Time horizons and substance use among African American youths living in disadvantaged urban areas.

Transitioning from adolescence to full-fledged adulthood is often challenging, and young people who live in disadvantaged urban neighborhoods face additional obstacles and experience disproportionately higher negative outcomes, including substance abuse and related risk behaviors. This study investigated whether substance use among African Americans ages 15 to 25 (M=18.86 years) living in such areas was related to present-dominated time perspectives and higher delay discounting. Participants (N=344, 110 males, 234 females) living in Deep South disadvantaged urban neighborhoods were recruited using Respondent Driven Sampling, an improved peer-referral sampling method suitable for accessing this hard-to-reach target group. Structured field interviews assessed alcohol, tobacco, and illicit drug use and risk/protective factors, including time perspectives (Zimbardo Time Perspective Inventory [ZTPI]) and behavioral impulsivity (delay discounting task). As predicted, substance use was positively related to a greater ZTPI orientation toward present pleasure and a lower tendency to plan and achieve future goals. Although the sample as a whole showed high discounting of delayed rewards, discount rates did not predict substance use. The findings suggest that interventions to lengthen time perspectives and promote enriched views of future possible selves may prevent and reduce substance use among disadvantaged youths. Discontinuities among the discounting and time perspective variables in relation to substance use merit further investigation.

Dimensions of impulsive behavior and treatment outcomes for adolescent smokers.

Adolescent cigarette smoking rates remain a significant public health concern, and as a result there is a continued need to understand factors that contribute to an adolescent's ability to reduce or quit smoking. Previous research suggests that impulsive behavior may be associated with treatment outcomes for smoking. The current research (N = 81) explored 3 dimensions of impulsive behavior as predictors of treatment response from a social-cognitive type program for adolescent smokers (i.e., Not On Tobacco; N-O-T). Measures included laboratory assessments of delay discounting, sustained attention, and behavioral disinhibition. A self-report measure of impulsivity was also included. Adolescent smokers who had better sustained attention were more likely to reduce or quit smoking by the end of treatment. No other measures of impulsivity were significantly associated with treatment response. From these findings, an adolescent smoker's ability to sustain attention appears to be an important behavioral attribute to consider when implementing smoking cessation programs such as N-O-T.

Cannabis use motives and personality risk factors.

According to the model of substance abuse of Conrod, Pihl, Stewart, and Dongier (2000), four personality factors (i.e., anxiety sensitivity [AS], introversion/hopelessness [I/H], sensation seeking [SS], and impulsivity [IMP]) are associated with elevated risk for substance use/misuse, with each personality factor being related to preference for particular drugs of abuse (e.g., AS with anxiolytics). However, cannabis use has not been consistently linked to any one of these personality factors. This may be due to the heterogeneity in cannabis use motives. The present study explored the association between these four personality risk factors and different cannabis use motives. Cannabis users completed an interview about their motives for cannabis use as well as the self-report Substance Use Risk Profile Scale (SURPS; Woicik, Conrod, Stewart, & Pihl, 2009), which measures the four personality risk factors. Results showed that AS was associated with conformity motives and I/H was associated with coping motives for cannabis use. SS was positively associated with expansion motives and IMP was associated with drug availability motives. Thus, personality risk factors in the model of Conrod et al. (2000) are associated with distinct cannabis use motives in a pattern consistent with theory.

Heroin and amphetamine users display opposite relationships between trait and neurobehavioral dimensions of impulsivity.

