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date: 14 August 2020

Abstract and Keywords

Trait impulsivity, defined as a preference for immediate rewards over larger delayed rewards and reflected in actions that are socially inappropriate, maladaptive, and enacted without consideration of consequences, is a highly heritable temperamental vulnerability to all externalizing spectrum disorders. Neuroimaging research indicates compromised mesolimbic function among those with clinically significantly impulse control deficits. Impulsive individuals display chronically low tonic dopamine (DA) levels and blunted phasic DA responses to incentives. Behaviorally, these deficits manifest in continuous searches for immediate, high-intensity rewards (e.g., novelty-seeking, risk-taking, drug use), which serve to temporarily up-regulate a chronically aversive mood state. When mesolimbic neural vulnerability interacts with environmental adversities, such as coercive parenting, deviant peer affiliations, neighborhood risk, and drug use, impulse control deficiencies worsen and progression from attention-deficit/hyperactivity disorder to more severe externalizing spectrum disorders becomes likely.

Keywords: trait impulsivity, externalizing spectrum disorders, impulse control deficits, mesolimbic system, rewards

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