Impulsiveness and cigarette smoking

Psychopathic Traits Are Associated with Lifetime History of Nicotine Dependence among Incarcerated Offenders

Background: Individuals scoring high on psychopathy engage in problematic patterns of alcohol and illicit substance use. However, our understanding regarding the association between psychopathy and nicotine use remains limited, which is surprising, given the detrimental consequences associated with such use. Previous studies have observed significant correlations between psychopathic traits (particularly Factor 2 scores assessing lifestyle/behavioral and antisocial traits from the Psychopathy Checklist - Revised [PCL-R]) and increased frequency of nicotine use. However, no study has investigated whether individuals scoring high on psychopathy are characterized by problematic patterns of nicotine use, including lifetime history of nicotine dependence.Objectives: The current study aimed to address this gap, specifically investigating whether PCL-R scores were associated with higher total scores from the Fagerström Test for Nicotine Dependence (FTND).Results: Across both incarcerated men and women, PCL-R total, Factor 2, and Facet 3 (measuring lifestyle/behavioral psychopathic traits) scores were positively correlated with FTND total scores. Additionally, across both samples, hierarchical linear regression analyses revealed these same psychopathy scores remained associated with higher FTND total scores when controlling for additional covariate measures (e.g., age, severity of alcohol and illicit substance use, race, ethnicity, and IQ).Conclusions/Importance: Though associated with small effect sizes, our results support the notion that lifestyle/behavioral psychopathic traits represent a general risk factor for engaging in risky behavior associated with deleterious health consequences, including nicotine use. Our results hold implications for the development of treatment approaches, designed to reduce problematic levels of substance use among individuals scoring high on psychopathy.

Relationship between smoking, narcissism, and impulsiveness among young women

Although the connection between smoking and individual differences has been recently recognized, the relationship between narcissistic personality traits and cigarette smoking has received less attention. The notion that personality traits can be associated with addictive behavior is influential in clinical practice. However, questions remain about specific interactions between smoking and personality characteristics that need empirical support to substantiate this hypothesis. This study thus identifies narcissistic and impulsive personality traits as precursors of smoking in a sample of tattooed individuals. In a cross-sectional study (N = 120), personality traits were assessed in young women (aged 18–35 years) using the narcissistic personality inventory and the Barratt Impulsivity Scale (BIS-11). The current study, using the regression analysis, has clearly demonstrated that young women who smoke have different personality characteristics as compared with women who do not smoke.

Orbitofrontal cortex volume links polygenic risk for smoking with tobacco use in healthy adolescents

BACKGROUND

Tobacco smoking remains one of the leading causes of preventable illness and death and is heritable with complex underpinnings. Converging evidence suggests a contribution of the polygenic risk for smoking to the use of tobacco and other substances. Yet, the underlying brain mechanisms between the genetic risk and tobacco smoking remain poorly understood.

METHODS

Genomic, neuroimaging, and self-report data were acquired from a large cohort of adolescents from the IMAGEN study (a European multicenter study). Polygenic risk scores (PGRS) for smoking were calculated based on a genome-wide association study meta-analysis conducted by the Tobacco and Genetics Consortium. We examined the interrelationships among the genetic risk for smoking initiation, brain structure, and the number of occasions of tobacco use.

RESULTS

A higher smoking PGRS was significantly associated with both an increased number of occasions of tobacco use and smaller cortical volume of the right orbitofrontal cortex (OFC). Furthermore, reduced cortical volume within this cluster correlated with greater tobacco use. A subsequent path analysis suggested that the cortical volume within this cluster partially mediated the association between the genetic risk for smoking and the number of occasions of tobacco use.

CONCLUSIONS

Our data provide the first evidence for the involvement of the OFC in the relationship between smoking PGRS and tobacco use. Future studies of the molecular mechanisms underlying tobacco smoking should consider the mediation effect of the related neural structure.

Predicting smoking and nicotine dependence from the DSM-5 alternative model for personality pathology

Individuals with personality disorders (PDs) have higher morbidity and mortality than the general population, which may be due to maladaptive health behaviors such as smoking. Previous studies have examined the links between categorical PD diagnoses/personality traits and smoking/nicotine dependence, but little is known about how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model for personality disorders relates to smoking and nicotine dependence. The current study examined this question in a sample of 500 participants using the Levels of Personality Functioning Scale to assess general personality pathology, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to measure specific traits, the Fagerström test for Nicotine Dependence to assess nicotine dependence, and questions about current and past smoking to assess smoking status (i.e., current, former, never). Multinomial logistic regression results demonstrated that general personality pathology (Criterion A) was not related to smoking status, and there were no reliable associations between traits (Criterion B) and smoking status. However, correlations showed that higher negative affectivity and disinhibition were related to higher levels of nicotine dependence within smokers. Findings are discussed in regard to previous findings linking personality pathology to smoking/nicotine dependence as well as the general validity of this new personality disorder diagnostic system. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal Associations of Substance Use Risk Profiles with the Use of Alternative Tobacco Products and Conventional Smoking among Adolescents

Although personality is associated with the onset of substance use (i.e., conventional smoking, alcohol use, and cannabis use) during adolescence, it is unclear whether personality traits are also associated with the onset of use of alternative tobacco products (ATPs), i.e., electronic cigarettes, shisha-pens, and water pipes. This study examines whether personality traits are associated with the onset of use of both conventional cigarettes and ATPs. Longitudinal data (baseline and 18-month follow-up) were used. The sample consisted of 1114 non-user adolescents (mean age = 13.36, SD = 0.93, 56% female) at baseline. To measure personality traits, the Substance Use Risk Profile Scale was used with four subscales: anxiety sensitivity, hopelessness, sensation seeking, and impulsivity. Structural equation models were conducted using Mplus 7.3. Results showed that both hopelessness and sensation seeking were associated with the onset of use of e-cigarettes and conventional cigarettes. Further, sensation seeking and impulsivity were associated with the onset of use of shisha-pens and water pipes. In conclusion, to prevent adolescents from using ATPs and/or conventional cigarettes, it is important to take their personality traits into account. More research on other (shared) risk factors and on more advanced stages of ATP use is needed before effective prevention strategies can be developed.

Adaptation and validation of a German version of the Dickman impulsivity inventory for the assessment of functional and dysfunctional impulsivity

Impulsive behavior tends to have a negative connotation in the sense that it is usually associated with detrimental or dysfunctional outcomes. However, under certain circumstances, impulsive behaviors may also have beneficial or functional outcomes. Dickman's Impulsivity Inventory (DII) measures these two distinct aspects of impulsivity, namely, dysfunctional impulsivity (the tendency to act with less forethought than do most people which leads to difficulties) and functional impulsivity (the tendency to act with little forethought when the situation is optimal). In the present study, we translated the DII into German and validated the German version in a sample of 543 adults. The original 23-item model was considered unsuitable for the German version as suggested by fit indices of a confirmatory factor analysis. Exploratory factor analyses rather supported a 16-item version. Further psychometric analyses and inferential statistical analyses on the final German DII indicated its appropriateness for use in German-speaking populations and support a two-factor solution of the DII. Finally, exploratory analyses on the German DII suggest differential relationships between dysfunctional and functional impulsivity and self-reported lifestyle-related variables (smoking, alcohol usage, and sports behavior).

The effect of maternal smoking on offspring smoking is unrelated to heritable personality traits or initial subjective experiences

INTRODUCTION

Maternal smoking is a risk factor for offspring smoking. Lifetime maternal smoking vs. prenatal tobacco exposure (PTE) appear to act through different mechanisms. This study tested the hypothesis that maternal smoking measures' effects on offspring smoking could be attributable to hereditary mechanisms: personality traits (novelty-seeking, impulsivity, neuroticism, self-esteem) and initial subjective smoking experiences (pleasurable, unpleasurable, dizziness).

METHODS

Data were drawn from the Social and Emotional Contexts of Adolescent Smoking Patterns (SECASP) study, an 8-year longitudinal study of 9 th or 10 th graders at baseline (≈age 15) who experiment with smoking (<100 lifetime cigarettes; N=594) at baseline. Young adult smoking frequency at the 8-year follow-up (≈age 23) was examined as a function of baseline characteristics (heritable trait, maternal smoking, PTE, sex) and baseline smoking frequency and nicotine dependence. Structural equation models determined whether inclusion of each heritable trait among offspring confounded the effects of maternal smoking (PTE or maternal smoking) on offspring smoking and nicotine dependence.

RESULTS

Impulsiveness was associated with intermediate adolescent smoking frequency (B=0.135, SD=0.043 p=0.002) and nicotine dependence (B=0.012, SD=0.003, p<0.001). Unpleasurable first experience (B=0.886, SD=0.374, p=0.018) and dizziness (B=0.629, SD=0.293, p=0.032) showed a trend with intermediate smoking frequency that was non-significant after correcting for multiple comparisons. These traits did not confound maternal smoking's effects.

CONCLUSIONS

None of the heritable traits examined in this model explained the effect of maternal smoking measures on adolescence or young adulthood offspring smoking. Further research is needed to elucidate the mechanism by which PTE and maternal smoking are linked to offspring smoking.

Early-Life Adversities and Recalcitrant Smoking in Midlife: An Examination of Gender and Life-Course Pathways

BACKGROUND

Little is known about life-course factors that explain why some individuals continue smoking despite having smoking-related diseases.

PURPOSE

We examined (a) the extent to which early-life adversities are associated with the risk of recalcitrant smoking, (b) psychosocial factors that mediate the association, and (c) gender differences in the associations.

METHODS

Data were from 4,932 respondents (53% women) who participated in the first and follow-up waves of the Midlife Development in the U.S. National Survey. Early-life adversities include low socioeconomic status (SES), abuse, and family instability. Potential mediators include education, financial strain, purpose in life, mood disorder, family problems/support, and marital status. We used sequential logistic regression models to estimate the effect of early-life adversities on the risk of each of the three stages on the path to recalcitrant smoking (ever-smoking, smoking-related illness, and recalcitrant smoking).

RESULTS

For women, low SES (odds ratio [OR] = 1.29; 1.06-1.55) and family instability (OR = 1.73; 1.14-2.62) are associated with an elevated risk of recalcitrant smoking. Education significantly reduces the effect of childhood SES, yet the effect of family instability remains significant even after accounting for life-course mediators. For men, the effect of low SES on recalcitrant smoking is robust (OR = 1.48; 1.10-2.00) even after controlling for potential mediators. There are noteworthy life-course factors that independently affect recalcitrant smoking: for both genders, not living with a partner; for women, education; and for men, family problems.

CONCLUSIONS

The findings can help shape intervention programs that address the underlying factors of recalcitrant smoking.

Motion correction in magnetic resonance spectroscopy

In vivo proton magnetic resonance spectroscopy and spectroscopic imaging (MRS/MRSI) are valuable tools to study normal and abnormal human brain physiology. However, they are sensitive to motion, due to strong crusher gradients, long acquisition times, reliance on high magnetic field homogeneity, and particular acquisition methods such as spectral editing. The effects of motion include incorrect spatial localization, phase fluctuations, incoherent averaging, line broadening, and ultimately quantitation errors. Several retrospective methods have been proposed to correct motion-related artifacts. Recent advances in hardware also allow prospective (real-time) correction of the effects of motion, including adjusting voxel location, center frequency, and magnetic field homogeneity. This article reviews prospective and retrospective methods available in the literature and their implications for clinical MRS/MRSI. In combination, these methods can attenuate or eliminate most motion-related artifacts and facilitate the acquisition of high-quality data in the clinical research setting.

Effect of within-session breaks in play on responsible gambling behaviour during sustained monetary losses

Rapid, continuous gambling formats are associated with higher risks for gambling-related harm in terms of excessive monetary and time expenditure. The current study investigated the effect on gambling response latency and persistence, of a new form of within-game intervention that required players to actively engage in response inhibition via monitoring for stop signals. Seventy-four experienced electronic gaming machine gamblers, with a mean age of 35.28 years, were recruited to participate in a rapid, continuous gambling task where real money could be won and lost. Participants were randomly allocated to either the control condition where no intervention was presented, or either a condition with a passive three minute break in play or a condition with a three minute intervention that required participants to engage in response inhibition. Although there was no main effect for experimental condition on gambling persistence, both interventions were effective in elevating response latency during a period of sustained losses. It was concluded that within-game interventions that create an enforced break in play are effective in increasing response latency between bets during periods of sustained losses. Furthermore, within-game interventions that require active involvement appear to be more effective in increasing response latency than standard, passive breaks in play.

