The neurobiology of impulsivity and substance use disorders: implications for treatment. Issue 1 (5th October 2018)

• Record Type: Journal Article
• Authors: Kozak, Karolina; Lucatch, Aliya M.; Lowe, Darby J.E.; Balodis, Iris M.; MacKillop, James; George, Tony P.
• Editors: Uhl, George R.
• Is Part Of: Annals of the New York Academy of Sciences. Volume 1451:Issue 1(2019)
• Page Start: 71
• Page End: 91
• Publication Date: 2018-10-05
• Subjects: impulsivity -- substance use disorders -- treatment -- tobacco -- cannabis -- alcohol; Medical sciences -- Periodicals; Medicine -- Periodicals; Science -- Periodicals; 610
• DOI: 10.1111/nyas.13977
• Languages: English
• ISSNs: 0077-8923

Abstract

Abstract: Impulsivity is strongly associated with substance use disorders (SUDs). Our review discusses impulsivity as an underlying vulnerability marker for SUDs, and treatment of co‐occurring impulsivity in SUDs. Three factors should be considered for the complex relationship between impulsivity and a SUD: (1) the trait effect of impulsivity, centering on decreased cognitive and response inhibition, (2) the state effect resulting from either acute or chronic substance use on brain structure and function, and (3) the genetic and environmental factors (e.g., age and sex) may influence impulsive behavior associated with SUDs. Both subjective and objective measures are used to assess impulsivity. Together, treatment developments (pharmacological, behavioral, and neurophysiological) should consider these clinically relevant dimensions assessed by a variety of measures, which have implications for treatment matching in individuals with SUD. Despite its heterogeneity, impulsivity is a marker associated with SUDs and may be understood as an imbalance of bottom‐up and top‐down neural systems. Further investigation of these relationships may lead to more effective SUD treatments. Abstract : Despite its heterogeneity, impulsivity is a marker associated with substance use disorders (SUDs) and may be understood as an imbalance of bottom‐up and top‐down neural systems. Our review discusses the multifaceted construct of impulsivity as an underlying vulnerability marker within the various stages of SUDs. We emphasize a transdiagnostic model for understanding impulsivity and addiction risk.