Table Of ContentADOLESCENT ADDICTION
Practical Resources for the Mental Health
Professional
ADOLESCENT
ADDICTION
Epidemiology,
Assessment, and
Treatment
SECOND EDITION
Edited by
Cecilia A. Essau
Department of Psychology, University of Roehampton, Whitelands College, London,
United Kingdom
Paul H. Delfabbro
School of Psychology, The University of Adelaide, Adelaide, SA, Australia
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Contributors
Abdul Rahman Ahmad Badayai Faculty of Social Sciences and Humanities, The
National University of Malaysia, Bangi, Malaysia
Nadzirah Ahmad Basri Kulliyyah of Medicine, International Islamic University
Malaysia, Kuantan Campus, Kuantan, Malaysia
Katrina Champion The Matilda Centre for Research in Mental Health and Sub-
stance Use, The University of Sydney, Sydney, NSW, Australia
Yoke Yong Chen Department of Psychological Medicine, Faculty of Medicine
and Health Sciences, University Malaysia Sarawak, Malaysia
Genevieve F. Dash Department of Psychological Sciences, University of
Missouri-Columbia, Columbia, MO, United States
Louisa Degenhardt National Drug and Alcohol Research Centre, University of
New South Wales, Sydney, NSW, Australia
Paul H. Delfabbro School of Psychology, The University of Adelaide, Adelaide,
SA, Australia
Cecilia A. Essau Department of Psychology, University of Roehampton,
Whitelands College, London, United Kingdom
Sarah W. Feldstein Ewing Department of Child and Adolescent Psychiatry,
Oregon Health and Science University, Portland, OR, United States
Jessica Furtado Department of Family Relations and Applied Nutrition, Univer-
sity of Guelph, Guelph, ON, Canada
Wayne Hall Centre for Youth Substance Abuse Research, University of
Queensland, St Lucia, QLD, Australia
Sarah Head Department of Family Relations and Applied Nutrition, University
of Guelph, Guelph, ON, Canada
Cecilie Juul Hinze Centre for Telepsychiatry, Mental Health Services in the
Region of Southern Denmark, Odense, Denmark
Delyse Hutchinson Faculty of Health, School of Psychology, Centre for Social
and Early Emotional Development, Deakin University, Geelong, VIC; National
Drug and Alcohol Research Centre, University of New South Wales, Sydney,
NSW; Murdoch Children’s Research Institute, Centre for Adolescent Health,
Royal Children’s Hospital, Melbourne, VIC; Department of Paediatrics, Univer-
sity of Melbourne, Royal Children's Hospital, Melbourne, VIC, Australia
Daniel L. King College of Education, Psychology, and Social Work, Flinders
University, Adelaide, SA, Australia
Janni Leung School of Psychology, University of Queensland, St Lucia, QLD,
Australia
ix
x Contributors
Mia Beck Lichtenstein Department of Clinical Research, University of Southern
Denmark; Centre for Telepsychiatry, Mental Health Services in the Region of
Southern Denmark, Odense, Denmark
Dennis Long Breakaway Addiction Services, Toronto, ON, Canada
Paul McArdle Children and Young Peoples' Service, Northumberland Tyne and
Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
Nicola C. Newton The Matilda Centre for Research in Mental Health and Sub-
stance Use, The University of Sydney, Sydney, NSW, Australia
Michèle Preyde Department of Family Relations and Applied Nutrition,
University of Guelph, Guelph, ON, Canada
Jennifer A. Silvers Department of Psychology, University of California Los
Angeles, Los Angeles, CA, United States
Steve Sussman Institute for Health Promotion & Disease Prevention Research,
Preventive Medicine, Psychology, & Social Work, University of Southern
California, Los Angeles, CA, United States
Samantha Teague Faculty of Health, School of Psychology, Centre for Social and
Early Emotional Development, Deakin University, Geelong, VIC, Australia
Kristine Rømer Thomsen Department of Psychology and Behavioral Sciences,
Center for Alcohol and Drug Research, Aarhus University, Aarhus C, Denmark
Chuong Hock Ting Department of Psychological Medicine, Faculty of Medicine
and Health Sciences, University Malaysia Sarawak, Malaysia
Jennifer Y. Tsai Institute for Health Promotion & Disease Prevention Research,
Preventive Medicine, Psychology, & Social Work, University of Southern
California, Los Angeles, CA, United States
Suzaily Wahab The National University of Malaysia Medical Centre, Cheras,
Malaysia
Preface
It is now a decade since the original edition of Adolescent Addiction
