The Multiple, Distinct Ways that Personality Contributes to Alcohol Use Disorders

Bridging the Gap: A Holistic View of Personality Factors in Individuals With and Without Alcohol Use

This comprehensive review examines the intricate interplay between personality factors and alcohol use, shedding light on the dynamic relationship that shapes the initiation, progression, and outcomes of alcohol-related behaviors. The exploration encompasses vital personality traits such as sensation seeking, impulsivity, neuroticism, extroversion, agreeableness, conscientiousness, and openness to experience. The bidirectional nature of this association is underscored, emphasizing how personality influences and is influenced by alcohol consumption patterns. Protective personality factors, including resilience, emotional regulation, and social support, are identified as crucial elements in mitigating the risk of alcohol use disorders (AUDs). The implications for clinical practice advocate for tailored interventions that address individual personality profiles, while policy considerations highlight the need for targeted prevention efforts that acknowledge the diverse ways individuals respond to alcohol use. Furthermore, a call for future research emphasizes emerging perspectives, improved methodologies, and ongoing exploration of intervention strategies to advance our understanding of this complex relationship and refine approaches for prevention and treatment. As we navigate this evolving field, the insights gleaned hold promise for shaping more compelling and nuanced interventions to address the diverse needs of individuals affected by AUDs.

Predicting Alcohol-Related Memory Problems in Older Adults: A Machine Learning Study with Multi-Domain Features

Memory problems are common among older adults with a history of alcohol use disorder (AUD). Employing a machine learning framework, the current study investigates the use of multi-domain features to classify individuals with and without alcohol-induced memory problems. A group of 94 individuals (ages 50-81 years) with alcohol-induced memory problems (the memory group) were compared with a matched control group who did not have memory problems. The random forests model identified specific features from each domain that contributed to the classification of the memory group vs. the control group (AUC = 88.29%). Specifically, individuals from the memory group manifested a predominant pattern of hyperconnectivity across the default mode network regions except for some connections involving the anterior cingulate cortex, which were predominantly hypoconnected. Other significant contributing features were: (i) polygenic risk scores for AUD, (ii) alcohol consumption and related health consequences during the past five years, such as health problems, past negative experiences, withdrawal symptoms, and the largest number of drinks in a day during the past twelve months, and (iii) elevated neuroticism and increased harm avoidance, and fewer positive "uplift" life events. At the neural systems level, hyperconnectivity across the default mode network regions, including the connections across the hippocampal hub regions, in individuals with memory problems may indicate dysregulation in neural information processing. Overall, the study outlines the importance of utilizing multidomain features, consisting of resting-state brain connectivity data collected ~18 years ago, together with personality, life experiences, polygenic risk, and alcohol consumption and related consequences, to predict the alcohol-related memory problems that arise in later life.

The Influence of Unlimited Sucrose Intake on Body Weight and Behavior-Findings from a Mouse Model

A potential relationship between unrestricted sucrose intake (USI), overweight, and emotional/behavioral control has not been well documented. We examined the influence of USI and having less sweetness than expected on body weight (BW), motor/exploratory, anxiety-like, and social dominant behavior in adult C57BL/6J male mice. Animals had free access to water (group 1) or 32% sucrose and water (sucrose groups 2–5) for 10 days. Then, group 2 remained with 32% sucrose while groups 3–5 were subjected to the downshift (24 h access to 4%, 8%, or 16% sucrose). All experimental groups were weighed and tested in the novel-open arena (NA), elevated plus maze (EPM), and tube tests to assess BW, motor/exploratory, anxiety-like, and social dominance behavior, respectively. USI did not influence animals’ BW but produced hyperactivity and anxiolytic-like behavior, which was evident in EPM but not in NA; the outcomes of the downshift were comparable. USI did not influence successes/wins in the tube test but altered emotions that drive the winning, favoring a less anxious behavioral phenotype; this was not evident in the downshifted groups. Observed findings suggest that USI promotes sensation-seeking and motivates dominance, without changing BW, while blunted emotional base of social dominance might be an early mark of the downshift.

Role of pregaming motives in accounting for links between maladaptive personality traits and drinking consequences

College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, such as maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which personality confers risk for consequences is by influencing students' motivation to drink. In this study of 441 college students, we investigated whether different motivations to pregame, a particularly risky and common drinking practice on college campuses, accounts for links between maladaptive traits and alcohol-related consequences. Results of bivariate analyses showed that all pregaming motives and maladaptive traits (except detachment) were strongly correlated with negative consequences. In path analytic models that adjusted for shared variance between pregaming motives and between maladaptive traits, results showed that traits had indirect effects on total drinking consequences via individual differences in pregaming motives as well as direct effects that were independent of motives. Specifically, antagonism, disinhibition, and negative affectivity predicted more drinking consequences via stronger motives to pregame for instrumental reasons over and above the general motivation to pregame, whereas detachment predicted fewer consequences via weaker instrumental pregaming motives. Antagonism and disinhibition were also associated with more drinking consequences, and detachment with fewer consequences, over and above pregaming motives and general personality problems. Our study indicates that one way maladaptive personality traits may shape alcohol-related consequences in college students is by associations with their motivations to pregame. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Association Between Impulsivity and Relapse in Patients With Alcohol Use Disorder: A Literature Review

AIM

Impulsivity has been identified as a key relapse risk factor in patients with alcohol use disorder (AUD); however, the inherent characteristics of this relationship have been largely understudied. The heterogeneity of AUD and variation in impulsivity constructs require careful consideration to inform future work examining the relationship. This study sought to review empirical findings examining facets of impulsivity and AUD relapse.

METHODS

A systematic search strategy was employed to capture studies on impulsivity measures related to AUD relapse. Impulsivity measures were qualitatively organized in terms of 'trait impulsivity'-typically measured by self-report questionnaires-and 'behavioural impulsivity', i.e. 'motor impulsivity', 'impulsive choice' and 'reflection impulsivity, assessed with cognitive-behavioural tasks.

RESULTS

Seventeen peer-reviewed papers were identified. Relapse outcomes varied substantially in relation to impulsivity measures. Twelve papers included aspects of 'trait impulsivity', and nine studies included 'behavioural impulsivity' measures, from which five studies dealt with the 'impulsive choice' subcategory. The Barratt Impulsivity Scale was the self-report questionnaire that was most frequently used.

CONCLUSIONS

All three included facets of impulsivity ('trait-, motor- and impulsive choice impulsivity') were associated with AUD relapse, but none seemed to be superior to another. This study confirmed that research on the relation between impulsivity and AUD relapse is relatively scarce. Future research and treatment options are proposed.

The Etiologic, Theory-Based, Ontogenetic Hierarchical Framework of Alcohol Use Disorder: A Translational Systematic Review of Reviews

Modern nosologies (e.g., ICD-11, DSM-5) for alcohol use disorder (AUD) and dependence prioritize reliability and clinical presentation over etiology, resulting in a diagnosis that is not always strongly grounded in basic theory and research. Within these nosologies, DSM-5 AUD is treated as a discrete, largely categorical, but graded, phenomenon, which results in additional challenges (e.g., significant phenotypic heterogeneity). Efforts to increase the compatibility between AUD diagnosis and modern conceptualizations of alcohol dependence, which describe it as dimensional and partially overlapping with other psychopathology (e.g., other substance use disorders) will inspire a stronger scientific framework and strengthen AUD's validity. We conducted a systematic review of 144 reviews to integrate addiction constructs and theories into a comprehensive framework with the aim of identifying fundamental mechanisms implicated in AUD. The product of this effort was the Etiologic, Theory-Based, Ontogenetic Hierarchical Framework (ETOH Framework) of AUD mechanisms, which outlines superdomains of cognitive control, reward, as well as negative valence and emotionality, each of which subsume narrower, hierarchically-organized components. We also outline opponent processes and self-awareness as key moderators of AUD mechanisms. In contrast with other frameworks, we recommend an increased conceptual role for negative valence and compulsion in AUD. The ETOH framework serves as a critical step towards conceptualizations of AUD as dimensional and heterogeneous. It has the potential to improve AUD assessment and aid in the development of evidence-based diagnostic measures that focus on key mechanisms in AUD, consequently facilitating treatment matching.

