Impulsivity and Alcohol Use Disorder

Alcohol use disorder (AUD), along with other substance use disorders, can be understood at least partially as disorders of impulsivity, or a persistent deficit in self-regulation in which the individual is increasingly unable to control arising impulses to consume the substance. In turn, understanding impulsivity in relation to AUD can inform our understanding of its aetiology and potentially identify novel treatment targets. A challenge to this ostensibly straightforward perspective is the many ways impulsivity can be measured and the highly variable associations among these measures, revealing a highly multidimensional construct. Recent investigations have begun to delineate the latent structure of impulsivity, and, in this chapter, we review how a conceptual model of three broad domains relates to AUD. These comprise impulsive personality traits (i.e., self-attributions on personality inventories), impulsive choice (i.e., overvaluation of immediate rewards), and impulsive action (i.e., behavioural inhibition). In each case, we review the state of the evidence in relation to AUD, followed by a discussion of these domains as potentially modifiable risk factors. Although intervention research is relatively nascent, clinical interventions to improve self-regulatory capacities are promising and have potential in the context of a precision medicine approach.