Risk behavior and addiction in adolescence – Hoorcolleges
Hoorcollege 1 (6 september)
- The following questions will be addressed during lecture 1:
o Lecture 1A: Introduction risk behavior and addiction in adolescence:
▪ 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?
o Lecture 1B: Implicit processes in substance use and addiction:
▪ 1) How do motivation, control and their interaction contribute to substance use and
addiction?
▪ 2) Why are adolescents at increased risk for escalation of substance use?
▪ 3) What is the role of cognitive biases/implicit processes in substance use and
addiction?
▪ 4) How to measure cognitive biases/implicit processes?
▪ 5) What are potential interventions for substance use and addiction targeting
motivation and control processes?
Hoorcollege 1A: Introduction Risk Behavior and Addiction in Adolescence
- Content:
o 1) How do we define Risk Behavior?
o 2) Which (neurological) developments take place during adolescence?
o 3) Why is there a peak in risk behaviors during adolescence?
o 4) What are psycho-active substances (drugs)?
o 5) How do we define Addiction?
o 6) Two learning principles
- 1) How do we define Risk Behavior?
o 1A) Risk behavior = Behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents. → Examples of risk behavior:
▪ 1A1) Substance use = E.g. smoking, alcohol use, cannabis use, use of XTC and other
party drugs).
▪ 1A2) Other risk behaviors = E.g. gambling, gaming, social media use.
o 1B) ‘The general developmental proces’:
Contact with a substance
Experimenting with a substance
Integrated use
Excessive use
Addicted use
o 1C) What we tend to regard as ‘risk behaviour’ depends on:
▪ 1C1) Characteristics of the particular substance or behavior → For instance: Smoking
versus gaming.
▪ 1C2) Cultural and societal norms → For example: Alcohol use in western versus
Islamic cultures.
▪ 1C3) Scientific knowledge → For example: Knowledge on the risks of alcohol use for
the cognitive development of adolescents.
o 1D) The article “Developmental Risks for Substance Use in Adolescence: Age at Risk Factor”
talks about predictors of substance use.
o 1E) According to the COM-B model (Michie et al., 2011), there are 3 factors predictors of risk
behavior:
,- 2) Which (neurological) developments take place during adolescence?
o 2A) Defininig adolescence (+/- 10 – 24 years) → 3 phases:
▪ 2A1) Early adolescence (aged 10 – 13 → In this phase, there is physical growth,
sexual maturation, psychosocial development, social identity formation.
▪ 2A2) Mid adolescence (aged 14 – 18) → In this phase adolescence experiment with
(risk) behaviours and there is personal identity formation.
▪ 2A3) Late adolescence (aged 19 – 24) → In this phase adolescence practice adult
roles.
o 2B) Neurological development during adolescence → 3 developments:
▪ 2B1) Strong grow in brain volume → This means: Increase in white matter
(connections), decrease in grey matter (nerve cells):
→ Loss of gray matter among girls and boys by age:
, ▪ 2B2) Increase in white matter → This means: Communication between brain regions
strongly improves. → This means:
• 1) Long term memory increases
• 2) Capacity for abstract thinking/metacognition increases
▪ 2B3) High plasticity of the brain.
- 3) Why is there a peak in risk behaviors during adolescence?
o 3A) Risk behavior in adolescence follows an inverted U-shaped curve:
→ Why is there a peak in risk behaviors during adolescence? → Reason = The speed of the
development of two different brain regions (emotional brain & rational brain) differs:
▪ 3A1) The affective-motivational system (emotional brain) develops fast.
→ The affecttive-motivational system (‘reward center’) is overactive in early and mid
adolescence. → This means: Adolescents experience stronger positive emotions than
adults when they receive or anticipate a reward. → This process is enhanced by
testosterone.
▪ 3A2) The control system (rational brain) develops slowly.
→ The control system (rational brain) develop slowly (until about 25 years). The
rational brain plays an important role in the development of executive function. →
For example:
• 1) Risk estimation
• 2) Monitoring long-term goals
• 3) Inhibit the tendency to respond to (short-term) possibilities for reward
(impulse control, behavioral inhibition, self control)
o 3B) ‘The Maturational Imbalance Model’ (Casey et al., 2011) discusses the differences
between the two different brain regions → Increased risk-taking during adolescence is a result
of an imbalance between motivational bottom-up versus controlling top-down processes (high
reward sensitivity versus immature impulse control):
, - 4) What are psycho-active substances (drugs)?
o 4A) Psychoactive substances = Chemical substances that cross the blood-brain barrier and
affect the function of the central nervous system thereby altering perception, mood, or
consciousness. → For example: High/euphoria, relaxation.
→ Other characteristics of psychoactive substances:
▪ 4A1) They often induce craving after (regular) use.
▪ 4A2) They often evoke loss of control after they have been used (regularly).
o 4B) Psychoactive substances differ in:
▪ 4B1) Type and strength of the psychoactive effect.
▪ 4B2) The degree to which they elicit craving and loss of control.
o 4C) Types of drugs (based on their psychoactive effects):
→ So, there are 3 types of effects:
• 4C1) Hallucinogens
• 4C2) Downers
• 4C3) Uppers
- 5) How do we define Addiction? → Sussman (2017) differentiates between intensional and extensional
definitions of addiction:
o 5A) Intensional definitions of addiction = These definitions aim to describe a causal addiction
process (see Sussman, table 1.2).
o 5B) Extensional definitions of addiction = These definitions give a classification of
characteristics of an addiction (e.g. DSM-5). → According to DSM-5 someone has a substance
use disorder when: Recurrent use over the last 12 months and meeting at least two or more of
the following criteria:
Hoorcollege 1 (6 september)
- The following questions will be addressed during lecture 1:
o Lecture 1A: Introduction risk behavior and addiction in adolescence:
▪ 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?
o Lecture 1B: Implicit processes in substance use and addiction:
▪ 1) How do motivation, control and their interaction contribute to substance use and
addiction?
