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Alcohol and Alcoholism Advance Access published online on April 25, 2006
Alcohol and Alcoholism, doi:10.1093/alcalc/agl030
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© The Author 2006. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved
Received September 2, 2005
Revised February 23, 2006
Accepted March 13, 2006

Article

BEHAVIOURAL ASPECTS OF IMPULSIVITY IN ALCOHOLICS WITH AND WITHOUT A CLUSTER-B PERSONALITY DISORDER

GEERT DOM 1 *, BIEKE DE WILDE 1, WOUTER HULSTIJN 2, WIM VAN DEN BRINK 3, and BERNARD SABBE 2

1 Psychiatric Centre Alexian Brothers, Boechout, Belgium
2 Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium
3 Academic Medical Centre (AMC) and Amsterdam Institute for Addiction Research (AIAR), Amsterdam, The Netherlands

* To whom correspondence should be addressed.
GEERT DOM, E-mail: geert.dom{at}skynet.be


  Abstract

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.


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