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How can you tell if someone might be thinking of suicide? Learn how to recognize suicidal behavior and the warning signs of someone thinking about suicide.

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Adolescence is an important developmental phase along the path to adulthood, years during which youth become increasingly independent from their families.¹ Yet parents and other family members still play a critical role in the promotion of adolescents’ well-being, by providing a positive support system within which youth can explore their changing identity.² There were 25 million children aged 12 to 17 in the United States in 2013, living in diverse family environments. An estimated 66 percent of adolescents live with both parents (biological, step, or adoptive), 25 percent are in single-mother households, while only 5 percent live with a single father. Just over 40 percent of all adolescents and as many as 60 percent of black and Hispanic adolescents live in low-income families.³ Overall, 21 percent of adolescents are Hispanic, 56 percent are white, non-Hispanic, and 15 percent are black, non-Hispanic.⁴ In this brief, we update the findings from the 2006 publication, The Family Environment and Adolescent Well-being: Exposure to Positive and Negative Family Influences,⁵ and highlight several key areas of interaction between the family environment and adolescent well-being, using national data sources.

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The Family Environment and Adolescent Well-Being - Child Trends

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Adolescence is an important developmental phase along the path to adulthood, years during which youth become increasingly independent from their families. 1 Yet parents and other family members still play a critical role in the promotion of adolescents' well-being, by providing a positive support system within which youth can explore their changing identity.

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Tips for building relationships with your teen

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Tips for building relationships with your teen

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Relationships with parents and families: how they change in adolescence

Teenagers' relationships with their parents and families change during adolescence, but teenagers need parent and family support as much as they did when they were younger.

When your child was young, your role was to nurture and guide them. Now you might be finding that your relationship with your child is becoming more equal.

You're a source of care, emotional support, security and safety for your child, as well as practical and financial help. Your child still loves you and wants you to be involved in their life - even though their attitude or behaviour might sometimes send a different message.

Most young people and their families have some ups and downs during these years, but things usually improve by late adolescence as children become more mature. And family relationships tend to stay strong right through.

Why pre-teens and teenagers need parents and families

Adolescence can be a difficult time - your child is going through rapid physical changes as well as emotional ups and downs. Young people aren't always sure where they fit, and they're still trying to work it out. Adolescence can also be a time when peer influences cause some stress.

During this time your family is a secure emotional base where your child feels loved and accepted, no matter what's going on in the rest of their life. Your family can build and support your child's confidence, resilience, optimism and identity.

When your family sets rules, boundaries and standards of behaviour, you give your child a sense of consistency, predictability, safety and belonging.

And believe it or not, your life experiences and knowledge can be really useful to your child - they just might not always want you to know it!

Supportive and close family relationships protect your child from risky behaviour like alcohol and other drug use and problems like depression. Your support and interest in what your child is doing at school can boost their desire to do well academically too.

Strong family relationships can go a long way towards helping your child grow into a well-adjusted, considerate and caring adult.

Building positive family relationships with teenagers: tips

The ordinary, everyday things that families do together can build and strengthen relationships with teenagers. These tips might help you and your family.

Love and appreciation
Show your child how much you love and appreciate them. This can be as simple as saying 'I love you' each night when they go to bed or giving them a high-five.

Celebrate your child's accomplishments
Celebrating your child's accomplishments, sharing their disappointments, and supporting their hobbies sends the message that your child's interests are important to you. You don't have to make a big deal of this - sometimes it's just a matter of showing up to watch your child play sport or music, or giving them a lift to extracurricular activities.

Family traditions
Family traditions, routines and rituals can help you and your child set aside regular dates and special times. For example, you might have a movie night together, a favourite meal or cooking session on a particular night, a family games afternoon or an evening walk together.

Family rules
Agreed-on rules, limits and consequences give teenagers a sense of security, structure and predictability. They help your child know what standards apply in your family, and what will happen if they push the boundaries. When your child is involved in making your family rules, they're more likely to see them as fair and stick to them. Negotiating rules with your child can also help you to reduce and manage conflict with your child.

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Relationships with parents and families: pre-teens and teenagers

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Teenagers need parents and families for love and support. Strengthen family relationships for teens with family meals, activities, rules and responsibilities.

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division of adolescent and school health

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Sexual Behaviors | Adolescent and School Health | CDC

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Abstinence from vaginal, anal, and oral intercourse is the only 100% effective way to prevent HIV, other STDs, and pregnancy. The correct and consistent use of male latex condoms can reduce the risk of STD transmission, including HIV infection. However, no protective method is 100% effective, and condom use cannot guarantee absolute protection against any STD or pregnancy.

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Changes physically, emotionally and socially 

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Changes physically, emotionally and socially 

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At 12-18 years, teenage bodies, emotions and identities change in different ways at different times. Here's what to expect from teenage development.

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As the nation's clearinghouse & comprehensive reporting center for all issues related to the prevention of and recovery from child victimization, NCMEC leads the fight against abduction, abuse, and exploitation - because every child deserves a safe childhood.

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National Bullying Prevention Center

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The kit ($30, with resources for up to 30 individuals) is designed to encourage coming together for a common goal: to make stronger connections among community members to help create a healthier environment for all and prevent bullying.
Request a Kit
Beyond Sticks & Stones: How to Help Your Child Address Bullying

This 70-page comprehensive guide ($10) offers prevention strategies for children, and the information and practical tools parents and other adults need to take action to address and prevent bullying.
Order a Copy
Take the Pledge

Take the Pledge

Pledge to treat others with kindness and be more accepting and inclusive.