The Attentional Bias in Current and Former Smokers

Attentional bias has been defined as the propensity of a person to allocate selective attention automatically to salient cues (Field and Powell, 2007). In the case of smoking, this bias implies that smokers are implicitly attracted by smoking-related stimuli, which produce behavioral, memory, and emotional effects (Volkow et al., 2006; Giardini et al., 2009). In more detail, scientific evidence pointed out that smoking is strongly supported by attentional bias that activates craving and urgency to smoke a cigarette. However, poor and conflicting data are available regarding the role of this cognitive bias on former smokers. The main aim of this study is to explore the occurrence of the attentional bias on of both current and former smokers, also with the aim to identify associations with behavioral, psychological and cognitive characteristic of participants. We collected data on 245 current, volunteers (male 50.6%; female 49.4%) aged 54.81 (SD = 14.352, range = 18–63), divided in current smokers (98), former smokers (102) and non-smokers (45). A combination of neuropsychology tests (Emotional Smoke Stroop Task and Go/no-Go task), and standardized questionnaires [Behavioral Inhibition System-Behavioral Approach System (BIS-BAS), Fagerström Test for Nicotine Dependence (FTND), Barratt Impulsiveness Scale, Motivational questionnaire] were used to assess the attentional bias, psychological variables, and smoking-related characteristics. Responses at the Emotional Smoke Stroop task revealed that current and former smokers are actually slower than non-smokers are when facing smoking cues, while performances at other Stroop conditions and at the Go/no-Go task are not statistically different. These results confirmed the occurrence of the attentional bias in current smokers, and above all points out that the same effect is present in former smokers. We found only small and selective correlations between attentional bias and psychological variables (e.g., impulsiveness and inhibition). In particular, impulsivity is not directly associated with the AB intensity. Also, smoking characteristics (e.g., years of smoking and dependence level) and the length of the period of abstinence do not seem to modulate implicit cognition of smoking cue. Our data support the idea that the attentional bias may be considered relevant in sustaining smoking and favoring relapse.

Profiles of Impulsivity in Problematic Internet Users and Cigarette Smokers

Problematic Internet use (PIU) has been gradually recognized as a mental health issue among adolescents and young students. PIU shows many similarities with substance use disorders, but the shared and distinct mechanisms underlying them are unclear. The purpose of the current study was to explore the relationships between impulsive traits and PIU as well as cigarette smoking behaviors among young adults. Two independent samples of university students (N 1 = 1281, N 2 = 1034, respectively) over 3 years were assessed with multiple measurements of impulsivity, including the Barratt Impulsiveness Scale-11 (BIS-11), the UPPSP Impulsive Behaviors Scale (UPPSP), and the Delay-discounting Test (DDT). Logistic regression models revealed that across the two independent samples, BIS-11 Attentional Impulsiveness was the common trait positively predicting both PIU and cigarette smoking. While BIS-11 Motor Impulsiveness as well as UPPSP Lack of Perseverance, Lack of Premeditation, and Negative Urgency were the typical traits linked to PIU as positive predictors, UPPSP Sensation Seeking was the unique trait linked to cigarette smoking as a positive predictor. These results suggested that specific dimensions of impulsivity might be concurrently implicated in PIU and cigarette smoking among young adults, putatively representing important trait marks for addictive behaviors.

Association of exercise with smoking-related symptomatology, smoking behavior and impulsivity in men and women

INTRODUCTION

Despite extensive efforts to develop effective smoking cessation interventions, 70-85% of American cigarette smokers who quit relapse within one year. Exercise has shown promise as an intervention; however, many results have been equivocal. This study explored how exercise is associated with smoking-related symptomatology, smoking behavior and impulsivity in male and female smokers.

METHODS

Participants were recruited throughout the United States using the on-line crowdsourcing platform, Amazon's Mechanical Turk. They completed a survey with self-report measures assessing exercise, smoking-related symptomatology, smoking behavior and impulsivity. Differences between men and women were tested using t- and chi-square tests. Regression analyses tested for associations between exercise and smoking-related symptomatology, smoking behavior and impulsivity.

RESULTS

Participants (N = 604) were, on average, 32 (SD = 6.2) years old, mostly Caucasian, with at least some college education and approximately half were women. Women exercised slightly less than men and had more negative affect, craving, physical symptoms and withdrawal. Women smoked more cigarettes per day, had greater nicotine dependency and more years of smoking. Positive affect was positively associated with exercise for both men and women; however, this association was significantly stronger in women. Negative affect and withdrawal were inversely associated with exercise for women only. Impulsivity was inversely associated with exercise for both men and women.

CONCLUSION

Exercise was significantly associated with several smoking-related symptomatology, smoking behavior and impulsivity variables for both men and women, suggesting that exercise may be a useful intervention for smoking cessation. Future prospective research should determine how exercise directly impacts smoking cessation.

Potential Adverse Effects of Violent Video Gaming: Interpersonal- Affective Traits Are Rather Impaired Than Disinhibition in Young Adults

The increasing trend of mass shootings, which were associated with excessive use of violent video games, fueled the debate of possible effects violent video games may have on adolescents and young adults. The aim of this study was to investigate the possible link between violent video gaming effects and the disposition of adverse behavior traits such as interpersonal-affective deficits and disinhibition. Data of 167 young adults, collected by an online questionnaire battery, were analyzed for lifetime video game exposure differences (i.e., non-gamers, non-violent video gamers, stopped violent video game users, and ongoing violent video game users) as well as for recent exposure effects on adverse behavior traits (Levenson’s Psychopathy Scale), while controlling for other potentially confounding lifestyle factors. While interpersonal-affective deficits were significantly higher in participants with ongoing violent video game exposure compared to non-gamers and non-violent video gamers, disinhibition was significantly higher in both – stopped and ongoing – violent video game exposure groups compared to non-gamers. Recent violent video game exposure was a stronger predictor for interpersonal-affective deficits, but was also significant for disinhibition. Considering that we observed small to medium effects in a sample of young adults with little to moderate use of violent video games highlights the importance of further investigating the potential adverse effects of violent video games on quality of social relationships.

