Spring Break and the Brain: Post #5 - Case Study

In a rare instance that I actually watched the Dr. Phil Show the topic was underage drinking and the posting of such activity on social networking sites (i.e. Facebook, My Space, etc.) [aired Jan 15., 2008].  The premise for discussion was how these postings can affect future employment, getting into college, and overall reputation.

The guest teenager, Mary who was about 16 or 17 years old, was quoted as saying:
"I have drunk pictures on Facebook but I don't keep track of what's on there.  I would post a picture of me wrapped around a toilet and be damn proud of it.  I would never hide my life to get a job.  Nothing anyone would say would get me off Facebook or to stop drinking.  I love to drink.  I started in the eighth grade at age 13.  Every time I drink, I get really drunk."

My immediate reaction was "WOW" on so many different levels.  Some of the same things that I am sure you are thinking about and reacting to.  But the more astonishing thing was Mary's mother's (Pam) reaction.
"The first time that I caught Mary Elizabeth drinking, she was 15 and that's when she had fallen and hit her head and ended up in a coma. The second time that we caught Mary Elizabeth drinking things got really out of hand and the police had to be called. ... She, you know, uses her judgment, I'm assuming.  We haven't caught her other than those two times really."
  
Really...there was a second time after your daughter was in a coma.
What..."it got really out of hand" when the police showed up.  I would think the first time and the coma thing would have been judged as "really out of hand." 

In response to her mother's comment, Mary replied:
"I didn't think going to the drunk tank for the night was a very big deal.  I just thought it was kind of a joke."

So, what's going on?  What are the things we want to consider?

• age of onset
• amount of consumption (binge drinking, heavy drinking)
• frequency of consumption (daily, weekly use)
• duration of consumption (months, years)
• any other drug use/abuse
• overall health, any problems or consequences of drinking (i.e. diet, sleep, exercise, organ damage, etc.)

What could be the damage to Mary's brain from all this drinking?

• frontal lobe changes/damage, specifically the prefrontal cortex
• size and state of the hippocampus
• cognitive functioning
• emotional regulation

What are the results of Mary's drinking?

• social acceptance (peers are party friends)
• self-esteem (proud of behavior - posting evidence so the whole world can see)
• rewards (reputation of being a party girl; she can hold her liquor)
• inability to see the seriousness of consequences
• domino affect of drinking (employers reactions, teachers perception, school performance)
• creates a concern regarding parenting issues and/or choices
• thoughts about any treatment or interventions

Would you want to work with her and how?
What do you think Mary is doing during Spring Break?