Depression, Alcohol Use Disorders, and Substance Use Disorders Moderate the Impulsivity
Levels of College Students
R. Rosen1, R. Jiantonio-Kelly1, S. Meda1, J. Sisante1, A. Dager1,2, S. Raskin6, H. Tennen5, C. Austad4, C, Fallahi4, R. Wood4,
G. Pearlson1,2,3
1Olin
Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT,
2Dept. of Psychiatry, 3Dept. of Neurobiology, Yale University School of Medicine, New Haven, CT, 4Dept. of Psychology, Central Connecticut State University, New Britain, CT, 5University of
Connecticut School of Medicine, Farmington, CT, 6Dept. of Psychology and Neuroscience Program, Trinity College, Hartford, CT
INTRODUCTION
Results & Discussion
HYPOTHESES
Alcohol is the drug of choice among college students.1
Considerable research has been done linking alcohol misuse
in college students (and others) to impulsivity.2,3
- A diagnosis of an AUD or SUD would be significantly related to all facets of impulsivity on the BIS-11 and to
total Zuckerman scores.
Recent research has extended the definition of impulsivity to
include multiple constructs, encompassing both impulsive
actions and impulsive decisions.4
- Research on depression in relation to impulsivity shows strong correlations between cognitive impulsivity9,
especially attentional and non-planning impulsivity. We therefore predicted that a diagnosis of MDD would be
related to the attentional and non-planning impulsivity scales of the BIS-11.
Impulsivity is a key symptom of both bipolar disorder and
major depression.5
-We predicted significant interaction effects between diagnoses of AUD, SUD, MDD, and impulsivity.
The current study aims to extend these findings, by clarifying
relationships between substance use, alcohol use, and
depression in a college population.
Figure 2: Three Way Interaction between AUD, SUD, and MDD on NonPlanning Impulsivity
Interaction Effects of AUD and
MDD on Non-Planning
Impulsiveness
(SUD=0)
MATERIALS & METHODS
 MDD –
 MDD +
BIS-11 NPImp
1848 college freshmen (48.1% male) aged 18-25 were recruited
on a voluntary basis from the ongoing NIAAA- funded 2100person BARCS (Brain and Alcohol Research in College
Students) study from two Connecticut academic institutions; one
a small, private college and the other a larger, public university.
Alcohol Use Disorders (AUD), Substance Use Disorders (SUD),
and current and/or lifetime Major Depressive Disorder (MDD)
were diagnosed using the MINI International Neuro-psychiatric
Interview for Diagnosis of Axis I Disorders (MINI).6
(See Figure 1)
Students classified as having an AUD or SUD had
corresponding MINI diagnoses of either Alcohol Abuse or
Dependence; or Substance Abuse or Dependence.
The Barratt Impulsiveness Scale, Version 11 (BIS-11), a 30-item
self-report scale, was used to evaluate personality dimensions
of impulsivity. BIS-11 tests for Attentional Impulsivity (difficulties
with concentration), Motor Impulsivity (acting without thinking),
and Non-Planning Impulsivity (lack of concern about the
future).7
The Zuckerman Sensation Seeking Scale was used to test
preference for stimulating activities; Subscales include
Disinhibition, Thrill and Adventure Seeking, Boredom
Susceptibility, and Experience Seeking. The current study used
the total Zuckerman score as an indicator of impulsivity.8
A multivariate general linear model analysis of variance
(MANOVA) was used as the key statistical approach.
Figure 1: Venn
Diagram
showing
overlap of
AUD, SUD, and
MDD
diagnoses.
Three Way Interaction of AUD,
SUD, and MDD on Non-Planning
Impulsiveness*
(SUD=1)
 MDD –
 MDD +
BIS-11 NPIMP
Significant associations are reported between depressive
symptoms in college students and difficulty in controlling
behavioral impulses.
AUD -
AUD +
Alcohol Use Disorder
0= no; 1 = yes
N=38
N=174
Although students diagnosed with major depression did not show
any significant main effects of impulsivity, a diagnosis of MDD did
have significant interaction effects with other measures. A three-way
interaction was found among students who were diagnosed with
AUD, SUD, and MDD concurrently, showing higher total scores on
BIS-11 non-planning impulsiveness (p=.005) than students
diagnosed with MDD and either an AUD or SUD. (See Figures 2
and 3)
These data help to solidify existing research examining links
between not only bipolar disorder, alcohol use and impulsivity, but
also major depression and substance use. SUD and AUD were both
associated with higher sensation seeking scores, and
attentional/motor/non-planning impulsivity. When combined with
depression, we observed higher scores in non-planning impulsivity
measures, consistent with the ‘impulsive decisions’ construct of
impulsivity, i.e. that depressed individuals have trouble choosing
among behavioral alternatives before making a decision. This is a
topic of interest, as impulsivity might help predict future AUD and
SUD. Future research should continue to examine the effects of
impulsivity on AUD, SUD, and depression outside of the college
student population and further clarify causes versus consequences.
AUD +
Alcohol Use Disorder
0=no; 1=yes
REFERENCES
Figure 3: Bar Graph Detailing Three-Way Interaction Effects Between
AUD, SUD, MDD, and BIS-11 Non-Planning Impulsiveness
35
*
30
1. Heffernan, T.M. et al. J Adolescent Health. 2006.
2. Vuchinich, R. et al. Exp clin Psychopharm. 1999.
3. MacKillop, J. et al. J Stud Alcohol Drugs. 2007.
4. Arce, E. et al. Psicothema. 2006.
5. Gonzalez, V. et al. Exp Clin Psychopharmacology. 2011.
6. Sheehan, D. et al. Mini International Neuropsychiatric Interview.
DSM-IV. 2008.
7. Patton, J. et al. J Clin Psych. 1995.
8. Zuckerman, M. et al Psychiatry Res. 1979.
9. Jakubczyk, A. et al. Journal of Affective Disorders. 2011.
25
20
Brain and Alcohol Research in College Students
No
Depression
MDD
-
10
N=38
Students with SUD had higher total scores on the Zuckerman
(p=0.000), and higher scores on the BIS-11 Attentional
Impulsiveness sub-scale (p=0.004) than students without SUDs.
Students with AUD also had higher total Zuckerman scores
(p=0.000), and higher Motor and Non-Planning Impulsiveness subscale scores on the BIS-11 (p=0.001).
*P=.005
AUD -
15
N=38
MANOVA showed both significant main effects and significant
interaction effects at a p<0.007 level when corrected for multiple
comparisons.
(aka BARCS Study) “Mascot”
MDD +
Depression
5
0
AUD and SUD -
Only AUD +
Only SUD +
AUD and SUD +
Funded by RO1 AA016599 (BARCS Study) and RC1 AA019036 to Dr. Godfrey Pearlson.