Results & Discussion Depression, Alcohol Use Disorders, and Substance Use Disorders Moderate the Impulsivity Levels of College Students R. Rosen 1 , R. Jiantonio-Kelly 1 , S. Meda 1 , J. Sisante 1 , A. Dager 1,2 , S. Raskin 6 , H. Tennen 5 , C. Austad 4 , C, Fallahi 4 , R. Wood 4 , G. Pearlson 1,2,3 1 Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT, 2 Dept. of Psychiatry, 3 Dept. of Neurobiology, Yale University School of Medicine, New Haven, CT, 4 Dept. of Psychology, Central Connecticut State University, New Britain, CT, 5 University of Connecticut School of Medicine, Farmington, CT, 6 Dept. of Psychology and Neuroscience Program, Trinity College, Hartford, CT 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 students. 1 Considerable research has been done linking alcohol misuse in college students (and others) to impulsivity. 2,3 Recent research has extended the definition of impulsivity to include multiple constructs, encompassing both impulsive actions and impulsive decisions. 4 Impulsivity is a key symptom of both bipolar disorder and major depression. 5 Significant associations are reported between depressive symptoms in college students and difficulty in controlling behavioral impulses. The current study aims to extend these findings, by clarifying relationships between substance use, alcohol use, and depression in a college population. HYPOTHESES - A diagnosis of an AUD or SUD would be significantly related to all facets of impulsivity on the BIS-11 and to total Zuckerman scores. - Research on depression in relation to impulsivity shows strong correlations between cognitive impulsivity 9 , especially attentional and non-planning impulsivity. We therefore predicted that a diagnosis of MDD would be related to the attentional and non-planning impulsivity scales of the BIS-11. - We predicted significant interaction effects between diagnoses of AUD, SUD, MDD, and impulsivity. MATERIALS & METHODS 1848 college freshmen (48.1% male) aged 18-25 were recruited on a voluntary basis from the ongoing NIAAA- funded 2100-person 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), Substance Use Disorders (SUD), and current and/or lifetime Major Depressive Disorder (MDD) were diagnosed using the MINI International Neuro-psychiatric Interview for Diagnosis of Axis I Disorders (MINI). 6 (See Figure 1) Students classified as having an AUD or SUD had corresponding MINI diagnoses of either Alcohol Abuse or Dependence; or Substance Abuse or Dependence. The Barratt Impulsiveness Scale, Version 11 (BIS-11), a 30-item self-report scale, was used to evaluate 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). 7 The Zuckerman Sensation Seeking Scale was used to test preference for stimulating activities; Subscales include Disinhibition, Thrill and Adventure Seeking, Boredom Susceptibility, and Experience Seeking. The current study used the total Zuckerman score as an indicator of impulsivity. 8 A multivariate general linear model analysis of variance (MANOVA) was used as the key statistical approach. REFERENCES Figure 3: Bar Graph Detailing Three-Way Interaction Effects Between AUD, SUD, MDD, and BIS-11 Non-Planning Impulsiveness Figure 2: Three Way Interaction between AUD, SUD, and MDD on Non- Planning Impulsivity MANOVA showed both significant main effects and significant interaction effects at a p<0.007 level when corrected for multiple comparisons. Students with SUD had higher total scores on the Zuckerman (p=0.000), and higher scores on the BIS- 11 Attentional Impulsiveness sub-scale (p=0.004) than students without SUDs. Students with AUD also had higher total Zuckerman scores (p=0.000), and higher Motor and Non- Planning Impulsiveness sub-scale scores on the BIS-11 (p=0.001). Although students diagnosed with major depression did not show any significant main effects of impulsivity, a diagnosis of MDD did have significant interaction effects with other measures. A three-way interaction was found among students who were diagnosed with AUD, SUD, and MDD concurrently, showing higher total scores on BIS-11 non-planning impulsiveness (p=.005) than students diagnosed with MDD and either an AUD or SUD. (See Figures 2 and 3) These data help to solidify existing research examining links between not only bipolar disorder, alcohol use and impulsivity, but also major depression and substance use. SUD and AUD were both associated with higher sensation seeking scores, and attentional/motor/non-planning impulsivity. When combined with depression, we observed higher scores in non-planning impulsivity measures, consistent with the ‘impulsive decisions’ construct of impulsivity, i.e. that depressed individuals have trouble choosing among behavioral alternatives before making a decision. This is a topic of interest, as impulsivity might help predict future AUD and SUD. Future research should continue to examine the effects of impulsivity on AUD, SUD, and depression outside of the college student population and further clarify causes versus consequences. Three Way Interaction of AUD, SUD, and MDD on Non- Planning Impulsiveness* (SUD=1) Interaction Effects of AUD and MDD on Non- Planning Impulsiveness (SUD=0) Alcohol Use Disorder 0= no; 1 = yes Alcohol Use Disorder 0=no; 1=yes AUD and SUD - Only AUD + Only SUD + AUD and SUD + 0 5 10 15 20 25 30 No Depression Depression MDD + BIS-11 NPImp BIS-11 NPIMP *P=.005 * 1. Heffernan, T.M. et al. J Adolescent Health. 2006. 2. Vuchinich, R. et al. Exp clin Psychopharm. 1999. 3. MacKillop, J. et al. J Stud Alcohol Drugs. 2007. 4. Arce, E. et al. Psicothema. 2006. 5. Gonzalez, V. et al. Exp Clin Psychopharmacology. 2011. 6. Sheehan, D. et al. Mini International Neuropsychiatric Interview. DSM-IV. 2008. 7. Patton, J. et al. J Clin Psych. 1995. 8. Zuckerman, M. et al Psychiatry Res. 1979. 9. Jakubczyk, A. et al. Journal of Affective Disorders. 2011. Depress ion N=211 SUD N=408 AUD N=254 N=38 N=38 N=38 Figure 1: Venn Diagram showing overlap of AUD, SUD, and MDD diagnoses. N=174 MDD - MDD – MDD + MDD – MDD + AUD - AUD + AUD - AUD +
Results & Discussion
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Results & Discussion
Depression, Alcohol Use Disorders, and Substance Use Disorders Moderate the Impulsivity Levels of College Students
R. Rosen1, R. Jiantonio-Kelly1, S. Meda1, J. Sisante1, A. Dager1,2, S. Raskin6, H. Tennen5, C. Austad4, 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
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 students.1 Considerable research has been done linking alcohol misuse in college students (and others) to impulsivity.2,3
Recent research has extended the definition of impulsivity to include multiple constructs, encompassing both impulsive actions and impulsive decisions.4
Impulsivity is a key symptom of both bipolar disorder and major depression.5
Significant associations are reported between depressive symptoms in college students and difficulty in controlling behavioral impulses.
The current study aims to extend these findings, by clarifying relationships between substance use, alcohol use, and depression in a college population.
HYPOTHESES- A diagnosis of an AUD or SUD would be significantly related to all facets of impulsivity on the BIS-11 and to total Zuckerman scores.
- Research on depression in relation to impulsivity shows strong correlations between cognitive impulsivity9, especially attentional and non-planning impulsivity. We therefore predicted that a diagnosis of MDD would be related to the attentional and non-planning impulsivity scales of the BIS-11.
- We predicted significant interaction effects between diagnoses of AUD, SUD, MDD, and impulsivity.
MATERIALS & METHODS1848 college freshmen (48.1% male) aged 18-25 were recruited on a voluntary basis from the ongoing NIAAA- funded 2100-person 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), Substance Use Disorders (SUD), and current and/or lifetime Major Depressive Disorder (MDD) were diagnosed using the MINI International Neuro-psychiatric Interview for Diagnosis of Axis I Disorders (MINI).6
(See Figure 1)
Students classified as having an AUD or SUD had corresponding MINI diagnoses of either Alcohol Abuse or Dependence; or Substance Abuse or Dependence.
