Behavioral Undercontrol Research Articles

Relations Between Executive Functioning and Internalizing Symptoms Vary as a Function of Frontoparietal-amygdala Resting State Connectivity.

The prefrontal cortex and the frontoparietal network are associated with a variety of regulatory behaviors. Functional connections between these brain regions and the amygdala are implicated in risk for anxiety disorders. The prefrontal cortex and frontoparietal network are also linked to executive functioning, or behaviors that help orient action towards higher order goals. Where much research has been focused on deleterious effects of under-controlled behavior, a body of work suggests that over-controlled behavior may also pose a risk for internalizing problems. Indeed, while work suggests that high levels of attention shifting may still be protective against internalizing problems, there is evidence that high levels of inhibitory control may be a risk factor for socioemotional difficulties. In the ABCD sample, which offers large sample sizes as well as sociodemographic diversity, we test the interaction between frontoparietal network-amygdala resting state functional connectivity and executive functioning behaviors on longitudinal changes in internalizing symptoms from approximately 10 to 12years of age. We found that higher proficiency in attention shifting indeed predicts fewer internalizing behaviors over time. In addition, higher proficiency in inhibitory control predicts fewer internalizing symptoms over time, but only for children showing resting state connectivity moderately above the sample average between the frontoparietal network and amygdala. This finding supports the idea that top-down control may not be adaptive for all children, and relations between executive functioning and anxiety risk may vary as a function of trait-level regulation.

Personality and peer groups in adolescence: Reciprocal associations and shared genetic and environmental influences.

Peer groups represent a critical developmental context in adolescence, and there are many well-documented associations between personality and peer behavior at this age. However, the precise nature and direction of these associations are difficult to determine as youth both select into, and are influenced by, their peers. We thus examined the phenotypic, genetic, and environmental links between antisocial and prosocial peer characteristics and several personality traits from middle childhood to late adolescence (ages 11, 14, and 17 years) in a longitudinal twin sample (N = 3762) using teacher ratings of personality and self-reports of peer characteristics. Less adaptive trait profiles (i.e., high negative emotionality, low conscientiousness, and low agreeableness) were associated with more antisocial and fewer prosocial peer characteristics across time. Associations between personality traits related to emotionality (negative emotionality and extraversion) and peer behavior were largely attributable to shared genetic influences, while associations between personality traits related to behavioral control (conscientiousness and agreeableness) and peer behavior were due to overlapping genetic and shared environmental influences. Overall, results suggest a set of environmental presses that push youth toward both behavioral undercontrol and antisocial peer affiliations, making the identification of such influences and their relative importance a critical avenue of future work.

Multidimensional Impulsive Personality Traits Mediate the Effect of Parent Substance Use Disorder on Adolescent Alcohol and Cannabis Use.

Theory suggests that behavioral undercontrol mediates the effect of parental substance disorder on offspring substance use, but no studies have tested multidimensional impulsive personality traits as mechanisms of risk. Adolescents (N = 392; 48% female) from a multigenerational study of familial alcohol disorder self-reported impulsive personality traits via the UPPS-P (Mage = 16.09; Range = 13-19) and alcohol/cannabis frequency one year later. The UPPS-P assesses negative and positive urgency (i.e., rash action in a negative or positive mood state), lack of premeditation (i.e., lack of planning/forethought), lack of perseverance (i.e., inability to finish tedious/boring tasks), and sensation seeking (i.e., thrill seeking/risk taking). Parent substance disorder was assessed via diagnostic interviews. Two-part hurdle models tested predictors of any substance use (i.e., binary part) and frequency of use (i.e., continuous part). Parent substance disorder was indirectly associated with any alcohol/cannabis use (binary part) and higher cannabis frequency (continuous part) through negative urgency. Parental substance disorder was associated with higher alcohol frequency through a lack of premeditation. Sensation seeking was associated with any alcohol/cannabis use but unrelated to parental substance disorder. Despite indirect effects, strong effects of parental substance disorder on substance use remained. The findings are discussed in terms of theory and public health implications.

Error-related brain activity as a transdiagnostic endophenotype for obsessive-compulsive disorder, anxiety and substance use disorder.