Investigating differences in sex, race/ethnicity, and impulsivity across substance user profiles: a person-centered approach

Although substance use is considered normative in college, continued examination of factors associated with problematic use is merited. This study identified latent substance user classes and examined their relations with sex, race/ethnicity, impulsivity-like facets, and substance use outcomes among 702 undergraduate students. Non-Alcohol Abstaining Users (NAA), Minimal Users (MU), and Polysubstance Users (PSU) emerged from latent class analysis. Variable-centered analyses indicated that substance user classes did not differ by sex. Students in the Asian and Other groups were at greater odds of being in the MU class than either NAA or PSU class, compared to White students. Differential patterns of impulsigenic trait levels emerged across latent classes. The present study highlights the utility of integrating person- and variable-centered approaches in studying heterogeneous substance use behaviors among college students. College PSU are particularly at risk for problematic outcomes, thus warranting preventive intervention that may target impulsigenic traits or polysubstance use.

Profiles of potential behavioral addictions' severity and their associations with gender, personality, and well-being: A person-centered approach

BACKGROUND

Addictions share common etiological factors associated with personality vulnerabilities such as narcissism or emotional instability. Also, there are gender differences in the type of and risk for addiction (e.g., men may be more prone to addictions, overall). These are considerably less understood in relation to behavioral addictions (BAs) than in substance use disorders. This study aimed to investigate associations between profiles of six potential BAs (study, shopping, gaming, Facebook, pornography, and food) and gender, personality, and well-being among Polish emerging adults, as a partial replication and extension of previous work.

PARTICIPANTS AND PROCEDURE

In a paper-and-pencil cross-sectional study, 1182 Polish undergraduate students (mean age = 20.33 years; SD = 1.68) completed questionnaires measuring six potential BAs alongside questions on demographic variables, personality traits (Big Five, narcissism), and well-being indicators (general quality of life, health quality, sleep quality, perceived stress, anxiety, and hopelessness).

RESULTS

Using latent profile analysis, four profiles were identified: (1) elevated levels of study, Facebook, shopping, and food addictions; (2) elevated levels of gaming and pornography addictions; (3) low or average levels of all potential BAs, and (4) highest levels of all potential BAs. The second and fourth profiles included men predominantly, and the first profile included almost exclusively women. The fourth profile, in comparison to all other profiles, demonstrated significantly higher scores on all potential BAs, narcissism, lowest conscientiousness and emotional stability, and lowest well-being.

CONCLUSIONS

The results suggest that there is a general proclivity to potential BAs. Furthermore, there are gender-specific profiles of potential BAs, which at present are poorly understood.

Risk for alcohol use/misuse among entering college students: The role of personality and stress

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We examined unique and joint effects of stress and personality on alcohol misuse.

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Factor-level Neuroticism is not uniquely associated with more alcohol misuse.

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Higher Neuroticism—Depression facet scores are associated with more alcohol misuse.

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Neuroticism—Depression moderates the association between stress and alcohol misuse.

Introduction

Excessive alcohol use amongst college students is associated with low grades, poor mental health, and risks to physical safety. Neuroticism, characterized by emotional instability and anxiety, and self-reported stress have both been shown to be strong predictors of alcohol use and misuse, however, previous studies have shown that measures of stress and Neuroticism are frequently confounded. This study tests the hypothesis that personality traits, and Neuroticism in particular, predict alcohol use/misuse in matriculating freshmen above and beyond reported levels of stress.

Methods

Data were collected as part of an IRB-approved longitudinal study, MAPme, examining behavioral health in college. Participants were 303 first-year college students (70% female) with an average age of 18.58 (SD = 0.39). Data were collected during the first eight weeks of the first semester at college.

Results

Overall, domain-level Neuroticism was not associated with alcohol use/misuse above and beyond perceived levels of stress and other Big Five domains (β = 0.14, p = 0.088). Notably, the depression facet of Neuroticism (Neuroticism—Depression), was positively associated with alcohol use/misuse when accounting for the shared effects of stress. Results demonstrated that the Neuroticism—Depression facet moderated the relationship between stress and alcohol use/misuse (β = 0.18, p = 0.020).

Conclusions

The Neuroticism—Depression facet is a better predictor of alcohol use/misuse than the Neuroticism domain, even when accounting for stress and other personality domains.

At low levels of the Depression facet, stress was negatively associated with alcohol use/misuse, but at high levels of the Depression facet, stress was positively associated with alcohol use/misuse. Taken together, our results shed new light into the combined and independent effects of Neuroticism and stress on alcohol use/misuse.

An Investigation of Alternative Factor Models of Impulsivity using the UPPS-P

The UPPS-P measures impulsivity as a five-factor construct (lack of premeditation, lack of perseverance, positive urgency, negative urgency and sensation seeking). Drawing on a number of theoretical considerations and alternative conceptions of impulsivity, the current study used confirmatory factor analysis (N = 1635) and multiple regression to evaluate and test alternative models comprising three, five, and a hierarchical model containing latent factors. The five factor and hierarchical models were shown to be valid and of near identical fit, whereas the three-factor model fit the data poorly. The current findings suggest that both the five factor and hierarchical models are useful applications of the UPPS-P. Depending on the purpose of future research, both models demonstrate utility in both risk assessment and treatment development. Multiple regression analysis revealed that positive urgency predicted problem gambling, which supports the predictive utility of impulsivity as a five-factor construct. While the latent factors of the hierarchical model are consistent with emerging theory, those using the UPPS-P should not overlook the unique contributions of the five factors. As the current study found meaningful predictive distinctions between positive and negative urgency, utilizing all five factors may increase measurement sensitivity and predictive utility.

DSM-5 Maladaptive Personality Domains among Treatment-Seeking Individuals with Alcohol Use Disorder: The Role of Disinhibition and Negative Affectivity

Background: Dimensional models of personality and personality disorders (PDs) have been widely investigated among individuals with alcohol use disorders (AUD). Nevertheless, DSM-5 maladaptive personality domains showed mixed associations with AUD. Furthermore, no studies have explored the role of DSM-5 maladaptive personality domains on the comorbidity between AUD and different PDs. Objective(s): This study aims at investigating whether DSM-5 maladaptive personality dimensions could differentiate individuals with AUD from normative and healthy controls (HCs) subjects. The study also investigated relationships between these personality dimensions and AUD clinical features (i.e. onset, severity of concurrent substance use disorders), as well as their role in accounting for the comorbidity between AUD and PDs. Methods: This study administered the personality inventory for DSM-5 (PID-5) to 99 treatment-seeking individuals (male 68.8%; female 31.2%; age: 48.12 (14.32)) with AUD (41 AUD only; 58 AUD with PDs), comparing the participants' levels of PID-5 domains with normative data and the data from a HC sample (N = 40; male 50%; female 50%; age: 48.12 (14.32)). Results: Disinhibition and negative affectivity were relevant maladaptive personality dimensions of AUD, even when controlling for the impact of PD diagnoses. Disinhibition and negative affectivity were associated to the onset of AUD and the severity of concurrent substance use disorders. The co-occurrence of AUD and PDs is related to other two domains, namely antagonism and detachment. Conclusions: AUD is a complex psychopathological disorder in which both externalizing and internalizing aspects determine relevant clinical features.

Personality and Alcohol-Related Risk: Neuroticism, Extraversion, and Alexithymia

Previous research has established associations of neuroticism and extraversion with risky or problematic alcohol use in both clinical and nonclinical samples. More recently, alexithymia—a personality trait defined by difficulties in identifying and describing feelings as well as concrete thinking—has been implicated as a risk factor for problematic drinking; however, whether it is an independent risk factor or overlaps with others has not been determined. The present study examined neuroticism, extraversion, and alexithymia in relation to risky drinking in a nonclinical sample of 285 alcohol consumers aged 18-60 years. Neuroticism and extraversion were measured with the International Personality Item Pool Big Five Factor Markers, whereas alexithymia was measured with the Toronto Alexithymia Scale 20. The Alcohol Use Disorders Identification Test provided an index of alcohol-related risk. Hierarchical regression indicated that neuroticism, extraversion, and alexithymia were all significant positive predictors of risky drinking after controlling for demographic and mood variables. Alexithymia was positively related to neuroticism, and both were negatively related to extraversion. The relationship between alexithymia and risky drinking was partially mediated by neuroticism, and the association of alexithymia with neuroticism was partially mediated by negative mood. Neuroticism, extraversion, and alexithymia appear to be independently related to alcohol-related risk, although the influence of alexithymia may partially overlap with that of neuroticism. Both alexithymia and neuroticism are associated with proneness to negative moods; a reliance on drinking to cope with such states may account for the links of both traits to risky or problematic drinking in line with Cloninger’s type I alcoholism. However, additional aspects of alexithymia may also contribute to its role in alcohol-related risk. The relationship of extraversion to risky drinking appears congruent with Cloninger’s type II alcoholism, where high reward sensitivity motivates drinking to enhance positive states.

UPPS-P facets of impulsivity and alcohol use patterns in college and noncollege emerging adults

BACKGROUND

Alcohol use and related problems reach a peak in emerging adulthood. Impulsivity is a multifaceted construct known to be involved in emerging adult alcohol use. Few studies have examined impulsivity and alcohol use across both college attending and noncollege attending emerging adults.

OBJECTIVES

To clarify the multifaceted nature of impulsivity and its links to emerging adult alcohol use, this study investigated whether the five distinct facets of the UPPS-P model of impulsivity were predictive of three different behavioral outcomes: alcohol intake, alcohol related problems and binge drinking. In addition, the moderating effects of college attendance were tested.

METHODS

A community sample comprising 273 Australian college and noncollege attendees (58.6% women; 41.4% men) aged between 18 and 30 years (M_age = 23.71, SD = 2.81).

RESULTS

Multiple regression analyses demonstrated that lack of premeditation predicted alcohol intake and binge drinking behavior, whilst positive and negative urgency predicted alcohol related problems. Moderation analyses revealed that the effects of impulsivity on alcohol patterns were consistent for college and noncollege attending emerging adults.

CONCLUSION

These findings highlight the importance of impulsive urgency (both positive and negative) in emerging adult problematic alcohol use, and support the generalizability of college samples to broader emerging adult populations. Emerging adults may use alcohol to avoid negative mood states and further enhance positive mood states. Improved emotional regulation may help both college and non-college emerging adults reduce their alcohol use.

Even More Complex…. When Mental Disorder Meets Addiction in Youth: Dual Pathology

BACKGROUND

The management of mental disorders in child and adolescent is challenging. In addition, when substance use disorders are associated with mental disorders, important complications are noted. Dual pathology and Substance-induced disorders should be distinguished in cases like this.

OBJECTIVE

To summarize the latest information on the epidemiology, etiology and management aspects of dual pathology in adolescents.

METHODS

PubMed, Web of Science, PsycINFO and SciELO databases were searched to perform a narrative review.

RESULTS

Dual pathology is the term used to designate the co-occurrence of an addictive disorder and at least one other mental health disorder, independently. To distinguish dual pathology from substance- induced disorders, the temporal association between the disorders in a longitudinal assessment should be emphasized. If the symptoms of the mental disorder appear prior to the substance use or after a long period of abstinence, a diagnosis of dual pathology should be considered. Patients with dual pathology present greater psychosocial issues, more medical problems, and worse prognosis than those with substance-induced disorders. The proposed etiological models agree that biological, psychological and social factors are shared in the development of these conditions.

CONCLUSION

Healthcare systems should focus on creating policies that will allow early detection, preventive public health measures, and an integrated and coordinated care for these patients. Public health policies should create means to promote awareness and prevention of these pathologies since early initiation of treatment (pharmacological, psychotherapeutic, family therapy, education in schools, behavioral interventions and treatment of comorbidities) reduces the risks associated to substance use disorders and other negative consequences.

Reexamining the Psychometric Properties of the Substance Use Risk Profile Scale

The Substance Use Risk Profile Scale (SURPS), a widely used self-report questionnaire, assesses four personality traits which predict risk for substance use (i.e., anxiety sensitivity, hopelessness, impulsivity, and sensation seeking). Given its use in research and clinical settings, as well as potential utility, this study aimed to provide a comprehensive psychometric evaluation of the SURPS. Undergraduate participants ( N = 718; 69% White; 26% Hispanic, aged 18-25 years, M = 19.00, SD = 1.33) completed a battery of measures, including the SURPS. Tests of measurement invariance, convergent and criterion validity, and internal consistency were conducted, as well as item response theory analyses and a treatment assignment simulation. Several items were removed before partial measurement invariance across gender was established with little information lost. Despite removing several SURPS items, the proposed factor structure was not empirically supported. More work is necessary to determine the predictive utility of assessing these personality traits to predict substance-related outcomes.

Alexithymia, Impulsivity, and Reward Sensitivity in Young Adult University Student Children of Alcoholics

BACKGROUND AND OBJECTIVES

Personality traits previously known as risk factors for alcohol use disorder (AUD) were assessed in 29 young adult children of alcoholics (COAs) and 68 young adult children of nonalcoholics (non-COAs). Male and female university students (M_age = 22.11 years) completed questions pertaining to demographics and alcohol use, and the Children of Alcoholics Screening Test; Toronto Alexithymia Scale; Barratt Impulsiveness Scale; Sensitivity to Punishment and Sensitivity to Reward Questionnaire; and Depression Anxiety Stress Scales.

RESULTS

Results indicated that personality traits of alexithymia, reward sensitivity, and impulsivity, as well as negative moods, were significantly elevated in COAs compared to non-COAs, independent of current alcohol consumption and drinking history.

CONCLUSIONS

Findings are consistent with familial transmission of AUD-associated personality traits in COAs, presumably via influences of genetics and/or familial environment.

Associations Between Personality and Drinking Motives Among Abstinent Adult Alcoholic Men and Women

Aims

Men and women differ in personality characteristics and may be motivated to use alcohol for different reasons. The goals of the present study were to characterize personality and drinking motives by gender and alcoholism status in adults, and to determine how alcoholism history and gender are related to the associations between personality traits and drinking motivation.

Methods

Personality characteristics were assessed with the Eysenck Personality Questionnaire, which includes Extraversion, Neuroticism, Psychoticism and Lie (Social Conforming) scales. To evaluate drinking motivation, we asked abstinent long-term alcoholic men and women, and demographically similar nonalcoholic participants to complete the Drinking Motives Questionnaire, which includes Conformity, Coping, Social and Enhancement scales.

Results

Patterns of personality scale scores and drinking motives differed by alcoholism status, with alcoholics showing higher psychopathology and stronger motives for drinking compared with controls. Divergent gender-specific relationships between personality and drinking motives also were identified, which differed for alcoholics and controls.

Conclusion

Alcoholic and control men and women differed with respect to the associations between personality traits and motives for drinking. A better understanding of how different personality traits affect drinking motivations for alcoholic men and women can inform individualized relapse prevention strategies.

Short Summary

Men and women differed in their personality traits and their motivations for drinking, and these relationships differed for abstinent alcoholic and control groups. Additionally, alcoholics scored higher on Neuroticism and Psychoticism personality traits, and had lower Enhancement and Social Conformity drinking motives than nonalcoholic controls.

The relationship between the UPPS-P impulsive personality traits and substance use psychotherapy outcomes: A meta-analysis

BACKGROUND

Although impulsive personality traits have been well implicated in substance use disorder (SUD) risk, little work has established how specific impulsive personality traits influence and are influenced by SUD psychotherapy outcomes. The purpose of this meta-analysis was to quantitatively review existing work to examine 1) how impulsive personality traits affect SUD psychotherapy outcomes and 2) reductions in impulsive personality traits during SUD psychotherapy.

METHODS

Studies were identified by conducting a comprehensive review of the literature.

RESULTS

For aim one (k=6), significant effects were found for lack of premeditation (g=0.60, SE=0.30, 95% CI 0.01-1.20; z=1.99, p=0.05) and negative urgency (g=0.55, SE=0.17, 95% CI 0.22-0.88, z=3.30, p=0.001), with trait scores related to poorer SUD psychotherapy outcomes. For aim two (k=10), decreases in sensation seeking (g=-0.10, SE=0.05, 95% CI -0.20 to 0.004; z=-1.88, p=0.02) and negative urgency (g=-0.25, SE=0.14, 95% CI -0.53 to 0.03; z=-1.75, p=0.03) during SUD psychotherapy were significant.

CONCLUSIONS

Overall, our quantitative synthesis suggests that lack of premeditation and negative urgency are related to poorer SUD psychotherapy outcomes. Although negative urgency and sensation seeking are decreasing during SUD psychotherapy, the magnitude of the change is quite small. Overall, we suggest that the measurement and targeting of impulsive personality traits in psychotherapy has strong potential to improve clinical outcomes across SUDs and a wide range of clinical problems and disorders.

Hostility predicts alcohol consumption over a 21-year follow-up in the Gazel cohort

BACKGROUND

Hostility has been found to be positively associated with alcohol intake in cross-sectional studies. Our aim was to examine prospectively the long-lasting association of hostility with alcohol consumption.

METHODS

We included 10,612 men and 3834 women from the French Gazel cohort with mean ages in 1993 of 48.6 (SD=2.9) and 45.7(SD=4.2), respectively. Hostility (i.e., total, cognitive and behavioral) was assessed in 1993 with the Buss and Durkee Hostility Inventory. Alcohol consumption was self-reported annually from 1994 to 2014. Hostility scores were introduced successively in general linear mixed models with annual alcohol consumption in drinks per week as dependent variable. Multivariable analyses were adjusted for age, occupational status, marital status, retirement status and depression score. All the analyses were stratified by sex.

RESULTS

Among men (women), 83.0% (76.2%) completed at least 75% of all annual assessment of alcohol consumption over a 21-year follow-up. In univariate analysis, alcohol consumption was associated with total and behavioral hostility in both sex (all p<0.001). In multivariable analyses, these associations remained significant with a greater size effect for behavioral hostility. Estimated means of alcohol consumptions ranged from 10.50 [95CI%: 10.01-10.92] drinks per week to 13.32 [95%CI: 12.90-13.74] in men and from 4.09 [95%CI: 3.71-4.46] to 5.78 [95%CI: 5.39-6.17] in women, for the first and last quartiles respectively (p trends<0.001 and all pairwise comparisons<0.01). Similar effects were observed among participants with at-risk alcohol consumption at baseline.

CONCLUSIONS

In both men and women, behavioral hostility predicted alcohol consumption over a 21-year follow-up. Interventions aiming at modulating behavioral hostility may help reducing its long-lasting influence on alcohol consumption.

Maladaptive Decision Making in Adults with a History of Adolescent Alcohol use, in a Preclinical Model, Is Attributable to the Compromised Assignment of Incentive Value during Stimulus-Reward Learning

According to recent WHO reports, alcohol remains the number one substance used and abused by adolescents, despite public health efforts to curb its use. Adolescence is a critical period of biological maturation where brain development, particularly the mesocorticolimbic dopamine system, undergoes substantial remodeling. These circuits are implicated in complex decision making, incentive learning and reinforcement during substance use and abuse. An appealing theoretical approach has been to suggest that alcohol alters the normal development of these processes to promote deficits in reinforcement learning and decision making, which together make individuals vulnerable to developing substance use disorders in adulthood. Previously we have used a preclinical model of voluntary alcohol intake in rats to show that use in adolescence promotes risky decision making in adulthood that is mirrored by selective perturbations in dopamine network dynamics. Further, we have demonstrated that incentive learning processes in adulthood are also altered by adolescent alcohol use, again mirrored by changes in cue-evoked dopamine signaling. Indeed, we have proposed that these two processes, risk-based decision making and incentive learning, are fundamentally linked through dysfunction of midbrain circuitry where inputs to the dopamine system are disrupted by adolescent alcohol use. Here, we test the behavioral predictions of this model in rats and present the findings in the context of the prevailing literature with reference to the long-term consequences of early-life substance use on the vulnerability to develop substance use disorders. We utilize an impulsive choice task to assess the selectivity of alcohol’s effect on decision-making profiles and conditioned reinforcement to parse out the effect of incentive value attribution, one mechanism of incentive learning. Finally, we use the differential reinforcement of low rates of responding (DRL) task to examine the degree to which behavioral disinhibition may contribute to an overall decision-making profile. The findings presented here support the proposition that early life alcohol use selectively alters risk-based choice behavior through modulation of incentive learning processes, both of which may be inexorably linked through perturbations in mesolimbic circuitry and may serve as fundamental vulnerabilities to the development of substance use disorders.

Personality risk for antisocial behavior: Testing the intersections between callous-unemotional traits, sensation seeking, and impulse control in adolescence

The current project seeks to integrate literatures on personality risk for antisocial behavior (ASB) by examining how callous-unemotional traits relate to (a) the development of disinhibited traits and (b) the association between disinhibited traits and ASB. In Study 1, using a nationally representative sample of youth (N > 7,000), we examined whether conduct problems and lack of guilt assessed during ages 4-10 years predicted levels of and changes in disinhibited traits over the course of adolescence, and moderated associations between these traits and ASB. High levels of childhood conduct problems were associated with higher levels of impulsivity, sensation seeking, and ASB in early adolescence, whereas lack of guilt was associated with lower levels of sensation seeking. Neither conduct problems nor lack of guilt significantly predicted changes in impulsivity or sensation seeking, and associations among changes in sensation seeking, impulsivity, and ASB were also consistent across levels of conduct problems and lack of guilt. In Study 2, using a cross-sectional sample of adolescents (N = 970), we tested whether callous-unemotional traits moderated associations between disinhibited traits and ASB. Consistent with the results of Study 1, associations between disinhibited personality and ASB were consistent across a continuous range of callous-unemotional traits.

