Self-rated impulsivity in healthy individuals, substance use disorder and ADHD: psychometric properties of the Swedish Barratt impulsiveness scale

ANK3 rs10994336 and ZNF804A rs7597593 polymorphisms: genetic interaction for emotional and behavioral symptoms of alcohol withdrawal syndrome

OBJECTIVE

Alcohol withdrawal syndrome (AWS) is a complex condition associated with alcohol use disorder (AUD), characterized by significant variations in symptom severity among patients. The psychological and emotional symptoms accompanying AWS significantly contribute to withdrawal distress and relapse risk. Despite the importance of neural adaptation processes in AWS, limited genetic investigations have been conducted. This study primarily focuses on exploring the single and interaction effects of single-nucleotide polymorphisms in the ANK3 and ZNF804A genes on anxiety and aggression severity manifested in AWS. By examining genetic associations with withdrawal-related psychopathology, we ultimately aim to advance understanding the genetic underpinnings that modulate AWS severity.

METHODS

The study involved 449 male patients diagnosed with alcohol use disorder. The Self-Rating Anxiety Scale (SAS) and Buss-Perry Aggression Questionnaire (BPAQ) were used to assess emotional and behavioral symptoms related to AWS. Genomic DNA was extracted from peripheral blood, and genotyping was performed using PCR.

RESULTS

Single-gene analysis revealed that naturally occurring allelic variants in ANK3 rs10994336 (CC homozygous vs. T allele carriers) were associated with mood and behavioral symptoms related to AWS. Furthermore, the interaction between ANK3 and ZNF804A was significantly associated with the severity of psychiatric symptoms related to AWS, as indicated by MANOVA. Two-way ANOVA further demonstrated a significant interaction effect between ANK3 rs10994336 and ZNF804A rs7597593 on anxiety, physical aggression, verbal aggression, anger, and hostility. Hierarchical regression analyses confirmed these findings. Additionally, simple effects analysis and multiple comparisons revealed that carriers of the ANK3 rs10994336 T allele experienced more severe AWS, while the ZNF804A rs7597593 T allele appeared to provide protection against the risk associated with the ANK3 rs10994336 mutation.

CONCLUSION

This study highlights the gene-gene interaction between ANK3 and ZNF804A, which plays a crucial role in modulating emotional and behavioral symptoms related to AWS. The ANK3 rs10994336 T allele is identified as a risk allele, while the ZNF804A rs7597593 T allele offers protection against the risk associated with the ANK3 rs10994336 mutation. These findings provide initial support for gene-gene interactions as an explanation for psychiatric risk, offering valuable insights into the pathophysiological mechanisms involved in AWS.

Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults

Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.

The interplay of childhood trauma, oxytocin, and impulsivity in predicting the onset of methamphetamine use

BACKGROUND

Childhood trauma is associated with substance use disorders, including methamphetamine use disorder (MUD). Oxytocin, involved in social bonding, stress regulation, and reward processing, may influence addiction vulnerability and impulsivity in individuals with a history of childhood trauma.

OBJECTIVE

To investigate the relationships among childhood trauma, oxytocin levels, impulsivity, and the age of first methamphetamine use in individuals with MUD.

PARTICIPANTS AND SETTING

The study included 298 male participants (148 individuals with MUD and 150 healthy controls) from both probation offices and psychiatric clinics.

METHODS

Childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), impulsivity with the Barratt Impulsiveness Scale-11 (BIS-11), and plasma oxytocin levels were obtained.

RESULTS

Individuals with MUD exhibited higher levels of childhood trauma, impulsivity, and lower plasma oxytocin levels compared to healthy controls. Childhood trauma was associated with a younger age of first methamphetamine use, higher impulsivity, and lower oxytocin levels among individuals with MUD. Plasma oxytocin levels partially mediated the relationship between childhood trauma and both the age of first methamphetamine use and impulsivity. Serial mediation analysis demonstrated that oxytocin levels and impulsivity sequentially mediated the relationship between childhood trauma and the age of first methamphetamine use.