Increased neural error-signals have been observed in obsessive-compulsive disorder (OCD), anxiety disorders, and inconsistently in depression. Reduced neural error-signals have been observed in substance use disorders (SUD). Thus, alterations in error-monitoring are proposed as a transdiagnostic endophenotype. To strengthen this notion, data from unaffected individuals with a family history for the respective disorders are needed. The error-related negativity (ERN) as a neural indicator of error-monitoring was measured during a flanker task from 117 OCD patients, 50 unaffected first-degree relatives of OCD patients, and 130 healthy comparison participants. Family history information indicated, that 76 healthy controls were free of a family history for psychopathology, whereas the remaining had first-degree relatives with depression (n = 28), anxiety (n = 27), and/or SUD (n = 27). Increased ERN amplitudes were found in OCD patients and unaffected first-degree relatives of OCD patients. In addition, unaffected first-degree relatives of individuals with anxiety disorders were also characterized by increased ERN amplitudes, whereas relatives of individuals with SUD showed reduced amplitudes. Alterations in neural error-signals in unaffected first-degree relatives with a family history of OCD, anxiety, or SUD support the utility of the ERN as a transdiagnostic endophenotype. Reduced neural error-signals may indicate vulnerability for under-controlled behavior and risk for substance use, whereas a harm- or error-avoidant response style and vulnerability for OCD and anxiety appears to be associated with increased ERN. This adds to findings suggesting a common neurobiological substrate across psychiatric disorders involving the anterior cingulate cortex and deficits in cognitive control.

The early biopsychosocial development of boys and the origins of violence in males.

We apply a biopsychosocial approach to introduce early-in-life experiences that explain a significant part of the male preponderance in the perpetration of violence. Early caregiver abuse and neglect, father absence, and exposure to family and neighborhood violence exacerbate boys' greater risk for aggressive behavior and increase the probability of carrying out violent acts later in life. We examine the development of the psychological self and explore conditions that encourage physical aggression, focusing on the impact on the infant and toddler's emergent mental representation of self, others, and self-other relationships. Boys' slower developmental timetable in the first years of life may enhance their vulnerability for disorganization in emergent neurobiological networks mediating organization of socioemotional relationships. Emergent attachment and activation relationship systems may differentially affect risk and resilience in boys and girls, particularly in single-parent families. Evidence has suggested that the dramatic increase in single-parent families is especially linked to corresponding increases in behavioral undercontrol, antisocial behavior, and the emergence of violence in boys.

Very early drinking: Event history models predicting alcohol use initiation from age 4 to 11 years

While it is not normative to initiate alcohol use prior to adolescence, substantial numbers of children do so. However, relatively little is known about the prevalence or predictors of alcohol initiation in childhood, compared to extensive research on adolescent initiation and alcohol use. The present study examines patterns and predictors of very early drinking initiation in childhood, focusing on child behavioral undercontrol and parent alcohol and drug use as time-varying risk factors across childhood, independent of sociodemographic background variables. Event history analyses model and predict the age of alcohol initiation across ages 4 to 11 in the ongoing Millennium Cohort Study. Methodological strengths include the prospective design initiated in infancy (prior to any alcohol consumption), multiple reporters, and large representative sample of children and parents (n = 11,355). Key predictors are child behavioral undercontrol and parent alcohol and drug use assessed across childhood. Weighted results show that <2% of children had their first drink of alcohol prior to their 8th birthday, rising to 13% by age 10–11 years. Odds of initiation are higher when parents rated children as behaviorally undercontrolled and when at least one parent in the household reported drinking alcohol and/or using illegal drugs, independent of sociodemographic group differences. Thus, an important minority initiated drinking during childhood, and there are key risk factors for early drinking. Increased focus on the epidemiology, etiology, and prevention of childhood drinking is needed.

Methylation of the glucocorticoid receptor gene, nuclear receptor subfamily 3, group C, member 1 (NR3C1), in maltreated and nonmaltreated children: Associations with behavioral undercontrol, emotional lability/negativity, and externalizing and internalizing symptoms.

