The role of positive urgency in alcohol-related risk-taking: An experimental investigation

Indiana University-Purdue University Indianapolis (IUPUI)The relationship between positive urgency, a personality trait reflecting rash action during extreme positive emotional states, and risk-taking has previously been experimentally examined. However, how positive urgency is related to risk-taking while under the acute influence of alcohol has not been examined. The overarching goal of this dissertation was to generate behavioral evidence concerning how the interaction between positive urgency and alcohol consumption influences risk-taking via changes in emotional arousal. In this study, 59 community dwelling adults (mean age = 29.45 (SD = 10.96), 32.2% women, 78% White) completed mood induction procedures (positive or neutral) while consuming a beverage (alcohol or placebo) and then completed the Balloon Analogue Risk Task (BART) as a measure of risk-taking. The positive mood induction was effective in inducing high arousal positive emotions. Overall, study hypotheses were not supported; however, because of low power, effect sizes and patterns of relationship are reported. The relationship between positive urgency and risk-taking was positive and small in the positive mood condition but negative and small in the neutral mood condition. The alcohol group and the placebo group showed similar patterns of risk-taking that are positive and small. Finally, the relationship between positive urgency changes in emotional arousal was positive and small only in the positive/alcohol condition; however, there was no relationship between changes in emotional arousal and risk-taking. These findings suggest that, while changes in emotional arousal may result from a combination of positive urgency and alcohol consumption, it may not be a focal mechanism that explains the relationship between positive urgency and risk-taking. Further, positive urgency is a risk factor whether or not alcohol consumption is present. Although the small sample size limited the power to test the hypotheses, the effect size estimates obtained in this study provide preliminary data for a more properly powered future study. The pattern of findings suggests the viability of further developing the current positive mood induction to establish a lab-based paradigm for positive urgency and the use of a different experimental risk-taking task to examine positive emotion-based risk-taking

The relationship among depressive symptoms, urgency, and problematic alcohol and cannabis use in community adults

This study examined alternative models for how negative and positive urgency influence the relationship between depressive symptoms and alcohol and cannabis use in a community sample. Methods Participants included adults (n = 675; age = 42.57, SD = 15.66; 65.0% female; 74.2% White) in the community sample from the Rockland Project by the Nathan Kline Institute. Path analyses were conducted. Results Negative urgency was a unique mediator in the relationship between depressive symptoms and problematic alcohol use (β =0.121, 95% CI = 0.060–0.182) and problematic cannabis use (β =0.120, 95% CI = 0.060–0.179). Negative and positive urgency significantly moderated the relationship between depressive symptoms and problematic cannabis use (negative urgency: β = 0.092, 95% CI = 0.040–0.145; positive urgency: β = 0.070, 95% CI = 0.022–0.119), such that the relationship was positive at high levels and negative at low levels of urgency. The patterns and levels of the relationships between depressive symptoms and cannabis use differed between negative and positive urgency. Neither urgency trait moderated the relationship between depressive symptoms and problematic alcohol use. Conclusions Despite being strongly related, negative and positive urgency have distinct roles in the relationship between depressive symptoms and problematic alcohol and cannabis use. Previous finding with younger samples that do not include both traits in the model at time generalize and at other times do not replicate, which warrants the continued examination of how these traits impart risk across the lifespan

The relationship between the UPPS-P impulsive personality traits and substance use psychotherapy outcomes: A meta-analysis

Background Although impulsive personality traits have been well implicated in substance use disorder (SUD) risk, little work has established how specific impulsive personality traits influence and are influenced by SUD psychotherapy outcomes. The purpose of this meta-analysis was to quantitatively review existing work to examine 1) how impulsive personality traits affect SUD psychotherapy outcomes and 2) reductions in impulsive personality traits during SUD psychotherapy. Methods Studies were identified by conducting a comprehensive review of the literature. Results For aim one (k = 6), significant effects were found for lack of premeditation (g = 0.60, SE = 0.30, 95% CI 0.01–1.20; z = 1.99, p = 0.05) and negative urgency (g = 0.55, SE = 0.17, 95% CI 0.22–0.88, z = 3.30, p=0.001), with trait scores related to poorer SUD psychotherapy outcomes. For aim two (k = 10), decreases in sensation seeking (g = −0.10, SE = 0.05, 95% CI −0.20 to 0.004; z = −1.88, p=0.02) and negative urgency (g = −0.25, SE = 0.14, 95% CI −0.53 to 0.03; z = −1.75, p=0.03) during SUD psychotherapy were significant. Conclusions Overall, our quantitative synthesis suggests that lack of premeditation and negative urgency are related to poorer SUD psychotherapy outcomes. Although negative urgency and sensation seeking are decreasing during SUD psychotherapy, the magnitude of the change is quite small. Overall, we suggest that the measurement and targeting of impulsive personality traits in psychotherapy has strong potential to improve clinical outcomes across SUDs and a wide range of clinical problems and disorders

