Decision-making and impulsivity in patients with alcohol dependence syndrome with comorbid attention deficit hyperactivity disorder

ABSTRACT

Objective

The purpose of the study was to examine decision-making and impulsivity in patients with alcohol dependence with or without comorbid attention deficit hyperactivity disorder (ADHD) compared to controls.

Methods

In this cross-sectional study, 28 patients with alcohol dependence syndrome (ADS) only, 30 with ADS with ADHD, and 28 healthy controls were recruited. All the participants were evaluated on Iowa Gambling Task, Balloon Analogue Risk Task, and Barrett Impulsivity Scale to assess decision-making, risk-taking, and impulsivity respectively.

Results

Repeated measure ANOVA indicated that both ADS only and ADS with ADHD groups had poorer decision-making as compared to healthy controls, with small effect sizes. One-way ANOVA showed a significant difference in the maladaptive risk-taking across ADS only, ADS with ADHD and healthy control groups. Similarly, there were significant differences in attention impulsivity and motor impulsivity between the groups. No relationship was found between decision-making and impulsivity.

Conclusions

Alcohol dependent patients had impaired decision-making and impulsivity irrespective of comorbid ADHD. Thus, risk-taking and decision-making may be cognitive markers of alcohol dependence syndrome itself.

KEY POINTS

What is already known about this topic:

(1) Cognitive impairment in ADS is related to executive functioning, such as decision-making.

(2) Impulsivity, as a trait, has also been shown to have an underlying role in alcohol dependence, as well as in ADHD.

(3) ADS with ADHD have an early onset of alcohol abuse as they are more likely to experiment freely with substance abuse.

What this article adds:

(1) There was a significant difference in decision-making and impulsivity across the groups i.e., ADS only, ADS with ADHD and healthy controls.

(2) No significant difference was found in decision making, impulsivity, and risk-taking between ADS patients with and without ADHD. However, ADS with ADHD group performed poorer compared to the other groups.

(3) No association in decision making, impulsivity and risk-taking was found in ADS patients.

KEYWORDS:

• Alcohol dependence
• ADHD
• decision-making
• risk-taking
• impulsivity

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.