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Article Excerpt
Adolescents increasingly are exposed to death, and the quality of their grief differs from that of adults or children. This article highlights adolescent experiences with death within the context of normative developmental tasks and a consideration of ethnic and gender variations.
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Risk-taking behavior among adolescents has been the subject of considerable theory and research during the past decade (Arnett & Balle-Jensen, 1993; Gibbons & Gerrard, 1995; Jessor, 1991). The counterpoint to this stream of exploration has been the efforts of other investigators to identify the factors that promote adolescent resilience to developing serious problems and engaging in excessively risky behaviors (Debold, Brown, Weseen, & Brookins, 1999; Masten, 2001; Roth & Brooks-Gunn, 2000). In light of the tension between death-defying activities, fearless notions of immortality, and unhealthy patterns of behavior on the one hand, and an increasing awareness of death, a developing sense of rationality, and the unfolding of life's possibilities on the other hand, our chief aim in this article is to establish the context in which adolescents begin to grapple with how to construct meaning in their experiences with death as they come to realize their personal mortality. The first section of our discussion reviews the major developmental tasks and challenges of the adolescent years. Second, we highlight how these changes are reflected in adolescents' understandings of death as well as how that may differ from the ideas of younger children and adults. Next, the nature of actual adolescent encounters with death are described. Following this analysis, we apply parallel lenses to look at adolescent grief, including similarities and differences with childhood and adulthood. Finally, the potential implications of this knowledge for intervention and clinical practice with adolescents are suggested.
WHAT IS AN ADOLESCENT?
Although there is no universally accepted definition of adolescence, we generally refer to the second decade of life (and sometimes beyond), which includes at least 40 million individuals in this country. According to the U.S. Census Bureau (2001), there were an estimated 36.6 million 10- to 18-year-olds in the year 2000, and their diversity is comprised of approximately 63% White, 15% Black, 15% Latino, 4% Asian, 1% Native American, and 3% multiethnic individuals. It is also interesting to note that an increasing proportion of American adolescents were born in foreign countries. Lerner and Galambos (1998) have indicated that most of the research that has studied adolescents has depended upon White middle-class samples and, therefore, may be limited in generalizing to minority members. Our discussion refers to research with diverse samples, and we divide the content of the discussion into the physical, cognitive, social, and emotional aspects of development. Obviously, these categories overlap, but they can serve to organize the field and make the information more manageable for mental health counselors to apply in daily work with adolescents.
The physical changes of puberty and their consequent interpretations as body image are among the most dramatic developments of the human life span. Adolescent sexuality represents much more than a biological landmark; it has strong implications for social and emotional growth. Although the sequence of events is fairly standard, there is enormous variability in the timing of pubertal unfolding (Kipke, 1999). Variations by race or gender are not nearly as widespread as between individuals, making the advanced preparation of adolescents a challenge for parents and educators. Graber, Lewinsohn, Seeley, and Brooks-Gunn (1997) have cautioned that adolescents who are significantly out of step with their peers in regard to pubertal timing, especially early maturing girls and later maturing boys, may be at greater risk for a host of psychological problems. It is an unfortunate truism that people often react to adolescents in terms of how mature they look rather than how cognitively and affectively mature they actually are.
The reactions of parents, peers, and others to an adolescent's physical looks contribute to his or her self-perceptions of appearance. This feedback may impact upon adolescents' decisions about participation in exercise or sports, clothing selection, make-up and jewelry, and eating behaviors. Each of these choices, in turn, influences social interactions, long-term health, sexual relationships, and self-esteem, among other possibilities. Perhaps the most widely publicized potential concern pertaining to physical development, particularly but not exclusively for girls, is the onset of an eating disorder. Striegel-Moore and Cachelin (1999) have described, for example, the pathway from coping with early female maturation to distorted body image to anorexia or bulimia. Although only a small percentage of 12 to 18-year-old females have been diagnosed with eating disorders, it is estimated that nearly 20% of girls may participate in unhealthy eating behaviors or the girls are otherwise heavily engaged in worrying about their physical appearance (Dounchis, Hayden, & Wilfley, 2001). It is not incidental to the purposes of our analysis, of course, that the more extreme cases of eating disorders can indeed lead to death.
