Summary Literature Notes Risk Behavior Addiction | UU | 2026/27

Literatuur

Addiction, adolescence, and the integration of control and motivation

adolescent risk-taking > inverted U shaped trajectory with a peak in adolescence and
young adulthood (low in childhood and adultery)).

 Inverted U-shaped developmental pattern:

 Childhood → Adolescence → Adulthood  Low → Peak → Lower

Hot vs. cold decision making

The distinction between hot and cold situations is important.

Hot situations involve:

 strong emotions;
 immediate rewards;
 social pressure;
 emotionally charged decisions

Cold situations involve:

 more deliberation;
 less emotional involvement;
 more rational consideration of information.

adolescents took more risks than children and adults particularly in hot, affective
situations, In cold situations, adolescents showed similar levels of risk-taking to other
age groups.

Adolescents may be particularly vulnerable to addiction because motivation and reward
processes develop differently from cognitive control processes.

 Bottom-up affective-motivational system
o This system develops early
o Is involved in rewards, emotions, motivation, approach behavior,
sensitivity to rewarding stimuli.
o Subcortical areas like the striatum and dopamine-related systems
 Top-down cognitive control system
o This system develops more gradually and continues developing into young
adulthood.
o Is involved inself-control, planning, working memory, response inhibition,
abstract thinking, goal-directed behavior
o Prefrontal cortex

, Creates potential imbalance during
adolescence. This imbalance is
especially problematic when
motivational processes are strongly
activated, such as in emotionally
charged situations or when peers
are present.



Addiction. There is a robust association between age of onset and risk for subsequent
alcohol and drug problems. Relationship between early substance use and later
substance-related problems. Heavy adolescent drinking is also associated with later
alcohol problems.

 Neural sensitization > Repeated drug use can make drug-related cues
increasingly powerful (Seeing alcohol → attention is automatically attracted →
desire/approach response → drinking)
o Can result in attentional bias = drug related cues automatically attract
attention
o Approach bias = person develops an automatic tendency to approach
drug-related stimuli.
 Habitual responses > Evidence that heavy alcohol and drug use results in
impaired control functions
 Negative reinforcement = Substance is then used because it reduces an
unpleasant emotional state.

The relationship between substance use and cognitive control may be bidirectional.
Longitudinal research suggests that binge drinking and impulsivity may influence each
other over time.

Dual-Process Models of Addiction = Risky or addictive behavior can occur when strong
impulsive motivational processes are not sufficiently controlled by reflective processes
(Alcohol cue → strong automatic desire → insufficient control → drinking). Working
memory and interference control can reduce the influence of automatic alcohol-related
processes. Several limitations to this model!!

Reinforcement/Reprocessing model of Reflectivity (R3 model) > The model argues that
reflective processing should not be viewed as one separate "control system." Instead,
reflective behavior emerges from interactions between: motivation; learned
associations; expected outcomes; top-down control; previous reinforcement; time
(Alcohol cue → alcohol response becomes activated. But an alternative response can
also become activated: Alcohol cue → "avoid alcohol" response → positive expected

, outcome). One of the most important additions of the R3 model is temporal dynamics. If
the person delays the response, the alternative controlled response has more time to
become activated.

Interventions. Motivational and control processes can be changed through learning and
training. Goal is to improve cognitive control or reduce problematic automatic biases.

Working memory training = aims to strengthen the ability to maintain and manipulate
information. Can improve cognitive control

transcranial Direct Current Stimulation (tDCS) = this involves low-level electrical
stimulation of the prefrontal cortex

Cognitive Bias Modification = attempts to change automatic cognitive biases associated
with addiction.

 Attentional bias modification = People with addiction can automatically pay more
attention to substance-related cues. Training can teach people to direct their
attention away from these cues.
 Approach bias = help not to approach

WMT = verbeteren van algemene cognitieve controle
CBM = veranderen van specifieke automatische biases

Conclusion

Adolescents are particularly vulnerable because:

1. motivational and reward systems develop relatively early;

2. cognitive control develops more slowly;

3. emotional situations can strongly activate motivation;

4. peers can increase reward-related motivation;

5. substance use can strengthen automatic drug-related responses;

6. heavy substance use may further impair cognitive control.

The R3 model emphasizes that learning, reinforcement, control and timing all influence
whether someone responds automatically or reflectively.

The problem is not simply that adolescents have "poor self-control." Rather, strong
motivational processes can become particularly difficult to regulate when emotions,
rewards and social influences are present, because the systems supporting cognitive
control are still developing.

Sussman A General Introduction to the Concept of Addiction and Addictive Effects

Substance addiction = repetitive intake of a drug (such as alcohol) or food)