Self-reported attentional and motor impulsivity are related to age at first methamphetamine use

IntroductionMethamphetamine (MA) users report higher levels of impulsivity relative to healthy controls, which may either result from, or precede, their substance use. Further, there is evidence that female MA users may be more impulsive than male MA users prior to MA use. Thus, the goal of the current study was to determine whether different subtraits of self-reported impulsivity are significantly related to age at first MA use, controlling for total years of MA use.MethodsA community sample of MA users was recruited for this study (N = 157; 113 males, 44 females). The Barratt Impulsiveness Scale (BIS-11) was used to assess self-reported impulsivity on three subscales (Attentional, Motor, Non-planning). Age at first MA use served as the dependent variable in a series of multiple regression models with BIS-11 subscales, sex, and their interaction as independent variables, controlling for total years of MA use.ResultsAttentional and Motor impulsivity were significantly related to age at first MA use when controlling for total years of MA use (Attentional: p = 0.008; Motor: p = 0.003).ConclusionsIndividuals who reported higher Attentional and Motor impulsivity started using MA at an earlier age, which could suggest that impulsivity levels may be an important marker of vulnerability towards MA use. These findings indicate that prevention efforts may be targeted towards individuals who report high levels of Attentional and Motor impulsivity, as they may be at greatest risk for earlier initiation of MA use.     

Relationship of PTSD With impulsivity Dimensions While Controlling the Effect of Anxiety and Depression in a Sample of Inpatients With Alcohol Use Disorder

Objective: The aim of the present study was to evaluate the relationship of posttraumatic stress disorder (PTSD) with impulsivity dimensions while controlling the effect of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). Methods: Participants were 190 male patients admitted to a specialized center for substance use disorders within a six month period. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Traumatic Experiences Checklist, and PTSD Checklist-Civilian version. Results: Age was lower in the group with PTSD (n = 63, 33.2%) than the group without PTSD (n = 127, 66.8%). Duration of education, marital, and employment status did not differ between the groups. STAI, BDI, and BIS-11-SF scores were higher in the group with PTSD. Trait anxiety, depression, and impulsivity predicted high PTSD risk in a logistic regression model. Same variables predicted the severity of PTSD symptoms in a linear regression. Among dimensions of impulsivity attentional component was the only predictor of PTSD symptoms severity, not motor or nonplanning impulsivity. Conclusions: These findings suggest that the PTSD may be related to impulsivity, particularly attentional impulsivity, even after controlling anxiety and depression among inpatients with AUD.     

History of regular nonmedical sedative and/or alcohol use differentiates substance-use patterns and consequences among chronic heroin users

BackgroundConcurrent use of sedating substances (e.g. alcohol or benzodiazepines) with opioids is associated with increased negative consequences of opioid use; however, few studies have attempted to differentiate effects of using sedating substances on heroin-use outcomes. This study examines differences between heroin users who use alcohol or misuse sedatives regularly and those who do not.MethodsSubstance-use data were collected from 367 non-treatment seeking, chronic heroin-using, 18-to-55 year-old participants. We created 4 groups based on self-reported lifetime history of regular (at least weekly) substance use: heroin only (n = 95), heroin and sedatives (n = 21), heroin and alcohol (n = 151), and heroin, sedative, and alcohol (n = 100). Chi-square analyses and ANOVAs with Bonferroni post hoc tests were used to explore differences between these groups.ResultsHeroin users who denied lifetime alcohol or nonmedical sedative use regularly endorsed fewer consequences associated with any substance they had used. Total adverse consequences of heroin use (e.g. health problems) were significantly higher among those who misused sedatives regularly, irrespective of alcohol use history (F(3,361) = 10.21; p < .001). Regular alcohol use did not independently impact heroin consequences but was associated with increased use of other substances.ConclusionsAlthough polysubstance use is normative among heroin users, the risks depend on the substances used. Regular sedative use is associated with increased heroin consequences whereas regular alcohol use is not. This study refines the investigation of polysubstance use and highlights subgroup differences depending on types of substances used regularly. This knowledge is critical for understanding substance-use motivations and creating avenues for harm reduction.     

Physical pain and impulsivity in alcohol-dependent patients

Background: Physical pain and impulsivity are considered to be prevalent and significant factors that influence the course of alcohol dependence. The aim of the study was to investigate relationships between different dimensions of impulsivity and the current experience of physical pain in individuals entering alcohol treatment.

