Adolescent brain development, Bryan Fox

1. AdolescentAdolescent
Development: A SetupDevelopment: A Setup
for Addiction?for Addiction?
Bryan Fox, Ph.D.Bryan Fox, Ph.D.

2. What is Adolescence?

3. 7Early maturation
12-1410-12Growth spurt
11-1310-12Onset of puberty
Biological Development

4. Cognitive Development
• ability to think abstractly
• ability to analyze situations
logically
• ability to think realistically about
the future, goal setting
• moral reasoning
• Entertain hypothetical situations,
use of metaphors
Need guidance for rational
decision making
10 years
20+ years

5. ADOLESCENCE
 Most elements of cognitive development
show a trajectory that follows age and
experience rather than the timing of
puberty
 Research demonstrates a significant
positive correlation between pubertal
maturation and socio-emotional system
(e.g., sensation seeking)

6. ADOLESCENCE
PUBERTY
Romantic motivation
Sexual interest
Emotional intensity
Sleep cycle changes
Appetite
Risk for affective
disorders (girls)
Increase in risk taking,
sensation seeking, and
novelty seeking
AGE/EXPERIENCE
Planning
Logic, reasoning
Inhibitory control
Problem solving
Understanding
consequences
Affect regulation
Goal setting and pursuit
Judgment and abstract
thinking

7. Brain Research Findings
The brain continues to develop during
adolescence.
Areas under construction:
• Prefrontal cortex – responsible
for organizing, setting priorities,
strategizing, controlling impulses
• Brain functions that help plan and
adapt to the social environment
• Brain functions that help put
situations into context; retrieve
memories to connect with gut
reactions

8.  Adolescence is a
period of profound
brain maturation.
 It was believed
that brain
development was
complete during
childhood
 The maturation
process is not
complete until
about age 24!!!

9. Test: Are you Smarter than 5th
Grader?
Would you prefer to attempt to pull a lucky lottery ticket from an
envelope where your chances are:
(a) 1 out of 10 chances of getting the ticket;
(b) 10 out of 100 chances of getting the
ticket;
(c) 100 out of 1,000 chances of getting the
ticket;
(d) Any of the above;
(e) None of the above.

10. • During late childhood, neurons get bushier and
increase in the number of connections.
• At about age 11 in girls and age 12½ in boys, this
thickening undergoes pruning.
• At the same time, the myelin sheaths that encase
nerve cells thicken.
• Myelin sheaths are like insulation on a wire; they
make nerve cell transmissions faster and more
efficient
• Net effect when complete is faster, yet fewer,
connections in the brain.
Construction Ahead

11. PRUNING
 “USE IT OR LOSE IT”– Reading, sports, music,
video games, x-box, hanging out—whatever
a child/teen is doing—these are the neural
synapses that will be retained
 How children/teens spend their time is
CRUCIAL to brain development since their
activities guide the structure of the brain

12. prefrontal
cortex
physical
coordination;
sensory
processing
motivation
emotion
judgment
amygdala
nucleus
accumbens
cerebellu
m
*Pruning occurs in stages from back to front
Construction Ahead

13. judgment emotion motivation physical
coordination
; sensory
processing;
Age 24

14. •Back of brain matures before the
front of the brain…
•sensory and physical activities
favored over complex, cognitive-
demanding activities
•propensity toward risky, impulsive
behaviors
•group setting may promote risk
taking
•poor planning and judgment
Brain Development

15. •Back of brain matures before to the
front of the brain…
•activities with high excitement
and low effort are preferred
•poor modulation of emotions (hot
emotions more common than
cold emotions)
•heightened interest in novel stimuli
Brain Development

16. Brain Development
 Underdevelopment of the frontal
lobe/prefrontal cortex and the limbic system
make adolescents more prone to “behave
emotionally or impulsively”
 Adolescents tend to use an alternative part of
the brain– the socio-emotional system rather
than the cognitive-control system to process
information

17. This imbalance leads to...
 planned thinking
 impulsiveness
 self-control
 risk-taking
more “hot” talking, less “cool” talking
PFC
amygdala
I like
to use
drugs!!

