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Wilhoit SA, Goodnight JA. Deviant peer affiliation mediates the prospective association from impulsivity to alcohol use in late adolescence. J Adolesc 2022; 95:454-467. [PMID: 36451310 DOI: 10.1002/jad.12127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 10/24/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Previous research has found that impulsivity and deviant peer affiliation predict alcohol use among adolescents. However, it remains unclear to what extent these risk factors predict alcohol use in conjunction with one another, and to what extent they predict over and above correlated risk factors, such as pre-existing externalizing problems and sociodemographic characteristics. The present study tested the hypothesis that deviant peer affiliation would mediate the prospective association between impulsivity and alcohol use in adolescence (ages 13-18 years), controlling for a wide range of family and child-level covariates. METHODS Analyses were conducted using data from 2318 participants from the Longitudinal Cohort Study of the Project on Human Development in Chicago Neighborhoods. Participants were approximately 9, 12, or 15 years of age at wave 1 of the study, with waves 2 and 3 taking place at approximately 2-year intervals. The sample composition was 50.3% male, 46.1% Hispanic, 35.6% Black, non-Hispanic, 14.4% White, non-Hispanic, and 3.9% other race/ethnicity. RESULTS Results from path analyses indicated that the prospective association between impulsivity and alcohol use was mediated by peer deviance, but only for the oldest (age 15) cohort. CONCLUSIONS Findings from the present study suggest that despite impulsivity being a dispositional characteristic, its effects on alcohol use in later adolescence are achieved through a social pathway, via affiliation with deviant peers. It further suggests that this pathway, especially the link from impulsivity to affiliation with deviant peers, may not operate until late adolescence. Findings suggest that alcohol use may be prevented or reduced among impulsive adolescents by reducing their exposure to delinquent peers.
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Affiliation(s)
- Sarah A. Wilhoit
- Department of Psychology Wayne State University Detroit Michigan USA
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Stevens AK, Blanchard BE, Littlefield AK. Impulsive dispositions and alcohol: what we know, how we know it, and where to go from here. Borderline Personal Disord Emot Dysregul 2018; 5:4. [PMID: 29556398 PMCID: PMC5845171 DOI: 10.1186/s40479-018-0081-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/01/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Relations between impulsigenic traits and alcohol-related outcomes have been the focus of much research, yet precise relations remain elusive. Historically, research used broadband conceptualizations of impulsivity, which yielded inconclusive findings. Attempts to ameliorate this problem led to more work on narrowband assessments of impulsivity. Despite that several narrowband self-report measures exist, few demonstrate adequate psychometric properties. Given the limits of self-report, researchers have also utilized laboratory-based measures of impulsive dispositions; however, this seems to have contributed more uncertainty to the literature. REVIEW We review commonly used self-report and laboratory-based measures of narrowband impulsivity, as well as assessments of alcohol-related constructs (e.g., consumption and consequences). We discuss remaining issues in impulsivity and alcohol assessment, which limit understanding of how impulsigenic traits influence alcohol-related behaviors. Cutting-edge conceptualizations and assessment of state-level impulsivity are also discussed. CONCLUSIONS More work is necessary to further this area of research, including establishing consistent nomenclature and a cohesive conceptualization of impulsigenic traits as they relate to alcohol use and alcohol use disorders.
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Affiliation(s)
- Angela K. Stevens
- Department of Psychological Sciences Texas Tech University, MS 2051 Psychological Sciences Building, Rm. 404, Lubbock, Texas 79409-2051 USA
| | - Brittany E. Blanchard
- Department of Psychological Sciences Texas Tech University, MS 2051 Psychological Sciences Building, Rm. 404, Lubbock, Texas 79409-2051 USA
| | - Andrew K. Littlefield
- Department of Psychological Sciences Texas Tech University, MS 2051 Psychological Sciences Building, Rm. 404, Lubbock, Texas 79409-2051 USA
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Evren C, Umut G, Bozkurt M, Evren B. Relationship of PTSD With impulsivity Dimensions While Controlling the Effect of Anxiety and Depression in a Sample of Inpatients With Alcohol Use Disorder. J Dual Diagn 2018; 14:40-49. [PMID: 29166213 DOI: 10.1080/15504263.2017.1404665] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the relationship of posttraumatic stress disorder (PTSD) with impulsivity dimensions while controlling the effect of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). METHODS Participants were 190 male patients admitted to a specialized center for substance use disorders within a six month period. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Traumatic Experiences Checklist, and PTSD Checklist-Civilian version. RESULTS Age was lower in the group with PTSD (n = 63, 33.2%) than the group without PTSD (n = 127, 66.8%). Duration of education, marital, and employment status did not differ between the groups. STAI, BDI, and BIS-11-SF scores were higher in the group with PTSD. Trait anxiety, depression, and impulsivity predicted high PTSD risk in a logistic regression model. Same variables predicted the severity of PTSD symptoms in a linear regression. Among dimensions of impulsivity attentional component was the only predictor of PTSD symptoms severity, not motor or nonplanning impulsivity. CONCLUSIONS These findings suggest that the PTSD may be related to impulsivity, particularly attentional impulsivity, even after controlling anxiety and depression among inpatients with AUD.
