Behavioral Disinhibition and the Development of Early-Onset Addiction: Common and Specific Influences
Abstract
Research on substance use disorders is often compartmentalized, focused on understanding addiction to one substance or substance class at a time. Although this approach has contributed significantly to knowledge about addictions, early-onset substance use disorders appear to share common etiology with each other and with other disorders, traits, behaviors, and endophenotypes associated with behavioral disinhibition. We propose that a common genetic liability to behavioral disinhibition underlies the co-occurrence of these externalizing attributes. This liability is expressed in part through brain mechanisms related to cognitive control, impulsivity, and sensitivity to reward, all of which are maturing during adolescence. During this important transitional period, problem behaviors emerge, including the initiation of substance use. Exposure to various environmental risks further amplifies the risk associated with the common liability, increasing the likelihood of addiction generally. Specific environmental and genetic factors ultimately contribute to the differentiation among externalizing disorders.
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Aggressive traits, emotional dysregulation, and externalizing psychopathology frequently precede problematic drinking.
“longitudinal studies reveal that aggressive traits, emotional dysregulation, and externalizing psychopathology frequently precede problematic drinking”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Iacono et al. 2008
Antisocial tendencies, irritability, and poor impulse control often emerge during childhood and adolescence and predict the later development of AUD.
“Longitudinal studies further support this view, showing that antisocial tendencies, irritability, and poor impulse control often emerge during childhood and adolescence and predict the later development of AUD (White et al. 1993; Iacono et al. 2008; Zucker et al. 2008; Cho et al. 2014).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Iacono et al. 2008
These traits show moderate heritability and contribute to a broader 'behavioral disinhibition' liability spanning both domains.
“These traits show moderate heritability and contribute to a broader “behavioral disinhibition” liability spanning both domains (Krueger et al. 2002; Iacono et al. 2008; Young et al. 2009).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Iacono et al. 2008
Temperamental traits such as disinhibition, negative affectivity, and heightened reward sensitivity are key predispositions for both externalizing behaviors and alcohol misuse.
“Temperamental traits such as disinhibition, negative affectivity, and heightened reward sensitivity are key predispositions for both externalizing behaviors and alcohol misuse.”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Iacono et al. 2008
Biological, psychological, and social risk factors interact dynamically over development.
“These biological, psychological, and social risk factors interact dynamically over development (Krueger et al. 2002; Iacono et al. 2008).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Iacono et al. 2008
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References 144 · Cited by 554
- Authors
- Iacono, W. G., Malone, S. M., & McGue, M.
- Affiliations
- University of Minnesota (US)
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2008-04-01
- Volume
- 4
- Issue
- 1
- Pages
- 325-348
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- OpenAlex
- W2160694463
- Cited by
- 554
- References
- 144
- Citations by year
- 2026: 17 · 2025: 15 · 2024: 20 · 2023: 27 · 2022: 22 · 2021: 26 · 2020: 48 · 2019: 27 · 2018: 34 · 2017: 33 · 2016: 35 · 2015: 51 · 2014: 45 · 2013: 38 · 2012: 42
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (K01AA015621, AA-11886, AA 015621, AA-09367, R01AA011886)
- National Institute of Mental Health (MH66140, R01MH066140)
- National Institute on Drug Abuse (DA13240, DA-05147, R01DA013240)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- behavioral disinhibition, substance use disorders, externalizing disorders, genetic susceptibility, cognitive control, impulsivity, reward sensitivity, adolescence, environmental risk factors, endophenotypes, comorbidities
- MeSH terms
- Brain, Electroencephalography, Humans, Phenotype, Social Behavior Disorders, Age of Onset, Event-Related Potentials, P300, Substance-Related Disorders
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