Kids Against Bullying website

Kids Against Bullying
website

Innovative, educational website for elementary school students to learn, engage in activities, and be inspired to advocate for self and others.

Teens Against Bullying website

Teens Against Bullying
website

A website created by and for middle and high school students, with ideas to address bullying, be heard, and lead change in an important social cause.

Questions Answered

Questions Answered

You asked, we answered! Response options include images, 60-second snapshot, longer articles, video and poll.

Students With Disabilities

Students With Disabilities

A comprehensive overview of addressing and preventing bullying and harassment of students with disabilities.

ALL IN

Free online, year round toolkit with a new classroom lesson each week! Create environments in which each student is INcluded, INvested and INvolved.

i was bullied in 8th grade and now i have a lot of kids sticking up for me. especially my friends i never told anybody but my friends did and i went to the police.
i will recomend you going to a teacher or councler or teacher.

david scot, 16, new york groton

I care because if others are getting bullied you can feel if you were how hard it would be. I've never bullied but I know how it feels if it was me and I have met people who bullied and it is just so wrong

allya, 12, newcastle

Hey! I'm from Spain and i was bullied when i was seven in school and at this sumer since one month ago...
Two of this persons was my ''best friends'' and hurted so much, maybe still hurting me even i know that i have to be strong.
indirects on twitter, leaving me alone, talking wrong to other abot me, callings...
Until  i say STOP, now i know i'm strong even i have to be alone, i know i can't, even hurts me. And i hope that the people who had or have bullying try to be strong :)

ivanelly, 16, Spain/Europe

I am So proud to have been apart of this entire project. Bringing people together for a greater cause is just something you can't forget. After seeing this website get so big,so fast. I can finally say that I was apart of something wayyy bigger than myself. I am just greatful it's reached this many people and become a tool for people.

Chelese, 16, MN

I've been bullied for several years. Infact I still am, and it's just not verbally, but also on the internet. Words DO hurt. I've been bullied for my size, they way I look, and just being diffrent. Pledgeing can make a diffrence even though it may not seem like it, but it does. Stand up for yourself. Understand that everyone is not gonna be your friend, so you don't need everyone to make your life happy.  Smile, cause your diffrent. and being diffrent is what makes a person a better person!

Katie, 13, Ky

I care about this because!
I have been through alot on my life , and I have being call weird , crazy , stupid .

And you need to be free , dont let no one , to destroy your self -esteem
you are gorgeous , free the way you are.

It's not your fault , But if you have being bullied
PLEASE FIND HELP.

we need to be against bullying
-x

v

Veronica Michelle, 17, Puerto Rico

Carmen's Corner

A series of six educational videos designed for young audiences. It features characters from PACER's Kids Against Bullying puppet program, highlights key concepts of bullying prevention, and promotes social-emotional learning. Educator guide and student worksheets accompany each video.
View the Latest Video
Become a Champion Against Bullying

Join the hundreds of nonprofits, schools, and community groups that collaborate directly with PACER's National Bullying Prevention Center by using and sharing our bullying prevention resources in their communities.
Submit your organization
Survey Monkey Contributes to NBPC

Sign up and you will receive surveys by e-mail from SurveyMonkey customers who need your opinion. For every survey you take, SurveyMonkey will donate 50 cents to PACER's National Bullying Prevention Center, plus you'll get a chance to win $100 in an instant win game.
Join Survey Monkey in supporting PACER's NBPC

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PACER's National Bullying Prevention Center

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unites, engages, and educates kids, teens, parents and communities nationwide to address bullying through creative, relevant, and interactive resources.

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Sexual behavior stats in adolescents...Univ. of Phoenix resource

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Sexual behavior stats in adolescents...Univ. of Phoenix resource

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Resources available for people already involved in drugs, including a chat line.

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Resources available for people already involved in drugs, including a chat line.

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A DEA resource for parents, educators and caregivers.

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Information about different drugs and their effects on the body.

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Information about different drugs and their effects on the body.

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Several public service announcements available & some addicts sharing their personal stories.

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Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

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Just Think Twice: Homepage | Just Think Twice

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Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

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Information on preventing drug use.  Free teacher packets available.

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Information on preventing drug use.  Free teacher packets available.

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Why is adolescence a critical time for preventing drug addiction?

As noted previously, early use of drugs increases a person's chances of becoming addicted. Remember, drugs change the brain-and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.

Risk of drug use increases greatly during times of transition. For an adult, a divorce or loss of a job may increase the risk of drug use. For a teenager, risky times include moving, family divorce, or changing schools. When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school.

A certain amount of risk-taking is a normal part of adolescent development. The desire to try new things and become more independent is healthy, but it may also increase teens' tendencies to experiment with drugs. The parts of the brain that control judgment and decision-making do not fully develop until people are in their early or mid-20s. This limits a teen's ability to accurately assess the risks of drug experimentation and makes young people more vulnerable to peer pressure.

Because the brain is still developing, using drugs at this age has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.

Can research-based programs prevent drug addiction in youth?

Yes. The term research-based or evidence-based means that these programs have been designed based on current scientific evidence, thoroughly tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the balance between risk and protective factors for drug use in families, schools, and communities. Studies have shown that research-based programs, such as described in NIDA's Principles of Substance Abuse Prevention for Early Childhood: A Research-Based Guide and Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders, can significantly reduce early use of tobacco, alcohol, and other drugs. Also, while many social and cultural factors affect drug use trends, when young people perceive drug use as harmful, they often reduce their level of use.

How do research-based prevention programs work?