The present study examined the effect of various dimensions of child maltreatment (i.e., developmental timing of maltreatment, number of maltreatment subtypes, and chronicity of maltreatment) on methylation of the glucocorticoid receptor gene, nuclear receptor subfamily 3, group C, member 1 (NR3C1), and investigated the associations between NR3C1 methylation and child outcomes. Participants included 534 children who attended a research summer camp program for school-aged maltreated (53.4%) and nonmaltreated (46.6%) children from low socioeconomic backgrounds. Results show that children with early onset maltreatment evidence significant hypermethylation compared to nonmaltreated children. Moreover, more maltreatment subtypes experienced and more chronic maltreatment are both related to greater NR3C1 hypermethylation. Findings also indicate that hypermethylation of NR3C1 is linked with a number of negative child outcomes including greater emotional lability-negativity, higher levels of ego undercontrol, more externalizing behavior, and greater depressive symptoms. Together, results highlight the role of methylation of NR3C1 in the effects of child maltreatment on the development of emotion dysregulation and psychopathology.

Affiliation with substance-using peers: Examining gene-environment correlations among parent monitoring, polygenic risk, and children's impulsivity.

Parental monitoring can buffer the effect of deviant peers on adolescents' substance use by reducing affiliation with substance-using peers. However, children's genetic predispositions may evoke poorer monitoring, contributing to negative child outcomes. We examined evocative genotype-environment correlations underlying children's genetic predisposition for behavioral undercontrol and parental monitoring in early adolescence via children's impulsivity in middle childhood, and the influence of parental monitoring on affiliation with substance-using peers a year and a half later (n = 359). Genetic predisposition for behavioral undercontrol was captured using a polygenic risk score, and a portion of passive rGE was controlled by including parents' polygenic risk scores. Children's polygenic risk predicted poorer parental monitoring via greater children's impulsivity, indicating evocative rGE, controlling for a portion of passive rGE. Poorer parental monitoring predicted greater children's affiliation with substance-using peers a year and a half later. Results are discussed with respect to gene-environment correlations within developmental cascades.

Predicting substance use in emerging adulthood: A genetically informed study of developmental transactions between impulsivity and family conflict.

Deviance proneness models propose a multilevel interplay in which transactions among genetic, individual, and family risk factors place children at increased risk for substance use. We examined bidirectional transactions between impulsivity and family conflict from middle childhood to adolescence and their contributions to substance use in adolescence and emerging adulthood (n = 380). Moreover, we examined children's, mothers', and fathers' polygenic risk scores for behavioral undercontrol, and mothers' and fathers' interparental conflict and substance disorder diagnoses as predictors of these transactions. The results support a developmental cascade model in which children's polygenic risk scores predicted greater impulsivity in middle childhood. Impulsivity in middle childhood predicted greater family conflict in late childhood, which in turn predicted greater impulsivity in late adolescence. Adolescent impulsivity subsequently predicted greater substance use in emerging adulthood. Results are discussed with respect to evocative genotype-environment correlations within developmental cascades and applications to prevention efforts.

Predicting problematic alcohol use with the DSM-5 alternative model of personality pathology.

High comorbidity between personality disorders and alcohol use disorders appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. However, very little is known about how the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5) Section III trait model of personality pathology relates to alcohol problems or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test (AUDIT) to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Furthermore, 2 of the 5 higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these 2 specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. (PsycINFO Database Record

Developmental pathways from prenatal tobacco and stress exposure to behavioral disinhibition

Prenatal tobacco exposure (PTE) and prenatal stress exposure (PSE) both have been linked to externalizing behavior, although their effects generally have been considered in isolation. Here, we aimed to characterize the joint or interactive roles of PTE and PSE in early developmental pathways to behavioral disinhibition, a profile of cognitive and behavioral under-control that presages severe externalizing behavior. As part of a prospective, longitudinal study, 296 children were assessed at a mean age of 5years. Exposures were assessed via repeated interviews across the prenatal period and bioassays of cotinine were obtained. Behavioral disinhibition was assessed using temperament measures in infancy, performance-based executive control tasks and measures of disruptive and inattentive behavior. PSE was associated with a higher probability of difficult temperament in infancy. Each exposure independently predicted poorer executive control at age 5years. Difficult temperament and executive control difficulties in turn predicted elevated levels of disruptive behavior, although links from PTE and PSE to parent-reported attention problems were less robust. Children who experienced these prenatal exposures in conjunction with higher postnatal stress exposure showed the lowest executive control and highest levels of disruptive behavior. Findings highlight the compounding adverse impact of PTE and PSE on children's behavioral trajectories. Given their high concordance, prenatal health campaigns should target these exposures in tandem.

