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Decision-Making in Adolescents and Young Adults

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Handbook of Health Decision Science

Abstract

Adolescence, which begins with the onset of puberty (average age of 12) and continues to young adulthood (up until age 21–24), represents a unique period in life characterized by greater freedom to make autonomous and meaningful decisions compared to childhood. However, adolescence is also a time when some areas of decision-making remain limited until age 18 or older, such as when making decisions concerning consenting to or denying medical treatment, choosing whether or not to have an abortion, participating in research, and purchasing and using alcohol and tobacco. These decisions occur juxtaposed to significant physical, cognitive, emotional, and psychosocial changes, which are coupled with societal influences offering mixed messages that both encourage and restrict decision-making autonomy, especially decisions involving health-risk behaviors. The various contexts influencing adolescent and young adult decision-making include cultural messages that encourage autonomy and risk-taking, parental monitoring that seeks to prevent risky health decisions, and peers who can be both a positive and negative influence on health-related decisions. This chapter will explain the foundational processes and theories used to conceptualize and study adolescent and young adult health-related decision-making while also reviewing the most recent findings in the field.

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References

  • Albert, D., & Steinberg, L. (2011). Judgment and decision making in adolescence. Journal of Research on Adolescence, 21(1), 211–224.

    Article  Google Scholar 

  • Adler, N. E., Ozer, E. J., & Tschann, J. (2003). Abortion among adolescents. American Psychologist, 58(3), 211–217. doi:10.1037/0003-066X.58.3.211.

    Article  PubMed  Google Scholar 

  • Berlan, E. D., & Bravender, T. (2009). Confidentiality, consent, and caring for the adolescent patient. Current Opinion in Pediatrics, 21, 450–456. doi:10.1097/MOP.0b013e32832ce009.

    Article  PubMed  Google Scholar 

  • Biehl, M., & Halpern-Felsher, B. L. (2001). Adolescents’ and adults’ understanding of probability expressions. Journal of Adolescent Health, 28(1), 30–35.

    Article  PubMed  Google Scholar 

  • Beidler, S. M., & Dickey, S. B. (2001). Children’s competence to participate in healthcare decisions. JONA’s Healthcare, Law, Ethics, and Regulation, 3(3), 80–87.

    Article  Google Scholar 

  • Bergus, G. R., Levin, I. P., & Elstein, A. S. (2002). Presenting risks and benefits to patients: The effect of information order on decision making. Journal of General and Internal Medicine, 17, 612–617.

    Article  Google Scholar 

  • Blum, R. M., Resnick, M. D., & Stark, T. A. (1987). The impact of a parental notification law on adolescent abortion decision-making. American Journal of Public Health, 77(5), 619–620.

    Article  PubMed  PubMed Central  Google Scholar 

  • Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Social Science and Medicine, 44(5), 681–692.

    Article  PubMed  Google Scholar 

  • Chou, W. S., Hunt, Y. M., Beckjord, E. B., Moser, R. P., & Hesse, B. W. (2009). Social media use in the United States: Implications for health communication. Journal of Medical Internet Research, 11(4), e48. doi:10.2196/jmir.1249.

    Google Scholar 

  • Coyne, I. (2008). Children’s participation in consultations and decision-making at health service level: A review of the literature. International Journal of Nursing Studies, 45, 1682–1689.

    Article  PubMed  Google Scholar 

  • Finken, L. (2005). The role of consultants in adolescents’ decision making: A focus on abortion decisions. In Janis Jacobs & Paul Klaczynski (Eds.), The development of judgment and decision making in children and adolescents (pp. 255–278). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.

    Google Scholar 

  • Fischhoff, B. (2008). Assessing adolescent decision-making competence. Developmental Review, 28, 12–28.