The multidimensional construct of impulsivity is implicated in all phases of the addiction cycle. Substance dependent individuals (SDIs) demonstrate elevated impulsivity on both trait and laboratory tests of neurobehavioral impulsivity; however our understanding of the relationship between these different aspects of impulsivity in users of different classes of drugs remains rudimentary. The goal of this study was to assess for commonalities and differences in the relationships between trait and neurobehavioral impulsivity in heroin and amphetamine addicts. Participants included 58 amphetamine dependent (ADIs) and 74 heroin dependent individuals (HDIs) in protracted abstinence. We conducted Principal Component Analyses (PCA) on two self-report trait and six neurobehavioral measures of impulsivity, which resulted in two trait impulsivity (action, planning) and four neurobehavioral impulsivity composites (discriminability, response inhibition efficiency, decision-making efficiency, quality of decision-making). Multiple regression analyses were used to determine whether neurobehavioral impulsivity is predicted by trait impulsivity and drug type. The analyses revealed a significant interaction between drug type and trait action impulsivity on response inhibition efficiency, which showed opposite relationships for ADIs and HDIs. Specifically, increased trait action impulsivity was associated with worse response inhibition efficiency in ADIs, but with better efficiency in HDIs. These results challenge the unitary account of drug addiction and contribute to a growing body of literature that reveals important behavioral, cognitive, and neurobiological differences between users of different classes of drugs.

Dependent heroin use and associated risky behaviour: the role of rash impulsiveness and reward sensitivity.

Impulsive temperament has long been considered as a risk factor for substance use disorders (SUD). Considering the heterogeneity of impulsivity, a biologically-based 2-factor model incorporating reward sensitivity and rash impulsiveness facets, has been proposed. Here we report how these two facets of impulsiveness could be associated with different aspects of dependent heroin use and associated risky behaviour. Two hundred and ninety three dependent heroin users and 232 non-users were assessed on reward sensitivity, rash impulsivity, and the related trait of punishment sensitivity. After adjusting for multiple comparisons, heroin users were found to be more rash-impulsive and reward-sensitive than non-users (p<0.001). Within users, rash impulsivity was associated with high risk behaviour including escalating heroin consumption, injecting heroin use, hazardous drinking, low treatment-seeking and risky sexual behaviour. Reward sensitivity was uniquely associated with early onset of drug use. While greater impulsivity is a common trait in drug users compared with non-users, the use of a 2-factor model of impulsivity provides additional information regarding specific aspects of drug initiation and maintenance that can be targeted in the prevention and treatment of heroin dependence.

Contribution of time of drinking onset and family history of alcohol problems in alcohol and drug use behaviors in Argentinean college students.

AIMS: The aim of the study was to analyze independent and potential interactive effects of age at drinking onset and family history of alcohol abuse on subsequent patterns of alcohol drinking, alcohol-related problems and substance use. METHODS: Participants were college students (60.3% females, mean age = 20.27 ± 2.54 years) from the city of Córdoba, Argentina. Several measures were used to assess alcohol, tobacco and drug use. The Spanish version of the Brief Young Adult Alcohol Consequences Questionnaire was used to assess alcohol-related problems. Factorial analyses of variance, or its non-parametric equivalent, were performed to explore differences in substance use behaviors and alcohol-related problems in subjects with early or late drinking onset and with or without family history of alcohol abuse. Chi-square tests were conducted to analyze the association between these two risk factors and categorical measures of alcohol, tobacco and drug use. RESULTS: Early onset of drinking was associated with amount of consumption of alcohol including up to hazardous levels, as well as tobacco and drug use. However, the frequency of alcohol problems and frequency of episodes of alcohol intoxication were only related to age of onset in those with a positive family history of alcohol problems. CONCLUSION: Delaying drinking debut is particularly important in the prevention of future alcohol problems in those adolescents who have a family history of such problems.

Delay and probability discounting of multiple commodities in smokers and never-smokers using multiple-choice tasks.

The purpose of the present study was to investigate temporal and probabilistic discounting in smokers and never-smokers, across a number of commodities, using a multiple-choice method. One hundred and eighty-two undergraduate university students, of whom 90 had never smoked, 73 were self-reported light smokers (<10 cigarettes/day), and 17 were heavy smokers (10+cigarettes/day), completed computerized batteries of delay and probability discounting questions pertaining to a total of eight commodities and administered in a multiple-choice format. In addition to cigarettes, monetary rewards, and health outcomes, the tasks included novel commodities such as ideal dating partner and retirement income. The results showed that heavy smokers probability discounted commodities at a significantly shallower rate than never-smokers, suggesting greater risk-taking. No effect of smoking status was observed for delay discounting questions. The only commodity that was probability discounted significantly less than others was 'finding an ideal dating partner'. The results suggest that probability discounting tasks using the multiple-choice format can discriminate between non-abstaining smokers and never-smokers and could be further explored in the context of behavioral and drug addictions.

