Abstract
Background: Psychopathy and substance use disorders (SUDs) are both characterized by neurocognitive impairments reflecting higher levels of impulsivity such as reward-driven decision-making and deficient inhibitory control. Previous studies suggest that psychopathy may exacerbate decision-making deficits, but it may be unrelated to other neurocognitive impairments among substance dependent individuals (SDIs). The aim of the present study was to examine the role of psychopathy and its interpersonal-affective and impulsive-antisocial dimensions in moderating the relationships between dependence on different classes of drugs and neurocognitive domains of impulsivity.Method: We tested 693 participants (112 heroin mono-dependent individuals, 71 heroin polysubstance dependent individuals, 115 amphetamine mono-dependent individuals, 76 amphetamine polysubstance dependent individuals, and 319 non-substance dependent control individuals). Participants were administered the Psychopathy Checklist: Screening Version (PCL:SV) and seven neurocognitive tasks measuring impulsive choice/decision-making (Iowa Gambling Task; Cambridge Gambling Task; Kirby Delay Discounting Task; Balloon Analog Risk Task), and impulsive action/response inhibition (Go/No-Go Task, Immediate Memory Task, and Stop Signal Task).Results: A series of hierarchical multiple regressions revealed that the interpersonal-affective dimension of psychopathy moderated the association between decision-making, response inhibition and both amphetamine and heroin dependence, albeit differently. For amphetamine users, low levels of interpersonal-affective traits predicted poor decision-making on the Iowa Gambling Task and better response inhibition on the Stop Signal task. In contrast, in heroin users high interpersonal-affective psychopathy traits predicted lower risk taking on the Cambridge Gambling Task and better response inhibition on the Go/No-Go task. The impulsive-antisocial dimension of psychopathy predicted poor response inhibition in both amphetamine and heroin users.Conclusions: Our findings reveal that psychopathy and its dimensions had both common and unique effects on neurocognitive function in heroin and amphetamine dependent individuals. Our results suggest that the specific interactions between psychopathy dimensions and dependence on different classes of drugs may lead to either deficient or superior decision-making and response inhibition performance in SDIs, suggesting that psychopathy may paradoxically play a protective role for some neurocognitive functions in specific subtypes of substance users.
Highlights
Impulsivity and Substance Use DisordersImpulsivity, defined as a “predisposition toward rapid, unplanned reactions to internal or external stimuli without regards to the negative consequences of these reactions” [1] is considered a key etiological factor in current conceptualizations of substance use disorders (SUDs) [2]
Trait impulsivity is considered to be on a continuum between lower, more adaptive levels and higher, more extreme and maladaptive levels, which feature prominently in externalizing psychiatric disorders that originate in childhood and are commonly comorbid with SUDs, such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder, and antisocial personality disorder (ASPD) [12]
The aim of the current study was to examine if psychopathy and its dimensions moderate the relationships between addiction to different classes of drugs and neurocognitive domains of impulsivity in substance users in protracted abstinence
Summary
Impulsivity and Substance Use DisordersImpulsivity, defined as a “predisposition toward rapid, unplanned reactions to internal or external stimuli without regards to the negative consequences of these reactions” [1] is considered a key etiological factor in current conceptualizations of substance use disorders (SUDs) [2]. Deficits in impulse control are considered both as vulnerability factors that increase the risk of initiation and maintenance of SUDs [3, 4], as well as consequences of chronic drug use reflecting long-term neuroadaptive changes in the brain linked to specific neurocognitive impairments [5, 6]. Psychopathy and substance use disorders (SUDs) are both characterized by neurocognitive impairments reflecting higher levels of impulsivity such as reward-driven decision-making and deficient inhibitory control. Previous studies suggest that psychopathy may exacerbate decision-making deficits, but it may be unrelated to other neurocognitive impairments among substance dependent individuals (SDIs). The aim of the present study was to examine the role of psychopathy and its interpersonal-affective and impulsive-antisocial dimensions in moderating the relationships between dependence on different classes of drugs and neurocognitive domains of impulsivity
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