Relationships between generalized impulsivity and subjective stimulant and sedative responses following alcohol administration

Disentangling between- and within-person alcohol and expectancy effects on acute alcohol craving

OBJECTIVE

Alcohol craving is a predictor of continued drinking and a diagnostic criterion for alcohol use disorder. Rewarding subjective effects potentiate craving, but it remains unclear if relations are expectancy-driven vs. alcohol-induced. In addition, it remains unclear if relations operate solely at the person level, or if there is also within-person dynamic change.

METHODS

Participants (N = 448) come from a placebo-controlled alcohol administration study. Participants in the alcohol condition reported subjective effects and alcohol craving on ascending (BAC = .068), peak (BAC = .079), and descending (BAC = .066) BAC limbs. Participants in the placebo condition were yoked to alcohol condition participants. Multilevel models tested whether (1) within-person deviations in subjective effects predicted within-person deviations in craving, (2) between-person levels of subjective effects predicted between-person levels of craving, and (3) effects were dependent upon experimental condition.

RESULTS

At the within-person level, increases in high arousal positive/stimulant effects were associated with within-person increases in alcohol craving, regardless of experimental condition. At the between-person level, interactions were observed between high arousal positive/stimulant (and low arousal positive/relaxing) effects and condition. Probing suggested that the association between person-level high arousal positive/stimulant effects and craving was statistically significant in the alcohol but not the placebo condition. Conversely, the association between person-level low arousal positive/relaxing effects and craving was positive and statistically significant in the placebo but negative in the alcohol condition.

CONCLUSIONS

Findings suggest expectancy-like relations among high arousal positive/stimulant effects and craving within-person. However, alcohol-induced positive reinforcement (i.e., stimulation) facilitated heightened person-level craving, whereas expectancy-like negative reinforcement (i.e., relaxation) attenuated person-level craving.

Planned versus unplanned drinking and cannabis use: Do facets of trait impulsivity influence daily risk?

OBJECTIVE

Planned and unplanned substance use have been examined as predictors of heavier alcohol and cannabis use and problems at the between-person level. However, it remains unclear whether planned versus unplanned use is riskiest at the day-level, and for whom. The present study tested whether day-level planned versus unplanned alcohol and cannabis use were associated with higher alcohol and cannabis consumption and negative consequences that day and whether two impulsive traits, lack of premeditation and positive urgency, moderated associations.

METHOD

Young adults (N = 409; 50.9% female) completed five bursts of daily surveys, each consisting of a morning and afternoon report across 14 consecutive days. During a baseline session, participants reported their impulsivity (UPPS-P). During afternoon surveys, participants reported their plans to use alcohol/cannabis that night. During morning surveys, participants reported number of drinks consumed/hours spent high yesterday and negative consequences experienced.

RESULTS

Planned drinking days were associated with a greater number of drinks and negative consequences, whereas planned cannabis use days were associated with more hours spent high but not negative consequences. In the drinking quantity model, there was a significant interaction for planned versus unplanned drinking by positive urgency. Planned drinking was associated with heavier alcohol consumption across levels of positive urgency; however, unplanned drinking was associated with heavier consumption for individuals with higher (vs. lower) levels of positive urgency.

CONCLUSIONS

Day-level planned drinking and cannabis use are important factors to target in just-in-time interventions. However, interventions focused on planned and unplanned drinking may be particularly effective for individuals with higher levels of positive urgency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Differential effects of UPPS-P impulsivity on subjective alcohol response and craving: An experimental test of acquired preparedness

Recent studies have extended the acquired preparedness model to experimental data, finding that impulsivity predicts subjective alcohol response, a related yet distinct construct from expectancies. However, studies have not tested whether specific facets of impulsivity predict subjective response, or whether impulsivity indirectly predicts alcohol craving through subjective response. Young adults who reported past-month binge drinking (N = 448) participated in a placebo-controlled alcohol administration study. Mediation models tested whether UPPS-P impulsivity facets indirectly predicted alcohol craving through subjective response on the ascending and descending limbs of the blood alcohol content (BAC). High arousal positive (e.g., sociable), low arousal positive (e.g., relaxed), high arousal negative (e.g., rude), and low arousal negative (e.g., dizzy) subjective effects were measured across limbs. Moderation by beverage condition was not detected, so models were collapsed across beverage condition. Sensation seeking indirectly predicted craving through high arousal positive subjective response on both limbs, whereas positive and negative urgency directly predicted craving. When controlling for baseline subjective response and craving, effects of sensation seeking and negative urgency on subjective response and craving became nonsignificant. The effects of positive urgency on craving remained, and an effect of positive urgency on high arousal positive effects emerged on the ascending limb. Findings suggest that relations among impulsivity, subjective response, and craving are contingent upon the specific facet of impulsivity. Interventions targeting predrink cue exposure and/or positive emotionality may be most effective for sensation seekers, whereas targeting subjective response and/or expectancies may be most efficacious for individuals high in positive urgency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily impulsivity is associated with alcohol use and problems via coping motives, but not enhancement motives

