Risk Behavior and Addiction in Adolescence
Lecture 1 – Introduction lecture
Content
1. How do we define Risk Behavior?
2. Which (neurological) developments take place during adolescence?
3. Why is there a peak in risk behavior during adolescence?
4. What are psycho-active substances (drugs)?
5. How do we define addiction?
6. Which implicit/automatic processes underlie the development of addiction?
7. Can one become addicted to games or social media use?
1. How do we define Risk Behavior?
Risk behavior
Risk behavior: behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development (welzijn) of adolescents
- Substance use (e.g., smoking, alcohol use, cannabis use, use of XTC and other party
drugs)
- Other risk behaviors (e.g. gambling, gaming, social media use)
The general developmental proces of addiction
Contact with a substance Experimenting with a substance Integrated use (je vind het leuk)
Excessive use (kan dagelijks gebruik worden) Addiction use
Het is een proces, niet van de een op andere dag
What we tend to regard as ‘risk behavior’ depends on…
Characteristics of the particular substance or behavior:
- For instance, smoking versus gaming
Sommige verslavingen ontwikkelen een stuk langzamer; gamen & sociale media nog
geen risicovol gedrag in experimentele fase
Je kunt iedere dag gamen en geen verslavingsgedrag vertonen
Cultural and societal norms:
- Example: alcohol use in western (accepted) versus Islamic cultures (forbidden)
Scientific knowledge:
- Example: knowledge on the risks of alcohol use for the cognitive development of
adolescents
Nu is er meer bekend over de negatieve gevolgen dan vroeger
Predictors of risk behavior (COM-B model, Michie et al., 2011)
1. Capability: You need to be capable of engaging in the behavior
- Dit verwijst naar de mentale en fysieke vaardigheden en capaciteiten die een persoon heeft om
een specifiek gedrag uit te voeren
2. Motivation: You need to be motivated to engage in the behavior
- Bereidheid en de motivatie van een persoon om een bepaald gedrag uit te voeren
3. Opportunity: You need to have access to the substance to engage
- Externe omstandigheden en kansen om bepaald gedrag uit te voeren
,2. Which (neurological) developments take place during adolescence?
Adolescence (+ 10 – 24 years)
Early adolescence (aged 10 – 13): physical growth (earlier for girls than for boys), sexual
maturation, psychosocial development, social identity formation (how de others perceive
me?) peers are getting more important, parents are less important, opinions of other start
to matter and you start to care a lot about what others think of you (important for social
development)
Mid adolescence (aged 14 – 18): experimenting with (risk) behavior, personal identity
formation how you see yourself, the need to be unique becomes more important
Late adolescence (aged 19 – 24): practicing adult roles first jobs, first love, living on your
own
Neurological development during adolescence
1. Strong grow in brain volume: increase in white matter (connections
between nerve cells & communicatie tussen hersengebieden),
decrease in grey matter (nerve cells; gebruikt voor informatie
verwerking en verzending)
- Loss of gray matter among girls and boys by age
Girls: 11 years
Boys: 12-13 years more grey matter
- Pruning (snoeien): the grey matter that isn’t used, you lose it!
- Zwakke en overbodige verbindingen worden verwijderd. De
afname van grijze materie tijdens de adolescentie is een
natuurlijk en adaptief proces dat de hersenen in staat stelt om
efficiënter te functioneren en zich aan te passen aan de
veranderende eisen van volwassenheid. Het betekent niet dat
de hersenen minder capabel zijn; integendeel, het stelt de
hersenen in staat om gespecialiseerder en effectiever te worden in hun functies.
