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Complete lecture notes of risk behaviour and addiction in adolescence
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Lecture 1: Introduction Risk Behaviour and Addiction inAdolescence 5/9
Substance use and addiction remain to be trending topics.
How do we define risk behavior?
Risk behavior: Behaviors that pose a risk to a healthy physical, cognitive, psychosocial development
of adolescents
- Substance use (e.g., smoking, alcohol use, cannabis use, use of XTC and other party drugs)
- Other risk behaviors (e.g., gambling, gaming, social media use)
Article cannabis use and the mental health of young people
The general developmental proces
What we tend to regard as risk behaviour depends on:
- Characteristics of the particular substance or behavior (smoking vs gaming)
- Cultural and societal norms (alcohol use in the west is normal but in Islamic cultures this is
not the case)
- Scientific knowledge (knowledge on the risks of alcohol use for the cognitive development of
adolescents is big)
Predictors of Risk Behaviour
1
,Which (neurological) developments take place during adolescence?
Adolescence is from the age of 10 until 24 years old.
- Early adolescence (aged 10 – 13): physical growth, sexual maturation, psychosocial
development, social identity formation
- Mid adolescence (aged 14 – 18): experimenting with (risk) behaviours, personal identity
formation
- Late adolescence (aged 19 – 24): practicing adult roles
In adolescence there is a strong grow in brain volume. There is an increase in white matter
(connections) and a decrease in grey matter (nerve cells). This decrease of grey matter starts earlier in
girls than in boys. This process is called pruning: if you don’t use the matter, you can lose it. You don’t
need it anymore.
Also there is high plasticity of the brain.
At last, because of the increase in white matter, the communication between the brain regions
strongly improves. This means that our long term memory increases and our capacity for abstract
thinking/metacognition increases.
Why is there a peak in risk behaviours during adolescence?
Risk behavior in adolescence follows an inverted U-shaped curve. This means that in childhood we
don’t practice risky behaviour, in adolescence we practice a lot of risky behaviour and in our
adulthood we don’t practice risky behaviour.
Our neurological development in adolescence diifers. The speed of the development of two different
brain regions differs. The affective-motivational system (emotional brain) develops fast and the
control system (rational brain) develops slowly.
Affective-motivational system (emotional brain)
The emotional brain is located in the nucleus accumbens. This part of the brain is our reward centre.
The affective-motivational system (‘reward center’) is overactive in early and mid adolescence.
Adolescents experience stronger positive emotions than adults when they receive or anticipate a
reward This process is enhanced by testosterone
2
,This part has a lot of bottom-up processes (external factors influences guidance) and is a behavioural
activation system (BAS).
Control system (rational brain)
The rational brain develops slowly (until about 25 years). The rational brain plays an important role in
the development of executive functions: Risk estimation, monitoring long-term goals, inhibit the
tendency to respond to (short-term) possibilities for reward (impulse control, behavioral inhibition,
self control).
The rational brain is located in the prefrontal cortex. This part of the brain is responsible for decision
making and is our control system. Here are a lot of top-down processes (internal guidance based on
prior knowledge) and this is part of behavioral inhibition system (BIS).
The Maturational Imbalance Model
Increased risk-taking during adolescence is a result of an imbalance between reward sensitivity (the
affective-motivational system) and impulse control (control system).
How can we define drugs or psychoactive substances?
Psychoactive substances are chemical substances that cross the blood-brain barrier and affect the
function of the central nervous system thereby altering perception, mood, or consciousness (e.g.,
high/ euphoria, relaxation).
Other characteristics of psychoactive substances:
- They often induce craving after (regular) use
- They often evoke loss of control after they have been used (regularly)
Psychoactive substances differ in type and strength of the psychoactive effect. They also differ in the
degree to which they elicit craving and loss of control.
3
, The drug which has the highest addiction risk after use
is nicotine. After nicotine follow heroin, cocaine and
alcohol.
Different types of drugs:
1. Hallucinogens: LSD, magic mushrooms
2. Downers/depressants: Heroin, GHB and
Alcohol
3. Uppers/stimulants: Cocaine, amphetamine, speed and nicotine
Some drugs are a combination of different types. For example, cannabis and ketamine are a
combination of a hallucinogen and a downer. Another example, XTC is a combination of a
hallucinogen and an upper. The reactions can be very different each time.
How can we define addiction?
Sussman (2017) differentiates between intensional and extensional definitions of addiction:
- Intensional: these definitions aim to describe a causal addiction process (see Sussman, Table
1.2)
- Extensional: a classification of characteristics of an addiction (e.g. DSM-5)
Substance use disorder (DSM-5 TR, 2022)
Recurrent use over the last 12 months AND meeting at least two or more criteria (2-3 mild, 4-5
moderate, 6> severe SUD)
Two learning principles underlying the development of addiction:
1. Positive reinforcement occurs when the rate of a behavior increases because a desirable
experience (e.g., euphoria, relaxation) is resulting from the behavior
4
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