Behavioral Inhibition Network Predicts Alcohol Use in Men and Stress in Women.

OBJECTIVE: Impulsivity, a complex construct linked to addictions, is often inconsistently assessed and conceptualized, making it difficult to effectively target in addiction treatment. The current study aimed to identify neural substrates underlying distinct impulsivity domains and explore their relationships with alcohol use and stress in both women and men. METHOD: We utilized a whole-brain machine learning strategy, connectome-based predictive modeling (CPM), to investigate brain networks linked to four composite impulsivity-related domains previously identified in the NIAAA-funded Brain and Alcohol Research in College Students dataset: impulsive action, approach/appetitive motivation, impulsivity/compulsivity, and behavioral inhibition/punishment sensitivity (BIPS). CPM (5-fold cross-validation, 100 repeats, and permutation testing) was applied using Monetary Incentive Delay Task fMRI data from 287 undergraduates. Identified networks were examined in relation to alcohol use and stress across sexes. RESULTS: The CPM model predicting BIPS was significant (r = 0.24, p = .001). Higher BIPS was associated with increased connectivity between default mode, motor/sensory, and cerebellar networks, and decreased connectivity among medial frontal, frontoparietal, default mode, and motor/sensory networks. BIPS network strength differed by sex (t(285) = 8.26, p < .001), with negative associations with alcohol use (p < .05) in men and positive associations with stressful life events (p < .05) in women. CONCLUSIONS: Identifying a neuromarker of BIPS in young adults may inform targeted interventions for impulsive behaviors, considering sex differences. Future research should explore whether neuromodulation or other interventions targeting this network could mitigate problem drinking in men and stress-related concerns in women.