The Effect of Cognitive Behavioral Therapy on Impulsivity in Addictive Disorders: a Narrative Review.

Abstract

Impulsivity is considered an important construct in the cycle of addiction, yet the effect of evidence-based treatments on impulsivity is unclear. The goal of this paper was to review the evidence regarding the effect of cognitive behavioral therapy (CBT), one of the most studied psychotherapies for addiction, on measures of impulsivity in addictive disorders. There is a robust literature implicating impulsivity as risk factor for development of a range of addictions and poorer treatment outcomes. However, this review identified only four randomized controlled trials evaluating CBT for an addictive behavior that included repeated assessment of impulsivity. All four were studies targeting substance use. There is limited evidence that CBT has a direct effect on change in measures of impulsivity among individuals being treated for substance use. Future clinical trials should include repeated measurement of impulsivity to examine CBT's effect on the underlying characteristics of addiction.