Impulsivities and addictions: a multidimensional integrative framework informing assessment and interventions for substance use disorders

Abstract

Impulse control is becoming a critical survival skill for the twenty-first century. Impulsivity is implicated in virtually all externalizing behaviours and disorders, and figures prominently in the aetiology and long-term sequelae of substance use disorders (SUDs). Despite its robust clinical and predictive validity, the study of impulsivity is complicated by its multidimensional nature, characterized by a variety of trait-like personality dimensions, as well as by more state-dependent neurocognitive dimensions, with variable convergence across measures. This review provides a hierarchical framework for linking self-report and neurocognitive measures to latent constructs of impulsivity and, in turn, to different psychopathology vulnerabilities, including substance-specific addictions and comorbidities. Impulsivity dimensions are presented as novel behavioural targets for prevention and intervention. Novel treatment approaches addressing domains of impulsivity are reviewed and recommendations for future directions in research and clinical interventions for SUDs are offered. This article is part of the theme issue ‘Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications’.

Testing the factor structure underlying behavior using joint cognitive models: Impulsivity in delay discounting and Cambridge gambling tasks.

“…Relation to behavioral metrics of performance on IGT and BART were not significant, though they may be connected to model parameters of these tasks if these additional tasks were to be modeled. to target multiple avenues leading to substance dependence (Vassileva & Conrod, 2018). Solving the problem of what creates the diverging factors between CGT and DDT measures of impulsivity is likely to require extensions of empirical paradigms to whittle the difference between tasks down to key factors.…”

Presynaptic dopamine function measured with [18F]fluorodopa and L-DOPA effects on impulsive choice

“…The identification of mutual as well as unique neural underpinnings of different facets of impulsive choice will advance our understanding of impulsivity and may also offer new insights into related mental health problems. In fact, impulsive choice has already been considered as a promising target for the development of more effective interventions across mental disorders 34,35 .…”

Consumo de substancias durante el embarazo y dimensiones de personalidad

“…Por último, la asociación entre psicoticismo y consumo de substancias durante el embarazo puede ser atribuido a que esta dimensión está relacionada con la impulsividad y con medir escaso razonamiento y prioridad Kuntsche et al, 2008). La impulsividad ha sido considerada un factor de vulnerabilidad para el consumo de substancias (Vassileva y Conrod, 2019), e incluso algunas teorías de la adicción la conceptualizan como un síndrome del control de los impulsos (Conrod y Nicolau, 2016). De hecho, la triada búsqueda de sensaciones, ansiedad, e impulsividad se han encontrado asociadas de forma repetida con el consumo de substancias (Crews y Boettiger, 2009;Ersche, Turton, Pradhan, Bullmore y Robbins, 2010).…”