Impaired decisional impulsivity in pathological videogamers.

BACKGROUND: Pathological gaming is an emerging and poorly understood problem. Impulsivity is commonly impaired in disorders of behavioural and substance addiction, hence we sought to systematically investigate the different subtypes of decisional and motor impulsivity in a well-defined pathological gaming cohort. METHODS: Fifty-two pathological gaming subjects and age-, gender- and IQ-matched healthy volunteers were tested on decisional impulsivity (Information Sampling Task testing reflection impulsivity and delay discounting questionnaire testing impulsive choice), and motor impulsivity (Stop Signal Task testing motor response inhibition, and the premature responding task). We used stringent diagnostic criteria highlighting functional impairment. RESULTS: In the Information Sampling Task, pathological gaming participants sampled less evidence prior to making a decision and scored fewer points compared with healthy volunteers. Gaming severity was also negatively correlated with evidence gathered and positively correlated with sampling error and points acquired. In the delay discounting task, pathological gamers made more impulsive choices, preferring smaller immediate over larger delayed rewards. Pathological gamers made more premature responses related to comorbid nicotine use. Greater number of hours played also correlated with a Motivational Index. Greater frequency of role playing games was associated with impaired motor response inhibition and strategy games with faster Go reaction time. CONCLUSIONS: We show that pathological gaming is associated with impaired decisional impulsivity with negative consequences in task performance. Decisional impulsivity may be a potential target in therapeutic management.

Single doses of THC and cocaine decrease proficiency of impulse control in heavy cannabis users.

BACKGROUND AND PURPOSE: Cannabis is the most popular drug used in the European Union, closely followed by cocaine. Whereas cannabis impairs neurocognitive function in occasional cannabis users, such impairments appear less prominent in heavy users, possibly as a result of tolerance. The present study was designed to assess whether the impairing effects of Δ(9) -tetrahydrocannabinol (THC) in heavy cannabis users would present in a wide range of neuropsychological functions or selectively affect specific performance domains. We also assessed the acute effects of cocaine on neurocognitive functions of heavy cannabis users. EXPERIMENTAL APPROACH: Heavy cannabis users, who had a history of cocaine use (n = 61), participated in a double-blind, placebo-controlled, three-way crossover study. Subjects received single doses of cocaine HCl (300 mg), cannabis (THC µg·kg(-1) ) and placebo, and completed a number of tests measuring impulse control and psychomotor function. KEY RESULTS: Single doses of cannabis impaired psychomotor function and increased response errors during impulsivity tasks. Single doses of cocaine improved psychomotor function and decreased response time in impulsivity tasks, but increased errors. CONCLUSIONS AND IMPLICATIONS: Heavy cannabis users display impairments in a broad range of neuropsychological domains during THC intoxication. Impairments observed in psychomotor tasks, but not in impulsivity tasks, appeared smaller in magnitude as compared with those previously reported in occasional cannabis users. Heavy cannabis users were sensitive to the stimulating and inhibitory effects of cocaine on psychomotor function and impulsivity respectively. The reduction in proficiency in impulse control may put drug users at increased risk of repeated drug use and addiction.

Patterns of substance use among Argentinean adolescents and analysis of the effect of age at first alcohol use on substance use behaviors.

OBJECTIVE: The present study used an empirically based method to characterize substance use in a sample of Argentinean adolescents and analyzed the association between age at drinking onset and substance use behaviors. Differences in alcohol expectancies and personality traits as a function of different patterns of substance use were also explored. METHOD: Data were obtained from 583 adolescents aged 13-18years (M=15.01years; SD=1.5years; 59.5% female) from the city of Cordoba, Argentina. Alcohol, tobacco, and drug use and age at first alcohol use were measured. Personality traits, including extroversion, conscientiousness, impulsivity, and aggression, and positive and negative alcohol expectancies were assessed. Latent Class Analysis was applied to examine the structure of five co-occurring substance use behaviors: frequency of alcohol use, quantity of alcohol use, prevalence of drunkenness episodes, tobacco use, and drug use. RESULTS: Latent Class Analysis revealed five distinct patterns of substance use. The classes differed in substance use behaviors, personality traits, and alcohol expectancies. Adolescents with early drinking onset were more likely to show heavier alcohol use, more drunkenness episodes, and more drug use than adolescents with late drinking onset. CONCLUSIONS: Latent Class Analysis allowed the detection of groups of adolescents with distinct patterns of substance use. These groups exhibited significantly different personality and alcohol expectancy profiles, likely representing subgroups who are at greater risk for developing alcohol-related problems.

