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TRANSCRIPT
Understanding the Social and Biological Aspects of Adolescent Development: The Implications for
Substance Use Prevention
Jason Burrow-Sánchez, PhDProfessor | Dept. Educational Psychology
Director | MP Prevention Technology Transfer CenterUniversity of Utah
June 19, 2019Utah Coalition Training Summit 2019
https://pttcnetwork.org/mountainplains
Key Questions
• What are the prevalence rates for adolescent substance use and substance use disorders?
• What are important biological and socialdevelopmental markers for adolescents?
• How do we connect prevention programming with developmental markers?
SAMHSA’s Strategic Prevention Framework• Comprehensive
Planning Process – to prevent substance use/misuse
• 5 Steps and 2 Guiding Principles
Source: https://www.samhsa.gov/capt/applying-strategic-prevention-framework
IOM Continuum of Care
Source: IOM, Mrazek & Haggerty, 1994
Prevention Triangle
Primary Prevention“Universal”
Secondary Prevention“Selective”
Tertiary Prevention“Indicated”
Source: Walker et al., 1996
80%
15%
5%
18.1 18.1
12.4
9.4
6.46.7
8.6
6.1
2.1 2.1
Alcohol E-Cigarette Marijuana Cigarette Prescp Rx
6, 8, 10, 12th Grades - Utah
Lifetime 30-Day
Source: SHARP Survey Data, 2017
Age/Grade
Use
31.8 32.1
25
16.3
9.2
14.7 15.5
12.3
4.63
Alcohol E-Cigarette Marijuana Cigarette Prescp Rx
12th Grade - Utah
Lifetime 30-Day
Source: SHARP Survey Data, 2017
42.5
34 34.1
15.6
26.7
20.9
13.5
7.5
Vaping (Any) Vaping Nic Vaping Flav Vaping Mar
12th Grade
Lifetime 30-Day
Source: Johnston et al., 2019 – Monitoring the Future
Source: Utah DSAMH 2016 Annual Report – 2014/15 SAMHSA & SHARP Data
12,080
1,326
SUD
Num
ber o
f You
thUtah Youth Treatment Need vs. Received
NEED TX RECEIVE TX
Why is Adolescent Brain Development Important?
Image Source: NIDA, www.drugabuse.gov
Major Parts of the Adolescent Brain• Cortex Area
• Prefrontal Cortex
• Limbic Area• Emotion
• Amygdala (fear, anger)• Hippocampus (new
memories)• Hypothalamus (hormones)
• Brain Stem• Keeps us alive
Content Source: Walsh, 2013Image Source: NIDA, www.drugabuse.gov
Reward Pathway
Image Source: NIDA, www.drugabuse.gov
Image Source: NIDA, www.drugabuse.gov
Source: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
Adolescent Risk Taking, Impulsivity, and Cognitive Control• Risk taking
• Engage in sensation-seeking behaviors • Adolescents engage in more risk-taking than younger or older
age groups
• Impulsivity• Correlates with risk-taking• Emotional rather than cognitive process
• Cognitive Control• Consequential thinking, decision making, problem solving
Source: Boucher & Sandhu (2013)
Puberty
Major Psychological Tasks
• Identity Development• Self
• “How do I see myself?”
• Others• “How do I see others?”• “How do others see me?”
• World• “How do I see the world?”• “How does the world see me?”
Identity Worksheet
Descriptors
Evaluation
Self
Others
“+” or “‐”
Source: Burrow-Sánchez et al., 2015
Social Markers of Adolescent Development• Age-based social markers:
• 13: Teenager
• 16: Driver’s License
• 18: Adult• Vote• May or may not be eligible for youth/adolescent
programming• Join Military
• 18-21: Use Tobacco Products Legally
• 21: Use Alcohol Legally
Adolescent Development
Birth Puberty Adolescence Young Adulthood
0 11-13 13-18 19 >
Adolescent
Family
Peers School
Community
Neighborhood
Societal Norms
Laws
Geographic Differences
Prevention of Substance Use• Prevent youth from using the substance
“Have you ever used a substance?”
• Prevent the delay of onset of substance use“When did you first use the substance?”
• Prevent the use of substances from becoming more severe
“How do you decrease the use of a substance?”
Perceived Risk and Substance Use
• Perceived risk of using a substance• Higher risk correlates with lower use
• Disapproval of using a substance• Higher disapproval correlates with lower use• Peer versus parental disapproval
• Use of a substance• Higher risk and disapproval correlates with less use
4.71%
4.99%
5.94%
5.76%
6.46%
8.80%
9.02%
36.57%
27.78%
27.66%
26.54%
25.75%
20.91%
16.21%
Utah
North Dakota
South Dakota
Wyoming
Total U.S.
Montana
Colorado
Perception of Risk Versus Use of Marijuana: Past 30 Days
12-17 Risk 12-17 Use
Source: National Survey on Drug Use and Health, SAMHSA, 2016-17 State Estimates
Source: Tsai et al., 2018
37.5
32.3
17.4
4.7
43.7
26.8
16.1
5.2
Friend/Family Use
Flavors
Less Harmful
Easier to Get
Reasons for Vaping
Middle School High School
Prevention (and Intervention) Principles
• Prevention is important• Prevent substance use or prevent problem from worsening
• Teach about changes in body and brain• Developmental growth periods• Effects of substances on brain/body
• Teach emotional regulation• Anxiety, anger, and negative moods
• Teach problem-solving and decision-making skills• Understanding consequences, choices, and planning of behavior
• Teach influence of contextual pressure• Peer pressure, social media, advertising
Ages, Developmental Tasks, & Areas of Intervention
Ages Developmental Tasks Intervention Areas
12-14 Identity, risk taking/impulsivity, emotional regulation
Emotional regulation,problem-solving, decision-making, peer relations
15-17 Identity, individuation, connection, exploration
Problem-solving,decision-making, etc.
18-20 Identity, school-to-work(school)
Goal setting, school and vocation skills
21-24 Identity, early adulthoodStability, goal attainment, transitions from school or work
Thank You!!
Jason Burrow-Sánchez, PhDEmail: [email protected]