The Role of Impulsivity Facets on the Incidence and Development of Alcohol Use Disorders

Abstract

Alcohol Use Disorder (AUD) is a chronic relapsing disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5; American Psychiatric Association 2013), “by a cluster of behavioural and physical symptoms, which can include, withdrawal, tolerance and craving”. Social, emotional, behavioural and cognitive factors are important contributors to AUD. Impulsivity, a multifaceted behavioural concept, defined as a predisposition for rapid and unplanned actions, without considering potential negative consequences of these actions, represents an important such factor. In this chapter, research on the role of distinct impulsivity dimensions in different severity stages of alcohol use is presented. Increased self-reported (trait) impulsivity and an inability to wait, as well as difficulty to adjust behaviour appropriately following a failure to withhold a response are observed across the spectrum of alcohol-use severities. Research on temporal impulsivity (inability to delay gratification) consistently shows deficits in more severe alcohol users. Data on temporal impulsivity in early stages of alcohol use are less consistent, with some studies showing no differences between high and moderate drinkers, while others indicating increased impulsivity in high alcohol users. Data on reflexion impulsivity are currently limited to draw conclusions. Recent research is also presented suggesting the importance of perception and interpretation of physiological and emotional signals on alcohol use behaviour highlighting the necessity of comprehensive integration of the field of the study of emotion and interoception with impulsivity research.