BACKGROUND

The present study sought to determine daily associations between impulsivity, coping and enhancement motives, alcohol use, and alcohol problems in the natural environment.

METHODS

Participants were 89 (47 women) heavy drinking, college students from a university in the southeastern U.S. who completed a 14-day ecological momentary assessment study. Each day, participants completed three random reports of momentary impulsivity and indicators of drinking motives and two additional reports at the beginning and end of any drinking occasions.

RESULTS

A series of multilevel mediation models were tested to examine indirect effects from impulsivity to alcohol use and alcohol problems through coping and enhancement motives. At the within-person level, results revealed that greater than usual impulsivity experienced prior to drinking was associated with greater coping motives, and this in turn was associated with greater number of drinks consumed that day (all p values <0.001). A similar indirect effect was revealed when impulsivity predicted alcohol problems that day through coping motives (p values range: <0.001 to .01). Greater enhancement motives than usual were associated with greater number of drinks consumed and alcohol problems experienced that day (p values range: <0.001 to.001), but associations with impulsivity were nonsignificant.

CONCLUSIONS

Findings supported daily fluctuations in drinking to cope motives as a salient mechanism explaining the link between daily impulsivity and level of alcohol use and alcohol problems. Fluctuations in daily impulsivity were associated with changes in motivations to drink which may benefit efforts aimed at reducing alcohol harms among young adults.

Prospective Effects of UPPS-P Impulsivity and Typical Drinking Context on Future Drinking Behavior

OBJECTIVE

Research suggests that impulsivity is a risk factor for problem drinking, but prior studies have yet to examine typical drinking context as a potential moderator of relations between impulsivity and drinking outcomes. Guided by Person-Environment Transactions Theory, the current study tested whether five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) interacted with typical drinking context to prospectively predict drinking quantity.

METHOD

Young adult participants (N = 448; mean age = 22.27) were recruited from a southwestern university and the surrounding community. Data from a baseline survey (Time [T] 1) and a 1-year follow-up (T2) were used for the current analyses. Impulsivity (UPPS-P Impulsive Behavior Scale), typical drinking context, and typical drinking quantity were assessed at T1, and typical drinking quantity at T2.

RESULTS

Context items were loaded onto latent factors comprising high-arousal (e.g., at a tailgate, large house party) and low-arousal (e.g., at a restaurant, on a date) drinking contexts. In univariate (separated by UPPS-P facet) and multivariate (UPPS-P facets together) models, lack of premeditation and positive urgency interacted with high-arousal drinking contexts to predict T2 drinking, such that individuals at high/mean levels of impulsivity drank more heavily the more frequently they drank in high-arousal contexts. Only interactions in univariate models remained significant after a false discovery correction, although effect sizes were very similar across univariate and multivariate models.

CONCLUSIONS

Individuals high in positive urgency and lack of premeditation may be particularly vulnerable to riskier drinking behavior in high-arousal environments. Findings advance the literature on context-specific cues that may be important intervention targets, particularly for individuals high in positive urgency and lack of premeditation.

Prospective Effects of UPPS-P Impulsivity and Typical Drinking Context on Future Drinking Behavior

OBJECTIVE

Research suggests that impulsivity is a risk factor for problem drinking, but prior studies have yet to examine typical drinking context as a potential moderator of relations between impulsivity and drinking outcomes. Guided by Person-Environment Transactions Theory, the current study tested whether five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) interacted with typical drinking context to prospectively predict drinking quantity.

