Impulsivity and Reward Processing Endophenotypes in Youth Alcohol Misuse

Abstract

We describe the contribution of impulsivity and reward processing endophenotypes to understanding youth alcohol misuse. We discuss studies that included self-report, behavioral, and neural measures of these endophenotypes. Regarding impulsivity, youth who misuse alcohol tend to engage in suboptimal decision-making and have increased urgency—diminished self-control due to emotional disruption. There is some evidence that prefrontal and parietal brain regions are hypoactive during response inhibition tasks in low-to-moderate alcohol misuse, with hyperactivation of dorsolateral prefrontal cortex and cingulate cortex associated with heavier misuse. Increased self-reported reward sensitivity is a risk factor for adolescent alcohol-use. Brain responses to rewards in youth alcohol misusers have produced inconsistent findings, perhaps due to the influence of other factors, such as family history and pubertal status at first drinking episode. Understanding of the etiology and generating preventative strategies for youth alcohol misuse could be enhanced by the accurate characterization of endophenotypes related to impulsivity and reward sensitivity.