Risk Behaviour and Addiction in Adolescence - Samenvatting ALLE literatuur + hoorcolleges

introduction
- Risk behaviour = risk to a healthy physical, cognitive, psychosocial
development of adolescents  can lead to addiction
 Types: substance use, online gambling, gaming, social media use
 Depends on
1) Characteristics of the particular substance/behavior (smoking is
risky cause you get addicted fast)
2) cultural/societal norms
3) scientific knowledge: adolescent brain is not completely
developed, so drinking alcohol negatively affects it (knowledge
has influence)
- Developmental process of addiction: first contact with a substance 
experimenting  integrated use (regular/daily smoker/drinker) 
excessive use  addicted use
 Positive reinforcement occurs when the rate of a behavior increases
because a desirable experience (e.g., euphoria, relaxation) is
resulting from the behavior.
 Negative reinforcement occurs when the rate of a behavior
increases because an aversive experience is prevented from
happening (e.g., withdrawal symptoms), or negative feeling is taken
away
- Developments during adolescence
1. Early adolescence (10-14): physical growth, sexual maturation,
psychosocial development, social identity formation (young people
looking at their place/status in peer groups)  After this phase boys
and girls are at the same point in their development
2. Mid adolescence (15 – 17): experimenting with (risk) behaviours,
personal identity formation
3. Late adolescence (18 – 24): practicing adult roles first jobs, serious
romantic relationships, first house etc.
- Neurological development:
1. Strong growth in brain volume: increase in white matter (connections),
but decrease in grey matter (nerve cells)  more rapidly in girls,
compared to boys
 Pruning: if you don’t use it, you lose it
2. High plasticity and flexibility of the brain: become very skilled in the
skills you use most  not using = losing
3. Increase in white matter: communication between brain regions
strongly improves
 Long term memory increases
 Capacity for abstract (critical) thinking and metacognition
increases  responsible for the conflict between parents &
children (getting more critical of the behaviors of parents)
- Peak risk behavior in adolescence:
 Due to the fact that two brain areas develop in different times 
emotional brain (affective-motivational system) develops fast, while
rational brain (control system) develops much slower  =
frontostriatal model of adolescent decision making

, o Affective-motivational system: overactive during early and
midadolescence, experience stronger positive emotions than
adults when they receive or anticipate a reward  bottom-up
o Control system: develops slowly, until about 25 years. Plays
an important role in the development of executive functions
 top-down
 Risk estimation
 Monitoring long-term goals (not skipping college
because of nice weather, but coming so you can get
your degree
 Inhibit the tendency to respond to (short-term)
possibilities for reward (impulse control, behavioral
inhibition, self control)
 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)
o Horse and rider metaphor: horse wants to run and be free,
rider wants the horse to be controlled (balancing)
 horse > motivational system: bottom-up processes,
behavioral activation
 rider > control system: top-down processes,
behavioural inhibition
- Addiction definition
1. Intensional: uses causal or process models to describe addiction,
offering strong explanatory insights into how addiction develops





2. extensional: classification of characteristics of an addiction

, 




 Dsm-5: clustering in 4 dimensions  loss of control, social and
other impairments, continuation of use despite knowledge of risk,
pharmalogica effects (withdrawal & tolerance)
- Criteria for diagnosis of addiction  mild (2 criteria), moderate (4 criteria)
and severe (6 or more criteria)
 Failure to fulfill major role obligations at work, school, home
 Frequent use of substances in situations in which it is physically
hazardous
 Continued use despite persistent / recurrent social or interpersonal
problems
 Tolerance
 Withdrawal symptoms or substance use to avoid withdrawal
symptoms
 Use of a substance in larger amounts or over a longer period than
intended
 Persistent desire or unsuccessful efforts to cut down or control
substance use
 Large amount of time spent in obtaining, using or recovering from
the substance
 Reduction of social, occupational or recreational activities due to of
substance use
 Use of substances despite persistent / recurrent physical or
psychological consequences
 Craving for the substance
- Stages of addiction;
1. Initial social use > alcohol is socially accepted & expected
2. Escalation of substance use > building up the frequency and quantity of
drinking for instance
3. Withdrawal > psychical symptoms, negative emotional state > full-
blown addiction
4. Recurrent relapses > some people have a relapse one time, others have
it their whole life
5. Loss of control
- Behavioural addictions: repeated behaviour leading to significant harm or
distress of a functionally impairing nature, which is not reduced by the
person and persists over a significant period of time”
- dsm 5 classifications:
1. Gambling Disorder  official disorder
2. Internet Gaming Disorder  condition warranting more clinical research
before considering it as a formal disorder
- Social media and gaming lead to significant harm/distress of a functionally
impairing nature, which is not reduced by the person