title: Impulsivity as a vulnerability factor for poor addiction treatment outcomes: a review of neurocognitive findings among individuals with substance use disorders.
abstract: With the current review, we explore the hypothesis that individual differences in neurocognitive aspects of impulsivity (i.e., cognitive and motor disinhibition, delay discounting and impulsive decision-making) among individuals with a substance use disorder are linked to unfavorable addiction treatment outcomes, including high drop-out rates and difficulties in achieving and maintaining abstinence. A systematic review of the literature was carried out using PubMed, PsycINFO and Web of Knowledge searches. Twenty-five unique empirical papers were identified and findings were considered in relation to the different impulsivity dimensions. Although conceptual/methodological heterogeneity and lack of replication are key limitations of studies in this area, findings speak for a prominent role of cognitive disinhibition, delay discounting and impulsive decision-making in the ability to successfully achieve and maintain abstinence during and following addiction treatment. In contrast, indices of motor disinhibition appear to be unrelated to abstinence levels. Whereas the relationship between impulsivity and treatment retention needs to be examined more extensively, preliminary evidence suggests that impulsive/risky decision-making is unrelated to premature treatment drop-out among individuals with a substance use disorder. The reviewed findings are discussed in terms of their clinical implications.
authors.affiliation: Department of Orthopedagogics, Ghent University, Belgium. Electronic address: Laura.Stevens@ugent.be.
authors.forename: Laura
authors.initials: L
authors.lastname: Stevens
authors.affiliation: Department of Clinical Psychology, Universidad de Granada, Spain; Institute of Neuroscience F. Olóriz, Universidad de Granada, Spain; School of Psychology and Psychiatry, Monash University, Melbourne, Victoria.
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands; Arkin Mental Health Care, Amsterdam, The Netherlands.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Goudriaan
authors.affiliation: Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.
authors.forename: Herbert
authors.initials: H
authors.lastname: Roeyers
authors.affiliation: Psychiatric Centre Alexian Brothers, Boechout, Belgium; Collaborative Antwerp Psychiatry Research Institute (CAPRI), Antwerp, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Dom
authors.affiliation: Department of Orthopedagogics, Ghent University, Belgium.
authors.forename: Wouter
authors.initials: W
authors.lastname: Vanderplasschen
mesh_terms: D003071:Cognition / Q000502:physiology; D003657:Decision Making / Q000502:physiology; D065786:Delay Discounting / Q000502:physiology; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology; D019966:Substance-Related Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D017211:Treatment Failure
keywords: Decision-making; Delay discounting; Impulsivity; Inhibitory control; Treatment outcomes