National drug use surveys indicate some children are using drugs by age 12 or 13. Prevention is the best strategy.

These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home. There are three types of programs:

Universal programs address risk and protective factors common to all children in a given setting, such as a school or community.

Selective programs are for groups of children and teens who have specific factors that put them at increased risk of drug use.

Indicated programs are designed for youth who have already started using drugs.

Young Brains Under Study

Using cutting-edge imaging technology, scientists from the NIDA's Adolescent Brain Cognitive Development (ABCD) Study will look at how childhood experiences, including use of any drugs, interact with each other and with a child's changing biology to affect brain development and social, behavioral, academic, health, and other outcomes. As the only study of its kind, the ABCD study will yield critical insights into the foundational aspects of adolescence that shape a person's future.

These brain images show the reward-related circuity in the cortical and subcortical regions of the brain that tend to be more active when a child is successful at achieving a reward. While all of the images show the regions of the brain that are active to reward, the regions in yellow and red are the most active.

Economics of Prevention

Evidence-based interventions for substance use can save society money in medical costs and help individuals remain productive members of society. Such programs can return anywhere from very little to $65 per every dollar invested in prevention.

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Preventing Drug Misuse and Addiction: The Best Strategy | National Institute on Drug Abuse

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Why is adolescence a critical time for preventing drug addiction? As noted previously, early use of drugs increases a person's chances of becoming addicted. Remember, drugs change the brain-and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.

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Things to consider when considering divorce.

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A House Divided-The Impact of Divorce on Adolescents - Watchtower ONLINE LIBRARY

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This is an authorized Web site of Jehovah's Witnesses. It is a research tool for publications in various languages produced by Jehovah's Witnesses.

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Being watched by peers changes teens risky behavior, not just peers influencing, according to study

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Being watched by peers changes teens risky behavior, not just peers influencing, according to study

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For the past six years, my colleague Jason Chein and I have been studying how peers affect adolescent decision-making. It is well known, for example, that a great deal of teenagers' risky behavior occurs when they are with their friends. In 2005, Margo Gardner and I published an experiment showing that, when adolescents played a video driving game with their friends watching, they took more chances (and crashed more often) than they did when alone, but we found no such peer effect on adults. Jason, who is a neuroscientist, and I wanted to understand what the underlying neural processes for this might be.

Studying peer influence in the fMRI environment is a challenging task, because we can't squeeze a group of people into the scanner at the same time. So we set up the adolescent's peers in an adjacent room, where they could see how the adolescent was "driving" when playing the game inside the magnet. We had a mike wired from that room into the scanner, so that the friends could let the adolescent know when they were watching.

Once again, we found that even being watched by friends elevates adolescents' but not adults' risk taking. But we also found that the presence of peers affects patterns of brain activity differently among adolescents and adults.

You can read more about our findings in an article in today's New York Times
http://well.blogs.nytimes.com/2011/02/03/teenagers-friends-and-bad-decisions/?scp=6&sq=tara%20parker%20pope&st=cse
It is common knowledge that peers influence teenagers to do things they might not do on their own. But what's important about the study is that we are able to show that the mere presence of peers -- not their direct goading -- affects adolescents' decision-making. And we are beginning to understand the underlying brain mechanisms that explain why

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For the past six years, my colleague Jason Chein and I have been studying how peers affect adolescent decision-making. It is well known, for example, that a great deal of teenagers' risky behavior occurs when they are with their friends.

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Legalizing marijuana has been bad for youth and communities.

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Legalizing marijuana has been bad for youth and communities.

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1. What is D.A.R.E.'s position regarding the legalization of marijuana? D.A.R.E. America is a non-profit organization dedicated to our mission of "Teaching students good decision-making skills to help them lead safe and healthy lives." As taught in our curricula, we...

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Abstract

The current generation of adolescents grows up in a media-saturated world. However, it is unclear how media influences the maturational trajectories of brain regions involved in social interactions. Here we review the neural development in adolescence and show how neuroscience can provide a deeper understanding of developmental sensitivities related to adolescents' media use. We argue that adolescents are highly sensitive to acceptance and rejection through social media, and that their heightened emotional sensitivity and protracted development of reflective processing and cognitive control may make them specifically reactive to emotion-arousing media. This review illustrates how neuroscience may help understand the mutual influence of media and peers on adolescents' well-being and opinion formation.

Introduction

Media play a tremendously important role in the lives of today's youth, who grow up with tablets and smartphones, and do not remember a time before the internet, and are hence called 'digital natives'1,2. The current generation of the adolescents lives in a media-saturated world, where media is used not only for entertainment purposes, such as listening to music or watching movies, but is also used increasingly for communicating with peers via WhatsApp, Instagram, SnapChat, Facebook, etc. Taken together, these media-related activities comprise roughly 6-9 h of an American youth's day, excluding home- and schoolwork ( https://www.commonsensemedia.org/the-common-sense-census-media-use-by-tweens-and-teens-infographic)3,4. Social media enable people to share information, ideas or opinions, messages, images and videos. Today, all kinds of media formats are constantly available through portable mobile devices such as smartphones and have become an integrated part of adolescents' social life5.