    Article  Google Scholar 

  • Fischhoff, B., Bruine de Bruin, W., Parker, A. M., Millstein, S. G., & Halpern-Felsher, B. L. (2010). Adolescents’ perceived risk of dying. Journal of Adolescent Health, 46, 265–269. doi:10.1016/j.jadohealth.2009.06.026.

    Article  PubMed  Google Scholar 

  • Garrett, C. C., Hocking, J., Chen, M. Y., Fairly, C. K., & Kirkman, M. (2011). Young people’s views on the potential use of telemedicine consultations for sexual health: Results of a national survey. BMC Infectious Diseases, 11(285), 1–11. doi:10.1186/1471-2334/11/285/prepub.

  • Gerrard, M., Gibbons, F. X., Houlihan, A. E., Stock, M. L., & Pomery, E. A. (2008). A dual-process approach to health risk decision making: The prototype willingness model. Developmental Review, 28, 29–61.

    Google Scholar 

  • Gibbons, F. X., Kingsbury, J. H., & Gerrard, M. (2012). Social-psychology theories and adolescent health risk behavior. Social and Personality Psychology Compass, 6(2), 170–183. doi:10.1111/j.1751-9004.2011.00412.x.

    Article  Google Scholar 

  • Goldberg, J. H., Halpern-Felsher, B. L., & Millstein, S. G. (2002). Beyond invulnerability: The importance of benefits in adolescents’ decisions to drink alcohol. Health Psychology, 21, 477–484.

    Article  PubMed  Google Scholar 

  • Halpern-Felsher, B. (2009). Adolescent decision making: An overview. The Prevention Researcher, 16(2), 3–7.

    Google Scholar 

  • Halpern-Felsher, B. L., Millstein, S. G., Ellen, J. M., Adler, N. E., Tschann, J. M., & Biehl, M. (2001). The role of behavioral experience in judging risks. Health Psychology, 20(2), 120–126. doi:10.1037//0278-6133.20.2.120.

    Google Scholar 

  • Henshaw, S. K., & Kost, K. (1992). Parental involvement in minors’ abortion decisions. Family Planning Perspectives, 24(5), 196–207, 213.

    Article  PubMed  Google Scholar 

  • Jacobs, J. (2004). Perceptions of risk and social judgments: Biases and motivational factors. In R. J. Bonnie & M. E. O’Connell (Eds.), Reducing underage drinking: A collective responsibility (pp. 417–436). Washington, DC: The National Academies Press.

    Google Scholar 

  • Lipstein, E. A., Brinkman, W. B., & Britto, M. T. (2012). What is known about parents’ treatment decisions? A narrative review of pediatric decision making. Medical Decision Making, 32, 246–258. doi:10.1177/0272989X11421528.

    Article  PubMed  Google Scholar 

  • Martenson, E. K., & Fagerskiold, A. M. (2008). A review of children’s decision-making competence in health care. Journal of Clinical Nursing, 17, 3131–3141.

    Article  PubMed  Google Scholar 

  • Michels, T. M., Kropp, R. Y., Eyre, S. L., & Halpern-Felsher, B. L. (2005). Initiating sexual experiences: How do young adolescents make decisions regarding early sexual activity? Journal of Research on Adolescents, 15(4), 583–607.

    Article  Google Scholar 

  • Moore, L., & Kirk, S. (2010). A literature review of children’s and young people’s participation in decisions relating to health care. Journal of Clinical Nursing, 19(15–16), 2215–2225. doi:10.1111/j.1365-2702.2009.03161.

    Article  PubMed  Google Scholar 

  • Morrell, H. E. R., Song, A. V., & Halpern-Felsher, B. L. (2010). Predicting adolescent perceptions of the risk and benefits of cigarette smoking: A longitudinal investigation. Health Psychology, 29(6), 610–617.

    Article  PubMed  PubMed Central  Google Scholar 

  • Piker, A. (2011). Balancing liberation and protection: A moderate approach to adolescent health care decision-making. Bioethics, 25(4), 202–208. doi:10.1111/j.1467-8519.2009.01754.x.

