Sex differences in disinhibition and its relationship to physical abuse in a sample of stimulant-dependent patients.
BACKGROUND
Research suggests that impulsivity is a vulnerability factor for developing stimulant dependence, that women develop dependence more quickly than men, and that physical abuse can increase impulsivity and may have greater adverse health consequences in women. This study sought to tie these findings together by evaluating: (1) sex differences in disinhibition prior to lifetime initiation of stimulant abuse and (2) the relationship between physical abuse and disinhibition in stimulant-dependent patients.


METHODS
The Frontal Systems Behavior Scale (FrSBe) is a reliable and valid self-report assessment of three neurobehavioral domains associated with frontal systems functioning (Apathy, Disinhibition, and Executive Dysfunction, summed for a Total), that assesses pre-morbid functioning and has a specific cutoff for defining clinically significant abnormalities. Six sites evaluating 12-step facilitation for stimulant abusers obtained the FrSBe from 118 methamphetamine- and/or cocaine-dependent participants. Lifetime physical abuse was measured by the Addiction Severity Index (ASI).


RESULTS
The proportion reporting clinically significant disinhibition was significantly higher in women (64.9%) than in men (45.0%, p=0.04), with no significant difference on the other FrSBe scales. Physical abuse in women, but not men, was associated with worse functioning, with physically abused, relative to non-abused, women having a significantly greater proportion with clinically significant disinhibition (p<0.01) and total neurobehavioral abnormalities (p<0.01).


CONCLUSIONS
These findings suggest that women may have significantly greater disinhibition than men prior to lifetime initiation of stimulant abuse and that physical abuse in women is associated with greater disinhibition.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3210 Jefferson Avenue, Cincinnati, OH 45220, USA. winhusen@carc.uc.edu
Theresa
T
Winhusen
Daniel
D
Lewis
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000523:psychology; D000697:Central Nervous System Stimulants; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D019970:Cocaine-Related Disorders / Q000523:psychology; D019548:Crime Victims / Q000523:psychology*; D003627:Data Interpretation, Statistical; D056344:Executive Function; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008694:Methamphetamine; D009483:Neuropsychological Tests; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000523:psychology*
D000697:Central Nervous System Stimulants; D008694:Methamphetamine