Adolescence, which is defined as the transition period between childhood and adulthood (approximately ages 10-22 years, although age bins differ between cultures), is a developmental stage in which parental influence decreases and peers become more important6. Being accepted or rejected by peers is highly salient in adolescence, also there is a strong need to fit into the peer group and they are highly influenced by their peers7. Therefore, it is imperative that we understand how adolescents process media content and peers' feedback provided on such platforms. Adolescents' social lives in particular seem to occur for a large part through smartphones that are filled with friends with whom they are constantly connected (cf. "A day not wired is a day not lived"5,8). This is where they monitor their peer status, check peers' feedback, rejection and acceptance messages, and encounter peers as (idealized) images9 on screens5,8,10. Likely, this plays an important role in adolescent development, and we therefore focus primarily on adolescents' social media use11. Most media research to date is based on correlational and self-report data, and would be strengthened by integrating experimental paradigms and more objectively assessed behavioral, emotional, and neural consequences of experimentally induced media use.

Recently, cognitive neuroscience studies have used structural and functional magnetic resonance imaging (fMRI) to examine how the adolescent brain changes over the course of the adolescent years6. The results of several studies demonstrate that cognitive and socio-affective development in adolescence is accompanied by extensive changes in the structure and function of the adolescent brain6. Structurally, white matter connections increase, allowing for more successful communication between different areas of the brain12. The maturation of these connections is related to behavioral control, for example, connections between the prefrontal cortex and the subcortical striatum mediate age-related improvements in the ability to wait for a reward13. In addition to these changes in white matter connections, neurons in the brain grow in number between conception and childhood, with greatest synaptic density in early childhood. This increase in synaptic density co-occurs with synaptic pruning, and pruning rates increase in adolescence, resulting in a decrease in synaptic density in late childhood and adolescence14. Structural MRI research revealed that the peak in grey matter volume probably occurs before the age of 10 years, but dynamic non-linear changes in grey matter volume continue over the whole period of adolescence, and the timing is region-specific15. Interestingly, changes in grey matter volume are observed most extensively in brain regions that are important for social understanding and communication such as the medial prefrontal cortex, superior temporal cortex and temporal parietal junction16. Figure 1 displays the extensive changes in the human cortex during adolescence.

Fig. 1

Longitudinal changes in brain structure across adolescence (ages 8-30). a Consistent patterns of change across four independent longitudinal samples (391 participants, 852 scans), with increases in cerebral white matter volume and decreases in cortical grey matter volume (adapted from Mills et al., 2016, NeuroImage105). b Of the two main components of cortical volume, surface area and thickness, thinning across ages 8 to 25 years is the main contributor to volume reduction across adolescence, here displayed in the Braintime sample (209 participants, 418 scans). Displayed are regional differences in annual percentage change (APC) across the whole brain, the more the color changes in the direction of green to blue, the larger the annual decrease in volume (adapted from Tamnes et al., 2017, J Neuroscience15)

Given that brain regions involved in many social aspects of life are undergoing such extensive changes during adolescence, it is likely that social influences-which also occur through the use of social media as the internet connects adolescents to many people at once-are particularly potent at this age in coalescence with their media use. Also, subcortical brain regions undergo pronounced changes during adolescence17. There is evidence that the density of grey matter volume in the amygdala, a structure associated with emotional processing, is related to larger offline social networks18, as well as larger online social networks19,20. This suggests an important interplay between actual social experiences, both offline and online, and brain development.

This review brings together research on media use among adolescents with neural development during adolescence. We will specifically focus on the following three aspects of media exposure of interest to adolescent development21: (1) social acceptance or rejection, (2) peer influence on self-image and self-perception, and (3) the role of emotions in media use. Finally, we discuss new perspectives on how the interplay between media exposure and sensitive periods in brain development may make some individuals more susceptible to the consequences of media use than others.

Being accepted or rejected online

Experiencing acceptance or rejection when communicating via digital media is an impactful social experience. Extensive research, including large meta-analyses, has demonstrated that social rejection in a computerized environment can be experienced similarly as face-to-face rejection and bullying, although the prevalence of cyberbullying is generally lower22,23 (and studies vary widely: prevalence rates depend on how cyberbullying is defined and measured). In all, cyberbullying peaks during adolescence24 and large overlap has been found between victims and bullies. In part, this overlap could be explained by victimized adolescents seeking exposure to antisocial and risk behavior media content25. The next subsections will describe recent discoveries in neuroscience on the neural responses to online rejection and acceptance.

Neural responses to online social rejection

The emotional and neural effects of being socially excluded have been well captured by research involving the Cyberball Paradigm26 ( https://cyberball.wikispaces.com/). Cyberball is a virtual ball-toss game in which the study participant tosses a ball with two simulated players (so-called confederates) via a screen. After a round of fair play, the confederates, who only throw the ball to each other, exclude the participant in the rejection condition. This results in pronounced negative effects on the participants' feeling to belong, ostracism, sense of control, and self-esteem26. Even though the paradigm was not designed to study online rejection as it occurs today on social media, the findings of prior Cyberball studies may provide an important starting point for understanding the processes involved in online rejection. In fact, inspired by Cyberball, a Social Media Ostracism paradigm has recently been developed by applying a Facebook format to study the effects of online social exclusion27.

Using functional MRI (fMRI), researchers have observed increased activity in the orbitofrontal cortex and insula after participants experienced exclusion, possibly signaling increased arousal and negative affect28. In addition, stronger activity in the dorsal anterior cingulate cortex (ACC) is observed in adolescents and young adults with a history of being socially excluded29, maltreated30, or insecure attachment, whereas spending more time with friends reduced ACC response in adolescents to social exclusion31. This may possibly protect adolescents against the negative influence of ostracism or cyberbullying, although all these studies are correlational. Therefore, it remains to be determined whether environment influences brain development or vice versa. Moreover, ACC and insula activity have also been explained as signaling a highly significant event because the same regions are also active when participants experience inclusion32. Furthermore, studies with adolescents observed specific activity in the ventral striatum33, and in the subgenual ACC when adolescents were excluded in the online Cyberball computer game34,35, the latter region is often implicated in depression36. Thus, being rejected was associated with activity in brain regions that are also activated when experiencing salient emotions37,38. These studies may indicate a specific window of sensitivity to social rejection in adolescence, which may be associated with the enhanced activity of striatum and subgenual ACC in adolescence33,36.

