Lectures Risk behavior and addiction in adolescence
LECTURE 1 (4,5)
Looking from different perspectives on problems, not only 1 perspective.
Four levels of influence:
Neurobiological level
Psychological (cognitive) level
(Psycho)social level parents/peers
Broader contextual level whole society as policy
Those four levels are recognized by the biopsychosocial model.
This lecture: the basic principles of neurobiology. Psychological (cognitive) and neurobiological
processes.
The subject of this course:
Risk behavior: behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents
Substance use: smoking, alcohol use, cannabis use, illicit drug use (party drugs)
Other risk behaviors: excessive gaming, social media use, gambling, excessive eating patterns
Addiction
The general process: Contact with a substance experimenting with a substance integrated use
excessive use (you really like it, you are very happy with it, you are going to use it more often, ot
only at party’s anymore) addicted use (it affects your whole life, as social life, school life)
Addictive behavior develops in a process.
When some behavior is a risk behavior depends on the sort of behavior.
When the game behavior becomes really excessive, then we call it risk behavior. If you are gaming
ally day, you do not say
But, by just trying one/two cigarettes at a party, it is really risk behavior. So, when you are only
experimenting with smoking, this already is risk behavior.
What we tend to regard as risk behavior depends on…
Scientific knowledge about the risks
Example: recent knowledge about the risks of alcohol use for the cognitive development of
adolescents
Cultural and societal norms
Example: differences in norms regarding alcohol use between Islamic and Western countries
Adolescence: about 10-24 years
Early adolescence (aged 10-13)
Physical growth, sexual maturation, psychosocial and psychosexual development, social
identity formation (= based on positive/negative responses of peers about being the same
as your peers)
Mid adolescence (aged 14-18): experimenting with (risk) behaviors, personal identity formation
(about how do I see myself, in which way am I different than others, not all about I wanna be the
same as others but being different than others)
Late adolescence (aged 19-24): practicing adult roles
Neurological development during adolescence:
1
, Strong grow in brain volume: increase in white matter (connections), decrease in grey matter
(nerve cells)
Volume grey matter differ among girls and boys. The brain (grey) development in boys goes
slower than girls (2 years). But boys do have more grey matter.
Pruning (snoeien): if you don’t use it, you lose it! So, always doing the same, is bad for the
brain, because no connections will be made. If you will never do a certain task, the
connections will fade.
Increase in white matter: communication between brain regions strongly improves ( “from many
small country roads to a few important highways”)
Long term memory increases
Capacity for abstract thinking/ metacognition increases: more critical reflections! (this is the
result of the few important highways develop)
The speed of the development of different brain regions differs
These differences may explain increase in risk behavior during adolescence!
Risky decision making in adolescence: the inverted U-shaped curve. You have more risk
behavior in adolescence in relation to childhood and adulthood (U-shape)
Development ‘Affective-Motivational System’ (= emotional brain)
- During early and mid-adolescence, the emotional brain (centered in the striatum,
Nucleys Accymbens) or the ‘reward center’ of the brain is overactive
- Adolescents experience stronger emotions than adults when they receive a reward
this process is enhanced by testosterone and …
Experimental research: response to a slot machie in different age groups (11-15, 18-24).
Outcome slot machine:
1: 3 different pictures = no reward
2:2 similar pictures = almost reward
3: 3 similar pictures = reward
Development ‘Control System’ (= rational brain)
The rational brain (centered in the prefrontal cortex) develops slowly (much slower that the
emotional brain)
The rational brain plays an important role in the development of executive functions:
Risk estimation
Monitoring long-term goals
Response inhibition: inhibition of the tendency to react to (short-term) possibilities for
reward (behavioural inhibition, self-control)
During adolescents the rations rain has large flexibility and plasticity: development is largely
affected by environmental processes.
The maturational imbalance model (Casey et al.)
Increased risk-taking during adolescence is a result of an imbalance between motivational
bottom-up vs controlling top-down.
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 mobbing from
the safety of home into the complicated world outside’.
How can we define drugs or psycho-active substances?
2
, Psychoactive substances are chemical substances that cross the blood-brain barrier and affect
the function of the central nervous system thereby altering perception, mood, or consciousness
(e.g. high/euphoria, relaxation)
Substances that induce craving after (regular) use
Substances that evoke loss of control after they have been used (regularly)
Psychoactive substances differ in:
Type and strength of the psychoactive effect
The degree to which they elicit craving and loss of control
For instance:
Nicotine: has a relative weak psychoactive effect, but a high risk of eliciting craving and loss of
control
Ecstasy or magic mushrooms: have a strong psychoactive effect, but a relative small risk of
eliciting craving and loss of control
Which psychoactive substance has the highest addiction risk (after use)?
1. Nicotine of those who smoked a cigarette only once 33 percent got addicted on nicotine
2. Heroine
3. Cocaine
4. Alcohol
5. Cannabis
6. Benzo (sleeping pills, anxiety pills)
7. Paddo
8. XTC
Types of psychoactive effects
Hallucinogens
LSD/ Magic mushrooms
Cannabis Ecstasy
Downers (depressants) Uppers
Heroin/GHB Cocaine/ amphetamine/ speed
Alcohol Nicotine
2017: data from HBSC
Alcohol use:
Alcohol use did not change since 2013;
About 40% of the 15y old’s and 50% of the 16y old’s has been drinking last month;
About 70% of these drinkers is drinking 5 or more glasses during an occasion (binge drinking)l
If they are drinking, they are drinking a lot.
Smoking:
Smoking decreased since 2013;
In 2017, 8% of the 15/16 years old’s has been smoking last month
Excessive use of alcohol/cannabis (binge drinking) is higher in the Netherlands than in other
countries.
