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Few studies, however, have examined its relations with drinking during a recovery attempt, and those that have typically used coarse measurements with few follow\u2010up periods. This study examined prospective and reciprocal relations between multiple indices of impulsivity and drinking over a 1\u2010year period among adults with AUD making a significant recovery attempt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009501,\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200941.4, 42.5% Male, 79% White) were enrolled at two sites. Longitudinal trajectories of alcohol use and impulsivity were examined using mixed effects and random\u2010intercept cross\u2010lagged panel models. Drinking variables included drinks per week (DpW), percent drinking days (%DD), and heavy drinking days (%HDD). Impulsivity variables included Negative\/Positive Urgency, Sensation Seeking, Lack of Premeditation, Lack of Perseverance, and a delay discounting task.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with baseline, significant decreases in multiple facets of impulsivity were observed during the follow\u2010up. The most robust relations were for Negative Urgency, with bidirectional cross\u2010lagged effects observed for all drinking outcomes (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      s\u2009=\u20090.09\u20130.18,\n                      <jats:italic>p<\/jats:italic>\n                      s\u2009&lt;\u20090.05) from months 3\u201312. Similarly, Positive Urgency forecasted subsequent %DD months 3\u201312 (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      s\u2009=\u20090.06\u20130.08,\n                      <jats:italic>p<\/jats:italic>\n                      s\u2009&lt;\u20090.05), and Lack of Perseverance predicted %HDD (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      s\u2009=\u20090.062\u20130.066,\n                      <jats:italic>p<\/jats:italic>\n                      s\u2009&lt;\u20090.05) from months 3\u201312. In other cases, drinking forecasted changes in impulsivity over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings highlight the malleability and predictive validity of impulsivity during AUD recovery, but reveal potential specificity by indicator and timeframe. The consistent later\u2010stage bidirectional associations between Negative Urgency and drinking suggest the importance of continuing to address negative emotion regulation during the AUD recovery process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70250","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T05:51:14Z","timestamp":1774417874000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relations between impulsivity and drinking in adults with alcohol use disorder during recovery: A longitudinal observational cohort study"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4595-6017","authenticated-orcid":false,"given":"Molly L.","family":"Garber","sequence":"first","affiliation":[{"name":"Peter Boris Centre for Addictions Research St. Joseph's Healthcare Hamilton  Hamilton Ontario Canada"},{"name":"Department of 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Clifton","sequence":"additional","affiliation":[{"name":"Department of Psychological Science Vassar College  Poughkeepsie New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-0750","authenticated-orcid":false,"given":"John F.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Recovery Research Institute Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8695-1071","authenticated-orcid":false,"given":"James","family":"MacKillop","sequence":"additional","affiliation":[{"name":"Peter Boris Centre for Addictions Research St. Joseph's Healthcare Hamilton  Hamilton Ontario Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences 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