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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    • "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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