Jesse Viner, MD

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What's Emerging About Emerging Adults?

Jesse Viner, MD
Founder and Executive Medical Director

 

Behavioral exploration and the search for myriad experience strengthen the self’s competence and facilitates a coherent motivational reward system; you learn to know both what you are  good at and what feels good.  For example, the career literature indicates that those emerging adults who try more and different work situations prior to forging a career commitment experience increased career success and satisfaction.

Siegel’s review of the research also demonstrates that the self does not develop optimally in isolation but within a context of relationships. Advances in the neurobiology of interpersonal experience (cf., Daniel Siegel, 1999) show that the brain forms its neural connections within human connections. In Siegel’s words, “Human connections shape neural networks”. The development of synaptic networks is how the brain expands and sustains the architecture for new learning. The brain, not just the heart and soul, needs emotional relationships to grow. According to Allan Schore (2003) a Yellowbrick Board of Advisor who is an internationally recognized scholar on attachment and affect regulation, it has been demonstrated that built into our DNA is the fact that intimate relationships throughout life act as psychobiological regulators of hormones that directly affect gene transcription. This has powerful implications for the healing role of intensive psychotherapy.

Today’s culture, especially on college campuses, while also decried, offers opportunities for exploration that did not exist even a decade ago. Jarrett Seaman, who will be at Yellowbrick on December 4th discussing his book Binge: Campus Life in the Age of Disconnection and Excess which was written following 2 years of research living on a dozen college campuses across America, describes how traditional dating has become the minority pattern replaced by the phenomena of spontaneous “hooking up”. This is where groups of men and women congregate for an evening together, most often involving alcohol and sometimes drugs, and everyone implicitly agrees to “see what happens”. This provides a fluid interpersonal context for experiencing oneself in relation to others, and coming to know individual needs, struggles and preferences. The current culture allows for both men and women to initiate though this path remains more treacherous for women. Studies show sexually aggressive or experienced women (Seaman’s research and surveys indicate over 80% of women have sex during college) are tarnished in reputation and lose status over time compared to equivalent men who rise in status. The culture of “hooking up” exists despite the fact that Glenn and Marquadt’s survey of 1000 women on 11 campuses demonstrates that 63% of career oriented college women state they intend to find their husband while in college.

When we consider some of the implications of these patterns and statistics we come to understand some of the socio-cultural factors that contribute to emerging adulthood being a time of instability.

Family culture and relationships, community norms, and institutional expectations of secondary schools no longer function as implicit regulators of the self. The emerging adult is challenged to autonomously define, establish and further develop these self regulating values, principles and capacities. According to Jennifer Tanner Ph.D., developmental research shows that during emerging adulthood there is a shift away from family and neighborhood toward greater individual identity, personal responsibility, personal power, self-regulation, and self-agency in the larger community and society as a whole.

Contexts such as college campuses are destabilizing as there is little guiding presence of authority beyond those provided by the law, multiple opportunities for exposure and provocation to engage in risk taking behaviors. Contradictory social and personal expectations for maintaining one’s membership while striving to achieve individual goals are often compounded by an ambivalence within the emerging adult regarding living out the values and expectations from their family of origin.

These challenges occur within a developmental context of as yet incomplete brain networking, loss and transition from the traditional infrastructure of community support available to minors, and increasing confrontation of their limited capacity to function in an ever increasing complex world beyond home.  Jennifer Tanner Ph.D. conceptualizes negotiating these challenges in emerging adult development as a process called “Recentering”. This represents a transformation of the locus of power and responsibility into a hopefully integrated and coherent emerging adult identity. All too often this process fails.

Research and clinical experience demonstrate that about 75% of those who are to become psychiatrically ill will do so in late adolescence and young adulthood. The U.S. Department of Health and Human Services estimates that 18% (6.4 million) of those 16-25 meet the criteria for a major psychiatric diagnosis. Freidman, et al conservatively assess that 7% (2.6 million) are functionally impaired as they transition into adulthood. These emerging adults often have a complex combination of psychiatric illnesses such as depression or anxiety, learning or processing difficulties interfering with skill development, and emotional struggles that distort personal growth.

Attempts at coping by troubled emerging adults often introduce complications from behavior patterns such as substance abuse or eating disorders which further compromise brain integrative and learning capacity, reinforce social disconnection, and arrest the development of emotional and executive competence. Problem behaviors such as binge-eating and vomiting affect brain function through the severe and enduring disruption of serotonin, dopamine, and opioid systems. This leads to further affective disorganization,  then dissociative somnolence.  Vomiting in bulimia, for example, is associated with decreased serotonin binding in the hypothalamus, disrupting regulation of appetite, satiety, and mood (Kaye, 2001).

Nutritional restriction in anorexia actually diminishes brain volume with corresponding cognitive impairment, obsessiveness and emotional dysregulation. It has been demonstrated that substance abuse affects the process of myelinization which remains incomplete into the mid-twenties. Myelin lining of neurons is consolidating during the emerging adult years, as is the development of the orbito-frontal cortex which is the brain base of impulse control and judgment. By affecting myelin in these critical brain areas, the networks can’t carry the same degree of stimulation, have limited resilience and are at risk for becoming overloaded much in the same way as narrow bandwidth carries limited signal and the system is at risk for crashing if there is signal overload.

Many young lives often never fully emerge into successful adulthood. The Children in Community Study (2000) compared young people with emotional and behavioral difficulties with others matched for gender and social class and found for those with psychiatric difficulties:

  • The risk for failure to complete school is 14 times greater
  • The rate of not being in school or employed at ages 18-21 was 4 times greater
  • The risk of engaging in illegal activity was 3 times greater
  • The risk of either gender being involved in a pregnancy was 6 times greater.

The authors conclude the evidence is compelling that millions vulnerable of young people with emotional and behavioral difficulties become delayed and derailed in the process of emerging into adulthood.

Seaman’s research demonstrates that even those emerging adults continuing to function academically have significant emotional difficulties. The number of undergraduates on psychiatric medication has tripled, including one quarter of Harvard’s students. Visits to university counseling centers has similarly increased.  The National Institute of Alcohol Abuse and Alcoholism 2002 report indicated 1400 annual alcohol related deaths. A National Institute of Justice report in 2002 found that 250,000 college women had been victims of rape with only 5% officially reported. Suicide remains the 2nd leading cause of death in emerging adulthood, outpaced by accidents which most often include alcohol. For every successful suicide, there are 40 failed attempts. Nine times again as many college students at some point seriously consider killing themselves.