HMN 2025: How Different impulsive traits carry different risks for harmful alcohol use, personalized treatment

The authors of a new study have identified distinct personality profiles of people with impulsivity, with different attributes that influence whether a person engages in, or avoids, high-risk drinking. The study suggests that the link between impulsivity and high-risk drinking is more nuanced than commonly understood. The profiles, described in Alcohol: Clinical and Experimental Research, may give health care providers a framework to personalize interventions more effectively to prevent harms related to alcohol use.

People with impulsive personalities tend to be highly emotionally reactive or act without sufficiently considering potential consequences. Impulsivity is associated with high-risk drinking and substance use, but not all impulsive individuals engage in problem drinking. Researchers for this study sought to identify any particular characteristics of impulsive personalities that distinguished those who engage in risky drinking behaviors from those who do not.

Two hundred participants recently treated for psychiatric symptoms underwent comprehensive assessments of personality traits, cognitive function, psychological symptoms, risk-taking behaviors, and alcohol consumption patterns.

Analyzing all the data, researchers identified three personality profiles. A “low risk” profile had low levels of both impulsivity and alcohol use disorder. An “emotionally reactive” profile was highly impulsive but had low levels of alcohol use disorder symptoms. And a “high risk” profile, had both high impulsivity and high levels of alcohol use disorder symptoms.

Each profile displayed distinguishing characteristics that guide clinical treatment to reduce the risk of problematic alcohol use. For example, the emotionally reactive group scored higher in neuroticism and lower in conscientiousness, suggesting interventions targeting emotion regulation, such as cognitive-behavioral therapy. Individuals in this group also scored higher on “fun-seeking” and may better engage with interventions that incorporate novelty and stimulation.

The high-risk group exhibited cognitive deficits on performance-based tasks reflective of impairments in decision-making and reward sensitivity, which are associated with substance use disorders. Treatment tailored to this group might include cognitive remediation therapies to improve deficits in memory, attention, problem-solving, and executive function.

The findings suggest that incorporating personality assessments into personalized treatment plans that address individual differences in personality and cognitive ability may more effectively prevent and treat problem alcohol use.