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Downloaded from UvA-DARE, the institutional repository of the University of Amsterdam (UvA) http://hdl.handle.net/11245/2.161587 File ID Filename Version uvapub:161587 Back matter final SOURCE (OR PART OF THE FOLLOWING SOURCE): Type PhD thesis Title Now is the time for reward! The developmental relationship between cognitive-motivational factors and adolescent substance use Author(s) T. Janssen Faculty FMG: Psychology Research Institute Year 2015 FULL BIBLIOGRAPHIC DETAILS: http://hdl.handle.net/11245/1.477411 Copyright It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content licence (like Creative Commons). UvA-DARE is a service provided by the library of the University of Amsterdam (http://dare.uva.nl) (pagedate: 2015-06-08)

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SUMMARY IN DUTCH

De algemene doelen van deze dissertatie waren om te onderzoeken of specifiek geselecteerde cognitieve- en omgevingsfactoren samengingen met de ontwikkeling van middelengebruik gedurende adolescentie. Adolescentie wordt vaak beschreven als een cruciale en risicovolle ontwikkelingsperiode waarin jongeren een toegenomen neiging tot risicogedrag vertonen. Het is in eerder onderzoek aangetoond dat middelengebruik samenhangt met verschillen in hersenfunctie, executief functioneren (oftewel het vermogen om gedrag te beheersen en te reguleren) en andere onderdelen van cognitie. Het is echter niet altijd duidelijk of deze verschillen voorafgaan aan middelengebruik, of ontstaan als gevolg van middelengebruik. Er zijn via recent onderzoek een aantal kernprocessen onderscheiden die in het bijzonder lijken samen te hangen met middelengebruik. Zo hebben strikte ouderregels omtrent alcoholgebruik invloed op alcoholgebruik tijdens en na adolescentie. Daarnaast zijn er risicodragende externaliserende (oorzaak zoekende buiten jezelf) en internaliserende (oorzaak zoekende binnen jezelf) persoonlijkheidstrekken die allen samenhangen met het ontstaan van middelengebruik. Ook afwijkingen in executief functioneren hangen samen met grotere hoeveelheden alcoholgebruik tijdens adolescentie. Tenslotte zijn er cognitieve afwijkingen die worden geactiveerd door bepaalde signalen uit de omgeving (denk aan geluiden en geuren die samengaan met restaurant- of barbezoek) en samengaan met een automatische gedragsverandering ten faveure van middelengebruik, die zo de kans op middelengebruik tijdens de adolescentie verhogen. Een centrale vraag in deze dissertatie is of de ontwikkeling van deze kernprocessen samengaat met de ontwikkeling van andere kernprocessen en met toename in middelengebruik. De empirische (onderzoeksresultaat-bevattende) hoofdstukken in deze dissertatie dekken deze kernprocessen af met vijf specifieke onderzoeksvragen. We gebruikten data uit een internetgebaseerd langetermijnonderzoek met vier meetpunten gespreid over twee jaar, om op deze vragen antwoord te zoeken. Bij elk meetpunt werden verschillende cognitieve processen, persoonlijkheidstrekken en omgevingsfactoren, alsook de hoeveelheid middelengebruik (met name alcohol-, tabaks- en marijuanagebruik) gemeten. Allereerst onderzochten we de rol van een belangrijke omgevingsfactor, namelijk alcoholspecifieke ouderregels, en de rol een belangrijke persoonsgerichte factor, namelijk persoonlijkheidstrekken, en de rol van een combinatie van de twee (denk: een persoonlijkheidstrek die zich vooral uit als er weinig ouderregels zijn), in de voorspelling van het ontstaan en verergeren van alcoholgebruik. Op basis van eerder onderzoek verwachtten wij dat er minder bewijs voor alcoholgebruik zou zijn als er strengere ouderregels zouden zijn. Daarnaast verwachtten we dat er meer bewijs voor alcoholgebruik zou zijn als deelnemers 203