Social rejection has also been studied using task paradigms that mirror online communication more specifically. In the social judgment paradigm, participants enter a chat room, where others can judge their profile pictures based on first impression39. This can result in being rejected or accepted by others in a way that is directly comparable to social media environments where individuals connect based on first impression (for example,'liking' on Instagram). A developmental behavioral study (participants between 10 and 23 years) showed that young adults expected to be accepted more than adolescents. Moreover, these adults, relative to adolescents, adjusted their evaluations of others more based on whether others accepted or rejected them, possibly indicating self-protecting biases40 (Fig. 2). Neuroimaging studies revealed that, being rejected based only on one's profile pictures resulted in increased activity in the medial frontal cortex, in both adults41 and children42, and studies in adolescents showed enhanced pupil dilation, a response to greater cognitive load and emotional intensity, to rejection43.

Fig. 2

Adolescents' expectations and adjustments of being liked and liking others. Social evaluation study in which participants between ages 10 and 23 years rated other peers on whether they liked the other person, whether they believed the other would like them, and a post scan rating of liking the other person after having received acceptance or rejection feedback from the other person. The faces used in this adaptation of figure are cartoon approximations of the original stimuli used in ref. 40; to see the original stimuli, please refer to ref. 40. The left graph shows that adolescents expect least to be liked by the other before receiving feedback (question B). The right graph shows a developmental increase in distinguishing between liking and disliking based on feedback from the other person (question D). (Adapted with permission from Rodman, 2017, PNAS40)

Taken together, these studies suggest that adolescents show stronger rejection expectation than adults, and subgenual ACC and medial frontal cortex are critically involved when processing online exclusion or rejection. In the next section, we describe how the brain of adolescents and adults respond to receiving positive feedback and likes from others.

Neural responses to online social acceptance

The positive feeling of social acceptance online is endorsed through the receipt of likes, one's cool ratio (i.e., followers > following; Business Insider, 11 June 2014: http://www.businessinsider.com/instagram-cool-ratio-2014-6?international=true&r=US&IR=T.) or popularity, positive comments and hashtags, among other forms of reward44,45. Neuropsychological research showed that being accepted evokes activation in similar brain regions, as when receiving other rewards such as money or pleasant tastes38. Most pronounced activity was found in the ventral striatum, together with the ventromedial prefrontal cortex and ventral tegmental area, which is consistently reported as a key region in the brain for the subjective experience of pleasure and reward46, including social rewards47. Likewise, being socially accepted through likes in the chat room task resulted in increased activity in the ventral striatum in children42, adolescents48,49 and adults41,50. This response is blunted in adolescents who experience depression36, or who have experienced a history of maternal negative affect51. Apparently, prior social experiences-such as parental relations-are an important factor for understanding which adolescents are more sensitive to the impact of social media51. In this regard, media research showed that popularity moderates depression10 and that attachment styles and loneliness increases the likelihood to seek socio-affective bonding with media figures52.

Interestingly, several studies and meta-analyses using gambling and reward paradigms have reported that activity in the ventral striatum to monetary rewards peaks in mid-adolescence53,54,55 (Fig. 3; see Box 1 for views on adolescent risk taking in various contexts). These findings may suggest general reward sensitivity in adolescence such that reward centers that respond to monetary reward may also show increased sensitivity to social reward in adolescence. Social reward sensitivity may be a strong reinforcer in social media use. A prior study in adults showed that activity in the ventral striatum in response to an increase in one's reputation, but not wealth, predicted frequency of Facebook use56. In a similar vein, adolescents showed sensitivity to "likes" of peers on social media44,57. In a controlled experimental study, adolescents showed more activity in the ventral striatum when viewing images with many vs. few likes, and this activation was stronger for older adolescents and college students compared to younger adolescents57. Thus, the same region that is active when being liked on the basis of first impression of a profile picture48, is also activated when viewing images that are liked by others, especially in mid-to-late adolescence, possibly extending into adulthood57 (see also ref. 58 for similar findings on music preference). These findings suggest that heightened reward sensitivity in mid-adolescence that was previously observed for monetary rewards53 may also be present for social rewards such as likes on Instagram. However, further research is needed to examine whether this is a specific sensitivity in early, mid or late adolescence, or perhaps this social reward sensitivity emerges in adolescence and remains in adulthood.

Fig. 3

Longitudinal neural developmental pattern of reward activity in adolescence. Longitudinal two-wave neural developmental pattern of nucleus accumbens activation during winning vs. losing, based on 249, and 238 participants who were included on the first and second time point, respectively (leading to 487 included brain scans in total). A quadratic pattern of brain activity was observed in the nucleus accumbens for the contrast winning > losing money in a gambling task, with highest reward activity in mid-adolescence. (Adapted with permission from Braams et al.55)

Online peer influence

In addition to adolescents' sensitivity to the feeling of belonging to the peer group59, the peer group also has a strong influence on opinions and decision-making60. Peers can exert a strong influence on adolescents through user-generated content on social media5,61. Co-viewing, sharing, and discussing media content with peers is common practice among adolescents in line with their developmental stage in which peers become more important than others. For example, adolescent girls often share pictures and comment on the "ideal" degree of slimness of the models they see via media when deciding how a 'normal' body should actually look62,63. Several recent neuroimaging studies, summarized below, have examined how the adolescent brain responds to peer comments about others and self, and subsequent behavioral adjustments and opinion changes. Even though not all of these designs were specific for online environments, the findings provide important starting points for understanding how adolescents are influenced by peer feedback in an online environment.

