Samenvatting Risk behavior and addiction in adolescence
Pedagogische Wetenschappen jaar 3 2024-2025
,Inhoud
Hoorcollege 1: an introduction to Risk Behaviour and the development of substance and
behavioural addictions during adolescence.................................................................................3
Gladwin...................................................................................................................................3
Aantekeningen hoorcollege.....................................................................................................4
Sussman..................................................................................................................................8
Trucco...................................................................................................................................10
Hall........................................................................................................................................13
Hoorcollege 2: the role of peers: Should peers be considered a risk or protective factor?.......15
Aantekeningen hoorcollege...................................................................................................15
Laninga..................................................................................................................................18
Hoeben..................................................................................................................................18
Hoorcollege 3: international teen trends in substance use: what’s driving them?....................18
Aantekeningen hoorcollege...................................................................................................18
Ball........................................................................................................................................20
Hoorcollege 4: The role of parents in the development of risk behaviour and addiction.........22
Aantekeningen hoorcollege...................................................................................................22
Koning et al., 2014................................................................................................................24
Koning et al., 2018................................................................................................................25
Hoorcollege 5: Prevention of risk behaviour and addiction in young people...........................26
Aantekeningen hoorcollege...................................................................................................26
Kleinjan & Engels.................................................................................................................28
Onrust....................................................................................................................................29
Hoorcollege 6: Individual vulnerability to risk behaviour and addiction.................................30
Aantekeningen hoorcollege...................................................................................................30
Castellanos-Ryan..................................................................................................................32
Peeters...................................................................................................................................33
Kreek.....................................................................................................................................34
Hoorcollege 7: Neurobiological processes and behavioural mechanisms of addiction............34
Aantekeningen hoorcollege...................................................................................................34
Volkow..................................................................................................................................37
Hoorcollege 8: The problem of addiction: Behavioural interventions and clinical treatment..39
Aantekeningen hoorcollege...................................................................................................39
Mitchie..................................................................................................................................41
Sussman................................................................................................................................43
,Hoorcollege 1: an introduction to Risk Behaviour and the
development of substance and behavioural addictions during
adolescence
Gladwin
During adolescence, children increasingly master the ability to control their behavior for the
benefit of longer-term goals. These advances in self-regulation abilities in adolescence,
however, are accompanied by pronounced changes in motivational processes. These can have
profound consequences for health in adolescence, as the imbalance between relatively strong
affective processes and still immature regulatory skills might contribute to the onset of
developmental disorders.
Risky decision making in adolescence
Adolescents are known to have a tendency to take more and greater risks than individuals in
other age groups in many life domains. The occurrence of these risk-taking behaviors follows
an inverted U-shape pattern across development, being relatively low in child hood,
increasing and peaking in adolescence and young adulthood, and declining again thereafter
(=adolescent risk taking). Heightened involvement of affective processes in risky decision
making leads to increased risk taking in adolescents (associated with impoverished use of risk
relevant information), compared to children and adults. In contrast, when risky decisions are
made involving mainly deliberative processes and no or little affect, adolescents show the
same levels of risk taking as children and adults. The presence of peers leads to increased risk
taking in adolescents (but not adults!). This socio-emotional influence of peers is not
surprising, given that much risk taking in adolescence occurs in the presence of peers + peers
become more important in their lives.
Neural developments underlying risky decision making
Two neurobiological models that characterise the adolescent brain:
1. Affective-motivational bottom-up system: subcortical brain areas, including the
dopamine-rich areas in the midbrain and their subcortical and cortical targets >
striatum and the medial prefrontal cortex (implicated in reward seeking behavior)
2. Top-down control system: prefrontal regions, such as the lateral prefrontal cortex,
posterior parietal brain regions (implicated in self-control, planning, abstract thinking,
working memory and goal-directed behavior)
The hypothesis is that these brain systems develop at a different pace during childhood and
adolescence and into young adulthood > changes in dopamine-receptor densities, changes in
white matter (increased myelinization & anatomical connectivity through white matter tracts),
changes in grey matter. The affective-motivational bottom-up system is mature around the
onset of puberty and early adolescence, while the top-down control system mature later in
development and more gradually into young adulthood > so, it’s harder for adolescents to
inhibit approach behavior in the presence of appetitive salient cues.
The above frontostriatal model of adolescent decision making thus describes a potential for
imbalance in motivational bottom-up versus controlling top-down processes.
Addiction
Two broad types of neuro-adaptations that result form repeated alcohol and drug use:
1. Neural sensitization: leads to strong impulsive reactions to classically conditioned
cues that signal alcohol or drugs. > this occurs more rapidly during adolescence. In
later phases of addiction, habitual responses become important, with automatically
, triggering approach-reactions to cues, outside voluntary control. There’s also evidence
that new initiation of drug use may be triggered by negative affect, that’s then
temporarily relieved (negative reinforcement > associated with severe drug
dependence)
2. There is evidence that heavy alcohol and drug use results in impaired control
functions, especially when heavy use takes place during adolescence > binge drinking
has strong effects on subsequent brain development involving cognitive and emotional
regulatory processes + adolescent binge-drinking and heavy use of marijuana is
associated with abnormalities, both regarding white matter structure, functional
properties (stronger cue-reactivity, impaired executive functions)
While most adolescents experiment with at least some addictive substances, only few of them
become addicted. This highlights the importance of better understanding individual
differences, especially in development, that form risk or protective factors for addiction.
Dual-process models of addiction
Risky behavior results from an inability of reflective processes to sufficiently modulate the
effects of impulsive processes, for instance by modulating the salience of information in
working memory. This imbalance is made explicit in dual-process models of addiction, which
emphasize the importance of drug-related consequences on the relationship between
impulsive and reflective processes > higher working memory capacity and interference with
control capacity weaken the impact of alcohol-related automatic processes.
Interventions
Interventions can be seen as beneficially biased learning environments, in which
reinforcement can be provided that will either increase the chance of successful controlled
processing, or reduce the need for it.
- Working memory training: it helped problem drinkers with strong positive memory
associations for alcohol, presumably because it helped them to overcome the bias to
approach alcohol, driven by these associations. A related method is the training of
self-control, which has also shown beneficial effects on smoking cessation >
generalised improvement on the brain may be due to increased frontoparietal
connectivity and changes involving the basal ganglia. This suggests that top-down
biasing aspect of working memory or executive control functions, as well as control of
access to working memory are trainable
- Cognitive bias modification: modulating biases that could underly failures of
controlled processing, including attentional biases, approach biases and evaluative
memory-biases
o Attentional bias modification
o Approach bias modification
Aantekeningen hoorcollege
How do we define Risk Behaviour?
Risk behavior: behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents > can lead to addiction
- Substance use: smoking/vaping, alcohol use, cannabis use, use of XTC
- Other risk behaviors: online gambling, gaming, social media use (behavioral addiction
> internet-related)
- Depends on:
o characteristics of the particular substance or behavior: experimenting with
smoking is a risky behavior, because you are very fast addicted to it