Study: Adolescents Engage in Fewer External Risky Behaviors but Report Increasing Internal Concerns

Adolescents over a 22-year period steadily moved away from external risky behaviors such as substance use but showed increased internal issues such as depression at the onset of the COVID pandemic, according to a study to be published in Pediatrics.  The study, “Trends in Mental and Behavioral Health Risks in Adolescents: 1999-2021,” published in the April 2025 Pediatrics (published online March 18), analyzed data from the national biennial Youth Risk Behavior Surveys distributed by the Centers for Disease Control and Prevention. A total 178,658 students in 9th-12th grades nationwide were analyzed across the entire study timeline. Results showed that a majority of adolescents are turning away from external risky behaviors such as substance use, sexually risky behaviors, and violence while also not showing signs of internalized behaviors such as depression. Despite this, a small group of adolescents, representing less than 9% of those surveyed, reported heightened mental health concerns as the study data moved into the first year of the COVID-19 pandemic. Authors found increased symptoms of hopelessness and suicidality. They suggest additional public health measures to lower negative mental health symptoms in adolescents. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.