MONDAY, June 29 (HealthDay News) -- Challenging the notion that risky behavior reflects a youthful sense of immortality, a new study has found almost 15 percent of American teens believe they will die before age 35 -- a perspective strongly linked to risky behavior.
"Prior research has shown that typically teenagers are no worse than adults in terms of viewing their own vulnerability, and, thankfully, most adolescents in this country do not believe that their risk of early death is high," noted study author Dr. Iris Wagman Borowsky, an associate professor of pediatrics at the University of Minnesota. "But we found that more than one in seven youths do have a pessimistic view about their future mortality and are more likely to take risks."
"So as a pediatrician, this says to me that I need to assess my young patients' ability to see themselves in the future," Borowsky added. "And, when I see a problem, to try to figure out how to instill optimism and hope, knowing that a pessimistic view may be an indicator of future risky behavior."
The findings, published in the July issue of Pediatrics, are based on a three-year tracking of attitudes and behaviors among 20,594 teens who were in 7th through 12th grade at the start of the study.
The teens were interviewed periodically to gauge their views on personal mortality and to tally the degree to which they engaged in such behaviors as attempting suicide, using illegal drugs, sustaining fight-related injuries that required medical care, engaging in unprotected sex, being arrested by the police and contracting HIV or AIDS.
The interviews revealed that nearly 15 percent of the teens believed they had just a 50-50 chance of living to age 35.
Race and wealth appeared to affect the risk for that belief. About 10 percent of white teens bore this pessimistic view, compared with 15 percent of Asian youth, 21 percent of Hispanic teens, 26 percent of African American teens and 29 percent of Native American teens.
The study also found that a teen's mental state and behavior were mutually influential. A teen who predicted a short lifespan, for instance, during an early interview was more likely to engage in subsequent risky behavior, and teens who engaged in risky behavior throughout the first year of the study were more likely to develop a pessimistic view of their future.
Borowsky suggested that efforts to prevent such a cycle of skewed perceptions and risky behavior among teens should focus on factors critical to instilling youthful optimism.
"We know that schools matter, and homes and parents matter," she said. "The concept of parents and family connectedness is so important with youth: having fun with your family and having parents you can communicate with and who tell you they love you. And having schools that create a climate where students feel connected and safe is very important. Positive media messages also play a role. These are all things that might prevent the development of a pessimistic view among youth."
Freya Sonenstein, a professor and director of the Center for Adolescent Health Promotion and Disease Prevention at the Bloomberg School of Public Health at Johns Hopkins University, said that addressing the perceptual problems highlighted in the study requires both one-on-one counseling and a recognition of those larger societal issues that could be driving adolescent optimism downward.
"Particularly where there's a high concentration of people who live in poverty -- often minority youth living in blighted neighborhoods with very high violence rates and drug use -- this kind of finding is certainly not surprising," Sonenstein said. "All you have to do is look around in the city of Baltimore, where I am myself, to understand why."
"So it's important to think about strategies -- intervention programs like the ones we have that work with kids around mental health issues -- to get kids to be more optimistic," she said. "And it's also very important to have physicians and other clinicians recognize that these expectations of an early death as a marker for high-risk behavior."
"But you also have to dig down a little deeper and look at the structural situation that make kids lose optimistic in the first place," Sonenstein said. "That's equally important."
The U.S. National Institute of Mental Health has more on adolescent mental health.
SOURCES: Iris Wagman Borowsky, M.D., Ph.D., associate professor, Department of Pediatrics, University of Minnesota, Minneapolis; Freya Sonenstein, Ph.D., professor and director, Center for Adolescent Health Promotion and Disease Prevention, Bloomberg School of Public Health, Johns Hopkins University, Baltimore; July 2009 Pediatrics
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