Method: A sample of 366 (73.5% men and 26.5% women) DSM-IV alcohol-dependent subjects was recruited in alcohol treatment centers in Poland. The study sample was divided into a ‘mild or no pain’ group (65.6%) and a ‘moderate or greater pain’ group (34.4%). Levels of impulsivity were measured by the stop-signal task as well as the total and subscale scores of the Barratt Impulsiveness Scale (BIS-11).

Results: The experience of physical pain was significantly associated with higher levels of impulsivity as measured by both total BIS-11 scores and longer stop reaction times. Physical pain remained as independent correlate of behavioral impulsivity (stop reaction time) and the BIS-11 subscale of attentional impulsivity while controlling for other variables. An additional analysis revealed that BIS-11 scores were not associated with stop reaction times.

Conclusions: Physical pain is an independent correlate of both subjectively reported and objectively measured levels of impulsivity. Therapeutic interventions aimed at reducing pain in alcohol-dependent individuals should be studied to evaluate their impact on improving attention and behavioral control.     

The development of a brief self-report questionnaire to measure ‘recent’ Rash Impulsivity: A preliminary investigation of its validity and association with recent alcohol consumption

Background

Traditionally, impulsivity has been regarded as a stable trait. However, a series of longitudinal and behavioural laboratory studies has found that impulsivity can fluctuate within individuals, suggesting that it has a state as well as a trait manifestation. Whilst existing impulsivity questionnaires tap the former, there is no self-report instrument to assess recent fluctuations in impulsivity.Research aims and designThe present study set out to develop and undertake preliminary validation of a measure of ‘recent’ impulsivity, focusing in particular on Rash Impulsivity. Part of the construct validation of the resulting Recent Rash Impulsivity Scale (RRIS) entailed examining its association with recent alcohol intake, since there are well-documented reciprocal relationships between alcohol consumption and inhibitory control. In developing the RRIS, items from existing trait impulsivity questionnaires were converted into a ‘previous two weeks’ format. The pilot RRIS was then administered, along with a parallel trait version (Trait Rash Impulsivity Scale; TRIS) and a well-established trait impulsivity measure (the BIS-11; Patton, Stanford & Barratt, 1995), to two cohorts of first-year undergraduates aged 17 to 25 (N = 240), on two occasions one month apart. Information about habitual and recent alcohol intake was also gathered.

Results

Factor analyses on both the RRIS and TRIS identified two factors: ‘Cognitive Impulsivity’ (CogImp) and ‘Motor Impulsivity’ (MotImp). Consistent with the RRIS being sensitive to fluctuations in impulsivity, it was found that, as predicted: i) the RRIS was somewhat less strongly correlated than the TRIS with an established trait measure (the BIS-11; Patton et al., 1995); ii) the test–retest stability of ‘Total’ scores (CogImp and MotImp) was weaker for the RRIS than the TRIS; iii) there was evidence that the RRIS MotImp and Total scales were more strongly predicted by recent alcohol intake than were their trait equivalents; and iv) the RRIS CogImp and Total scales correlated more strongly with their trait equivalents in participants whose alcohol consumption had remained stable recently (relative to their habitual intake), compared to those whose consumption had recently changed.

Conclusions

These data suggest that transient changes in impulsivity can be assessed via self-report, and that the RRIS is sensitive to recent changes in alcohol intake. Subject to a more intensive and detailed validation, it is thus promising as a tool for tapping and characterising fluctuations in behavioural control and for exploring a range of factors to which this might be associated.     

Neuropsychological performance,impulsivity, symptoms of ADHD,and Cloninger's personality traits in pathological gambling

Pathological gambling (PG) is a prevalent public health problem associated with fronto-temporal dysfunction and maladaptive personality traits. To further test these associations, we assessed neuropsychological performance in pathological gamblers (PGs) and controls. We also examined selected personality characteristics and symptoms of attention deficit hyperactivity disorder (ADHD). Subjects were recruited from the community. All received a comprehensive neuropsychological battery, the ADHD Rating Scale, and personality measures including the Barratt Impulsiveness Scale and a version of the Temperament and Character Inventory. People with DSM-IV PG (n?=?54) and controls (n?=?65) were comparable in age, sex, and education level. PGs were more likely to have comorbid lifetime mood, anxiety, and substance use disorders; antisocial personality disorder; and other impulse control disorders. PGs performed significantly worse on the Wisconsin Card Sort Test-64 perseverative responses subscale and the Trails B test; they also had lower performance and full scale IQs. PGs had elevated levels of depression, ADHD symptoms, trait impulsivity, novelty seeking, and harm avoidance, but lower levels of reward dependence. High levels of self-reported impulsivity or ADHD symptoms in PGs did not predict worse neuropsychological performance. We conclude that PGs performed worse than controls on two measures of executive function and had lower IQs. They also had more psychiatric comorbidity, higher levels of trait impulsivity and ADHD symptoms, and both novelty seeking and harm-avoidance, but lower levels of reward-dependence. This study does not support the notion that there is a pattern of neuropsychological deficits associated with high levels of impulsivity or ADHD symptoms in PGs.     

