Behavioural aspects of impulsivity in alcoholics with and without a cluster-B personality disorder.
OBJECTIVE
Studies have shown that alcoholics with a cluster-B personality disorder (cluster-B PD) are characterized by high levels of impulsivity. However, impulsivity has mainly been studied as a broad concept without its different aspects being considered. The present study compared abstinent alcoholic inpatients without any personality disorder (PD) and abstinent alcoholics with cluster-B PD on different aspects of impulsivity, i.e. self-reported impulsivity and neuropsychological indicators such as behavioural control and delay of gratification.


METHODS
Forty alcohol-dependent inpatients without PD and 22 alcohol-dependent inpatients with a cluster-B PD were compared on two self-report impulsivity questionnaires (Barratt impulsiveness scale; sensation-seeking scales) and three behavioural impulsivity tasks [Go/No-Go task; delay discounting task (DDT); Stroop colour word test]. Tests were administered after stable abstinence of at least 3 weeks.


RESULTS
Self-report measures of impulsivity were higher in cluster-B alcoholics than in alcoholics without PD. Behavioural tasks revealed a more differentiated pattern of impairments. On the Go/No-Go task, cluster-B alcoholics were impaired in inhibitory control but not in reaction time compared with alcoholics without PD. In contrast, no significant differences on the DDT and the Stroop were observed.


CONCLUSIONS
Alcohol-dependent patients with and without a cluster-B PD differ in terms of behavioural inhibition but not in terms of activation or the ability to delay gratification. This finding may partly account for their impulsive and (self-) destructive behaviours. Treatment planning should pay specific attention to these impairments in behavioural control.
Dom
Geert
G
Psychiatric Centre Alexian Brothers, Provinciesteenweg 408, Boechout, 2530, Belgium. geert.dom@skynet.be
De Wilde
Bieke
B
Hulstijn
Wouter
W
van den Brink
Wim
W
Sabbe
Bernard
B
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D002755:Choice Behavior; D015897:Comorbidity; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis* / Q000523:psychology; D007266:Inhibition, Psychological; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology; D010555:Personality Inventory; D011930:Reaction Time; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000523:psychology