Impulsivity as a vulnerability factor for poor addiction treatment outcomes: A review of neurocognitive findings among individuals with substance use disorders

Abstract

With the current review, we explore the hypothesis that individual differences in neurocognitive aspects of impulsivity (i.e., cognitive and motor disinhibition, delay discounting and impulsive decision-making) among individuals with a substance use disorder are linked to unfavorable addiction treatment outcomes, including high drop-out rates and difficulties in achieving and maintaining abstinence. A systematic review of the literature was carried out using PubMed, PsycINFO and Web of Knowledge searches. Twenty-five unique empirical papers were identified and findings were considered in relation to the different impulsivity dimensions. Although conceptual/methodological heterogeneity and lack of replication are key limitations of studies in this area, findings speak for a prominent role of cognitive disinhibition, delay discounting and impulsive decision-making in the ability to successfully achieve and maintain abstinence during and following addiction treatment. In contrast, indices of motor disinhibition appear to be unrelated to abstinence levels. Whereas the relationship between impulsivity and treatment retention needs to be examined more extensively, preliminary evidence suggests that impulsive/risky decision-making is unrelated to premature treatment drop-out among individuals with a substance use disorder. The reviewed findings are discussed in terms of their clinical implications.

Gender Moderates the Partial Mediation of Impulsivity in the Relationship Between Psychiatric Distress and Problematic Online Gaming: Online Survey (Preprint)

“…Impulsivity has been proposed to contribute significantly to the development and/or maintenance of addictions (Gullo & Dawe, 2008;Petry et al, 2015). It has also been linked to poor addiction treatment outcomes (Stevens et al, 2014). Furthermore, impulsivity has been associated with problematic Internet use and POG.…”

Review on Treatment of Substance Use Disorders

“…High treatment drop outs has been associated with younger age and cognitive deficits [108][109][110][111]. Proactive engagement services result in individuals remaining engaged through the treatment process [112,113].…”

Changes in Executive Function Following Short-Term Tobacco Cessation Therapy in College Students

“…Given that repeated administration of executive measures across time might be amenable to practice effects or other artifacts of repeated assessment, this study included a group of non-smokers who were administered the same battery of measures across a similar time span. It was hypothesized that executive abilities would increase in participants who underwent tobacco cessation therapy particularly in domains related to inhibition and impulsivity given the impact on these executive measures in previous studies [31,41].…”