Comorbidity of Internet gaming disorder and alcohol use disorder: A focus on clinical characteristics and gaming patterns

BACKGROUND AND OBJECTIVES

Although Internet gaming disorder (IGD), which has been considered as a behavioral addiction in DSM-5, shares core features with alcohol use disorder (AUD), there has been minimal research on the clinical implications of the comorbidity between IGD and AUD. The purpose of this study is to investigate clinical psychopathologies and Internet game usage patterns of IGD, AUD, and their comorbid status.

METHODS

Participants (n = 1819) completed a cross-sectional web-based survey. The survey questionnaire included socio-demographic data, the IGD scale according to DSM-5 criteria, the Korean version of Alcohol Use Disorders Identification Test for AUD, the Dickman Impulsivity Inventory (DII)-short version for impulsivity, the Brief Self-Control Scale (BSCS) for self-control, the subscales of the Symptom Check-List 90 Items-Revised (SCL-90-R) for depression and anxiety, and the Behavioral Inhibition System/Behavioral Approach System Scale, and the Internet game usage patterns.

RESULTS

The comorbidity group had substantially more severe clinical features such as impulsivity, impaired self-control, and mood symptoms than either IGD or AUD only. Especially the depression scale for the comorbidity group (26.0) is considerably higher than 13.0 for IGD and 16.0 for AUD alone. Furthermore, the comorbidity group spent twice as much money on Internet gaming as IGD alone (all p < .05).

CONCLUSIONS AND SIGNIFICANCE

The findings of this study indicate that the comorbidity between IGD with AUD showed more severe psychopathological impairments, and the respective persons spent more money on gaming than either IGD or AUD alone. These particular characteristics may serve as feasible therapeutic targets in clinical settings. (Am J Addict 2017;26:326-334).

The SLC6A3 gene possibly affects susceptibility to late-onset alcohol dependence but not specific personality traits in a Han Chinese population

Dopaminergic dysfunction has an important role in the pathoetiology of alcohol dependence (AD). The purpose of this study was to determine whether the solute carrier family 6 member 3 (SLC6A3) gene (also known as the dopamine transporter DAT gene) was associated with AD, and whether variants in the SLC6A3 locus were associated with specific personality traits in patients with AD. Sixteen polymorphisms in SLC6A3 were analyzed using 637 patients with AD and 523 healthy controls. To reduce clinical heterogeneity, patients were classified into two subgroups: early-onset AD (EOAD) and late-onset AD (LOAD). The Tridimensional Personality Questionnaire was used to assess the personality traits novelty seeking (NS) and harm avoidance (HA) in the patients with AD. Using allele frequency and genotype distribution comparisons and logistic regression analysis, we found evidence of association between rs6350 and AD (P < 0.05). Following subgroup analysis, we confirmed evidence of an association in patients with LOAD (P = 0.003), but not in patients with EOAD. Heterozygous carriers of the A allele have a nearly 3 times greater risk to develop LOAD compared to individuals who do not have an A allele. Although we found that patients with AD had higher NS and HA scores compared to controls (P < 0.001), we did not find evidence of association between SLC6A3 polymorphisms and either NS or HA in patients with AD using linear regression analysis. The findings from our study indicate that the SLC6A3 gene may have a role in susceptibility to late-onset AD in the Han Chinese population.

Personalizing substance use treatment based on pre-treatment impulsivity and sensation seeking: A review

BACKGROUND

Theoretically, substance use disorder (SUD) treatment that matches an individual's etiology and/or maintaining factors should be more effective than a treatment that does not directly address these factors. Impulsivity and sensation/reward seeking may contribute to the development and maintenance of SUDs, and are potential candidate variables for assigning patients to treatment. The goal is to identify whether current research can provide insight into which treatments may be most effective for individuals high in impulsivity or sensation seeking, relative to other treatments. A secondary goal is to provide recommendations for personalizing SUD treatment based on etiology or maintaining factors.

METHOD

This review summarizes clinical trials that speak to the differential effectiveness of two or more treatments for alcohol, tobacco, and other drug use disorders, based on pre-treatment impulsivity, sensation seeking, or related constructs.

RESULTS

Few studies examine the differential effectiveness of two or more treatments for individuals high in impulsivity or sensation seeking. Very preliminary evidence suggests that contingency management may hold promise for individuals high in impulsivity. Pharmacological trials were under-represented in the current review, despite evidence that the effectiveness of some pharmacological interventions may be moderated by impulsivity.

CONCLUSIONS

Potential reasons for slow rate of progress to date are provided. Given slow accumulation of evidence, an alternative method for personalizing treatment based on pre-treatment psychosocial factors, including impulsivity and sensation/reward seeking, is proposed. Future research may explore the role of contingency management for SUD among individuals with high pre-treatment impulsivity or sensation seeking. Finally, novel, technology-enhanced behavioral mechanisms are discussed as an adjunct to SUD treatment for these high-risk populations.

Impulsivity and risk for prescription opioid misuse in a chronic pain patient sample

Misuse of, and addiction to, prescription opioid pain relievers is a growing concern, in both non-clinical samples and chronic pain patients receiving opioid analgesic therapy. Research is needed to identify which patients may be more prone to misuse or dependence on opioids in a chronic pain treatment setting. Based on literature showing the role of impulsivity in substance use disorders generally, we predicted that impulsivity may also be important to understanding which individuals may be at risk for opioid misuse when opioids are prescribed for pain. The present study examined associations between impulsivity facets and measures of prescription opioid misuse and symptoms. Four facets of impulsivity were examined: urgency, sensation seeking, lack of premeditation, and lack of perseverance. 143 patients receiving treatment for chronic pain at a regional pain clinic completed a series of questionnaires including the UPPS and measures of opioid risk and misuse. Consistent with predictions, urgency was associated with risk for future misuse (β=0.246, p<0.05), current misuse (β=0.253, p<0.01), and symptoms of current opioid use disorder (OUD; β=0.206, p<0.05). Sensation seeking was also associated with current misuse (β=0.279, p<0.01). These results suggest that identifying facets of impulsivity is important to understanding and assessing for risk of prescription opioid misuse in the context of chronic pain treatment. These data indicate that patients who react impulsively to negative mood states and cravings may be especially prone to developing aberrant use patterns when taking prescription opioids. This is the first known study to identify the role of urgency in predicting risk for OUDs in chronic pain patients.

Acute subjective response to alcohol as a function of reward and punishment sensitivity

Individual differences in subjective response to alcohol play a crucial role in the development of heavy drinking and related problems. In light of this, a growing focus of research has been identifying factors that contribute to differences in response. The aim of the present study was to determine whether individual differences in the subjective experience of rewarding and aversive effects of alcohol are a specific manifestation of general differences in reward and punishment sensitivity. Eighty-nine participants (M age=22.4, SD=1.9; 47.2% women) consumed a moderate dose of alcohol, i.e., peak breath alcohol concentration (BrAC)≈0.080g%, and rated their level of stimulation and sedation at seven timepoints over the BrAC curve. Sensitivity to reward and punishment were assessed by a self-report questionnaire prior to consumption. Multilevel growth models showed that post-consumption changes in stimulation ratings varied as a function of participants' level of reward and punishment sensitivity. Drinkers more sensitive to reward reported feeling more stimulated shortly after drinking and exhibited an attenuated rate of decline in stimulation over the blood alcohol curve, relative to drinkers with less strong reward sensitivity. Reward sensitivity was not related to subjective ratings of sedation, and punishment sensitivity was not related to either stimulation or sedation ratings. Findings suggest that reward sensitivity may increase risk for alcohol misuse among young adult social drinkers by increasing their subjective feelings of stimulation while drinking.