2. Increase in white matter: communication between brain regions strongly improves
- Long term memory increases
- Capacity for abstract thinking/ metacognition increases can also cause more
arguments because you start to think more critical
- Brain works more efficiently, stronger connections
- Sneller nieuwe informatie en vaardigheden leren
3. High plasticity/kneedbaarheid of the brain: you can learn easier during adolescence
You can develop en lose certain skills
3. Why is there a peak in risk/criminal behaviors during adolescence?
Risk behavior in adolescence follows an inverted U-shaped curve
,Neurological development in adolescence
The speed of the development of two different brain regions differs
The affective-motivational system (emotional brain) develops fast and earlier bottom-up
The control system (rational brain) develops slowly and later top-down
Prefrontal cortex (control system, rational brain)
Nucleus accumbens (reward center, affective-
motivational system, emotional brain)
Affective-motivational system (emotional brain)
The affective-motivational system (‘reward center’) is overactive in early and mid-
adolescence
Adolescents experience stronger positive emotions than adults and late adolescence when
they receive or anticipate a reward (pleasant feeling, getting a compliment, winning a price)
- This proces is enhanced by testosterone boys have more testosterone (mid/ late),
that’s why boys engage more in risk behavior
Control system (rational brain)
The rational brain develops slowly (until about 25 years)
The rational brain plays an important role in the development of executive functions:
- Risk estimation: later you are better equipped in predicting risks of behavior
- Monitoring long-term goals: in adolescence it is harder to monitor these
- Inhibit the tendency to respond to (short-term) possibilities for a reward (better impulse
control, behavioral inhibition/ gedragsremming, self-control)
The Maturation Imbalance Model (Casey et al., 2011)
Increased risk-taking during adolescence is a result of an imbalance between motivational
system/ bottom-up versus controlling top-down processes (high reward sensitivity versus
immature/ onrijpe impulse control)
- Als gevolg hiervan kunnen adolescenten vatbaarder zijn voor risicovol gedrag en
impulsieve beslissingen, omdat hun emotionele hersengebieden sterker kunnen wegen
dan hun cognitieve controlemechanismen reageren sterker op emotionele beloningen
en prikkels; grotere bereidheid om nieuwe dingen te proberen
- Adolescenten ervaren intenser gevoel van genot en voldoening bij een beloning of een
plezierige ervaring, deze verhoogde gevoeligheid voor beloning kan adolescenten
aanmoedigen om risicovol gedrag te vertonen, omdat ze de beloningen die ze kunnen
ontvangen aantrekkelijker vinden dan volwassenen.
The horse and rider metaphor the rider wants
to keep control (controlled) and the horse wants
to ride (impulsive)
, Motivational system: bottom-up process, behavioral activation (BAS) automatic & impulsive
- Gedrag op basis van beloningen en verlangens
- Omdat hun emotionele reacties sterker zijn, kunnen adolescenten soms beslissingen
nemen op basis van die sterke emoties, zelfs als dit niet altijd de slimste of veiligste keuze
is. Dit wordt impulsief gedrag genoemd. Ze kunnen bijvoorbeeld iets doen zonder er eerst
over na te denken of zonder de gevolgen te overwegen, puur omdat ze op dat moment zo
sterk voelen geen beslissingen op basis van logica of planning
Control system: top-down process, behavioral inhabitation (BIS) reflective & controlled
- Beheersen en onderdrukken gedrag (met name situaties waarin impulsen en verlangens
mogelijk riskant of ongeschikt zijn), rationeel nadenken over gedrag en de gevolgen ervan
4. What are psycho-active substances (drugs)?
How can we define drugs or psycho-active substances?
Psychoactive substances are all kinds of chemical substances that cross/passeren the blood-
brain barrier (chocolate and behavior doesn’t do that) and affect the function of the central
nervous system thereby altering/chancing perception, mood, or consciousness, dependent of
the substance you use (e.g. high/euphoria, relaxation) veranderen functioneren hersens
Other characteristics of psychoactive substances:
- They often induce craving after (regular) use intense verlangens
- They often evoke loss of control after they have been used (regularly) more difficult to
stop using it
Psychoactive substances differ in…
Type and strength of the psychoactive effect
The degree to which they elicit/opwekken craving and loss of control
Nicotine doesn’t give an extreme feeling, but results in a lot of craving and loss of control
XTC gives a more extreme feeling, but doesn’t result in craving
For which substance is the risk highest to develop addiction after one has used the substance?
