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College aantekeningen van Risk behavior and addiction in adolescence ()
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Lecture 1: IntroductionHow do we define risk behavior?
Risk behavior: Behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents. The predicting behavior of developing addiction.
- 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, eating habits.
The general developmental process: contact with substance (friends are using it and offer
you something) -> experimenting with a substance -> integrated use -> excessive use ->
addicted use.
What we tend to regard as risk behavior depends on:
- Characteristics of the particular substance or behavior.
o For instance, smoking versus gaming. Smoking can be risk behavior in the
experimental phase, gaming is not. XTC is not immediately a risk behavior
when you use it once. You can game a lot of hours per week, but this doesn’t
say you are addicted.
- Cultural and societal norms:
o Example: alcohol use in western versus Islamic cultures. In western society we
believe we can moderately use alcohol. In Islamic cultures, alcohol is not
allowed in most cases.
- Scientific knowledge (when is something risk behavior or not?)
o Example: knowledge on the risks of alcohol use for the cognitive development
of adolescents. We know drinking and smoking is bad now, but back in the
days nobody knew.
All behaviors develop as a result of the capability, motivation, and opportunity.
,Which (neurological) developments take place during adolescence?
Adolescence starts at ±10 years and ends at 24 years.
- Early adolescence (aged 10 – 13): physical growth, sexual maturation, psychosocial
development (parents become less important), social identity formation (how do
others perceive me? -> the responses they get are important for their social
development).
- Mid adolescence (aged 14 – 18): experimenting with (risk) behaviors, personal
identity formation (how do I perceive myself? -> need to be unique).
- Late adolescence (aged 19 – 24): practicing adult roles such as having first
relationships, first jobs, living without parents.
Neurological development during adolescence ->
strong grow in brain volume: increase in white matter
(connections), decrease in grey matter (nerve cells).
This starts earlier in girls. All the grey matter that is not
used, will be lost so there is more space for white
matter. Also, there is a high plasticity of the brain,
brain is flexible, can learn a lot, develop certain skills.
Increase in white matter: communication between
brain regions strongly improves:
- Long term memory increases.
- Capacity for abstract thinking/metacognition
increases. Young people become more critical
on the outside world.
The child brain, which is similar to a lot of small paths, will in this time develop to a big
highway. It is going to work more efficiently.
,Why is there a peak in risk behaviors during adolescence?
In mid adolescence, the peak is at its highest.
People have to learn fast, have experience with a
lot of new situations and behaviors.
The speed of the development of 2 different brain
regions:
- The affective-motivational system
(emotional brain) develops earlier and
faster.
- The control system (rational brain) develops
slowly.
The affective-motivational system (emotional
brain):
- 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.
o This process is enhanced by testosterone. Boys have it in higher amounts,
boys engage more in risk behaviors than girls do, because of this.
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:
o Risk estimation.
o Monitoring long-term goals.
o Inhibit the tendency to respond to (short-term) possibilities for reward
(impulse control, behavioral inhibition, self-control).
, The horse and the rider metaphor: the horse is the motivational system, bottom-up
processes, BAS. Has his own way, wants to do to what he wants. But if the rider (control
system: top-down processes, BIS) is strong enough, he can control the horse. All kinds of
behaviors are inhibited or stopped.
What are psycho-active substances (drugs)?
-> 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 psycho-active substances:
- They often induce craving after (regular) use.
- They often evoke loss of control after they have been used (regularly).
Psycho-active substances differ in:
- Type and strength of the psycho-active effect.
- The degree to which they elicit craving and loss of control.
Nicotine is the most addictive after one use. After that it is heroin.
Cannabis is a combination of a downer and a hallucinogen. XTC is a combination of an upper
and hallucinogen.
How do we define addiction?
- Intensional: these definitions aim to describe a causal addiction process.
- Extensional: a classification of characteristics of an addiction.
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