Trait and state impulsivity in males with tendency towards Internet-pornography-use disorder

IntroductionImpulsivity has been identified to be involved in the development and maintenance of specific Internet-use disorders (IUD). It can be differentiated between relatively stable trait impulsivity and state impulsivity which is dependent on environmental and affective factors such as craving. Following the I-PACE (Interaction of Person-Affect-Cognition-Execution) model, both trait and state impulsivity may play an interactive role in IUD. The present study aimed to investigate the relationship between trait and state impulsivity and symptom severity of Internet-pornography-use disorder (IPD) as one form of IUD.MethodsFifty heterosexual males participated in this study. State impulsivity was measured with reaction times in a modified stop-signal task. Each participant conducted two blocks of this task which included neutral and pornographic pictures. Moreover, current subjective craving, trait impulsivity, and symptom severity of IPD were assessed using several questionnaires.ResultsResults indicate that trait impulsivity was associated with higher symptom severity of IPD. Especially those males with higher trait impulsivity and state impulsivity in the pornographic condition of the stop-signal task as well as those with high craving reactions showed severe symptoms of IPD.ConclusionThe results indicate that both trait and state impulsivity play a crucial role in the development of IPD. In accordance with dual-process models of addiction, the results may be indicative of an imbalance between the impulsive and reflective systems which might be triggered by pornographic material. This may result in loss of control over the Internet-pornography use albeit experiencing negative consequences.     

Impulsivity and vitamin D in bariatric surgery candidates

Background

Obesity is recognized as a major health problem. Vitamin D is involved in maintaining energy metabolism by regulation of glucose transporters, uncoupling proteins, and normal brain function. We aimed to explore a relationship between impulsivity, eating behaviors, and 25-hydroxyvitamin D concentration in a sample of 322 bariatric surgery candidates.

Impulsivity in Patients with Bipolar Disorder and Cocaine or Amphetamine Dependence Given Lamotrigine

ABSTRACT

Objective: Impulsivity is a component of bipolar disorder, substance-related disorders, and antisocial personality disorder.

Method: Barratt Impulsiveness Scale nonplanning subscale (BIS-11-NP) scores were assessed from 2001–2003 in 37 outpatients in Dallas, Texas with bipolar disorder and cocaine or amphetamine dependence during therapy with lamotrigine.

Results: Baseline BIS-11-NP scores correlated positively with baseline suicidality. BIS-11-NP scores decreased significantly from baseline to exit. Baseline to exit change on the BIS-11-NP correlated with change in some psychiatric symptom measures, drug craving, and days of drug use. A limitation of the study is the small sample size.

Conclusion: The results suggest that lamotrigine is associated with decreased impulsivity.     

Adversity among drug users: relationship to impulsivity

Illicit substance users experience adverse life events, but few studies have examined the role of impulsivity in these events. The present investigation sought to establish a link between negative life experiences and a trait measure of impulsivity and demonstrate that this association remains even accounting for potential confounds. Participants were 330 heroin and cocaine users recruited from the community for a health service research study. Participants completed a structured interview that assessed topics including drug and alcohol use, impulsivity, and negative life events. This group of drug users reported high rates of adverse life events in the 6 months prior to the assessment. No specific substance abuse/dependence diagnosis or combination of diagnoses was associated with adversity. Number of substance-related diagnoses was associated with adverse life events, but not when adjusting for impulsivity. Experience of these events was significantly associated with impulsivity (p<.001), above and beyond the shared relation with demographic variables, substance abuse and dependence, and number of substance-related diagnoses. These findings document the high frequencies of recent adverse life events among illicit drug users and indicate that trait impulsivity is associated with increased risk of these life events.     

Testing daily associations between impulsivity,affect, and alcohol outcomes: a pilot study

Background: Considerable research has examined impulsivity between individuals, but less research has focused on whether impulsivity fluctuates within a person. Although previous research supports trait levels of impulsivity as a risk factor for increased alcohol involvement, it is unclear whether daily (i.e., state) fluctuations in impulsivity coincide with same-day drinking behaviors. The present pilot study tested (1) the extent to which impulsivity fluctuates within-person; (2) the influence of daily impulsivity on alcohol use outcomes across all days (i.e., whether drinking occurred, the number of drinks consumed, and intentions to drink) and on drinking days only (i.e., whether heavy episodic drinking occurred and the number of problems experienced); and (3) daily affect as moderators of these relationships.

