Multi-Problem Adolescents: An Increasing Problem

Increasingly more adolescents are developing mental health problems, in addition to coming into conflict with authority. Why is this?

Written and verified by the psychologist Gorka Jiménez Pajares.

Last update: 15 March, 2023

Being a teenager can be difficult. Indeed, in this period of life, there are substantial changes that determine how they’ll turn out in adulthood. In effect, being a teen implies cutting some of the ties that bind them to childhood and building new ones.

However, teens can often perceive life as stormy, dramatic, and unstable. This occurs because, in Western culture, unlike in others, there are no rites, rituals, or practices that indicate to the adolescent that they’ve ceased to be a child and have become a fully-fledged adult (Madruga, 2019).

A dangerous cocktail

Teens experience many difficulties. For example, there are significant changes, both in their body and their social relationships. In addition, their brains are far from fully developed, and they tend to experience emotions more intensely. A percentage of them find drugs a way of coping and reducing their short-term discomfort. But, it means they’re likely to fall into extremely painful traps.

The term multi-problem adolescents is used when, in this vital period, the teen is dealing with problems such as drug addiction, as well as other problems like mental health and legal issues. In fact, currently, in Europe, more than two million adolescents are experiencing these problems.

The figures for mental disorders in developed countries, such as Spain or the US, show that close to 15 percent of people between the ages of four and 17 have a diagnosed mental disorder (Ribas-Siñol, 2015). Moreover, there are increasingly more cases of adolescents who consume multiple substances and develop other comorbid clinical pictures. In other words, they present several clinical entities at the same time.

Drugs, a springboard to other mental disorders

Today, substance abuse is on the increase in adolescents. Indeed, 25 percent confess to having done so in recent weeks. Among the most consumed substances in this population are alcoholic beverages and cannabis. In addition, cocaine use is growing exponentially, something that’s alarming to the experts.

This dramatic increase in substance use has serious consequences. For example, multi-problem adolescents tend to be more violent and engage in criminal behavior more frequently. Often, their goal is to obtain money to pay for drugs. As a result, they find it difficult to integrate into society and experience serious legal problems.

When an adolescent presents, in addition to drug addiction, another clinical entity, such as depression or trauma, it’s known as a dual pathology. This type of condition makes any intervention more complex. That’s because health problems are combined with problems at the judicial level.

Frequent disorders in multi-problem adolescents

The fact that today, health problems in adolescence are starting earlier and are more numerous is noteworthy. In fact, it’s been found that almost half of the adolescents suffering from dual disorders exhibit more than three disorders at the same time. The data varies depending on the type of study and there are some clinical entities that appear more frequently in multi-problem adolescents.

All of these can be interrelated. However, it’s difficult to know which of them has been developed first and has strengthened the others. For this reason, great clinical expertise is required when addressing the problems presented by these adolescents.

Behavior problems

The most frequent disorders in this population are conduct disorders. They’re often manifested in hostile behaviors. For example, theft, lying, or disobeying socially established norms.

The American Psychiatric Association (2014) claims that a characteristic of these adolescents is their low capacity to tolerate frustration. The repercussions vary, depending on the sex of the adolescent:

• Girls tend to lie more. They also miss school more often and use more drugs, compared to boys. The aggressions they commit occur in the relational context, being of a more psychological than physical nature. For example, verbal harassment.
• On the other hand, boys commit more physical aggression. Thus, they tend to commit acts of vandalism and fight. Behaviors related to the theft of objects are also more characteristic in males. In effect, they exhibit a more intense opposition to social norms.

According to the ontogenetic model proposed by McDonough (Fonseca, 2021), substance use is a contextual predisposing factor for the development of conduct disorders. In addition, other elements such as punishment-based upbringing and exposure to violent environments are relevant factors in dual pathology.

The shadow of depression

Depression is the second most common clinical entity in multi-problem adolescents. Indeed, currently, almost five percent of adolescents suffer from depression. It’s one of the most prevalent disorders in this sector of the population.

Among males, it’s especially associated with conduct disorders and drug use. This cocktail makes them more likely to commit suicide, which is the third most common factor of mortality in this population (Ribas-Siñol, 2015).

One theory is known as the self-medication hypothesis. It could explain why adolescents are using substances such as cocaine, which is a stimulant drug, with the aim of reducing their depressive symptoms. It could also be the reason for cases of adolescents consuming this particular substance being on the increase.

Minds wounded by trauma

Trauma is another common disorder that multi-problem adolescents tend to suffer. It arises from continuous situations of abuse. In fact, adolescents might fall victim to substance abuse to face hostile and abusive environments.

As a matter of fact, the APA (2014) mentions that substance abuse and conduct disorders are strongly linked to childhood trauma. More particularly, oppositional defiant disorder. In addition, it points out that drugs can be a way of avoiding dealing with extraordinarily intense memories from an emotional point of view.

Overlapping conditions

As you can see, the clinical entities that emerge in the context of drug abuse frequently overlap. Considering the fact that we’re going through a decade marked by economic instability, a pandemic, and war, it’s understandable that the feelings of insecurity and emptiness that adolescents may experience are intensifying.

Therefore, it’s increasingly common to find adolescents in health clinics who have an extensive history of drug addiction, depression, behavior problems, and trauma. This increase is extremely worrying and alarming to the health systems. Indeed, they’re constantly striving to continue research and develop prevention programs that help the adolescent population lead healthy lives.