Despite the fact that impulse control increases during adolescence with normal development, affective, cognitive, and behavior processes are still immature. Immaturity in these processes may lead to a typical adolescent’s tendency to act impulsively, be emotionally reactive, and ignore the negative consequences of their behavior. Impulsive, emotional reactivity without consideration of potential consequences increases the likelihood of risk taking and initiation of substance use (Chambers et al. 2003; Clark et al. 2005; Dahl, 2004; Spear, 2000; Volkow, 2005; Volkow and Li, 2005). Adolescents with severe impulse control problems may have earlier onset of substance use and worse clinical prognoses. For example, among 11 year olds, impulsive behavioral disorders (e.g. Oppositional Defiant Disorder, Conduct Disorder, and ADHD) are predictive of earlier initiation of alcohol use (McGue et al. 2001). Similarly, boys with impulse control problems have a higher risk for development of a substance use disorder, and impulsivity appears to impart this risk by leading to an earlier age of first drink of alcohol (von Diemen et al. 2008). Furthermore, additional factors may be involved in the development of more severe outcomes, such as mood disorders and other psychopathology that often occurs with suicidal behavior (Bridge et al. 2006).
