Impulsivity in abstinent early- and late-onset alcoholics: differences in self-report measures and a discounting task

Aims To test the hypothesis that early-onset alcoholics (ECIAs) can be differentiated from late-onset alcoholics (LOAs) by more severe substance-related problems and higher levels of impulsivity and aggression. Design and measurements A cross-sectional patient survey with a community comparison group. The European Addiction Severity Index was used to assess substance-related problems and the Barratt Impulsiveness Scale, the Dutch version of the Zuckermann Sensation Seeking Scale and the Buss-Durkee Hostility Inventory were used to assess impulsive and aggressive traits. Impulsive decision making was assessed using a delay discounting task (DDT) with hypothetical monetary rewards. Participants and setting Participants were FCAs (n=42) and LOAs (n=46) recruited from an addiction treatment centre and an unmatched, non-substance-abusing comparison group (n=54). Findings The FOAs had higher levels of impulsive decision making than both the LOAs and the comparison group. The EOAs had higher scores than the LOAs on measures of impulsiveness, aggressiveness and the severity of substance-related problems. Conclusions This study provides evidence that FOAs are more impulsive and aggressive than LOAs. Further identification of alcoholism subtypes based on dimensions of impulsivity should be considered in the light of their relationship with pharmacological and behavioural treatment interventions.