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Zakowicz P, Skibińska M, Wasicka-Przewoźna K, Skulimowski B, Waśniewski F, Chorzepa A, Różański M, Twarowska-Hauser J, Pawlak J. Impulsivity as a Risk Factor for Suicide in Bipolar Disorder. Front Psychiatry 2021; 12:706933. [PMID: 34366939 PMCID: PMC8342888 DOI: 10.3389/fpsyt.2021.706933] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/10/2021] [Indexed: 11/17/2022] Open
Abstract
The accurate assessment of suicide risk in psychiatric, especially affective disorder diagnosed patients, remains a crucial clinical need. In this study, we applied temperament and character inventory (TCI), Barratt impulsiveness scale 11 (BIS-11), PEBL simple reaction time (SRT) test, continuous performance task (CPT), and Iowa gambling task (IGT) to seek for variables linked with attempted suicide in bipolar affective disorder group (n = 60; attempters n = 17). The main findings were: strong correlations between self-report tool scores and objective parameters in CPT; the difference between attempters and non-attempters was found in the number of correctly responded trials in IGT; only one parameter differed between attempters and non-attempters in BPI diagnosis; and no significant differences between suicide attempters and non-attempters in TCI, BIS-11, and SRT were found. These justify the conclusion that impulsivity itself is not a strong predictor, and used as a single variable might not be sufficient to indicate the high suicide risk group among bipolar patients.
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Affiliation(s)
- Przemysław Zakowicz
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland.,Center for Child and Adolescent Treatment in Zabó, Zielona Góra, Poland
| | - Maria Skibińska
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Bartosz Skulimowski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Filip Waśniewski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Aneta Chorzepa
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Różański
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Twarowska-Hauser
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland.,Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland.,Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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Congia P, Mannarino S, Deiana S, Maulu M, Muscas E. Association between adult ADHD, self-report, and behavioral measures of impulsivity and treatment outcome in cocaine use disorder. J Subst Abuse Treat 2020; 118:108120. [PMID: 32972646 DOI: 10.1016/j.jsat.2020.108120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/11/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
A large and growing body of literature supports the association between cocaine addiction and impulsivity. The aim of the study was to test whether pretreatment screening for adult ADHD, and self-report and behavioral measures of impulsivity have prognostic utility in clinical practice with cocaine users. We enrolled a cohort of N = 86 treatment-seeking cocaine users, assisted by a public addiction service, in a 24 week study. At baseline, we performed screening for adult ADHD, assessed the presence of co-occurring mental disorders, and applied measures of drug use severity, trait-like impulsivity (Barratt Impulsiveness Scale; BIS-11), decision-making (Iowa Gambling Task; IGT), risk-taking (Balloon Analogue Risk Task; BART), and ability to inhibit cognitive interference (Stroop Color Word Test; SCWT). Patients positive to the screening for ADHD showed a higher level of self-reported impulsivity and a longer history of drug use, but did not differ from those without ADHD in adherence to psychosocial treatments and number of negative urines for cocaine during the 24 weeks. Among all of the self-report and behavioral measures used, only IGT BIS-11 was associated with cocaine abstention. The small effect size and the problematic direction of the associations found do not give strong support to the routine use of self-regulation measures to guide clinical decisions in public addiction treatment settings.
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Affiliation(s)
- Pierpaolo Congia
- Drug Addiction Service, SER.D.2, ATS - Sardegna, ASSL Cagliari, Italy.
