Alcohol and Alcoholism Advance Access originally published online on April 25, 2006
Alcohol and Alcoholism 2006 41(4):412-420; doi:10.1093/alcalc/agl030
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BEHAVIOURAL ASPECTS OF IMPULSIVITY IN ALCOHOLICS WITH AND WITHOUT A CLUSTER-B PERSONALITY DISORDER
1 Psychiatric Centre Alexian Brothers, Boechout, Belgium, 2 Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium and 3 Academic Medical Centre (AMC) and Amsterdam Institute for Addiction Research (AIAR), Amsterdam, The Netherlands
* Author to whom correspondence should be addressed: Psychiatric Centre Alexian Brothers, Provinciesteenweg 408, Boechout, 2530, Belgium. Tel.: +32 3 455 75 31; Fax: +32 3 454 20 84; E-mail: geert.dom{at}skynet.be
(Received 2 September 2005; first review notified 14 October 2005; in revised form 23 February 2006; accepted 13 March 2006)
Aims: 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. Conclusion: 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.