was published in 2008. Since then, there has been rapid growth in the lit-
erature relating to adolescent edition with the emergence of several new
major journals, including the Journal of Behavioral Addictions and the
International Journal of Mental Health and Addiction. More broadly, there
have been significant political changes within the world which have influ-
enced how addiction has been treated at a policy level. In some countries,
we have witnessed the emergence of strongly conservative governments
that have been content to retain the status quo (e.g., a tough stance on
drugs). In others (e.g., Canada and Portugal), we have witnessed the emer-
gence of more progressive approaches that have taken a stronger health
and de-criminalization approach to drug use. Across the world, there has
been a strong emphasis on public health approaches to influence smoking
rates and curb the overuse of alcohol (e.g., United Kingdom, Australia,
Canada, and Scandinavia). There has also been growing interest in adopt-
ing a child protection approach to adolescent addiction with the promo-
tion or advertising of activities such as gambling to young people which
has been seen as an area of interest for consumer law as well as classifica-
tion standards.
Many areas of addiction have changed during this period.
Smoking: Smoking rates in young people have decreased in many
Western countries (United States, Canada, UA, and Australia), but similar
changes do not appear to be observed in other parts of the world (e.g.,
in Asia). Evidence also suggests a decreasing gap in the smoking rates
observed for boys and girls, so that there is a need for a greater focus
on the role of gender in the development of smoking habits. Modern re-
search also needs to take into account the growing popularity of vaping
and other infusion methods or e-cigarettes.
Gambling: Many studies are observing significant declines in rates of
gambling and problem gambling in young people under the age of 18. This
change appears to be due to decreasing interest in land-based forms of gam-
bling and young people’s greater preoccupation with technology-based ac-
tivities. Many video games and apps available on phones make extensive
use of micro-transaction models which mirror some of the strategies used
by the gambling industry. Such models encourage people to spend money,
so it is not surprising to find that young people may have less disposable
income for traditional forms of gambling (e.g., slot machines or lotteries).
xi
xii Preface
Alcohol: Many countries including Australia have reported changes in
how alcohol is marketed and promoted to young people. Attention has
switched away from traditional drinks such as spirits, wine, or beer to-
ward premixed drinks which combine soft drinks and alcohol (Alcopops).
Video games: Video games have changed substantially in the last decade.
Massive online games are much more common and popular than in the
2000s and there are now e-sports tournaments where players can compete
for monetary prizes. There is also now a betting industry associated with
these activities (e-sports betting) as well as a range of third party operators
who profit from the popularity of video games and their features, e.g.,
skins trading and betting. Gambling-like prizes are also increasingly be-
ing inserted into live streaming services such as Twitch where people can
watch video games being played.
Gambling: The gambling industry has changed significantly in the last
10 years. Young people are now increasingly exposed to gambling-like
content, often in video game contexts or when they are using iPads or
iPhones. Simulated gambling activities (often called social casino games)
are available on social media sites such as Facebook. There are also ded-
icated video game modules, gambling-like games or content embedded
within video games (Loot boxes), and now a range of activities such as
Fantasy Sports which can be played by young people and then wagered
on once they turn 18.
Assessment issues: There has been considerable discussion and develop-
ment work into measures to capture excessive video gaming or Internet
activity. None of this new work is captured by the original addition of
the book. The new edition will also enable authors to ensure that recom-
mended assessment tools reflect current best practice in the field.