Summary in Dutch hoger scoorden op risico-geassocieerde persoonlijkheidstrekken. Op basis van de onderzoeksresultaten concludeerden wij dat hogere scores op persoonlijkheidstrekken sensatiezucht en hopeloosheid, en laag-strikte (lakse) ouderregels voorspellend waren voor meer alcoholgebruik bij latere metingen. Er was echter geen bewijs dat bij deze deelnemers de invloed van risico-geassocieerde persoonlijkheidstrekken afhing van hoe streng de ouderregels waren. Ten tweede onderzochten we de rol van zelf aangegeven (in een vragenlijst die door de deelnemer zelf wordt ingevuld) als indirect gemeten (zoals met een computertaak die het gedrag van de deelnemer beoordeelt) onderdelen van impulsiviteit en sensatiezucht en hun samenhang met het ontstaan van middelengebruik. Op basis van eerder onderzoek verwachtten wij dat zowel zelf aangegeven als indirect gemeten onderdelen ieder op hun eigen manier voorspellen zouden zijn voor het ontstaan van middelengebruik. Wij bevonden dat, als de invloed van leeftijd en geslacht werd uitgesloten, voornamelijk zelf aangegeven onderdelen van sensatiezucht voorspellend waren voor het ontstaan van middelengebruik gedurende de meetperiode. Indirect gemeten onderdelen leken geen grote rol te hebben. Ten derde onderzochten we de rol van twee indirect gemeten onderdelen van executief functioneren (werkgeheugencapaciteit en responsinhibitie, oftewel het vermogen een initiële reactie niet door te zetten) en hun verband met het ontstaan van alcoholgebruik en binge-drinken. Op basis van eerder onderzoek verwachtten wij dat slechte prestaties op beide onderdelen voorspellend zouden zijn voor het ontstaan van alcoholgebruik en binge-drinken op jongere leeftijd. De resultaten van ons onderzoek lieten zien dat slechte prestaties op deze twee onderdelen inderdaad voorspellend waren voor een vroeger ontstaan van alcoholgebruik, terwijl specifiek werkgeheugencapaciteit voorspellend was voor een vroeger ontstaan van binge-drinken. Ten vierde onderzochten wij langetermijnrelaties tussen onderdelen van impulsiviteit en indirect gemeten alcoholspecifieke cognitieve afwijkingen, en de langetermijnrelatie tussen deze cognitieve afwijkingen en later optredende verschillen in alcoholgebruik. Op basis van eerder onderzoek verwachtten wij dat bij meer blijk van impulsiviteit en meer alcoholgebruik, de kans op aanwezigheid van cognitieve afwijkingen zou toenemen. Daarnaast verwachtten we dat een grotere hoeveelheid cognitieve afwijking, op lange termijn voorspellend zou zijn voor een toename in alcoholgebruik. We bevonden dat hogere scores op een maat voor cognitieve afwijkingen in de aandacht (de zogeheten visuele-probe-taak) op lange termijn voorspellend waren voor een grotere mate van alcoholgebruik bij onze deelnemers. Echter waren er geen 204

indicaties dat eerder alcoholgebruik of eerdere hoge scores op onderdelen van impulsiviteit, op lange termijn voorspellend waren voor een toename in cognitieve afwijkingen. Ten vijfde onderzochten we of de ontwikkeling van indirect gemeten toenaderingsafwijkingen (oftewel de automatische neiging om alcoholbronnen te benaderen en te consumeren) samenhing met de ontwikkeling van alcoholgebruik. Op basis van eerder onderzoek voorspelden wij dat het intercept van cognitieve afwijkingen (oftewel verschillen in het basisniveau aan cognitieve afwijkingen) zou samenhangen met zowel het intercept van alcoholgebruik, als de toename van alcoholgebruik gedurende het verloop van het onderzoek. Ook voorspelden wij dat de toename in cognitieve afwijkingen zou samenhangen met het intercept van alcoholgebruik en met de toename in alcoholgebruik. Ten slotte voorspelden wij dat deze samenhangen sterker zouden zijn (zodat verschillen in cognitieve afwijkingen en verschillen in alcoholgebruik meer met elkaar in overeenstemming zouden zijn) als die deelnemer slechte prestaties op gebied van werkgeheugencapaciteit liet zien. Wij bevonden dat het intercept van cognitieve afwijkingen samenhing met het intercept van alcoholgebruik, maar dat er geen indicaties waren voor samenhang tussen toenames in elk proces. Bovendien waren er geen indicaties dat de aard van deze samenhang afhing van werkgeheugencapaciteit. In het algemeen concludeerden wij dat er bewijs was dat individuele verschillen in zowel indirect gemeten, als zelf aangegeven cognitieve processen voorspellend waren voor verschillen in middelengebruik. Echter was er weinig bewijs bij deze deelnemers dat het omgekeerde ook gebeurde: dat eerder alcoholgebruik voorspellend was voor veranderingen in deze cognitieve processen. Interessant genoeg was dit ook het geval bij cognitieve afwijkingen, waarvan over het algemeen wordt aangenomen dat ze het gevolg zijn van beloonde leerervaringen na het innemen van middelen. In deze dissertatie geven wij echter ook aan dat problemen met het accuraat meten van indirect gemeten processen mogelijk hier invloed gehad op kunnen hebben. 205

ACKNOWLEDGEMENTS

In Memoriam This dissertation is dedicated to the memory of Mark D. Wood, recently and suddenly taken from life at age 54. As father, mentor, professor, life enthusiast, generous and hospitable friend, loving husband and diligent academic, he improved and enriched the lives of family, friends, and colleagues. I will miss him always.