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Are heavy drinkers more impulsive than light drinkers? : A comprehensive multi-dimensional assessment of impulsivity in non-dependent heavy drinking young adults

Student thesis: Doctoral ThesisDoctor of Philosophy

Background and aims: The aim of this study was to review whether (and which) impulsivity sub-domains are elevated in groups of non-dependent alcohol misusers (e.g., heavy/hazardous drinkers, binge drinkers, etc.), relative to healthy drinking comparison groups. It set out to answer this by reviewing studies comparing groups on impulsivity multi-dimensionally – that is, via more than one index (at least one self-report and at least one behavioural). Comprehensively profiling non-dependent alcohol misusers’ impulsivity may increase understanding of the potential mechanism(s) involved in the initial development to and maintenance of such misuse (and possibly to subsequent dependence).
Methods: The search was performed via three scientific databases (Embase, Medline and PsycINFO) and was limited to empirical studies comparing non-clinical groups of drinkers aged 18-25 years and published in English language journals. The titles and abstracts of all non-duplicate returns were screened in order to determine eligibility. A subsequent ancestry search involved screening the (titles and abstracts of papers in the) references sections of all eligible papers. Grey literature was not included. The findings of the included papers were qualitatively reviewed, before each was rated using the National Institutes for Health quality assessment tool for observational cohort and cross-sectional studies.
Results: Just eight studies were found to have compared impulsivity multidimensionally in groups of young adult (i.e. 18-25) non-clinical alcohol misusers, relative to comparison groups. Collectively, findings indicate that self-reported rash impulsivity is elevated in the quasi-experimental groups, whilst behavioural inhibitory control and delay discounting are not. Due to insufficient amounts of data, it is unclear whether response-initiation, risk-taking and reflection impulsivity may be elevated in non-clinical alcohol misusers. The quality of the eight studies included in the final review was generally rated ‘fair’, none being rated ‘good’, due to a range of potential sources of confound. Conclusions: Across all impulsivity sub-domains assessed in these studies, only selfreported rash impulsivity appears a reliable risk factor for the maintenance (and possibly, initial development) of non-clinical patterns of alcohol misuse, at least in young adults. However, the potential inclusion of dependent drinkers across the included studies represents a serious limitation, raising questions about findings/conclusions. Overall, more studies are needed that assess impulsivity multidimensionally in groups of alcohol misusers, relative to healthy drinkers; these studies should ensure better control of possible sources of confound.
Original languageEnglish
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Award date2017

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