CONCLUSIONS

The findings reveal the complex interplay among childhood trauma, oxytocin, impulsivity, and methamphetamine use, emphasizing the importance of considering these factors in prevention and intervention strategies for MUD. Future research should explore oxytocin and impulsivity-focused interventions to mitigate the effects of childhood trauma and reduce MUD development risk.

Impulsive choice in individuals with comorbid amphetamine use disorder and attention deficit-hyperactivity disorder

BACKGROUND

Amphetamine use disorder (AMPH) and attention deficit-hyperactivity disorder (ADHD) often co-occur and are associated with poor treatment outcomes. Elevated impulsivity is a core feature in both disorders. Little is known however about the specific neurocognitive profile regarding different facets of impulsivity, and specifically impulsive choice, in comorbid populations.

METHODS

Three groups (ADHD + AMPH, ADHD only and healthy controls (HC)) were assessed with self-reported impulsivity and cognitive tasks of impulsive choice, operationalized as delay aversion (DA) and reflection impulsivity.

RESULTS

Twenty-nine participants with comorbid ADHD + AMPH, 25 participants with ADHD only and 116 HC completed screening, including self-rating scales, and cognitive testing. 20, 16 and 114 participants completed computerized cognitive tasks in the ADHD + AMPH group, ADHD group and HC group, respectively. The ADHD + AMPH group reported significantly higher motor, attentional and non-planning impulsiveness, and showed a significantly higher degree of impulsive choice, compared to both groups. There were no differences in task-related impulsiveness between ADHD only and HC.

CONCLUSIONS

The current findings suggest that individuals with ADHD + AMPH have overall elevated levels of impulsivity compared to individuals with ADHD only. In addition, that ADHD + AMPH is specifically associated with impairments in task-related impulsive choice, which was not found in ADHD only compared to HC. The neurocognitive profile in this specific patient group may represent a need for more systematic screening within healthcare settings in order to develop effective and targeted treatment for comorbid patients.

TRIAL REGISTRATION

EudraCT, 2012-004298-20.

Swimming Activity Alleviates the Symptoms of Attention: Deficit Hyperactivity Disorder (ADHD) a Case Report

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, hyperactivity, and impulsivity. Sport and physical activity have been shown to play a major role in the development of cognition, memory, selective attention, and motor reaction time, especially among adolescents with ADHD. In this context, the objective of this study was to investigate the effects of a swimming exercise program on the symptoms of ADHD in an adult with a diagnosis since childhood. The training intervention was performed for eight weeks, and the results demonstrated that the swimming-learning program significantly alleviated the symptoms of inattention and hyperactivity, as measured by the psychometric indices used in the study. Further studies are needed to establish and understand the association between physical activities and improved mental performance in adults with ADHD.

Impulsivity and aggression in suicide ideators and suicide attempters of high and low lethality

BACKGROUND

Impulsivity and aggression have been associated with all forms of suicidal behaviour and linked to theories of suicide capability. There is a need to clarify the role of impulsivity and aggression in the progression from suicidal thoughts to suicide attempts and suicide.

METHOD

In this naturalistic cross-sectional study, suicide ideators (35), low lethal suicide attempters (37), and high lethal suicide attempters (26) were compared with the Columbia-suicide severity rating scale (C-SSRS), Barratt impulsiveness scale (BIS-11), and the Buss & Perry aggression questionnaire (AQ).

RESULTS

Physical aggression score (p = 0.032) contributed to the difference between predicted low lethal suicide attempt and predicted high lethal suicide attempt. This model predicting physical aggression showed a fairly weak positive relationship (OR = 1.1) to high lethal attempt and explained 13% of the variance so there is a need for further replications to verify these results. Impulsive behaviour scores in females were significantly higher in the low lethal suicide attempt group compared to suicide ideators (F(2.51) = 3.47, p = 0.039, η²= 0.12). Hostility aggression in females was significantly higher in the high lethal suicide attempters compared to suicide ideators (F(2.52) = 3.53, p = 0.037, η² = 0.12). Physical aggression scores in females were significantly higher in the high lethal attempters compared to suicide ideators (F(2.52) = 6.79, p = 0.002, η²= 0.21). When these analyses were conducted without the participants who died in suicide, men in the high lethal attempt group scored significantly higher than men in the low lethal attempt group (F(2.37) = 3.8, p = 0.031, η² = 0.17), but men did not differ in aggression and impulsivity scores in other comparisons.