Impulsivity, cognitive function, and their relationship in heroin-dependent individuals.

There is mixed evidence concerning cognitive function and heroin dependence. In this study, abstinent heroin-dependent individuals (n = 86) and age- and sex-matched non-drug-using controls (n = 88) were compared on self-report measures of impulsivity and computerized assessments of cognitive function. Abstinent heroin-dependent individuals reported greater motor impulsivity and experience seeking and showed functional weaknesses in cognitive ability, including impulsivity and distractibility (d = 0.28 to 0.49), but not decision making or working memory. Self-reported impulsivity was uncorrelated with cognitive function. These results suggest underlying brain-related factors in heroin dependence and have implications for therapeutic intervention.

The future is now: comparing the effect of episodic future thinking on impulsivity in lean and obese individuals.

The choice of small immediate rewards as opposed to larger delayed rewards, or delay discounting, is an important dimension of impulsive decision making. The inability to delay gratification is related to obesity, as well as other maladaptive behaviors such as substance abuse, problem drinking, smoking, pathological gambling, and risky HIV behaviors. One way to reduce delay discounting (DD) may be to use prospective imagery in the form of episodic future thinking (EFT) during inter-temporal decision making. We have recently shown that EFT reduces DD and ad libitum energy intake in obese individuals. However, no studies have examined whether the magnitude of the EFT effect differs between lean and overweight/obese individuals. We conducted a within-subject design experiment to compare the efficacy of EFT versus a control task in reducing DD between lean (N=24) and overweight/obese (N=24) women. Participants attended two sessions in which they engaged in either EFT or control episodic thinking during a DD task. We also examined whether individual differences such as trait time perspective, behavioral inhibition or behavioral activation moderated the EFT effect on DD. Results showed EFT reduced DD similarly for lean and overweight/obese individuals. The EFT effect was moderated by behavioral activation. This suggests EFT is just as effective in reducing impulsive decision making in obese individuals as it is in lean individuals and may be useful in reducing other impulsive obesity related behaviors.

Hunger modulates behavioral disinhibition and attention allocation to food-associated cues in normal-weight controls.

Overeating, weight gain and obesity are considered as a major health problem in Western societies. At present, an impairment of response inhibition and a biased salience attribution to food-associated stimuli are considered as important factors associated with weight gain. However, recent findings suggest that the association between an impaired response inhibition and salience attribution and weight gain might be modulated by other factors. Thus, hunger might cause food-associated cues to be perceived as more salient and rewarding and might be associated with an impairment of response inhibition. However, at present, little is known how hunger interacts with these processes. Thus, the aim of the present study was to investigate whether hunger modulates response inhibition and attention allocation towards food-associated stimuli in normal-weight controls. A go-/nogo task with food-associated and control words and a visual dot-probe task with food-associated and control pictures were administered to 48 normal-weight participants (mean age 24.5 years, range 19-40; mean BMI 21.6, range 18.5-25.4). Hunger was assessed twofold using a self-reported measure of hunger and a measurement of the blood glucose level. Our results indicated that self-reported hunger affected behavioral response inhibition in the go-/nogo task. Thus, hungry participants committed significantly more commission errors when food-associated stimuli served as distractors compared to when control stimuli were the distractors. This effect was not observed in sated participants. In addition, we found that self-reported hunger was associated with a lower number of omission errors in response to food-associated stimuli indicating a higher salience of these stimuli. Low blood glucose level was not associated with an impairment of response inhibition. However, our results indicated that the blood glucose level was associated with an attentional bias towards food-associated cues in the visual dot probe task. In conclusion our results suggest that hunger induces an approach bias and is associated with an impairment of response inhibition when normal-weight participants are confronted with food-associated cues. These findings are important as these processes play a crucial role with regard to the control of food-intake and weight gain and are assumed to contribute to obesity. Thus, individualized treatment approaches taking into account the experience of hunger in everyday-life situations should be considered in addition to a training of response inhibition.

