Risk behavior and addiction in
adolescence
HC1 - Introduction 1
HC2 - Individual vulnerability 4
HC3 - Peer influence 6
HC4 - The role of parents in the prevention 8
HC5 - International teen trends in substance use 10
HC6 - Substance use prevention 12
HC7 - Neurobiological processes and behavioral mechanisms 15
HC8 - Treatment and comorbidity 18
Overview: Theories, models and hypotheses 21
,HC1 - Introduction
Risk behavior is behavior that poses a risk to a healthy physical, cognitive, psychosocial
development of adolescents.
● Substance use like smoking, alcohol use, cannabis use, the use of party drugs etc.
● Other risk behaviors like gambling, gaming, social media use etc.
- Smoking is immediately a risk behavior when using for the first time. Things like gaming
and social media use are not, only when it’s becoming excessive.
Contact with a substance → experimenting with a substance → integrated use → excessive
use → addicted use
What we tend to regard as a risk behavior depends on three things:
● Characteristics of the particular substance or behavior
● Cultural and societal norms
● Scientific knowledge (about risks etc)
Three categories of adolescence:
● Early adolescence (aged 10-13): physical growth,
sexual maturation, psychosocial development and
social identity formation.
○ Social identity formation is about awareness
about how people perceive.
● Mid adolescence (aged 14-18): experimenting with
(risk) behaviors and personal identity formation.
○ Personal identity formation is about how
someone perceives themselves (being unique).
● Late adolescence (aged 19-24): practicing adult roles.
Neurological development during adolescence:
● Strong grow in brain volume: increase in white matter
(connections) and decrease in gray matter (nerve cells).
○ Boys have more gray matter than girls.
○ In early adolescence there is a lot of pruning: if you don’t use it, you lose it.
● The brain has a high plasticity during adolescence. You can easily develop and lose
skills during this time.
● Increase in white matter: communication between brain regions strongly improves.
○ Long term memory increases.
○ Capacity for abstract thinking/metacognition increases.
■ Adolescents are becoming more critical → more conflicts.
Risk behavior in adolescence follows an inverted U-shaped curve in statistics. There is often
a peek during adolescence, which decreases again in adulthood.
The speed of development of two different brain regions differs:
● The affective-motivational system (emotional brain) develops fast
● The control system (rational brain) develops slowly (until about 25 years).
- The affective-motivational system (‘reward center’) is overactive in early and mid
adolescence.
1
, ● Adolescents experience stronger positive
emotions than adults when they receive a reward.
● This process is enhanced by testosterone, which is
probably why boys are more often involved in risk
behavior than girls.
- The rational brain plays an important role in the development of
executive functions:
● Risk estimation
● Monitoring long-term goals
● Inhibit the tendency to respond to (short-term) possibilities for
reward (impulse control, behavioral inhibition, self control)
In short: Increased risk-taking during adolescence is a result of
an imbalance between reward sensitivity (the affective
motivational system) and impulse control (control system).
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).
- Other characteristics of psychoactive substances:
● They often induce craving after (regular) use.
● They often evoke loss of control after they have been used (regularly).
These types of drugs differ in the type of strength of the psychoactive effect and the degree
to which they elicit craving and loss of control.
Differentiates between intensional and extensional definitions
of addiction:
● Intensional: these definitions aim to describe a causal
addiction process (see Sussman (2017)).
● Extensional: a classification of characteristics
of an addiction (e.g. DSM-5).
○ Four categories for the classification of
substance use disorder:
■ Loss of control
■ Social land other impairments
■ Continuation despite knowledge of risky use
■ Pharmacological effects (tolerance and withdrawal)
Two learning principles underlying the development of addiction:
1. Positive reinforcement occurs when the rate of a behavior increases because a
desirable experience (e.g., euphoria, relaxation) is resulting from that behavior.
2. Negative reinforcement occurs when the rate of a behavior increases because an
aversive experience is prevented from happening (e.g., prevention of withdrawal
symptoms).
When you use a drug, dopamine releases in the nucleus accumbens (NA), which is a reward.
● At the same time, brain adaptation happens due to the shock. This results in a
decrease in the sensitivity of the reward system.
