become more negative, or more anxious or more aggressive just because they are entering puberty, she says." (Penn State Population Research Institute, 1998) Melatonin and sleep One final area of information on teenage brain development to be included here concerns sleep patterns. Once again we recognize a facet of the stereotype teen – hidden under the duvet until lunchtime or beyond. And once again we find that changes during adolescence are to blame.Conference Papers We all need sleep to recharge the batteries: certain key functions are happening in our brains, while our bodies are inert. This is especially true for teenagers, where hormones connected with growth and sexual development are released during sleep. Indeed, it is a hormone called melatonin, secreted from the pineal gland, which tells us its time to go to sleep in the first place. Sleep researcher Mary Carskadon, based at Brown University School of Medicine in Rhode Island, has found through two key surveys that teenagers Page 24Page 1 of 8 of 38
  25. 25. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate need more sleep than most of us believe, and certainly more than most get; Edge yet during these years, their melatonin release doesnt happen until later in the evening. Thus they need to catch up at the weekends. "Eight to nine year-olds sleep perfectly. The melatonin in the brain kicks in at 9pm, so they can sleep for ten hours before it is time to get up for school. In adolescents, however, the melatonin doesnt kick in until 10.30, the same as for adults, and yet they still need 10 hours sleep." (Daily Telegraph, 2002) Carskadon has also been quoted criticizing school hours which begin early in the day: "The eyes are open, but the brains are asleep… This is not a time of day when teenagers can be reasonably expected to participate in class." (Carskadon, 2004) Her work does not go as far as identifying a direct link between sleep deprivation and school grades, but the clues are definitely there. A study she conducted with Amy Wolfson (1998), of the College of the Holy Cross, found that students who reported that they were getting Cs or lower at school obtained about 25 minutes less sleep and went to bed about 40 minutes later than students who reported they were getting As and Bs. Three years ago, an experiment in the States provided some evidence that later starts for schools would be beneficial: "Researchers at the University of Minnesota reported the results of a study of more than 7,000 high-school students whose school district had switched in 1997 from a 7:15am start time to an 8:40am start time. Compared with students whose schools maintained earlier start times, students with later starts reported getting more sleep on school nights, being less sleepy during the day, getting slightly higher grades and experiencing fewer depressive feelings and behaviours." (Carpenter, 2001)Conference Papers Page 25Page 1 of 8 of 38
  26. 26. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety WHAT THIS ALL MEANS David Blackburn, Corporate Edge To summarize the key points: ! the teenage brain was considered until fairly recently to be essentially fully-grown; ! research now tells us that a considerable stage of development occurs, beginning with a period of growth, then a phase of pruning throughout the teenage years; ! thus teenagers are faced with a use it or lose it scenario, where key skills may be lost forever; ! the development process begins at the back of the brain and ends with the front – the prefrontal cortex, which we know is responsible for our rational decision-making; ! so teenagers are immature, and many of their behaviours can be understood; ! whilst the facts are true of all adolescents over the years, environmental factors have made the current generation more susceptible than ever before. Many inferences will already have been drawn. Statistics were included earlier which link the teen years to certain issues, and what is now known about teenage brain development may certainly be a factor. Other inferences are also drawn; the following article links teenage brain development and smoking. Edward Levin, of the Duke University Medical Center in North Carolina, conducted an experiment with teenage rats (it not being ethical to conduct smoking research of this kind with young people): "The results indicate that early nicotine exposure can leave a lasting imprint on the brain. The brain continues to develop throughout the teenage years. Early nicotine use may cause the wiring of the brain to [develop] inappropriately." (Bhattacharya, 2003) This predisposition to nicotine addiction can apply to drugs also; we know that environmental issues and pressures will tempt many teenagers to experiment; now we also learn that they are more likely to get hooked. Dr Andrew Chambers, of Yale School of Medicine, analysed over 140 studies and reported the following: "“Several lines of evidence suggest that socio-cultural aspectsConference Papers particular to adolescent life alone do not fully account for greater drug intake,” said lead author Dr Andrew Chambers in the American Journal of Psychiatry. The team’s review suggests that particular sets of brain circuits involved in the development of addictions are the same as those that rapidly undergo change during the teenage years. “Normally these processes cause adolescents to be more driven than children or adults to have new experiences,” he said. “But these conditions also reflect a less mature neurological system of inhibition, which leads to Page 26Page 1 of 8 of 38
  27. 27. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate impulsive actions and risky behaviours, including experimentation and Edge abuse of addictive drugs.” (Healthy Pages web site, 2003) This theme is continued by Professor Michelle Ehrlich, of Thomas Jefferson University in Philadelphia, who claims, in an article in the Journal of Neuroscience, that the teenage brain is more predisposed to drug-taking than either childrens or adults brains (Roger Highfield, 2002).Conference Papers Page 27Page 1 of 8 of 38
