Fluctuating disinhibition: implications for the understanding and treatment of alcohol and other substance use disorders.
paper
Primary
Public
- Authors
- Jones, Andrew; Christiansen, Paul; Nederkoorn, Chantal; Houben, Katrijn; Field, Matt
- Year
- 2013
- Journal
- Frontiers in psychiatry
- PMID
- 24155728
- DOI
- 10.3389/fpsyt.2013.00140
- PMCID
- PMC3804868
Disinhibition is present in various maladaptive behaviors, including substance use disorders. Most previous research has assumed that disinhibition is a psychological construct that is relatively stable within individuals. However, recent evidence suggests that the ability to inhibit behavior fluctuates in response to environmental and psychological triggers. In this review we discuss some of the factors that cause (dis)inhibition to fluctuate, we examine whether these fluctuations contribute to subjective craving and substance consumption, and we ask if they might increase the risk of relapse in those who are attempting to abstain. The research that we discuss has furthered our understanding of the causal relationships between disinhibition and substance use disorders, and it also highlights opportunities to develop novel treatment interventions. We conclude that substance misusers and their therapists should be made aware of the triggers that can cause disinhibition to fluctuate, and we highlight the need for more research to investigate the effectiveness of inhibitory control training in clinical settings.
Environmental triggers and psychological processes that underlie changes in state disinhibition, and their influence on substance use. Individuals have a stable capacity for inhibitory control, but a component of this capacity appears to fluctuate in response to environmental triggers and psychological processes. If individuals are in a disinhibited state, they are more likely to engage in substance use, or relapse to substance use after a period of abstinence. If individuals experience a decrease in state disinhibition, they are less likely to engage in substance use, or relapse. Drug-related cues, alcohol intoxication, ego depletion, arousal, stress, motivational biases, and over-confidence all lead to increased disinhibition and thereby increase the risk of substance use. Disinhibition can be reduced after different types of cognitive training, by motivational biases, and by moderate levels of stress and arousal – resulting in a reduced risk of substance use.
| # | Section | Preview |
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| 40 | Conclusions and Future Directions | Within this relatively stable capacity for inhibitory control, we see “state” fluctuations in… |
| 41 | Conclusions and Future Directions | Priorities for future research include the identification of other factors that influence state… |
| 42 | Conclusions and Future Directions | Finally, future research should focus on improving the efficacy of this training and identifying the… |
| 43 | Conclusions and Future Directions | However, we emphasize that clinicians should employ caution when attempting to strengthen inhibitory… |
| 44 | Conclusions and Future Directions | To conclude, in this review we have identified the environmental triggers and psychological… |
| 45 | Conflict of Interest Statement | The authors declare that the research was conducted in the absence of any commercial or financial… |
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In this knowledge base
| Title | Year | PMID |
|---|---|---|
| Random Forest Classification of Alcohol Use Disorder Using EEG Source Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures. | 2020 | 32121585 |
External
| Title | Authors | Journal | Year | Link |
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| An Ecological Momentary Assessment Study of Fluctuations in Inhibitory Control and Its Predictive Validity of Alcohol Use. | Burton S et al. | — | 2026 | → |
| Daily self-control demands and loss of control over drinking: The moderating role of trait impulsivity and peer exposure. | Liu Y et al. | — | 2026 | → |
| A prospective study of the impact of an emotional intelligence program on opioid relapse and its determinants in upper Egypt. | Maghawry HF et al. | — | 2025 | → |
| Inhibitory and excitatory conditioned cues associated with alcohol differentially modulate the nucleus accumbens shell: involvement of 5-HT<sub>7</sub> receptors. | Hauser SR et al. | — | 2025 | → |
| The Digital Media-use Effects (d-MUsE) Model: A comprehensive framework for exploring/studying functional and dysfunctional effects on adolescent wellbeing. | Liebherr M et al. | — | 2025 | → |
| Cortical paired associative stimulation shows impaired plasticity of inhibition networks as a function of chronic alcohol use. | Sallie SN et al. | — | 2024 | → |
| Identifying the role of (dis)inhibition in the vicious cycle of substance use through ecological momentary assessment and resting-state fMRI. | Chirokoff V et al. | — | 2024 | → |
| Self-regulatory control processes in youths: A temporal network analysis approach. | Turri F et al. | — | 2024 | → |
| The relationship between inhibitory control and food consumption or choice: A systematic review and meta-analysis. | McGreen J et al. | — | 2023 | → |
| Behavioral restriction, lorazepam, and escitalopram uniquely influence the expression of naturalistic stereotypy in deer mice: perspectives on anxiety- and compulsive-like behavior. | Burke JT et al. | — | 2022 | → |
| Effects of stress, alcohol prime dose, and sex on ad libitum drinking. | Patock-Peckham JA et al. | — | 2022 | → |
| Elevated ad libitum alcohol consumption following continuous theta burst stimulation to the left-dorsolateral prefrontal cortex is partially mediated by changes in craving. | McNeill AM et al. | — | 2022 | → |
| A meta-analytic investigation of the role of reward on inhibitory control. | Burton S et al. | — | 2021 | → |
| Do the Transmissible Liability Index (TLI) and Adolescent Cannabis Use Predict Paranoid and Schizotypal Symptoms at Young Adulthood? | Sharma P et al. | — | 2021 | → |
| Emotion-Attention Interaction in the Right Hemisphere. | Hartikainen KM | — | 2021 | → |
| Heterogeneity of Executive Function Abilities in Recently Detoxified Patients with Alcohol Use Disorder: Evidence from a Cluster Analysis. | Schmid F et al. | — | 2021 | → |
| Limited Evidence of Associations Between Executive Functioning and Alcohol Involvement In UK Adolescents. | Burton S et al. | — | 2021 | → |
| PSYCHOPATHY, BORDERLINE PERSONALITY DISORDER, AND SUBSTANCE USE IN INCARCERATED FEMALES. | Edwards BG et al. | — | 2021 | → |
| The Effects of Placebo and Moderate Dose Alcohol on Attentional Bias, Inhibitory Control and Subjective Craving. | McNeill AM et al. | — | 2021 | → |
| Cognitive and emotional predictors of real versus sham repetitive transcranial magnetic stimulation treatment response in methamphetamine use disorder. | Chen T et al. | — | 2020 | → |
| Does alcohol cue inhibitory control training survive a context shift? | Jones A et al. | — | 2020 | → |
| High-Risk, but Hidden: Binge Drinking among Men Who Have Sex with Men and Transgender Women in Lima, Peru, 2012-2014. | Passaro RC et al. | — | 2020 | → |
| Inhibitory control and problematic Internet-pornography use - The important balancing role of the insula. | Antons S et al. | — | 2020 | → |
| Random Forest Classification of Alcohol Use Disorder Using EEG Source Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures. | Kamarajan C et al. | — | 2020 | → |
| The Critical Lack of Data on Alcohol and Marijuana Use by Adolescents on the Autism Spectrum. | Adhia A et al. | — | 2020 | → |
| The role of neuropsychological mechanisms in implementation intentions to reduce alcohol consumption among heavy drinkers: a randomized trial. | McGrath E et al. | — | 2020 | → |
| Using Smartphone Sensor Data to Assess Inhibitory Control in the Wild: Longitudinal Study. | Tseng VW et al. | — | 2020 | → |
| A latent class analysis of alcohol and drug use immediately before or during sex among women. | Reynolds GL et al. | — | 2019 | → |
| Alcohol-Specific Computerized Interventions to Alter Cognitive Biases: A Systematic Review of Effects on Experimental Tasks, Drinking Behavior, and Neuronal Activation. | Batschelet HM et al. | — | 2019 | → |
