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Notes all lectures Risk behavior and addiction in adolescence 2022/2023
Everything that is said during the lectures of this course + the questions that are treated.
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Voorbeeld 3 van de 18 pagina's
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Voorbeeld van de inhoud
Lecture 1A: Introduction Risk Behavior and Addiction inAdolescence
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. How do motivation, control and their interaction contribute to substance use and addiction?
7. Why are adolescents at increased risk for escalation of substance use?
8. What is the role of cognitive biases/implicit processes in substance use and addiction?
9. How to measure cognitive biases/implicit processes?
10. What are potential interventions for substance use and addiction targeting motivation and
control processes?
Risk behavior:
- Behaviors that pose a risk to a healthy physical, cognitive, psychosocial development
of adolescents.
o Substance use, smoking, drugs, alcohol.
o Other risk behaviors like gambling, gaming, social media.
Developmental process of addiction
Contact with a substance experimenting with the substance integrated use excessive
use addicted use
What calling something risk behavior depends on:
- Characteristics of the particular substance or behavior.
- Cultural and societal norms. Alcohol in the western use is not called risk behavior
“healthy use of alcohol” in Islamic cultures this behavior is already called risk
behavior.
- Scientific knowledge.
Predictors of substance use LOPEZ-LEON & RALEY
3 factors that predict risk behavior:
1. Motivation. You need to be motivated to engage in the behavior.
2. Opportunity. You need to have access to the substance to engage.
3. Capability. You need to be capable of engaging in the behavior.
Adolescence 10-24 years.
- Early adolescence (10-13). Physical growth, sexual maturation, psychosocial
development, social identity formation (opinions of other start to matter and you start
to care about what others think of you)
- Mid adolescence (14-18). Experimenting with behaviors, personal identity formation
(how you see yourself.)
- Late adolescence (19-24). Practicing adult roles.
,Neurological development during adolescence:
1. Strong grow in brain volume. Increase in white matter (connections between nerve
cells), decrease in grey matter (nerve cells).
2. Increase in white matter: communication between brain regions strongly improves.
Long term memory increases. Capacity for abstract thinking/metacognition increases.
(can also cause more arguments because you start to think more critical).
3. Pruning: all brain cells you don’t use, you lose.
4. High plasticity of the brain. You can learn easier during adolescence.
Why is there a peak in risk behavior during adolescence?
The speed of the development of two different brain regions differs:
- The affective-motivational system (emotional brain) develops fast.
- The control system (rational brain) develops slowly.
The affective-motivational system starts becoming very active in the beginning of
adolescence and mid adolescence. You experience stronger positive emotions when you
receive or anticipate a reward enhanced by testosterone. Boys have more testosterone,
that’s why boys engage more in risk behavior.
The control system develops slower. The rational brain plays a role in:
- Risk estimation. Later you are better equipped in predicting risks of behavior.
- Monitoring long-term goals. In adolescence it is harder to monitor these.
- The tendency to respond to possibilities for a reward. You develop a better impulse
control, behavioral inhibition, self-control.
Increased risk-taking during adolescence is a result of imbalance between high reward
sensitivity versus immature impulse control.
What are psycho-active substances?
Chemical substances that cross the blood-brain barrier and affect the function of the central
nervous system thereby altering perception, mood or consciousness.
- They often induce craving after use. When you have been using a substance for a
while, you start to crave the feeling again.
- They often evoke loss of control after use.
Psychoactive substances differ in type and strength of psychoactive effects and the degree to
which they elicit craving and loss of control. smoking effects are not that clear in
comparison to euphoric drugs as XTC or magic mushrooms.
Types of drugs:
1. Hallucinogens. Lsd/magic mushrooms.
2. Uppers (stimulants). Nicotine/cocaine/speed.
3. Downers (depressants). Heroin/ghb/alcohol/cannabis.
How do we define addiction?
Intensional. DSM-5, recurrent use over the last 12 months and meeting at least two or more of
the following criteria:
o Loss of control.
o Social and other impairments.
, o Continuation despite knowledge of risky use.
o Pharmacological effects (tolerance and withdrawal)
- Extensional.
Two learning principles underlying the development of addiction:
1. Positive reinforcement occurs when the rate of a behavior increases because a
desirable event is resulting from the behavior (e.g. euphoria, relaxation).
2. Negative reinforcement occurs when the rate of a behavior increases because an
aversive event is prevented from happening (e.g. prevention of withdrawal symptoms).
Why do we experience withdrawal symptoms?
Drug use: dopamine release you experience a pleasant feeling your brain gets used to
these substances (the sensitivity of the reward system is decreasing).
If you use drugs more often, your brain anticipates and your brain starts showing withdrawal
symptoms.
The decrease of the sensitivity of the brain reward system:
- Reduction number of dopamine receptors.
- Making the existing receptors less sensitive to dopamine.
Results:
- Tolerance. You need more of the drug to experience the same effects.
- Withdrawal symptoms.
- A reduced sensitivity to natural incentives. Normal things in life, like eating or sex,
become less rewarding than drugs.
Dual process models:
1. Reflective & controlled control. Fronto-parietal (executive control, goal-directed
behavior, inhibition, attention)
2. Automatic & impulsive motivation. Subcortical (affective learning, reward,
salience)
Substance use will start with drugs and drugs cues activate the addiction system. If you want
to overcome the use of the drugs you need to control the behavior.
When addicted, the motivation system is overactive and control lacks. Therefore, external
influences can easily trigger risk behavior.
Incentive salience theory and associative learning. neural representation become
motivational magnets and are able to grab the addict’s attention.
1. Repeated use of drugs with rewarding outcome.
2. Drug cues get pairs with this rewarding outcome.
3. Drug cues itself become salient because of physical and mental pairing with the
reward.
A person may risk all sorts of negative consequences as a function of giving in to the craving
related to the sensitized incentive value of the addictive behavior.
Approach bias: tendency to approach a drug related stimuli rather than avoid these stimuli.
How to measure? Approach-avoidance task.
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