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Unformatted text preview: Scan and Deliver ILLiad m: 805584 l||||||||||||||||||||||||||||||||l|||||l Borrower: headdy Eaddy, Heather Journal Title: Adolescent brain development: vulnerabilities and opportunities Volume: Issue: Month/Year: 2004 Pages: 310-319 Article Author: Article Title: Regulatory processes, risk, and resilience in adolescent development Call Number: Q11 .N5 v.1021 Location: Cited in: Notes: Regulatory Processes, Risk, and Resilience in Adolescent Development ANN S. MASTEN Institute of Child Development, University of Minnesota, Minneapolis, [Minnesota 55455-0345, USA ABSTRACT: This article highlights the potential of developmental psychopa- thology as a useful integrative perspective for the challenging task of linking the study of brain development and adolescent behavior in context; it considers clues from behavioral research on resilience on the nature of regulatory pro— cesses as risks and assets, or vulnerabilities and protective factors for the de- velopment of competence and psychopathology in adolescence; and it advocates more integrative neurobehavioral research on risk and resilience in adolescent development. KEYWORDS: developmental psychopathology; resilience; regulatory processes; adolescents Understanding successful and unsuccessful pathways through adolescence is clearly vital to the sciences concerned with human development in all its forms at all levels, and also to the stakeholders in the health and well-being of adolescents and the cit- izens they will become-parents, practitioners, policy-makers, communities, soci- ety, and young people themselves. At the beginning of the let century, we stand at an exciting and challenging juncture in the effort to illuminate the processes that ac- count for normative and deviant patterns of development entering and leaving ado- lescence and the strategies that may work to alter pathways in more favorable directions. This volume highlights the potential of advances in the neurobehavioral sciences to elucidate processes that contribute to successful development and psy— chopathology in adolescence. At the same time, it is clear we have a long way to go not only in charting basic brain development in adolescence, but in understanding the complex interplay of individual adolescents and the contexts in which their de- velopment unfolds. Adolescent brain development is inextricably embedded in a much larger network of interacting systems that profoundly influence how the brain develops and how adolescents put their brains to use as they make their way through life. This article has three goals: (1) to highlight the potential of developmental psy- chopathology as a useful integrative perspective for the challenging task of linking the study of brain development and adolescent behavior in context, and (2) to con- sider clues from behavioral research on resilience on the nature of regulatory pro— Address for correspondence: Ann S. Masten, Institute of Child Development, 51 East River Road, Minneapolis, MN 55455-0345. Voice: 612-624-0215; fax: 612-624-6373. [email protected] Ann. NY. Acad. Sci. 1021: 310—319 (2004). © 2004 New York Academy of Sciences. doi: 10.1196/annals.l308.036 310 MASTEN: REGULATION, RISK, AND RESILIENCE 311 cesses as risks and assets, or vulnerabilities and protective factors for the development of competence and psychopathology in adolescence; and (3) to advo- cate for more integrative neurobehavioral research on risk and resilience in adoles- cent development. DEVELOPMENTAL PSYCHOPATHOLOGY AND THE ADOLESCENT The developmental psychopathology perspective, reinforced by theory and data from studies of risk and resilience, underscores the importance of a dynamic systems model of development that embeds adolescent development, including individual brain development, in a larger network of social and cultural systems. Interactions of individuals and the systems in which development unfolds not only serve regulatory functions for individual behavior but also shape and are shaped by brain development. Developmental psychopathology is an integrative approach to understanding be- havior problems in the full context of human development, with a focus on variations in adaptation, the processes that account for that variation, and how patterns of mal- adaptation may be prevented or ameliorated. This perspective emerged over the past three decades as theory and research on child development and psychopathology converged}—4 This perspective has several key implications for understanding the role of brain development in adolescence. First, developmental transitions are important. Periods of rapid or dramatic trans- formation in organism or context or both, which clearly is the situation both for the transition into and out of adolescence, are likely hot spots for observing onset or off— set of psychopathology, and also periods when changes in vulnerabilities and oppor- tunities may arise and redirect