title: Impulsivity is an independent predictor of 15-year mortality risk among individuals seeking help for alcohol-related problems.
abstract: BACKGROUND
  Although past research has found impulsivity to be a significant predictor of mortality, no studies have tested this association in samples of individuals with alcohol-related problems or examined moderation of this effect via socio-contextual processes. The current study addressed these issues in a mixed-gender sample of individuals seeking help for alcohol-related problems.
  
  
  METHODS
  Using Cox proportional hazard models, variables measured at baseline and Year 1 of a 16-year prospective study were used to predict the probability of death from Years 1 to 16 (i.e., 15-year mortality risk). There were 628 participants at baseline (47.1% women); 515 and 405 participated in the follow-up assessments at Years 1 and 16, respectively. Among Year 1 participants, 93 individuals were known to have died between Years 1 and 16.
  
  
  RESULTS
  After controlling for age, gender, and marital status, higher impulsivity at baseline was associated with an increased risk of mortality from Years 1 to 16; however, this association was accounted for by the severity of alcohol use at baseline. In contrast, higher impulsivity at Year 1 was associated with an increased risk of mortality from Years 1 to 16, and remained significant when accounting for the severity of alcohol use, as well as physical health problems, emotional discharge coping, and interpersonal stress and support at Year 1. In addition, the association between Year 1 impulsivity and 15-year mortality risk was moderated by interpersonal support at Year 1, such that individuals high on impulsivity had a lower mortality risk when peer/friend support was high than when it was low.
  
  
  CONCLUSIONS
  The findings highlight impulsivity as a robust and independent predictor of mortality and suggest the need to consider interactions between personality traits and socio-contextual processes in the prediction of health-related outcomes for individuals with alcohol use disorders.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, Stanford University School of Medicine, Palo Alto, California 94025, USA. bloni001@stanford.edu
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Blonigen
authors.forename: Christine
authors.initials: C
authors.lastname: Timko
authors.forename: Bernice S
authors.initials: BS
authors.lastname: Moos
authors.forename: Rudolf H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000401:mortality* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007175:Impulsive Behavior / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate