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BMC Psychiatry

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Open Access 01-12-2021 | Research

Disentangling substance use and related problems: urgency predicts substance-related problems beyond the degree of use

Authors: Malin K. Hildebrandt, Raoul Dieterich, Tanja Endrass

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Substance use disorders are reliably associated with high impulsivity and sensation seeking. Importantly, both precede problematic substance use, implicating them as risk factors. Individuals with substance use disorders show variable degrees of substance use (combined quantity and frequency) and substance-related problems and differ in both aspects from healthy controls. Dimensional research has indicated differential associations of impulsivity-related traits as well as sensation seeking with the degree of substance use and substance-related problems. The current study aimed to clarify whether impulsivity-related traits and sensation seeking predict substance-related problems above and beyond the degree of substance use and are thus specifically linked to problems, the dimension that characterizes substance use disorders.

Method

We assessed impulsivity-related traits and sensation seeking using self-report, as well as delay discounting, a behavioral indicator of impulsivity, in a sample of 258 substance-using adults.

Results

Sensation seeking and impulsivity-related traits significantly predicted the degree of substance use, with sensation seeking explaining the largest portion of variance. In contrast, self-reported impulsivity, in particular when experiencing negative emotions (urgency), but not sensation seeking or delay discounting, predicted substance-related problems when controlling for the degree of substance use.

Conclusions

This suggests that urgency, but not sensation seeking, may be specifically linked to substance-related problems and thus especially relevant for substance use disorders. Taken together, this study underlines the necessity to assess and control for the degree of substance use in risk factor research concerning substance-related problems. Thus, it may inform future research improving targeted prevention and therapy.

Available only for authorised users

Diagnostic and statistical manual of mental disorders. In: American Psychiatric A, American Psychiatric Association DSMTF, editor. DSM-5. Arlington, VA: American Psychiatric Association; 2013.

Verdejo-García A, Lawrence AJ, Clark L. Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies. Neurosci Biobehav Rev. 2008;32(4):777–810. https://doi.org/10.1016/j.neubiorev.2007.11.003.CrossRefPubMed

Poulton A, Hester R. Transition to substance use disorders: impulsivity for reward and learning from reward. Soc Cogn Affect Neurosci. 2020;15(10):1182–91. https://doi.org/10.1093/scan/nsz077.

Foulds JA, Boden JM, Newton-Howes GM, Mulder RT, Horwood LJ. The role of novelty seeking as a predictor of substance use disorder outcomes in early adulthood. Addiction. 2017;112(9):1629–37. https://doi.org/10.1111/add.13838.CrossRefPubMed

Norbury A, Husain M. Sensation-seeking: dopaminergic modulation and risk for psychopathology. Behav Brain Res. 2015;288:79–93. https://doi.org/10.1016/j.bbr.2015.04.015.CrossRefPubMed

Kozak K, Lucatch AM, Lowe DJE, Balodis IM, MacKillop J, George TP. The neurobiology of impulsivity and substance use disorders: implications for treatment. Ann N Y Acad Sci. 2019;1451(1):71–91. https://doi.org/10.1111/nyas.13977.CrossRefPubMed

Whiteside SP, Lynam DR. The five factor model and impulsivity: using a structural model of personality to understand impulsivity. Personal Individ Differ. 2001;30(4):669–89. https://doi.org/10.1016/S0191-8869(00)00064-7.CrossRef

Miller J, Flory K, Lynam D, Leukefeld C. A test of the four-factor model of impulsivity-related traits. Personal Individ Differ. 2003;34(8):1403–18. https://doi.org/10.1016/S0191-8869(02)00122-8.CrossRef

Magid V, Maclean MG, Colder CR. Differentiating between sensation seeking and impulsivity through their mediated relations with alcohol use and problems. Addict Behav. 2007;32(10):2046–61. https://doi.org/10.1016/j.addbeh.2007.01.015.CrossRefPubMedPubMedCentral

10.

Whiteside S, Lynam D, Miller J, Reynolds S. Validation of the UPPS impulsive behavior scale: a four-factor model of impulsivity. Eur J Personal. 2005;19(7):559–74. https://doi.org/10.1002/per.556.CrossRef

11.

Mitchell M, Potenza M. Addictions and personality traits: impulsivity and related constructs. Curr Behav Neurosci Rep. 2014;1(1):1–12. https://doi.org/10.1007/s40473-013-0001-y.CrossRefPubMedPubMedCentral

12.

Duckworth AL, Kern ML. A meta-analysis of the convergent validity of self-control measures. J Res Pers. 2011;45(3):259–68. https://doi.org/10.1016/j.jrp.2011.02.004.CrossRefPubMedPubMedCentral

13.