Types of drugs (based on their psychoactive effects)
Lecture 1 – Introduction lecture
Content
1. How do we define Risk Behavior?
2. Which (neurological) developments take place during adolescence?
3. Why is there a peak in risk behavior during adolescence?
4. What are psycho-active substances (drugs)?
5. How do we define addiction?
6. Which implicit/automatic processes underlie the development of addiction?
7. Can one become addicted to games or social media use?
1. How do we define Risk Behavior?
Risk behavior
Risk behavior: behaviors that pose a risk to a healthy physical, cognitive, psychosocial
development (welzijn) of adolescents
- Substance use (e.g., smoking, alcohol use, cannabis use, use of XTC and other party
drugs)
- Other risk behaviors (e.g. gambling, gaming, social media use)
The general developmental proces of addiction
Contact with a substance Experimenting with a substance Integrated use (je vind het leuk)
Excessive use (kan dagelijks gebruik worden) Addiction use
Het is een proces, niet van de een op andere dag
What we tend to regard as ‘risk behavior’ depends on…
Characteristics of the particular substance or behavior:
- For instance, smoking versus gaming
Sommige verslavingen ontwikkelen een stuk langzamer; gamen & sociale media nog
geen risicovol gedrag in experimentele fase
Je kunt iedere dag gamen en geen verslavingsgedrag vertonen
Cultural and societal norms:
- Example: alcohol use in western (accepted) versus Islamic cultures (forbidden)
Scientific knowledge:
- Example: knowledge on the risks of alcohol use for the cognitive development of
adolescents
Nu is er meer bekend over de negatieve gevolgen dan vroeger
Predictors of risk behavior (COM-B model, Michie et al., 2011)
1. Capability: You need to be capable of engaging in the behavior
- Dit verwijst naar de mentale en fysieke vaardigheden en capaciteiten die een persoon heeft om
een specifiek gedrag uit te voeren
2. Motivation: You need to be motivated to engage in the behavior
- Bereidheid en de motivatie van een persoon om een bepaald gedrag uit te voeren
3. Opportunity: You need to have access to the substance to engage
- Externe omstandigheden en kansen om bepaald gedrag uit te voeren
,2. Which (neurological) developments take place during adolescence?
Adolescence (+ 10 – 24 years)
Early adolescence (aged 10 – 13): physical growth (earlier for girls than for boys), sexual
maturation, psychosocial development, social identity formation (how de others perceive
me?) peers are getting more important, parents are less important, opinions of other start
to matter and you start to care a lot about what others think of you (important for social
development)
Mid adolescence (aged 14 – 18): experimenting with (risk) behavior, personal identity
formation how you see yourself, the need to be unique becomes more important
Late adolescence (aged 19 – 24): practicing adult roles first jobs, first love, living on your
own
Neurological development during adolescence
1. Strong grow in brain volume: increase in white matter (connections
between nerve cells & communicatie tussen hersengebieden),
decrease in grey matter (nerve cells; gebruikt voor informatie
verwerking en verzending)
- Loss of gray matter among girls and boys by age
Girls: 11 years
Boys: 12-13 years more grey matter
- Pruning (snoeien): the grey matter that isn’t used, you lose it!
- Zwakke en overbodige verbindingen worden verwijderd. De
afname van grijze materie tijdens de adolescentie is een
natuurlijk en adaptief proces dat de hersenen in staat stelt om
efficiënter te functioneren en zich aan te passen aan de
veranderende eisen van volwassenheid. Het betekent niet dat
de hersenen minder capabel zijn; integendeel, het stelt de
hersenen in staat om gespecialiseerder en effectiever te worden in hun functies.
