Risk behavior and addiction in adolescence (200800285)
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Risk behavior and addiction in adolescence
Lecture 1: An introduction to risk behavior and the development of substance and
behavioral addictions during adolescence
Literature:
- Cannabis use and the mental health of young people
- Understanding the etiology of adolescent substance use through developmental
perspectives
- A general introduction to the concept of addiction and addictive effects Sussman 2017
Questions:
1. Which (neurological) developments take place during adolescence?
2. Why is there a peak in risk behaviors during adolescence?
3. How do we define risk behavior, psycho-active substances (drugs) and addiction?
4. Which learning principles play a role in the development of addiction?
5. Which neurobiological mechanism play a role in the development of tolerance and
withdrawal symptoms?
6. What is the role of cognitive biases/implicit processes in substance use and addiction?
7. Which behavioral addictions are now officially recognized by diagnostic classification
systems such as the DSM-5 and the ICD-11?
8. How do we define behavioral addictions?
9. Do social media disorder symptoms lead to significant harm to adolescents’ wellbeing
and functioning, and if so, what are the exact consequences of social media disorder
symptoms?
10. Why is it important to obtain official recognition for internet-related addictions by
diagnostic classification systems for DSM-5 and the ICD-11?
,Content
1. How do we define risk behavior?
Risk behavior: behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents
- Substance use: smoking, alcohol use, drugs
- Other risk behaviors: gambling, gaming, social media
The general developmental process: when do you call it addiction?
- Contact with a substance → experimenting with a substance → integrated use →
excessive use (daily) → addicted use
What we tend to regard as ‘risk’ behavior depends on…
- Characteristics of the particular substance or behavior (smoking versus gaming): daily
smoking is seen as addiction but daily gaming is not necessarily addiction
- Culutural and societal norms: alcohol use in western versus Islamic cultures
- Scientific knowledge: knowledge on the risks of alcohol use for the cognitive
development of adolescents (vroeger was jong beginnen met drinken geen risk behavior)
Predictors of risk behavior (Com-B model, Michie et al. 2011)
- Motivation: You have to have a certain motivation (can be
longterm or spontanious) to engage in the behaviour
- Opportunity: You have to have access to the substance
- Capability: You have to be capable to engage in the behaviour.
2. Which neurological developments take place during adolescence?
Adolescence: +10 – 24 years
3 fases of adolescence
- Early adolescence (10-13): physical growth, sexual maturation, psychosocial
development, social identity formation (how do others percieve me?), parents less
important,
- Mid adolescence (14-18): experimenting with (risk) behviours, personal identity
formation (how do I percieve myself? Need to be unique)
- Late adolescence (19-24): practicing adult roles (first jobs, living without parents)
,Neurological development during adolescence
1. Strong grow in brain volume: increase in white matter (connections
between brain cells), decrease in grey matter (outer part,
nerve cells)
- Loss of gray matter among girls and boys by age →
- Pruning (snoeien): if you don’t use it, you lose it
2. Increase in white matter: communication between brain
regions strongly improves
- Long term memory increases
- Capacity for abstract thinking/ metacognition increases: can cause more arguments
because they become more critical
3. High plasticy of the brain: you can learn easier during adolescence. Brain cells are
eliminated if not used
3. Why is there a peak in risk behaviors during adolescence?
Risk behavior in adolescence follows an incerted U-shaped curve:
Neurological development in adolescence
The speed of the development ot two different brain regions differs
- The affective-motivational system (emotional brain) develops fast
- The control system (rational brain) develops slowly
Prefrontal cortex: control system, rational brain
Nucleus accumbens: reward center, affective-
motivational system, emotional brain
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 (higher chance at gambling addiction)
- This process is enhanced by testosterone (boys have more from this than girls)
, 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 maturational Imbalance model (Casey et al,
2011)
- Increased risk-taking during adolescence is a
result of an imbalance between reward
sensitivity (the affective-motivational system)
and impulse control (control system)
- Shows that there is an increase in the bottom-
up developments (motivational brain is very
active, reward sensitivity very active), top-down process slow increase (risk estimation).
(high reward sensitivity versus immature impulse control)
The horse (automatic en impulsive) and rider (reflective and controlled) metaphor
- Motivational system (horse): bottum-up processes, behavioral activation (BAS)
- Control system (rider): top-down processes, behavioral inhibition (remming) (BIS)
4. What are psycho-active substances and how can we define drugs or psycho-active
substances?
Psychoactive substances: chemical substances that cross the blood-brain barrier and affect
the function of the central nervous system thereby altering perception, mood or
consciousness (euphoria, relaxation)
Other caracteristics of psychoactive substances
- They often induce craving after (regular) use
- They often evole loss of control after thet have been uses (regularly)
B.v. smoking effects are not that clear (not high or euphoria or something like that) but
smoking leads to a lot of craving and loss of control (addictive)
Xtc (psychoactive effect is strong, but risk of eliciting feeling of craving and loss of control are
less high).
Psychoactive substances differ in
- Type of strength of the psychoactive effect
- The degree to which they elicit craving and loss of control
For which substance is the risk highest to develop addiction after one has used the
substance?
- Nicotine, heroine, cocaine
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