Broader research developments: There has been considerable growth in the
neuropsychology literature relating to addiction as well as conceptual de-
velopments in understanding the etiology of problematic activities during
adolescence. In addition to established, developmental, and ecological
models, there are also now life-course models which examine how signifi-
cant events or individuals may change the trajectory of young people’s in-
volvement in certain activities or developmental trajectories. Public health
perspectives now strongly underscore many research programs relating
to adolescent addiction.
Treatment: A broader range of research is now available to understand
the best methods for treating adolescent addiction. Many of the new and
emerging behaviors (e.g., Internet and video game-related behaviors)
have received much greater attention over the last few years. However,
well-validated and effective treatments for newly technology-related be-
haviors appear to require further development. It is likely that develop-
ments in this area will feature more strongly in future editions of this book.
Already, there is evidence of a greater focus on using modern technologies
Preface xiii
to deliver more suitable interventions for young people who may not be so
likely to seek assistance from conventional face-to-face treatment services.
Like its first edition, this volume is divided into three main sections.
Part one will address the foundations of addictive problems, including
developmental, social, and neurobiological factors. Part two will address
eight common addictive problems among adolescents: Alcohol addiction;
Drug addiction; Nicotine and e-cigarettes addiction; Gambling addiction;
Internet and video game addiction; Sexual addiction; Smartphone addic-
tion; and Exercise addiction. Each of these chapters will follow the same
format:
‐ Introduction and clinical characteristics
‐ Screening and clinical assessment methods
‐ Epidemiology, comorbidity, and course and outcome
‐ Protective and risk factors
‐ Evidence-based clinical strategies for prevention and treatment
‐ Concise summary of key clinical points
Part three will discuss challenges and recommendations for future re-
search in adolescent addiction.
The wealth of information concerning the definition, prevalence, co-
morbidity, course, risk factors, prevention, and intervention of the various
types of adolescent addictions will make this volume a valuable reference
for both the novice and the expert and for both the clinicians and the re-
searchers interested in this field. It is hoped that this volume will, not only
serve to illustrate our current knowledge of adolescent addictions, but
may also stimulate further research, which may contribute to an improved
understanding of these problems.
We are most grateful to the authors who have contributed to this vol-
ume, all of whom have made major contribution to the field of adolescent
addiction. We are especially honored by their contributions and dedica-
tion to this book project, and more importantly, by their enhancement
of our understanding of adolescent addiction. We would also like to ac-
knowledge the support and patience of the staff at Elsevier Science Ltd.
Cecilia A. Essau
Paul H. Delfabbro
Index
Note: Page numbers followed by f indicate figures and t indicate tables.
A Health Behaviour in School-Aged
Abstract reasoning, 27–28 Children (HBSC) Study, 50
Addiction-related problems, 3 high-risk populations, selective
Adolescent brain, 23–24 interventions, 88–91
Adolescent sexual addiction, 244 indigenous youth, 89–90
Alcohol Policy Scale, 79–80 individual risk factors
Alcohol Use Disorder (AUD) behavioral and emotional
Australian Secondary Students’ Alcohol problems, 59–60
and Drug Survey (ASSAD), 50 early adolescent alcohol
Avon Longitudinal Study of Parents and initiation, 60–61
Children (ALSPAC), 54 impulsive and antisocial personality
broader societal factors, 79–80 traits, 59–60
and Cannabis Use Disorder (CUD), internalizing and alcohol
54–55 problems, 59–60
Christchurch Health and Development negative affect pathway, 59–60
Study (CHDS), 53–54 prenatal exposure to alcohol, 62–64
college/university population sex and sexual identity, 61–62
