Behavioural aspects of impulsivity in alcoholics with and without a cluster-B personality disorder. Alcohol and Alcoholism, 41(4), 412-20

Psychiatric Centre Alexian Brothers, Provinciesteenweg 408, Boechout, 2530, Belgium.
Alcohol and Alcoholism (Impact Factor: 2.89). 05/2006; 41(4):412-20. DOI: 10.1093/alcalc/agl030
Source: PubMed


Studies have shown that alcoholics with a cluster-B personality disorder (cluster-B PD) are characterized by high levels of impulsivity. However, impulsivity has mainly been studied as a broad concept without its different aspects being considered. The present study compared abstinent alcoholic inpatients without any personality disorder (PD) and abstinent alcoholics with cluster-B PD on different aspects of impulsivity, i.e. self-reported impulsivity and neuropsychological indicators such as behavioural control and delay of gratification.
Forty alcohol-dependent inpatients without PD and 22 alcohol-dependent inpatients with a cluster-B PD were compared on two self-report impulsivity questionnaires (Barratt impulsiveness scale; sensation-seeking scales) and three behavioural impulsivity tasks [Go/No-Go task; delay discounting task (DDT); Stroop colour word test]. Tests were administered after stable abstinence of at least 3 weeks.
Self-report measures of impulsivity were higher in cluster-B alcoholics than in alcoholics without PD. Behavioural tasks revealed a more differentiated pattern of impairments. On the Go/No-Go task, cluster-B alcoholics were impaired in inhibitory control but not in reaction time compared with alcoholics without PD. In contrast, no significant differences on the DDT and the Stroop were observed.
Alcohol-dependent patients with and without a cluster-B PD differ in terms of behavioural inhibition but not in terms of activation or the ability to delay gratification. This finding may partly account for their impulsive and (self-) destructive behaviours. Treatment planning should pay specific attention to these impairments in behavioural control.

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    • "In summary, where laboratory measures of impulsivity have been used, alcohol-dependent subjects and heavy drinkers exhibit: (a) a significant impairment in performance in the CPT (Bjork et al., 2004; Rubio et al., 2007, 2008); (b) impairments in the SST (Duka et al., 2003; Bjork et al., 2004; Mitchell et al., 2005; Goudriaan et al., 2006; Rubio et al., 2007, 2008; Rose and Duka, 2008; Glass et al., 2009; Lawrence et al., 2009); (c) increased rates of risky responses in a Risk-Taking Task (Bjork et al., 2004); and (d) preference for small-immediate rewards in reward delay tasks (Richards et al., 1999; Duka et al., 2003; Bjork et al., 2004; Mitchell et al., 2005; Dom et al., 2006a,b,c; Rubio et al., 2007, 2008). On the other hand, modulation of the startle reflex, which essentially measures the amplitude of the eye blink, is a well-replicated phenomenon that is recently gaining importance in addiction research (Donohue et al., 2007). "
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    ABSTRACT: It is well known that impulsivity is a risk factor for the development of Addictive Disorders, and more specifically Alcohol Use Disorders (AUD). Recently, the Startle-Response Based Tasks (SRBT) and its different forms of plasticity have been found to be impaired in the alcoholic population. This is the first study to explore the correlation between impulsivity laboratory tasks and the SRBT test, in order to determine whether impulsivity and startle response (SR) could be related and in turn, explain their association with Alcohol Dependence (AD). Subjects: 40 men, who met DSM-IV criteria for AD and had been abstinent for at least one month. Impulsivity was assessed using three laboratory tests: Continuous Performance Test (CPT), Stop-Signal Task (SST) and Differential Reinforcement for Low-Rate Responding (DRL6). Patients also underwent the SR test. They were compared to 40 matched controls. Impulsivity laboratory measures tasks (SST and commissions of the CPT) correlated positively with the magnitude of SR (P < 0.05) and with habituation (P < 0.05). Scores on DRL6 correlated negatively with the magnitude of SR (P < 0.05). This was not found in the control group. The fact that impulsivity laboratory measures and the SR are correlated in patients but not in controls, could imply the existence of a common link for these two measures in alcoholic patients. Our findings support the hypothesis of the existence of two different vulnerability pathways for the development of AUD: anxiety and disinhibitory behaviour. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.
    Alcohol and alcoholism (Oxford, Oxfordshire). Supplement 03/2015; 50(3). DOI:10.1093/alcalc/agv006
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    • "For example, adolescent smokers who exhibit a greater number of ADHD symptoms discount more than those who do not (Fields et al., 2009). Similarly, individuals with alcohol dependence who also exhibit a Cluster B personality disorder (Dom et al., 2006) discount more than those without that comorbidity. Furthermore, attempting suicide among substance abusers (Liu et al., 2012) and need-sharing among heroindependent adults (Odum et al., 2000) are associated with greater rates of discounting. "
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    • "Various neuropsychological frameworks have been used to explore the individual behavioral differences of impulsivity. Roughly there are two different approaches to evaluate impulsivity level: subjective self-reported measures of personality that rely on an individual's self-perception of behaviour and objective behavioural tasks that estimate the performance level (Dom et al., 2006). Both laboratory and self-report personality measures of impulsivity appear to be related to risk of psychopathology (Swann et al. 2002). "
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