How can we define addiction?
3
LECTURE 1 (4,5)
Looking from different perspectives on problems, not only 1 perspective.
Four levels of influence:
Neurobiological level
Psychological (cognitive) level
(Psycho)social level parents/peers
Broader contextual level whole society as policy
Those four levels are recognized by the biopsychosocial model.
This lecture: the basic principles of neurobiology. Psychological (cognitive) and neurobiological
processes.
The subject of this course:
Risk behavior: behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development of adolescents
Substance use: smoking, alcohol use, cannabis use, illicit drug use (party drugs)
Other risk behaviors: excessive gaming, social media use, gambling, excessive eating patterns
Addiction
The general process: Contact with a substance experimenting with a substance integrated use
excessive use (you really like it, you are very happy with it, you are going to use it more often, ot
only at party’s anymore) addicted use (it affects your whole life, as social life, school life)
Addictive behavior develops in a process.
When some behavior is a risk behavior depends on the sort of behavior.
When the game behavior becomes really excessive, then we call it risk behavior. If you are gaming
ally day, you do not say
But, by just trying one/two cigarettes at a party, it is really risk behavior. So, when you are only
experimenting with smoking, this already is risk behavior.
What we tend to regard as risk behavior depends on…
Scientific knowledge about the risks
Example: recent knowledge about the risks of alcohol use for the cognitive development of
adolescents
Cultural and societal norms
Example: differences in norms regarding alcohol use between Islamic and Western countries
Adolescence: about 10-24 years
Early adolescence (aged 10-13)
Physical growth, sexual maturation, psychosocial and psychosexual development, social
identity formation (= based on positive/negative responses of peers about being the same
as your peers)
Mid adolescence (aged 14-18): experimenting with (risk) behaviors, personal identity formation
(about how do I see myself, in which way am I different than others, not all about I wanna be the
same as others but being different than others)
Late adolescence (aged 19-24): practicing adult roles
Neurological development during adolescence:
1
, Strong grow in brain volume: increase in white matter (connections), decrease in grey matter
(nerve cells)
Volume grey matter differ among girls and boys. The brain (grey) development in boys goes
slower than girls (2 years). But boys do have more grey matter.
Pruning (snoeien): if you don’t use it, you lose it! So, always doing the same, is bad for the
brain, because no connections will be made. If you will never do a certain task, the
connections will fade.
Increase in white matter: communication between brain regions strongly improves ( “from many
small country roads to a few important highways”)
Long term memory increases
Capacity for abstract thinking/ metacognition increases: more critical reflections! (this is the
result of the few important highways develop)
The speed of the development of different brain regions differs
These differences may explain increase in risk behavior during adolescence!
Risky decision making in adolescence: the inverted U-shaped curve. You have more risk
behavior in adolescence in relation to childhood and adulthood (U-shape)
Development ‘Affective-Motivational System’ (= emotional brain)
- During early and mid-adolescence, the emotional brain (centered in the striatum,
Nucleys Accymbens) or the ‘reward center’ of the brain is overactive
- Adolescents experience stronger emotions than adults when they receive a reward
this process is enhanced by testosterone and …
Experimental research: response to a slot machie in different age groups (11-15, 18-24).
Outcome slot machine:
1: 3 different pictures = no reward
2:2 similar pictures = almost reward
3: 3 similar pictures = reward
Development ‘Control System’ (= rational brain)
The rational brain (centered in the prefrontal cortex) develops slowly (much slower that the
emotional brain)
The rational brain plays an important role in the development of executive functions:
Risk estimation
Monitoring long-term goals
Response inhibition: inhibition of the tendency to react to (short-term) possibilities for
reward (behavioural inhibition, self-control)
During adolescents the rations rain has large flexibility and plasticity: development is largely
affected by environmental processes.
The maturational imbalance model (Casey et al.)
Increased risk-taking during adolescence is a result of an imbalance between motivational
bottom-up vs controlling top-down.
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 mobbing from
the safety of home into the complicated world outside’.
How can we define drugs or psycho-active substances?
2
, Psychoactive substances are chemical substances that cross the blood-brain barrier and affect
the function of the central nervous system thereby altering perception, mood, or consciousness
(e.g. high/euphoria, relaxation)
Substances that induce craving after (regular) use
Substances that evoke loss of control after they have been used (regularly)
Psychoactive substances differ in:
Type and strength of the psychoactive effect
The degree to which they elicit craving and loss of control
For instance:
Nicotine: has a relative weak psychoactive effect, but a high risk of eliciting craving and loss of
control
Ecstasy or magic mushrooms: have a strong psychoactive effect, but a relative small risk of
eliciting craving and loss of control
Which psychoactive substance has the highest addiction risk (after use)?
1. Nicotine of those who smoked a cigarette only once 33 percent got addicted on nicotine
2. Heroine
3. Cocaine
4. Alcohol
5. Cannabis
6. Benzo (sleeping pills, anxiety pills)
7. Paddo
8. XTC
Types of psychoactive effects
Hallucinogens
LSD/ Magic mushrooms
Cannabis Ecstasy
Downers (depressants) Uppers
Heroin/GHB Cocaine/ amphetamine/ speed
Alcohol Nicotine
2017: data from HBSC
Alcohol use:
Alcohol use did not change since 2013;
About 40% of the 15y old’s and 50% of the 16y old’s has been drinking last month;
About 70% of these drinkers is drinking 5 or more glasses during an occasion (binge drinking)l
If they are drinking, they are drinking a lot.
Smoking:
Smoking decreased since 2013;
In 2017, 8% of the 15/16 years old’s has been smoking last month
Excessive use of alcohol/cannabis (binge drinking) is higher in the Netherlands than in other
countries.
How can we define addiction?
3