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Affiliation(s)
- Cuneyt Evren
- a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) , Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Gokhan Umut
- a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) , Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Muge Bozkurt
- a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) , Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Bilge Evren
- b Department of Psychiatry , Baltalimani State Hospital for Muskuloskeletal Disorders , Istanbul , Turkey
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DeVito EE, Herman AI, Konkus NS, Zhang H, Sofuoglu M. Atomoxetine in abstinent cocaine users: Sex differences. Data Brief 2017; 14:566-572. [PMID: 28861456 PMCID: PMC5568877 DOI: 10.1016/j.dib.2017.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 12/04/2022] Open
Abstract
Data presented are from a sex-differences secondary analysis of a human laboratory investigation of single doses of atomoxetine (40 mg and 80 mg) versus placebo in abstinent individuals with cocaine use disorders (CUD). Subjective drug effects, cognitive performance and cardiovascular measures were assessed. The primary atomoxetine dose analyses (which do not consider sex as a factor) are reported in full elsewhere (DeVito et al., 2017) [1].
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Affiliation(s)
- Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, United States.,Veterans Affairs Medical Center, West Haven, CT, United States
| | - Aryeh I Herman
- Department of Psychiatry, Yale School of Medicine, United States.,Veterans Affairs Medical Center, West Haven, CT, United States
| | - Noah S Konkus
- Department of Psychiatry, Yale School of Medicine, United States
| | - Huiping Zhang
- Department of Psychiatry, Yale School of Medicine, United States
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, United States.,Veterans Affairs Medical Center, West Haven, CT, United States
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DeVito EE, Herman AI, Konkus NS, Zhang H, Sofuoglu M. Atomoxetine in abstinent cocaine users: Cognitive, subjective and cardiovascular effects. Pharmacol Biochem Behav 2017; 159:55-61. [PMID: 28716656 DOI: 10.1016/j.pbb.2017.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/01/2017] [Accepted: 07/03/2017] [Indexed: 01/09/2023]
Abstract
No pharmacotherapies are approved for the treatment of cocaine use disorders (CUD). Behavioral treatments for CUD are efficacious for some individuals, but recovery rates from CUD remain low. Cognitive impairments in CUD have been linked with poorer clinical outcomes. Cognitive enhancing pharmacotherapies have been proposed as promising treatments for CUD. Atomoxetine, a norepinephrine transporter inhibitor, shows potential as a treatment for CUD based on its efficacy as a cognitive enhancer in other clinical populations and impact on addictive processes in preclinical and human laboratory studies. In this randomized, double-blind, crossover study, abstinent individuals with CUD (N=39) received placebo, 40 and 80mg atomoxetine, over three sessions. Measures of attention, response inhibition and working memory; subjective medication effects and mood; and cardiovascular effects were collected. Analyses assessed acute, dose-dependent effects of atomoxetine. In addition, preliminary analyses investigating the modulation of atomoxetine dose effects by sex were performed. Atomoxetine increased heart rate and blood pressure, was rated as having positive and negative subjective drug effects, and had only modest effects on mood and cognitive enhancement.
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Affiliation(s)
- Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, 1 Church Street, New Haven, CT 06510, USA; Veterans Affairs Medical Center, 950 Campbell Avenue, West Haven, CT 06516, USA.
| | - Aryeh I Herman
- Veterans Affairs Medical Center, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA
| | - Noah S Konkus
- Department of Psychiatry, Yale School of Medicine, 1 Church Street, New Haven, CT 06510, USA.
| | - Huiping Zhang
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA.
| | - Mehmet Sofuoglu
- Veterans Affairs Medical Center, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA.
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Anton RF, Schacht JP, Voronin KE, Randall PK. Aripiprazole Suppression of Drinking in a Clinical Laboratory Paradigm: Influence of Impulsivity and Self-Control. Alcohol Clin Exp Res 2017; 41:1370-1380. [PMID: 28493623 DOI: 10.1111/acer.13417] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/05/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Aspects of impulsivity have been implicated in the development, or maintenance, of alcohol use disorder (AUD). The brain dopamine system is implicated in both reward processing/memory (typically subcortical) and in brain inhibitory control mechanisms (typically cortical). Using a validated clinical laboratory paradigm, the dopamine/serotonin "stabilizing" drug, aripiprazole was evaluated in non-treatment-seeking AUD individuals based on their level of impulsivity/self-control. METHODS Ninety-nine individuals (77% male; mean age 27; 7.5 drinks per day; 83% heavy drinking days) meeting DSM-IV criteria for alcohol dependence were randomized to aripiprazole (N = 47 evaluable) or placebo (N = 48 evaluable) based on their Barratt Impulsiveness Scale (BIS-11) score (above or below 68). Aripiprazole, or similar placebo, was titrated to 15 mg over 8 days. Drinking was recorded over 6 days under natural conditions. On Day 8, after 1 day of required abstinence, individuals participated in a bar laboratory paradigm that included a priming drink (breath alcohol concentration [BAC] target 0.02 to 0.03 g/dl) and free-choice consumption of up to 8 drinks (max BAC 0.1 g/dl) in exchange for a "bar credit" of $2 per drink (max $16). End points were drinks per day under natural conditions and drinks consumed in the bar laboratory after the priming drink. RESULTS There was no significant main effect of aripiprazole or interaction with BIS-11 score during the natural drinking period. However, there was a main effect of aripiprazole on bar laboratory drinking (p = 0.04) and aripiprazole reduced the total number of drinks consumed more among individuals with low self-control (p = 0.034) and increased latency to consume those drinks (p = 0.045) more among those with high impulsivity. Relative to placebo, aripiprazole caused more side effects and increased alcohol-induced sedation, but neither significantly influenced its interaction with impulsivity/self-control scores on drinking. CONCLUSIONS This paradigm forced a choice between immediate drinking reward and delayed monetary reward. In those with high impulsivity and/or low self-control, aripiprazole shifts the balance away from immediate drinking toward a later reward. Medications targeting cortical dopamine/serotonin balance might show clinical benefit of reduced drinking, among individuals with impulsivity/low self-control.