| | - Silvia Mannarino
- Drug Addiction Service, SER.D.2, ATS - Sardegna, ASSL Cagliari, Italy
| | - Stefania Deiana
- Drug Addiction Service, SER.D.2, ATS - Sardegna, ASSL Cagliari, Italy
| | - Melania Maulu
- Drug Addiction Service, SER.D.2, ATS - Sardegna, ASSL Cagliari, Italy
| | - Elisabetta Muscas
- Drug Addiction Service, SER.D.2, ATS - Sardegna, ASSL Cagliari, Italy
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Hung CC, Zhang S, Chen CM, Duann JR, Lin CP, Lee TSH, Li CSR. Striatal functional connectivity in chronic ketamine users: a pilot study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 46:31-43. [DOI: 10.1080/00952990.2019.1624764] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Chia-Chun Hung
- Bali Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
- Institute of Brain Science, National Yang Ming University, Taipei, Taiwan
| | - Sheng Zhang
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Chun-Ming Chen
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Jeng-Ren Duann
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Institute for Neural Computation, University of California San Diego, La Jolla, CA, USA
| | - Ching-Po Lin
- Institute of Brain Science, National Yang Ming University, Taipei, Taiwan
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
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Barnhart WR, Buelow MT. Assessing impulsivity: Relationships between behavioral and self-report measures in individuals with and without self-reported ADHD. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Reynolds GL, Fisher DG, Brocato J, van Otterloo L, Khahlil K, Huckabay L. Stressful point-of-care rapid testing for human immunodeficiency virus, hepatitis C virus, and syphilis. Int J STD AIDS 2016. [PMID: 28632469 DOI: 10.1177/0956462416684460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Even with technological advances in point-of-care rapid testing for HIV, hepatitis, and syphilis, individuals may still find the experience of submitting to testing, and receiving results, to be stressful. Participants completed the rapid test experience questionnaires to assess stress both prior to and after the specimen collection. Participants completed the risk behavior assessment, the coping strategies indicator, and the Barratt impulsivity scale. Participants chose which rapid tests they wanted using a list administered via computer. Logistic regression analysis was used to model self-reported stress prior to testing and after testing. A total of 1097 individuals completed testing. Individuals who scored high on avoidance reported a stressful experience at pretest (OR = 1.15, CI = 1.04, 1.26) while higher educational attainment was associated with no stress at both time points. Injection drug users, avoidant, and impulsive individuals experience stress either before or after rapid testing. Education appears to be protective against stressful testing.
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Affiliation(s)
- Grace L Reynolds
- 1 Health Care Administration Department, California State University, Long Beach, CA, USA.,2 Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- 2 Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,3 Psychology Department, California State University, Long Beach, CA, USA
| | - Jo Brocato
- 4 School of Social Work, California State University, Long Beach, CA, USA
| | - Lucy van Otterloo
- 5 School of Nursing, California State University, Long Beach, CA, USA
| | - Khaloud Khahlil
- 5 School of Nursing, California State University, Long Beach, CA, USA
| | - Loucine Huckabay
- 5 School of Nursing, California State University, Long Beach, CA, USA
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Wright NE, Scerpella D, Lisdahl KM. Marijuana Use Is Associated with Behavioral Approach and Depressive Symptoms in Adolescents and Emerging Adults. PLoS One 2016; 11:e0166005. [PMID: 27835662 PMCID: PMC5106002 DOI: 10.1371/journal.pone.0166005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/23/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Repeated CB1 binding due to THC results in downregulation of the endocannabinoid system in cortex and limbic regions, perhaps disrupting frontolimbic functioning. This is particularly a concern in young adults who are still undergoing neurodevelopment in frontal and limbic regions. Such disruptions may be linked to increased depressive symptoms, anxiety symptoms, and executive dysfunction, and decreased behavioral approach. OBJECTIVES Here we examine the influence of young adult marijuana use on anxiety, depressive symptoms, behavioral approach, and executive dysfunction. The influence of alcohol and gender were also assessed. METHODS 84 participants (42 MJ, 42 controls) aged 18-25 were balanced for gender (39 F). Exclusion criteria included: MRI contraindications, left handed, comorbid Axis-I disorders, major medical or neurologic disorders, prenatal issues, or prenatal alcohol/illicit drug exposure, or excessive other drug use. Participants completed the FrsBE, BIS/BAS, State-Trait Anxiety Inventory (State), and BDI-II. Multiple regressions were run to predict anxiety, depressive symptoms, behavioral approach, and executive dysfunction from MJ group status, past year alcohol use, gender, and MJ*gender interactions, controlling for cotinine and ecstasy. RESULTS MJ group predicted increased depressive symptoms (p =.049). Decreased fun-seeking (p =.04), reward response (p =.01), and BAS total (p =.01) were predicted by MJ group. Gender predicted decreased reward responsiveness in females (p =.049) and decreased BIS in females (p =.03). Female marijuana users had increased anxiety symptoms (p =.04) and increased disinhibition (p =.04). Increased cotinine predicted increased drive (p =.046), reward responsiveness (p =.008) and BAS Total (p =.02). Apathy and Executive Dysfunction were not predicted by any measures. All results had small effect sizes. CONCLUSIONS/IMPORTANCE Depressive symptoms were greater in MJ users, while behavioral approach was decreased. Cotinine levels predicted increased behavioral approach. Female MJ users also had greater anxiety and disinhibition. In sum, these findings suggest sub-clinical threshold deficits related to regular marijuana use that are indicative of a need to prevent marijuana use in adolescents and young adults.