▪ 2) Why are adolescents at increased risk for escalation of substance use?
▪ 3) What is the role of cognitive biases/implicit processes in substance use and
addiction?
▪ 4) How to measure cognitive biases/implicit processes?
▪ 5) What are potential interventions for substance use and addiction targeting
motivation and control processes?
Hoorcollege 1A: Introduction Risk Behavior and Addiction in Adolescence
- Content:
o 1) How do we define Risk Behavior?
o 2) Which (neurological) developments take place during adolescence?
o 3) Why is there a peak in risk behaviors during adolescence?
o 4) What are psycho-active substances (drugs)?
o 5) How do we define Addiction?
o 6) Two learning principles
- 1) How do we define Risk Behavior?
o 1A) Risk behavior = Behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents. → Examples of risk behavior:
▪ 1A1) Substance use = E.g. smoking, alcohol use, cannabis use, use of XTC and other
party drugs).
▪ 1A2) Other risk behaviors = E.g. gambling, gaming, social media use.
o 1B) ‘The general developmental proces’:
Contact with a substance
Experimenting with a substance
Integrated use
Excessive use
Addicted use
o 1C) What we tend to regard as ‘risk behaviour’ depends on:
▪ 1C1) Characteristics of the particular substance or behavior → For instance: Smoking
versus gaming.
▪ 1C2) Cultural and societal norms → For example: Alcohol use in western versus
Islamic cultures.
▪ 1C3) Scientific knowledge → For example: Knowledge on the risks of alcohol use for
the cognitive development of adolescents.
o 1D) The article “Developmental Risks for Substance Use in Adolescence: Age at Risk Factor”
talks about predictors of substance use.
o 1E) According to the COM-B model (Michie et al., 2011), there are 3 factors predictors of risk
behavior:
,- 2) Which (neurological) developments take place during adolescence?
o 2A) Defininig adolescence (+/- 10 – 24 years) → 3 phases:
▪ 2A1) Early adolescence (aged 10 – 13 → In this phase, there is physical growth,
sexual maturation, psychosocial development, social identity formation.
▪ 2A2) Mid adolescence (aged 14 – 18) → In this phase adolescence experiment with
(risk) behaviours and there is personal identity formation.
▪ 2A3) Late adolescence (aged 19 – 24) → In this phase adolescence practice adult
roles.
o 2B) Neurological development during adolescence → 3 developments:
▪ 2B1) Strong grow in brain volume → This means: Increase in white matter
(connections), decrease in grey matter (nerve cells):
→ Loss of gray matter among girls and boys by age:
, ▪ 2B2) Increase in white matter → This means: Communication between brain regions
strongly improves. → This means:
• 1) Long term memory increases
• 2) Capacity for abstract thinking/metacognition increases
▪ 2B3) High plasticity of the brain.
- 3) Why is there a peak in risk behaviors during adolescence?
o 3A) Risk behavior in adolescence follows an inverted U-shaped curve:
→ Why is there a peak in risk behaviors during adolescence? → Reason = The speed of the
development of two different brain regions (emotional brain & rational brain) differs:
▪ 3A1) The affective-motivational system (emotional brain) develops fast.
→ The affecttive-motivational system (‘reward center’) is overactive in early and mid
adolescence. → This means: Adolescents experience stronger positive emotions than
adults when they receive or anticipate a reward. → This process is enhanced by
testosterone.
▪ 3A2) The control system (rational brain) develops slowly.
→ The control system (rational brain) develop slowly (until about 25 years). The
rational brain plays an important role in the development of executive function. →
For example:
• 1) Risk estimation
• 2) Monitoring long-term goals
• 3) Inhibit the tendency to respond to (short-term) possibilities for reward
(impulse control, behavioral inhibition, self control)
o 3B) ‘The Maturational Imbalance Model’ (Casey et al., 2011) discusses the differences
between the two different brain regions → Increased risk-taking during adolescence is a result
of an imbalance between motivational bottom-up versus controlling top-down processes (high
reward sensitivity versus immature impulse control):
, - 4) What are psycho-active substances (drugs)?
o 4A) Psychoactive substances = Chemical substances that cross the blood-brain barrier and
affect the function of the central nervous system thereby altering perception, mood, or
consciousness. → For example: High/euphoria, relaxation.
→ Other characteristics of psychoactive substances:
▪ 4A1) They often induce craving after (regular) use.
▪ 4A2) They often evoke loss of control after they have been used (regularly).
o 4B) Psychoactive substances differ in:
▪ 4B1) Type and strength of the psychoactive effect.
▪ 4B2) The degree to which they elicit craving and loss of control.
o 4C) Types of drugs (based on their psychoactive effects):
→ So, there are 3 types of effects:
• 4C1) Hallucinogens
• 4C2) Downers
• 4C3) Uppers
- 5) How do we define Addiction? → Sussman (2017) differentiates between intensional and extensional
definitions of addiction:
o 5A) Intensional definitions of addiction = These definitions aim to describe a causal addiction
process (see Sussman, table 1.2).
o 5B) Extensional definitions of addiction = These definitions give a classification of
characteristics of an addiction (e.g. DSM-5). → According to DSM-5 someone has a substance
use disorder when: Recurrent use over the last 12 months and meeting at least two or more of
the following criteria:
