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Drug Abuse and Behavioral Disinhibition

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Drug Abuse and Addiction in Medical Illness

Abstract

Traditional models of drug abuse emphasize the drug’s rewarding effects as reinforcing drug use to the point of physical dependence and addiction. However, the past several years have seen an increased focus on the role of cognitive disturbances both as temporary acute reactions to drugs and as enduring impairments owing to prolonged chronic drug abuse. This chapter focuses on impairments of impulse control and reviews several lines of research that point to the role of impaired control in the development and maintenance of drug abuse disorders. The sections describe how the concept of impaired control is embedded in diagnostic classifications of alcohol abuse disorders and how impaired control characterizes constructs, such as impulsivity and disinhibition, which are key aspects of personalities and psychopathologies commonly associated with drug abuse. Cognitive approaches to the concept of impaired self-control are also examined with the aim of identifying how specific impairments in the ability to inhibit an action can contribute to drug abuse, and possibly emerge as a consequence of prolonged drug abuse. The chapter concludes by highlighting areas for further research, such as gaining a better understanding of the role of deficient inhibitory control in drug abuse for more effective treatment development.

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Acknowledgments

This work was supported by grants R21 DA021027 and P50 DA005312 from the National Institute on Drug Abuse, and by grant R01 AA12895 from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychology, University of Kentucky, Lexington, KY, 40506-0044, USA

    Mark T. Fillmore

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  1. Mark T. Fillmore
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Correspondence to Mark T. Fillmore .

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Editors and Affiliations

  1. Inst. Pharmaceutical Sciences, Department of Psychopharmacology, Utrecht University, Universiteitsweg 99, Utrecht, 3584CG, Netherlands

    Joris C. Verster

  2. Dept. Psychiatry, Medical University of South Carolina, President St. 67, Charleston, 29425, South Carolina, USA

    Kathleen Brady

  3. School of Medicine, Div. Alcoholism & Drug Abuse, New York University, First Ave. 550, New York, 10016, New York, USA

    Marc Galanter

  4. Institute of Psychiatry, King's College London, National Addiction Centre, Windsor Walk 4, London, SE5 8AF, United Kingdom

    Patricia Conrod

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Fillmore, M.T. (2012). Drug Abuse and Behavioral Disinhibition. In: Verster, J., Brady, K., Galanter, M., Conrod, P. (eds) Drug Abuse and Addiction in Medical Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3375-0_2

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