the course of development. A number of disorders and symptoms of psychopathology, including depression, self—injury behavior, substance abuse, eating disorders, bipolar disorder, and schizophrenia have striking develop- mental patterns corresponding to transitions in early and late adolescence.5 Devel- opmental transitions represent reorganization in multiple systems in response to changes within the organism, the context, and their many interactions. Brain devel- opment and physical maturation trigger some of these changes; however, experienc- es (some of them occurring as a result of adolescent decision making or cultural traditions or age-graded role transitions) also may set off cascades of change that in- fluence gene expression and brain organization. Second, psychopathology is assumed to arise from complex interactions of or— ganism and the multiple systems in which the life of the organism is embedded.6’7 Observable changes in behavior are likely to result from multiple causes (the princi- ple of multicausality), at multiple levels of interaction, reflecting the co-action of or- ganism and environment from genes to society. As a result, common endpoints and final pathways can emerge from diverse beginnings (the principle of equifinality) and individuals who start down the same path can end up going down many different roads over time (the principle of multifinality). From this perspective, the same prob- lem of adolescence, whether it be violence, pregnancy, alcohol use or smoking, or self—injurious behavior is assumed to have multiple causes and arise in diverse kinds of people for diverse reasons. Similarly, the same genetic vulnerability or injury in a developing brain can result in a diverse array of subsequent phenotypes and lime- tional variations in behavior. 312 ANNALS NEW YORK ACADEMY OF SCIENCES This multi-systems perspective highlights the importance of connecting multiple levels of analysis and the multidisciplinary collaborators necessary to do so.8 Devel— opmental psychopathology increasingly reflects the integration of biological and neuroscience models and methods with the disciplines more traditionally focused on behavior and psychosocial models and methods?‘11 In this respect, this volume ex- emplifies the new face of developmental psychopathology in the let century. Third, the organism is an active agent in development. Individuals recruit, elicit responses, and in other ways choose and influence the contexts that in turn contribute to their development. Adolescents can choose to hang around with antisocial peers that accelerate their deviant behavior.12 They choose to attend school or do their homework instead of attending a party. As access to electronic tools expand, adoles- cents can actively interact with diverse media and people all over the world, and in- creasingly control their interactions and exposure to people and information.13’14It is unclear how the “virtual worlds” of adolescents, where context can be individual- ized to an unprecedented degree, are influencing brain development.5 Fourth, the developmental psychopathology perspective assumes transactional influences between individual and other systems. 15 Individuals and their peers, fam- ilies, teachers, and all the many other people they interact with in the contexts of dai- ly life reciprocally influence each other. Adolescents behave in ways that are engaging, manipulating, off-putting, and sometimes alarming to other people in their lives, with many consequences. Moreover, the people in their lives are also interact- ing, such that there can be indirect consequences of adolescent behavior on others who in turn will take actions that alter subsequent adolescent experiences. Getting into trouble with peers may lead to police or school authorities interacting with par- ents, with subsequent consequences for the lives of adolescents. From a transactional perspective, we have just begun to chart the symphony of co-regulation that may govern the course of behavior among adolescents and the people in their lives. Moving up to a more macro-system level of interaction, adolescents, through their collective purchasing power in modern societies also influence the clothes, movies, music, TV, food, and other products that are made and how they are market- ed. Concomitantly, marketers actively recruit adolescents to buy and choose their products. Increasingly, advertising appears to be deliberately couched in regulatory terms addressing the needs and concerns of adolescents: this product will help you feel better, look better, attract sexual interest, make friends, or be cooler. Fifth, developmental psychopathology assumes that research on positive and de- viant functioning and development are mutually informative. It is crucial to under- stand not only pathways to problems but also the pathways away from problems. Thus, developmental psychopathology encompasses the study of good and poor ad— aptation, competence and symptoms, risks and