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RBAA summary & clips: Risk Behavior and Addiction in Adolescence

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Summary of Risk Behavior and Addiction in Adolescence () at Universiteit Utrecht, covering the foundational theories and models for understanding adolescent risk behaviors. Topics include the behavior change wheel, interdisciplinary theoretical frameworks across biological, psychological, and social levels, neurological development in adolescence, and the distinction between motivational, capability, and opportunity factors in behavior change. These notes are essential for grasping the core concepts and diagnostic tools used throughout the course, making them invaluable for exam preparation and understanding how to apply explanatory models to real-world risk behaviors. This summary is absolutely enough to pass the exam!

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RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
WEEK 1
CLIPS
Interdisciplinary social science of theoretical models from different disciplines
with 4 levels of influence:
1) (neuro)biological level
2) Psychological level
3) Social level
4) Broader level

Explanatory model = a visual representation that explains and organizes
knowledge and helps you explain how certain behavior can be. Steps:
1) Literature about the behavior
2) Find risk factors
3) Visualize in a model (direct of indirect effect on the behavior)
4) Expand model
3 kinds of factors:
- Proximal factors = person factors, close to the outcome (direct effect)
- Distal factors = close contact factor (friends, family)
- Ultimate factors =distant contractual factor

HC1: INTRODUCTION BEHAVIOR AND ADDICTION IN ADOLESCENCE
Risk behavior = behaviors that pose a risk to healthy physical, cognitive,
psychological development of adolescents.
- Substance use = smoking, vaping, alcohol use, cannabis use, use of XTC
and other party/designer drugs
- Other risk behaviors: gambling (gokken), gaming, social media use

General process of addiction:
experimenting
contact with integrated excessive use
with addicted use
substance
substance use (daily) (much)


What we tend to regard as risk behavior depends on:
- Characteristics of the substance/behavior (smoking VS gaming)
- Cultural/societal norms (western VS Islamic)
- Advances in scientific knowledge (ex: brain development)

Predictors of risk behavior:

,The behavior change wheel:
- Capability, opportunity and motivation:
factors that explain risk/addictive
behavior
- Red circle: behavioral interventions that
prevent or change risk/addictive
behavior
- Grey circle: policy measures that
precent risk/addictive behavior

Adolescence (10-24 years):
- Early adolescence (10-14) = physical
growth, sexual maturation (relations),
psychosocial development, social
identity formation (what you want others to see), parents less important,
peers more important
- Mid adolescence (15-17) = experimenting with (risk) behaviors
(substance use), personal identity formation (what do you want to see)
- Late adolescence (18-27) = practicing adult roles

Neurological development in adolescence:
1) Strong grow in brain volume
o Decrease in grey matter = nerve cells who process information:
thinking, memory, emotions, movement, because of pruning (=
removing the weaker/unused connections)
o Increase in white matter = connections, communication between
brain regions
2) High plasticity and flexibility of the brain: train brain regions to strengthen
connections
3) Increase in white matter
o Long term memory increases
o Capacity for abstract (critical) thinking and metacognition increases

Peak in risk behavior during adolescence (u-shape) because of the neurological
development during adolescence:
- The affective-motivational system (emotional brain) develops fast
Interaction
- The control system (rational brain) develops slowly

Affective-motivational system = bottom-up process, behavior activation
(BAS), reward center is overactive during early and mid adolescence, adolescents
experience stronger positive emotions when they receive or anticipate a reward
(process is enhanced by testosterone). The VTA produces dopamine and sends
it to the nucleus accumbens, thereby creating feelings of reward.
 Brain parts: nucleus accumbens, amygdala, VTA, hippocampus

Control system = top-down process, behavioral inhibition (BIS), develops slowly
until 25 years and plays an important role in the development of executive
functions:
- Risk estimation
- Monitoring long-term goals
- Inhibition of the tendency to respond to (short-term) possibilities for reward
(impulse control, behavioral inhibition, self control)
 Brain parts: prefrontal cortex

, Maturation imbalance model = increased risk-taking during adolescence is a
result of an imbalance between reward sensitivity (the affective-motivational
system) and impulse control (control system).
Psychoactive substances = chemical substances that cross the blood-brain
barrier and affect the function of the central nervous system thereby changing
mood, perceptions, or consciousness (high/euphoria, relaxation). Often induce
craving and evoke loss of control after they have been used. Psychoactive
substances differ in the strength of psychoactive effect and degree of craving and
loss of control.

Addiction risk after use:
1) Nicotine
2) Heroine
3) Cocaine
4) Alcohol
5) Cannabis
6) Benzo
7) Paddo
8) XTC (MDMA)

Definition of addiction:
- Intentional = aim to describe a causal addiction process
- Extensional = a classification of characteristics of an addiction

4 categories of substance use disorder (SUD) from the DSM-5:
Recurrent use over the last 12 months AND meeting at least two or more criteria
(2-3 mild, 4-5 moderate, 6< severe SUD)
- Loss of control
- Social and other impairments
- Continuation despite knowledge of risky use
- Pharmacological effects (tolerance and withdrawal)

2 learning principles underlying the development of addiction:
1) Positive reinforcement = rate of a behavior increases because a
desirable experience (euphoria or relaxation) is resulting from the behavior
2) Negative reinforcement = rate of a behavior increases because an
aversive experience is prevented rom happening (withdrawal symptoms or
a negative feeling)

Neurobiology of withdrawal symptoms:
reward
dopamine relwase brain
drug use in the nucleus adaptation =
accumbens (NA) sensitivity of the
reward system is
decreasing
This decrease in the sensitivity of the brain reward system results from:
- Reduction in the number of dopamine receptors
- The existing dopamine receptors become less sensitive to dopamine
Resulting in:
1) Tolerance = needing a higher dose of the drug to have the same effect
2) Withdrawal symptoms during abstinence

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