A sense of urgency: Trait impulsivity in co-occurring bipolar and alcohol use disorder

IF 3 Q2 SUBSTANCE ABUSE Alcohol (Hanover, York County, Pa.) Pub Date : 2024-08-28 DOI:10.1111/acer.15430
Kaiya Brand, William Mellick, Bryan Tolliver, James J. Prisciandaro
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Abstract

Background

Bipolar disorder (BD) and alcohol use disorder (AUD) often co-occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., “urgency,” measured by the UPPS-P), however, remain underexplored in this population and could have distinct associations with clinical correlates.

Methods

This cross-sectional study used a two-by-two (BDxAD) factorial design, including groups with BD + AD (n = 28), BD (n = 29), AD (n = 28), and healthy controls (HC) (n = 27), to identify between-group differences among the five subscales of the UPPS-P. Associations of UPPS-P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined.

Results

BD + AD had the highest scores for every UPPS-P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS-11 total scores were most correlated with the urgency subscales of the UPPS-P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS-11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale.

Limitations

Cross sectional design and predominantly white sample.

Conclusions

Unlike the BIS-11, UPPS-P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co-occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS-P should be utilized in future studies and clinical settings measuring trait impulsivity in this population.

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紧迫感:双相情感障碍和酒精使用障碍共存时的特质冲动。
背景:双相情感障碍(BD)和酒精使用障碍(AUD)经常同时存在,BD + AUD的特征是冲动性比单独存在的任何一种障碍都要高。然而,在这一人群中,冲动的情绪方面(如用 UPPS-P 测量的 "紧迫感")仍未得到充分探索,而且可能与临床相关性有不同的联系:这项横断面研究采用了二乘二(BDxAD)因子设计,包括BD + AD组(n = 28)、BD组(n = 29)、AD组(n = 28)和健康对照组(HC)(n = 27),以确定UPPS-P五个分量表之间的组间差异。此外,还研究了UPPS-P各分量表与巴拉特冲动量表(BIS)总分及相关临床变量的关系:除 "感觉寻求 "外,BD + AD 在 UPPS-P 各分量表中的得分均为最高,其中 "积极紧迫感 "和 "消极紧迫感 "分量表对 BD 和 AD 的主效应最大。BIS-11 总分与 UPPS-P 的紧迫感分量表的相关性最大。在 BD + AD 组中,阴性紧迫感与临床测量结果具有独特的相关性。快速循环与紧迫感分量表和BIS-11评分都有关联,酒精依赖量表与预谋分量表的相关性最大:局限性:横断面设计,样本主要为白人:与BIS-11不同,UPPS-P能够区分冲动的情绪和非情绪方面,这与BD+AD并发症患者尤其相关,因为情绪多变是症状表现的关键部分。因此,UPPS-P应在未来的研究和临床环境中用于测量这类人群的特质冲动性。
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