Momentary fluctuations in impulsivity domains: Associations with a history of childhood ADHD, heavy alcohol use, and alcohol problems

Abstract

BackgroundThe current study examined if fluctuation in in-the-moment impulsivity was more pronounced for adults with, versus without, a childhood history of ADHD and if ADHD group moderated the association between fluctuation in impulsivity and alcohol use behaviors. MethodsTwo hundred and eleven adult drinkers (52% ADHD) completed a 10-day, 6 times/day, momentary assessment of state impulsivity. Self-reported trait impulsivity, alcohol problems, and frequency of 5+ drinks in the past 12 months were also assessed. ResultsThe ADHD group had more variability in three domains of state impulsivity (negative urgency, positive urgency, sensation seeking) compared to the nonADHD group. After including global trait impulsivity, the ADHD and nonADHD groups only differed on state sensation seeking. Fluctuation in two domains of state impulsivity were related to frequency of 5+ drinks (lack of planning: ADHD RR = 3.60, p < 0.001, nonADHD RR=0.90, p = 0.81; negative urgency: ADHD RR=4.32, p = 0.01, nonADHD RR=0.49, p = 0.24) and number of different alcohol problems (lack of planning: ADHD RR=4.87, p < 0.001, nonADHD RR=0.58, p = 0.29; negative urgency: ADHD RR=4.96, p = 0.01, nonADHD RR=0.24, p = 0.04) for participants with a history of ADHD but were not related (or related to fewer problems) for those without childhood ADHD. Higher variability in positive urgency was related to more alcohol problems for the participants with childhood ADHD but not the nonADHD participants (ADHD RR=3.00, p = 0.03, nonADHD RR=0.50, p = 0.25). ConclusionsFindings highlight the importance of assessing fluctuation in several domains of impulsivity and may elucidate important treatment targets for alcohol problems for adults with ADHD histories.