METHOD

Young adult participants (N = 448; mean age = 22.27) were recruited from a southwestern university and the surrounding community. Data from a baseline survey (Time [T] 1) and a 1-year follow-up (T2) were used for the current analyses. Impulsivity (UPPS-P Impulsive Behavior Scale), typical drinking context, and typical drinking quantity were assessed at T1, and typical drinking quantity at T2.

RESULTS

Context items were loaded onto latent factors comprising high-arousal (e.g., at a tailgate, large house party) and low-arousal (e.g., at a restaurant, on a date) drinking contexts. In univariate (separated by UPPS-P facet) and multivariate (UPPS-P facets together) models, lack of premeditation and positive urgency interacted with high-arousal drinking contexts to predict T2 drinking, such that individuals at high/mean levels of impulsivity drank more heavily the more frequently they drank in high-arousal contexts. Only interactions in univariate models remained significant after a false discovery correction, although effect sizes were very similar across univariate and multivariate models.

CONCLUSIONS

Individuals high in positive urgency and lack of premeditation may be particularly vulnerable to riskier drinking behavior in high-arousal environments. Findings advance the literature on context-specific cues that may be important intervention targets, particularly for individuals high in positive urgency and lack of premeditation.

Trajectories of state impulsivity domains before and after alcohol consumption in the naturalistic environment

BACKGROUND AND AIMS

Studies have demonstrated that ecological momentary assessment (EMA) can effectively capture within-person variations in impulsive states and that this relates to alcohol use. The current study aimed to examine the daily trajectories of five facets of impulsivity prior to and following drinking initiation. Additionally, we explored how race, sex, baseline trait impulsivity facets, and ADHD may moderate this relation.

DESIGN AND SETTING

EMA was used to collect real-time data at 6 semi-random time points and self-initiated reports of drinking onset throughout the day over a 10-day period Measurements Five state and trait impulsivity facets were assessed via the UPPS-P. Naturalistic alcohol use, ADHD history, and demographic characteristics were also assessed PARTICIPANTS: Participants were 135 adult drinkers from a larger study examining alcohol response for Black and White adults with and without a history of childhood ADHD FINDINGS: Generalized estimating equations showed that the linear trajectory of negative urgency significantly increased prior to drinking. Following drinking initiation, the linear trajectory of sensation seeking significantly decreased. There was not significant change in the trajectories of positive urgency, lack of premeditation and lack of perseverance before or after drinking initiation. Additionally, race and ADHD history moderated the trajectory of sensation seeking and race moderated the trajectory of lack of planning.

CONCLUSIONS

Findings highlight the possibility of identifying proximal changes in impulsivity facets prior to and after initiation of drinking. Results can be used to inform real-time interventions that target risk periods to ultimately decrease alcohol use.

Drinking less on cannabis use days: The moderating role of UPPS-P impulsive personality traits

Objective: Several studies suggest that alcohol and cannabis co-users are heavier drinkers and experience more alcohol-related consequences. However, day-level associations between co-use and drinking levels are mixed. One reason may be that individual characteristics moderate the daily impact of using alcohol alone or in conjunction with cannabis. The theory would suggest that highly impulsive individuals may drink more on co-use days, yet this assertion remains untested. Therefore, the current study tested whether impulsivity moderated the effect of co-use on same-day drinking quantity within veterans, a high-risk sample for substance use and impulsivity. Method: In a longitudinal observational study, co-using veterans (N = 139) completed three semi-annual assessments reporting on their daily drinking quantity and cannabis use via Timeline Followback (Observations = 19,245) and impulsivity via the UPPS-P. Mixed effect modeling was used to test hypotheses that co-use (compared to alcohol-only) days would be associated with heavier drinking for those high (but not low) in positive and negative urgency. Results: Significant interactions were found for positive urgency (PU) and lack of perseverance (LP), such that individuals at mean and low levels of PU and LP drank less on co-use (compared to alcohol-only) days. There were no significant interactions for other UPPS-P impulsivity facets. Conclusion: Findings are consistent with a substitution/compensatory effect for individuals at mean and low levels of both UPPS-P facets, and may be a byproduct of frequent cannabis use in veterans. In contrast, findings suggest that co-use and alcohol-only days may be characterized by similarly high levels of drinking for highly impulsive individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Neural correlates of inhibitory control are associated with stimulant-like effects of alcohol

