Negative emotion-driven impulsivity predicts substance dependence problems.

Impulsivity is predominant among users of several drugs of abuse including alcohol, cocaine, and amphetamines, and it is considered a risk factor for later development of alcohol and substance abuse and dependence. However, there is little consensus on how impulsivity should be defined and measured, and there are few studies on the relationship between separate dimensions of impulsivity and substance dependence. We used a multidimensional measure of impulsivity (the UPPS scale) to examine differences between 36 individuals with substance dependence (ISD) and 36 drug-free controls on the dimensions of urgency, lack of premeditation, lack of perseverance, and sensation seeking. In addition, we examined which dimensions of impulsivity better predicted addiction-related problems as measured with the addiction severity index. Results revealed that ISD show high scores on dimensions of urgency, lack of perseverance, and lack of premeditation (effect sizes ranging from 1.10 to 1.96), but not on sensation seeking. Among the different impulsivity dimensions, urgency was the best predictor of severity of medical, employment, alcohol, drug, family/social, legal and psychiatric problems in ISD, explaining 13-48% of the total variance of these indices. Furthermore, urgency scores alone correctly classified 83% of the participants in the ISD group. Urgency is characterized by a tendency to act impulsively in response to negative emotional states. Thus, our results could have important implications for novel treatment approaches for substance dependence focused on emotional regulation.

[1]  A. Odum,et al.  Needle sharing in opioid-dependent outpatients: psychological processes underlying risk. , 2000, Drug and alcohol dependence.

[2]  D. Hommer,et al.  Impulsivity in abstinent alcohol-dependent patients: relation to control subjects and type 1-/type 2-like traits. , 2004, Alcohol.

[3]  G. Fein,et al.  Impairment on a simulated gambling task in long-term abstinent alcoholics. , 2004, Alcoholism, clinical and experimental research.

[4]  K. Zakzanis,et al.  Statistics to tell the truth, the whole truth, and nothing but the truth: formulae, illustrative numerical examples, and heuristic interpretation of effect size analyses for neuropsychological researchers. , 2001, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[5]  S. Dawe,et al.  The role of impulsivity in the development of substance use and eating disorders , 2004, Neuroscience & Biobehavioral Reviews.

[6]  R. Sinha,et al.  Difficulties in emotion regulation and impulse control during cocaine abstinence. , 2007, Drug and alcohol dependence.

[7]  W. Bickel,et al.  Shortened time horizons and insensitivity to future consequences in heroin addicts. , 1998, Addiction.

[8]  W. Bickel,et al.  Heroin addicts have higher discount rates for delayed rewards than non-drug-using controls. , 1999 .

[9]  S. Whiteside,et al.  The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity , 2001 .

[10]  E. Reilly,et al.  P300 Event-Related Potential Amplitude and Impulsivity in Cocaine-Dependent Subjects , 2004, Neuropsychobiology.

[11]  D. Dougherty,et al.  Laboratory measured behavioral impulsivity relates to suicide attempt history. , 2004, Suicide & life-threatening behavior.

[12]  K. Brady,et al.  Impulsivity and rapid discounting of delayed hypothetical rewards in cocaine-dependent individuals. , 2003, Experimental and clinical psychopharmacology.

[13]  Deanna M Barch,et al.  Opiate addicts lack error-dependent activation of rostral anterior cingulate , 2004, Biological Psychiatry.

[14]  Steven W Anderson,et al.  Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers , 2001, Neuropsychologia.

[15]  A. Verdejo‐Garcia,et al.  Cognitive impulsivity in cocaine and heroin polysubstance abusers. , 2007, Addictive behaviors.

[16]  Rita Z. Goldstein,et al.  Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. , 2002, The American journal of psychiatry.

[17]  R. Rogers,et al.  Elevated Impulsivity and Impaired Decision-Making in Abstinent Ecstasy (MDMA) Users Compared to Polydrug and Drug-Naïve Controls , 2006, Neuropsychopharmacology.

[18]  C. Li,et al.  Performance monitoring and stop signal inhibition in abstinent patients with cocaine dependence. , 2006, Drug and alcohol dependence.

[19]  E. Barratt,et al.  Increased impulsivity in cocaine dependent subjects independent of antisocial personality disorder and aggression. , 2002, Drug and alcohol dependence.

[20]  D. Clark,et al.  Childhood risk categories for adolescent substance involvement: a general liability typology. , 2005, Drug and alcohol dependence.

[21]  Robert A Zucker,et al.  Poor response inhibition as a predictor of problem drinking and illicit drug use in adolescents at risk for alcoholism and other substance use disorders. , 2006, Journal of the American Academy of Child and Adolescent Psychiatry.

[22]  G. Koob,et al.  Drug Addiction, Dysregulation of Reward, and Allostasis , 2001, Neuropsychopharmacology.

[23]  M. Fillmore,et al.  Impaired inhibitory control of behavior in chronic cocaine users. , 2002, Drug and alcohol dependence.

[24]  E. Barratt,et al.  The impact of impulsivity on cocaine use and retention in treatment. , 2001, Journal of substance abuse treatment.