The Barratt Impulsiveness Scale, Version 11 (BIS-11), a 30-item self-report scale, was used to evaluate 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).7
The Zuckerman Sensation Seeking Scale was used to test preference for stimulating activities; Subscales include Disinhibition, Thrill and Adventure Seeking, Boredom Susceptibility, and Experience Seeking. The current study used the total Zuckerman score as an indicator of impulsivity.8
A multivariate general linear model analysis of variance (MANOVA) was used as the key statistical approach.
REFERENCES
Figure 3: Bar Graph Detailing Three-Way Interaction Effects Between AUD, SUD, MDD, and BIS-11 Non-Planning Impulsiveness
Figure 2: Three Way Interaction between AUD, SUD, and MDD on Non-Planning Impulsivity
MANOVA showed both significant main effects and significant interaction effects at a p<0.007 level when corrected for multiple comparisons.
Students with SUD had higher total scores on the Zuckerman (p=0.000), and higher scores on the BIS-11 Attentional Impulsiveness sub-scale (p=0.004) than students without SUDs. Students with AUD also had higher total Zuckerman scores (p=0.000), and higher Motor and Non-Planning Impulsiveness sub-scale scores on the BIS-11 (p=0.001).
Although students diagnosed with major depression did not show any significant main effects of impulsivity, a diagnosis of MDD did have significant interaction effects with other measures. A three-way interaction was found among students who were diagnosed with AUD, SUD, and MDD concurrently, showing higher total scores on BIS-11 non-planning impulsiveness (p=.005) than students diagnosed with MDD and either an AUD or SUD. (See Figures 2 and 3)
These data help to solidify existing research examining links between not only bipolar disorder, alcohol use and impulsivity, but also major depression and substance use. SUD and AUD were both associated with higher sensation seeking scores, and attentional/motor/non-planning impulsivity. When combined with depression, we observed higher scores in non-planning impulsivity measures, consistent with the ‘impulsive decisions’ construct of impulsivity, i.e. that depressed individuals have trouble choosing among behavioral alternatives before making a decision. This is a topic of interest, as impulsivity might help predict future AUD and SUD. Future research should continue to examine the effects of impulsivity on AUD, SUD, and depression outside of the college student population and further clarify causes versus consequences.
Three Way Interaction of AUD, SUD, and MDD on Non-Planning
Impulsiveness*(SUD=1)
Interaction Effects of AUD and MDD on Non-Planning
Impulsiveness(SUD=0)
Alcohol Use Disorder0= no; 1 = yes
Alcohol Use Disorder0=no; 1=yes
AUD and SUD - Only AUD + Only SUD + AUD and SUD +0
5
10
15
20
25
30
No Depression
DepressionMDD +
BIS
-11
NP
Imp
BIS
-11
NP
IMP
*P=.005
*
1. Heffernan, T.M. et al. J Adolescent Health. 2006. 2. Vuchinich, R. et al. Exp clin Psychopharm. 1999. 3. MacKillop, J. et al. J Stud Alcohol Drugs. 2007.4. Arce, E. et al. Psicothema. 2006. 5. Gonzalez, V. et al. Exp Clin Psychopharmacology. 2011.6. Sheehan, D. et al. Mini International Neuropsychiatric Interview. DSM-IV. 2008.7. Patton, J. et al. J Clin Psych. 1995.8. Zuckerman, M. et al Psychiatry Res. 1979.9. Jakubczyk, A. et al. Journal of Affective Disorders. 2011.
Depression
N=211
SUDN=408
AUDN=254
N=38N=38N=38
Figure 1: Venn Diagram showing overlap of AUD, SUD, and MDD diagnoses.
N=174
MDD -
MDD –
MDD +
MDD – MDD +
AUD - AUD + AUD - AUD +
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