2. Increase in white matter: communication between brain regions strongly improves
- Long term memory increases
- Capacity for abstract thinking/ metacognition increases can also cause more
arguments because you start to think more critical
- Brain works more efficiently, stronger connections
- Sneller nieuwe informatie en vaardigheden leren
3. High plasticity/kneedbaarheid of the brain: you can learn easier during adolescence
You can develop en lose certain skills
3. Why is there a peak in risk/criminal behaviors during adolescence?
Risk behavior in adolescence follows an inverted U-shaped curve
,Neurological development in adolescence
The speed of the development of two different brain regions differs
The affective-motivational system (emotional brain) develops fast and earlier bottom-up
The control system (rational brain) develops slowly and later top-down
Prefrontal cortex (control system, rational brain)
Nucleus accumbens (reward center, affective-
motivational system, emotional brain)
Affective-motivational system (emotional brain)
The affective-motivational system (‘reward center’) is overactive in early and mid-
adolescence
Adolescents experience stronger positive emotions than adults and late adolescence when
they receive or anticipate a reward (pleasant feeling, getting a compliment, winning a price)
- This proces is enhanced by testosterone boys have more testosterone (mid/ late),
that’s why boys engage more in risk behavior
Control system (rational brain)
The rational brain develops slowly (until about 25 years)
The rational brain plays an important role in the development of executive functions:
- Risk estimation: later you are better equipped in predicting risks of behavior
- Monitoring long-term goals: in adolescence it is harder to monitor these
- Inhibit the tendency to respond to (short-term) possibilities for a reward (better impulse
control, behavioral inhibition/ gedragsremming, self-control)
The Maturation Imbalance Model (Casey et al., 2011)
Increased risk-taking during adolescence is a result of an imbalance between motivational
system/ bottom-up versus controlling top-down processes (high reward sensitivity versus
immature/ onrijpe impulse control)
- Als gevolg hiervan kunnen adolescenten vatbaarder zijn voor risicovol gedrag en
impulsieve beslissingen, omdat hun emotionele hersengebieden sterker kunnen wegen
dan hun cognitieve controlemechanismen reageren sterker op emotionele beloningen
en prikkels; grotere bereidheid om nieuwe dingen te proberen
- Adolescenten ervaren intenser gevoel van genot en voldoening bij een beloning of een
plezierige ervaring, deze verhoogde gevoeligheid voor beloning kan adolescenten
aanmoedigen om risicovol gedrag te vertonen, omdat ze de beloningen die ze kunnen
ontvangen aantrekkelijker vinden dan volwassenen.
The horse and rider metaphor the rider wants
to keep control (controlled) and the horse wants
to ride (impulsive)
, Motivational system: bottom-up process, behavioral activation (BAS) automatic & impulsive
- Gedrag op basis van beloningen en verlangens
- Omdat hun emotionele reacties sterker zijn, kunnen adolescenten soms beslissingen
nemen op basis van die sterke emoties, zelfs als dit niet altijd de slimste of veiligste keuze
is. Dit wordt impulsief gedrag genoemd. Ze kunnen bijvoorbeeld iets doen zonder er eerst
over na te denken of zonder de gevolgen te overwegen, puur omdat ze op dat moment zo
sterk voelen geen beslissingen op basis van logica of planning
Control system: top-down process, behavioral inhabitation (BIS) reflective & controlled
- Beheersen en onderdrukken gedrag (met name situaties waarin impulsen en verlangens
mogelijk riskant of ongeschikt zijn), rationeel nadenken over gedrag en de gevolgen ervan
4. What are psycho-active substances (drugs)?
How can we define drugs or psycho-active substances?
Psychoactive substances are all kinds of chemical substances that cross/passeren the blood-
brain barrier (chocolate and behavior doesn’t do that) and affect the function of the central
nervous system thereby altering/chancing perception, mood, or consciousness, dependent of
the substance you use (e.g. high/euphoria, relaxation) veranderen functioneren hersens
Other characteristics of psychoactive substances:
- They often induce craving after (regular) use intense verlangens
- They often evoke loss of control after they have been used (regularly) more difficult to
stop using it
Psychoactive substances differ in…
Type and strength of the psychoactive effect
The degree to which they elicit/opwekken craving and loss of control
Nicotine doesn’t give an extreme feeling, but results in a lot of craving and loss of control
XTC gives a more extreme feeling, but doesn’t result in craving
For which substance is the risk highest to develop addiction after one has used the substance?
Types of drugs (based on their psychoactive effects)
