Role of Impulsivity, Aggression in Alcohol Dependence – A Cross Sectional Study from Vellore, India

Abstract

BACKGROUND Alcohol use disorder is one of the dangerous public health burden. The construct of impulsivity and its various dimensions in relation with aggression are relevant for understanding alcohol dependence and relapse. The goal of the study is to describe the role of impulsivity and aggression in the context of alcohol dependence. The purpose and implications of this study was to understand the human factors contributing to aggression and impulsivity and in providing advanced treatment programs. METHODS This cross-sectional study was discussed in detail and approved by the ethical committee of the Madras Medical College. The cases were selected consecutively from all the patients attending the outpatients as well as inpatient for the same after fulfilling the inclusion and exclusion criteria, within seven days of last intake of alcohol. The diagnosis was made according to International Classification of Diseases (ICD-10) criteria after ruling out psychotic disorder and other comorbid medical illnesses. Informed consent was obtained from all the patients and caregivers. Descriptive statistics used meticulously to measure the magnitude. RESULTS This study found significant positive correlation (P < 0.001) between impulsivity, aggression subtypes with alcohol dependence. Various subsets in Barrett impulsivity scale (BIS) and subsets of Buss Perry aggression scales (BPAS) had positive correlations. We found that as severity of dependence increases, impulsivity and aggression scores increases and vice versa. The comparison of means of illness variables within groups showed that there was no significant difference between groups in terms of age of onset of illness, last alcohol intake, number of hospital admissions, duration of abstinence and frequency of relapse. CONCLUSIONS This study describes the important role of behavioural model and disease model of alcoholism, 1,2 greatly stresses the inability to control the quantity and frequency of the drinking behaviour. There is higher level of connectivity between alcohol dependence with biological and behavioural indicators of impulsivity and aggression. 3 It supports that relapse is an acquired behaviour in which the individual is able to control his substance taking pattern through adequate cognitive behavioural techniques in addition to pharmacological treatment and also suggest more research needed in future to focus on causality and intervention. KEY WORDS Impulsivity, Aggression, Alcohol dependence, Relapse