Does drinking refusal self-efficacy mediate the impulsivity-problematic alcohol use relation?

There is consistent evidence that impulsivity-like traits relate to problematic alcohol involvement; however, identifying mechanisms that account for this relation remains an important area of research. Drinking refusal self-efficacy (or a person's ability to resist alcohol; DRSE) has been shown to predict alcohol use among college students and may be a relevant mediator of the impulsivity-alcohol relation. The current study examined the indirect effect of various constructs related to impulsivity (i.e., urgency, sensation seeking, and deficits in conscientiousness) via several facets of DRSE (i.e., social pressure, opportunistic, and emotional relief) on alcohol-related problems among a large sample of college students (N=891). Overall, results indicated that certain DRSE facets were significant mediators of the relation between impulsivity-related constructs and alcohol problems. More specifically, emotional-relief DRSE was a mediator for the respective relations between urgency and deficits in conscientiousness and alcohol problems, whereas social-DRSE was a significant mediator of the respective relations between urgency and sensation seeking with alcohol problems. Results from this study suggest particular types of DRSE are important mediators of the relations between specific impulsivity constructs and alcohol-related problems. These findings support prevention and intervention efforts that seek to enhance drinking refusal self-efficacy skills of college students, particularly those high in certain personality features, in order to reduce alcohol-related problems among this population.

Longitudinal Associations among Impulsivity, Friend Substance Use, and Adolescent Substance Use

Adolescent substance use is an increasing problem in the United States, and some researchers posit a bidirectional relation between adolescent substance use and the personality trait of impulsivity (e.g., Quinn, Stappenbeck, & Fromme, 2011). Friend substance use has been shown to be a powerful predictor of adolescent substance use, with prior research suggesting a bidirectional relation between adolescent substance use and friend substance use (e.g., Simons-Morton & Chen, 2006). Extant literature has not tested the bidirectional relation between adolescent substance use and impulsivity with longitudinal data nor has it examined this relation while considering the bidirectional relation with the social context factor of friend substance use. Using three waves of longitudinal data, we tested if there was a bidirectional relation between adolescent substance use and impulsivity while also examining the influences of friend substance use. Participants were 131 adolescents (male = 55%, mean age = 13 years at Wave 1). We tested nested models and examined whether adding equality constraints degraded the model fit using a Wald test. Results of structural equation modeling indicated that, after controlling for baseline levels of substance use, impulsivity predicted adolescent and friend substance use over time, whereas adolescent and friend substance use did not predict impulsivity. Adolescents with substance using friends were likely to increase their own substance use. The findings imply that aiming at both improving adolescents’ ability to regulate impulsivity and deterring associations with friends who are using substances is essential for prevention and intervention efforts against substance use development in adolescents.

Alcohol use initiation is associated with changes in personality trait trajectories from early adolescence to young adulthood

BACKGROUND

Recent work has demonstrated the codevelopment of personality traits and alcohol use characteristics from early adolescence to young adulthood. Few studies, however, have tested whether alcohol use initiation impacts trajectories of personality over this time period. We examined the effect of alcohol use initiation on personality development from early adolescence to young adulthood.

METHODS

Participants were male (nmen = 2,350) and female (nwomen = 2,618) twins and adoptees from 3 community-based longitudinal studies conducted at the Minnesota Center for Twin and Family Research. Data on personality traits of Positive Emotionality (PEM; Well-being), Negative Emotionality (NEM; Stress Reaction, Alienation, and Aggression), and Constraint (CON; Control and Harm Avoidance)-assessed via the Multidimensional Personality Questionnaire (MPQ)-and age of first drink were collected for up to 4 waves spanning ages 10 to 32.

RESULTS

Alcohol use initiation was associated with significant decreases in levels of Well-being and CON traits, most notably Control; and significant increases in levels of all NEM traits, particularly Aggression. In general, the effects of alcohol use initiation on personality traits were moderated by gender and enhanced among those with earlier age of first drink.

CONCLUSIONS

From early adolescence to young adulthood, alcohol use initiation predicts deviations from normative patterns of personality maturation. Such findings offer a potential mechanism underlying the codevelopment of personality traits and alcohol use characteristics during this formative period of development.

Predicting problematic alcohol use with the DSM-5 alternative model of personality pathology

High comorbidity between personality disorders and alcohol use disorders appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. However, very little is known about how the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5) Section III trait model of personality pathology relates to alcohol problems or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test (AUDIT) to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Furthermore, 2 of the 5 higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these 2 specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. (PsycINFO Database Record

Pathways Between Concealable Stigmatized Identities and Substance Misuse

Individuals with concealable stigmatized identities often possess no obviously devalued attributes, yet are at greater risk for problematic substance use compared to their privileged counterparts. We present a conceptual model, which proposes that identity-relevant content and characteristics have important implications for cognitive, affective, and behavioral consequences of stigma-related stress. In doing so, we synthesize stigma-related models from the extant literature and attempt to integrate these concepts with previous work detailing potential contributors to substance use behaviors specifically. Finally, we ask readers to consider the various ways in which the content and characteristics of an individual's stigmatized identity might combine with situational and additional individual difference factors to influence the likelihood of substance misuse.

Integrating Social-Contextual and Intrapersonal Mechanisms of "Maturing Out": Joint Influences of Familial-Role Transitions and Personality Maturation on Problem-Drinking Reductions

BACKGROUND

"Maturing out" of problem drinking is associated with both role transitions (e.g., getting married) and personality development. However, little is known concerning how these 2 mechanisms jointly influence problem-drinking desistance. This study investigated whether salutary effects of role transitions and personality occur at different points in young-adult development and whether they mediate one another's effects.

METHODS

Participants were initially recruited as first-year undergraduates, with family history of alcoholism overrepresented by design (N = 489). Using 4 waves of data at roughly ages 21, 25, 29, and 34, cross-lagged panel models estimated prospective relations among familial-role transitions (marriage or parenthood), personality (disinhibition, conscientiousness, and neuroticism), and problem drinking.

RESULTS

Mixed support was found for the prediction of roles being more strongly associated with earlier maturing out of problem drinking and personality being more strongly associated with later maturing out. Regarding mediation, no evidence was found for the expectation that role effects would be mediated by personality. However, results did support mediation of personality effects by role transitions. Specifically, lower disinhibition and higher conscientiousness in emerging adulthood predicted role adoption, which, in turn, predicted later problem-drinking reductions. Family history of alcoholism also distally influenced these mediation processes.

CONCLUSIONS

The differential timing of role and personality effects is consistent with the notion of decreasing contextual influences and increasing intrapersonal influences across development. In light of role incompatibility theory, results suggest that, over the course of development, the association of familial roles with problem drinking may increasingly reflect problem-drinking effects on role entry (i.e., role selection) and decreasingly reflect role entry effects on problem drinking (i.e., role socialization). As emerging-adult disinhibition and conscientiousness were associated with an apparent developmental cascade of both direct and indirect effects, findings highlight their potential importance as etiologic mechanisms and intervention targets.