The Theory of Planned Behavior and E-cig Use: Sensation Seeking, E-cig Attitudes and E-cig Use

poster abstractE-cig use is growing in popularity in the United States, but the underlying risk factors for e-cig use are not well understood. Positive attitudes towards e-cigs play an important role in e-cig use and such attitudes are related to current e-cig use, intent to use, and actual future use of e-cigs. Using a Theory of Planned Behavior framework (Ajzen & Fishbein, 1988), the present study investigated how attitudes towards e-cig use and impulsive personality traits (negative urgency, positive urgency, lack of perseverance, lack of premeditation, sensation seeking) are related to the likelihood of e-cig use. Five hundred and forty-five participants (Mean age = 34.11, SD = 10.96, 48.6% female, 86.2% Caucasian) completed the Comparing E-Cigarettes and Cigarettes questionnaire (CEAC; attitude measure), the Short UPPS-P Impulsive Behavior Scale, and an ecig use measure. E-cig users were significantly higher in negative urgency, F(3,542)=3.88, p=.005, and positive urgency, F(3,542) = 2.80, p=.003, traits that represent the tendency to act impulsively in extreme negative and positive emotional states, respectively. Those who use e-cigs also reported significantly higher scores on all the CEAC subscale scores (General Benefits, F(3, 542) = 102.10, p<.001, Addiction/Cessation, F(3,542) = 67.20, p<.001, and Improve Health, F(3, 542) = 125.03, p<.001). A structural path analysis revealed that sensation seeking is significantly related to positive e-cig attitudes (b=0.63, p<.001) and these attitudes were related to a higher likelihood of being an e-cig user (b=0.63, p<.001), after controlling for all other impulsivity traits and demographics. These findings provide initial support for a theoretical model of how impulsivity and attitudes toward e-cig use influence e-cig use and targeting these factors could be prime points of intervention for e-cig use

Age and Impulsive Behavior in Drug Addiction: A Review of Past Research and Future

Impulsive behavior is implicated in the initiation, maintenance, and relapse of drug-seeking behaviors involved in drug addiction. Research shows that changes in impulsive behavior across the lifespan contribute to drug use and addiction. The goal of this review is to examine existing research on the relationship between impulsive behavior and drug use across the lifespan and to recommend directions for future research. Three domains of impulsive behavior are explored in this review: impulsive behavior-related personality traits, delay discounting, and prepotent response inhibition. First, we present previous research on these three domains of impulsive behavior and drug use across developmental stages. Then, we discuss how changes in impulsive behavior across the lifespan are implicated in the progression of drug use and addiction. Finally, we discuss the relatively limited attention given to middle-to-older adults in the current literature, consider the validity of the measures used to assess impulsive behavior in middle-to-older adulthood, and suggest recommendations for future research

The Theory of Planned Behavior and E-cig Use: Impulsive Personality, E-cig Attitudes, and E-cig Use

The current paper applied the theory of planned behavior (TPB; Ajzen and Fishbein 1988) to understand how impulsive personality traits and attitudes concerning e-cig use relate to the likelihood of electronic cigarette (e-cig) use. Seven hundred fourteen participants (mean age = 34.04, SD = 10.89, 48.6% female) completed cross-sectional measures of e-cig use attitudes (CEAC) and the Short UPPS-P Impulsive Behavior Scale. A structural path analysis suggested that urgency and deficits in conscientiousness were significantly related to e-cig attitudes (CFI = 0.99, TLI = 0.99, RMSEA = 0.02; urgency: β = 0.32, p = .001; deficits in conscientiousness: β = −0.48, p < .001). E-cig attitude scores were significantly higher for e-cig users than non-users, β = 0.85, p < .001. There was no significant direct path from impulsive personality traits to e-cig use. Findings provide initial support for a model in which impulsive traits are related to e-cig use through positive e-cig attitudes

Relationship of Negative Urgency to Cingulo-Insular and Cortico-Striatal Resting State Functional Connectivity in Tobacco Use

