title: Controversies about the enhanced vulnerability of the adolescent brain to develop addiction.
abstract: Adolescence, defined as a transition phase toward autonomy and independence, is a natural time of learning and adjustment, particularly in the setting of long-term goals and personal aspirations. It also is a period of heightened sensation seeking, including risk taking and reckless behaviors, which is a major cause of morbidity and mortality among teenagers. Recent observations suggest that a relative immaturity in frontal cortical neural systems may underlie the adolescent propensity for uninhibited risk taking and hazardous behaviors. However, converging preclinical and clinical studies do not support a simple model of frontal cortical immaturity, and there is substantial evidence that adolescents engage in dangerous activities, including drug abuse, despite knowing and understanding the risks involved. Therefore, a current consensus considers that much brain development during adolescence occurs in brain regions and systems that are critically involved in the perception and evaluation of risk and reward, leading to important changes in social and affective processing. Hence, rather than naive, immature and vulnerable, the adolescent brain, particularly the prefrontal cortex, should be considered as prewired for expecting novel experiences. In this perspective, thrill seeking may not represent a danger but rather a window of opportunities permitting the development of cognitive control through multiple experiences. However, if the maturation of brain systems implicated in self-regulation is contextually dependent, it is important to understand which experiences matter most. In particular, it is essential to unveil the underpinning mechanisms by which recurrent adverse episodes of stress or unrestricted access to drugs can shape the adolescent brain and potentially trigger life-long maladaptive responses.
authors.affiliation: Center for Psychiatric Neuroscience, Division of Child and Adolescent Psychiatry, Lausanne University Hospital Lausanne, Switzerland.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Bernheim
authors.affiliation: Division of Child and Adolescent Psychiatry, Lausanne University Hospital Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Halfon
authors.affiliation: Center for Psychiatric Neuroscience, Division of Child and Adolescent Psychiatry, Lausanne University Hospital Lausanne, Switzerland ; Division of Child and Adolescent Psychiatry, Lausanne University Hospital Lausanne, Switzerland.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Boutrel
keywords: adolescence; animal models; brain imaging; drug addiction; impulsivity