Jesse Viner, MD Laura Humphrey, PhD
Jesse Vine, MD   Laura Viner, PhD

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“Minding The Brain”: A Developmental Neurobiological Model for Substance Abuse Treatment in Emerging Adults

Jesse Viner, MD, Founder and Executive Medical Director
Laura Viner, PhD

 

Prior to the turn of the 21st century, we lacked a theoretical framework for distinguishing 18 to 29 year-olds from those who are younger and older. This lack of developmental theory resulted in scant scientific research describing the mental health issues that young people in this age group face. Not surprisingly, we have very few treatment models designed to fit their mental health needs. Because substance use disorders are common in this age group, debilitating during years when much growth is expected, and an unfortunate precipitant of accidents and death, the absence of treatment models designed to fit this specific age group is particularly alarming. However, recent advances in developmental theory and neurobiological research present an opportunity to design developmentally-sensitive models for the treatment of substance abuse disorders in 18 to 29 year-olds.

The objective of this article is to introduce The Developmental Neurobiological Model for substance abuse treatment in emerging adults. Emerging adulthood (ages 18 to 29) is a transforming neurobiological and developmental maturational window during which individuals are challenged to negotiate new social prescriptions affecting the personal foundation for separateness, identity and selfintegration, and attachment patterns. This is occurring at a time when brain maturation and its neurobiological underpinnings may be in consonance with or at odds with such growth.

This article introduces a therapeutic model for the treatment of substance abuse in emerging adults informed by developmental psychology, attachment theory and research on neurobiological maturation. The model harnesses the brain’s neuroplastic capacity during this period by targeting psychotherapeutic, psychosocial and neurobiological interventions towards crucial brain networks that are in the process of developmental maturation but have been aborted and/ or distorted by substance abuse. These interventions facilitate neural network maturation in the service of fostering and reinforcing selfmastery and healthy functioning in the emerging adult.

Emerging adulthood as a distinct phase of development

Arnett (2000) introduced the term emerging adulthood to identify the developmental phase in persons ages 18-29 years. This developmental phase, according to Arnett (2004), is characterized by: 1) identity exploration, where one’s sense of self and self-identification in major life areas such as love, work and world perspective is refined and redefined; 2) generalized instability in all areas of life with uncertainty of future possibilities and potential life paths; 3) a state of in-between adolescence and adulthood; 4) self-focus with a shift toward greater individual identity, personal power, self-regulation and self-agency; and 5) possibilities and risks with risk factors peaking and biological, psychological and sociocultural influences emerging that may be uniquely destabilizing to this age group.

Tanner’s (2006) concept of recentering complements Arnett’s theory by integrating emerging adulthood into the individual life span, and reframing the concept of transition into adulthood as a three-stage process that involves leaving adolescence, experiencing emerging adulthood, and entering young adulthood. Tanner describes an individualized developmental trajectory by which the emerging adult must: 1) separate from family and form primary attachments with peers and other adults; 2) transition from child and adolescent dependencies to engage with the larger world; 3) consolidate a resilient regard for self and identity as a capable and valued member of society; 4) launch a relatively self-sufficient career and life; and 5) develop effective, goaldirected, self-regulated life skills.

Neuroscience research has shown that normal brain maturation in emerging adults parallels the increasing complexity of these developmental and psychosocial demands. The primary, organizing purpose of brain formation and growth throughout the lifespan is to evolve an increasingly complex and higher-order representation of self and self in relation to the world (Siegel, 1999). Identity formation is a critical biological process for survival and adaptation, and emerging adulthood is a pivotal period in the maturation of attachment patterns (e.g., secure, anxious-avoidant, ambivalent, disorganized), which in turn affect self-integration and emotional regulation. The self does not develop optimally in isolation, but within the context of relationships which provide affirming, soothing and vitalizing functions as well as new learning. Siegel asserted that “human connections shape neural connections.” This process can be both aborted and distorted when attachment patterns become organized around substances.