choose between a large but delayed reward and a small but more immediate reward (Mitchell et al., 2005); and the Iowa Gambling Test (Fernández-Serrano et al., 2010). The many findings from these combined studies of alcoholics clearly demonstrate executive dysfunction as a characteristic of the disorder. Even though descriptions of the impairments vary across reports, the inconsistencies are plausible because of the multiplicity and complexity of executive functioning components, and because researchers have used diverse tasks to measure them. In any case, executive dysfunction has been found to be associated with low motivation to change drinking behaviors (Le Berre et al., 2012). This creates difficult conditions for recovery from addiction and therefore, likely serves as a cognitive barrier to treatment. Loss of inhibition, poor insight, distractibility, perseverative responding, impaired decision-making, and difficulties with impulse control contribute to increased likelihood of relapse (Crews and Boettiger, 2009; Sullivan et al., 2010).
