Deficits in executive function (EF) often act as premorbid vulnerability factors that may promote initial alcohol-seeking and problematic use, and worsen alongside escalating severity of AUD, as proposed in the neurobiological theory. For example, EF deficits (e.g. in response inhibition) may hamper regulation of impulsive urges to engage in risky drinking (Jones, Meier, Corbin, & Chassin, 2021). In a large longitudinal study of adolescents, associations between alcohol use and impairments in working memory and inhibitory control were attributable to common vulnerability rather than neurotoxicity (Morin et al., 2019). Although performance in some domains of cognition shows evidence of recovery following abstinence, impairments in working memory and inhibitory control appear to persist (Nowakowska-Domagała, Jabłkowska-Górecka, Mokros, Koprowicz, & Pietras, 2017; Stavro, Pelletier, & Potvin, 2013; but see Pitel et al., 2009). It may be that executive dysfunction confers vulnerability to escalating use following initiation and worsens in some domains as use becomes chronic and problematic.
