Dimensions of trait and task-based impulsivity associated with alcohol use disorder and history of suicidality

Impulsivity underlies both alcohol misuse and suicidal behavior, but limited research has examined whether impulsivity dimensions vary by problematic drinking and history of suicidality. The objective of this study was to examine differences in trait and task-based impulsivity dimensions based on clinical assessment of alcohol use disorder (AUD), suicidal ideation (SI), and suicidal attempt (SA).

1250 participants from the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol were categorized into 5 groups: neither suicidality nor AUD ("neither"; 49.1 %), suicidality without AUD ("SI-SA Only"; 3.0 %), AUD without suicidality ("AUD Only"; 30.5 %), AUD with SI ("AUD-SI"; 12.1 %), and AUD with SA ("AUD-SA"; 5.2 %). We measured impulsivity using the UPPS-P Impulsive Behavior Scale, the Barratt Impulsiveness Scale (BIS), and the delay discounting task. Linear regression models were conducted.

Compared with the Neither group, negative urgency, lack of premeditation, lack of perseverance, positive urgency, and all BIS subscales (attentional, motor, and non-planning) were consistently higher among individuals with AUD only (Hedges's g ranged 0.56-1.13), and the scores were even higher among those who also endorsed history of SI (Hedges's g ranged 0.90-1.83) or SA (Hedges's g ranged 1.14-2.16). These findings were robust against adjustment for covariates. Mean score on the delay discounting task was highest in the AUD-SA group, but group differences were not statistically significant after adjusting for covariates.

Individuals with both current AUD and suicide attempt history scored the highest across multiple dimensions of trait impulsivity. Findings underscore the importance of suicide assessment and prevention in the context of AUD treatment.