Coskunpinar A, Dir AL, Cyders MA. Multidimensionality in impulsivity and alcohol use: a meta-analysis using the UPPS model of impulsivity. Alcohol Clin Exp Res. 2013;37(9):1441–50. https://doi.org/10.1111/acer.12131.CrossRefPubMedPubMedCentral

14.

Patton JH, Stanford MS, Barratt ES. Factor structure of the barratt impulsiveness scale. J Clin Psychol. 1995;51(6):768–74. https://doi.org/10.1002/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1.CrossRefPubMed

15.

McAdams KK, Donnellan MB. Facets of personality and drinking in first-year college students. Personal Individ Differ. 2009;46(2):207–12. https://doi.org/10.1016/j.paid.2008.09.028.CrossRef

16.

Mason WA, Toumbourou JW, Herrenkohl TI, Hemphill SA, Catalano RF, Patton GC. Early age alcohol use and later alcohol problems in adolescents: individual and peer mediators in a bi-national study. Psychol Addict Behav. 2011;25(4):625–33. https://doi.org/10.1037/a0023320.CrossRefPubMedPubMedCentral

17.

Castellanos-Ryan N, Parent S, Vitaro F, Tremblay RE, Séguin JR. Pubertal development, personality, and substance use: a 10-year longitudinal study from childhood to adolescence. J Abnorm Psychol. 2013;122(3):782–96. https://doi.org/10.1037/a0033133.CrossRefPubMedPubMedCentral

18.

Fernie G, Peeters M, Gullo MJ, Christiansen P, Cole JC, Sumnall H, et al. Multiple behavioural impulsivity tasks predict prospective alcohol involvement in adolescents. Addiction. 2013;108(11):1916–23. https://doi.org/10.1111/add.12283.CrossRefPubMedPubMedCentral

19.

Lynam DR, Miller JD. Personality pathways to impulsive behavior and their relations to deviance: results from three samples. J Quant Criminol. 2004;20(4):319–41. https://doi.org/10.1007/s10940-004-5867-0.CrossRef

20.

Magid V, Colder CR. The UPPS impulsive behavior scale: factor structure and associations with college drinking. Personal Individ Differ. 2007;43(7):1927–37. https://doi.org/10.1016/j.paid.2007.06.013.CrossRef

21.

Cyders M, Smith G. Emotion-based dispositions to rash action: positive and negative urgency. Psych Bull. 2008;134(6):807–28. https://doi.org/10.1037/a0013341.CrossRef

22.

Cyders MA, Coskunpinar A, VanderVeen JD. Urgency: A common transdiagnostic endophenotype for maladaptive risk taking. In: The dark side of personality: Science and practice in social, personality, and clinical psychology. Washington, DC: American Psychological Association; 2016. p. 157–88.CrossRef

23.

Peckham AD, Jordan H, Silverman A, Jarvi Steele S, Björgvinsson T, Beard C. From urges to action: negative urgency and nonsuicidal self-injury in an acute Transdiagnostic sample. Arch Suicide Res. 2020;24(3):367–83. https://doi.org/10.1080/13811118.2019.1625831.CrossRefPubMed

24.

MacKillop J, Amlung MT, Few LR, Ray LA, Sweet LH, Munafò MR. Delayed reward discounting and addictive behavior: a meta-analysis. Psychopharmacology. 2011;216(3):305–21. https://doi.org/10.1007/s00213-011-2229-0.CrossRefPubMedPubMedCentral

25.

Wesley MJ, Lohrenz T, Koffarnus MN, McClure SM, De La Garza R 2nd, Salas R, et al. Choosing money over drugs: The neural underpinnings of difficult choice in chronic cocaine users. J Addiction. 2014;2014:189853.CrossRef

26.

Sofis MJ, Budney AJ, Stanger C, Knapp AA, Borodovsky JT. Greater delay discounting and cannabis coping motives are associated with more frequent cannabis use in a large sample of adult cannabis users. Drug Alcohol Depend. 2020;207:107820. https://doi.org/10.1016/j.drugalcdep.2019.107820.CrossRefPubMed

27.

Amlung M, Vedelago L, Acker J, Balodis I, MacKillop J. Steep delay discounting and addictive behavior: a meta-analysis of continuous associations. Addiction. 2017;112(1):51–62. https://doi.org/10.1111/add.13535.CrossRefPubMed

28.

Claus ED, Kiehl KA, Hutchison KE. Neural and behavioral mechanisms of impulsive choice in alcohol use disorder. Alcohol Clin Exp Res. 2011;35(7):1209–19. https://doi.org/10.1111/j.1530-0277.2011.01455.x.CrossRefPubMedPubMedCentral

29.