Using presurgical psychological testing to predict 1-year appointment adherence and weight loss in bariatric surgery patients: predictive validity and methodological considerations

BackgroundPrevious studies suggest that presurgical psychopathology accounts for some of the variance in suboptimal weight loss outcomes among Roux-en-Y gastric bypass (RYGB) patients, but research has been equivocal. ObjectivesThe present study seeks to extend the past literature by examining associations between presurgical scale scores on the broadband Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and suboptimal weight loss and poor adherence to follow-up 1 year postoperatively after accounting for several methodologic considerations. SettingCleveland Clinic Bariatric and Metabolic Institute, Cleveland, Ohio, USA. MethodsThe sample consisted of 498 RYGB patients, who produced a valid presurgical MMPI-2-RF protocol at program intake. The sample was primarily female (72.9%), Caucasian (64.9%), and middle-aged (mean = 46.4 years old; standard deviation [SD] = 11.6). The mean presurgical body mass index (BMI) was 47.4 kg/m2 (SD = 8.2) and mean percent weight loss (%WL) at 1 year postoperatively was 31.18 %WL (SD = 8.44). ResultsAs expected, scales from the Behavioral/Externalizing Dysfunction (BXD) domain of the MMPI-2-RF were associated with worse weight loss outcomes and poor adherence to follow-up, particularly after accounting for range restriction due to underreporting. Individuals producing elevated scores on these scales were at greater risk for achieving suboptimal weight loss (<50% excess weight loss) and not following up with their appointment compared with those who scored below cut-offs. ConclusionsPatients who are more likely to engage in undercontrolled behavior (e.g., poor impulse control), as indicated by presurgical MMPI-2-RF findings, are at greater risk for suboptimal weight loss and poor adherence to follow-up following RYGB. Objective psychological assessments should also be conducted postoperatively to ensure that intervention is administered in a timely manner. Future research in the area of presurgical psychological screening should consider the impact of underreporting and other discussed methodologic issues in predictive analyses.

Risk factors for alcoholism in the Oklahoma Family Health Patterns project: Impact of early life adversity and family history on affect regulation and personality

AimThis study examined the impact of early lifetime adversity (ELA) on affect regulation and personality in persons with family history (FH+) and without (FH−) a family history of alcoholism. We examined the impact of early life adversity in healthy young adults, 18–30 years of age enrolled in a long-term study on risk for alcohol and other substance abuse. MethodsELA was assessed by a composite score of low socioeconomic status and personal experience of physical or sexual abuse and/or separation from parents before age 16, resulting in a score of 0, 1–2, or >3 adverse events. Unstable affect regulation and personality variables were obtained via self-report measures. ResultsHigher ELA scores were seen in FH+ (χ2=109.2, p<0.0001) and in women (χ2=17.82, p=0.0019). Although higher ELA predicted less emotional stability and more behavioral undercontrol, further analysis including both FH and ELA showed that FH+ persons are prone to poor affect regulation, negative moods, and have risky drinking and drug abuse tendencies independent of ELA level. ELA predicts reduced stress reactivity and poorer cognitive control over impulsive behaviors as shown elsewhere. ConclusionsThe present work shows that FH+ have poor mood regulation and antisocial characteristics. The greater prevalence of ELA in FH+ persons indicates that life experience and FH+ work in tandem to result in risky patterns of alcohol and drug experimentation to elevate risk for alcoholism. Further studies of genetic and environmental contributions to alcoholism are called for.

Left middle frontal gyrus response to inhibitory errors in children prospectively predicts early problem substance use

