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Recent Research on Impulsivity in Individuals With Drug Use and Mental Health Disorders: Implications for Alcoholism

Authors

  • Robert D. Rogers,

    1. From the Department of Psychiatry (RDR), University of Oxford, Warneford Hospital, Oxford, UK; Department of Experimental Psychology (RDR), University of Oxford, Oxford, UK; Department of Psychiatry and Behavioral Sciences (FGM, ACS), The University of Texas Health Science Center at Houston, Houston, Texas; Department of Experimental Psychology (LC), University of Cambridge, Cambridge, UK.
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  • Frederick G. Moeller,

    1. From the Department of Psychiatry (RDR), University of Oxford, Warneford Hospital, Oxford, UK; Department of Experimental Psychology (RDR), University of Oxford, Oxford, UK; Department of Psychiatry and Behavioral Sciences (FGM, ACS), The University of Texas Health Science Center at Houston, Houston, Texas; Department of Experimental Psychology (LC), University of Cambridge, Cambridge, UK.
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  • Alan C. Swann,

    1. From the Department of Psychiatry (RDR), University of Oxford, Warneford Hospital, Oxford, UK; Department of Experimental Psychology (RDR), University of Oxford, Oxford, UK; Department of Psychiatry and Behavioral Sciences (FGM, ACS), The University of Texas Health Science Center at Houston, Houston, Texas; Department of Experimental Psychology (LC), University of Cambridge, Cambridge, UK.
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  • Luke Clark

    1. From the Department of Psychiatry (RDR), University of Oxford, Warneford Hospital, Oxford, UK; Department of Experimental Psychology (RDR), University of Oxford, Oxford, UK; Department of Psychiatry and Behavioral Sciences (FGM, ACS), The University of Texas Health Science Center at Houston, Houston, Texas; Department of Experimental Psychology (LC), University of Cambridge, Cambridge, UK.
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  • The subject of this mini-review was presented at a symposium held by the Internal Society for Research on Impulsivity (ISRI) at the Scientific Meeting of the Research Society on Alcoholism (RSA) in San Diego on June 9, 2009. The organizer and chair of the symposium was Professor Marc Potenza. The speakers were Professors Gerry Moeller, Alan C. Swann, Luke Clark, and Robert D. Rogers.

Reprint requests: Professor Robert D. Rogers, BA, MSc, PhD, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; Tel: +44-1865-226399; Fax: +44-1865-793101; E-mail:robert.rogers@psych.ox.ac.uk

Abstract

Alcohol misuse and dependence, and many of its accompanying psychological problems, are associated with heightened levels of impulsivity that both accelerate the development of clinically significant illness and complicate clinical outcome. This article reviews recent developments in our understanding of impulsivity as they relate to brain circuitry that might underlie these comorbid factors, focusing upon the clinical features of substance use (and dependence), bipolar disorder, and pathological gambling. Individuals who are affected by these disorders exhibit problems in several domains of impulsive behavior including deficient response or “motor” control, and the tolerance of prolonged delays prior to larger rewards at the expense of smaller rewards (“delay-discounting”). These populations, like alcoholic dependents, also exhibit impairments in risky decision-making that may reflect dysfunction of monoamine and catecholamine pathways. However, several areas of uncertainty exist including the specificity of impairments across disorders and the relationship between impulse control problems and altered evaluation of reward outcomes underlying observed impairments in action selection.

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