Impulsivity related personality traits and cigarette smoking in adults: A meta-analysis using the UPPS-P model of impulsivity and reward sensitivity

BACKGROUND

Although there is considerable evidence of an association between impulsivity and cigarette smoking, the magnitude of this association varies across studies. Impulsivity comprises several discrete traits that may influence cigarette use in different ways. The present meta-analysis aims to examine the direction and magnitude of relationships between specific impulsivity-related traits, namely lack of premeditation, lack of perseverance, sensation seeking, negative urgency, positive urgency and reward sensitivity and both smoking status and severity of nicotine dependence in adults across studies and to delineate differences in effects across these relationships.

METHODS

Ninety-seven studies were meta-analysed using random-effects models to examine the relationship between impulsivity-related traits and smoking status and severity of nicotine dependence. A number of demographic and methodological variables were also assessed as potential moderators.

RESULTS

Smoking status and severity of nicotine dependence were significantly associated with all impulsivity-related traits except reward sensitivity. Lack of premeditation and positive urgency showed the largest associations with smoking status (r = 0.20, r = 0.24 respectively), while positive urgency showed the largest association with severity of nicotine dependence (r = 0.23). Study design moderated associations between lack of premeditation and lack of perseverance and smoking status, with larger effects found in cross-sectional compared to prospective studies.

CONCLUSIONS

Finding suggest that impulsivity is associated with an increased likelihood of being a smoker and greater nicotine dependence. Specific impulsivity-related traits differentially relate to smoking status and severity of nicotine dependence. Understanding the complexity of impulsivity-related traits in relation to smoking can help to identify potential smokers and could inform cessation treatment.

Identifying Pleiotropic Genes in Genome-Wide Association Studies for Multivariate Phenotypes with Mixed Measurement Scales

We propose a multivariate genome-wide association test for mixed continuous, binary, and ordinal phenotypes. A latent response model is used to estimate the correlation between phenotypes with different measurement scales so that the empirical distribution of the Fisher’s combination statistic under the null hypothesis is estimated efficiently. The simulation study shows that our proposed correlation estimation methods have high levels of accuracy. More importantly, our approach conservatively estimates the variance of the test statistic so that the type I error rate is controlled. The simulation also shows that the proposed test maintains the power at the level very close to that of the ideal analysis based on known latent phenotypes while controlling the type I error. In contrast, conventional approaches–dichotomizing all observed phenotypes or treating them as continuous variables–could either reduce the power or employ a linear regression model unfit for the data. Furthermore, the statistical analysis on the database of the Study of Addiction: Genetics and Environment (SAGE) demonstrates that conducting a multivariate test on multiple phenotypes can increase the power of identifying markers that may not be, otherwise, chosen using marginal tests. The proposed method also offers a new approach to analyzing the Fagerström Test for Nicotine Dependence as multivariate phenotypes in genome-wide association studies.

An efficient genome-wide association test for mixed binary and continuous phenotypes with applications to substance abuse research

We propose a new genome-wide association test for mixed binary and continuous phenotypes that uses an efficient numerical method to estimate the empirical distribution of the Fisher's combination statistic under the null hypothesis. Our simulation study shows that the proposed method controls the type I error rate and also maintains its power at the level of the permutation method. More importantly, the computational efficiency of the proposed method is much higher than the one of the permutation method. The simulation results also indicate that the power of the test increases when the genetic effect increases, the minor allele frequency increases, and the correlation between responses decreases. The statistical analysis on the database of the Study of Addiction: Genetics and Environment demonstrates that the proposed method combining multiple phenotypes can increase the power of identifying markers that may not be, otherwise, chosen using marginal tests.

nAChR dysfunction as a common substrate for schizophrenia and comorbid nicotine addiction: Current trends and perspectives

INTRODUCTION

The prevalence of tobacco use in the population with schizophrenia is enormously high. Moreover, nicotine dependence is found to be associated with symptom severity and poor outcome in patients with schizophrenia. The neurobiological mechanisms that explain schizophrenia-nicotine dependence comorbidity are not known. This study systematically reviews the evidence highlighting the contribution of nicotinic acetylcholine receptors (nAChRs) to nicotine abuse in schizophrenia.

METHODS

Electronic data bases (Medline, Google Scholar, and Web of Science) were searched using the selected key words that match the aims set forth for this review. A total of 276 articles were used for the qualitative synthesis of this review.

RESULTS

Substantial evidence from preclinical and clinical studies indicated that dysregulation of α7 and β2-subunit containing nAChRs account for the cognitive and affective symptoms of schizophrenia and nicotine use may represent a strategy to remediate these symptoms. Additionally, recent meta-analyses proposed that early tobacco use may itself increase the risk of developing schizophrenia. Genetic studies demonstrating that nAChR dysfunction that may act as a shared vulnerability factor for comorbid tobacco dependence and schizophrenia were found to support this view. The development of nAChR modulators was considered an effective therapeutic strategy to ameliorate psychiatric symptoms and to promote smoking cessation in schizophrenia patients.

CONCLUSIONS

The relationship between schizophrenia and smoking is complex. While the debate for the self-medication versus addiction vulnerability hypothesis continues, it is widely accepted that a dysfunction in the central nAChRs represent a common substrate for various symptoms of schizophrenia and comorbid nicotine dependence.

Discounting of qualitatively different delayed health outcomes in current and never smokers

In delay discounting, temporally remote outcomes have less value. Cigarette smoking is associated with steeper discounting of money and consumable outcomes. It is presently unclear whether smokers discount health outcomes more than nonsmokers. We sought to establish the generality of steep discounting for different types of health outcomes in cigarette smokers. Seventy participants (38 smokers and 32 nonsmokers) completed 4 hypothetical outcome delay-discounting tasks: a gain of $500, a loss of $500, a temporary boost in health, and temporary cure from a debilitating disease. Participants reported the duration of each health outcome that would be equivalent to $500; these durations were then used in the respective discounting tasks. Delays ranged from 1 week to 25 years. Smokers' indifference points for monetary gains, boosts in health, and temporary cures were lower than indifference points from nonsmokers. Indifference points of 1 outcome were correlated with indifference points of other outcomes. Smokers demonstrate steeper discounting across a range of delayed outcomes. How a person discounts 1 outcome predicts how they will discount other outcomes. These 2 findings support our assertion that delay discounting is in part a trait.