BackgroundA core vulnerability trait for substance use disorder (SUD) is behavioral disinhibition. Error processing is a central aspect of inhibitory control that determines adaptive adjustment of performance; yet it is a largely overlooked aspect of disinhibition as it relates to risk for SUD. We investigated whether differences in brain activation during both successful and failed inhibition predicts early problem substance use. MethodForty-five 9–12 year olds underwent a functional MRI scan during a go/no-go task. They were then followed over approximately 4 years, completing assessments of substance use. Externalizing behavior was measured at ages 3–8, 9–12 and 11–13. Participants with drug use or problem alcohol use by ages 13–16 (n=13; problem-user group) were individually matched by gender, age, and family history of alcoholism with non-substance-using children (n=13; non-user group). The remaining 19 participants provided an independent sample from which to generate unbiased regions-of-interest for hypothesis testing in the problem-user and non-user groups. ResultsNo differences were observed between groups in activation during correct inhibition compared with baseline. A significant difference arose in left middle frontal gyrus (LMFG) activation during failed inhibition compared with correct inhibition, with the problem-user group demonstrating blunted activation. The problem-user group also had more externalizing problems at ages 11–13. Logistic regression found that activation of LMFG significantly predicted group membership over and above externalizing problems. ConclusionsBlunted LMFG activation during performance errors may underlie problems adapting behavior appropriately, leading to undercontrolled behavior, early problem substance use and increased risk for SUD.

Give me just a little more time: Effects of alcohol on the failure and recovery of cognitive control.

Numerous externalizing behaviors, from aggression to risk taking to drug abuse, stem from impaired cognitive control, including that brought about by the acute effects of alcohol. Although research generally indicates that alcohol impairs cognitive abilities, a close examination of the literature suggests that alcohol's effects are quite variable and likely depend on a number of contextual factors. The purpose of the current study was to characterize the effects of alcohol on cognitive control in terms of neural and behavioral responses to successful and unsuccessful control attempts. Participants were randomly assigned to consume an alcohol (0.80 g/kg ETOH), placebo, or nonalcoholic control beverage prior to completing a cognitive control (flanker) task while event-related brain potentials were recorded. Alcohol reduced the amplitude of the error-related negativity on error trials and increased the posterror compatibility effect in response time. Of particular interest, neural indices of conflict monitoring and performance adjustment (frontal slow wave) were attenuated by alcohol, but only on trials following errors. These functions had recovered, however, by 2 trials after an error. These findings suggest that alcohol's effects on cognitive control are best characterized as impaired (or delayed) recovery following control failures. Implications of these findings for understanding alcohol's effects on behavioral undercontrol are discussed.

Influence of Sensation Seeking on Response to Alcohol Versus Placebo: Implications for the Acquired Preparedness Model

Previous research has identified several aspects of behavioral undercontrol that are associated with heavy drinking and problems. Further, research on the acquired preparedness model (Smith and Anderson, 2001) has identified biased learning as a potential mechanism of these effects. Traits like sensation seeking have been linked to stronger positive and weaker negative expectancies, which, in turn, contribute to increased risk for heavy drinking and problems. Although expectancies are thought to represent potentially biased expectations about drinking outcomes, they may also reflect individual differences in alcohol response. The present study examined the strength of associations between sensation seeking and both expectancies (response to placebo) and subjective response under alcohol. Using a between-subjects design, young adult social drinkers (N = 236) were randomly assigned to receive alcohol (target breath alcohol concentration of .08%) or placebo, after which they reported on subjective experiences of stimulation and sedation. Sensation seeking was significantly related to stimulant response, and the strength of this association did not differ by beverage condition (alcohol vs. placebo). The findings argue against a pharmacological explanation for results of prior studies of the acquired preparedness model and support a biased learning interpretation of relations between sensation seeking and positive expectancies. Results also extend the findings on the acquired preparedness model to an implicit measure of positive alcohol expectancies (subjective response to placebo). Future studies using additional measures of implicit expectancies (e.g., Implicit Association Test) would be helpful in determining the relative strength of implicit and explicit expectancies as mediators within the acquired preparedness model.

Cigarette Smoking Initiation During College Predicts Future Alcohol Involvement: A Matched-Samples Study

