Disinhibitory psychopathology and delay discounting in alcohol dependence: personality and cognitive correlates

Abstract

Increased discounting of delayed rewards may reflect a decision bias that contributes to excessive use of alcohol and more generally, to an impulsive, disinhibitory predisposition that is characterized by a preference for immediate over long-term rewards. The current study examined the association between delay discounting of rewards and the covariation among several types of disinhibitory problems that are often comorbid with alcohol dependence (AD). Lifetime problems with alcohol, marijuana, other drugs, childhood conduct disorder, and adult antisocial behavior were assessed in a sample of 426 young adults, 257 of whom had a lifetime diagnosis of AD. Higher delay discounting rates were associated with the covariation among all domains of disinhibitory problems and were not uniquely associated with any one domain. Higher delay discounting rates also were associated with lower intelligence, lower working memory capacity, and higher trait impulsivity. The results suggest that increased delay discounting of rewards may reflect aspects of a general vulnerability to externalizing, disinhibitory disorders.

Figures 1a and 1b

Blom-transformed lifetime problem counts by diagnostic group for alcohol problems in the top panel (1a) and an aggregate measure of childhood conduct disorder (CCD) plus adult antisocial behavior (AAB) problems in the bottom panel (1b). The bars on the left represent number of participants in each diagnostic group, while the bars below are frequencies of problem counts in the entire sample.

Figure 2

Log₁₀ transformed discounting rate k by diagnostic group. The error bars represent a 95% confidence interval for the group mean, and the dashed line represents the grand mean.

Figure 3

Median points of indifference and predicted discounting curves for men and women.

Figure 4

SEM of the association between disinhibitory disorders (DD) and log₁₀ transformed discounting rate k. Alc, mar, and drg are lifetime problems with alcohol, marijuana, and drug use, and ccd and aab are lifetime childhood conduct and adult antisocial behavior problems.

Figure 5

SEM of the association among measures of harm avoidance, impulsivity, working memory capacity, and general intelligence (Shipley IQ scores), and delay discounting rate, log₁₀(k). ** p < .01; *** p < .001.