Impulsivity and cigarette craving among adolescent daily and occasional smokers

INTRODUCTION

Impulsivity is a multi-dimensional construct that is robustly related to cigarette smoking. While underlying factors that account for this relation are not well understood, craving has been proposed as a central mechanism linking impulsivity to smoking. In order to further refine our understanding of associations between impulsivity and cigarette craving, the current study examined the association between impulsivity and tonic and cue-elicited craving among a sample of adolescent smokers. We expected trait impulsivity would be positively associated with both tonic and cue-elicited craving, and that this relationship would be stronger among daily vs. occasional smokers.

METHODS

106 smokers (ages 16-20) completed the questionnaires and reported their cigarette craving prior to and immediately following presentation of each of three counterbalanced cue types: (a) in vivo smoking, (b) alcohol, and (c) neutral cue.

RESULTS

Impulsivity was positively associated with tonic craving for daily smokers (β=.38; p=.005), but not occasional smokers (β=.01; p=.95), with a significant impulsivity x smoker group interaction (β=1.31; p=.03). Impulsivity was unrelated to craving following smoking or alcohol cue, regardless of smoker group (all p's>.16).

CONCLUSIONS

Results suggest a moderated effect in which impulsivity is positively associated with tonic craving for daily smokers, but not occasional smokers. Tonic craving may serve as a mechanism linking impulsivity, smoking persistence, and nicotine dependence among daily smokers.

Impulsivity and opioid drugs: differential effects of heroin, methadone and prescribed analgesic medication

BACKGROUND

Previous studies have provided inconsistent evidence that chronic exposure to opioid drugs, including heroin and methadone, may be associated with impairments in executive neuropsychological functioning, specifically cognitive impulsivity. Further, it remains unclear how such impairments may relate of the nature, level and extent of opioid exposure, the presence and severity of opioid dependence, and hazardous behaviours such as injecting.

METHOD

Participants with histories of illicit heroin use (n = 24), former heroin users stabilized on prescribed methadone (methadone maintenance treatment; MMT) (n = 29), licit opioid prescriptions for chronic pain without history of abuse or dependence (n = 28) and healthy controls (n = 28) were recruited and tested on a task battery that included measures of cognitive impulsivity (Cambridge Gambling Task, CGT), motor impulsivity (Affective Go/NoGo, AGN) and non-planning impulsivity (Stockings of Cambridge, SOC).

RESULTS

Illicit heroin users showed increased motor impulsivity and impaired strategic planning. Additionally, they placed higher bets earlier and risked more on the CGT. Stable MMT participants deliberated longer and placed higher bets earlier on the CGT, but did not risk more. Chronic opioid exposed pain participants did not differ from healthy controls on any measures on any tasks. The identified impairments did not appear to be associated specifically with histories of intravenous drug use, nor with estimates of total opioid exposure.

CONCLUSION

These data support the hypothesis that different aspects of neuropsychological measures of impulsivity appear to be associated with exposure to different opioids. This could reflect either a neurobehavioural consequence of opioid exposure, or may represent an underlying trait vulnerability to opioid dependence.

Cigarette Cravings, Impulsivity, and the Brain

Craving is a core feature of tobacco use disorder as well as a significant predictor of smoking relapse. Studies have shown that appetitive smoking-related stimuli (e.g., someone smoking) trigger significant cravings in smokers impede their self-control capacities and promote drug seeking behavior. In this review, we begin by an overview of functional magnetic resonance imaging (fMRI) studies investigating the neural correlates of smokers to appetitive smoking cues. The literature reveals a complex and vastly distributed neuronal network underlying smokers' craving response that recruits regions involved in self-referential processing, planning/regulatory processes, emotional responding, attentional biases, and automatic conducts. We then selectively review important factors contributing to the heterogeneity of results that significantly limit the implications of these findings, namely between- (abstinence, smoking expectancies, and self-regulation) and within-studies factors (severity of smoking dependence, sex-differences, motivation to quit, and genetic factors). Remarkably, we found that little to no attention has been devoted to examine the influence of personality traits on the neural correlates of cigarette cravings in fMRI studies. Impulsivity has been linked with craving and relapse in substance and tobacco use, which prompted our research team to examine the influence of impulsivity on cigarette cravings in an fMRI study. We found that the influence of impulsivity on cigarette cravings was mediated by fronto-cingulate mechanisms. Given the high prevalence of cigarette smoking in several psychiatric disorders that are characterized by significant levels of impulsivity, we conclude by identifying psychiatric patients as a target population whose tobacco-smoking habits deserve further behavioral and neuro-imaging investigation.

Impulsivity and cigarette smoking: discounting of monetary and consumable outcomes in current and non-smokers

RATIONALE

In delay discounting, temporally remote rewards have less value. Cigarette smoking is associated with steeper discounting of delayed money. The generality of this to nonmonetary outcomes, however, is unknown.

OBJECTIVES

We sought to determine whether cigarette smokers also show steep discounting of other delayed outcomes.

METHODS

Sixty-five participants (32 smokers and 33 non-smokers) completed four delay-discounting tasks, each involving different hypothetical outcomes. In the monetary task, participants indicated their preference for a smaller amount of money available immediately (titrated across trials) and $100 awarded at delays ranging from 1 week to 25 years (tested in blocks). In the three other discounting tasks the larger-later reward was $100 worth of a favorite food, alcoholic drink, or a favorite form of entertainment. All other aspects of these discounting tasks were identical to the monetary discounting task.

RESULTS

As previously shown, smokers discounted delayed money more steeply than non-smokers did. In addition, smokers discounted delayed food and entertainment rewards more steeply than did nonsmokers. A person's discounting of one outcome was correlated with discounting of other outcomes. Non-smokers discounted money less steeply than all other outcomes; smokers discounted money significantly less than food.

CONCLUSIONS

When compared to nonsmokers, cigarette smokers more steeply discount several types of delayed outcomes. This result, together with the finding that cross-commodity discounting rates were correlated within subjects, suggests that delay discounting is a trait that extends across domains.

