Impaired control over alcohol use: An under-addressed risk factor for problem drinking in young adults?

Impaired control over alcohol use may be defined as "a breakdown of an intention to limit consumption in a particular situation" (Heather, Tebbutt, Mattick, & Zamir, 1993, p. 701) and has long been considered an important feature of alcohol dependence. Evidence suggests impaired control is highly relevant to young adult problem drinking. In the natural history of problem drinking, impaired control tends to develop early and may predict alcohol-related problems prospectively in undergraduates. Impaired control over alcohol use may be a facet of generalized behavioral undercontrol specifically related to drinking. In particular, impaired control is theoretically and empirically related to impulsivity. The question of whether impaired control represents a facet of impulsivity or a related but separate construct requires further study. However, theoretical arguments and empirical evidence suggest that there are unique qualities to the constructs. Specifically, existing data suggest that self-report measures of impaired control and impulsivity over alcohol use relate distinctly to problem drinking indices in young adults. Several lines of future research concerning impaired control are suggested, using the impulsivity literature as a guide. We conclude that impaired control is a valuable construct to the study of young adult problem drinking and that measures of impaired control should be included in more young adult alcohol studies. The extent to which impaired control over the use of other substances and impaired control over engagement in other addictive behaviors are clinically relevant constructs requires additional study.