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Affiliation(s)
- Raymond F Anton
- Alcohol Research Center, Addictions Science Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Joseph P Schacht
- Alcohol Research Center, Addictions Science Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Konstantin E Voronin
- Alcohol Research Center, Addictions Science Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Patrick K Randall
- Alcohol Research Center, Addictions Science Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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Caswell AJ, Celio MA, Morgan MJ, Duka T. Impulsivity as a Multifaceted Construct Related to Excessive Drinking Among UK Students. Alcohol Alcohol 2015; 51:77-83. [PMID: 26115988 DOI: 10.1093/alcalc/agv070] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 05/30/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS A substantial number of university students exceed alcohol guidelines. Impulsivity has been repeatedly implicated in heavy alcohol use, yet despite knowledge that impulsivity is multifaceted, there have previously been few studies applying multiple measures of self-report and behavioural impulsivity to examine the relationship with excessive student drinking. This results in a limited understanding of the relationship of various facets of impulsivity to student drinking. METHODS Participants completed a comprehensive battery of impulsivity measures: the Barratt Impulsiveness Scale as a self-report index and the Stop Signal Task, Information Sampling Task and Monetary Choice Questionnaire as behavioural measures of three facets of impulsivity. Participants who exceeded UK drinking guidelines were compared to those who did not on measures of impulsivity. Hierarchical linear regression was then employed to test whether indices of impulsivity were associated with the average units consumed per week. RESULTS Participants who exceeded UK guidelines reported increased impulsivity in facets of self-report impulsivity. They also displayed performance deficits in normal adjustment of Go responses on the Stop Signal Task. In the regression model, nonplanning impulsivity on the Barratt Impulsiveness Scale was seen to predict quantity of alcohol consumed per month. CONCLUSIONS The study applies a comprehensive selection of behavioural and self-report measures of impulsivity and indicates that excessive drinkers are more impulsive in some but not all aspects. The results indicate that the wide range of deficits apparent in alcohol-dependent individuals are not evident in this younger, heavy drinking population, but that specific performance and self-identified deficits are already apparent.
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Affiliation(s)
- A J Caswell
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI 02909, USA
| | - M A Celio
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI 02909, USA
| | - M J Morgan
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK Sussex Addiction Research and Intervention Centre (SARIC), School of Psychology, University of Sussex, Brighton BN1 9QH, UK Norwegian Center for Addiction Research, University of Oslo, Oslo, Norway
| | - T Duka
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK Sussex Addiction Research and Intervention Centre (SARIC), School of Psychology, University of Sussex, Brighton BN1 9QH, UK
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Dougherty DM, Mullen J, Hill-Kapturczak N, Liang Y, Karns TE, Lake SL, Mathias CW, Roache JD. Effects of tryptophan depletion and a simulated alcohol binge on impulsivity. Exp Clin Psychopharmacol 2015; 23:109-21. [PMID: 25730415 PMCID: PMC4388789 DOI: 10.1037/a0038943] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Researchers have suggested binge drinkers experience disproportionate increases in impulsivity during the initial period of drinking, leading to a loss of control over further drinking, and that serotonergic mechanisms may underlie such effects. We examined the effects of a simulated alcohol binge and tryptophan depletion on 3 types of impulsivity-response initiation (immediate memory task [IMT]), response inhibition (GoStop task), and delay discounting (single key impulsivity paradigm [SKIP])-and tested whether observed effects were related to real-world binging. Adults (N = 179) with diverse drinking histories completed a within-subject crossover design over 4 experimental days. Each day, participants underwent 1 of 4 test conditions: tryptophan depletion/alcohol, tryptophan depletion/placebo, tryptophan-balanced control/alcohol, or tryptophan-balanced control/placebo. The simulated binge involved consuming 0.3 g/kg of alcohol at 5, 6, and 7 hr after consuming the tryptophan-depletion/balanced mixture. Impulsivity was measured before and after each drink. Relative to the placebo beverage condition, when alcohol was consumed, impulsive responding was increased at moderate and high levels of intoxication on the IMT and the GoStop but only at high levels of intoxication on the SKIP. Tryptophan depletion had no effect on impulsivity. Effects of alcohol and tryptophan manipulations on impulsivity were unrelated to patterns of binge drinking outside the laboratory. The effects of alcohol consumption on impulsivity depend on the component of impulsivity and the dose of alcohol consumed. Such effects do not appear to be a result of reduced serotonin synthesis. In addition, real-world binge drinking behaviors were unrelated to behavioral changes observed in the laboratory.