assets, vulnerabilities and protective factors. It is assumed that a full understanding of psychopathology and problems re- quires a deep understanding of normative and deviant processes that may be involved in etiology and prevention. Studies of naturally occurring pathways are important, as are studies to experimentally manipulate the direction of development. Sixth, the developmental psychopathology perspective emphasizes the impor- tance of longitudinal studies for understanding the interplay of genes, individual and context, at multiple levels, in shaping development. Variations in the causes, tempo, context, and timing of development within and across systems, within and across in- dividuals can create very misleading conclusions in cross—sectional studies, as noted MASTEN: REGULATION, RISK, AND RESILIENCE 313 by theorists and statisticians.16 Moreover, hindsight has a habit of leading one to misguided conclusions about continuity and change in development. Prospective, longitudinal studies are quintessential developmental psychopathology because they are much more likely to reveal unexpected pathways toward and away from the behavior of interest. The importance of a longitudinal perspective obtains for experimental studies of intervention as well as for studies of naturally occurring pathways in development. An important illustration of this point can be found in the Seattle Social Develop- ment Project.l7'19 Utilizing data from a large prospective panel study of antisocial behavior, these investigators have illustrated pathways toward and away from seri- ous antisocial behavior and examined the predictors of those pathways, utilizing in— novative methods of growth curve analysis and identification of developmental trajectories popularized by Nagin20 and others. Utilizing data from a longitudinal panel study, they have examined divergence and convergence of pathways from var- ious starting levels of antisocial behavior at age 13, in search of the predictors of pathways and change. Beginning from a moderate level of juvenile offenses, for ex- ample, desisting versus escalating pathways are predicted by individual characteris- tics (aggression, internalizing symptoms) and also neighborhood qualities (drug availability). Beginning with low levels of offenses, escalating pathways (late onset offending) versus holding the positive course of no offending are forecasted by greater antisocial peer involvement, lower school bonding, and more drug availabil- ity in the neighborhood. Other kinds of risky behavior (such as teen pregnancy and drug problems) are also predictable from similar risk or protective factors in the ad- olescent or environment in this study. As part of the same project, these investigators have embedded an experimental intervention into a subgroup of the children in this study, all residents of risky neigh- borhoods for antisocial behavior. Based on their social development model, they de- signed an intervention targeting processes believed to influence movement onto prosocial or antisocial pathways, including school bonding. There were three groups compared in this longitudinal intervention trial, with schools assigned to different treatment conditions: a full treatment group who received a multifaceted interven- tion throughout elementary school, a late treatment group that received only the late elementary school years of the program, and a comparison group with no interven- tion participating in the panel study. Results are compelling in several ways. First, the intervention worked to reduce multiple kinds of risky behavior as assessed years later.19 Second, the intervention resulted in greater school bonding, a key hypothe- sized mediator of pathways toward or away from antisocial behavior. Third, the treatment effects could be attributed to school bonding. Generally their results are consistent with the idea that school bonding is a protective factor in the battle against antisocial development and that efforts to create stronger bonds by intervening in el- ementary school can work. However, the data are quite interesting in another way. The treatment effects ev- ident for the full treatment group are clear at age 13 (a year after the treatment had concluded) and then disappear for several years (ages 14 to 16) only to re-emerge later in adolescence. If the follow-up assessment for this prevention study had been limited to one assessment at age 15, conclusions would be quite different about whether and how it worked. It is intriguing to consider the possibility that treatment effects were temporarily swamped by the noise of developmental change during the 314 ANNALS NEW YORK ACADEMY OF SCIENCES early teen years. It is also conceivable that acting “unbonded” to school is normative during the early secondary school years, whereas open involvement and attachment to school is normative later on in high school. In any case, these data underscore the important of longitudinal data for a clear picture of