A systematic assessment of delay discounting in relation to cocaine and nicotine dependence.

Delay discounting is a measure of impulsivity describing how a reinforcer loses value as the delay to its receipt increases. Greater delay discounting is reliably observed among those with different substance use disorders (SUDs) compared to the general population. Nevertheless, the relation between delay discounting and the type and number of substances used remains unclear. The aim of this study was to compare delay discounting across four groups of participants: cocaine- and nicotine-dependent participants, cocaine-dependent only participants, nicotine-dependent only participants, and non-dependent controls. One hundred and seven participants completed a computerized delay discounting task for hypothetical monetary values. Data were fit to Mazur's hyperbolic equation to derive the discounting rate k. Results showed that delay discounting was significantly greater in the cocaine- and nicotine-dependent group, compared to the nicotine-dependent only group, compared to control group. Delay discounting was also greater in the cocaine-dependent only group relative to the nicotine-dependent only and control groups, but no differences were observed between the cocaine- and nicotine-dependent group and the cocaine-dependent only group. This study provides evidence that delay discounting differs depending on the type of SUD but not on the number of SUDs.

Cigarette smoking and measures of impulsivity in a college sample.

BACKGROUND: An association between impulsivity and smoking has been consistently reported in the literature, but few studies have examined how distinct dimensions of impulsivity may relate differentially to smoking initiation versus persistent smoking. The aim of the current study was to examine the relationship between self-report and behavioral measures of impulsivity and smoking status in college students. METHODS: Participants (N = 243) completed a self-report history of tobacco use, 2 self-report measures of impulsivity (the Barratt Impulsiveness Scale and Zuckerman Sensation-Seeking Scale), and 2 behavioral measures (the Delay Discounting Task and Iowa Gambling Task). All participants were classified as never-smokers, triers, or smokers based on their smoking history, and between-group differences on the 4 measures were examined. RESULTS: On the self-report measures, all 3 groups differed on sensation seeking, with the never-smokers reporting the lowest levels and the smokers reporting the highest. Furthermore, the smokers reported significantly higher disinhibitory impulsivity than the triers and never-smokers. The groups did not differ on the behavioral measures. CONCLUSIONS: These results indicate that distinct dimensions of impulsivity characterize different smoking phenotypes. In particular, sensation seeking is associated with the initiation of smoking, whereas disinhibitory impulsivity is associated with the transition to more persistent and regular use of cigarettes.

Impulsivity makes more susceptible to overeating after contextual appetitive conditioning.

Animals can learn that specific contexts are associated with important biological events such as food intake through classical conditioning. Very few studies suggest this is also possible in humans and contextual appetitive conditioning might even be a main determinant of habitual overeating in vulnerable humans. A Virtual Reality laboratory was used to test whether humans show conditioned responding (increased food desires and expectations, increased salivation and increased food intake) to a specific context after repeated pairings of this context with intake. It was also examined whether the personality trait impulsivity strengthens this contextual appetitive conditioning. Conditioned context-induced reactivity was indeed demonstrated and impulsivity predicted increased intake in only the intake-associated context. It is concluded that humans easily learn desires to eat in intake-related environments. The data also suggest that in particular more impulsive people are vulnerable for conditioned context-induced overeating. This relatively easy learning of associations between specific contexts and intake might stimulate habitual overeating and contribute to increased obesity prevalence.

Relationship of age to impulsivity and decision making: a baseline secondary analysis of a behavioral treatment study in stimulant use disorders.

