Impulsivity differences in recreational cannabis users and binge drinkers in a university population
Introduction
Alcohol and cannabis are the most frequently consumed substances by adolescents and young adults worldwide (United Nations Office on Drugs and Crime, 2010, World Health Organization, 2011). In Europe, the lifetime prevalence for cannabis use in young adults 15- to 34-year-olds has been estimated at 31.6%, and 6.9% of this age group have used the drug in the last month (European Monitoring Centre for Drugs and Drug Addiction, 2010). Recent decades have witnessed the emergence of a pattern of alcohol consumption in young adults called binge drinking (Cortés Tomás et al., 2007, Cortés Tomás et al., 2008, Courtney and Polich, 2009), which can be defined as frequently engaging in heavy alcohol consumption episodes (≥5 drinks on a single occasion) during the weekend. The reported prevalence of binge drinking in young adults 15- to 34-year-olds in Europe has been estimated at 30.9% (Institute of Alcohol Studies, 2007). The consequences of cannabis and alcohol use have been associated with psychopathological disorders such as psychosis, depression and anxiety (Dawson et al., 2005, de Irala et al., 2005, Hall et al., 2004, Mason et al., 2009, Wittchen et al., 2007).
Past literature suggests that variations in the risk and severity of substance use disorders (SUDs) are caused by biological, psychological and environmental factors. It has been proposed, however, that the exacerbation of cognitive, affective and behavioral dysregulation by drug use during late adolescence can induce neuroadaptive changes that contribute to the susceptibility to SUDs, particularly in high-risk individuals (Clark et al., 2008, Dawes et al., 2000, McNamee et al., 2008, Vanyukov et al., 2003a, Vanyukov et al., 2003b). Considerable evidence indicates that the psychological constructs of sensation-seeking and impulsivity, both commonly observed during adolescence (Simon et al., 1994, Spear, 2000), are risk factors for SUDs and psychopathological disorders (Chakroun et al., 2004, Clark et al., 2008, Crews and Boettiger, 2009, Kreek et al., 2005, Pedersen, 1991, Schumann et al., 2010, Tarter et al., 2006, Verdejo-García et al., 2008). Self-report studies have shown increased impulsivity and sensation-seeking personality traits in non-clinical samples of alcohol and cannabis consumers and in SUD clinical populations (Verdejo-García et al., 2008), compared to non-drug using controls (Chakroun et al., 2004, Pedersen, 1991, Simons et al., 2005, Simons et al., 2009). Additionally, studies of neurocognitive laboratory tasks have shown that drug use and abuse are related to altered performance on various impulsive behavioral measures (de Wit, 2009, Perry and Carroll, 2008, Verdejo-García et al., 2008). Impulsive choice is based on delay-discounting (choosing a small, immediate reward over a large, delayed reward). Impulsive choice is elevated in social alcohol drinkers (Vuchinich and Simpson, 1998), alcohol-dependent populations (Mitchell et al., 2005, Petry, 2001) and abstinent alcoholics (Bjork et al., 2004, Fein et al., 2004). Impulsive decision-making is based on risky decision-making (selection of the highly rewarding option despite the clear potential for negative outcomes). Impulsive decision-making, as measured by a gambling task, has previously been associated with binge drinking (Goudriaan et al., 2007), alcohol use (Verdejo-García et al., 2008) and chronic heavy cannabis use (Verdejo-Garcia et al., 2007, Whitlow et al., 2004). Another measure of impulsive decision-making is termed reduced reflection (inadequate information evaluation before making a decision), and it has been observed in abstinent alcoholics (Weijers et al., 2001) and cannabis users (Clark et al., 2009, Solowij et al., 2012). Impulsive action, in terms of response-inhibition deficit (the inability to inhibit or stop a prepotent behavior), has been observed in alcohol-dependent populations (Goudriaan et al., 2006, Kamarajan et al., 2005) and abstinent alcoholics (Bjork et al., 2004). Few studies have addressed this issue in other populations, such as binge drinkers (see Field et al., 2008). In contrast to the findings in those who use alcohol, most studies have not shown differences in cannabis users compared to drug-naïve participants (Quednow et al., 2007). However, acute cannabis administration has been observed to impair response inhibition (McDonald et al., 2003, Ramaekers et al., 2006, Ramaekers et al., 2009).
In summary, alcohol and cannabis use populations have been characterized as having impulsivity and sensation-seeking traits. The alcohol use populations have shown deficits on all three impulsive behaviors (impulsive choice, decision-making and action), while cannabis use populations have only shown clear deficits on decision-making tasks.