Poor inhibitory control and heightened feelings of stimulation after alcohol are two well-established risk factors for alcohol use disorder (AUD). Although these risk factors have traditionally been viewed as orthogonal, recent evidence suggests that the two are related and may share common neurobiological mechanisms. Here we examined the degree to which neural activity during inhibition was associated with subjective reports of stimulation following alcohol. To assess neural changes during inhibition, moderate alcohol drinkers performed a stop signal task during fMRI without drug. To assess subjective responses to alcohol they ingested alcohol (0.8 g/kg) or placebo beverages under double-blind conditions and provided subjective reports of stimulation and sedation. Feelings of stimulation following alcohol were inversely associated with activity in the supplementary motor area, insula, and middle frontal gyrus during inhibition (successful stop trials compared to go trials). Feelings of sedation did not correlate with brain activation. These results extend previous findings suggesting that poor inhibitory control is associated with more positive subjective responses to alcohol. These interrelated risk factors may contribute to susceptibility to future excessive alcohol use, and ultimately lead to neurobiological targets to prevent or treat AUD.

Rewarding Subjective Effects of the NMDAR Antagonist Nitrous Oxide (Laughing Gas) Are Moderated by Impulsivity and Depressive Symptoms in Healthy Volunteers

BACKGROUND

Nitrous oxide (N2O) is an anesthetic gas with both therapeutic and abuse potential. Because N2O is an NMDA receptor (NMDAR) antagonist, its effects are expected to resemble those of the prototypical NMDAR antagonist, ketamine. In this study, we examined the subjective rewarding effects of N2O using measures previously employed in studies of ketamine. We also tested for moderation of these effects by bipolar phenotype, depressive symptoms, and impulsivity.

METHODS

Healthy volunteers were randomly assigned to either 50% N2O (n = 40) or medical air (n = 40). Self-reported rewarding (liking and wanting), and alcohol-like effects were assessed pre-, peri- and post inhalation.

RESULTS

Effect sizes for the various rewarding/alcohol-like effects of N2O were generally similar to those reported in studies of moderate-dose ketamine. Impulsivity moderated the subjective reinforcing (liking) effects of inhaled gas, while depressive symptoms moderated motivational (wanting [more]) effects. However, depression and impulsivity had opposite directional influences, such that higher impulsivity was associated with higher N2O liking, and higher depression, with lower N2O wanting.

CONCLUSION

To the extent that static (versus longitudinal) subjective rewarding effects are a reliable indicator of future problematic drug use, our findings suggests that impulsivity and depression may predispose and protect, respectively, against N2O abuse. Future studies should examine if these moderators are relevant for other NMDAR antagonists, including ketamine, and novel ketamine-like therapeutic and recreational drugs. Similarities between moderate-dose N2O and moderate-dose ketamine in the intensity of certain subjective effects suggest that N2O may, at least to some extent, serve as substitute for ketamine as a safe and easily implemented experimental tool for probing reward-related NMDAR function and dysfunction in humans.

Poor inhibitory control is associated with greater stimulation and less sedation following alcohol

RATIONALE AND OBJECTIVE

Poor inhibitory control is a well-established risk factor for alcohol use disorder (AUD). Similarly, greater sensitivity to the stimulant effects and less sensitivity to the sedative effects of alcohol are also strongly linked to risk for AUD. Traditionally, these two risk factors have been considered to be orthogonal, and thus they have been studied independently. However, recent evidence from animal and human studies suggests that they may be related. The current study examined the relationship between inhibitory control and subjective responses to alcohol in a sample of healthy young adults.

METHODS

Moderate social drinkers (N = 69) first completed the stop signal task to assess inhibitory control. They then participated in four sessions in which they received an oral dose of ethanol (0.8 g/kg) or placebo in alternating order, providing self-report measures of stimulation and sedation on the Biphasic Alcohol Effects Scale (BAES) at regular intervals.

RESULTS

Linear mixed effects models showed that poor inhibitory control was associated with greater stimulation and less sedation following alcohol compared with placebo.

CONCLUSION

These findings provide the first direct evidence that individuals with poor inhibitory control experience greater sensitivity to the rewarding, stimulant effects of alcohol, and less sensitivity to the negative, sedative effects. These findings suggest that inhibition and subjective response to alcohol are not independent risk factors, and that together they constitute a heightened profile of risk for AUD.