Impulsivity differences in recreational cannabis users and binge drinkers in a university population

https://doi.org/10.1016/j.drugalcdep.2012.02.011Get rights and content

Abstract

Background

Recreational cannabis use and alcohol binge drinking are the most common drug consumption patterns in young adults. Impulsivity and several psychopathological signs are increased in chronic drug users, but the implications of recreational use are still poorly understood.

Methods

We evaluated impulsivity, sensation-seeking traits, impulsive decision-making, inhibitory control and possible symptoms of depression, anxiety and psychosis in three groups of young university adults: recreational cannabis users (N = 20), alcohol binge drinkers (N = 22) and non-drug users (N = 26).

Results

The cannabis and binge drinking groups had increased scores for impulsivity and sensation-seeking traits. Both groups also exhibited increased impulsive decision-making on the two-choice task and the Iowa Gambling task; however, only the cannabis group was significantly different from the non-drug group regarding inhibitory control (Go/No-Go and Stop tasks). The cannabis and binge drinking groups did not show differences in the psychopathological symptoms evaluated.

Conclusions

Our observations of this population of non-dependent drug users are consistent with the increased impulsivity traits and behaviors that have been described previously in chronic drug abusers. In this study, compared to no drug use, the recreational use of cannabis was associated with a major dysfunction of the different facets of impulsive behaviors. However, alcohol binge drinking was related only to impulsive decision-making. These results suggest that impulsivity traits and behaviors are present not only in chronic drug abusers but also in recreational drug users. Future work should continue to investigate the long-term effects of these common consumption patterns on various impulsive behaviors and psychopathological symptoms.

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.

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