TY - JOUR
T1 - Impulsivity, neural deficits, and the addictions
T2 - The “oops” factor in relapse
AU - Adinoff, Bryon
AU - Rilling, Laurie M.
AU - Williams, Mark J.
AU - Schreffler, Erica
AU - Schepis, Ty S.
AU - Rosvall, Traci
AU - Rao, Uma
N1 - Funding Information:
Bryon Adinoff is affiliated with the Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas and VA North Texas Health Care System, Dallas, TX. Laurie M. Rilling, Mark J. Williams, Erica Schreffler, Traci Rosvall, and Uma Rao are affiliated with the Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas. Ty S. Schepis is affiliated with Yale University School of Medicine, New Haven, CT. Address correspondence to: Bryon Adinoff, MD, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8564 (E-mail: bryon.adinoff@utsouthwestern.edu). Preparation of this manuscript was supported by the VA North Texas Health Care System and the National Institute on Drug Abuse grant no. DA11434 and DA020024.
PY - 2007/8/27
Y1 - 2007/8/27
N2 - Impulsive behaviors are observed in a wide range of psychiatric disorders, including substance use, bipolar, attention-deficit hyperactivity, antisocial and borderline personality, gambling, and eating disorders. The shared phenotype of impulsivity is thought to significantly contribute to both the etiology and perpetuation of these disorders. In this review, we focus upon the relevance of impulsivity to the addictive disorders, particularly substance use disorders. First, the literature supporting the presence of impulsive behaviors prior to the onset of drug use and addiction is discussed. The relevance of impulsivity to relapse is then presented, with a focus on three distinct neurocognitive constructs: automaticity, response inhibition, and decision making. Automaticity is a quickly occurring relapse process resulting from the learned habits induced by persistent drug use. Addicted persons with response inhibition deficits are unable to suppress these previously reinforced behaviors. Decision-making deficits contribute to relapse through a poorly considered assessment of the consequences of drug use. The brain regions associated with each model of impulsive behavior are described, and relevant neurobiologic disruptions in addicted subjects are discussed in the context of their specific neurocognitive deficit(s). Descriptive confusions in the terminology and confounds inherent in the study of impulsivity are described. Empirical investigations documenting the hypothesized relationship between specific deficits in impulsive behaviors, coupled with their neurobiological correlates, and relapse should be the focus of future studies.
AB - Impulsive behaviors are observed in a wide range of psychiatric disorders, including substance use, bipolar, attention-deficit hyperactivity, antisocial and borderline personality, gambling, and eating disorders. The shared phenotype of impulsivity is thought to significantly contribute to both the etiology and perpetuation of these disorders. In this review, we focus upon the relevance of impulsivity to the addictive disorders, particularly substance use disorders. First, the literature supporting the presence of impulsive behaviors prior to the onset of drug use and addiction is discussed. The relevance of impulsivity to relapse is then presented, with a focus on three distinct neurocognitive constructs: automaticity, response inhibition, and decision making. Automaticity is a quickly occurring relapse process resulting from the learned habits induced by persistent drug use. Addicted persons with response inhibition deficits are unable to suppress these previously reinforced behaviors. Decision-making deficits contribute to relapse through a poorly considered assessment of the consequences of drug use. The brain regions associated with each model of impulsive behavior are described, and relevant neurobiologic disruptions in addicted subjects are discussed in the context of their specific neurocognitive deficit(s). Descriptive confusions in the terminology and confounds inherent in the study of impulsivity are described. Empirical investigations documenting the hypothesized relationship between specific deficits in impulsive behaviors, coupled with their neurobiological correlates, and relapse should be the focus of future studies.
KW - Addictive disorders
KW - Automaticity
KW - Impulsive behavior
KW - Substance use
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U2 - 10.1300/J069v26S01_04
DO - 10.1300/J069v26S01_04
M3 - Article
C2 - 19283972
AN - SCOPUS:65349131851
SN - 1055-0887
VL - 26
SP - 25
EP - 39
JO - Journal of Addictive Diseases
JF - Journal of Addictive Diseases
ER -