Little is known about the relationship between cigarette smoking initiation and subsequent alcohol involvement. To address this question, the present study compared alcohol use between students who initiated smoking during college and a matched sample of never-smoking students. We hypothesized greater increases in alcohol involvement among smoking initiators, mediated by exposure to cigarette use situations. Included in the present study were 104 Chinese American and Korean American undergraduates who at baseline (freshman year) reported never having smoked a cigarette. Subjects were drawn from 433 participants in a naturalistic longitudinal study of tobacco use who were assessed annually each year in college. Cigarette smoking status was assessed annually as part of a structured interview. Initiators and never-smokers were matched on gender, ethnicity, baseline alcohol use, parental smoking status, and behavioral undercontrol. As predicted, participants who initiated smoking during college reported significantly greater increases in the number of past-30-day total drinks consumed (p < .001) and reported greater prevalence of heavy drinking episodes (p < .05). The effect of smoking initiation on the change in the number of past-30-day drinks at the final assessment was partially mediated by exposure to smoking (p < .05). Exploratory analyses indicated that greater recent smoking significantly predicted increased alcohol consumption over and above the effect of exposure. Students who initiate smoking during college appear at risk for increased alcohol involvement. Part of this risk is explained by environmental contextual factors, specifically exposure to situations involving other smokers that also may result in greater exposure to alcohol use.

Gender-specific gene-environment interaction in alcohol dependence: the impact of daily life events and GABRA2.

Gender-moderated gene-environment interactions are rarely explored, raising concerns about inaccurate specification of etiological models and inferential errors. The current study examined the influence of gender, negative and positive daily life events, and GABRA2 genotype (SNP rs279871) on alcohol dependence, testing two- and three-way interactions between these variables using multi-level regression models fit to data from 2,281 White participants in the Collaborative Study on the Genetics of Alcoholism. Significant direct effects of variables of interest were identified, as well as gender-specific moderation of genetic risk on this SNP by social experiences. Higher levels of positive life events were protective for men with the high-risk genotype, but not among men with the low-risk genotype or women, regardless of genotype. Our findings support the disinhibition theory of alcohol dependence, suggesting that gender differences in social norms, constraints and opportunities, and behavioral undercontrol may explain men and women's distinct patterns of association.

Roles of family cohesiveness, marital adjustment, and child temperament in predicting child behavior with mothers and fathers

The current study explored how family characteristics (i.e., family cohesiveness and marital adjustment) and child characteristics (i.e., temperament) assessed when the child was 13 months old predicted child behavior with mothers and fathers at 36 months. Mother–father–child interaction was observed to assess family cohesiveness at 13 months. Mothers and fathers also completed questionnaires assessing their perceptions of marital adjustment and their child’s temperament at 13 months. Based on dyadic parent–child interactions at 36 months, under-controlled behavior and positive engagement were examined as outcome variables. Results indicated that observed family cohesiveness predicted positive engagement with both parents. Moreover, in families with high cohesiveness at 13 months, child behavior was significantly consistent across mother–child and father–child interactions, whereas in families with low cohesiveness, consistency of child behavior was not observed. Results also revealed that fathers’ perceptions of marital adjustment directly predicted child behavior with fathers, while the combination of low family cohesiveness/low marital adjustment and difficult temperament predicted child behavior with mothers.

Characteristics of Alcoholic Smokers, Nonsmokers, and Former Smokers: Personality, Negative Affect, Alcohol Involvement, and Treatment Participation

Previous research has indicated that smoking behavior in the general population is linked to personality traits such as behavioral undercontrol and negative emotionality, but it is unknown whether these traits pertain to alcoholic smokers. Further, prior research has not established whether alcoholic smokers differ from their nonsmoking counterparts in terms of alcohol involvement severity and treatment participation. Exploration of these associations is important, given the high prevalence of cigarette smoking among alcoholics. Treatment-seeking alcoholics were categorized into daily cigarette smokers (n = 76), nonsmokers (n = 34), and former smokers (n = 33). These groups were compared on personality traits, negative affect, alcohol involvement, and alcohol outpatient treatment participation. All three groups scored similarly on a variety of personality traits (e.g., extraversion and neuroticism), and on most aspects of negative affect, with the exception of anxiety (smokers scored higher than nonsmokers and former smokers). In terms of alcohol involvement, alcoholic smokers reported greater negative drinking consequences and alcohol physical dependence relative to former smokers, even considering that alcoholic smokers had relatively more abstinent days. Finally, alcoholic smokers attended considerably fewer alcohol outpatient treatment sessions relative to both nonsmokers and former smokers. Common risk factors for both alcoholism and smoking behavior, such as personality traits and negative affect, may obscure personality differences between smokers and nonsmokers in an alcohol treatment sample. Furthermore, findings suggest that current nicotine use among alcoholics is associated with greater anxiety and severity of alcoholism than among their former-smoking counterparts.