Short-term prospective effects of impulsivity on binge drinking: mediation by positive and negative drinking consequences

OBJECTIVE

Although the association of impulsivity with diverse alcohol outcomes has been documented, the mechanisms by which impulsivity predicts drinking over time remain to be fully characterized. The authors examined whether positive drinking consequences, but not negative drinking consequences, mediated the association between impulsivity and subsequent binge drinking, over and above prior binge drinking.

PARTICIPANTS

Participants were 171 college students.

METHODS

Participants completed 2 online surveys with an average interval of 68 days between assessments at Time 1 (September to October 2012) and Time 2 (November to December 2012).

RESULTS

Path analysis showed that, among 5 facets of impulsivity, the effect of sensation seeking on subsequent binge drinking was completely mediated by prior positive consequences. No mediating effects of negative consequences were found.

CONCLUSIONS

Prior experience of positive drinking consequences may serve as one of the risk pathways by which sensation seeking shapes binge drinking over time. Personalized intervention strategies may utilize information about students' impulsivity facets to address their binge drinking and alcohol-related consequences.

Impulsivity and Alcohol Involvement: Multiple, Distinct Constructs and Processes

Of all the personality traits associated with problematic alcohol involvement, traits related to impulsivity appear to show the most robust relations to alcohol use and alcohol-related problems. This article reviews both seminal articles that focus on broadband measures of impulsivity and newer research linking more specific impulsivity-related traits to the development and course of problematic alcohol involvement, with a specific focus on self-report measures of impulsivity-related traits. Specifically, empirical support for different theoretical models that account for the overlap between impulsivity-related traits and problematic alcohol involvement is discussed, including current limitations of existing research. Recent studies suggest that specific impulsivity constructs relate to distinct aspects of alcohol-related behavior. Further, there is emerging evidence that problematic alcohol use and impulsivity-related traits are dynamically related, such that changes in these constructs appear to correlate during specific developmental periods. We close by discussing potential research directions that may provide increased clarity in understanding the impulsivity-alcohol relation.

Adolescent alcohol use is predicted by childhood temperament factors before age 5, with mediation through personality and peers

BACKGROUND

Very few studies chart developmental pathways from early childhood to adolescent alcohol-related outcomes. We test whether measures of temperament collected from mothers at multiple assessments from 6 months through 5 years predict alcohol-related outcomes in mid-adolescence, the developmental pathways that mediate these effects, and whether there are gender differences in pathways of risk.

METHODS

Structural models were fit to longitudinal data from the Avon Longitudinal Study of Parents and Children, an epidemiological sample of pregnant women with delivery dates between April 1991 and December 1992, with children followed longitudinally. Temperamental characteristics were assessed at 6 time points from 6 to 69 months of age. Alcohol use and problems were assessed at age 15.5. Analyses here utilize data from 6,504 boys and 6,143 girls.

RESULTS

Childhood temperament prior to age 5 predicted adolescent alcohol use and problems at age 15.5 years, even after controlling for socio-demographic factors and parental alcohol problems. In both boys and girls, 2 largely uncorrelated and distinct temperament styles-children who were rated as having consistent emotional and conduct difficulties through age 5, and children who were rated as consistently sociable through age 5-both showed elevated rates of alcohol problems at age 15.5, but via different mediational pathways. In both genders, the association between emotional and conduct difficulties and alcohol problems was mediated through reduced conscientiousness and lower emotional stability. The association between sociability and alcohol problems was mediated through increased extraversion and sensation-seeking for both genders. Boys also showed mediation for sociability and alcohol outcomes through friendship characteristics, and girls through lower conscientiousness and reduced emotional stability.

CONCLUSIONS

Our findings support multiple pathways to alcohol consumption and problems in adolescence. Some of these pathways are shared in boys and girls, while other risk factors are more salient in one gender or the other.

The associations between self-consciousness, depressive state and craving to drink among alcohol dependent patients undergoing protracted withdrawal

Context

In order to understand how certain personality traits influence the relation between depression symptoms and craving for alcohol, trait self-consciousness (trait SC) was examined during a withdrawal and detoxification program.

Methods

Craving (Obsessive and Compulsive Drinking Scale), depressive state (Beck Depression Inventory) and trait SC (Revised Self-Consciousness Scale) were assessed in alcohol-dependent inpatients (DSM-IV, N = 30) both at the beginning (T1: day 1 or 2) and at the end (T2: day 14 to18) of protracted withdrawal during rehabilitation.

Results

A significant decrease in craving and depressive symptoms was observed from T1 to T2, while SC scores remained stable. At both times, strong positive correlations were observed between craving and depression. Moreover, regression analyses indicated that trait SC significantly moderated the impact of depression on cravings for alcohol.

Limitations

This study was performed on a relatively small sample size. Administration of medications during detoxification treatment can also be a confounding factor. Finally, craving could have been evaluated through other types of measurements.

Conclusions

During protracted withdrawal, alcohol craving decreased with the same magnitude as depressive mood. Depressive symptoms were related to alcohol craving but only among patients with high trait SC scores. Our results suggest that metacognitive approaches targeting SC could decrease craving and, in turn, prevent future relapses.

Working memory and impulsivity predict marijuana-related problems among frequent users

BACKGROUND

Although marijuana is the most commonly used illicit substance in the US, only a small portion of users go on to develop dependence, suggesting that there are substantial individual differences in vulnerability to marijuana-related problems among users. Deficits in working memory and high trait impulsivity are two factors that may place marijuana users at increased risk for experiencing related problems.

METHODS

Using baseline data from an experimental study that recruited 104 frequent marijuana users (M=71.86% of prior 60 days, SD=22%), we examined the associations of working memory and trait impulsivity with marijuana-related problems.

RESULTS

Lower working memory, as measured by Trail Making Test B, but not short-term memory capacity, predicted more marijuana-related problems. Higher trait impulsivity scores were independently associated with greater number of problems.

CONCLUSIONS

Results suggest that marijuana users with reduced executive cognitive ability are more susceptible to developing problems related to their use. Trait impulsivity and executive working memory appear to be independent risk factors for experiencing marijuana-related problems.

How phenotype and developmental stage affect the genes we find: GABRA2 and impulsivity

CONTEXT

The detection and replication of genes involved in psychiatric outcome has been notoriously difficult. Phenotypic measurement has been offered as one explanation, although most of this discussion has focused on problems with binary diagnoses.

OBJECTIVE

This article focuses on two additional components of phenotypic measurement that deserve further consideration in evaluating genetic associations: (1) the measure used to reflect the outcome of interest, and (2) the developmental stage of the study population. We focus our discussion of these issues around the construct of impulsivity and externalizing disorders, and the association of these measures with a specific gene, GABRA2.

DESIGN, SETTING, AND PARTICIPANTS

Data were analyzed from the Collaborative Study on the Genetics of Alcoholism Phase IV assessment of adolescents and young adults (ages 12-26; N = 2,128).

MAIN OUTCOME MEASURES

Alcohol dependence, illicit drug dependence, childhood conduct disorder, and adult antisocial personality disorder symptoms were measured by psychiatric interview; Achenbach youth/adult self-report externalizing scale; Zuckerman Sensation-Seeking scale; Barratt Impulsivity scale; NEO extraversion and consciousness.

RESULTS

GABRA2 was associated with subclinical levels of externalizing behavior as measured by the Achenbach in both the adolescent and young adult samples. Contrary to previous associations in adult samples, it was not associated with clinical-level DSM symptom counts of any externalizing disorders in these younger samples. There was also association with sensation-seeking and extraversion, but only in the adolescent sample. There was no association with the Barratt impulsivity scale or conscientiousness.