Neural responses to online peer feedback

Neuroimaging studies in adolescents showed that peer feedback indeed influences adolescents' behavior. Neural correlates may provide more insight in the specific parts of the feedback that drives these behavioral sensitivities64. One way this is demonstrated is by having individuals rate certain products such as music preference or facial attractiveness. After their initial rating, participants received feedback from others, which was either congruent or incongruent with their initial rating. Afterwards, individuals made their ratings again, and the researchers analyzed whether behavior changed in the direction of the peer feedback. Indeed, both adults and adolescents adjusted their behavior towards the group norm58,64, demonstrating general sensitivity to peer influence. Furthermore, when receiving peer feedback that did not match their own initial rating, participants showed enhanced activity in the ACC and insula, two regions involved in detecting norm violations58,65. More specifically, increased ACC activity was associated with more adjustment to fit peer feedback norms in adolescents58.

Peer feedback effects are not only found for how individuals rate products, but also can strongly influence how they view themselves. Girls are especially sensitive to pressure for media's thin-body ideal, and peer feedback supporting this ideal is associated with more body dissatisfaction62,63. We recently showed that norm-deviating feedback on ideal body images resulted in activity in the ACC-insula network in young females (18-19-years), which was stronger for females with lower self-esteem66 (Fig. 4). Interestingly, the girls also adjusted their ratings on what they believed was a normal or too-thin looking body in the direction of the group norm. Together, these findings suggest that peer feedback through social media can influence the way adolescents look at themselves and others.

Fig. 4

The Body Image Paradigm to study combined media and peer influence. This paradigm is designed for experiments to study the influence of peers on body image perception. a Participants are presented with a bikini model, and they can make a judgment whether the model is too thin or of normal weight. Their response appears on the left side of the model. Then, they are presented with ostensible peer feedback (the peer norm). b When this feedback deviates from their own judgment, this is associated with increased activity in dorsal anterior cingulate cortex (dACC) and bilateral insula, regions often implicated in processing norm violations. c Responses are larger for participants with lower self-esteem (Adapted from Van der Meulen et al.66)

Neural responses to prosocial peer feedback

Interestingly, however, we also found that peer feedback can influence social behavior in a prosocial direction, for example, by having peers positively evaluate prosocial behavior that benefits the group. Neuroimaging studies of social cognition have demonstrated that thinking about other peoples' intentions or feelings is associated with activity in a network of regions, including medial prefrontal cortex, the superior temporal sulcus and the temporal parietal junction, also referred to as the social brain network67. In an online peer influence study, adolescents could donate money to the group, which would benefit not only themselves but also others. Prior to the study, the participants met the other participants (confederate peers) that were not part of the group that was dividing the money. These peers, however, gave online feedback through likes on the participants' choices. More likes were given when participants donated more to the group. This feedback was followed by higher donations68, and was associated with enhanced activation in the social brain network, such as the medial frontal cortex, temporal parietal junction and superior temporal sulcus69. Notably, the change in social brain activity in the peer feedback condition was more pronounced for younger adolescents (ages 12-13-years) compared to mid-adolescents (15-16-years)69. Together, these studies suggest that early adolescence may be an especially sensitive period for social media influences in risk-perception60 as well as prosocial directions69. These findings fit well with Blakemore and Mills'6 suggestion that, adolescence may be a sensitive period for social reorientation and social brain development, although results vary regarding whether sensitive periods are more pronounced in early or mid-adolescence. Understanding the specific sensitive windows may be important to target future interventions. Therefore, future research is needed to examine whether this is a specific sensitivity in early-to-mid-adolescence, or whether and how social reward sensitivity remains in adulthood.

Precedence of emotions and impulsivity

A third factor that affects how adolescents process (social) media relates to the intense emotional experiences that usually accompany adolescence70. Emotional needs may guide adolescents' media use and processing; for example, feeling lonely may ease the path to connect to a media figure or to rely on social media for one's social interaction52,71,72. Furthermore, being engaged in media fare may evoke strong emotional reactions, such as when playing violent video games or when experiencing online rejection73,74. Adolescents in particular appear to be guided by their emotions in how they use and process media5. For example, the degree of anger and frustration experienced by early-to-mid adolescent victims of bullying was associated with increased exposure to media fare portraying antisocial, norm-crossing and risk-taking behaviors over time, making these youngsters more likely to become bullies themselves25. Another study showed that anger instigated a more lenient moral tolerance of antisocial media content in early adolescents but not in young adults74. Furthermore, adolescent victims of bullying who regulated their anger through maladaptive strategies (e.g., other-blame, rumination) showed higher levels of cyberbullying themselves25.

Neural responses related to retaliation and emotion regulation

Neuroscience studies can potentially provide more insight in the moral leniency following adolescents' anger. Neuroscience research on adolescent development has shown that the development of the prefrontal cortex, an important region for emotion regulation, matures until early adulthood15,75. A better understanding of the interactions between brain regions that show direct responses to emotional content, and brain regions that help to regulate these responses can possibly elucidate how adolescents regulate their behavior related to media-based interactions.