2
adolescence
HC1 - Introduction 1
HC2 - Individual vulnerability 4
HC3 - Peer influence 6
HC4 - The role of parents in the prevention 8
HC5 - International teen trends in substance use 10
HC6 - Substance use prevention 12
HC7 - Neurobiological processes and behavioral mechanisms 15
HC8 - Treatment and comorbidity 18
Overview: Theories, models and hypotheses 21
,HC1 - Introduction
Risk behavior is behavior that poses a risk to a healthy physical, cognitive, psychosocial
development of adolescents.
● Substance use like smoking, alcohol use, cannabis use, the use of party drugs etc.
● Other risk behaviors like gambling, gaming, social media use etc.
- Smoking is immediately a risk behavior when using for the first time. Things like gaming
and social media use are not, only when it’s becoming excessive.
Contact with a substance → experimenting with a substance → integrated use → excessive
use → addicted use
What we tend to regard as a risk behavior depends on three things:
● Characteristics of the particular substance or behavior
● Cultural and societal norms
● Scientific knowledge (about risks etc)
Three categories of adolescence:
● Early adolescence (aged 10-13): physical growth,
sexual maturation, psychosocial development and
social identity formation.
○ Social identity formation is about awareness
about how people perceive.
● Mid adolescence (aged 14-18): experimenting with
(risk) behaviors and personal identity formation.
○ Personal identity formation is about how
someone perceives themselves (being unique).
● Late adolescence (aged 19-24): practicing adult roles.
Neurological development during adolescence:
● Strong grow in brain volume: increase in white matter
(connections) and decrease in gray matter (nerve cells).
○ Boys have more gray matter than girls.
○ In early adolescence there is a lot of pruning: if you don’t use it, you lose it.
● The brain has a high plasticity during adolescence. You can easily develop and lose
skills during this time.
● Increase in white matter: communication between brain regions strongly improves.
○ Long term memory increases.
○ Capacity for abstract thinking/metacognition increases.
■ Adolescents are becoming more critical → more conflicts.
Risk behavior in adolescence follows an inverted U-shaped curve in statistics. There is often
a peek during adolescence, which decreases again in adulthood.
The speed of development of two different brain regions differs:
● The affective-motivational system (emotional brain) develops fast
● The control system (rational brain) develops slowly (until about 25 years).
- The affective-motivational system (‘reward center’) is overactive in early and mid
adolescence.
1
, ● Adolescents experience stronger positive
emotions than adults when they receive a reward.
● This process is enhanced by testosterone, which is
probably why boys are more often involved in risk
behavior than girls.
- The rational brain plays an important role in the development of
executive functions:
● Risk estimation
● Monitoring long-term goals
● Inhibit the tendency to respond to (short-term) possibilities for
reward (impulse control, behavioral inhibition, self control)
In short: Increased risk-taking during adolescence is a result of
an imbalance between reward sensitivity (the affective
motivational system) and impulse control (control system).
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).
- Other characteristics of psychoactive substances:
● They often induce craving after (regular) use.
● They often evoke loss of control after they have been used (regularly).
These types of drugs differ in the type of strength of the psychoactive effect and the degree
to which they elicit craving and loss of control.
Differentiates between intensional and extensional definitions
of addiction:
● Intensional: these definitions aim to describe a causal
addiction process (see Sussman (2017)).
● Extensional: a classification of characteristics
of an addiction (e.g. DSM-5).
○ Four categories for the classification of
substance use disorder:
■ Loss of control
■ Social land other impairments
■ Continuation despite knowledge of risky use
■ Pharmacological effects (tolerance and withdrawal)
Two learning principles underlying the development of addiction:
1. Positive reinforcement occurs when the rate of a behavior increases because a
desirable experience (e.g., euphoria, relaxation) is resulting from that behavior.
2. Negative reinforcement occurs when the rate of a behavior increases because an
aversive experience is prevented from happening (e.g., prevention of withdrawal
symptoms).
When you use a drug, dopamine releases in the nucleus accumbens (NA), which is a reward.
● At the same time, brain adaptation happens due to the shock. This results in a
decrease in the sensitivity of the reward system.
2