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Affiliation(s)
- Donald M. Dougherty
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX,Corresponding Author: Donald M. Dougherty, Ph.D., Professor and Director of the Division of Neurobehavioral Research, Department of Psychiatry, The University of Texas Health Science Center at San Antonio, NRLC MC 7793, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA, , Phone: 210-567-2745; Fax: 210-567-2748
| | - Jillian Mullen
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Yuanyuan Liang
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Tara E. Karns
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Sarah L. Lake
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Charles W. Mathias
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - John D. Roache
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX
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Bozkurt M, Evren C, Can Y, Evren B, Cetingok S, Yilmaz A. Relationships of personality dimensions with impulsivity in alcohol-dependent inpatient men. Nord J Psychiatry 2014; 68:316-22. [PMID: 24047120 DOI: 10.3109/08039488.2013.830772] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Impulsivity is closely related to substance use and abuse, both as a contributor to use and as a consequence of use. Particular dimensions of temperament and character were reported to be associated with trait impulsivity in different populations. AIM The aim of the present study was to evaluate the relationship of personality dimensions with impulsivity among men with alcohol dependence. Also we wanted to control the effect of depression and anxiety symptoms on this relationship. METHODS Participants were consecutively admitted male alcohol-dependent inpatients (n = 94) and healthy controls (n = 63). Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), the Temperament and Character Inventory (TCI) and the Symptom Checklist-Revised (SCL-90-R). RESULTS Severity of impulsivity and dimensions of impulsivity were higher in alcohol-dependent inpatients than in healthy controls. Impulsivity was negatively correlated with reward dependence, persistence, self-directedness and cooperativeness, but positively correlated with novelty seeking, harm avoidance, depression and anxiety. Although high depression and temperament dimensions (high novelty seeking, harm avoidance and low reward dependence) predicted impulsivity, combinations of personality dimensions that predict dimensions of impulsivity differed. CONCLUSIONS RESULTS may suggest that together with depression when impulsivity is the problem, both dimensions of impulsivity and personality must be evaluated and the treatment should be shaped accordingly for alcohol-dependent inpatients.
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Affiliation(s)
- Muge Bozkurt
- Muge Bozkurt, M.D., Psychiatrist, Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy State Hospital for Psychiatric and Neurological Diseases , Istanbul , Turkey
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Wilcox CE, Dekonenko CJ, Mayer AR, Bogenschutz MP, Turner JA. Cognitive control in alcohol use disorder: deficits and clinical relevance. Rev Neurosci 2014; 25:1-24. [PMID: 24361772 DOI: 10.1515/revneuro-2013-0054] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 11/27/2013] [Indexed: 01/25/2023]
Abstract
Cognitive control refers to the internal representation, maintenance, and updating of context information in the service of exerting control over thoughts and behavior. Deficits in cognitive control likely contribute to difficulty in maintaining abstinence in individuals with alcohol use disorders (AUD). In this article, we define three cognitive control processes in detail (response inhibition, distractor interference control, and working memory), review the tasks measuring performance in these areas, and summarize the brain networks involved in carrying out these processes. Next, we review evidence of deficits in these processes in AUD, including both metrics of task performance and functional neuroimaging. Finally, we explore the clinical relevance of these deficits by identifying predictors of clinical outcome and markers that appear to change (improve) with treatment. We observe that individuals with AUD experience deficits in some, but not all, metrics of cognitive control. Deficits in cognitive control may predict clinical outcome in AUD, but more work is necessary to replicate findings. It is likely that performance on tasks requiring cognitive control improves with abstinence, and with some psychosocial and medication treatments. Future work should clarify which aspects of cognitive control are most important to target during treatment of AUD.
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Adinoff B, Devous MD, Williams MJ, Harris TS, Best SE, Dong H, Zielinski T. Differences in regional cerebral blood flow response to a 5HT3 antagonist in early- and late-onset cocaine-dependent subjects. Addict Biol 2014; 19:250-61. [PMID: 22458709 DOI: 10.1111/j.1369-1600.2012.00450.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
5-hydroxytryptamine 3 (5HT3) receptors are important modulators of mesostriatal dopaminergic transmission and have been implicated in the pathophysiology of cocaine reward, withdrawal and self-administration. In addition, the 5HT3 antagonist ondansetron is effective in treating early-onset, but not late-onset, alcohol-dependent subjects. To explore the role of 5HT3 receptor systems in cocaine addiction using functioning imaging, we administered ondansetron to 23 abstinent, treatment-seeking cocaine-addicted and 22 sex-, age- and race-matched healthy control participants. Differences between early- (first use before 20 years, n = 10) and late-onset (first use after 20 years, n = 10) cocaine-addicted subjects were also assessed. On two separate days, subjects were administered ondansetron (0.15 mg/kg intravenously over 15 minutes) or saline. Regional cerebral blood flow (rCBF) was measured following each infusion with single photon emission computed tomography. No significant rCBF differences between the cocaine-addicted and control participants were observed following ondansetron relative to saline. Early-onset subjects, however, showed increased (P < 0.001) right posterior parahippocampal rCBF following ondansetron. In contrast, late-onset subjects showed decreased rCBF following ondansetron in an overlapping region of the right parahippocampal/hippocampal gyrus. Early-onset subjects also displayed increased rCBF in the left anterior insula and subthalamic nucleus following ondansetron; late-onset subjects showed decreased rCBF in the right anterior insula. These findings suggest that the age of drug use onset is associated with serotonergic biosignatures in cocaine-addicted subjects. Further clarification of these alterations may guide targeted treatment with serotonergic medications similar to those successfully used in alcohol-dependent patients.