Several studies examined this question by focusing on anger following rejection. Rejected-based anger often leads to retaliatory actions. Several paradigms have also shown that adolescents are more aggressive after being rejected online. For example, they gave longer noise blasts and shared less of their resources with people who previously rejected them in an online environment41,73,76. More activity in dorsolateral prefrontal cortex (DLPFC) after rejection was associated with less subsequent aggression41 and more giving76, possibly indicating that increased activity in the DLPFC helps individuals to control their anger following rejection. Other research showed changes in neural coupling when young men played violent video games77. Thus, social rejection can evoke anger, but some adolescents may be better at regulating these emotions than others. Adolescents who regulate these emotions better show stronger activity in DLPFC, a region known to be involved in self-control41,75.

Applying adaptive emotion regulation strategies (e.g., putting into perspective, refocusing, reappraisal) possibly requires enhanced demands on DLPFC78. Possibly, the late maturation of the DLPFC, together with heightened emotional reactivity, may make adolescents more likely to be influenced by media content. For example, research showed that emotional experiences biased participants' perception of media footage: despite being told beforehand that the footage contained fiction-based materials, they attributed significantly higher levels of realism to it under conditions of emotional arousal than in a neutral state79. Subsequently, participants attributed more information value to the fiction-based footage up to similar levels as to the reality-based clip.

One possible direction to better understand how adolescents deal with emotional media content is by examining parallel processes. It is likely that engaging in media is associated with multiple processes79 such as the fast processing of emotions associated with engagement, sensation-seeking and emotional responses to media content, as well as more reflective and relatively slower processes, such as perspective taking and emotion regulation80. We interpret such parallel processing as coordinated networks of an inter-related imbalance between heightened emotional responsivity and protracted development of reflective processing and cognitive control75. For example, adolescents show a peak in neural responsivity to emotional faces in the ventral striatum and anterior insula, compared to children and adults81,82. In addition, adolescents show protracted development of social brain regions implicated in perspective taking6,83, and flexible engagement of lateral prefrontal cortex, possibly depending on personal goals84. When media encounters are emotionally gripping, such parallel processing may explain why people may take (fake) information from media as real-'it just feels real'79. The emotional response seems to blur the borders between fact and fake; the instantaneous response based on emotional or accompanying sensory feedback apparently takes (momentary) control precedence over cognitive reflection and biases subsequent information processing79. These findings may perhaps also explain how social reality can be perceived in accordance to how the world is represented in emotion-arousing, sensationalist or populist media messages, even when it concerns so-called "fake news". In all, these suggestions call for further empirical testing, specifically also comparing adolescents and adults, in which the pattern of brain changes is combined with behavioral research and opinion formation.

Another intriguing question for future research is whether regulation or control of media-generated emotions can be trained. It was previously found that training of executive functions is associated with increased activity in DLPFC85, but it remains an open question whether activity in DLPFC can be influenced by (aggression) regulation training and behavioral control, and whether this results in changes in the functional and structural properties of the brain. If such training were possible, video games and immersive virtual environments might provide even more useful training environments. In this respect, promising projects are ongoing, testing the use of biofeedback videogames to help youth cope with stress and anxiety and identify physiological markers, and patterns of emotion regulation86. Game interventions are also developed to help children to cope effectively with anxiety-inducing situations87. These enrichment and training programs may also be useful to test specific media sensitivities by controlling the amount of media exposure. Such designs will have important benefits over studies examining correlations between naturally occurring behaviors and developmental outcomes, which often do not allow for control of other variables such as temperament or environmental changes.

Taken together, individuals differ in how they respond to media content, especially when these evoke emotional responses or are evaluated in an emotion-aroused state. There are only preliminary studies available that link these individual differences to brain development, but possibly the regulating role of DLPFC is important to control emotional responses to rejection, fake news, violent video games, or appealing ideals. These are all questions that need to be addressed in future research, but are highly relevant given the developmental stage and time adolescents engage with these prevalent forms of media.

Outlook for future studies

We described research in three directions that we believe are crucial in understanding how the omnipresent use of (social) media among today's adolescents may influence them, through the following: (1) social rejection and acceptance, (2) peer influence on opinions of self and others, and (3) emotion precedence in media use and effects. We have provided a first overview of how neuroscience research may aid in a better understanding of these influences in a mediated context. However, study results appear to vary regarding the specific adolescent age ranges; sometimes effects seem specific for early- or mid-adolescents, while in other studies adolescents and (young) adults do not differ and the indicated age ranges also vary widely (e.g., for some, 'late adolescence' is between 13 and 17 years old, whereas in other reports, 17-25 years of age is referred to as 'late', see also ref. 88). Most adolescent samples are relatively older, whereas early adolescents (aged 10-15) are understudied and seem of particular interest in regards of sensitivity in these three areas. Therefore, further research is needed to align specific age ranges to developmental stages.

Current media technology opens possibilities to understand sensitivities to media and peers in adolescence. For example, YouTube, Facebook, and Instagram provide excellent environments to study combined with media content and peers' feedback in adolescence27,89. Moreover, such social media platforms introduced so-called user-generated content90 and options to present and express oneself in media environments have increased tremendously, thereby increasing media's social functions. Taking the ethical aspects of performing social media research into account, as it can impinge on users' privacy, social media devices also provide great opportunities to understand how media exposure affects day-to-day fluctuations in mood and self-esteem.