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Affiliation(s)
- Natasha E. Wright
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Danny Scerpella
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
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Adinoff B, Carmody TJ, Walker R, Donovan DM, Brigham GS, Winhusen TM. Decision-making processes as predictors of relapse and subsequent use in stimulant-dependent patients. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:88-97. [PMID: 26743586 PMCID: PMC4817850 DOI: 10.3109/00952990.2015.1106550] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Decision-making processes have been posited to affect treatment outcome in addicted patients. OBJECTIVE The present multi-site study assessed whether two measures of decision-making predicted relapse and subsequent use in stimulant-dependent patients. METHODS A total of 160 methamphetamine- or cocaine-dependent patients participating in a multi-site clinical trial evaluating a modified 12-step facilitation intervention for stimulant-dependent patients (STAGE-12) were assessed. Decision-making processes of risk and delay (Iowa Gambling Task [IGT]) and response reversal (Wisconsin Card Sorting Task [WCST]) were obtained shortly after treatment admission followed by assessment of stimulant use over the next six months. The relationships of the IGT and WCST (Perseverative Errors) with relapse (yes/no) and days of stimulant use during the 6-month period following post-randomization were evaluated. RESULTS Performance on the IGT and WCST did not significantly predict relapse status or time to relapse. Unexpectedly, worse performance on the IGT was associated with a fewer number of stimulant use days (p = 0.001). In contrast, worse performance on the WCST (more perseverative errors) was associated with a greater number of stimulant use days (p = 0.0003). The predictive effects of perseverative errors on subsequent use were confined to methamphetamine-dependent and Minority participants. CONCLUSIONS Decision-making processes, as measured in the current study, do not uniformly predict relapse or subsequent use. A decrease in the salience attribution of non-drug reinforcers may explain the positive relationship between IGT performance and post-relapse use. More comprehensive and global measures of impulsiveness may better assess relapse risk and use.
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Affiliation(s)
- Bryon Adinoff
- a VA North Texas Health Care System, Dallas VAMC , Dallas , TX , USA
- b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Thomas J Carmody
- b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Robrina Walker
- b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Dennis M Donovan
- c Alcohol & Drug Abuse Institute, University of Washington , Seattle , WA , USA
- d Department of Psychiatry & Behavioral Sciences , University of Washington , Seattle , WA , USA
| | - Gregory S Brigham
- e Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience , University of Cincinnati College of Medicine , Cincinnati , OH , USA
- f Maryhaven , Columbus , OH , USA
| | - Theresa M Winhusen
- e Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience , University of Cincinnati College of Medicine , Cincinnati , OH , USA
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Murray DE, Durazzo TC, Mon A, Schmidt TP, Meyerhoff DJ. Brain perfusion in polysubstance users: relationship to substance and tobacco use, cognition, and self-regulation. Drug Alcohol Depend 2015; 150:120-8. [PMID: 25772434 PMCID: PMC4387082 DOI: 10.1016/j.drugalcdep.2015.02.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Brain perfusion is altered in both alcohol dependence and stimulant dependence. Although most substance users also abuse/depend on alcohol concurrently (polysubstance users; PSU), rigorous perfusion research in PSU is limited. Also, the relationships of perfusion abnormalities with cognition, impulsivity, or decision making are not well known. METHODS Arterial spin labeling MRI and neuropsychological measures assessed perfusion levels and neurocognition in 20 alcohol-dependent individuals with comorbid-stimulant dependence (PSU), 26 individuals dependent on alcohol only (ALC), and 31 light/non-drinking controls (LD). The patient groups included smokers and non-smokers. RESULTS ALC had lower perfusion than LD in subcortical and cortical brain regions including the brain reward/executive oversight system (BREOS). Contrary to our hypothesis, regional perfusion was generally not lower in PSU than ALC. However, smoking PSU had lower perfusion than smoking ALC in several regions, including BREOS. Lower BREOS perfusion related to greater drinking severity in smoking substance users and to greater smoking severity in smoking ALC. Lower regional perfusion in ALC and PSU correlated with worse performance in different cognitive domains; smoking status affected perfusion-cognition relationships in ALC only. Lower BREOS perfusion in both substance using groups related to higher impulsivity. CONCLUSION Although regional perfusion was not decreased in PSU as a group, the combination of cigarette smoking and polysubstance use is strongly related to hypoperfusion in important cortical and subcortical regions. As lower perfusion relates to greater smoking severity, worse cognition and higher impulsivity, smoking cessation is warranted for treatment-seeking PSU and ALC.
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Affiliation(s)
- Donna E. Murray
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA,Please send correspondence to: Donna E. Murray, Center for Imaging of Neurodegenerative Diseases (114M), San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121, USA, Office: 415-221-4810 x2553, Fax: 415-668-2864,
| | - Timothy C. Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Anderson Mon
- School of Applied Sciences and Statistics, Koforidua Polytechnic, Ghana
| | - Thomas P. Schmidt
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Dieter J. Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
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