Impulsivity is generally described as the tendency of an individual to act and behave with little or no forethought, hardly considering the consequences a given behavior might have on the self or on the community .
Clinical research shows that impulsive behaviour is a risk factor for substance abuse [1-5] and studies demonstrate that it is associated with poor clinical outcomes [6, 7] and relapse, even after long withdrawal periods [8, 9].
Impulsivity is usually assessed through clinical interviews and self-reported questionnaires [10, 11] which mainly measure three different components:
- Attentional impulsivity (tendency to make quick decisions and poor ability to focus on specific tasks)
- Motor impulsivity (the tendency to act without thinking)
- Non-planning impulsivity (the reduced ability or interest to plan ahead and consider the future
While impulsive decision making and impulsive behavior appear to be heavily based on the cognitive/attentive domain [11-13] increased physiological arousal and a wide range of emotional states such as anxiety, anger, sadness, or joy are also associated with impulsivity [14, 15].
From a neurobiological point of view, higher depressive symptoms and impulsivity are associated with both structural and functional anomalies in the brain, including the prefrontal cortex [16-20] and, as these anomalies reflect changes in the electroencephalogram (EEG) [21-24], EEG-based therapeutic interventions for addiction have been explored in research studies.
One of these interventions is EEG-neurofeedback training, is a learning-based form of biofeedback aimed at facilitating self-regulation of EEG activity in target brain regions and networks [25, 26]. EEG-neurofeedback training has been shown to be useful in the treatment of drug addiction, reducing impulsivity and increasing abstinence rates , also playing a role at lowering reactivity to drug-related stimuli .
Other neurofeedback research  also indicates that neurofeedback not only contributed to modulate impulsivity in long-term abstinent addicts but also reduced anxiety and depression symptoms, hence lowering the likelihood for relapse [30-32].
Fig.1 Clinical progression during neurofeedback therapy (the average of clinical symptoms for all subjects/each session is shown over the whole treatment period. NFB: neurofeedback).
Research indicates that neurofeedback training effectively modulates impulsivity in long-term abstinent individuals with history of drug addiction, and that improved control of impulsivity prevents relapse, not only in substance abuse but also in violent behavior.
Moreover, improvement of clinical symptoms of anxiety and depression, suggests that neurofeedback training also improves general well-being in this population.
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