Anna Wnorowska

Impulsivity, risky behaviors and accidents in alcohol-dependent patients

Impulsivity and alcohol drinking are both considered as important predictors of unintentional as well as intentional injuries. However, relationships of impulsivity with risky behaviors and a history of accidents have not been investigated in alcohol dependence. The aim of this study was to analyze relationships between the frequency of risky behaviors and level of behavioral as well as cognitive impulsivity in alcohol-dependent patients. By means of Barratts Impulsiveness Scale (BIS) and stop-signal task, the levels of cognitive and behavioral impulsivity among 304 alcohol-dependent patients were measured. Also, patients were asked to answer questions from the Short Inventory of Problems applying to risky behaviors and accidents after alcohol drinking. In addition participants completed a questionnaire to assess frequency of other behaviors from the analyzed spectrum (use of other drugs, driving or aggressive behavior after alcohol drinking). The statistical analysis revealed a significant association between impulsivity and frequency of risky behaviors in alcohol-dependent patients. Individuals with higher scores in BIS behaved more frequently in a risky way and had significantly more accidents after alcohol drinking. The association with risky behaviors was strongest for non-planning and attentional impulsivity subscales, whereas frequency of accidents was particularly associated with motor impulsivity. A multivariate analysis revealed that impulsivity was the most important predictor of risky behaviors, but did not significantly predict a history of accidents. Our study confirms that impulsivity is an important correlate of risky behaviors in alcohol-dependent individuals, along with global psychopathology and severity of alcohol dependence.

Relationship Between Emotional Processing, Drinking Severity and Relapse in Adults Treated for Alcohol Dependence in Poland

AIMS Growing data reveals deficits in perception, understanding and regulation of emotions in alcohol dependence (AD). The study objective was to explore the relationships between emotional processing, drinking history and relapse in a clinical sample of alcohol-dependent patients. METHODS A group of 80 inpatients entering an alcohol treatment program in Warsaw, Poland was recruited and assessed at baseline and follow-up after 12 months. Baseline information about demographics, psychopathological symptoms, personality and severity of alcohol problems was obtained. The Schutte Self-Report Emotional Intelligence (EI) Test and Toronto Alexithymia Scale (TAS) were utilized for emotional processing assessment. Follow-up information contained data on drinking alcohol during the last month. RESULTS At baseline assessment, the duration of alcohol drinking was associated with lower ability to utilize emotions. Patients reporting more difficulties with describing feelings drank more during their last episode of heavy drinking, and had a longer duration of intensive alcohol use. A longer duration of the last episode of heavy drinking was associated with more problems identifying and regulating emotions. Poor utilization of emotions and high severity of depressive symptoms contributed to higher rates of drinking at follow-up. CONCLUSIONS These results underline the importance of systematic identification of discrete emotional problems and dynamics related to AD. This knowledge has implications for treatment. Psychotherapeutic interventions to improve emotional skills could be utilized in treatment of alcohol-dependent patients.

Violent behavior and driving under the influence of alcohol: Prevalence and association with impulsivity among individuals in treatment for alcohol dependence in Poland

Background: Driving while intoxicated or under the influence (DUI; for the purposes of this paper, we use the following terms synonymously: driving under the influence, driving while intoxicated, and drunk driving) and engaging in interpersonal violence are two injury-related problems of high public health importance that have both been linked to alcohol consumption. This study sought to estimate the prevalence of DUI and violence in a sample of individuals in treatment for alcohol dependence in Poland. Patient characteristics associated with DUI and violence involvement, with a particular focus on impulsivity, were examined. Methods: Three hundred and sixty-four patients consecutively admitted to four alcohol treatment programs in Warsaw, Poland participated in this study. Questions concerning history of interpersonal violence as well as those about DUI were derived from the Michigan Alcoholism Screening Test. Impulsivity level was measured using the Barratt Impulsiveness Scale 11, the Revised NEO Personality Inventory, and the stop-signal task. Results: Among all participants in the study, 148 (40.1%) had been arrested in the past for DUI, and 196 (55%) reported involvement in a fight under the influence of alcohol (FUI). The DUI group had a significantly earlier onset of alcohol problems, a longer period of heavy alcohol use, and fewer women in comparison to participants without a DUI history. FUI patients were significantly younger, with a younger average age of onset of drinking problems, longer period of heavy drinking, and lower percentage of women than the non-FUI group. Conclusion: Both of the self-reported measures of impulsivity indicated a higher level of impulsivity among participants from the FUI group than those from the non-FUI group.