| Impaired subjective self-control in alcohol use: An ecological momentary assessment study. | Remmerswaal D et al. | — | 2019 | → |
| Interactions of immediate and long-term action regulation in the course and complications of bipolar disorder. | Lijffijt M et al. | — | 2019 | → |
| The effect of alcohol cue exposure and acute intoxication on inhibitory control processes and ad libitum alcohol consumption. | Baines L et al. | — | 2019 | → |
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| Competing Motivations: Proactive Response Inhibition Toward Addiction-Related Stimuli in Quitting-Motivated Individuals. | Brevers D et al. | — | 2018 | → |
| Continuous Theta Burst Transcranial Magnetic Stimulation of the Right Dorsolateral Prefrontal Cortex Impairs Inhibitory Control and Increases Alcohol Consumption. | McNeill A et al. | — | 2018 | → |
| Daily Patterns of Marijuana and Alcohol Co-Use Among Individuals with Alcohol and Cannabis Use Disorders. | Metrik J et al. | — | 2018 | → |
| Deficient inhibition in alcohol-dependence: let's consider the role of the motor system! | Quoilin C et al. | — | 2018 | → |
| Do daily fluctuations in inhibitory control predict alcohol consumption? An ecological momentary assessment study. | Jones A et al. | — | 2018 | → |
| Does self-control modify the impact of interventions to change alcohol, tobacco, and food consumption? A systematic review. | Stautz K et al. | — | 2018 | → |
| From neuroscience to evidence based psychological treatments - The promise and the challenge, ECNP March 2016, Nice, France. | Goodwin GM et al. | — | 2018 | → |
| Marijuana use is associated with alcohol use and consequences across the first 2 years of college. | Gunn RL et al. | — | 2018 | → |
| Momentary assessment of impulsive choice and impulsive action: Reliability, stability, and correlates. | McCarthy DE et al. | — | 2018 | → |
| PTSD symptoms and alcohol-related problems among veterans: Temporal associations and vulnerability. | Simons JS et al. | — | 2018 | → |
| Elevated alcohol consumption following alcohol cue exposure is partially mediated by reduced inhibitory control and increased craving. | Field M et al. | — | 2017 | → |
| Executive functions in alcohol-dependence: A theoretically grounded and integrative exploration. | Brion M et al. | — | 2017 | → |
| Optogenetic activation of amygdala projections to nucleus accumbens can arrest conditioned and unconditioned alcohol consummatory behavior. | Millan EZ et al. | — | 2017 | → |
| Acute stress increases ad-libitum alcohol consumption in heavy drinkers, but not through impaired inhibitory control. | McGrath E et al. | — | 2016 | → |
| A Serious Game to Increase Healthy Food Consumption in Overweight or Obese Adults: Randomized Controlled Trial. | Blackburne T et al. | — | 2016 | → |
| Does inhibitory control training improve health behaviour? A meta-analysis. | Allom V et al. | — | 2016 | → |
| Impulsivity and Alcohol Dependence Treatment Completion: Is There a Neurocognitive Risk Factor at Treatment Entry? | Rupp CI et al. | — | 2016 | → |
| On the automaticity of response inhibition in individuals with alcoholism. | Noël X et al. | — | 2016 | → |
| The Dynamics of Addiction: Craving versus Self-Control. | Grasman J et al. | — | 2016 | → |
| The impact of cognitive impairment and impulsivity on relapse of alcohol-dependent patients: implications for psychotherapeutic treatment. | Czapla M et al. | — | 2016 | → |
| Alcohol-related and negatively valenced cues increase motor and oculomotor disinhibition in social drinkers. | Jones A et al. | — | 2015 | → |
| A comparison of three types of web-based inhibition training for the reduction of alcohol consumption in problem drinkers: study protocol. | Jones A et al. | — | 2014 | → |
| Banishing the Control Homunculi in Studies of Action Control and Behavior Change. | Verbruggen F et al. | — | 2014 | → |
| Pathways Between Concealable Stigmatized Identities and Substance Misuse. | Talley AE et al. | — | 2014 | → |
| A triadic neurocognitive approach to addiction for clinical interventions. | Noël X et al. | — | 2013 | → |