CONCLUSIONS

Our results suggest that the pathway by which GABRA2 initially confers risk for eventual alcohol problems begins with a predisposition to sensation-seeking early in adolescence. The findings support the heterogeneous nature of impulsivity and demonstrate that both the measure used to assess a construct of interest and the age of the participants can have profound implications for the detection of genetic associations.

Motivational typologies of drinkers: do enhancement and coping drinkers form two distinct groups?

AIMS

This study used a person-centered approach to test whether drinking motive typologies could be identified.

DESIGN

Longitudinal study of college students within the intensive multivariate prospective alcohol college-transitions (IMPACTS) data set.

SETTING

University campus in the United States.

PARTICIPANTS

University students (baseline n reporting alcohol motives = 2158; baseline age = 18.60 years old).

MEASUREMENTS

The drinking motives questionnaire-revised (DMQ-R).

FINDINGS

Using Steinley & Brusco's cluster analysis approach [based on the theoretical ratio expected between the within sum of squares and the total sum of squares when the data are divided into two clusters when no cluster structure is present; the cut-off for the ratio is 0.25 for uniform (multivariate uniform) distributions and 0.36 for normal (multivariate normal) distributions], we examined whether there was evidence for distinct clusters of individuals that differed on their overall level of motives to drink. We tested the fit of a one-group (cluster) solution compared to multi-cluster solutions. Both cross-sectionally and prospectively, the data could not be partitioned into two or more clusters [regardless of whether the cut-off assuming a multivariate uniform distribution (i.e. 0.25) or the more liberal multivariate normal distribution (i.e., 0.36) was used]. These findings showed that enhancement and coping drinkers do not form two distinct groups but, rather, these motives exist on a continuum such that individuals who are high in one internal motive tend to be high in the other motive.

CONCLUSIONS

Coping and enhancement drinkers do not form two distinct groups. Variable-centered approaches to drinking motives may be a better alternative to classifying all drinkers as either enhancement or coping drinkers for both clinical and research endeavors.

Genetic and environmental influences on the relationship between mastery and alcohol dependence

BACKGROUND

Sense of mastery, a personal resource, is likely to have an inverse association with alcohol dependence. Previous evidence, however, is sparse. In addition, the extent to which an association is due to genetic or environmental factors is unknown.

METHODS

Data were from 3,983 male twins and 2,630 female twins who had ever used alcohol, interviewed in the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Mastery was measured by a 6-item scale. Lifetime diagnosis of alcohol dependence was based on DSM-IV criteria assessed in a structured diagnostic interview. Univariate analyses modeled the relative contributions of genetic and environmental factors to mastery and alcohol dependence using Mx software. Bivariate Cholesky models were fit to the mastery and alcohol dependence raw data.

RESULTS

In the best-fitting model of mastery, genetic factors accounted for about 33% of the observed variance. Nonshared environmental factors, including random measurement error, accounted for the remaining 67%. Fifty-six percent of the variance in liability to alcohol dependence was genetic, and the other 44% was explained by the nonshared environment. The phenotypic polychoric correlation between mastery and alcohol dependence of -0.18 was primarily (67% in the best-fitting model) explained by genes common to both low mastery and alcohol dependence; the rest was explained by nonshared environmental factors.

CONCLUSIONS

The findings indicate that genetic risk for alcohol dependence overlaps with genetic factors that influence sense of mastery. Key challenges for future research are to identify the genes that influence mastery and alcohol dependence, as well as the environmental pathways by which they come to be linked.

Personality pathology and alcohol dependence at midlife in a community sample

The present study examined the association between personality pathology (PP) and alcohol dependence (AD; both lifetime and in the past 12 months) among middle-aged to older adults incorporating three sources of assessment, specifically, diagnostic interviews as well as self- and informant reports. We collected data from a representative sample of community participants (N = 1,630; ages 54-65 years) and their informants (N = 1,462). Measures employed were the substance use disorder sections of the Mini-International Neuropsychiatric Interview Schedule for Mental Disorders, the Structured Interview for DSM-IV Personality (American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev.; DSM-IV-TR SIDP) and the NEO-Personality Inventory-Revised (Costa, P. T., & McCrae, R. R., Revised NEO-Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) manual, 1992, Odessa, FL, Psychological Assessment Resources; self-report and informant versions). To complement the diagnostic interview for personality disorders (PDs), we utilized a PD-count technique derived from the five-factor model (FFM), which provided an index of PP liability. Factors representing lifetime and past-12 month AD were regressed on each of the 10 PP factors constructed from the SIDP interview, as well as self-report and informant FFM-count scores. Lifetime diagnosis of AD was positively associated with higher scores on several PP measures, including paranoid, schizotypal, antisocial, borderline, histrionic, and narcissistic PP. There was an inverse relation between lifetime AD and the factor score for obsessive-compulsive PP. With regard to AD in the past 12 months, antisocial, borderline, histrionic, and narcissistic PP factors were significantly associated with increased risk for AD, whereas the obsessive-compulsive and schizoid PP factors were associated with decreased risk for AD. The present data indicate that features of antisocial and borderline PP continue to exhibit a relatively strong association with risk for AD in later middle age.

Coping motives, negative moods, and time-to-drink: exploring alternative analytic models of coping motives as a moderator of daily mood-drinking covariation

Affect regulation models of alcohol use posit individuals use alcohol to modify mood states. Importantly, these models hypothesize that individual differences in coping motives for drinking moderate the relation between drinking and negative moods. Despite consistently significant correlations among negative moods, coping motives, and alcohol involvement in numerous between-level studies, within-person analyses have yielded results inconsistent with theoretical models. Analytic techniques modeling time-to-drink have provided results more consistent with theory, though there remains a paucity of research using these methods. The purpose of the current study was to explore whether coping motives moderate the relation between negative moods and the immediacy of drinking using methodology outlined by Hussong (2007) and Armeli, Todd, Conner, and Tennen (2008). Overall, our study showed little evidence for hypothesized mood-motive-alcohol use relations, thus demonstrating that time-to-drink approaches may not provide more consistent support for these hypotheses.

Do people who "mature out" of drinking see themselves as more mature?

BACKGROUND

Self-perceptions of adulthood during the 20s and 30s are influenced by role transitions, age-related norms, and character traits. These factors are also associated with alcohol use disorders (AUDs), which peak and subsequently decrease during this time of life. Previous developmental research has found that alcohol misuse in adolescence predicts lower reported maturity, whereas alcohol misuse in emerging adulthood is not related to maturity. This study examines how self-perceived maturity (SPM) is affected by AUD status, maturity-related personality characteristics, and role transition variables at ages 25, 29, and 35, and how those relationships change over time.

METHODS

Data were drawn from a cohort study of 410 college students (N = 489 at baseline). Students were ascertained as first-time freshmen at a large, public midwestern university in the fall of 1987 but were followed up regardless of subsequent enrollment. The data for the current study were drawn from Waves 5 to 7, when participants were, on average, 25, 29, and 35 years of age. Structural equation modeling was used to determine whether the relation between the SPM item "I feel mature for my age" and DSM-III AUD status was moderated by age.

RESULTS

Results suggested that individuals with AUDs are more likely to endorse lower SPM levels compared to their nondiagnosing peers at ages 29 and 35 but not at age 25. In contrast, none of the relations between Conscientiousness, concern about Future Consequences, role status variables, and AUD was moderated by time.

CONCLUSIONS

These results suggest that alcohol-related problems may be perceived as more "age appropriate" during the mid-20s than at later ages in life and that such developmentally sensitive aspects of self-concept might be useful in cognitive interventions for young adults.