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College aantekeningen voor Risk behavior and Addiction

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  • January 13, 2022
  • 39
  • 2021/2022
  • Class notes
  • Van den eijnden
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Week 36

Lecture 1: Introduction ‘Risk behaviour and addiction in adolescence’ (Dr. Regina van den Eijnden)
• Gladwin, T. E., Figner, B., Crone, E. A., & Wiers, R. W. (2011). Addiction, adolescence, and the integration of control and motivation. Developmental Cognitive Neuroscience, 1(4), 364-
376.
• Dobbs, D. (2011). Beautiful Brains. Moody, Impulsive, Maddening. Why do teenagers act the way they do? Viewed through the eyes of evolution, their most exasperating traits may
be the key to success as adults. National Geographic, October 2011.
• Sussman, S. (2017). Chapter 1: A general introduction to the concept of addiction and addictive effects. In Substance and Behavioral Addictions: Concepts, Causes, and Cures (pp. 3-
31). Cambridge University Press.
• Lopez-Leon M., & Raley, J.A. (2013). Developmental Risks of Substance Use in Adolescence: Age as Risk Factor. In Rosner R., Clinical Handbook of Adolescent Addiction (pp. 132-138).
Willey-Blackwell.

Adolescence = 10-24
• Risky decision making in adolescence = U-shaped curve andersom
• Early adolescence (10-13) = physical growth, sexual maturation, psychosocial and psychosexual development, social identity formation
• Mid adolescence (14-18) = experimenting with risk behaviors, personal identity formation
• Late adolescence (19-24) = practicing adult roles

Neurological development
• Strong grow in brain volume = increase in white matter (connections), decrease in grey matter (nerve cells)
o Boys have more grey matter than girls and the grey matter decrease by age of 14 = pruning (snoeien → if you don’t use it, you lose it) = U-shaped curve andersom
• Increase in white matter = communication between brain regions strongly improves
o Long term memory increases
o Capacity for abstract thinking/metacognition increases
• High plasticity
• The speed of the development of different brain regions differ = Gladwin et al. (2011)
o The affective-motivational system (emotional brain) develops much faster than the control system (rational brain)

Development affective-motivational system (emotional brain)
• During early and mid adolescence, the affective-motivational system in the brain (reward center) of the brain is overactive
• Adolescents experience stronger emotions than adults when they receive or anticipate a reward → this process is enhanced by testosterone

Development control system (rational brain)
• The rational brain (centered in the prefrontal cortex) develops slowly (much slower than the emotional brain)
• The rational brain plays an important role in the development of executive functions
o Risk estimation, monitoring long-term goals, response inhibition: inhibition of the tendency to react to (short-term) possibilities for reward (behavioural inhibition, self
control)

Prefrontral cortex = COLD rational brain, top-down processes, slow, effortful, logical,
Nucleus accumbens = HOT reward center, bottom-up processes, fast, automatic, emotional

,The maturational imbalance model
• Increased risk-taking during adolescence is a result of an imbalance between motivational bottom-up vs controlling top-down processes (heightened reward sensitivity vs immature
impulse control)






Alternative theory (article Dobbs)
• The adaptive adolescence view = the teen is not only work in progress, but can be looked upon as an exquisitely sensitive, highly adaptable creature wired almost perfectly for the
job of moving from the safety of home into the complicated world outside
Risk behavior = behaviors that pose a risk to a healthy physical, cognitive, psychosocial development of adolescents
What we tend to regard as risk behavior depends on
• Characteristics of the particular substance or behavior → for instance, smoking vs gaming
• Cultural and societal norms → alcohol use in western vs Islamic cultures
• Scientific knowledge → knowledge on the risks of alcohol use for the cognitive development of adolescents
• Risicogedrag komt voort uit een onvermogen van reflectieve processen om de effecten van impulsieve processen voldoende te moduleren.

The process of addiction
• Contact with a substance → experimenting with a substance → integrated use → excessive use → addicted use

How can we define drugs or psychoactive 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 (high/euphoria, relaxation)
• Other characteristics of psychoactive substances
o They often induce craving after regular use
o They often evoke loss of control after they have been used (regularly)

Psychoactive substances differ in
• Type and strength of the psychoactive effect
• The degree to which they elicit craving and loss of control

Dutch adolescents higher heavy episodic drinking and lifetime use of cannabis than other European countries

Sussman (2017) differentiates between intensional and extensional definitions
• Intensional addiction = these definitions aim to describe a causal addiction process

, o Intensional models: processes that are hypothesized to play a role in the development of addiction → table 1.2 van Sussman en factors and models by Lopez-Leon & Raley
• Extensional addition = a classification of characteristics of an addiction




Two learning principles underlying the development of addiction
• Positive reinforcement occurs when the rate of a behavior increases because a desirable event (euphoria, relaxation) is
resulting from the behavior
• Negative reinforcement occurs when the rate of a behavior increases because an aversive event is prevented from happening (prevention of withdrawal symptoms)

This decrease in the sensitivity of the brain reward system
• Reduction number of dopamine receptors
• Making the existing receptors less sensitive to dopamine
Result
• Tolerance (needing a higher dose of the drug to have the same effect)
• Withdrawal symptoms (during abstinence)
• A reduced sensitivity to natural incentives → reduced sexual interest in cocaine users
Theory of planned behavior → people balance benefits and costs

,

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