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Risk behavior and addiction in adolescents - Hoorcollege aantekeningen
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Risk behavior in AdolescenceHoorcollege 1
Substance use and addiction remain to be trending topics
- A lot in newspapers
- Old topic
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, cannabis)
Other risk behaviors (..)
The general developmental proces
1. Contact with a substance
2. Experimenting with a substance
3. Integrated use
4. Excessive use
5. Addicted use
What we tend to regard as risk behavior depends on…
- Characteristics of the particular substance or behavior (smoking vs gaming)
- Cultural 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
Predictors of substance use (Lopez-leon & Raley, 2013)
Capability
Motivation behaviour
Opportunity
Adolescence (+10 – 24 years)
- Early adolescence (aged 10-13): physical growth, sexual maturation,
psychosocial development, social identity formation
- Mid adolescence (aged 14-18 years): experimenting with risk behaviours,
personal identity formation (who am I?)
- Late adolescence (aged 19-24): practicing adult roles, having relations
Neurological development during adolescence
1. Strong grow in brain volume:
increase in white matter
(connections), decrease in grey
matter (nerve cells)
2. Loss of gray matter among girls and boys by age
Pruning (snoeien): if you don’t use it, you lose it!
, 3. High plasticity of the brain (learn skills if you are young)
4. Increase in white matter: communication between brain regions strongly
improves
- Long term memory increases
- Capacity for abstract thinking/metacognition increases
Neurological development in adolescence
The speed of the development of two different brain regions differs
- The affective-motivational (emotional brain) develops fast
- The control system (rational brain) develops slowly
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
- This process is enhanced by testosterone
Control system (rational brain)
- The rational brain develops slowly (until about 25 years)
- The rational brain plays an important role in the experience of executive
functions:
Risk estimation
Monitoring long-term goals
, Inhibit the tendency to respond to short term possibillities for reward (impulse
control, behavioral inhibition, self-control)
The maturational Imbalance model
- Increased risk-taking during adolescence is a result of an imbalance between
motivational bottom-up versus controlling top-down processes (high reward
sensitivity versus immature impulse control)
How can we define drugs or psychoactive substances?
Psychoactive substances are chemical substances that cross the blood-brain barrier
and affect the function of central nervous system thereby altering perception, mood
or consciousness.
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
- The degree to which they elicit craving and loss of control
- Cannabis/ketamine and XTC are in between
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
- Extensional: a classification of characteristics of an addiction
Two learning principles underlying the development of addiction:
1. Positive reinforcement occurs when the rate of a behavior increases because
of a desirable event (relaxation) is resulting from the behavior
2. Negative reinforcement occurs when the rate of a behavior increases because
an aversive event is prevented from happening (prevention of withdrawal
symptoms)
Why withdrawal symptoms?
Drug use
Dopamine release in the nucleus accumbens (NA) brain adaptation (the
sensitivity of the reward system is decreasing)
Reward
This decrease in the sensitivity of the brain reward system
- Reduction number of dopamine receptors
- Making the existing receptors less sensitive to dopamine
Result:
1. Tolerance (needing a higher dose of the drug to have the same effect)
2. Withdrawal symptoms (during abstinence)
3. A reduced sensitivity to natural incentives
- Reduced sexual interest in cocaine users
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