Lim AC, Cservenka A, Ray LA. Effects of alcohol dependence severity on neural correlates of delay discounting. Alcohol Alcohol. 2017;52(4):506–15. https://doi.org/10.1093/alcalc/agx015.CrossRefPubMed

30.

Steward T, Mestre-Bach G, Fernández-Aranda F, Granero R, Perales JC, Navas JF, et al. Delay discounting and impulsivity traits in young and older gambling disorder patients. Addict Behav. 2017;71:96–103. https://doi.org/10.1016/j.addbeh.2017.03.001.CrossRefPubMed

31.

Murphy C, Mackillop J. Living in the here and now: interrelationships between impulsivity, mindfulness, and alcohol misuse. Psychopharmacology. 2012;219(2):527–36. https://doi.org/10.1007/s00213-011-2573-0.CrossRefPubMed

32.

Cyders MA, Coskunpinar A. Measurement of constructs using self-report and behavioral lab tasks: is there overlap in nomothetic span and construct representation for impulsivity? Clin Psychol Rev. 2011;31(6):965–82. https://doi.org/10.1016/j.cpr.2011.06.001.CrossRefPubMed

33.

Beesdo-Baum K, Zaudig M, First MB, Wittchen HU. SCID-5-CV: Strukturiertes Klinisches Interview für DSM-5-Störungen - Klinische Version : Deutsche Bearbeitung des Structured Clinical Interview for DSM-5 Disorders - Clinician Version von Michael B. First, Janet B.W. Williams, Rhonda S. Karg, Robert L. Spitzer: Hogrefe; 2019.

34.

Schmidt R, Gay P, D'Acremont M, Van der Linden M. A german adaptation of the UPPS impulsive behavior scale: psychometric properties and factor structure. Swiss J Psychol. 2008;67(2):107–12. https://doi.org/10.1024/1421-0185.67.2.107.CrossRef

35.

Kämpfe-Hargrave N, Mitte K. A German validation of the UPPS impulsive behavior scale. Eur J Psychol Assess. 2009;25(4):252–9. https://doi.org/10.1027/1015-5759.25.4.252.CrossRef

36.

Forstmeier S, Maercker A. Selbstkontrolle im höheren Erwachsenenalter: Eine deutsche Version des Delay Discounting Tests von Kirby. Psychother Psychosom Med Psychol. 2011;61(06):e19–33. https://doi.org/10.1055/s-0031-1277169.CrossRefPubMed

37.

Ballard K, Knutson B. Dissociable neural representations of future reward magnitude and delay during temporal discounting. Neuroimage. 2009;45(1):143–50. https://doi.org/10.1016/j.neuroimage.2008.11.004.CrossRefPubMed

38.

Gray JC, Amlung MT, Palmer AA, MacKillop J. Syntax for calculation of discounting indices from the monetary choice questionnaire and probability discounting questionnaire. J Exp Anal Behav. 2016;106(2):156–63. https://doi.org/10.1002/jeab.221.CrossRefPubMedPubMedCentral

39.

Kirby KN, Marakovic NN. Delay-discounting probabilistic rewards: rates decrease as amounts increase. Psychon Bull Rev. 1996;3(1):100–4. https://doi.org/10.3758/BF03210748.CrossRefPubMed

40.

R Development Core team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2010.

41.

Fox J, Weisberg S. An {R} Companion to Applied Regression. 3rd ed. Thousand Oaks {CA}: Sage; 2019.

42.

Cyders MA, Flory K, Rainer S, Smith GT. The role of personality dispositions to risky behavior in predicting first-year college drinking. Addiction. 2009;104(2):193–202. https://doi.org/10.1111/j.1360-0443.2008.02434.x.CrossRefPubMedPubMedCentral

43.

Moss HB, Chen CM, Yi H-Y. Measures of substance consumption among substance users, DSM-IV abusers, and those with DSM-IV dependence disorders in a nationally representative sample. J Stud Alcohol Drugs. 2012;73(5):820–8. https://doi.org/10.15288/jsad.2012.73.820.CrossRefPubMedPubMedCentral

44.

Mellis A, Woodford A, Stein J, Bickel W. A second type of magnitude effect: Reinforcer magnitude differentiates delay discounting between substance users and controls: differences in discounting are magnitude dependent. J Exp Anal Behav. 2017;107(1):151–60. https://doi.org/10.1002/jeab.235.CrossRefPubMedPubMedCentral

Title: Disentangling substance use and related problems: urgency predicts substance-related problems beyond the degree of use
Authors: Malin K. Hildebrandt
Raoul Dieterich
Tanja Endrass
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03240-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Disentangling substance use and related problems: urgency predicts substance-related problems beyond the degree of use

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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