A sense of urgency: Trait impulsivity in co‐occurring bipolar and alcohol use disorder

Abstract

AbstractBackgroundBipolar disorder (BD) and alcohol use disorder (AUD) often co‐occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., “urgency,” measured by the UPPS‐P), however, remain underexplored in this population and could have distinct associations with clinical correlates.MethodsThis cross‐sectional study used a two‐by‐two (BDxAD) factorial design, including groups with BD + AD (n = 28), BD (n = 29), AD (n = 28), and healthy controls (HC) (n = 27), to identify between‐group differences among the five subscales of the UPPS‐P. Associations of UPPS‐P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined.ResultsBD + AD had the highest scores for every UPPS‐P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS‐11 total scores were most correlated with the urgency subscales of the UPPS‐P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS‐11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale.LimitationsCross sectional design and predominantly white sample.ConclusionsUnlike the BIS‐11, UPPS‐P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co‐occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS‐P should be utilized in future studies and clinical settings measuring trait impulsivity in this population.