The neurobiology of impulsivity and substance use disorders: implications for treatment

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.

Emotion dysregulation and internalizing symptoms affect relationships between ADHD symptoms and borderline personality features among male patients with substance use disorders

“…Difficulties applying coping strategies and avoiding impulsive behaviour at times of emotional distress indicate decrements in emotional flexibility, and may reflect a change in priority from self-control to affect regulation [112]. Findings of the present study are also consistent with previous research indicating that impulse control disorders are more common in patients with SUDs [58,61,64,113].…”

“…In others words, symptoms of ADHD in childhood may be a risk factor for the later development of BPFs or there is a common aetiology for both of these symptom clusters. Indeed, EDR and impulsivity, in particular, are regarded as a core features of BPD [1,53,54] as it is in adult ADHD [27,54], and SUDs have been conceptualized as disorders of emotional regulation [55][56][57] and impulsivity [58]. Thus, these may suggest that associations between BPFs and variables such as ADHD symptoms and EDR is an important subject to study, particularly among patients with SUDs.…”

Mental disorders and risk of suicide attempt in prisoners

“…Despite this consistent pattern of findings across populations and settings, however, a few empirical studies have yet sought to examine why these specific disorders may govern behavioural enaction among individuals considering suicide. With regard to substance use disorders, a plausible explanation is that the effects of alcohol and/or illicit drug use-either acute or because of long-term sequelae of use-may lower behavioural inhibition and impair decision-making [76,77], making it more likely that one will act upon their suicidal thoughts [67,78]. Such deficits in executive functioning have equally been reported in individuals diagnosed with PTSD [79].…”

PTPRD: neurobiology, genetics, and initial pharmacology of a pleiotropic contributor to brain phenotypes

“…However, PTPRD is not identified by meta‐analyses of personality data genetics in samples of largely U.S. origin . Impulsivity and venturesomeness, personality phenotypes that are related to addictions, have not been associated with PTPRD . However, such traits might be tested in future studies of the impulsiveness that is associated with substance use disorders.…”