youth and psychopathology: a developmental...

YOUTH AND PSYCHOPATHOLOGY: A DEVELOPMENTAL PERSPECTIVEPROF. DR. ANJA C. HUIZINK

TWO RESEARCH LINES

1) Prenatal Exposure to Maternal Influences (stress, smoking, drinking, cannabis use) and infant/child behavioral and developmental outcomes

2) Biopsychological factors for Adolescent Risk Taking

Behavior (focus on Substance Use)

BOTH: Important developmental stages in human life

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Faculteit der Psychologie en Pedagogiek

ADOLESCENCE RISK TAKING

A. Brain development and Adolescent Risk Taking

B. Two studies:

1) Adolescent Risk Taking: SU among non-western immigrants in the Netherlands

- Introduction i4Culture study

2) Adolescent Risk Taking: Role of Endophenotypes (JOIN)

- Stress reactivity

- Behavioral disinhibition

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ADOLESCENCE AND RISK TAKING

Adolescence: period of major transitions

- Psychological level: finding your own identity

- Social level: become an independent person and form new relationships (parents peers)

- Physiological level: puberty maturation

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Brain development is ongoing (e.g. Crone et al., 2004, 2006)

- Growth/maturation of more complex networks

- Maturation of ventrolateral prefrontal cortex (better inhibition)

- Maturation of lateral-frontal cortex (interference of non-relevant stimuli)

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Increased sensitivity to reward & stress

- Nucleus accumbens + amygdala: sensitive to hormonal changes

- Strong responses to reward

- Emotional system very sensitive, and not yet under full control of prefrontal cortex

- Increased sensitivity for stress and increased response to (social) stressors

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ADOLESCENCE= EXPLORING BOUNDARIES

7 Prof. dr. Anja C. Huizink


ADOLESCENCE = LOOKING FOR NEW SENSATIONS

8 Prof. dr. Anja C. Huizink


ADOLESCENCE

Normal adolescent behavior thus includes:

- Exploratory behavior:

- Trying new things, new behaviors

- Impulsive behavior: no longer-term view

- Peer behavior does matter

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ADOLESCENCE

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Child

Adolescent

Adult

Onset

psychopathology

I 4 CULTURE STUDY

Comparison of Cannabis Use DSM-IV criteria

- Across countries (USA vs Netherlands)

- Across sexes and ages (adolescents vs adults)

- Across different ethnicities

Need of cultural-divers cohort of adolescents and young adults

Initiation of i4Culture: non-western immigrant youth in the Netherlands (i.e., Surinamese, Antillean, Turks/Morrocans, Asian)

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0

10

20

30

40

50

60

70

80

90

100

No religion Alcohol use Cannabis use

Surinamese

Indonesian

Turks/Morrocans

Dutch

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Substance Useamong 19-year-olds


ENDOPHENOTYPES OF ADOLESCENT SUBSTANCE USE

Genotype

Endophenotype

Phenotype

Environment


JOIN: YOUTH RESEARCH IN THE NETHERLANDS

JOIN

At random (representative)sample 14-20 year-olds

Follow-up is ongoing

N = 346

ENRICHED WITH: HIGH-RISK YOUTH

Adolescents with at least 1 parent with SUD

N= 83 (more intensive EEG measures)

Autonomal activity

Cortisol levels

JOiN – MethodologyStress physiology measurement

Endophenotype

Endophenotype 1:

CNS disinhibition -

lowered activity of the PFC

Endophenotype 2:

Reward sensitivity when

making decisions

JOiN – MethodologyBehavioural Disinhibition Pathway

Endophenotype

ADOLESCENCE AND STRESS

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Child

Adolescent

Adult

Onset

psychopathology

stress


DEVELOPMENT OF STRESS DURING ADOLESCENCE

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0

0,5

1

1,5

2

2,5

3

3,5

4

PARENTS PEERS LOOKS FUTURE LEISURE

MeanItemscore

12-13YRS 14-15YRS


STRESS AND SUBSTANCE USE

Stress: has an assocation with addiction among adult

populations (and in animal studies)

Complicated relationship: cause or result?

Why do people use substances in stressful situations?

- coping/ self-medication

- neurocognitive adaptations due to stress: elevated

reward, increased craving, loss of control, compulsiveness

EXAMPLE: STRESS RESPONSE CORTISOL

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0,0

0,5

1,0

1,5

2,0

2,5

3,0

Max increase: max during task minus pre-task

cannabis users

tobacco users

abstainers

STRESS AND SUBSTANCE USE AMONG YOUTH

Other theoretical model may apply for

Stress SU among youth

Mostly: sensation-seeking rather than self-medication

Specific developmental period

Amsterdam Stress Lab: just started

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BEHAVIORAL DISINHIBITION AND SUBSTANCE USE

Various dimensions of Behavioral Disinhibition, or loss of control:

- Attentional control: target and novelty P300 amplitudes

- Decision-making (associated with rewards): feedback related P300 amplitude elicited by BART

- Error-processing: ERN elicited by Flanker paradigm

Measured with EEG: Event-Related Potentials (ERP)

- P300: index of mental processes underlying allocation of attention

- ERN: error-related negativity, reflects error-detection

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BEHAVIORAL PARADIGMS

Attention: Oddball Task

- Random occurrence of infrequent target stimuli (letter X)

- Embedded in a series of task-irrelevant non-target stimuli (letter O)

- Also infrequent novel (distracting) stimuli

- Target stimuli elicits target-P300 amplitude

- Novel stimuli orienting response novelty-P300

Main findings:

- Reduced target-P300 (allocation of attention) associated with SU, and family history of SUD

- Reduced novelty-P300 in high-risk youth (impaired orienting response to unexpected stimuli)

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Decision making: BART + ERP measures

- Balloon Analogue Risk Task: risky decision making

- Automatic response mode: select number of pumps

- 60 balloons; Feedback: money earned/lost for each balloon

- Feedback elicits P300

Main findings:

- More risky decisions in HR males

- Blunted P300 amplitudes in response to feedback (pos/neg)

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Error-processing: Eriksen Flanker Task

- 100 ms after error: negative deflection ERP

- Error-related Negativity (ERN): error detection

- Four different letter strings presented; congruent (SSSSS) or incongruent (SSHSS)

- Respond as quickly and accurately to central target letter (S or H in examples)

Main findings:

- Smaller ERN amplitudes in HR (lower response to errors)

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SUMMARY

Adolescence reflects “window of vulnerability” for onset of

Psychopathology, including Substance Use

Endophenotypes provide insights into some underlying mechanisms

In general: BLUNTED reactivity to both stress (CORT) and behavioral stimuli (EEG) was found in youth at risk for SU

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TEAM

i4Culture:

Dr. Hanneke Creemers

Monique Delforterie (PhD)

JOIN:

Dr. Brittany Evans

Dr. Anja Euser

Prof. dr. Ingmar Franken

Dr. Kirstin Greaves-Lord

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THANK YOU!

Interested in Research Master at VU?

Interested in Collaboration?

Interested in Amsterdam Stress Lab?

Other questions?

Contact: [email protected]


FINDINGS OF I4CULTURE

No effect of acculturation strategy with SU

- we expected strongest effect of assimilation (no effects either of integration, separation, marginalization)

Effect of language at home: if Dutch, more SU (and more SU peers)

Parenting effects more or less similar across groups

- More child self-disclosure less SU

- More parental solicitation more SU

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youth and psychopathology: a developmental...

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