CONCLUSION

Suicide prevention should address physical aggression, as high levels can be associated with high lethal attempts. Assessment of suicidal patients should address impulsive behaviour with the insight that it can be more prominent in female low lethal suicide attempters. It could be that assessment and treatment of suicidal patients should be tailored differently for men and women. Aggression as a feature of suicide capability could be the link that makes suicide possible.

The Role of Impulsivity and Reward Deficiency in "Liking" and "Wanting" of Potentially Problematic Behaviors and Substance Uses

A few studies have examined the changes in substance- and behavior-related "wanting" and "liking" of human subjects, the key properties of Incentive Sensitization Theory (IST). The aim of this study was to examine the dissociation between "wanting" and "liking" as a function of usage frequency, intensity, and subjective severity in individuals across four substances (alcohol, nicotine, cannabis, and other drugs) and ten behaviors (gambling, overeating, gaming, pornography use, sex, social media use, Internet use, TV-series watching, shopping, and work). Also, the potential roles of impulsivity and reward deficiency were investigated in "wanting," "liking," and wellbeing. The sex differences between "wanting" and "liking" were also examined. Based on our findings using structural equation modeling with 749 participants (503 women, M age = 35.7 years, SD = 11.84), who completed self-report questionnaires, "wanting" increased with the severity, frequency, and intensity of potentially problematic use, while "liking" did not change. Impulsivity positively predicted "wanting," and "wanting" positively predicted problem uses/behaviors. Reward deficiency positively predicted problem uses/behaviors, and both impulsivity and problem uses/behaviors negatively predicted wellbeing. Finally, women showed higher levels of "wanting," compared to men. These findings demonstrate the potential roles of incentive sensitization in both potentially problematic substance uses and behaviors.

Not Only Excessive Daytime Sleepiness but Also Depression Symptoms, Chronological Age and Onset-Age Were Associated with Impulsivity in Narcolepsy Type 1 Patients

OBJECTIVE

To detect the factors associated with total and subscales impulsivity scores in narcolepsy and further explore the non-linear relationship between these factors and impulsivity score.

METHODS

One hundred and fifty-eight narcolepsy type 1 (NT1) patients were involved in this cross-sectional study. Patients completed questionnaires evaluating impulsivity symptoms (Barratt impulse scale-11, BIS-11), depression symptoms (Center for Epidemiologic Studies Depression Scale for Children, CES-DC or Self-Rating Depression Scale, SDS) and sleepiness (Epworth Sleepiness Scale, ESS). Parameters from polysomnography and multiple sleep latency test were also collected. Linear regression analysis was performed to detect the factors associated with total and subscales impulsivity scores. Then, generalized additive models and smooth curve fitting were performed to explore the non-linear relationship between chronological age and impulsivity scores.

RESULTS

Factors associated with higher total impulsivity score were higher ESS, older onset and adolescents. Factors associated with higher attentional impulsivity score were higher ESS, older onset and adolescents. Factors associated with higher motor impulsivity score were higher ESS, younger onset and depression symptoms. Factors associated with higher non-planning impulsivity score were adolescents, older onset and depression symptoms. A non-linear relationship between age and impulsivity scores (total impulsivity score, attentional impulsivity score and non-planning impulsivity score) was detected in NT1 patients.

CONCLUSION

Not only excessive daytime sleepiness but also onset-age, depression symptoms and chronological age were associated with impulsivity in NT1 patients. The non-linear relationship between age and impulsivity scores suggested brain and mental development alterations in NT1 patients.