Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model.
This paper presents a review and a model of the development of addictive behaviors in (human) adolescents, with a focus on alcohol. The model proposes that addictive behaviors develop as the result of an imbalance between two systems: an appetitive, approach-oriented system that becomes sensitized with repeated alcohol use and a regulatory executive system that is not fully developed and that is compromised by exposure to alcohol. Self-regulation critically depends on two factors: ability and motivation to regulate the appetitive response tendency. The motivational aspect is often still weak in heavy drinking adolescents, who typically do not recognize their drinking as problematic. Motivation to regulate use often develops only years later, after the individual has encountered serious alcohol-related problems. Unfortunately, at that point behavioral change becomes harder due to several neurocognitive adaptations that result from heavy drinking. As we document, there is preliminary support for the central elements of the model (appetitive motivation vs. self-regulation), but there is a paucity of research directly addressing these mechanisms in human adolescents. Further, we emphasize that adolescent alcohol use primarily takes place in a social context, and that therefore studies should not solely focus on intra-individual factors predicting substance use and misuse but also on interpersonal social factors. Finally, we discuss implications of the model for interventions.
Wiers
Reinout W
RW
Experimental Psychology, Maastricht University, Maastricht, The Netherlands. r.wiers@psychology.unimaas.nl
Bartholow
Bruce D
BD
van den Wildenberg
Esther
E
Thush
Carolien
C
Engels
Rutger C M E
RC
Sher
Kenneth J
KJ
Grenard
Jerry
J
Ames
Susan L
SL
Stacy
Alan W
AW
D000293:Adolescent / Q000502:physiology*; D000294:Adolescent Behavior / Q000502:physiology*; D000818:Animals; D001066:Appetite / Q000502:physiology; D016739:Behavior, Addictive / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D009042:Motivation; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000523:psychology