Impulsive action and impulsive choice across substance and behavioral addictions: cause or consequence?

Area of Science:

• Neuroscience
• Psychiatry
• Behavioral Science

Background:

• Substance use disorders are widespread and disabling.
• Behavioral addictions (e.g., gambling, compulsive internet use) show clinical and neurobiological similarities to substance addictions.
• Impulsivity, encompassing action and choice, is a key area of overlap.

Purpose of the Study:

• To review the overlap between substance and behavioral addictions, focusing on impulsivity.
• To examine the role of impulsive action and choice in addiction.
• To identify future research directions and treatment implications.

Main Methods:

• Literature review and meta-analysis findings were considered.
• Focus on studies examining impulsive action and choice in substance and behavioral addictions.
• Exploration of neurobiological correlates through imaging studies.

Main Results:

• Acute drug use can modulate impulsive choice and action, dependent on baseline function.
• Chronic drug use is consistently associated with elevated impulsive choice and action.
• Elevated impulsivity may precede substance use disorder development, acting as a vulnerability marker.
• Behavioral addictions also show elevated impulsive action compared to controls.

Conclusions:

• Impulsivity is a critical shared feature between substance and behavioral addictions.
• Further research is needed to determine if cognitive deficits are state-dependent or trait-like.
• Understanding these cognitive deficits can inform neurobiological models and treatment strategies for addiction.