[25]  John K. Cochran,et al.  Sensation-Seeking and Delinquent Substance Use: An Extension of Learning Theory , 1995 .

[26]  David S. Leland,et al.  Increased risk-taking decision-making but not altered response to punishment in stimulant-using young adults. , 2005, Drug and alcohol dependence.

[27]  H. Flor,et al.  Cue-induced activation of the striatum and medial prefrontal cortex is associated with subsequent relapse in abstinent alcoholics , 2004, Psychopharmacology.

[28]  Edward Gottheil,et al.  Pre—Treatment Measures of Impulsivity, Aggression and Sensation Seeking Are Associated with Treatment Outcome for African—American Cocaine—Dependent Patients , 2004, Journal of addictive diseases.

[29]  W. Hulstijn,et al.  Impulsivity in abstinent early- and late-onset alcoholics: differences in self-report measures and a discounting task. , 2006, Addiction.

[30]  R. Sinha,et al.  Stress-induced cocaine craving and hypothalamic-pituitary-adrenal responses are predictive of cocaine relapse outcomes. , 2006, Archives of general psychiatry.

[31]  H. Tennen,et al.  Reliability of personality disorder symptoms and personality traits in substance-dependent inpatients. , 2001, Journal of abnormal psychology.

[32]  Carlo Contoreggi,et al.  Drug abusers show impaired performance in a laboratory test of decision making , 2000, Neuropsychologia.

[33]  S. Faraone,et al.  A twin study of the neuropsychological consequences of stimulant abuse. , 2003, Archives of general psychiatry.

[34]  D. Metzger,et al.  The Fifth Edition of the Addiction Severity Index. , 1992, Journal of substance abuse treatment.

[35]  K. Carey,et al.  Lability and Impulsivity Synergistically Increase Risk for Alcohol‐Related Problems , 2004, The American journal of drug and alcohol abuse.

[36]  J. Adès,et al.  Impulse-control disorders in alcoholics are related to sensation seeking and not to impulsivity , 1998, Psychiatry Research.

[37]  T. Robbins,et al.  From arousal to cognition: the integrative position of the prefrontal cortex. , 2000, Progress in brain research.

[38]  T. Patterson,et al.  Impulsivity and methamphetamine use. , 2005, Journal of substance abuse treatment.

[39]  J. Simons,et al.  Methamphetamine and alcohol abuse and dependence symptoms: associations with affect lability and impulsivity in a rural treatment population. , 2005, Addictive behaviors.

[40]  A. Bechara,et al.  Decision-making and addiction (part II): myopia for the future or hypersensitivity to reward? , 2002, Neuropsychologia.

[41]  S. Whiteside,et al.  Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: application of the UPPS impulsive behavior scale. , 2003, Experimental and clinical psychopharmacology.

[42]  Monique Ernst,et al.  Decision making in adolescents with behavior disorders and adults with substance abuse. , 2003, The American journal of psychiatry.

[43]  A. Bechara,et al.  Impulsivity and Decision Making , 2005, The Journal of nervous and mental disease.

[44]  T. Robbins,et al.  Neural systems of reinforcement for drug addiction: from actions to habits to compulsion , 2005, Nature Neuroscience.

[45]  M. Morgan.  Recreational Use of “Ecstasy” (MDMA) Is Associated with Elevated Impulsivity , 1998, Neuropsychopharmacology.

[46]  E. Barratt,et al.  Psychiatric aspects of impulsivity. , 2001, The American journal of psychiatry.

[47]  JaneR . Taylor,et al.  Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli , 1999, Psychopharmacology.

[48]  W. Mccown,et al.  Multi-impulsive personality disorder and multiple substance abuse: evidence from members of self-help groups. , 1988, British journal of addiction.

[49]  W. Hulstijn,et al.  Differences in impulsivity and sensation seeking between early- and late-onset alcoholics. , 2006, Addictive behaviors.

[50]  J. Evenden.  Varieties of impulsivity , 1999, Psychopharmacology.

[51]  Stacey B. Daughters,et al.  Differences in impulsivity and sexual risk behavior among inner-city crack/cocaine users and heroin users. , 2005, Drug and alcohol dependence.

[52]  W K Bickel,et al.  Impulsive and self-control choices in opioid-dependent patients and non-drug-using control participants: drug and monetary rewards. , 1997, Experimental and clinical psychopharmacology.

[53]  J. Kaufman,et al.  Cingulate Hypoactivity in Cocaine Users During a GO-NOGO Task as Revealed by Event-Related Functional Magnetic Resonance Imaging , 2003, The Journal of Neuroscience.

[54]  J. Monterosso,et al.  Deficits in response inhibition associated with chronic methamphetamine abuse. , 2005, Drug and alcohol dependence.

[55]  William Gardner,et al.  Neurobehavioral disinhibition in childhood predicts early age at onset of substance use disorder. , 2003, The American journal of psychiatry.

[56]  Antonio Verdejo-García,et al.  Experience of emotions in substance abusers exposed to images containing neutral, positive, and negative affective stimuli. , 2005, Drug and alcohol dependence.

[57]  A. Bechara,et al.  Decision-Making and the Iowa Gambling Task: Ecological validity in individuals with substance dependence , 2006 .