Decision making, risky behavior, and alcoholism

Jazmin Camchong, Michael Endres, George Fein

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Alcoholism can be described as a disorder characterized by impulsive decision-making processes, wherein potential short-term appetitive outcomes of drinking (e.g., intoxication) are deemed more important than potential long-term aversive consequences of drinking (e.g., drunk-driving arrests). Separate but interrelated neurocognitive pathways to impulsive decision making exist - one reflected by weak "top-down" executive control over impulsive and compulsive urges to consume alcohol, the other reflected by a strong "bottom-up" appetitive drive in impulsive and compulsive urges to consume alcohol. We present behavioral evidence of poor executive control and strong appetitive drive and neural evidence describing differences in functional and organizational patterns in brain executive control and appetitive drive networks. We discuss how these behavioral and neural aspects of alcoholism are associated with impulsive decision making and risky behavior in alcoholics, and how these patterns differ at different stages of alcoholism dependence and recovery.

Original languageEnglish (US)
Pages (from-to)227-236
Number of pages10
JournalHandbook of Clinical Neurology
StatePublished - Jan 1 2014


  • Alcohol
  • Appetitive drive
  • Brain network
  • Decision making
  • Executive control
  • Impulsivity
  • Risky behavior


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