Because stimulant use disorders remain prevalent across the lifespan, cognition is an important area of clinical care and research focus among aging adults with stimulant use disorders. This secondary analysis of a National Institute on Drug Abuse Clinical Trials Network study suggests that decision making, verbal learning/memory, executive function, and set shifting are important cognitive domains to screen clinically and treat in aging adults with stimulant use disorders. Some suggestions are made on how clinical treatment providers can practically use these results. An important direction for future research is the development of cognitively remediating treatments for impaired cognitive domains in aging adults with stimulant use disorders.

Untreated major depressive disorder with and without atypical features: a clinical comparative study.

AIMS AND METHOD: A comparative study of major depression with and without atypical features (as per DSM IV TR criteria) was planned to assess illness characteristics, resulting dysfunction and co-morbidities, which can have important implications in its management. Serially, 107 newly registered patients with depression not taking any treatment for at least a month were included. Patients with psychotic features in present or past, known bipolar disorder and likely organic aetiology were excluded. They were interviewed using SCID I (Structured clinical interview for DSM IV axis I disorders). Impulsiveness, suicidal ideation and functioning in various spheres was also assessed and compared between those with and without atypical features. RESULTS: Atypical features were seen in a significant number (55.14%) of patients especially from urban and semi-urban areas. Interpersonal sensitivity and leaden paralysis were the commonest atypical features apart from mood reactivity. Presence of hypersomnia and/or hyperphagia documented in 36 (33.65%) of 107 patients. Comparison of patients with and without atypical features revealed no significant difference in illness characteristics including suicidal ideation. However, they differed in level of impulsiveness and associated psychiatric co-morbidities. Also, deterioration of functioning with rising HDRS was more significant in patients without atypical features. CLINICAL IMPLICATIONS: Presence of atypical features is common in patients with major depressive disorder. These patients should be vigilantly assessed and managed in view of equal morbidity but different co-morbidities like anxiety and soft bipolar disorders than those without atypical features.

Craving effect of smoking cues in smoking and antismoking stimuli in light smokers.

Cue-reactivity models may be able to inform light and intermittent smoking patterns not yet explained by withdrawal models. For instance, smoking cues in smoking and antismoking advertisements may elicit cravings in smokers at equal rates, which may promote smoking maintenance. Moreover, smoking has been associated with impulsivity, but has not been explored in light and intermittent smokers (LITS). Aims of this study included the assessment of the impact of smoking and antismoking advertisements on post-exposure cravings in LITS and assessment of impulsivity as a moderator between cue exposure and cravings. Data from 155 LITS were analyzed. Participants were exposed to one of three stimuli conditions (i.e., smoking, antismoking, and neutral) and completed measures of demographics, tobacco use and history, impulsivity, and cravings. Univariate analysis demonstrated that smoking stimuli produced higher cravings relative to antismoking and neutral stimuli, whereas no differences between antismoking and neutral stimuli were observed. Impulsivity did not moderate the relationship between stimuli condition and cravings. Implications stemming from these findings include the further regulation of smoking advertisements and future exploration of smoking and smoking cessation in the context of cue-reactivity.

Personality traits and leptin.

OBJECTIVE: Personality traits related to high neuroticism and low conscientiousness are consistently associated with obesity. Hormones implicated in appetite and metabolism, such as leptin, may also be related to personality and may contribute to the association between these traits and obesity. The present research examined the association between leptin and Five Factor Model personality traits. METHODS: A total of 5214 participants (58% women; mean [standard deviation] age = 44.42 [15.93] years; range, 18-94 years) from the SardiNIA project completed the Revised NEO Personality Inventory, a comprehensive measure of personality traits, and their blood samples were assayed for leptin. RESULTS: As expected, lower conscientiousness was associated with higher circulating levels of leptin (r = -0.05, p < .001), even after controlling for body mass index, waist circumference, or inflammatory markers (r = -0.05, p < .001). Neuroticism, in contrast, was unrelated to leptin (r = 0.01, p = .31). CONCLUSIONS: Individuals who are impulsive and lack discipline (low conscientiousness) may develop leptin resistance, which could be one factor that contributes to obesity, whereas the relation between a proneness to anxiety and depression (high neuroticism) and obesity may be mediated through other physiological and/or behavioral pathways.