interventions internalizing disorders, 53–54
eHealth interventions, 92–93 levels of risk, 81
motivational interventions, 91–92 and major depression disorder (MDD), 54
comorbidity, 53–55 Monitoring the Future Study (MTF)
and comorbid psychiatric disorders, 54 survey, 47–48
Composite International Diagnostic National Comorbidity
Interview (CIDI), 52 Survey-Adolescent Supplement
consequences, 56–57 (NCS-A), 52
craving and tolerance, 46 National Health Service (UK), 49
Diagnostic Statistical Manual of Mental National Survey on Drug Use and Health
Disorders 4th (DSM-IV) criteria, (NSDUH), 48
51–52 National Youth Risk Behaviour Survey
disability-adjusted life-years (DALY), 47 (YRBS), 48–49
epidemiological studies, 51 Oregon Adolescent Depression Project
European Schools Project survey, 49 (OADP), 54–55
evidence-based prevention, 81 parenting factors, 51
externalizing disorders, 53–54 behavior management, 70–72
family risk factors environmental influences, 68–69
family functioning, 67–68 parent-adolescent relationship
family structure, 64–65 quality, 72–73
socioeconomic background, 65–67 parental attitudes, 73–74
gateway model, 54–55 parental drinking, 74
genetic and environmental factors, 55 parental monitoring, 69–70
Global School-based Student Health parental supply of alcohol, 75–76
Survey (GSHS), 50–51 parental support and involvement, 69
335
336 Index
Alcohol Use Disorder (AUD) (Continued) in low- and middle-income countries,
peer environment, 76–78 114–115
prevalence rates, 47, 52–53 media campaigns, 123–124
problem behavior theory, 55 patterns of drug use, 116
selective preventive interventions, 81 peer affiliations, 123
self-medication hypothesis, 55 pharmacological effects, 117
social-ecological framework, 57–58, 58f prevalence, 115
spectrum of alcohol use, abuse, and psychosocial consequences, 115
dependence, 46, 46f risk factors, 121, 123
symptoms, 51–52 and schizophrenia, 120
Treatment Episode Data Set school and community
(TEDS), 53 interventions, 124
universal school-based interventions, self-medication hypothesis, 121
81–88 social and contextual factors, 121–122
AUD. See Alcohol Use Disorder (AUD) social environmental hypothesis, 116
Australian Parental Supply of Alcohol treatment, 125–128, 126–127t
Longitudinal Study (APSALS), CDC Best Practices for Comprehensive
61, 76 Tobacco Control Programs 2014, 147
Australian Secondary Students’ Alcohol Centrality indices, 303
and Drug Survey (ASSAD), 50 Christchurch Health and Development
Avon Longitudinal Study of Parents and Study (CHDS), 53–54
Children (ALSPAC), 54 Cognitive behavior therapy (CBT), 149, 176,
200–201
B Cognitive control, 25
Behavioral addictions, 3–5, 188, 216–218, Cognitive flexibility, 25
228, 232–233, 241, 282 Communities Mobilizing for Change on
Behavioral disinhibition pathway, 59–60 Alcohol (CMCA), 90
Behavioral research, 27 Comorbidity
Big Five personality traits, 196, 228 of addictive problems and psychiatric
Binge drinking, 45, 47–48, 61, 65–66, 70, disorders, 304–305
87–88 in adolescents, 292
BOLD response, 30 alcohol use disorder (AUD), 54
Brief Alcohol Screening and Intervention assessment bias, 302–304
for College Students (BASICS) assessment implications, 305–307
model, 91–92 bridges and nodes, 303
Brief Screener for Tobacco, Alcohol, and centrality indices, 303
Other Drugs (BSTAD), 141 in substance use disorder (SUD)
Burden and health outcomes, 9–11 and anxiety disorders, 294–295
and attention-deficit/hyperactivity
C disorder, 297–299
Campaign for Tobacco-Free Kids, 147 conduct disorder and oppositional
Cannabis use disorders (CUD), 10, 20, 22, defiant disorder (ODD), 296–297
54–55 and depressive disorders, 295–296
adolescent educational outcomes, and psychiatric disorders, 293
118–119 temporal sequence, 299–302
common liability hypothesis, 116 training implications, 310
and depression, 119 treatment implications, 307–309
diagnostic criteria, 111–113 Comorbid mental health disorders, 5
family factors, 122 Composite International Diagnostic
genetic vulnerability, 117 Interview (CIDI), 52
individual factors, 122–123 Compulsive sexual behavior, 241, 244, 251
longitudinal studies, 115 CUD. See Cannabis use disorders (CUD)