  28. 28. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate In one of our Immersion interviews, a young teenager made it clear that he Edge knew he was vulnerable to the temptation to try drugs: Immersion interview #4 – Harry Harry is 13. He lives in a terraced house in the city, with his mum, dad, sister aged 15 and brother aged 18. Harrys brother has had severe problems with depression through his teenage years, and is only just coming out of it. Harry appears mostly unaffected – a confident boy who enjoys badminton and playing the drums. He gets into trouble at school – but all minor stuff – arguing with teachers and so on. He has always had a high disposition towards risk, scaling high gates and walls as a child. The danger is that this now moves away from climbing walls intoConference Papers experimenting with substances: Page 28Page 1 of 8 of 38
  29. 29. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety "There are some people at my school who do drugs, but Blackburn, Corporate David not any of my friends, so I Edge am not really tempted… I would feel pressurized into taking them, because if (my friends) think its OK, then I should do it as well. But they all think its quite stupid and I think it is." Jay Giedd himself adds to this area: "Its also a particularly cruel irony of nature, I think, that right at this time when the brain is most vulnerable is also the time when teens are most likely to experiment with drugs or alcohol." (Giedd, 2004b) Clearly this leads to advice as to how parents should, and shouldnt, behave with their teenage children, if they want to remain sane; many books have appeared on the shelves addressing this very issue; a personal favourite is titled Get Out Of My Life (But First Take Me And Alex Into Town) (Tony Wolf & Suzanne Franks, 2002). However, Judith Harris tells us that parents have little influence on their children, in terms of how they behave outside the home, especially by the time they are teenagers: "It is true that if you ask kids who influences them more – what theyd do if their parents and their friends gave conflicting advice – younger children are more likely to say theyd listen to their parents. But they are asked thisConference Papers question out of context and the one whos asking is a grown-up. They may interpret the question as meaning Whom do you love more? and of course they love their parents more than they love their friends. The question has been answered by the relationship department of their mind but it is the group department that will, in the long run, determine how they will behave when theyre not at home… Adolescence is when the choices get made. When they sort themselves into groups, teenagers are defining themselves." (Harris, 1998) Page 29Page 1 of 8 of 38
  30. 30. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge Harris thesis is that nurture, to the extent that it shares influence with nature, is essentially about peer influence, rather than parental influence. So perhaps reading books about how parents should manage teenagers is not an answer. This is not to suggest that because teenagers are more influenced by their peers that adults should give up on them. Indeed, the area of Information, Advice and Guidance which the new Connexions service has taken on is hugely important. It is because adolescents are poor at making decisions, that they need help, even if their outward appearance seems to reject it: "When children are small, we patiently teach them how to read and write, how to count or tie their shoelaces because we know that these are essential skills. Yet when our children reach adolescence, we often withdraw and offer less guidance because they are so much more capable physically of doing things for themselves." (Figes, 2002) One important area of life which is taking notice of the new research findings is that of teenage culpability. This is critical in the States, where a teenager can be put to death for committing a murder. The American Bar Association published a paper summarizing the discoveries of Jay Giedd and others, and came to the following conclusion: "These discoveries support the assertion that adolescents are less morally culpable for their actions than competent adults and are more capable of change and rehabilitation. The ultimate punishment for minors is contrary to the idea of fairness in our justice system, which accords the greatest punishments to the most blameworthy. This fresh understanding of adolescence does not excuse juvenile offenders from punishment for violent crime, but it clearly lessens their culpability." (Juvenile Justice Center, 2004) The Supreme Court in the States is, at the time of writing, considering a case which will determine the constitutionality of the juvenile death penalty (due for announcement in February 2005). In a polemical piece published recently (David Fassler, 2004), the author argues the case for listening to the recent research using MRI to inform this decision. Indeed, he tells us that an amicus brief has been filed by the American Medical Association, the American Psychiatric Association, The American Academy of Child and AdolescentConference Papers Psychiatry and the American Academy of Psychiatry of the Law stating opposition to the execution of juvenile offenders, triggered by the new findings about the teenage brain. Page 30Page 1 of 8 of 38
  31. 31. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate We now understand that the brain works on a "use it or lose it" basis while it is Edge undergoing development. One of these phases of development occurs during the teenage years. This is when a large proportion of teenagers, especially boys, spend large amounts of time playing on PlayStations, GameCubes and Xboxes: "An incredible 95% of (UK) teenage boys have a games console at home and half spend over nine hours a week playing on them." (Holden & Griffiths, 2004) There have been a number of studies looking at the effects of such games on behaviour. Findings are inconclusive, in the sense that some studies report more aggressive behaviour related to video games-playing (for instance, see Anderson & Dill, 2000) whilst others do not (for example Wiegman and Van Shie, 1998). For an excellent summary of research in this area, see Wolock, 2004. For the purposes of this paper however, there is a strong argument to suggest that some teenagers will be allowing