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Lecture notes risk behaviour and addiction in adolescense
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Extensive notes of all lectures from te course risk behaviour and addiction in adolescence .
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Anne Ponsteensv lectures risk behaviour and addiction
Lecture 1 - Implicit processes underlying substance use and addiction
- Risk behaviour = behaviour that poses a risk to a healthy physical, cognitive
psychosocial development of adolescents
- Risk behaviour exists in substance use (alcohol, cannabis etc.) and other risk
behaviour (gambling, gaming etc.)
- General developmental process: contact with a substance → experimenting with a
substance → integrated use → excessive use → addicted use
- When is something risk behaviour or addiction? The stage in which we call
something addiction differs by substance. It depends on:
1. Characteristics of the particular substance or behaviour (smoking vs gaming →
smoking is called risk behaviour in an earlier stage)
2. Cultural and societal norms (alcohol use in western vs Islamic culture)
3. Scientific knowledges (knowledge on the risk of alcohol use for the cognitive
development of adolescents)
- There are 3 factors that predict (risk)behaviour (COM-B model): capability (you have
to be able/capable to engage in behaviour), motivation (long- or short term),
opportunity (access/possibilities to engage in behaviour)
- Stages of adolescence:
1. Early adolescence (10-13): physical growth, psychosocial development, social
identity formation (how do others see me?)
2. Mid adolescence (14-18): experimenting with (risk)behaviours, personal
identity formation (how do I see myself?)
3. Late adolescence (19-24): practising adult roles
- There’s also a neurological development during adolescence such as:
1. Big changes in brain volume, grey matter (nerve cells) decreases (pruning, if
you don’t use it, you lose it, this process is to make the brain more efficient)
2. High plasticity of the brain (it is easier to learn new things at a young age)
3. Increase in white matter (connections), meaning te communication between
brain regions strongly improves (long term memory and capacity for abstract
thinking increases)
- Girls experience these changes at an earlier stage than boys
- Why do risk behaviours peak during adolescence?
1. The affective-motivational system (emotional brain) grows very fast during
early and mid-adolescence means that adolescence experience stronger positive
emotions than adults when they receive or anticipate a reward (this process is
enhanced by testosterone)
2. The control system (the rational brain) develops slowly. The rational brain plays
an important role in the development of executive functions such as risk
estimation, monitoring long-term goals and inhibit the tendency to respond to
short-term possibilities for reward (impulse control, behavioural inhibition)
- Increased risk-taking during adolescence is a result of an imbalance between the
motivational (due to quick growth of the nucleus accumbens) and controlling (due to
slow growth of the prefrontal cortex) processes
, Anne Ponsteen
- Psychoactive substances = substances that can cross the blood-brain barrier and
affect the central nervous system (so it influences the mood, perception, or
consciousness). They often induce craving and evoke loss of control
- Psychoactive substances differ in strength and effect and the degree to which they
elicit craving and loss of control (which are predictors of addiction)
- Nicotine and heroine are the most addictive psychoactive substances, XTC and
paddo’s are the least addictive (they don’t really elicit craving and loss of control)
- Types of drugs (some drugs fall into 2 categories):
1. Downers (depressants): heroin, alcohol
2. Uppers (stimulants): nicotine, speed
3. Hallucinogens: LSD, magic mushrooms
- How can we define addiction?
- Sussman (2017) distinguishes intensional and extensional definitions of addiction:
- Intensional: definition aims to describe a causal addiction process
- Extensional: a classification of characteristics of an addiction
- Extensional definition: substance use disorder is defined as recurrent use over the
last 12 months and meeting at least two or more of the following criteria: loss of
control, social and other impairments, continuation despite knowledge of risky use,
pharmacological effects (such as tolerance and withdrawal)
- Two learning principles underlying the development of addiction:
1. Positive reinforcement occurs when the rate of a behaviour increases because
of a desirable event (such as euphoria/relaxation) is resulting from the behaviour
2. Negative reinforcement occurs when the rate of a risk behaviour (such as drug
use) decreases (for example because you try to stop or there’s nothing available)
and an aversive event is happening (withdrawal symptoms) → to prevent
aversive events the rate of behaviour increases
- What happens in the brain that causes withdrawal symptoms?
Drug use leads to dopamine release, which feels like a reward. But the brain also
adapts to drug use by preparing for a release of more dopamine, the brain is
anticipating on another shot of dopamine (if this shot isn’t coming the brain releases
withdrawal symptoms)
- The sensitivity of the brain reward system decreases because of:
1. a reduction in number of dopamine receptors
2. the existing receptors are less sensitive to dopamine
- Results are:
1. tolerance (needing a higher dose to have the same effect)
2. Withdrawal symptoms during abstinence
3. Reduced sensitivity to natural incentives (eating, sleeping, sex etc. become
less rewarding)
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- The front of the brain (fronto-parietal) is more reflective and controlling, the core
(subcortical) focuses more on motivation, there are a lot of reciprocal connections
between the two systems
- Drug cues affect the motivation system. When the drug cues/other external
influences are too present, the control system can’t suppress the drug cue
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