Delay discounting rates: a strong prognostic indicator of smoking relapse

BACKGROUND

Recent evidence suggests that several dimensions of impulsivity and locus of control are likely to be significant prognostic indicators of relapse.

METHOD

One-hundred and thirty-one treatment seeking smokers were enrolled in six weeks of multi-component cognitive-behavioral therapy with eight weeks of nicotine replacement therapy.

ANALYSIS

Cox proportional hazard regressions were used to model days to relapse with each of the following: delay discounting of $100, delay discounting of $1000, six subscales of the Barratt Impulsiveness Scale (BIS), Rotter's Locus of Control (RLOC), Fagerstrom's Test for Nicotine Dependence (FTND), and the Perceived Stress Scale (PSS). Hazard ratios for a one standard deviation increase were estimated with 95% confidence intervals for each explanatory variable. Likelihood ratios were used to examine the level of association with days to relapse for different combinations of the explanatory variables while accounting for nicotine dependence and stress level.

RESULTS

These analyses found that the $100 delay discounting rate had the strongest association with days to relapse. Further, when discounting rates were combined with the FTND and PSS, the associations remained significant. When the other measures were combined with the FTND and PSS, their associations with relapse non-significant.

CONCLUSIONS

These findings indicate that delay discounting is independently associated with relapse and adds to what is already accounted for by nicotine dependence and stress level. They also signify that delay discounting is a productive new target for enhancing treatment for tobacco dependence. Consequently, adding an intervention designed to decrease discounting rates to a comprehensive treatment for tobacco dependence has the potential to decrease relapse rates.

Cigarette smoking and measures of impulsivity in a college sample

BACKGROUND

An association between impulsivity and smoking has been consistently reported in the literature, but few studies have examined how distinct dimensions of impulsivity may relate differentially to smoking initiation versus persistent smoking. The aim of the current study was to examine the relationship between self-report and behavioral measures of impulsivity and smoking status in college students.

METHODS

Participants (N = 243) completed a self-report history of tobacco use, 2 self-report measures of impulsivity (the Barratt Impulsiveness Scale and Zuckerman Sensation-Seeking Scale), and 2 behavioral measures (the Delay Discounting Task and Iowa Gambling Task). All participants were classified as never-smokers, triers, or smokers based on their smoking history, and between-group differences on the 4 measures were examined.

RESULTS

On the self-report measures, all 3 groups differed on sensation seeking, with the never-smokers reporting the lowest levels and the smokers reporting the highest. Furthermore, the smokers reported significantly higher disinhibitory impulsivity than the triers and never-smokers. The groups did not differ on the behavioral measures.

CONCLUSIONS

These results indicate that distinct dimensions of impulsivity characterize different smoking phenotypes. In particular, sensation seeking is associated with the initiation of smoking, whereas disinhibitory impulsivity is associated with the transition to more persistent and regular use of cigarettes.

Ventral striatal dopamine synthesis capacity is associated with individual differences in behavioral disinhibition

Pathological gambling, alongside addictive and antisocial disorders, forms part of a broad psychopathological spectrum of externalizing disorders, which share an underlying genetic vulnerability. The shared externalizing propensity is a highly heritable, continuously varying trait. Disinhibitory personality traits such as impulsivity and novelty seeking (NS) function as indicators of this broad shared externalizing tendency, which may reflect, at the neurobiological level, variation in the reactivity of dopaminergic (DAergic) brain reward systems centered on the ventral striatum (VS). Here, we examined whether individual differences in ventral striatal dopamine (DA) synthesis capacity were associated with individual variation in disinhibitory personality traits. Twelve healthy male volunteers underwent 6-[¹⁸F]Fluoro-L-DOPA (FDOPA) positron emission tomography (PET) scanning to measure striatal DA synthesis capacity, and completed a measure of disinhibited personality (NS). We found that levels of ventral, but not dorsal, striatal DA synthesis capacity were significantly correlated with inter-individual variation in disinhibitory personality traits, particularly a propensity for financial extravagance and irresponsibility. Our results are consistent with preclinical models of behavioral disinhibition and addiction proneness, and provide novel insights into the neurobiology of personality based vulnerability to pathological gambling and other externalizing disorders.

Cigarette smoking in obsessive-compulsive disorder and unaffected parents of OCD patients

BACKGROUND

Cigarette smoking is more prevalent among individuals with psychiatric disorders than the general population. Obsessive-compulsive disorder (OCD) may be an intriguing exception, although no recent study has investigated this hypothesis in OCD patients. Moreover, it is unknown whether reduced smoking rates are present in unaffected first-degree relatives of OCD patients.

METHODS

We assessed smoking prevalence in adults with OCD and unaffected parents of youth with OCD (PYOCD). To this end, 113 adults with OCD completed online questionnaires assessing symptom severity and smoking status. Smoking status was obtained from an independent sample of 210 PYOCD assessed for psychiatric diagnoses.

RESULTS

Smoking prevalence rates in adults with OCD (13.3%; n=15) and PYOCD (9.5%; n=20) samples were significantly lower than those found in representative samples of the general population (19-24%, all P<.001) and Axis I disorders (36-64%; all P<.001). There were no smokers in the adult OCD subset without clinically significant depressive symptoms (n=54).

CONCLUSION

Low prevalence of smoking in OCD may be familial and unique among psychiatric disorders, and might represent a possible state-independent OCD marker. Hypotheses concerning the uncharacteristically low prevalence rates are discussed with relation to OCD phenomenology and pathophysiology.

Are there reciprocal relationships between substance use risk personality profiles and alcohol or tobacco use in early adolescence?

AIM

We examined whether reciprocal relationships were present between the SURPS personality profiles and substance use in early adolescence.

METHODS

Longitudinal data of four-waves of a broader effectiveness study were used from 1068 early adolescents.

RESULTS

Our cross-lagged models indicated that sensation seeking and impulsivity show strongest reciprocal associations with substance use during early adolescence. In contrast, no reciprocity was present between substance use and anxiety sensitivity and only one reciprocal relationship was present between substance use and hopelessness.