A critical question that remains largely unanswered is how adolescents' abundant media use may impact them developmentally in terms of structural brain development, functional brain development, and related behavior. The scientific evidence thus far is still scarce and results are mixed91,92. For example, digital-screen time and mental well-being appear to be best described by quadratic functions with moderate use not intrinsically harmful93. Several recent studies have shown that habitual use is associated with a reduced ability to delay gratification94, but can also have positive consequences such as increased ability to flexibly switch between tasks95 and feeling socially connected96. Adolescents who spend more time on their mobile devices may engage less in 'real' offline social interactions and the consequences of these communication changes are not yet well understood. Perhaps, consequences differ among those who experience their online interactions as similar to their offline interactions, or as separate worlds. Important moderators and mediators should also be taken into account to understand how online communication is processed. Finally, being constantly online also affects sleep patterns, which impacts mood as well97. In all, the majority of these studies are based on self-reported new media use and outcomes. Integrating both experimental methods and neuroscientific insights may advance our understanding of who is susceptible under which circumstances to which effects, positive or negative.

Conclusion

In this review, we described the emerging body of research focused on how new media use is processed by the still developing adolescent brain. In particular, we highlighted the neural systems that are associated with behaviors that are important for social media use, including social reward processing, emotion-based processing, regulation, and mentalizing about others98. As these neural systems are still underdeveloped and undergoing significant changes during adolescence, they may contribute to sensitivity to online rejection, acceptance, peer influence, and emotion-loaded interactions in media-environments. In future research, it will be important to understand these processes better, especially the specific developmental sensitivities, as well as to understand which adolescents are more and less susceptible for beneficial or undesirable media influences.

The review of the literature suggests that peer sensitivities are possibly larger in adolescents than in older age groups. Peer influence effects have been well demonstrated in adolescent decision-making research, showing that adolescents take more risks in the presence of peers and when peers stimulate risk-taking99. This seems to hold similarly for peer influence online through online comments, also with less risky behaviors62. These findings have been interpreted to suggest that adolescents have a strong need to follow norms of their peer group and show in-group adherence100. There is a strong need for studies that experimentally test whether increased influence of peers, possibly through developing social brain regions, combined with strong sensitivity to acceptance and rejection, makes adolescence a tipping point in development for how social media can influence their self-concept and expectations of self and others. It is likely that these sensitivities are not related to one process specifically, but the combination of developmental brain networks and associated behaviors75,84. A critical question for future research is how neural correlates observed in this review predict future behavior or emotional responses in adolescents.

Social media have at least the following two important functions: (i) socially connect with others (the need to belong) and (ii) manage the impression individuals make on others (reputation building, impression management, and online self-presentation)98. The emerging trajectory of acceptance sensitivity, peer 'obedience', and emotion precedence may make adolescents specifically susceptible to sensationalist and fake news, unrealistic self-expectations, or regulating emotions through adverse use of media. Important questions for future research relate to unraveling whether adolescents are more sensitive to these news items than children and adults, who is most sensitive to which kind of media influence, how (one-sided) media use may influence adolescent development over time, and understand not only the risks but also how media provides opportunities for positive development, such as engaging with friends, forming new peer relations, and experiment with uncertainties or overcoming fears. Studying the interplay between media use and sensitive periods in brain development will provide important directions for understanding how media may impact youth and who is most vulnerable and under which conditions. Key questions for future research are to understand whether recent changes in media usage, delivery, dosage, and levels of engagement (e.g., as more active creators and participants, for example) are leading to different or amplified neural responses in adolescents relative to adults. Using longitudinal research, it will be important to test whether there is evidence that the still developing adolescent brain is more sensitive to, or more likely to be shaped by these changing patterns of media usage. 1

Box 1 Multiple perspectives on adolescent risk-taking

Adolescence is often defined as a period of increased risk taking and sensation-seeking, this is observed across cultures101 and across species102. However, the way risk-taking is expressed differs across generations. In middle ages, risk-taking in adolescence took place through reckless fights and wars. In contrast, in the late 20th century and early 21st century, adolescents were more prone towards risk-taking in context of alcohol, sex, and drug experimentation103. Recently, through social media, new forms of risk-taking are expressed, such as excessive or unlimited self-disclosure or sexting104. These observations suggest that social media may be the new way in which sensation-seeking behavior is expressed, which is possibly an adolescent-specific tendency to explore and learn to adapt to new social environments.

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Acknowledgements

We thank the reviewers for their detailed and insightful comments on the manuscript, and Lara Wierenga for providing helpful comments on previous versions of the manuscript. This work was supported by The Netherlands Organization for Scientific Research (NWO-VICI 453-14-001 E.A.C.) and by an innovative ideas grant of the European Research Council (ERC CoG PROSOCIAL 681632 to E.A.C.). Both authors were supported by the Netherlands Institute for Advanced Study in the Humanities and Social Sciences (NIAS: September 2013-September 2014).

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1. Department of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, 2333AK, Leiden, Netherlands

2. Department of Communication Science, Media Psychology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, Netherlands

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The authors declare no competing financial interests.

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Correspondence to Eveline A. Crone.

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https://doi.org/10.1038/s41467-018-03126-x

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Media use and brain development during adolescence

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The current generation of adolescents grows up in a media-saturated world. However, it is unclear how media influences the maturational trajectories of brain regions involved in social interactions. Here we review the neural development in adolescence and show how neuroscience can provide a deeper understanding of developmental sensitivities related to adolescents' media use.

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Short term effects of video games on the brain and emotions

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Short term effects of video games on the brain and emotions

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Resources for students, parents, and educators.

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Ways to get involved can vary specifically from students, parents, teachers and youth workers. Getting involved can be as simple as telling your friends about The Jason Foundation & youth suicide. However The Jason Foundation has endless ways for a community or individual to get more involved.