Method: Participants were 24 young adult drinkers without postsecondary education who completed a baseline plus 14 follow-up daily surveys. Each day, participants reported their impulsivity, affect, and drinking behavior.

Results: Multilevel modeling revealed that 42.5% of the variability in daily impulsivity was due to within-person differences. Impulsivity was related to greater odds of heavy episodic drinking and more alcohol-related problems on drinking days. Positive affect moderated the relationship between impulsivity and alcohol-related problems, and the relationship between impulsivity and drinking intentions.

Conclusions: Findings suggest that changes in positive affect and impulsivity may be a risk factor for alcohol problems in a daily context. Future research examining within-person impulsivity and negative outcomes may benefit from considering positive affect.     

Associations among impulsivity,trauma history,and alcohol misuse within a young adult sample

ObjectiveYoung adult alcohol misuse is associated with numerous long-term adverse outcomes. Given the link between impulsivity and alcohol use, we examined whether three impulsivity-related traits differentially predicted number of drinks per drinking day (DDD). We also examined whether these effects varied for those with different trauma histories.MethodThe current study (n = 254) examined motor, non-planning, and attentional impulsivity as predictors of DDD. It also examined whether impulsivity was differentially predictive of DDD across individuals in: a control group (non-trauma exposed), a trauma exposed but non-PTSD group, and a PTSD group.ResultsRegardless of group, more motor impulsivity was associated with more DDD. The effect of non-planning impulsivity varied according to trauma history. Specifically, more non-planning impulsivity predicted more DDD for those without PTSD. Finally, attentional impulsivity was not predictive of DDD.ConclusionsYoung adults with high levels of motor impulsivity, regardless of trauma history, may be a particularly high-risk group in terms of propensity for alcohol use/misuse. Additionally, high levels of non-planning impulsivity may signify those at greater risk for alcohol misuse, among those without PTSD. Motor impulsivity and non-planning impulsivity may serve as useful intervention targets in alcohol misuse prevention efforts. Implications for future research in this area are discussed.     

Further Examination of the Association Between Heavy Marijuana Use and Crime Among Youths Entering a Juvenile Detention Center

ABSTRACT

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of hyperactivity, inattention, and impulsivity. As shown in the literature, this disorder is frequently associated with alcohol and drug abuse. Patients affected by ADHD show high levels of impulsivity and sensation seeking. These characteristics can significantly increase the risk of alcohol abuse, which is itself a clinical condition associated with high levels of impulsivity. Clinical studies suggest that atomoxetine is effective and safe in patients affected by both ADHD and alcohol dependence; however, information focused specifically on impulsivity is very limited. In an open-label study, we evaluated the difference in impulsivity level between alcohol-dependent patients with and without a diagnosis of ADHD. Furthermore, we hypothesized that, in patients with ADHD, atomoxetine could reduce the impulsivity trait.     

Hopelessness,Temperament, and Health Perception in Heroin Addicts

ABSTRACT

The aim of this study was to investigate temperament, hopelessness (a measure of suicide risk), and health perception in heroin addicts. The study involved the administration of the TEMPS-A Rome, the Beck Hopelessness Scale (BHS), the MINI Neuropsychiatric Interview, and the Multidimensional Health Questionnaire. Participants were 100 heroin addicts who were matched by age and sex with 100 randomly selected non-users. Heroin addicts obtained higher scores on TEMPS-A Dys/Cyc/Anx temperament and on the irritable temperament. In the heroin addicts, anxiety, depression, preoccupation with health, health illness self-blame, health monitoring, and negative thinking about health were positively associated with hopelessness, dysthymic/anxious/cyclothymic temperament, and irritable temperament. Motivation to avoid unhealthiness, health assertiveness, health expectation optimism, and health satisfaction were negatively associated with hopelessness, dysthymic/anxious/cyclothymic temperament, and irritable temperament. More knowledge on health attitudes in heroin addicts may help in delivering a treatment plan for this selective population.     

Comparison of the Internal State Scale to Clinician-Administered Assessments in Patients with Bipolar Disorder and Alcohol Abuse or Dependence

Abstract

Objectives: Self-report measures require less clinician time to administer than clinician-rated assessments. The Internal State Scale (ISS) is a well-validated self-report measure that assesses symptoms of mania and depression in patients with bipolar disorder (BPD). However, the ISS has never been specifically evaluated in patients with BPD and comorbid substance misuse. Substances can induce mood symptoms complicating diagnosis and mood state assessment.