CONCLUSIONS

In trying to prevent early adolescents from alcohol and tobacco use, it might be of key importance to acknowledge the mutual influence between certain personality profiles and substance use. Specifically, sensation seeking and impulsivity are relevant during early adolescence and awareness of early adolescents' vulnerability for these personality predispositions is warranted.

Individual- and community-level correlates of cigarette-smoking trajectories from age 13 to 32 in a U.S. population-based sample

BACKGROUND

Characterizing smoking behavior is important for informing etiologic models and targeting prevention efforts. This study explored the effects of both individual- and community-level variables in predicting cigarette use vs. non-use and level of use among adolescents as they transition into adulthood.

METHODS

Data on 14,779 youths (53% female) were drawn from the National Longitudinal Study of Adolescent Health (Add Health); a nationally representative longitudinal cohort. A cohort sequential design allowed for examining trajectories of smoking typologies from age 13 to 32 years. Smoking trajectories were evaluated by using a zero-inflated Poisson (ZIP) latent growth analysis and latent class growth analysis modeling approach.

RESULTS

Significant relationships emerged between both individual- and community-level variables and smoking outcomes. Maternal and peer smoking predicted increases in smoking over development and were associated with a greater likelihood of belonging to any of the four identified smoking groups versus Non-Users. Conduct problems and depressive symptoms during adolescence were related to cigarette use versus non-use. State-level prevalence of adolescent smoking was related to greater cigarette use during adolescence.

CONCLUSIONS

Individual- and community-level variables that distinguish smoking patterns within the population aid in understanding cigarette use versus non-use and the quantity of cigarette use into adulthood. Our findings suggest that efforts to prevent cigarette use would benefit from attention to both parental and peer smoking and individual well-being. Future work is needed to better understand the role of variables in the context of multiple levels (individual and community-level) on smoking trajectories.

Associations of functional and dysfunctional impulsivity to smoking characteristics

OBJECTIVES

Although the relation between impulsivity and smoking is well-documented, one model of impulsivity that has received little attention in the addiction literature separates impulsivity into 2 dimensions: functional impulsivity (tendency to make quick effective decisions) and dysfunctional impulsivity (tendency to make quick ineffective decisions).

METHODS

This cross-sectional study examined relations of functional and dysfunctional impulsivity to smoking characteristics in 212 non-treatment-seeking daily smokers (M = 15 cigarettes per day, M age = 24 years, 53% women).

RESULTS

Dysfunctional impulsivity exhibited small- to medium-sized positive associations with difficulty refraining from smoking in forbidden places, craving, and smoking without awareness. Functional impulsivity was inversely associated with a measure of cigarette craving. Other suggestive associations were found; however, these were not statistically significant after type I error correction.

CONCLUSIONS

Although the overall predictive validity of these impulsivity constructs for explaining variance in smoking characteristics was relatively modest, the results suggest that conceptualizing impulsivity as a unitary construct indicative of a tendency to make quick decisions may mask heterogeneity within the impulsivity-smoking relationship. These findings suggest that high-dysfunctional impulsivity smokers may perhaps require more intensive interventions to dampen motivation to smoke. They also highlight the possibility that certain manifestations of impulsivity are not related with increased smoking behavior and may actually associate with reduced drive to smoke.

Do substance use risk personality dimensions predict the onset of substance use in early adolescence? A variable- and person-centered approach

Various studies found personality to be related to substance use, but little attention is paid to the role of personality risk dimensions with regard to an early onset of alcohol, tobacco, and marijuana use. Therefore, the current study used a variable-centered approach to examine whether anxiety sensitivity, hopelessness, sensation seeking, and impulsivity predict the onset of alcohol, tobacco, and marijuana use in early adolescence. Additionally, we adopted a person-centered approach to examine whether different personality subgroups could be identified, and whether these subgroups would be predictive of substance use. For that purpose, longitudinal data of a broader effectiveness study were used from 758 early adolescents (53 % female) aged 11-14 years. Structural equation models showed that hopelessness and sensation seeking were predictive of having ever used alcohol and tobacco. Also, sensation seeking was predictive of marijuana use. Latent profile analyses on the first wave data revealed a three-profile solution for boys (i.e., resilients, internalizers, and externalizers) and a two-profile solution for girls (i.e., resilients and internalizers). In contrast to our expectation, further analyses revealed no significant differences in substance use between the different subprofiles for both boys and girls. The separate personality dimensions thus seem more relevant in predicting the onset of substance use compared to the personality profiles. However, the personality profiles might be informative in explaining more excessive substance use behaviors.

Delay discounting, locus of control, and cognitive impulsiveness independently predict tobacco dependence treatment outcomes in a highly dependent, lower socioeconomic group of smokers

Tobacco use disproportionately affects lower socioeconomic status (SES) groups. Current explanations as to why lower SES groups respond less robustly to tobacco control efforts and tobacco dependence treatment do not fully account for this disparity. The identification of factors that predict relapse in this population might help to clarify these differences. Good candidates for novel prognostic factors include the constellation of behaviors associated with executive function including self-control/impulsiveness, the propensity to delay reward, and consideration and planning of future events. This study examined the ability of several measures of executive function and other key clinical, psychological, and cognitive factors to predict abstinence for highly dependent lower SES participants enrolled in intensive cognitive-behavioral treatment for tobacco dependence. Consistent with predictions, increased discounting and impulsiveness, an external locus of control as well as greater levels of nicotine dependence, stress, and smoking for negative affect reduction predicted relapse. These findings suggest that these novel factors are clinically relevant in predicting treatment outcomes and suggest new targets for therapeutic assessment and treatment approaches.

Meditation-induced changes in high-frequency heart rate variability predict smoking outcomes

BACKGROUND

High-frequency heart rate variability (HF-HRV) is a measure of parasympathetic nervous system (PNS) output that has been associated with enhanced self-regulation. Low resting levels of HF-HRV are associated with nicotine dependence and blunted stress-related changes in HF-HRV are associated with decreased ability to resist smoking. Meditation has been shown to increase HF-HRV. However, it is unknown whether tonic levels of HF-HRV or acute changes in HF-HRV during meditation predict treatment responses in addictive behaviors such as smoking cessation.

PURPOSE

To investigate the relationship between HF-HRV and subsequent smoking outcomes.