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Affiliation(s)
- Bryon Adinoff
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA VA North Texas Health Care System, Dallas, TX, USA Nuclear Medicine Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA University of Texas School of Public Health, Dallas, TX, USA
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12
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Yarosh HL, Hyatt CJ, Meda SA, Jiantonio-Kelly R, Potenza MN, Assaf M, D.Pearlson G. Relationships between reward sensitivity, risk-taking and family history of alcoholism during an interactive competitive fMRI task. PLoS One 2014; 9:e88188. [PMID: 24505424 PMCID: PMC3913753 DOI: 10.1371/journal.pone.0088188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/04/2014] [Indexed: 01/03/2023] Open
Abstract
Background Individuals with a positive family history for alcoholism (FHP) have shown differences from family-history-negative (FHN) individuals in the neural correlates of reward processing. FHP, compared to FHN individuals, demonstrate relatively diminished ventral striatal activation during anticipation of monetary rewards, and the degree of ventral striatal activation shows an inverse correlation with specific impulsivity measures in alcohol-dependent individuals. Rewards in socially interactive contexts relate importantly to addictive propensities, yet have not been examined with respect to how their neural underpinnings relate to impulsivity-related measures. Here we describe impulsivity measures in FHN and FHP individuals as they relate to a socially interactive functional magnetic resonance imaging (fMRI) task. Methods Forty FHP and 29 FHN subjects without histories of Axis-I disorders completed a socially interactive Domino task during functional magnetic resonance imaging and completed self-report and behavioral impulsivity-related assessments. Results FHP compared to FHN individuals showed higher scores (p = .004) on one impulsivity-related factor relating to both compulsivity (Padua Inventory) and reward/punishment sensitivity (Sensitivity to Punishment/Sensitivity to Reward Questionnaire). Multiple regression analysis within a reward-related network revealed a correlation between risk-taking (involving another impulsivity-related factor, the Balloon Analog Risk Task (BART)) and right ventral striatum activation under reward >punishment contrast (p<0.05 FWE corrected) in the social task. Conclusions Behavioral risk-taking scores may be more closely associated with neural correlates of reward responsiveness in socially interactive contexts than are FH status or impulsivity-related self-report measures. These findings suggest that risk-taking assessments be examined further in socially interactive settings relevant to addictive behaviors.
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Affiliation(s)
- Haley L. Yarosh
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut, United States of America
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail:
| | - Christopher J. Hyatt
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut, United States of America
| | - Shashwath A. Meda
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut, United States of America
| | - Rachel Jiantonio-Kelly
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut, United States of America
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Michal Assaf
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut, United States of America
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Godfrey D.Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut, United States of America
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
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Coskunpinar A, Dir AL, Cyders MA. Multidimensionality in impulsivity and alcohol use: a meta-analysis using the UPPS model of impulsivity. Alcohol Clin Exp Res 2013; 37:1441-50. [PMID: 23578176 DOI: 10.1111/acer.12131] [Citation(s) in RCA: 335] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 01/30/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although there is considerable support for the relationship between impulsivity and alcohol use, the use of multidimensional conceptualizations of impulsivity and alcohol use has lead to varying relationship sizes across studies. The aims of the current meta-analysis are to (i) examine variability in the magnitude of the bivariate relationship between impulsivity and alcohol use across studies and (ii) describe the pattern of effects between specific impulsivity traits and alcohol use variables, using the UPPS model of impulsivity. METHODS Ninety-six studies were meta-analyzed using a random effects model to examine the relationship between general impulsivity and alcohol use, as well as the relationships among separate impulsivity traits based in the UPPS model of impulsivity and specific alcohol use outcomes. RESULTS Results indicate that, in general, impulsivity and alcohol use are related (r = 0.28); however, this effect size varied significantly across studies (from -0.05 to 1.02). Drinking quantity was most strongly predicted by lack of perseverance (r = 0.32), whereas all traits equally predicted drinking frequency. Drinking problems were most highly related to negative (r = 0.35) and positive (r = 0.34) urgency, and alcohol dependence was most highly related to negative urgency (r = 0.38) and lack of planning (r = 0.37). CONCLUSIONS Effect sizes between impulsivity and alcohol use vary significantly by UPPS trait used in each study; thus, findings suggest and further reinforce the view in the literature that specific impulsivity-related constructs differentially relate to specific alcohol use outcomes.