COMT and BDNF Gene Variants Help to Predict Alcohol Consumption in Alcohol-dependent Patients.

Background: The neurobiology of alcohol dependence (AD) involves alterations in neurotransmitters and the stress response. We hypothesized that an interaction between functional variants of dopaminergic and neurotrophic genes may influence drinking in AD. Methods: The relationship between alcohol consumption and single-nucleotide polymorphisms, Val66Met in the brain-derived neurotrophic factor (BDNF), and Val158Met in the catechol-O-methyltransferase (COMT), was analyzed among 281 alcohol-dependent individuals. Results: Individuals carrying both the COMT Met158Met genotype and the BDNF Val66Val genotype drank more than those with other variants of these genes (P = 0.039). Those who had a family history of AD also drank more than those without a family history (P = 0.048). Patients with both Met/Met genotype in the COMT Val158Met polymorphism and Val/Val genotype in the BDNF Val66Met polymorphism suffered from more health problems than those carrying other variants (P = 0.030) and had lower motivation to change drinking patterns (P = 0.031). Conclusions: Patients carrying both the BDNF Val66Val and COMT Met158Met variants had higher alcohol consumption. These effects may be influenced by the effects of BDNF and COMT on dopamine responses to alcohol. Motivation-enhancing strategies might benefit the group of patients identified by genotyping in this study, and also treatment aimed at reducing alcohol consumption.

Corrigendum: Relationship between emotional processing, drinking severity and relapse in adults treated for alcohol dependence in Poland [Alcohol And Alcoholism, 50, 2, (2014), (173-179)] doi: 10.1093/alcalc/agu099

Aims: Growing data reveals deficits in perception, understanding and regulation of emotions in alcohol dependence (AD). The study objective was to explore the relationships between emotional processing, drinking history and relapse in a clinical sample of alcohol-dependent patients.Methods: A group of 80 inpatients entering an alcohol treatment program in Warsaw, Poland was recruited and assessed at baseline and follow-up after 12 months. Baseline information about demographics, psychopathological symptoms, personality and severity of alcohol problems was obtained. The Schutte Self-Report Emotional Intelligence (EI) Test and Toronto Alexithymia Scale (TAS) were utilized for emotional processing assessment. Follow-up information contained data on drinking alcohol during the last month.Results: At baseline assessment, the duration of alcohol drinking was associated with lower ability to utilize emotions. Patients reporting more difficulties with describing feelings drank more during their last episode of heavy drinking, and had a longer duration of intensive alcohol use. A longer duration of the last episode of heavy drinking was associated with more problems identifying and regulating emotions. Poor utilization of emotions and high severity of depressive symptoms contributed to higher rates of drinking at follow-up. Conclusions: These results underline the importance of systematic identification of discrete emotional problems and dynamics related to AD. This knowledge has implications for treatment. Psychotherapeutic interventions to improve emotional skills could be utilized in treatment of alcohol-dependent patients.

EPA-0215 - Genetic polymorphisms, impulsivity and suicide attempts: looking for a comprehensive model of relapse in alcohol dependence

Background The serotonin system is considered to contribute to both predisposition and course of addictions. A major, suggested link between low serotonin activity and alcohol drinking is impulsivity, which can be manifested by suicidal behavior. The objective of our study was to build a comprehensive model of mutual relationships between HTR2A T102C (rs6313) polymorphism, suicidality, impulsivity and relapse in alcohol dependence. Material and methods A sample of 254 alcohol dependent subjects were recruited in alcohol treatment centers and prospectively assessed at baseline and follow-up after 12 months. Information about demographics, psychopathological symptoms, history of suicide attempts and alcohol problems was obtained. The stop-signal task was performed and blood samples for genetic analysis were collected. Relapse was defined as any drinking during the follow up period. Results The statistical analysis revealed a significant association between CC genotype in HTR2A T102C polymorphism and relapse. Other factors that turned out to be significantly associated with relapse were history of impulsive suicide attempt and baseline depressive symptoms, with genetic factor being the strongest predictor of relapse in multivariate model (OR=2.125). In addition we observed a significant association between CC genotype and behavioral impulsivity as well as history of suicide attempts. We also found a significant association between stop reaction time and lifetime history of suicide attempts. Conclusions Our results provide a consistent perspective of importance of 5-HT2A receptor associated with impulsivity, suicidality and relapse. Based on these findings we propose a more comprehensive model of mutual relationships between relapse, impulsivity, suicidality and HTR2A polymorphism.