Impulsivity, impulsive and reflective processes and the development of alcohol use and misuse in adolescents and young adults

Abstract

This paper contrasts dual-process and personality approaches in the prediction of addictive behaviors and related risk behaviors. In dual-process models, behavior is described as the joint outcome of qualitatively different "impulsive" (or associative) and "reflective" processes. There are important individual differences regarding both types of processes, and the relative strength of both in a specific situation is influenced by prior behavior and state variables (e.g., fatigue, alcohol use). From this perspective, a specific behavior (e.g., alcohol misuse) can be predicted by the combined indices of the behavior-related impulsive processes (e.g., associations with alcohol), and reflective processes, including the ability to refrain from a motivationally salient action. Personality approaches have reported that general traits such as impulsivity predict addictive behaviors. Here we contrast these two approaches, with supplementary analyses on four datasets. We hypothesized that trait impulsivity can predict specific risky behaviors, but that its predictive power disappears once specific behavior-related associations, indicators of executive functioning, and their interaction are entered into the equation. In all four studies the observed interaction between specific associations and executive control (EC) was robust: trait impulsivity did not diminish the prediction of alcohol use by the interaction. Trait impulsivity was not always related to alcohol use, and when it was, the predictive power disappeared after entering the interaction between behavior-specific associations and EC in one study, but not in the other. These findings are interpreted in relation to the validity of the measurements used, which leads to a more refined hypothesis.

Keywords: addiction; alcohol; developmental psychopathology; dual process models; executive control; impulsivity; personality.

Figure 1

Typical pattern of result from moderation studies (see main text for many examples of references).

Figure 2

A framework for the prediction of impulsive behavior by impulsive vs. reflective processes and associated boundary conditions (moderators). Pathway a represents the specific impulsive (associative) processes activated in the specific risky situation, which automatically activate action tendencies, usually approach. This is positively related to a general tendency to seek rewarding and stimulating experiences and sensitivity to reward (trait sensation seeking). Pathway b represents EC processes activated in the risky situation, including self-control ability and motivation to control. Pathway c represents the moderating effects of boundary conditions, which moderate the relative influence of pathways a and b. For example, after drinking alcohol, the impulsive (associative) processes get stronger, while the reflective processes get weaker. Pathway d represents the moderation of (behavior-specific) impulsive processes by reflective processes, as demonstrated in recent studies (see also Figure 1). Pathway e represents “rational risk taking”: after weighing pros and cons (reflective process), the risk is taken. Question addressed in the re-analyses presented here is whether individual differences in trait impulsivity can be viewed as a moderator, similar to executive control capacity or self-control, or whether it uniquely predicts risky behavior, independent of specific impulsive and reflective processes (pathway f). In addition, it is tested whether the moderated pathway of specific associations is robust, for controlling for trait impulsivity and sensation seeking (pathways f and g).