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Affiliation(s)
- Ayca Coskunpinar
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
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Reed SC, Levin FR, Evans SM. Alcohol increases impulsivity and abuse liability in heavy drinking women. Exp Clin Psychopharmacol 2012; 20:454-65. [PMID: 23066857 PMCID: PMC3598581 DOI: 10.1037/a0029087] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Heavy drinking has increased in recent years and has been linked to numerous health-related risks, particularly in women. A number of factors may play a role in exacerbating the risks linked to heavy drinking, such as impulsivity, which itself is related to a number of risky behaviors. The present study investigated the effects of alcohol (0, 0.5, 0.75 g/kg) on impulsivity in female heavy drinkers (n = 23) and female light drinkers (n = 23) using a double-blind, placebo-controlled outpatient design; all women were tested during follicular phase of the menstrual cycle. Each session, participants completed a range of tasks including subjective measures of abuse liability, cognitive performance tasks, three behavioral impulsivity tasks, and a risk-taking task. Alcohol increased impulsivity on the Immediate and Delayed Memory Task (IMT and DMT) and Delay Discounting task. Heavy drinkers scored higher on impulsivity self-reports and were more impulsive on the IMT and the GoStop task than light drinkers. The high dose of alcohol further increased impulsive performance on the IMT and DMT in heavy drinkers. There were no group differences or alcohol effects on the Balloon Analogue Risk Task. Alcohol increased sedative-like effects more in light drinkers and increased stimulant-like effects and alcohol liking more in heavy drinkers. In summary, female heavy drinkers are less sensitive to the negative effects of alcohol, report more positive effects of alcohol, and are more impulsive than female light drinkers. Moreover, impulsive responding was exacerbated by alcohol drinking among female heavy drinkers, indicating that women who drink at this level are at increased risk for developing alcohol use disorders and engaging in other risky behaviors, particularly after drinking.
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Affiliation(s)
- Stephanie Collins Reed
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA.
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15
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Impulsive sensation seeking, parental history of alcohol problems, and current alcohol and tobacco use in adolescents. J Addict Med 2012; 2:185-93. [PMID: 19956365 DOI: 10.1097/adm.0b013e31818d8916] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study attempted to evaluate whether impulsive sensation seeking mediated the relationship between parental alcohol problems and offspring alcohol and tobacco use. METHODS Participants were Connecticut high school students (n = 2733) completing a survey of high-risk behaviors. Variables of interest included past month alcohol use, past month binge alcohol use, frequency of past month alcohol use, past month tobacco use, having a biological parent with an alcohol problem, and score on the impulsive sensation seeking (ImpSS) scale from the Zuckerman-Kuhlman Personality Questionnaire - Form III. RESULTS ImpSS scores were elevated in past month users of alcohol, binge users of alcohol, users of both tobacco and alcohol, and they increased with increasing frequency of past month alcohol use. Also, parental history of alcohol use increased the likelihood of past month alcohol use, binge use, use of both tobacco and alcohol, and higher levels of past month alcohol use. Mediational analyses did not appear to support the hypothesis that impulsive sensation seeking mediates the relationship between parental history of alcohol problems and alcohol and tobacco use in offspring. CONCLUSIONS Impulsive sensation seeking and parental history of alcohol problems appear to be independent factors that contribute to the co-occurrence of alcohol and tobacco use in adolescents. These findings can inform prevention and treatment efforts.
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Prisciandaro JJ, Korte JE, McRae-Clark AL, Brady KT. Associations between behavioral disinhibition and cocaine use history in individuals with cocaine dependence. Addict Behav 2012; 37:1185-8. [PMID: 22710029 DOI: 10.1016/j.addbeh.2012.05.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 05/29/2012] [Accepted: 05/30/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Behavioral disinhibition has been suggested as both a cause and consequence of substance use disorders. Many studies examining associations between behavioral disinhibition and substance use history have focused on individuals with alcohol dependence or non-dependent college students. In the present study, the relationship between behavioral disinhibition and cocaine use history in individuals with cocaine dependence is examined. METHODS Forty-six non-treatment-seeking cocaine-dependent men and women completed impulsivity (Barratt impulsiveness scale; BIS) and novelty seeking (temperament and character inventory; TCI) questionnaires at the baseline visit of an ongoing study. Unadjusted, and adjusted for gender and age, Pearson correlations were calculated between BIS, TCI, and cocaine use variables from the structured clinical interview for DSM-IV and timeline follow-back (age of onset, quantity/frequency of past 30 day cocaine use). RESULTS As expected, elevated motor impulsivity and novelty seeking were each associated with younger age of dependence onset. Also, individuals with lower levels of persistence on the TCI reported more days of cocaine use over the previous month. Unexpectedly, increased novelty seeking and attentional impulsivity were associated with fewer days of cocaine use and less money spent on cocaine, respectively. Controlling for age and gender did not substantially change the pattern of observed associations. CONCLUSIONS The present study provides preliminary evidence for associations between behavioral disinhibition and cocaine use history in cocaine-dependent individuals. Given our relatively small sample size and the correlational nature of our findings, further research is needed to replicate and extend our results.
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Lejuez CW, Magidson JF, Mitchell SH, Sinha R, Stevens MC, de Wit H. Behavioral and biological indicators of impulsivity in the development of alcohol use, problems, and disorders. Alcohol Clin Exp Res 2010; 34:1334-45. [PMID: 20491733 DOI: 10.1111/j.1530-0277.2010.01217.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Alcohol use disorders (AUDs) are a devastating public health problem. The construct of impulsivity is biologically based and heritable, and its various dimensions are relevant for understanding alcohol use. The goal of the current manuscript is to review recent behavioral and biological research examining various dimensions of impulsivity and their relation to AUDs from risk for initial use through dependence and relapse. Moreover, we also highlight key psychological variables including affective processes as they relate to current use and early indications of alcohol problems, as well as psychopathology, violence, and aggression in relation to AUDs. Each section includes a critical summary and we conclude the review with future directions focused on issues relevant to measurement, causality, and intervention. Throughout the review, we attempt to be as specific as possible about the dimensions of impulsivity being referenced, while attempting to draw parallels and highlighting differences as the existing literature allows.