METHODS

HF-HRV during resting baseline and during mindfulness meditation was measured within two weeks of completing a 4-week smoking cessation intervention in a sample of 31 community participants. Self-report measures of smoking were obtained at a follow up 17-weeks after the initiation of treatment.

RESULTS

Regression analyses indicated that individuals exhibiting acute increases in HF-HRV from resting baseline to meditation smoked fewer cigarettes at follow-up than those who exhibited acute decreases in HF-HRV (b = -4.89, p = 0.008).

CONCLUSION

Acute changes in HF-HRV in response to meditation may be a useful tool to predict smoking cessation treatment response.

Comorbid trajectories of tobacco and marijuana use as related to psychological outcomes

Heterogeneous classes of comorbid trajectories of tobacco and marijuana use were examined in order to determine how they are related to subsequent antisocial behavior, poor self-control, and internalizing behavior. Data are from a 4-wave longitudinal study of African American (n = 243) and Puerto Rican (n = 232) adolescents and adults in the community. Logistic regression analyses were employed to measure the association between the comorbid trajectories of tobacco and marijuana use and the psychological difficulty variables. The authors found 6 joint trajectory groups. The authors compared the non-or-experimental tobacco/marijuana use group with the other user groups in each of the psychological difficulty domains. The infrequent tobacco/late-onset marijuana use and chronic tobacco/marijuana use groups differed most strongly from the non-or-experimental tobacco/marijuana use group across the antisocial behavior, poor self-control, and internalizing problems domains. The chronic tobacco/maturing out marijuana use group also had significant associations in each of these domains. The infrequent tobacco/marijuana use and late-onset tobacco/infrequent marijuana use groups had no or weak associations with the psychological outcomes. Tobacco and marijuana cessation programs should identify and address comorbid use of tobacco and marijuana, and antisocial behavior, poor self-control, and internalizing problems, which are associated with histories of comorbid use of the 2 substances.

Impaired goal-directed behavioural control in human impulsivity

Two dissociable learning processes underlie instrumental behaviour. Whereas goal-directed behaviour is controlled by knowledge of the consequences, habitual behaviour is elicited directly by antecedent Pavlovian stimuli without knowledge of the consequences. Predominance of habitual control is thought to underlie psychopathological conditions associated with corticostriatal abnormalities, such as impulsivity and drug dependence. To explore this claim, smokers were assessed for nicotine dependence, impulsivity, and capacity for goal-directed control over instrumental performance in an outcome devaluation procedure. Reduced goal-directed control was selectively associated with the Motor Impulsivity factor of Barrett's Impulsivity Scale (BIS), which reflects propensity for action without thought. These data support the claim that human impulsivity is marked by impaired use of causal knowledge to make adaptive decisions. The predominance of habit learning may play a role in psychopathological conditions that are associated with trait impulsivity.

Impulsivity and symptoms of nicotine dependence in a young adult population

Introduction:

Impulsivity is widely regarded as a risk factor for drug dependence. However, its relationship with the symptomatology of nicotine dependence is poorly understood.

Methods:

To examine the nature of these relationships, we recruited 404 daily and occasional smokers from a predominantly student population and assessed the association between impulsivity, as measured by the Barratt Impulsiveness Scale (BIS-11) and several self-reported measures of smoking rate and nicotine dependence, including the Diagnostic and Statistical Manual’s (DSM-IV) criteria.

Results:

Overall, impulsivity was high throughout the entire sample but only modestly associated with nicotine dependence. Within the diagnostic criteria of nicotine dependence, two symptoms, which reflect automatized or habitual smoking, were most strongly associated with impulsivity.

Conclusion:

These data support recent human and animal work, which suggests that impulsivity is linked to the formation of habitual drug use, and are discussed within the framework of a dual-system account of drug seeking.

The role of impulsivity in the aetiology of drug dependence: reward sensitivity versus automaticity

RATIONALE

Impulsivity has long been known as a risk factor for drug dependence, but the mechanisms underpinning this association are unclear. Impulsivity may confer hypersensitivity to drug reinforcement which establishes higher rates of instrumental drug-seeking and drug-taking behaviour, or may confer a propensity for automatic (non-intentional) control over drug-seeking/taking and thus intransigence to clinical intervention.

METHOD

The current study sought to distinguish these two accounts by measuring Barratt Impulsivity and craving to smoke in 100 smokers prior to their completion of an instrumental concurrent choice task for tobacco (to measure the rate of drug-seeking) and an ad libitum smoking test (to measure the rate of drug-taking-number of puffs consumed).

RESULTS

The results showed that impulsivity was not associated with higher rates of drug-seeking/taking, but individual differences in smoking uptake and craving were. Rather, nonplanning impulsivity moderated (decreased) the relationship between craving and drug-taking, but not drug-seeking.

CONCLUSIONS

These data suggest that whereas the uptake of drug use is mediated by hypervaluation of the drug as an instrumental goal, the orthogonal trait nonplanning impulsivity confers a propensity for automatic control over well-practiced drug-taking behaviour.

Impulsiveness and venturesomeness in German smokers

INTRODUCTION

Cigarette smoking is a behavior, which is influenced by genetic, demographic, and psychological factors. A large body of research has examined the association of cigarette smoking variables with individual differences in personality traits. The aim of the current study was to replicate the findings of higher self-reported impulsivity in smokers compared with never-smokers in a German sample using Eysenck´s construct of impulsivity. Furthermore, it was intended to further the knowledge about associations between different self-reported impulsivity components and different smoking variables.

METHODS

We used the Impulsiveness-Venturesomeness-Empathy questionnaire (I7) to measure self-reported impulsiveness and venturesomeness and the Temperament and Character Inventory (TCI) to measure novelty seeking (NS) in a sample of 82 nicotine-dependent smokers and 119 never-smokers.

RESULTS

Smokers scored higher on impulsiveness, venturesomeness, and NS than never-smokers independent of age, gender, and years of education. We found a significant association between venturesomeness, impulsiveness and smoking status in daily smokers.

CONCLUSIONS

In summary, this study provides evidence that impulsiveness and venturesomeness as well as the novelty-seeking subscale extravagance are significantly associated with smoking status in a German sample of female and male smokers compared with never-smokers.