The value of impulsivity to define subgroups of addicted individuals differing in personality dysfunction, craving, psychosocial adjustment and wellbeing: A latent class analysis

Abstract

Background: High impulsivity is trans-diagnostically associated with several addiction-related disorders including pathological gambling, substance dependence and personality disorders. Here we applied latent class analysis to test the value of impulsivity indices to identify subgroups of addicted individuals that may entail different diagnostic compositions and differ in addiction-related outcomes. Methods: A sample diagnosed with cocaine dependence (with and without personality disorders from Cluster B and Cluster C) and pathological gamblers were recruited. We applied latent class analyses to the scores of participants on the UPPS-P impulsive behavior scale consisting on five impulsivity personality pathways (Sensation Seeking, Lack of Perseverance, Lack of Premeditation, Negative Urgency, and Positive Urgency) to measure trait impulsivity, and the Stroop Color-Word Interference Test and d2 Cancellation Test to measure cognitive impulsivity. The resulting Classes were compared in terms of diagnostic composition, estimates of substance use behavior and personality dysfunction, and addiction-related outcomes: craving, psychosocial adjustment and quality of life. Results: In accordance with impulsivity scores, the three groups of addicted individuals are best represented as two separate classes: Class 1 scored significantly higher than Class 2 in trait impulsivity measures, and performed worse than Class 2 in cognitive impulsivity tests. Class 1 was composed of significantly more cocaine users with comorbid personality disorders, whereas Class 2 was composed of significantly more pathological gamblers. As for outcome variables, individuals classified in Class 1 had higher levels of personality dysfunction and craving, and poorer psychosocial adjustment and quality of life. Conclusion: Our results support the value of impulsivity measures to identify clinically meaningful subgroups of addicted individuals that differ in diagnostic composition, dimensional estimates of personality pathology, and addiction-related outcomes.