Adolescent Decision Making: Implications for Prevention Programs . The Decision-Making Framework


Decision theory describes the steps involved in making any decision, including recognizing that a decision must be made, understanding the goals that one hopes to attain, making a list of options, determining the consequences — both positive and negative — of each option, determining the desirability of each consequence, evaluating the likelihood of each consequence, and integrating all the information.  The entire process occurs within a context or situation that may influence the options available and their consequences.  Workshop chair Baruch Fischhoff, professor of social and decision sciences and of engineering and public policy at Carnegie Mellon University, explained some of the benefits to thinking about decision making from this perspective.  Decision theory provides a common descriptive framework for describing how people actually make decisions, for comparing what people actually do with what they could conceivably do under ideal circumstances, and for uncovering ways to help people improve their decision-making skills.

In real life, people often make choices out of habit or tradition, without going through the decision-making steps systematically, Fischhoff noted.  Decisions may be made under social pressure or time constraints that interfere with a careful consideration of the options and consequences (Reason, 1990).  Decisions may be influenced by one's emotional state at the time a decision is made (Plous, 1993).  When people lack adequate information or skills, they may make less than optimal decisions (Fischhoff, 1992b).  Even when people have time and information, they often do a poor job of understanding the probabilities of consequences; even when they know the statistics, they are more likely to rely on personal experience than information about probabilities (National Research Council, 1989).

Most of the research about decision making has been done with adults.1  To what extent can the research findings be applied to adolescents? Box 1 lists some of the questions that need to be answered for each step in the decision-making process in order to apply this framework to adolescents.  Box 2 presents Fischhoff's speculative answers to the questions.

People cannot decide to follow a course of action if they have not considered that action as an option.  Many programs for adolescents are designed to expand their range of options, yet very few researchers have studied how adolescents — or adults — generate options (Beyth-Marom and Fischhoff, 1997).  One study of adolescent girls' contraceptive practices found that they equated birth control with the pill and therefore did not consider other forms of birth control as options (Rogel et al., 1980).  In-depth interviews with adolescent girls about tough decisions they had made revealed that they often saw only one either-or choice rather than a series of options (Beyth-Marom and Fischhoff, 1997).

More research has focused on how people view the consequences of various options than on option generation itself.  Research suggests that, from the age of about 12 or 13, young people are similar to adults in their ability to identify and evaluate possible consequences of engaging in risky behaviors (Beyth-Marom et al., 1993; Office of Technology Assessment, 1991).  Teenagers are slightly more likely than adults to list social consequences of engaging in or avoiding a risky behavior (Beyth-Marom et al., 1993).  Teenagers also report engaging in behaviors that they describe as more likely to have positive than negative consequences (e.g., Bauman et al., 1988; Gilbert et al., 1986; Haveman et al., 1997).

In the decision-making framework, Fischhoff explained, not only does one need to recognize consequences, but also one must determine the likelihood that a consequence will occur.  Adolescents' involvement in risky behaviors has often been attributed to their thinking of themselves as invulnerable — as thinking that bad consequences will not happen to them.  Research shows that they are no more likely than adults to see themselves as invulnerable (Cohn et al., 1995; Quadrel et al., 1993).  That is not to say that adults do a good job of estimating probabilities of the likelihood of their experiencing negative consequences.  Numerous studies have found that adults tend to see themselves as less likely than others to experience negative outcomes and more likely to experience positive ones (Baumhart, 1968; Finn and Bragg, 1986; Johnson and Tversky, 1983; Larwood and Whitaker, 1977; Perloff, 1983; Svenson, 1981; Weinstein, 1987; Whitely and Hern, 1991).  Young people favor their own experience and anecdotal evidence over probabilistic information in making decisions, particularly about social situations, as do adults (Jacobs and Potenza, 1991).

Adolescence is a time of physical, cognitive, social, and emotional growth and change.  Workshop presenter Lawrence Cohn, associate professor of psychology at the University of Texas at El Paso, discussed adolescent cognitive development and its potential implications for decision making.  It is generally asserted that, during adolescence, there is an increasing capacity for abstract reasoning, counterfactual reasoning, reasoning from premises that are not true, systematic reasoning, and a growing capacity for probabilistic reasoning.  These abilities are all relevant to decision making.  An increased ability to grasp the concept of probability should encourage a more realistic understanding of the chance of various outcomes occurring.  An increased capacity for systematic reasoning should provide teenagers with the ability to imagine future outcomes and transpose them into the present, thereby enabling them to assess the consequences of their actions.  An increased ability to coordinate independent pieces of information should encourage teenagers to attend to all relevant aspects of choices.