The present study assessed risk-associated personality traits, different forms of impulsive behavior and psychopathology co-morbidity in non-clinical samples of the two most predominant drug use patterns (recreational cannabis use and binge drinking) in a young Spanish population. The main objectives were as follows: (1) to assess sensation-seeking and impulsivity personality traits, (2) to characterize impulsive choice, decision-making and actions with different impulsivity measures and (3) to investigate the presence of psychopathological symptoms in a Spanish university population of recreational cannabis users and alcohol binge drinkers. In accordance with past literature, we hypothesized that the drug user groups would have increased levels of impulsivity and sensation-seeking traits, compared to the non-drug user group. Moreover, we hypothesized that binge drinkers, as in other alcohol populations, would show impairment in impulsive action, choice and risk decision-making tasks, while the cannabis group would only show detrimental effects in impulsive choice and decision-making. Finally, given the previous findings suggesting that sensation seeking, impulsivity traits and impulsive behaviors are frequently associated with psychopathological disorders, we hypothesized that the drug user group might also present some psychopathological symptoms, compared to the non-drug user group.
Section snippets
Participants
All participants (N = 312) were university students in the Province of Almería, Spain. For the purposes of this study, we obtained a sub-sample of 68 healthy individuals who were 18–24 years old with normal or corrected-to-normal vision and no history of psychiatric or neurological illnesses (Table 1). The sub-sample consisted of recreational cannabis users (N = 20), binge drinkers (N = 22) and non-drug users (N = 26).
Session 1: drug use, personality and psychopathological assessment
To assess the level of riskiness of alcohol and cannabis use among the study
Participant characteristics
The cannabis group scored an average of 1.65 ± 0.58 points on the CAGE cannabis test, reported current drug use of one cannabis joint per month or per week and a low frequency of alcohol consumption (Table 1). The alcohol group scored an average of 1.54 ± 0.59 points on the CAGE alcohol test and consumed more than six alcoholic drinks per episode during the weekend (Table 1). Neither the cannabis nor the alcohol groups reported the use of other illegal drugs (data not shown). Finally, the non-drug
Discussion
We found that recreational cannabis use and binge drinking were associated with increased impulsivity and sensation-seeking traits of participants, compared with participants who did not use drugs and with impulsive decision-making. Moreover, the cannabis group also exhibited deficits in inhibitory control. However, no psychopathological symptoms were observed in these populations.
In the personality questionnaires, the cannabis and alcohol groups exhibited significant elevations in impulsivity
Role of funding source
This study was funded by Convenio Universidad de Almería y Consejería de Igualdad y Bienestar Social, Junta de Andalucía, Spain (2008–2010), Grants from the Ministerio de Ciencia e Innovación (PSI2009-08626 and PSI2009-09261), Ministerio de Sanidad y Consumo from Spain (FIS, PI09-01163) and FEDER funds.
Contributors
All authors have contributed to and approved the final manuscript. Margarita Moreno participated in data collection, statistical analysis, and manuscript preparation. Jose Manuel Garcia-Montes participated in the design and data analysis of psychological assessment. MªAngeles Fernández-Estevez participated in the design, application, data collection of neurocognitive tasks and manuscript preparation. Fernando Sanchez-Santed, Laura Esteban and Valeria Edith Gutierrez-Ferre participated in study
Conflict of interest
All authors declare that they have no conflict of interest.
References (99)
- et al.
Impulsivity and history of drug dependence
Drug Alcohol Depend.
(1998) - et al.
Insensitivity to future consequences following damage to human prefrontal cortex
Cognition
(1994) - et al.
Impulsivity in abstinent alcohol-dependent patients: relation to control subjects and type 1-/type 2-like traits
Alcohol
(2004) - et al.
Substance use, affective problems and personality traits: test of two association models
Encephale
(2004) - et al.
Laboratory and psychometric measurements of impulsivity among violent and nonviolent female parolees
Biol. Psychiatry
(1999) - et al.
Reflection impulsivity in current and former substance users
Biol. Psychiatry
(2006) - et al.
Impulsivity, frontal lobes and risk for addiction
Pharmacol. Biochem. Behav.
(2009) - et al.
Developmental sources of variation in liability to adolescent substance use disorders
Drug Alcohol Depend.
(2000) - et al.
Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations
Drug Alcohol Depend.
(2005) - et al.
Acute administration of d-amphetamine decreases impulsivity in healthy volunteers
Neuropsychopharmacology
(2002)
Drug addiction endophenotypes: impulsive versus sensation-seeking personality traits
Biol. Psychiatry
What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance?
Neurosci. Biobehav. Rev.
Impaired inhibitory control of behavior in chronic cocaine users
Drug Alcohol Depend.
Neuroimaging of marijuana smokers during inhibitory processing: a pilot investigation
Brain Res. Cogn. Brain Res.
Why does schizophrenia develop at late adolescence?