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Affiliation(s)
- C W Lejuez
- Department of Psychology, University of Maryland, Center for Addictions, Personality and Emotion Research, Maryland 20742, USA.
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18
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Binge drinking in undergraduates: relationships with sex, drinking behaviors, impulsivity, and the perceived effects of alcohol. Behav Pharmacol 2009; 20:518-26. [PMID: 19730367 DOI: 10.1097/fbp.0b013e328330c779] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Binge drinking on university campuses is associated with social and health-related problems. To determine the factors that may predict this behavior, we collected information on alcohol use, alcohol expectations, and impulsivity from 428 undergraduate students attending a Canadian university. The subjective effects of a binge drinking dose of alcohol were assessed in a subset of participants. In the larger sample, 72% of students reported drinking at or above binge drinking thresholds on a regular basis. Men reported alcohol consumption per drinking occasion, which was consistent with other studies, but the frequency of drinking occasions among women was higher than in earlier studies, suggesting that consumption in women may be increasing. Compared with men, women reported different expectations of alcohol, specifically related to sociability and sexuality. Self-reported impulsivity scores were related, albeit weakly, to drinking behaviors and to expectations in both the sexes. Finally, intoxicated binge drinkers reported feeling less intoxicated, liking the effects more, and wanting more alcohol than did non-binge drinkers receiving an equivalent dose of alcohol. These results have implications for sex-specific prevention strategies for binge drinking on university campuses.
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Two types of classification in female alcoholism. Arch Womens Ment Health 2009; 12:291-9. [PMID: 19434477 DOI: 10.1007/s00737-009-0075-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 04/23/2009] [Indexed: 10/20/2022]
Abstract
Two types of alcoholism with distinct clinical features and mode of inheritance have been identified in male alcoholics. The relevant studies, however, have given consistent results in men but not in women. The current study tested the hypothesis that the type I and II classification is also valid in women. A sample of 103 hospitalised alcohol-dependent women were given face-to-face structured interviews considering four different classification criteria sets devised for differentiation of alcoholism type I and II and type A and B along with SCID I and II. The two types of classification could be replicated with three of the four criteria sets, 73 women being allocated to the larger cluster C1, and 30 women to a smaller cluster C2. Comparing the patients from both clusters with each other, eight variables were identified which excellently discriminate between the groups. The two types of classification for alcoholism could also be found in a female sample. A type II of female alcohol-dependent patient was identified, characterized by parental alcoholism and paternal and patient's tendency for violent behavior. Type I lacks these characteristics. Early identification of the type II female alcoholic may be clinically important.
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Edmonds GW, Bogg T, Roberts BW. Are personality and behavioral measures of impulse control convergent or distinct predictors of health behaviors? JOURNAL OF RESEARCH IN PERSONALITY 2009. [DOI: 10.1016/j.jrp.2009.06.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rothman EF, Edwards EM, Heeren T, Hingson RW. Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers. Pediatrics 2008; 122:e298-304. [PMID: 18676515 DOI: 10.1542/peds.2007-3412] [Citation(s) in RCA: 189] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States. METHODS In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank. RESULTS Sixty-six percent of respondents reported >or=1 adverse childhood experiences, and 19% reported experiencing >or=4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at <or=14 years of age (compared with at >or=21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol. CONCLUSIONS Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be social).
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Affiliation(s)
- Emily F Rothman
- Department of Social and Behavioral Sciences, Boston University School of Public Health, Boston, Massachusetts 02118, USA.
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von Diemen L, Bassani DG, Fuchs SC, Szobot CM, Pechansky F. Impulsivity, age of first alcohol use and substance use disorders among male adolescents: a population based case-control study. Addiction 2008; 103:1198-205. [PMID: 18494839 DOI: 10.1111/j.1360-0443.2008.02223.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the association between impulsivity, age of first alcohol consumption (AFD) and substance use disorders (SUD) in a non-clinical sample of adolescents. DESIGN AND SETTING Population-based case-control study of male adolescents between 15 and 20 years of age nested in a community survey in southern Brazil. PARTICIPANTS Cases were drug or alcohol abusers/dependents defined according to DSM-IV abuse/dependence criteria (n = 63). Individuals who had experienced alcohol use but where non-abusers served as controls (n = 355). Cases and controls completed a structured face-to-face interview. MEASUREMENTS The Mini International Neuropsychiatric Interview (MINI) was completed during the original survey and used to identify cases and controls. Impulsivity was measured by means of the Barratt Impulsivity Scale (BIS 11). Self-reported AFD and socio-demographic data were collected and analyzed through logistic regression according to a hierarchical model. FINDINGS Impulsivity and AFD were significantly associated with SUD. Both higher impulsivity [odds ratio (OR) 3.3, 95% confidence interval (CI) 1.4-7.8] and earlier AFD (OR 1.2, 95% CI 1.0-1.3) remained associated with SUD after model adjustments. CONCLUSIONS The findings from this population-based case-control study suggest that impulsivity and age of first alcoholic drink are associated strongly with alcohol and drug problems. Additionally, impulsivity seems to contribute to a premature exposure to alcohol by hastening the AFD. If the temporal effect of these associations is confirmed in longitudinal designs including broader population groups, our findings may contribute to the development of clinical and policy interventions aiming at reducing the incidence and morbidity associated with substance-related problems among adolescents.
