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The shift toward assessing and promoting protective factors is a major paradigm change in adolescent health care, and clinicians can be an important partner with families and schools to foster healthy youth development.

With the introduction of antibiotics and immunizations over the past century, the leading causes of morbidity and mortality among adolescents shifted from infectious diseases to behavioural risks such as alcohol-related accidents, illicit drug use, self-harm and suicide, violence and unintended pregnancy.

They also can have an extreme sensitivity to particular sensory experiences.

All of these diagnostic characteristics will affect relationship skills throughout childhood, and will eventually limit an adult’s ability to achieve a long-term successful relationship.

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They have also documented key protective factors that are linked to lower rates of risk behaviours and more positive outcomes, even for youth who face unsafe environments, family problems and other stressors.Health promotion efforts began to focus on these health-compromising behaviours of young people, and research from the 1980s and the 1990s began to use large-scale school-based surveys to document the prevalence and to monitor trends of such risk behaviours among students (1).Interventions that focused on preventing or reducing the risk behaviours had some success; yet, although risk factors can detour and even derail healthy youth development, reducing risks alone is not sufficient for youth to thrive.Correspondence: Dr Elizabeth Saewyc, School of Nursing, University of British Columbia, T201–2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5.Telephone 604-822-7505, fax 604-822-7466, e-mail [email protected] Although risk behaviours can threaten healthy youth development, reducing risks alone is not sufficient to help youth successfully negotiate adolescence.