18. In the presence of
stress…
PFC
amygdala
I hate school;
I am going to
skip classes
and get
drunk!

19. PFC
amygdala
GOOD NEWS!
The pruning of the PFC neurons
produces a more efficient PFC by
young adulthood
I am
planning
for the
future

20. Risk Taking Behavior?
But there is
concern –
Adolescents
overestimate
their capacities,
rely on their
immature ability
to judge, or give
in to peer
pressure
It is normal! -
Exploration of
new behaviors,
decision
making skills,
identity
development

21. Can Addiction be Prevented by
Delaying Drug Use Onset?
• The average age of onset for teen drug use is
somewhere around 12-13.
• Every year that the onset of alcohol use is
postponed significantly reduces the likelihood of
developing disordered drinking

22. Percentages of Past Year Alcohol Dependence or
Abuse Among Adults Aged 21 or Older, by Age of First
Use (SAMHSA, 2004)
16
15
9
4.2
2.6
0
5
10
15
20
< 12 yrs 12-14 yrs 15-17 yrs 18-20 yrs 21+ yrs
Age Started Drinking
PercentDiagnosedas
ETOHDependent

23. Adolescent Developmental
Tasks
 Individuation
A drive to be seen as more than a minor component of
the larger family unit. Strong desire to be seen
independently
 Separation
A need to literally/figuratively distance from the family
rule. A need for “their own space.”
 Autonomy
A sense that they want/need to begin to set their own
rules and make their own choices (good and bad).
 Collaboration
A realization that “no man is an island.” To succeed you
must work with others.

24. “Normal” Adolescent
Development
Age 12-15 Age 16-19
Physical
• Growth Spurt
• Hormone Surge
Emotional
• Psycho-sexual Stress
• Self-conscious
• Ego Ideals
Cognitive
• Concrete vs Abstract Thinking
• Lack of Time Perspective
Physical
• Physical Maturity
• Hormone Balance
Emotional
• Psycho-sexual Adjustment
• Intimacy
• Self Concept
Cognitive
• Formal Operational Thought
• Time Perspective

25. Arrested Development
 Substance use of any kind slows growth
and maturation.
 Consistent use (not necessarily abuse or
dependence) effectively freezes
development.
Bottom Line:
Expectations continue to rise
with age, but ability to meet
those expectations does not.

26. Case Example
 John – 18yo male ordered to
treatment following an arrest for car-
jacking
 Using since age 12 after witnessing his
father die on Christmas Eve
 Several “incidents” along the way.
Each explained away – “not acting his
age”
 Development stunted in every way
 “Caught up” within approximately 8-10
months

27. Engaging Adolescents in
Treatment
 Recognize extent of developmental
delay
 Involve parents early and often
 Target problems caused by the drug use –
not the use initially
 Know their world, but don’t pretend you
live in it.

28. Strategies
 An immature pre-frontal cortex means teens
are not skilled at integrating information to
analyze potential outcomes in relation to
consequences
 Teens do not take information, organize it,
and understand it in the same way that adults
do—they have to learn how to do this
 Inconsistency should be the expectation until
late teens/early 20’s

29.  Important to understand that teens often fail
to heed common sense or adult warnings
because they simply may not be able to
understand and/or accept reasons that seem
logical and reasonable to adults
 NEVER assume that you and a teen are
having the same understanding of a
conversation
Strategies

30. Strategies
 Time, guidance, and experience =
ability to apply the “emotional brakes”
to decision making
 During this time of development, teens
need adult mentors and role-models
who demonstrate how to make good
decisions and how to control emotions.
 Learning the PROCESS improves the
OUTCOME

31. Strategies
 Adolescence involves the maturation
of self-regulation of behavior and
emotions—teens need to learn how to
navigate complex social situations
under conditions of strong emotions –
such as
- social anxieties, romantic relationships,
academic pressures, desires for immediate
gratification vs. long term goals, moral
dilemmas, and success/failure

32. Strategies
 Teens are not adults—Brain development is
not complete
 Teens are operating from the
emotional/impulsive/reward oriented part
of the brain
 Communication is a complicated process
 Technology is transforming the world
 Disparities between knowing/feeling and
understanding/behaving

33. “It’s relationships, not programs, that
change children. A great program
simply creates the environment for
healthy relationships to form between
adults and children.”
-- Bill Milliken
Founder and Vice Chairmen of
Communities in Schools,
author of Tough Love.

34. Questions?!
Please feel free to ask questions
that go beyond the scope of this
presentation.