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Affiliation(s)
- Lisia von Diemen
- Center for Drug and Alcohol Research, Federal University of Rio Grande do Sul, Brazil.
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Verdejo-García A, Lawrence AJ, Clark L. Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies. Neurosci Biobehav Rev 2008; 32:777-810. [PMID: 18295884 DOI: 10.1016/j.neubiorev.2007.11.003] [Citation(s) in RCA: 915] [Impact Index Per Article: 57.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 11/28/2007] [Accepted: 11/29/2007] [Indexed: 11/19/2022]
Abstract
There is a longstanding association between substance-use disorders (SUDs) and the psychological construct of impulsivity. In the first section of this review, personality and neurocognitive data pertaining to impulsivity will be summarised in regular users of four classes of substance: stimulants, opiates, alcohol and 3,4-methylenedioxymethamphetamine (MDMA). Impulsivity in these groups may arise via two alternative mechanisms, which are not mutually exclusive. By one account, impulsivity may occur as a consequence of chronic exposure to substances causing harmful effects on the brain. By the alternative account, impulsivity pre-dates SUDs and is associated with the vulnerability to addiction. We will review the evidence that impulsivity is associated with addiction vulnerability by considering three lines of evidence: (i) studies of groups at high-risk for development of SUDs; (ii) studies of pathological gamblers, where the harmful consequences of the addiction on brain structure are minimised, and (iii) genetic association studies linking impulsivity to genetic risk factors for addiction. Within each of these three lines of enquiry, there is accumulating evidence that impulsivity is a pre-existing vulnerability marker for SUDs.
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Affiliation(s)
- Antonio Verdejo-García
- Pharmacology Research Unit, Institut Municipal d'Investigació Mèdica, Barcelona Biomedical Research park, Dr. Aiguader 88, 08003 Barcelona, Spain.
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Huang DB, Kamat PP, Wang J. Demographic characteristics and antisocial personality disorder of early and late onset alcoholics identified in a primary care clinic. Am J Addict 2007; 15:478-82. [PMID: 17182452 DOI: 10.1080/10550490601000504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
A total of 1,734 persons were prospectively screened in a primary care clinic to examine the demographic characteristics and presence or absence of antisocial personality disorder among early onset alcoholics (EOA) and late onset alcoholics (LOA). A total of 76 EOA (male = 58 and female = 18) and 80 LOA (male = 56 and female = 24), as determined by the Comprehensive Drinking Profile Scale, participated in the study. EOA tended to be single and were younger, in a lower socioeconomic class, raised by non-biological parents, more likely to have antisocial personality disorder, and more likely to commit certain convicted offenses compared to LOA (p <or= .05). This study found that EOA identified in a primary care clinic have a different demographic profile and are more likely to have antisocial personality disorder compared to LOA.
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Affiliation(s)
- David B Huang
- University of Texas at Houston School of Public Health, Houston, Texas, USA.
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Abstract
Two types of behavioral measure are primarily used to examine impulsivity in humans and animals: Go/No-go tasks to assess inhibition and relative preference tasks to assess delay aversion. Several examples of each type of task are described so that common cognitive processes and variables affecting performance can be identified. Data suggest that smokers are more impulsive on each of these impulsivity measures than nonsmokers. Several models can be proposed to account for this group difference: (a) the differences predate and, possibly, are causally related to the initiation of cigarette smoking; (b) higher levels of impulsivity are associated with continued smoking, either through an association with heightened positive subjective effects of nicotine or heightened negative effects of nicotine abstinence (withdrawal); (c) nicotine causes neuroadaptations that result in elevated impulsivity in smokers. Studies relating to each of these models are reviewed, and it is concluded that all three models may contribute to the observed higher levels of impulsivity in smokers. However, pertinent studies are limited and additional systematic research is needed.
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Affiliation(s)
- Suzanne H Mitchell
- Department of Behavioral Neuroscience, Oregon Health & Science University, USA
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Swann AC, Birnbaum D, Jagar AA, Dougherty DM, Moeller FG. Acute yohimbine increases laboratory-measured impulsivity in normal subjects. Biol Psychiatry 2005; 57:1209-11. [PMID: 15866563 DOI: 10.1016/j.biopsych.2005.02.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2004] [Revised: 02/04/2005] [Accepted: 02/08/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND State-dependent changes in impulsivity may be related to norepinephrine. To examine possible relationships between norepinephrine and acute changes in impulsivity, we measured effects of yohimbine, which increases norepinephrine release by blocking alpha-2 noradrenergic receptors, on laboratory-measured impulsivity in healthy subjects without psychiatric or substance-use disorders. METHODS Impulsivity was assessed using the Immediate and Delayed Memory Tasks (IMT-DMT), derived from the Continuous Performance Test, before and after placebo or two doses of yohimbine, given 4 days apart. Blood pressure was monitored, and psychiatric symptoms were measured using self-rated visual analog scales. RESULTS Yohimbine was associated with a dose-related increase in impulsive IMT commission errors, with an increase of > 50% relative to baseline at the higher dose. The activation factor of the Internal State Scale was increased at the same dose. CONCLUSIONS These results are consistent with increased impulsivity in normal subjects given yohimbine, possibly related to increased norepinephrine.
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Affiliation(s)
- Alan C Swann
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas 77030, USA.
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