    Article  PubMed  Google Scholar 

  • Quinn, G. P., Murphy, D., Knapp, C., Stearsman, D. K., Bradley-Klug, K. L., Sawczyn, K., et al. (2011). Who decides? Decision making and fertility preservation in teens with cancer: A review of the literature. Journal of Adolescent Health, 49, 337–346.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reyna, V. F. (2008). A theory of medical decision making and health: Fuzzy trace theory. Medical Decision Making, 28, 850–865. doi:10.1177/0272989X08327066.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reyna, V. F. (2012). A new intuitionism: Meaning, memory, and development in fuzzy-trace theory. Judgment and Decision Making, 7(3), 332–359.

    Google Scholar 

  • Reyna, V. F., & Farley, F. (2006). Risk and rationality in adolescent decision making: Implications for theory, practice, and public policy. Psychological Science in the Public Interest, 7(1), 1–44. doi:10.1111/j.1529-1006.2006.00026.x.

    PubMed  Google Scholar 

  • Schlam, L., & Wood, J. (2000). Informed consent to the medical treatment of minors: Law and practice. Health Matrix, 10, 141–174.

    PubMed  Google Scholar 

  • Spring, B. (2008). Health decision making: Lynchpin of evidence-based practice. Medical Decision Making, 28, 866–874.

    Article  PubMed  PubMed Central  Google Scholar 

  • Song, A. V., Morrell, H. E. R., Cornell, J. L., Ramos, M. E., Biehl, M., Kropp, R. Y., & Halpern- Felsher, B. L. (2009). Perceptions of smoking-related risks and benefits as predictors of adolescent smoking initiation. American Journal of Public Health, 99, 487–492.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steinberg, L., Albert, D., Cauffman, E., Banich, M., Graham, S., & Woolard, J. (2008). Age differences in sensation seeking and impulsivity as indexed by behavior and self-report: Evidence for a dual systems model. Developmental Psychology, 44(6), 1764–1778. doi:10.1037/a0012955.

    Google Scholar 

  • Steinberg, L., Cauffman, E., Woolard, J., Graham, S., & Banich, M. (2009). Are adolescents less mature than adults?: Minors’ access to abortion, the juvenile death penalty, and the alleged APA “flip-flop.” American Psychologist, 64(7), 583–594.

    Google Scholar 

  • Steinberg, L., Graham, S., O’Brien, L., Woolard, J., Cauffman, E., & Banich, M. (2009). Age differences in future orientation and delay discounting. Child Development, 80(1), 28–44. doi:10.1111/j.1467-8624.2008.01244.x.

    Google Scholar 

  • Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental Review, 28, 78–106.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steinburg, L. (2010). A behavioral scientist looks at the science of adolescent brain development. Brain and Cognition, 72, 160–164.

    Article  Google Scholar 

  • Zebrack, B., & Isaacson, S. (2012). Psychosocial care of adolescent and young adult patients with cancer survivors. Journal of Clinical Oncology, 30(11), 1221–1226. doi:10.1200/JCO.2011.39.5467.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Stanford University, Palo Alto, CA, USA

    Bonnie Halpern-Felsher & Sarah Stitzel

  2. Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA

    Majel Baker

Authors
  1. Bonnie Halpern-Felsher
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  2. Majel Baker
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  3. Sarah Stitzel
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Corresponding author

Correspondence to Bonnie Halpern-Felsher .

Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA

    Michael A. Diefenbach

  2. Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

    Suzanne Miller-Halegoua

  3. Department of Community Health Sciences, Boston University, Boston, Massachusetts, USA

    Deborah J. Bowen

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Halpern-Felsher, B., Baker, M., Stitzel, S. (2016). Decision-Making in Adolescents and Young Adults. In: Diefenbach, M., Miller-Halegoua, S., Bowen, D. (eds) Handbook of Health Decision Science. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3486-7_12

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