Adolescents are often diffident, avoidant, and socially awkward, especially in conversation with adults, and even moreso in relation to subjects that are perceived as embarrassing, or in any way "odd" (as much of a mental state examination frankly is, when judged according to common sense standards.)

Research on Adolescent NeuroDevelopmental characteristics, demonstrates that (primarily on account of a mismatch between their relatively under-developed frontal brain regions compared to other components of the limbic system which log socially relevant communications and generate affective responses to these) they are easily overwhelmed by the emotional impact of social situations. This triggers "fight or flight" responses or attachment behaviours, both of which inhibit Mentalization and limit the capacity for engagement.