elements of their brain concerned with socialization to be lost, as they communicate solely with their TV screen or monitor. To some extent this will be counterbalanced in terms of those who play in pairs or groups. The advice, that appears in a number of sources, is that teenagers will benefit from continuing sport and music. It is fair to say that a number of young people begin these activities in their childhood, but drop them when the social pressures of teenage emerge. It is also fair to say that many schools, whilst prizing their prowess at sport and/or music, nonetheless place greater emphasis to their students on achievement in academic subjects. Parents would do well to consider the advice which suggests that continuation of physical activity and creative arts will have benefits beyond the obvious ones: "Basal Ganglia: larger in females than in males, this part of the brain acts like a secretary to the prefrontal cortex by helping it prioritize information. The basal ganglia and prefrontal cortex are tightly connected: at nearly the same time, they grow neuron connections and then prune them. This area of the brain is also active in small and large motor movements, so it may be important to expose preteens to music and sports while it is growing." (Dell, 2004) Once again Jay Giedd has words on the subject:Conference Papers "The pruning-down phase is perhaps even more interesting, because our leading hypothesis for that is the "Use it or lose it" principle. Those cells and connections that are used will survive and flourish. Those cells and connections that are not used will wither and die. So if a teen is doing music or sports or academics, those are the cells and connections that will be hard-wired. If theyre lying on the couch or Page 31Page 1 of 8 of 38
  32. 32. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate playing video games or MTV, those are the cells and connections that Edge are going [to] survive." (Giedd, 2004b) For this paper, evidence emerged in the Immersion interviews, that where teenagers were involved in sport or music, or indeed both, there were fewer problems at home. Immersion interview #5 – Jake Jake is 15. He lives in a terraced cottage on the outskirts of the city, with his mum. Jake lost his dad when he was just one, so has grown up an only child in a single - parent family. He has stayed well on the rails however: the worst that appears to have happened at home is when his mum found cigarette butts in his room. This was just an experimentation with a friend however. Typically, Jake cannot explain why he did it.Conference Papers Page 32Page 1 of 8 of 38
  33. 33. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety Otherwise, Jake and his mum only argue about David Blackburn, Corporate what time he goes to bed. Edge Jake plays rugby - at full - back for the county – and bass guitar in a band. The use it or lose it principle is also connected to the issue of drug and alcohol use amongst teenagers. This is especially dangerous since use of these substances contributes to the lose it side of the equation: "From pot to cocaine, from angel dust to Ecstasy to heroin to alcohol, to nicotine, which is, after all, just another drug, all addictive, mood- altering drugs behave like terrorists hijacking the brain-reward neural pathways, giving your brain instant false, temporary rewards and whatConference Papers is worse, setting your brain up to need the next jolt. The healthy reward circuits, unused, are beginning to disappear." (Carlson, 2004) Page 33Page 1 of 8 of 38
  34. 34. The Teen Brain: Whats Going On In There? Dealing with the decase of anxiety David Blackburn, Corporate Edge IMPLICATIONS FOR THE MARKET RESEARCH INDUSTRY How do we deal with this knowledge of teenagers? Parents of teens going through the changes outlined above often express frustration at the lack of communication. Remember Michael Bradley (2004) and the image of the German Shepherd puppy. The average teenager has no more sensible response to the question "Why?", perhaps in terms of Why they didnt go to school, or Why they cut up a favourite T-shirt, than the puppy has as to why he used your favourite carpet as a toilet. And the reason is probably the same: that they dont know Why. We need to consider what we as researchers ask of young people whose brains are undergoing what is major refurbishment, whether it is within a quantitative questionnaire, or in a qualitative interview or stimulus board. Deborah Yurgelun-Todd, who did the experiment with fearful faces is quoted thus: "We have to think about the idea that they might not be hearing the words in the ways we intend them." (Strauch, 2003) So, not only should we be considering what to ask teenagers, but also, clearly, how to ask questions, and how to interpret the answers. It is likely that we are guilty often of providing complex questions, which to the teenage brain are difficult to decode if they contain an emotional as well as a rational element to them. If simplifying the process is the order of the day, then in qualitative research, perhaps the individual interview will elicit more salient responses than the group situation, or even pairs, where the complication of the relationship with the other person may confuse the young persons thinking. We would normally adopt this protocol for sensitive topics: how can we as adults perceive what is and what is not sensitive to the developing teenager? IMPLICATIONS FOR MARKETERS It is to be hoped that a proportion of the readership for this paper will be those actually marketing to teenagers. One of my clients swears by What Kids Buy and Why (Acuff, 1997); whilst this provides an interesting description of the differing ages and their psychological triggers, its publishing date means that all references to teenagers and brain development are out-of-date. In herConference Papers introduction to her book, Barbara Strauch (2003) says: "Indeed, the field is changing so fast, I found myself checking dates on any scientific study I looked at. Oh, 1996, too old." The research cited in this paper is relatively new: it is to be hoped that Acuff updates his book; indeed that other, new books emerge to grapple with what we have learnt. Page 34Page 1 of 8 of 38