The Relationship Between Measures of Impulsivity and Clinical Characteristics of Patients With Alcohol Use Disorder


The current article presents findings on the interaction between impulsivity features and clinical characteristics of patients with alcohol use disorders (AUD). Patients (n = 88), who were completing detoxification program for the symptoms of AUD, were recruited for the study. They completed biographical questionnaire, Penn Craving
Scale (PACS), self-report screening measure of the symptoms of adult ADHD (ASRS v.1.1) and underwent a series of experimental tasks (Delay Discounting Task (DDT), Stroop Task, Continuous Performance Test-Identical Pairs (CPT-IP), Tower of London (ToL)). Two distinct groups of impulsivity features were identified using cluster
analysis. One group, which was comprised of DDT and ToL measures, described the level of impulsivity during the decision-making process. The second group included Stroop task and CPT-IP measures and expressed the level of response inhibition and interference control. In addition, the model of interaction between measures
of impulsivity and clinical characteristics of patients was developed. The self-report measure of inattention and hyperactivity had significant effect on the level of craving and the duration of remission. No significant relationships were observed between DDT clinical characteristics.

Keywords: impulsivity, alcohol use disorder, delay discounting, stroop task, Tower of London, CPT-IP, craving, ASRS

[1] Bari, A. and Robbins, T. W. (2013). Inhibition and impulsivity: Behavioral and neural basis of response control. Progress in Neurobiology, vol. 108, pp. 44–79.

[2] Cornblatt, B. A., Lenzenweger, M. F., and Erlenmeyerkimling, L. (1989). The Continuous Performance-Test, Identical Pairs Version.2. Contrasting Attentional Profiles in Schizophrenic and Depressed-Patients. Psychiatry Research, vol. 29, no. 1, pp. 65–85.

[3] Cornblatt, B. A., Lenzenweger, M. F., and Erlenmeyer-Kimling, L. (1989). The continuous performance test, identical pairs version: II. Contrasting attentional profiles in schizophrenic and depressed patients. Psychiatry Research, vol. 29, no. 1, pp. 65–85.

[4] Courtney, K. E., Arellano, R., Barkley‐Levenson, E., et al. (2012). The relationship between measures of impulsivity and alcohol misuse: an integrative structural equation modeling approach. Alcoholism: Clinical and Experimental Research, vol. 36, no. 6, pp. 923–931.

[5] Cyders, M. A., and Smith, G. T. (2008). Emotion-based Dispositions to Rash Action: Positive and Negative Urgency. Psychological Bulletin, vol. 134, no. 6, pp. 807–828. DOI:

[6] Dick, D. M., Smith, G., Olausson, P., et al. (2010). Understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction Biology, vol. 15, no. 2, pp. 217–226.

[7] Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, vol. 146, no. 4, pp. 348–361.

[8] Fernie, G., Peeters, M., Gullo, M. J., et al. (2013). Multiple behavioural impulsivity tasks predict prospective alcohol involvement in adolescents. Addiction, vol. 108, no. 11, pp. 1916–1923.

[9] Field, M., Christiansen, P., Cole, J., et al. (2007). Delay discounting and the alcohol Stroop in heavy drinking adolescents. Addiction, vol. 102, no. 4, pp. 579–586.

[10] Flannery, B. A., Volpicelli, J. R., and Pettinati, H. M. (1999). Psychometric properties of the Penn alcohol craving scale. Alcoholism: Clinical and Experimental Research, vol. 23, no. 8, pp. 1289–1295.

[11] Franken, I. H., van Strien, J. W., Nijs, I., et al. (2008). Impulsivity is associated with behavioral decision-making deficits. Psychiatry Research, vol. 158, no. 2, pp. 155–163.

[12] Gowin, J. L., Sloan, M. E., Stangl, B. L., et al. (2017). Vulnerability for alcohol use disorder and rate of alcohol consumption. American Journal of Psychiatry, vol. 174, no. 11, pp. 1094–1101.

[13] Holmes, A. J., Hollinshead, M. O., Roffman, J. L., et al. (2016). Individual differences in cognitive control circuit anatomy link sensation seeking, impulsivity, and substance use. Journal of Neuroscience, vol. 36, no. 14, pp. 4038–4049.

[14] Janushko, M. G., Shamanina, M. V., Aristova, T. A., et al. (2015). Standartizacija shkaly «Kratkaja ocenka kognitivnyh funkcij u pacientov s affektivnymi rasstrojstvami»(BAC-A) na osnove normativnyh dannyh rossijskoj populjacii. Rossijskij psihiatricheskij zhurnal, no. 2, pp. 68–75.

[15] Jentsch, J. D., Ashenhurst, J. R., Cervantes, M. C., et al. (2014). Dissecting impulsivity and its relationships to drug addictions. Annals of the New York Academy of Sciences, vol. 1327, no. 1, pp. 1–26.

[16] Keefe, R. S., Fox, K. H., Davis, V. G., et al. (2014). The Brief Assessment of Cognition In Affective Disorders (BAC-A): Performance of patients with bipolar depression and healthy controls. Journal of Affective Disorders, vol. 166, pp. 86–92.

[17] Kessler, R. C., Adler, L., Ames, M., et al. (2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS). Psychological Medicine, vol. 35, no. 2, pp. 245–256.

[18] Klimanova, S. G., Trusova, A. V., Berezina, A. A., et al. (2017). Vremennoe diskontirovanie i pokazateli interferencii metodiki Strupa u pacientov s alkogol‘noj zavisimost‘yu. Lurievskij podxod v mirovoj psixologicheskoj nauke: tezisy‘ dokladov, c. 86. Ekaterinburg : Izd-vo Ural. un-ta.

[19] Lejuez, C. W., Magidson, J. F., Mitchell, S. H., et al. (2010). Behavioral and biological indicators of impulsivity in the development of alcohol use, problems, and disorders. Alcoholism: Clinical and Experimental Research, vol. 34, no. 8, pp. 1334– 1345.

[20] Lejuez, C. W., Magidson, J. F., Mitchell, S. H., et al. (2010). Behavioral and biological indicators of impulsivity in the development of alcohol use, problems, and disorders. Alcoholism: Clinical and Experimental Research, vol. 34, no. 8, pp. 1334– 1345.

[21] Logan, G. D., Schachar, R. J., and Tannock, R. (1997). Impulsivity and inhibitory control. Psychological Science, vol. 8, no. 1, pp. 60–64.

[22] López-Caneda, E., Rodríguez Holguín, S., Cadaveira, F., et al. (2013). Impact of alcohol use on inhibitory control (and vice versa) during adolescence and young adulthood: a review. Alcohol and Alcoholism, vol. 49, no. 2, pp. 173–181.

[23] MacKillop, J., Mattson, R. E., Anderson MacKillop, E. J., et al. (2007). Multidimensional assessment of impulsivity in undergraduate hazardous drinkers and controls. Journal of Studies on Alcohol and Drugs, vol. 68, no. 6, pp. 785–788.

[24] MacKillop, J., Weafer, J., Gray, J. C., et al. (2016). The latent structure of impulsivity: Impulsive choice, impulsive action, and impulsive personality traits. Psychopharmacology, vol. 233, no. 18, pp. 3361–3370.

[25] Moeller, F. G., Barratt, E. S., Dougherty, D. M., et al. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, vol. 158, no. 11, pp. 1783–1793.

[26] Mueller, S. T. and Piper, B. J. (2014). The psychology experiment building language (PEBL) and PEBL test battery. Journal of Neuroscience Methods, vol. 222, pp. 250–259.

[27] Reynolds, B. and Schiffbauer, R. (2005). Delay of gratification and delay discounting: A unifying feedback model of delay-related impulsive behavior. The Psychological Record, vol. 55, no. 3, pp. 439–460.

[28] Robles, E., Huang, B. E., Simpson, P. M., et al. (2011). Delay discounting, impulsiveness, and addiction severity in opioid-dependent patients. Journal of Substance Abuse Treatment, vol. 41, no. 4, pp. 354–362.

[29] Ryb, G. E., Dischinger, P. C., Kufera, J. A., et al. (2006). Risk perception and impulsivity: Association with risky behaviors and substance abuse disorders. Accident Analysis & Prevention, vol. 38, no. 3, pp. 567–573.

[30] Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London B, vol. 298, no. 1089, pp. 199–209.

[31] Shin, S. H., Hong, H. G., and Jeon, S. M. (2012). Personality and alcohol use: the role of impulsivity. Addictive Behaviors, vol. 37, no. 1, pp. 102–107.

[32] Smith, G. T. and Cyders, M. A. (2016). Integrating affect and impulsivity: The role of positive and negative urgency in substance use risk. Drug and Alcohol Dependence, vol. 163, no. 1, S3–S12.

[33] Stephan, R. A., Alhassoon, O. M., Allen, K. E., et al. (2017). Meta-analyses of clinical neuropsychological tests of executive dysfunction and impulsivity in alcohol use disorder. The American Journal of Drug and Alcohol Abuse, vol. 43, no. 1, pp. 24–43.

[34] Steward, T., Mestre-Bach, G., Fernández-Aranda, F., et al. (2017). Delay discounting and impulsivity traits in young and older gambling disorder patients. Addictive Behaviors, vol. 71, pp. 96–103.

[35] Strasser, E. S., Haffner, P., Fiebig, J., et al. (2016). Behavioral measures and self-report of impulsivity in bipolar disorder: no association between Stroop test and Barratt Impulsiveness Scale. International Journal of Bipolar Disorders, vol. 4, p. 16. Retrieved from

[36] Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, vol. 18, no. 6, p. 643.

[37] Swann, A. C., Bjork, J. M., Moeller, F. G., et al. (2002). Two models of impulsivity: Relationship to personality traits and psychopathology. Biological Psychiatry, vol. 51, no. 12, pp. 988–994.

[38] Trusova, A. V., Berezina, A. A., Klimanova, S. G., et al. (2015). Cognitive control in patients with alcohol use disorder: testing three function model. Archives of Psychiatry and Psychotherapy (in press).

[39] Whiteside, S. P. and Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, vol. 30, no. 4, pp. 669–689.

[40] Zermatten, A., Van der Linden, M., d’Acremont, M., et al. (2005). Impulsivity and decision making. The Journal of Nervous and Mental Disease, vol. 193, no. 10, pp. 647–650.