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Chunk #6 — Core Characteristics of the Externalizing Risk Phenotype for SUD

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Parsing the Undercontrol/Disinhibition Pathway to Substance Use Disorders: A Multilevel Developmental Problem.
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The issue of labeling is more than a simple dispute about terminology. A careful parsing of these constructs indicates that their subcomponential attributes operate at several levels. Behavioral undercontrol, or behavioral disinhibition, refers to a vulnerability of disinhibitory processes that involves the inability or unwillingness or failure to inhibit behavior even in the face of anticipated or already received negative consequences (Hawkins et al., 1992; Kandel, 1978; Zucker, 2006). Antisocial behavior, delinquency, and rule-breaking fall at the level of observable behavior. However, the construct also subsumes inferential traits like impulsivity, low behavioral constraint, impaired impulse control, as well as lack of control over cravings for food, sex, or drugs. Undercontrolled individuals are more likely to carry out activities that are normatively inappropriate or socially disapproved, such as aggression or open conflict with authority; they also have greater proneness to engage in risky behaviors without weighing the consequences of their actions. At the same time, this trait is distinct from other, closely related constructs. For example, inhibition is “a temperament or style of reacting with fear or withdrawal when confronted with