TEENAGE SUBSTANCE ABUSE

Teenage substance abuse and crime

Teenage substance abuse and crime

Introduction

Recent theories of substance use and addiction are heavily influenced by representations of substance-use behaviors and their association with reinforcing outcomes. Although not explicitly cognitive, incentive motivation theories of substance use are based on anticipation or memory of positive or reinforcing consequences of a behavior. Behavioral choice theory provides another associative learning theory of addictive behavior. According to behavioral choice theories, preference for substance use depends on both the reinforcing outcome associated with substance use and the potential reinforcing outcomes of other activities. Both incentive motivation and behavioral choice theories postulate that substance use is governed by learned associations between actions and outcomes. Whereas incentive theories of addiction focus on the uniquely powerful or qualitatively distinct reinforcement value of abused substances arising from their direct action in particular brain regions, behavioral choice theories emphasize preference for an activity within the context of other activities and the availability of reinforcing substitutes. The analytical approach is behavioral, but the theory assumes cognitive representations of behavior-outcome associations. It is worth noting here that incentive motivation and behavioral choice theories do not necessarily involve conscious or rational decision making. Implicit cognition methods may be particularly powerful tools for investigating the unconscious influences on behavior choice.

Discussion & Analyses

There have been a number of approaches to measuring cognitive changes that predict substance use. Our focus is on associative memories about substance use and alternative behaviors. The measures researchers use include both explicit outcome expectancies, implicit behavioral associates, and ambiguous word associations. Using the expectancy paradigm, studies in teenagers have shown that alcohol-related associations are formed prior to drinking initiation and that positive alcohol outcome expectancies prospectively predict consumption in adolescent drinkers. Alcohol outcome expectancies (1) correlate with alcohol use, (2) predate actual drinking experience, (3) predict future drinking, (4) are modified by drinking experiences, and (5) mediate other antecedent influences. Implicit measures of substance-use associations also reveal a strong proximal relationship with substance use (Lopez, Katsulis & Robillard, 2009). Evidence from alcohol use in teenagers demonstrates that implicit measures of substance-use memory associations (1) correlate independently with alcohol use when demographic and other cognitive variables are controlled, (2) change before substance use begins, and (3) predict future drinking independently of demographic, personality, and other cognitive variables.

Implicit memory methods provide new measures to assess associations between substance use and its anticipated outcomes that are reflective of incentive motivations and behavioral reinforcer associations underlying choice. Indeed, measuring behavior-outcome associations without explicit awareness may overcome resistance in the assessment process. Implicit methods may also access memories that are inaccessible to awareness and reveal unconscious influences on behavior. Implicit cognition may be particularly important in adolescence, a developmental stage marked by impulsivity, risk-taking, and novelty-seeking. Such behaviors are more easily influenced by unconscious processes and are related to levels of early substance use (Apa-Hall, Schwartz-Bloom McConnell, 2008). The relative lack of preplanning in teenagers underscores the importance of prevention programs that identify the implicit factors influencing impulsive substance ...