Clin. Psychol. Rev.
Response inhibition and impulsivity: an fMRI study
Neuropsychologia
Alcoholism is a disinhibitory disorder: neurophysiological evidence from a Go/No-Go task
Biol. Psychol.
Risk-taking decisions in pathological gamblers is not a result of their impaired inhibition ability
Psychiatry Res.
New scales for the assessment of schizotypy
Pers. Indiv. Differ.
Performance on the IOWA card task by adolescents and adults
Neuropsychologia
Early-onset cannabis use and cognitive deficits: what is the nature of the association?
Drug Alcohol Depend.
Dimensions of impulsive behavior: personality and behavioral measures
Pers. Indiv. Differ.
Preliminary evidence of reduced cognitive inhibition in methamphetamine-dependent individuals
Psychiatry Res.
Sensation seeking and drug use among high risk latino and anglo adolescents
Pers. Indiv. Differ.
The adolescent brain and age-related behavioral manifestations
Neurosci. Biobehav. Rev.
Functional relevance of pre-supplementary motor areas for the choice to stop during Stop signal task
Neurosci. Res.
Liability to substance use disorders: 2. A measurement approach
Neurosci. Biobehav. Rev.
Liability to substance use disorders: 1. Common mechanisms and manifestations
Neurosci. Biobehav. Rev.
The differential relationship between cocaine use and marijuana use on decision-making performance over repeat testing with the Iowa Gambling Task
Drug Alcohol Depend.
Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies
Neurosci. Biobehav. Rev.
Brain glucose metabolism in chronic marijuana users at baseline and during marijuana intoxication
Psychiatry Res.
Reflection-impulsivity, personality and performance: a psychometric and validity study of the Matching Familiar Figures Test in detoxified alcoholics
Person. Individ. Diff.
A short form of the metacognitions questionnaire: properties of the MCQ-30
Behav. Res. Ther.
Long-term heavy marijuana users make costly decisions on a gambling task
Drug Alcohol Depend.
Psychometric schizotypy and attentional deficit
Psicothema
Diagnostic and Statistical Manual of Mental Disorders
Recreational drug use and impulsivity in a population of Canadian undergraduate drinkers
Front. Psychiatry
Impulsivity: cognitive, behavioral, and psychophysiological correlates
An inventory for measuring depression
Arch. Gen. Psychiatry
Opposite effects of delta-9-tetrahydrocannabinol and cannabidiol on human brain function and psychopathology
Neuropsychopharmacology
A developmental functional MRI study of prefrontal activation during performance of a Go-No-Go task
J. Cogn. Neurosci.
Response inhibition and reward response bias mediate the predictive relationships between impulsivity and sensation seeking and common and unique variance in conduct disorder and substance misuse
Alcohol. Clin. Exp. Res.
Alcohol, psychological dysregulation, and adolescent brain development
Alcohol. Clin. Exp. Res.
Disrupted ‘reflection’ impulsivity in cannabis users but not current or former ecstasy users
J. Psychopharmacol.
Adaptación castellana de la escala de evaluación conductual para la depresión de Beck
Rev. Psiquiatr. Psicol. Clín.
Características que definen el fenómeno del botellón en universitarios y adolescentes
Adicciones
Aspectos cognitivos relacionados con la práctica del botellón
Psicothema
Binge drinking in young adults: data, definitions, and determinants
Psychol. Bull.
Causal relationship between cannabis use and psychotic symptoms or depression. Should we wait and see? A public health perspective
Med. Sci. Monit.
Cited by (112)
Which came first: Cannabis use or deficits in impulse control?
2021, Progress in Neuro-Psychopharmacology and Biological PsychiatryEffects of frequent marijuana use on risky decision-making in young adult college students
2020, Addictive Behaviors ReportsGreater delay discounting and cannabis coping motives are associated with more frequent cannabis use in a large sample of adult cannabis users
2020, Drug and Alcohol DependenceCitation Excerpt :Several limitations of the literature examining associations between cannabis use, self-regulation, and emotion regulation must be addressed to better understand how these constructs relate to cannabis use. For example, most studies include relatively small samples with predominately low levels of cannabis use (Buckner et al., 2007; Kollins, 2003; Moreno et al., 2012). Small samples with lower levels of cannabis use can restrict identification and testing within empirically defined subgroups of users for which these constructs may be most influential.
The relation between ADHD symptoms, perceived stress and binge drinking in college students
2020, Psychiatry ResearchInitiation of Moderately Frequent Cannabis use in Adolescence and Young Adulthood is Associated with Declines in Verbal Learning and Memory: A Longitudinal Comparison of Pre-versus Post-Initiation Cognitive Performance
2021, Journal of the International Neuropsychological Society