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November 28, 2011

Technologies, Adolescence, and Impulse Control Behaviors and Addictions

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Marc N. Potenza, MD, PhD

Yale University School of Medicine, New Haven, Connecticut

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Technological advances in computers and video games have made the use of these media common throughout society in general and among youth in particular. Adolescents have high rates of risk-taking behaviors, such as substance use and gambling, and they may be especially vulnerable to developing problems related to these behaviors, given their developmental stage of transitioning from childhood to adulthood and “testing” adult-like behaviors. The extent to which computers and video games represent another outlet for potentially risky behaviors that share similarities with other risk behaviors is an important question worth empirical testing, particularly as child/adolescent engagement in behaviors like gambling and substance use have been linked to adverse functioning both in adolescence and in adulthood.1,2

It is tempting to speculate that excessive computer use and video game playing would not only share similarities but also have unique features when compared with other risk behaviors, and existing data support this notion. For example, recent research3 linked problematic Internet use in adolescents to substance use, depression, and aggression, a pattern also seen with problematic gambling and various forms of substance use and abuse/dependence. However, data also support unique associations with some risk behaviors in youth. For example, peer influences may be less influential in some forms of risk behaviors than others. Among high school students who gambled (either on the Internet or not), problem/at-risk gambling was less closely linked to gambling with friends (ie, peer involvement) among those who gambled on the Internet than it was among the non-Internet gambling group.4

Recent studies suggest that adolescent brain development may underlie risk-taking and addiction, with subcortical pro-motivational and emotional circuitry maturing prior to frontal cortical control regions.5 With this developmental process in mind, it will be important to develop prevention and treatment interventions accessible to and meaningful for adolescents. Given frequent initiation of engagement in computer use, video game playing, gambling, and other potentially risky behaviors in childhood, early-life interventions warrant consideration.

It is also important to consider the positive impact that such behaviors, including not only computer use and video game playing but also adolescent risk-taking in general, may have from developmental perspectives with respect to developing behavioral control and balancing participation in possibly less enjoyable tasks versus more enjoyable activities. Engaging in some of these behaviors may be helpful, informative, or advantageous, with perhaps the most clear example being computer use. Computer use, video game playing, and gambling are all normative behaviors during adolescence, in that the majority of adolescents engage in each of these behaviors. Examining the health associations with each of these behaviors, both at specific levels (ie, quantity/frequency) and in various types (eg, computer use for schoolwork, social connectedness, interactive gaming, gambling), is warranted. Considering these behaviors within a developmental framework, and with an understanding of individual differences that may represent resilience or vulnerability factors with respect to developing problems with the behaviors, will be important in this process in order to optimize public health.

Financial disclosure:Dr Potenza has received grant/research support from the National Center for Responsible Gaming, Mohegan Sun Casino, and Psyadon and has received other financial support from American Psychiatric Press, Oxford Press, legal consulting, and Somaxon.

References

1. Wanner B, Vitaro F, Carbonneau R, et al. Cross-lagged links among gambling, substance use, and delinquency from midadolescence to young adulthood: additive and moderating effects of common risk factors. Psychol Addict Behav. 2009;23(1):91–104. PubMed

2. Yip SW, Desai RA, Steinberg MA, et al. Health/functioning characteristics, gambling behaviors, and gambling-related motivations in adolescents stratified by gambling problem severity: findings from a high school survey. Am J Addict. 2011;20(6):495–508. PubMed

3. Liu TC, Desai RA, Krishnan-Sarin S, et al. Problematic Internet use and health in adolescents: data from a high school survey in Connecticut. J Clin Psychiatry. 2011;72(6):836–845. Abstract

4. Potenza MN, Wareham JD, Steinberg MA, et al. Correlates of at-risk/problem Internet gambling in adolescents. J Am Acad Child Adolesc Psychiatry. 2011;50(2):150–159. PubMed

5. Somerville LH, Jones RM, Casey BJ. A time of change: behavioral and neural correlates of adolescent sensitivity to appetitive and aversive environmental cues. Brain Cogn. 2010;72(1):124–133. PubMed

Category: Substance Use Disorder
Link to this post: https://www.psychiatrist.com/blog/technologies-adolescence-and-impulse-control-behaviors-and-addictions/
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One thought on “Technologies, Adolescence, and Impulse Control Behaviors and Addictions

  1. I think you are dead on about the prefrontal/frontal lobe slow development (not until 25ish and longer with our developmentaly delayed youth) They do not have the wiring and do not benefit from experience in order to gain a sense of danger about high risk behaviors. They also then to be “low gain” and thus have a high capacity for risk, which they find exciting rather than fearful. I worked in Juvenile Prisons for 14 years and have a plethora of anecdotal information. Which will never see the light of publication on how these young men/women perceive their world. I am terminally ill and in the twilight of my 35+ year career so I have the age and wisdom and privelege of providing my opinion. I had classes with Carl Rogers when he was in the same age bracket. Interventions come in the form of personal relations with each individual over the long run with reapect and and caring which is reciprocal. Our native american forefathers and eastern cultures used to revere the wisdom of old age and would sit at the feet of the “masters” to learn and they were commited to one another. That is how I had my best successes. I gave them the same respect and listened intently to their views as well. My oldest grandson would sit in front of me on the floor whilst I was on the “throne” and ask a million questions and was in awe of the answers given then or later. The answer is in the bonding, caring and commitment to each other. It took me 28 years of keeping a relationship with my ADHD son, even in near death situations to finally get to that point. You just don’t give in or give up.

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