The Ups and Downs of Relating Nondrug Reward Activation to Substance Use Risk in Adolescents
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ADOLESECNT/YOUNG ADULT ADDICTION (M HEITZEG, SECTION EDITOR)
The Ups and Downs of Relating Nondrug Reward Activation to Substance Use Risk in Adolescents James M. Bjork 1 Published online: 7 August 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose of Review A wealth of epidemiological and cohort research, together with a healthy dose of anecdote, has characterized late adolescence and emerging adulthood as a time of increased substance use and other risky behaviors. This review will address whether differences between adolescents or between adolescents and other age groups in dopaminergic mesolimbic recruitment by (nondrug) rewards inferred from functional magnetic resonance imaging (fMRI) could partially explain morbidity and mortality from risky-behavior-related causes in adolescents. Recent Findings Recent findings do not suggest a definitive directionality with regard to whether increased vs decreased mesolimbic responsiveness to nondrug rewards correlates with real-world risk-taking. Inconsistent relationships between reward activation and real-world risky behavior in these reports reflect in part methodological differences as well as conceptual differences between populations in terms of whether tepid mesolimbic recruitment by rewards is a marker of psychiatric health. Summary There are several potential reasons why the directionality of relationships between reward-elicited brain activation and substance use risk (specifically) might differ. These factors include differences between adolescents in histories/exposure of substance use, motivation for substance use, the component of the instrumental behavior being studied, and the cognitive demands of the incentive tasks. Systematic manipulation of these discrepant study factors might offer a way forward to clarify how motivational neurocircuit function relates to addiction risk in adolescents. Keywords Reward . Adolescence . Risk-taking . Addiction . fMRI . Motivation
Introduction Teenagers complain there’s nothing to do, then stay out all night doing it. ~Bob Phillips
This article is part of the Topical collection on Adolesecnt/Young Adult Addiction * James M. Bjork [email protected] 1
Institute for Drug and Alcohol Studies, Department of Psychiatry, Virginia Commonwealth University, 203 E Cary St, Room 202, Richmond, VA 23219, USA
Substance use disorder (SUD) imposes devastating costs to health, quality of life, and economic productivity worldwide and frequently has its origins in adolescent onset of substance use. Notably, earlier onset of substance use in adolescence has been extensively linked to increased odds of SUD (e.g., [1, 2]). Cohort studies have attributed this linkage in part to a core propensity for externalizing behavior that would promote precocious substance use as well as subsequent loss of control [3]. Therefore, understanding environmental and neurodevelopmental causes of adolescent substance use has been a top public health and biomedical research concern. One key focus in the effort has been to use functional magnet
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