Summary Risk Behavior and Addiction 2022
Lecture 1
Lopez & Raley, 2013
- Adolescents are less likely to report withdrawal effects, experience shorter periods of
addiction and recover more rapidly when they do experience withdrawal
- Their own surroundings: social, family, biological, educational etc. are risk factors
Developmental factors to risk taking behavior
- Prefrontal cortex is not yet fully developed, which plays a part in higher cognitive functions
such as risk estimation, risk choice, consequence evaluation – making them more prone to
trying risky behaviors
Inexperience and risky behavior
Rebelliousness – either becoming submissive or independent
Sensation seeking
Identity formation – higher psychosocial vulnerability in a period of establishing a
peer friend group and finding your identity
The Gateway Hypothesis – the risk of experimental use
- Progressive chain sequence of using psychoactive substances; legalized psychoactives –
cannabis – other illegal substances
Cannabis is a crucial part in this line, acting as the ‘gateway’ drug
- Supporting evidence
Biochemical – bridge between cannabis and other illegal substances is declining due
to chemical changes in the brain as a result of cannabis use
Individual learning level – experimenting with cannabis and learning its euphoric
effects rather than the negative consequences, diminishing risk perception of other
substances
Societal level – surrounding yourself with cannabis drug dealers, brings you closer to
the world of hard drug dealers as well
Cognitive impairment – due to intoxication by cannabis being lured towards using
hard drugs
o Prevention programs focus on taking away a gateway drug
Other factors that contribute to use of psychoactive substances
- Substance availability
- Birth cohort – other birth years have more access and opportunity to drugs than others
- Comorbid psychiatric illness
- Non-diagnostic personal characteristics – e.g., impulsivity, risk taking behavior etc.
Reverse Gateway Hypothesis
- Cannabis used precedes the use of nicotine, making cannabis a gateway drug to nicotine
- Support in literature
Reducing sedative effects and enhancing rewarding effects – prolonging the rewards
Reinforcing effects of cannabis
,Sussman, 2017
Substance vs. behavioral addiction
- Substance – addiction to the repetitive intake of a drug or food
- Behavioral – addiction to the repetitive action or behavior, not directly taking something into
the body
Addiction – misuse of drugs that led to physiological withdrawal symptoms, caused by adaptations to
the nervous system
- Drugs are then exogenous liquids that cross the blood-brain barrier, carrying out endogenous
tasks
- Types of conceptions of addiction
Intentional definition – causal or process model (this happens that caused this etc.)
o E.g., self-medication, psychological dependence, obsessive compulsive
behavior – using the form of addiction to relieve oneself of a situation or
feeling
Extensional definition – listing of addiction features leading to a theory-based type
perspective
o E.g., DSM 5
Physiological and psychological dependence – prolonged engagement in behavior that causes
physiological and psychological equilibrium
- Tolerance – needing greater amounts of the same substance to reach earlier achieved
feelings of relief, pleasure etc.
- Withdrawal – abstinence syndrome/abrupt termination of use, sometimes causing physical
disturbances with most occurring a catecholamine storm, causing high temperatures,
tachycardia and tremors.
- Craving – intense desire which is compelling and reoccurring
Impulsive-Obsessive/Compulsive behavior – addiction with focus on ‘release’, so relief rather than
equilibrium
- Positive reinforcement – building of tension is released resulting in pleasure, causing possible
cyclical manners, releasing the pressure the same wat time and time again – achieving
something positive, wanting it more
- Negative reinforcement – build up of tension with anxiety and stress which is relieved when
acting out the behavior, but no particular pleasure is achieved, which then build up anxiety
again creating a craving for the release – giving something negative, wanting to get rid of it
OCD and compulsive addiction are not the same – OCD is more focused on repetition
of behaviors that release anxiety, whereas addiction involves more complex
behaviors to achieve appetitive effects.
, Galdwin et al., (2011)
During adolescents, they start to master the ability to control their behavior for long-term goals. In
the brain is still in development which can result in excessively risky behavior. Much of this behavior
occurs in the presence of peers.
Neural developments – frontostriatal model
- The adolescent brain has two interacting systems – ‘hot’ affective-motivational bottom-up
and slowly developing ‘cold’ top-down control systems.
Affective-motivational – involves subcortical brain areas (e.g., dopamine) such as
striatum and prefrontal cortex implicated in the reward representation, matures on
the onset of puberty
Control – lateral prefrontal cortex, posterior parietal brain regions involved in self-
control, planning, abstract thinking, working memory and goal directed behavior,
develops gradually into young adulthood.
- During adolescents the brain undergoes many changes in brain areas, while shifting from
childhood to adulthood.
- Due to already working reward center (affective-motivational brain), there is high activity
when anticipating or receiving rewards, then because the control system is underdeveloped
there are unable to inhibit behavior in the presence of salient cues.
Addiction
- There are two broad types of neuroadaptations that result from repeated alcohol and drug
use.
1. Neural sensitization leads to strong impulsive reactions to classically conditioned cues
that signal alcohol and drugs – later in addiction habitual responses become important
since addiction related cues trigger approach-reactions. Also think of negative
reinforcement, where drug use alleviated negative affect.
2. Heavy alcohol and drug use can result in impaired self-control, especially when such
heavy use happens during adolescence
- Binge drinking predicts impulsive behavior, but impulsive behavior can result in binge
drinking.
Interventions
- They aim to ‘train away’ the consequences of drug abuse or attempts to compensate for
biological immaturities.
Working memory training – trains the likelihood of successful control e.g.,
overcoming bias control
o Low voltage electrical stimulation – reductions in craving
Cognitive bias modification – aimed at modulating biases which underlie failures of
controlled processing such as attentional bias, approach bias or evaluative memory
bias.
o Attentional bias modification – modified version of the initial assessment
instrument, where the probe appears less often on the location of the
disorder-related stimulus.
