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Risk Behavior and Addiction in Adolescence: Comprehensive lecture notes (with figures + tables)

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Comprehensive lecture notes of the Risk Behavior and Addiction in Adolescence course. Useful tables and figures have been added!

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Hoorcolleges Risk Behavior and addiction in adolescence
HC1a: Risk Behavior in Relationship to Adolescent Development

Risky decision making in adolescence:

- Figure: Adolescence is often marked by risky behavior. There is a peak in risk
taking in adolescence.




Adolescence:
 Early adolescence (10-13) = Physical growth, sexual maturation, psychosocial and
psychosexual development, social identity formation. Peers are becoming important,
and they are interested in the social position in a group. The need for social
acceptance is more important.
 Mid adolescence (14-18) = Experimenting with (risk) behaviors, personal identity
formation. Focus shifts more to personal identity, the need for social approval is now
getting more balanced to the need to be yourself.
 Late adolescence (19-24) = Practicing adult roles. More responsibilities.
Neurological development during adolescence:
1. Strong grow in brain volume: increase in white matter (connections), decrease in
grey matter (nerve cells).
- Figure: Volume gray matter among girls and boys by age.
- Pruning = If you don’t use it, you lose it. That is the case with gray matter. This
is necessary to make the brain more efficient. It is important to use some brain
areas, whereas they will lose them.

, -
2. Increase in white matter: communication between brain regions strongly improves.
The brain works efficient.
- Long term memory increases.
- Capacity for abstract thinking/metacognition increases. Adolescents become
more critical.  more conflict during parents and adolescents.
3. High plasticity: Positive and negative experiences have a strong effect on
adolescences, more than children or adults.
- Example: Social isolation give a strong boost to certain parts of the brain, but
leaves other parts behind.
4. The speed of the development of different brain regions differs:
- The affective-motivational system (emotional brain) develops much faster than
the control system (rational brain). These differences in the speed may explain
the peaking risk behavior.
 Development affective-motivational system (emotional brain):
o During early and mid-adolescence, the affective-motivational
system in the brain (reward center) of the brain is overactive. And
less active in late adolescence. That is
o Adolescents experience stronger emotions than adults when they
receive or anticipate a reward. This process is enhanced by
testosterone, so more influence with boys.
 Development control system (rational brain):
o Rational brain (centered in the prefrontal cortex) develops slowly
and much slower than the emotional brain.
o The rational brain plays an important role in the development of
executive functions as:
1. Risk estimation. For example to estimate the risk of drinking
alcohol and then driving.
2. Monitoring long-term goals.
3. Response inhibition: inhibition of the tendency to react to
(short-term) possibilities for reward (behavioral inhibition, self-
control).

,Why do adolescence show more risk behavior than children or adults?
 The Maturational Imbalance Model = Increased risk-taking during adolescence is a
result of an imbalance between (emotional brain) motivational bottom-up versus
(rational brain) controlling top-down processes (heightened reward sensitivity versus
immature impulse control).




 Alternative theory (Dobbs): the adaptive adolescence view = The teen is not only
‘work in progress’, but can be looked upon as ‘an exquisitely sensitive, highly
adaptable creature wired almost perfectly for the job of moving from the safety of
home intro the complicated outside world.’ It is the result of evolutionary principles
and adaptation.

, HC1b: Introduction Risk Behavior and Addiction

History and today:
 History: Addiction is a very old phenomenon. Documents showing that substance use
addiction was already experienced by our oldest ancestors. They were chewing
certain plants to experience their psychoactive effects.
 Today: Although the substances vary, substance abuse and addictions remains to be
a trending topic.
- Example: ‘Zeker 64 dwarslaesies door lachgas’, ‘zorgen om ketamine: vijf keer
meer meldingen bij ehbo na drugsgebruik’ etc.
Definitions:
 Risk behavior = Behaviors that pose a risk to a healthy physical, cognitive,
psychosocial development of adolescents. This can be substance use or other risk
behaviors which can result in addiction.
 When is substance use risk behavior? The context is important:
- Characteristics of the particular substance or behavior: for instance, smoking or
gaming.
- Cultural and societal norms: alcohol use in western versus in Islamic cultures.
- Scientific knowledge: knowledge on the risks of alcohol use for the cognitive
development of adolescents. Even small amounts of alcohol is now ‘risky’ for
teenagers, it changed over the years because of new scientific knowledge.
 Drugs/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. Other characteristics of psychoactive
substances are craving after regular use and people often evoke loss of control after
they have been used regularly.
- Psychoactive substances differs in:
1. Type and strength
2. Degree to which they elicit craving and loss of control
 Addiction = Sussman (2017) differentiates between intensional and extensional
definitions of addiction:
- Intentional = These definitions aim to describe a causal addiction process. The
processes that underly the development of an addiction.
- Extensional = A classification of characteristics of an addiction in the DSM-5.
There is a difference between light, moderate and severe substance use
disorder. Criteria:

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