Negative urgency, defined as a tendency to act rashly under extreme negative emotion, is strongly associated with tobacco use. Despite the robust evidence linking negative urgency and tobacco use and accumulating evidence suggesting that localized, segregated brain regions such as the nucleus accumbens (NAcc), insula, and amygdala are related to negative urgency, resting state functional connectivity (rsFC) of negative urgency in tobacco use has not yet been examined. This study included 34 daily tobacco users and 62 non-users matched on age, gender, race/ethnicity, and lifetime psychiatric diagnosis from a publicly available neuroimaging dataset collected by the Nathan Kline Institute-Rockland Project. Using the bilateral NAcc, insula, and amygdala as seed regions, seed-based rsFC analyses were conducted on the whole brain. In the whole sample, negative urgency was positively correlated with rsFC between the left insula and right dorsal anterior cingulate cortex (dACC). Compared to non-users, tobacco users had a stronger rsFC strength between the right amygdala and right middle temporal gyrus. In tobacco users, negative urgency was negatively associated with rsFC between the left NAcc and right dACC and between the left NAcc and right dorsolateral prefrontal cortex; these relationships were positive in non-users. Identifying functional connectivity implicated in negative urgency and tobacco use is the crucial first step to design and test pharmacological and physiological interventions to reduce negative urgency related tobacco use

PTSD Symptoms Mediate the Relationship Between Sexual Abuse and Substance Use Risk in Juvenile Justice-Involved Youth

Juvenile justice-involved youth face disproportionate rates of sexual abuse, which increases the risk of post-traumatic stress disorder (PTSD) and substance use disorders (SUDs), both of which are associated with poor long-term outcomes. The present study tested two mediation and moderation models, controlling for age, race, and history of physical abuse, with gender as a moderator, to determine whether PTSD symptoms serve as a risk factor and/or mechanism in the relationship between sexual abuse and substance use. Data were examined for 197 juvenile justice-involved youth (mean age = 15.45, 68.9% non-White, 78.4% male) that completed court-ordered psychological assessments. Results indicated that PTSD symptoms significantly mediated the relationship between sexual abuse and drug (β = 3.44, confidence interval [CI] [0.26, 7.41]; test for indirect effect z = 2.41, p = .02) and alcohol use (β = 1.42, CI [0.20, 3.46]; test for indirect effect z = 2.23, p = .03). PTSD symptoms and gender were not significant moderators. Overall, PTSD symptoms mediate the relationship between sexual abuse and SUDs in juvenile justice-involved youth, which suggests viability of targeting PTSD symptoms as a modifiable risk factor to reduce the effects of sexual abuse on substance use in this high-risk population

Conduct disorder symptoms and illicit drug use in juvenile justice involved youth: The reciprocal relationship between positive illicit drug use attitudes and illicit drug use

Conduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12-18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (β = 0.16, CI 0.09-0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (β = 0.20, CI 0.12-0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use

Resting-State Neural Circuit Correlates of Negative Urgency: A Comparison Between Tobacco Users and Non-Tobacco Users

Negative urgency, defined as a tendency to act rashly under extreme negative emotion, is strongly associated with tobacco use. Despite the robust cross-sectional and experimental evidence linking negative urgency and tobacco use, neural correlates of negative urgency in tobacco use have not been studied. The purpose of the current study was to 1) identify neural circuits that differ between tobacco users and non-tobacco users and 2) explore the relationship between resting-state seed-based functional connectivity (rsFC) and negative urgency, both in the overall group and between tobacco users and non-tobacco users. Using negative urgency-related brain regions as seed regions (voxel level p = .005, cluster-level α \u3c .05), compared to non-tobacco users (n = 21; mean age = 36.57, 62% female, 76% white), tobacco users (n = 22; mean age = 37.50, 64% female, 77% white) had stronger rsFC strengths in the right amygdala—left medial orbitofrontal cortex/ventromedial prefrontal cortex circuit and the right nucleus accumbens—right temporoparietal junction circuit. Additionally, rsFC in the bilateral temporal pole—left supramarginal gyrus circuits was positively correlated with negative urgency (Left temporal pole: r = .55, p \u3c .001; Right temporal pole: r = .51, p \u3c .001). The current study extends previous neuroimaging findings, which have mainly focused on how negative urgency is related to brain responses in localized, segregated brain regions, by examining the network-level interactions between different brain regions. This study provides prime preliminary data for future neuroimaging studies of negative urgency by providing potential target networks that would aid the development of novel intervention strategies for negative urgency-based maladaptive behaviors