change over the course of ado- lescent development. RESILIENCE RESEARCH IN DEVELOPMENTAL PSYCHOPATHOLOGY Hints about Regulatory Processes Implicating Brain Development in Adolescence The study of behavioral resilience phenomena in developmental psychopatholo- gy may offer some important clues about the significance of regulatory processes for successful passages through adolescence and the corresponding role of brain devel— opment and processes in regulating affect, arousal, and behavior. The study of resil— ience had its beginnings in the study of populations at risk for psychopathology, as part of an effort to study etiological processes”—24 Prospective developmental stud- ies of children at risk for problems led to the observation that there are diverse out- comes (i.e., multifinality) among groups of children considered to be a risk due to their status as a member of a known risk group (with elevated probability of some undesired outcome) or their known exposure to psychosocial adversities strongly as- sociated with problems, such as family violence or poverty. The striking phenome- non of individuals with successful development among groups of very high—risk children inspired a pioneering group of investigators to study the processes that could account for such apparent resilience. This body of work, encompassing a vast array of risk factors, outcomes, and possible mediating or moderating processes, from diverse situations and cultures, consistently points to a “short list” (TABLE 1) of factors linked to better outcomes in adolescence and more successful transitions from childhood to adolescence and adolescence to adulthood.25‘28 This list may re- flect the operation of fundamental human adaptation systems common to all or many human lives that play a central role in psychosocial development.22 Some of these systems can be located at a given time in the adolescent (such as cognitive abilities and executive functioning) and some of which are located in the context (such as ef— fective parenting and good schools). However, all of these systems develop and change over time, and therefore must reflect the dynamic interactions of all the sys- tems involved in development. The most damaging hazards in human development may be the ones that damage or alter these adaptive systems. Children can and do overcome horrible experiences; however, there are situations that have lasting con- sequences mediated by alterations in important adaptive systems, including brain damage or deviations resulting from maltreatment, malnutrition, or neglect. These systems also may be influenced by genes or genetic defects that constrain develop- ment (e.g., Down syndrome) or genetic vulnerabilities that impair the development of adaptive systems under certain conditions, as postulated in diathesis—stressor models of mental disorders (e.g., schizophrenia). It is worth noting that the most widely implicated factors associated with malad— aptation versus resilience in adolescents all implicate what might be termed regula- tory capital. A speculative list is provided in TABLE 2. Like “human capital,” some MASTEN: REGULATION, RISK, AND RESILIENCE 315 TABLE 1. The “short list” of widely reported correlates and predictors of resilience in youth One or more effective parents Connections to other competent and caring adults Cognitive, attention, and problem—solving skills Effective emotion and behavior regulation Positive self-perceptions (of efficacy, worth) Beliefs that life has meaning; hopefulness Religious faith and affiliations Aptitudes and characteristics valued by society (e.g., talent, attractiveness) Prosocial friends Socioeconomic advantages Effective school, school bonding Effective community (e.g., safe, with emergency services, recreation centers) TABLE 2. Regulatory processes implicated by studies of resilience Executive functioning Emotion regulation Attachments to adults who monitor and support youth effectively Relationships with peers who up- or down—regulate others effectively Bonding to prosocial socializing and community organizations Opportunities for regulatory capacity—building of these resources are attributes of the individual and how well the central nervous system is operating to direct successful behavior, such as intellectual skills, quality of executive functioning, or good concentration skills. Others, like “social capital,” are resources derived from connections to other people, and draw on the regulatory effectiveness of these relationships or people, such as effective parenting or strong mentoring relationships. Still others reflect connections to social and cultural orga- nizations that provide structure, rules, expectations, and support, such as schools, sport teams, clubs, and religious organizations. Sampson and colleagues29 have de- scribed neighborhoods high on this type of social and regulatory capital as high in “collective efficacy,” a measurable neighborhood attribute that is associated with fewer problems in youth. These systems could operate in a number of ways. Some children appear to enter the challenging period of adolescence with poor regulatory skills, reflecting earlier processes and experiences: they do not have what is required for safe negotiation of the challenges of adolescence, particularly in the risky environments they are likely to face. In other cases, adolescents appear to have adequate regulatory capacity, but it becomes misdirected (from society’s point of view) toward negative aims or even co-opted by antisocial peers and adults. This may occur as a result of bad neighbor- hoods or peer influences, real and perceived oppression or discrimination, war, etc. 316 ANNALS NEW YORK ACADEMY OF SCIENCES Still other adolescents may flourish despite risky environments or faulty brain func- tion, through compensatory processes. Thus, this literature hints that for some ado- lescents, the problem is poor regulatory skills in the organism, for others the core problem is availability of contextual resources, and for others, the core issue is how they choose to deploy perfectly adequate regulatory capacity. Clearly, it will be im- portant to distinguish poor skills from poor applications of skills in studies to link brain development and function to behavior in adolescence. Nonetheless, the resil- ience literature generally suggests that good regulatory capacity, utilized effectively toward achieving competence in age-salient developmental tasks, holds the key to successfully negotiating the adolescent transition. There are also hints in the literature on resilience that “late blooming” occurs, that there are adolescents who appear to be off-course in development, who then regroup and become successful young adults.Z3’30 The processes by which this might occur are a matter of speculation; the possibilities, however, have intriguing implications for the study of brain development. One possibility is that the transition to adulthood offers greater freedom of action and more opportunities for life-altering changes in context (e.g., military service, marriage, moving to job opportunities, college). The other possibility is that a developmental change occurs in cognition or motivation that leads to an awakening or epiphany about the direction needed in one’s life and subsequent actions to correct that course. These developmental changes in thinking and planning may result from brain developments that make it possible to reflect, plan, delay gratification, and coordinate one’s motivation, behavior, and life in new ways, as referred to by Keating at this symposium, just as new opportunities are be- coming available in the environment, providing chances for course correction in de- velopment as adolescents transition to adult life. Despite many hints that regulatory processes are central to positive developmen- tal pathways through adolescence in the resilience literature, very little work in this framework has integrated brain development and its implications into the story. Only recently are scientists undertaking explicit neurobehavioral approaches to resilience.10’31’32 Three waves of research are evident in the history of behavioral research on re- silience developmental psychopathology.33 The first wave, which began about three decades ago and is waning now, was characterized by identifying among young peo- ple at risk for diverse reasons the correlates and predictors of good adaptation—at- tributes of the individuals, their families, and communities that seem to make a difference. The second wave that ensued and continues to build is focused on iden- tifying the processes and mechanisms “behind the factors” that may explain how re— silience occurs manually. The second-wave work is focused on mediators and moderators of adaptation in the context of risk or adversity. The third wave of work, which is just beginning, is focused on creating resilience through intervention, to put hypothesized processes to the test in experimental designs based on a risk/resilience framework. The Seattle Social Development Project19 illustrates how all three stages of research can be combined. In their panel study, as described above, they identified predictors of good versus undesirable outcomes. One of these predictors was school bonding, a process hypothesized to mediate the pathways to good outcomes among high risk youth. In the intervention study, they attempted to moderate this mediation process (through their intervention program) to create resilience among high risk children. MASTEN: REGULATION, RISK, AND RESILIENCE 317 The biology and neuroscience of resilience is just getting underway, thus there is likely to be some lag in the integration of brain processes into the ongoing waves of work on resilience. Hopefully, the shift from descriptive correlates to processes will progress quickly for two reasons: first, behavioral scientists have provided clues about correlates and possible processes at a behavioral level; and second, neurosci- entists