Higher Impulsivity As a Distinctive Trait of Severe Cocaine Addiction among Individuals Treated for Cocaine or Alcohol Use Disorders

Abstract

AimsDespite alcohol being the most often used addictive substance among addicted patients, use of other substances such as cocaine has increased over recent years, and the combination of both drugs aggravates health impairment and complicates clinical assessment. The aim of this study is to identify and characterize heterogeneous subgroups of cocaine- and alcohol-addicted patients with common characteristics based on substance use disorders, psychiatric comorbidity and impulsivity.MethodsA total of 214 subjects with cocaine and/or alcohol use disorders were recruited from outpatient treatment programs and clinically assessed. A latent class analysis was used to establish phenotypic categories according to diagnosis of cocaine and alcohol use disorders, mental disorders, and impulsivity scores. Relevant variables were examined in the latent classes (LCs) using correlation and analyses of variance and covariance.ResultsFour LCs of addicted patients were identified: Class 1 (45.3%) formed by alcohol-dependent patients exhibiting lifetime mood disorder diagnosis and mild impulsivity; Class 2 (14%) formed mainly by lifetime cocaine use disorder patients with low probability of comorbid mental disorders and mild impulsivity; Class 3 (10.7%) formed by cocaine use disorder patients with elevated probability to course with lifetime anxiety, early and personality disorders, and greater impulsivity scores; and Class 4 (29.9%) formed mainly by patients with alcohol and cocaine use disorders, with elevated probability in early and personality disorders and elevated impulsivity. Furthermore, there were significant differences among classes in terms of Diagnostic and Statistical Manual of Mental Disorders-4th Edition-Text Revision criteria for abuse and dependence: Class 3 showed more criteria for cocaine use disorders than other classes, while Class 1 and Class 4 showed more criteria for alcohol use disorders.ConclusionCocaine- and alcohol-addicted patients who were grouped according to diagnosis of substance use disorders, psychiatric comorbidity, and impulsivity show different clinical and sociodemographic variables. Whereas mood and anxiety disorders are more prevalent in alcohol-addicted patients, personality disorders are associated with cocaine use disorders and diagnosis of comorbid substance use disorders. Notably, increased impulsivity is a distinctive characteristic of patients with severe cocaine use disorder and comorbid personality disorders. Psychiatric disorders and impulsivity should be considered for improving the stratification of addicted patients with shared clinical and sociodemographic characteristics to select more appropriate treatments.

Problematic Facebook use and problematic video gaming as mediators of relationship between impulsivity and life satisfaction among female and male gamers

“…Taking into account the I-PACE model [15,16], it can be assumed that impulsivity is one of the crucial predictors of problematic behaviors. Additionally, many studies point to high impulsivity as one of the essential risk factors of psychoactive substance use [50][51][52] and behavioral addictions [53][54][55][56][57][58]. Previous studies have also indicated that high impulsivity is associated with low life satisfaction [27] and that addictions are also associated with low life satisfaction [59][60][61].…”

Food Addiction: Implications for the Diagnosis and Treatment of Overeating

“…The role of impulsivity in SUDs is well documented [55,57,58,59,60]. Many studies have reported higher impulsivity levels with increasing substance use across a wide range of questionnaires and behavioural tasks, and for a variety of different substances [61,62,63,64,65,66]. For example, Noël et al [67] performed a series of behavioural tasks assessing the ability to suppress irrelevant responses (response inhibition) and irrelevant information (proactive interference) in a group of detoxified alcohol-dependent individuals and matched healthy controls.…”

Uso problemático del smartphone: el papel de los Cinco Grandes, la Tríada Oscura y la impulsividad

“…Este resultado está en línea con la literatura previa sobre el tema (Grant et al, 2019;Jo et al, 2018;Kim et al, 2016;Peterka-Bonetta et al, 2019;Wu et al, 2013). Además, este resultado era esperable, ya que la impulsividad se ha relacionado con numerosas adicciones, incluida la adicción a la cocaína (García-Marchena et al, 2018), al alcohol (Shin et al, 2012), a la comida (VanderBroek-Stice et al, 2017), al tabaco (Liu et al, 2019), al sexo (Levi et al, 2020), etc.…”