Adolescents' social cognition — the way they think about their social world, the people they interact with, and the groups they participate in — may differ from that of adults and influence their decision-making skills.  Workshop presenter Janis Jacobs, associate professor of human development and family studies and psychology at Pennsylvania State University, mentioned three key ways in which mastering knowledge about the social world differs from other cognitive skills (Jacobs and Ganzel, 1993).  First, social outcomes are generally uncertain, so that the best reasoning and decision making does not guarantee the best social outcomes and poor reasoning does not guarantee a bad social outcome.  Second, information about relationships and social events often must be inferred over a long period of time.  Third, the social world is constantly changing.  As children enter adolescence, they are exposed to a greater variety of adults and peers, and they are gaining greater autonomy.  Adolescents make important decisions under the set of circumstances in which we know adults have the greatest difficulty:  unfamiliar tasks, choices with uncertain outcomes, and ambiguous situations.

Jacobs also noted that she has found different styles of decision making in two studies (Jacobs, 1998; Jacobs and Potenza, 1990).  Some people prefer to gather information and carefully weigh different options.  Others say that they prefer to rely on intuition and make snap decisions.  A third group is inconsistent in their strategies and report high levels of indecision.  In both studies, the first two groups thought of themselves as good decision makers, but 7th and 8th graders who made snap decisions were more likely to be involved in risky behaviors than those who carefully weighed options and evaluated consequences.

There may be other differences between adolescents and adults that may also influence the way they make decisions.  Cohn noted that teenagers see occasional or experimental involvement in health-threatening activities as less dangerous than do their parents.  Compared with their parents, teenagers perceive less risk in occasionally drinking alcohol, getting drunk, or smoking cigarettes.  Notably, however, they do recognize that frequent involvement in these activities places them at greater risk for harm (Cohn et al., 1995).  Some evidence suggests that teenagers also misperceive independent risks as cumulative, that is, they think that one must be exposed to a hazard a number of times before experiencing negative consequences.  An example of this reasoning is the pregnant adolescent who did not think she could get pregnant the first time.  Cohn noted that adolescents may also overestimate their ability to recognize and avoid dangerous situations.

Workshop presenter Reed Larson, professor of human and community development and psychology at the University of Illinois, Urbana-Champaign, explained the role that emotions may play in adolescent decision making.  Emotions affect how people think and behave and influence the information people attend to.  When people are experiencing positive emotions, they tend to underestimate the likelihood of negative consequences to their actions; when they are experiencing negative emotions, they tend to focus on the near term and lose sight of the big picture.  Both adolescents' and adults' decision-making abilities are influenced by emotions.  Larson's research has found that adolescents experience more emotions, in general, than do adults (Larson et al., 1980; Larson and Richards, 1994).2  About one-quarter to one-third of adolescents' strong emotions — both positive and negative — are tied in some way to real or fantasized romantic emotions (Larson and Asmussen, 1991).

Another factor that may influence the decisions adolescents make, according to workshop presenter Elizabeth Cauffman, postdoctoral fellow at the Center on Adolescence at Stanford University, is their level of maturity of judgment.  In her research, maturity of judgment encompasses three dimensions:  responsibility — being self-reliant and having a healthy sense of autonomy; perspective — taking the long-term view and concern for others; and temperance — being able to limit impulsivity and exercise self-control.  The less mature a young person was rated in the study, the more likely he or she was to choose a less "responsible" option (such as shoplifting, smoking marijuana, etc.).  In general, Cauffman's research found that maturity was curvilinearly related to age; that is, maturity level was high among 6th graders, dropped to its lowest level among 10th and 11th graders, then began increasing into young adulthood, when it plateaued.  She also found that girls generally were more mature than boys at a given age.  However, the level of maturity of judgment was a better predictor of choosing a "responsible" option than was age.  For example, a mature 15-year-old was more likely to make a "responsible" decision (such as not smoking marijuana, not shoplifting, etc.) than an immature 24-year-old (Steinberg and Cauffman, 1996).

  1. Overviews of research on adult decision-making processes can be found in Ableson and Levi (1985), Fischhoff (1988), Fischhoff et al. (1987), Slovic et al. (1988), and von Winterfeldt and Edwards (1986).
  2. Experimental work in brain imaging by Deborah Yurgelun-Todd suggests that adolescents may process emotions in the part of the brain responsible for instinct and gut reactions (the amygdala), whereas adults process emotions in the frontal section — the part of the brain associated with rational reasoning (Boston Globe, 1998). This suggests a physiological maturation of the brain that continues throughout adolescence.