are rapidly advancing the basic understanding of brain processes pertinent to adaptive functioning and behavioral development. EMERGING TRENDS IN THE DEVELOPMENTAL PSYCHOPATHOLOGY 0F ADOLESCENCE This volume reflects a transformation occurring in contemporary models of ado— lescent development that is also evident in the research on risk and resilience and likely results from mergers and collaborations across disciplines concerned with young people and their well-being. There is a shift to models that encompass multi- ple systems and multiple levels, integrating developmental theory, general systems theory, developmental epidemiology and psychiatry, behavioral genetics, molecular genetics, and neuroscience. As a result, models are more dynamic and complex. Re- search has moved beyond individual and family influences to address peer, neigh— borhood, school, cultural, and media effects as well as their joint effects on the course of individual development. At the same time, there is increasing effort to add deeper models within the organism that connect more levels of neurocircuitry, mo- lecular genetics, and biological processes to cognitive behavior, action, or adaptive outcomes. There is growing interest in “biological embedding” and related topics fo— cused on how experience is carried forward by the individual in development but also how the organism may compensate for deficiencies in function or right itself and how brain plasticity works. There are more urgent calls for research that addresses issues of great concern to society and moves beyond understanding to preventing vi- olence, substance abuse and binge drinking, driving accidents, obesity, self-injurious behavior, and other problems strongly associated with adolescence and with the reg- ulation of affect, arousal, and behavior. There are questions about modern cultures and societies and how they may contribute to or prevent such problems. The continu- ing shift of puberty onset to earlier ages, particularly in girls, coupled with the emer- gence of a prolonged transition period to establish full-fledged adulthood in many societiesi34 is raising a host of questions about the interactions of biology and con- text and the way we live and scaffold the development of our children on the road to adulthood and self-regulation. It is clear that there are casualties along the way to maturity, ofien manifesting dur- ing transition periods, at school entry, the transition to adolescence, or the transition to adulthood. However, it is important to remember that most children become capable adults well-adapted to their society and that the road to success can be bumpy or cir- cuitous. Periods of rapid change or development in capacity or expansion in opportu- nity, such as occur during the entry years into adolescence as well as the exit years, may herald a risky passageway until the regulatory capacity develops to manage new skills, opportunities, or impulses. We want adolescents to learn to drive safely, to have good friends, to effectively navigate the electronic world, and to be happy while mak- ing wise decisions about the ways they raise or lower their arousal and the contexts in 318 ANNALS NEW YORK ACADEMY OF SCIENCES which they spend their time. If, as suggested here, regulatory processes play a central role in resilience among children at risk due to adversity and disadvantage, and many of these youth do not have adequate personal or social regulatory capacity operating in their favor, then it is imperative to understand the processes by which regulatory cap— ital can be promoted, protected, and recovered in development. A better science of adolescent brain development is going to illuminate the pro- cesses of risk and resilience that threaten and protect young people as they navigate the years from childhood to adulthood. Eventually, our efforts to promote success and prevent casualties through these passages should provide benefits. Meanwhile, nurturing this new scientific enterprise is going to take patience, painstaking work at many levels of inquiry, collaboration among scientists from diverse fields of train— ing, new ways of thinking and training, and thoughtful funding to facilitate the sci- ence, the training, and the collaboration that will be required. REFERENCES 1. CICCHETTI, D. 1990. An historical perspective on the discipline of developmental psy- chopathology. In Risk and Protective Factors in the Development of Psychopathol- ogy. J. Rolf, Ed.: 2—28. Cambridge University Press. New York. 2. MASTEN, A.S. & W.J. CURTIS. 2000. Integrating competence and psychopathology: Pathways toward a comprehensive science of adaptation in development. Dev. Psy- chopathol. 12: 529—550. 3. CUMMINGS, E.M., P.T. DAVIES & S.B. CAMPBELL. 2000. Developmental Psychopathol- ogy and Family Process. Guilford. New York. 4. SROUFE, L.A. & M. RUTTER. 1984. The domain of developmental psychopathology. Child Dev. 55: 17—29. 5. 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