Methods: The ISS was compared with the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS) in 21 patients with BPD and alcohol abuse/dependence at baseline and for up to 16 weeks postbaseline. In addition, ISS-determined mood state was compared to mood state from a structured diagnostic interview.

Results: Significant baseline correlations were observed between the ISS depression subscale and HRSD, ISS activation subscale and YMRS, and ISS perceived conflict subscale and BPRS. Significant correlations of baseline to exit change scores were found between the ISS activation and YMRS, but not ISS depression and HRSD, or ISS perceived conflict and BPRS. All participants had a mixed mood state by structured diagnostic interview. The ISS diagnosed the manic/hypomanic portion of this mood state in 76% of participants but found depression in only 38%.

Conclusions: As in BPD patients without substance abuse, the ISS generally showed correlations with clinician-rated scales at baseline, with less strong correlations observed on change scores. The ISS diagnosis of mania or hypomania appeared to correspond more highly than depression with the findings from a structured diagnostic interview.     

The relationship between lifetime stress and addiction severity in cocaine-dependent participants

ObjectiveThe primary focus of the current report was to determine if there was an association between LSC-R and ASI-Lite scores in cocaine-dependent individuals. The secondary focus was to determine if any demographic/drug use variables or comorbid psychiatric diagnoses (e.g. alcohol-dependence, mood disorders) were associated with higher LSC-R or ASI-Lite scores. We hypothesized that scores on the LSC-R would be positively correlated with ASI-Lite scores.MethodThe sample included 239 cocaine-dependent individuals. The primary assessments administered were the LSC-R, the ASI-Lite, and the demographic/drug use questionnaire.ResultsSimple linear regression revealed that total lifetime stress was positively and significantly correlated with total ASI-Lite scores; however, the r² value was very low indicating that this relationship is more likely explained by other factors. It was also determined that participants with a diagnosis of alcohol dependence versus those that did not had significantly higher ASI-Lite scores (even when the alcohol composite score was included as a covariate). Participants with a diagnosis of a mood disorder versus those who did not had significantly higher LSC-R scores and females had significantly higher LSC-R scores when compared to males. After performing a median split, those cocaine users with High LSC scores had significantly higher Beck Depression Inventory-II scores, total ASI-Lite scores, and Fagerström Test of Nicotine Dependence scores when compared to those individuals with Low LSC scores. Further analysis of the ASI-Lite demonstrated that composite scores in the domains of Medical, Drug, Legal, Family and Social Status, and Psychiatric were all significantly elevated in the High LSC group.ConclusionsOverall, those with higher lifetime stress demonstrated higher addiction severity and depressive symptoms versus those that endorsed lower lifetime stress. Thus, additional research should be conducted investigating the impact stressful life events has on drug use patterns and characteristics.     

Rash impulsiveness and reward sensitivity in relation to risky drinking by university students: potential roles of frontal systems

Background

Two forms of impulsivity, rash impulsiveness and reward sensitivity, have been proposed to reflect aspects of frontal lobe functioning and promote substance use. The present study examined these two forms of impulsivity as well as frontal lobe symptoms in relation to risky drinking by university students.

Methods

University undergraduates aged 18–26 years completed the Alcohol Use Disorders Identification Test (AUDIT), Barratt Impulsiveness Scale (BIS-11), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), Frontal Systems Behavior Scale (FrSBe), and a demographics questionnaire assessing age, gender, and age of onset of weekly drinking (AOD).

Results

AUDIT-defined harmful drinkers reported earlier AOD and scored higher on BIS-11, the Sensitivity to Reward (SR) scale of the SPSRQ, and the Disinhibition and Executive Dysfunction scales of the FrSBe compared to lower risk groups. Differences remained significant after controlling for duration of alcohol exposure. Path analyses indicated that the influence of SR on AUDIT was mediated by FrSBe Disinhibition, whereas the influence of BIS-11 on AUDIT was mediated by both Disinhibition and Executive Dysfunction scales of the FrSBe.

Conclusions

Findings tentatively suggest that the influence of rash impulsiveness on drinking may reflect dysfunction in dorsolateral prefrontal and orbitofrontal systems, whereas the influence of reward sensitivity on drinking may primarily reflect orbitofrontal dysfunction. Irrespective of the underlying functional brain systems involved, results appear to be more consistent with a pre-drinking trait interpretation than effects of alcohol exposure.