Results & Discussion

Impulsivity Measures Sensitive to Alcohol Use Disorders and DepressionR. Rosen1, D. Glahn1,2,3, M. Ginley1, A. Dager1,2, J. Sisante1, R. Jiantonio1, C. Austad4, H. Tennen5, S. Raskin6, C. Fallahi4, R. Wood4,

& G. Pearlson1,2,3

1Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT,

2Dept. of Psychiatry, 3Dept. of Neurobiology, Yale University School of Medicine, New Haven, CT, 4Dept. of Psychology, Central Connecticut State University, New Britain, CT, 5University of Connecticut School of Medicine, Farmington, CT, 6Dept. of Psychology and Neuroscience Program, Trinity College, Hartford, CT

MATERIALS AND METHODS

INTRODUCTION

Funded by RO1 AA016599 (BARCS Study) and RC1 AA019036 to Dr. Godfrey Pearlson.

Brain and Alcohol Research in College Students

(aka BARCS Study) “Mascot”

Alcohol is the drug of choice among college students1. Considerable research has been done linking alcohol misuse in college students to impulsivity2,3.

Research has found that impulsivity due to lack of planning and inability to pay attention is often linked to depression, because depression is often characterized by feelings of helplessness and hopelessness about the future4.

Impulsivity is not a unitary construct, but composed of multiple dimensions. Different facets of impulsivity may uniquely predict different aspects of alcohol use5.

The current study examines impulsivity as a multi-faceted construct to better understand which dimensions of impulsivity may predict alcohol use disorders and depression6,7 .

By using both cognitive self-report assessments as well as behavioral impulsivity measures, we aimed to find the specific aspects of impulsivity having the largest effect size in alcohol use and depression among a college population.

HYPOTHESES

- Students with AUDs would be significantly more likely than healthy individuals to score higher on all facets of impulsivity on the BIS-11. Those with alcohol dependence would have larger effect sizes for all types of impulsivity than those with alcohol abuse. Failure to slow down on pumping after an unsuccessful trial (a facet of impulsivity related to inability to inhibit responses) in the computerized BART task would yield a larger effect size for alcohol use disorders and depression than healthy individuals.

- Research on depression in relation to depression and impulsivity has shown strong correlations between cognitive impulsivity11, especially attentional and non-planning impulsivity, and low correlations between depression and behavioral impulsivity. We predicted that there would be a small effect size for depression in relation to motor impulsivity, and a large effect size for depression and attentional/non-planning impulsivity.

1. Heffernan, T.M. et al. (2006). Does excessive alcohol use in teenagers affect their everyday prospective memory? Journal of Adolescent Health, 39: 138-140.

2. Vuchinich, R. et al. Exp clin Psychopharm (1999)3. MacKillop, J. et al. J Stud Alcohol Drugs. 20074. Castellanos,, N. (2011). Response inhibition and reward response bias mediate the predictive relationships between

impulsivity and sensation seeking and common and unique variance in conduct disorder and substance misuse. ACER, 35, 140-155.

5. Curcio, A. et al (2011). Selected impulsivity facets with alcohol use/problems: The mediating role of drinking motives. Addictive Behaviors, 36, 959-964.

6. Meda, S., et al (2009). Investigating the behavioral and self-report costructs of impulsivity domains using principal component analysis. Behavioral Pharm, 20, 390-399.

7. Evenden, J., (1999). Varieties of impulsivity. Psychopharm, 16, 123-128.8. Sheehan, D. et al. (1992) Mini International Neuropsychiatric Interview.

9. Patton, J. et al (1995). Factor structure of the Barrett Impulsiveness Scale. J Clin Psych, 51, 768-774.10. Lejuez, C. et al. (2002). Evaluation of a behavioral measure of risk-taking: the Balloon Analog Risk Task (BART). J

Exp Psychol Appl, 8, 75-84. 10. Shin, S. et al(2012). Personality and alcohol use: The role of impulsivity. Addictive Behaviors, 37, 102-107.11. Jakubczyk, A. et al. (2011). Relationships of impulsiveness and depressive symptoms in alcohol dependence.

Journal of Affective Disorders, In Press.

MATERIALS & METHODS

936 college freshmen (47.4% male) aged 18-25 were recruited on a voluntary basis from the ongoing NIAAA- funded BARCS (Brain and Alcohol Research in College Students) study from two Connecticut academic institutions; one a small, private college and the other a larger, public university.

Alcohol Use Disorders (AUD) and Major Depression were diagnosed using the MINI International Neuropsychiatric Interview for Diagnosis of Axis I Disorders8.

Students were classified as having either alcohol abuse (n=95) or alcohol dependence (n=121). Combined, 216 students who had an AUD. Participants were also classified by whether or not they have major depression (n=106).

The Barratt Impulsiveness Scale, Version 11 (BIS-11), a 30-item assessment, was used to evaluate the personality dimensions of impulsivity. BIS-11 tests for Attentional Impulsivity (difficulties with concentration), Motor Impulsivity (acting without thinking), and Non-Planning Impulsivity (lack of concern about the future) Subscales derived from first order factors include: attention, motor, self control, cognitive complexity, perseverance, and cognitive instability9.

The Balloon Analog Risk Task (BART-10), a computerized impulsivity task, was used to assess risky behavior via balloon inflations that are linked to monetary gains; as balloon grows larger, monetary gains increase; if the balloon explodes, all money is lost10.

REFERENCES

Figure 2: Effect Size of Alcohol Abuse, Alcohol Dependence on the BIS-11 Using Cohen’s d.

Figure 1: Effect Size of Alcohol Use Disorders and Depression on the BIS-11 and BART Impulsivity Measures Using Cohen’ s d.

BISS Attention BISS Motor MISS Non-planning0

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Alcohol Depen-dence (n=212)

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Significance was corrected for multiple comparisons using false discovery rate and tests are considered significant at p <0.01.

In the current study, effect size was figured out using Cohen’s d to indicate which domains were most effective. For this sample, <.15 is a small effect size, .15 – .4 is a medium effect size, and .4-.7 is a large effect size.

Students diagnosed with an AUD had significantly higher scores on attentional, motor, and non-planning impulsivity, with all three facets of impulsivity having a large effect size. All subscales from the BIS-11 were significantly higher for those with AUDs, with large effect sizes in the attention, motor, and cognitive complexity subscales. Students with AUDs also had a significantly higher rate of unsuccessful pumps on the BART task, indicating a higher level of risky behavior than healthy individuals. As hypothesized, all domains of impulsivity were higher for those with alcohol dependence than for those with alcohol abuse.

Students diagnosed with current depression had significantly higher scores on attentional impulsivity as well as higher scores on the attention, and cognitive instability scales from the BIS-11. There were large effect sizes between those with depression and healthy controls for attentional impulsivity and the attention subscale of the BIS-11, implying that depressed individuals have more trouble concentrating than healthy controls. Depression also has a medium effect size for all of the BART variables, indicating that those with depression are more likely to make impulsive decisions about gain and loss.

Future research could go a step further by looking at individuals with both alcohol use disorders and depression to see what facets of impulsivity are implicated in such cases.