Adolescent cognitive development provides an important foundation for decision making in the realm of risky or unwise activities. Advances in abstract thinking, the ability to see the perspectives of others, a focus on the future, increasing capacities for problem solving, and a decline in absolutist constructions of right and wrong herald a cognitive maturity that eventually culminates in reducing risk-taking behavior. The transition toward achieving this higher level of reasoning, however, is lengthy and fraught with temporary regressions to more primitive cognitive states. Fischhoff, Crowell, and Kipke (1999) have identified a number of strategies for helping adolescents to learn to more effectively evaluate their options. For instance, parents can encourage their teenagers to seek accurate information about the actual prevalence of alcohol and drug use in order to minimize the peer pressures to engage in these risky activities. When guiding their adolescents, parents must be aware that adolescents enjoy argument as a means of practicing their logical abilities, often jump to conclusions to test their effects on listeners, actively seek to discredit or contradict adult positions to bolster their own confidence, yet still feel the need to have adults assist them in critical arenas. Adolescent competence was found to relate directly to the strength of emotional connections with their parents (Ohannessian, Lerner, Lerner, & Eye, 1998).
There are many ways in which adolescents can demonstrate their developing skills and talents. Instead of belaboring deficiencies and weaknesses, teachers and parents need to capitalize on particular areas of strength to promote further cognitive growth in adolescents. Moral judgment, in particular, may also be stimulated by modeling altruistic behavior and by encouraging volunteerism (Eisenberg, Carlo, Murphy, & Van Court, 1995). Imaginative thinking and hypothetical reasoning are not mutually exclusive with the development of logic skills. Adolescents dare to dream about all kinds of possibilities, including those that may be more controversial. Incomplete notions about the meaning of death may be part of the questioning that an adolescent experiences. Just as the uncertainty about physical change may be unsettling, the expectations for greater rationality can also be frightening. For the physically disabled, physical growth is extremely challenging; and for the learning disabled, cognitive lags may be quite traumatic. Svetaz, Ireland, and Blum (2000) have reported that rates of attempted suicide and violent behavior are higher for adolescents who are learning disabled than for the overall adolescent population.
The social world of the adolescent is heavily dominated by the peer group, but also includes the family, the school, the community, work and religious settings, and the mass media. Involvement with peer groups is a primary mechanism for establishing a sense of independence from the family, but that does not mean attachment to parents is less vital (O'Koon, 1997). Long-term evidence has also suggested that acceptance by the peer group in adolescence has implications for lowered risk of poor adjustment in adulthood (Hansen, Giacoletti, & Nangle, 1995). Peer relations seem to become increasingly more meaningful to the adolescent and typically evolve from same-sex to mixed-sex groupings to couples. Although there may be differences in friendship activities between males and females and between ethnic groups, the qualities of honesty and loyalty, and intimacy for girls, appear consistently in the literature (Clark & Ayers, 1993). The social skills to maintain friendships and to avoid isolation and rejection have been demonstrated to be helpful in minimizing delinquency, substance abuse, school dropout, and aggression (Asher & Coie, 1990). New forms of peer interaction such as computer chat rooms, e-mail exchanges, and instant messaging, as well as cyberdating romantic relationships, are ever more significant in the lives of adolescents (Roberts, 2000).
The context of family and school settings is equally important to protecting the developing adolescent from the exaggerated influence of negative peer models. Parents need to provide warmth and understanding, reasonable expectations for behavior, appropriate limits with realistic consequences, and a strong sense of involvement in their children's lives. Likewise, teachers must be perceived as fair, concerned adults who are able to engage their students in successful achievement of their educational goals. These factors transcend specific family structure, public vs. private school, number of siblings, or teacher-student ratio. Although there is evidence that teenagers from divorced families may have more psychological problems than those from intact families (Conger & Chao, 1996) or that transitions from one school to another can be academically disruptive and lead to school disengagement (Seidman, Aber, & French, in press), there is a surprising degree of resilience for coping with difficult situations. More careful monitoring and supervision of adolescents is often required, particularly in lower socioeconomic status and dangerous neighborhoods (Leventhal & Brooks-Gunn, 2000). Each of these factors interacts with...
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