Study Tracks Shift in Adolescent Mental and Behavioral Health

TOPLINE:

An analysis of high school students from 1999 to 2021 showed teens with low-risk behaviors grew from about 40% in 1999 to nearly 60% by 2021. Mental health problems, such as sadness and suicidality, increased, and behavioral risks, such as carrying a weapon and fighting, decreased.

METHODOLOGY:

• Researchers analyzed 22 years of data pulled from the Youth Risk Behavior Survey covering 178,658 high school students in the United States.
• Teens self-reported mental health symptoms such as sadness, hopelessness, or thoughts of suicide and behavioral risks like substance use, sexual activity, and violence on repeated surveys.
• The analysis identified five adolescent mental and behavioral health risk profiles: Low everything; high sex; high everything, which included teens with above-average levels in all mental and behavioral health factors; high substance use; and high internalizing.

TAKEAWAY:

• The low everything profile grew from 40% in 1999 to nearly 60% in 2021; the high internalizing profile grew from 9% to nearly 18% in 2021.
• The high sex (20% in 1999), high everything (13%), and high substance use (10%) profiles all decreased in prevalence over time, falling to approximately 10%, 5%, and 4%, respectively, by 2021, with pronounced decreases during the COVID-19 pandemic period (2019-2021).
• Younger adolescents were more likely to have a low everything or high internalizing profile, while older adolescents saw higher numbers in the high sex and high everything profiles.
• Women made up about 66% of the high internalizing group over the span of the study period, while men made up about 35% and were more prevalent in the high everything (58%) and high substance use (61%) groups.

IN PRACTICE:

“Results provide a clear picture showing that over the past two decades, a far lower proportion of adolescents are engaged in high levels of behavioral health risk behaviors or behavioral risks combined with mental health risks, while far more are showing limited engagement in all such risk behaviors,” the study authors wrote. “It is important to assess the repercussions of these changes for individual and societal well-being.”

SOURCE:

The study was led by Rebekah Levine Coley, PhD, at the Counseling, Developmental & Educational Psychology Department at the Lynch School of Education and Human Development at Boston College in Chestnut Hill, Massachusetts. It was published online on March 18 in Pediatrics.

LIMITATIONS:

The study did not include all mental health disorders, such as anxiety or eating disorders. The birth control item in the survey only included heterosexual sex, and the weapon-carrying item only focused on school settings. Demographics were limited to men or women and did not include information on family income or location. Small proportions of ethnic groups, such as American Indian/Alaskan Native and Native Hawaiian/Pacific Islanders, limited statistical power. The study excluded teens not in school. The study only tracked trends over time and did not explore the reasons behind them.

DISCLOSURES:

The authors had no relevant conflict of interests to disclose.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.