The Relationship of Urgency to Impulsive Decision-Making During Heightened Affective States in Problem Drinkers A dissertation presented to the faculty of the College of Arts and Sciences of Ohio University In partial fulfillment of the requirements for the degree Doctor of Philosophy Brittni V. Morgan August 2018 © 2018 Brittni V. Morgan. All Rights Reserved. 2 This dissertation titled The Relationship of Urgency to Impulsive Decision-Making During Heightened Affective States in Problem Drinkers by BRITTNI V. MORGAN has been approved for the Department of Psychology and the College of Arts and Sciences by Julie A. Suhr Professor of Psychology Joseph Shields Interim Dean, College of Arts and Sciences 3 Abstract MORGAN, BRITTNI V., Ph.D., August 2018, Psychology The Relationship of Urgency to Impulsive Decision-Making During Heightened Affective States in Problem Drinkers Director of Dissertation: Julie A. Suhr Problematic alcohol use remains a significant public health concern among college student populations. Individual differences in the personality traits of neuroticism and impulsivity, particularly its urgency facets, have been found to place some individuals at greater risk for problematic alcohol use. Both positive and negative urgency have been shown to strongly relate to and predict problematic alcohol use outcomes across various populations, including college students. Notably, the vast majority of urgency studies have used only self-report measures, have not controlled for neuroticism, and have not measured actual engagement in impulsive or risky behaviors on behavioral measures of impulsivity such as the Iowa Gambling Task (IGT). Impaired performance on the IGT has been demonstrated in substance users, at-risk groups, and individuals with higher levels of impulsivity and urgency. However, studies that have examined the relationship between urgency and behavioral performance on the IGT have done so in a neutral affective state, without manipulation of mood. The present study examined the relationship between positive and negative urgency and decision-making performance on the IGT after mood induction, controlling for neuroticism. 159 undergraduates who reported high-risk alcohol use on the Alcohol Use Disorders Identification Test (AUDIT; Saunders et al., 1993) were randomly assigned to a positive, negative, or neutral mood induction group and completed the IGT after mood induction. 4 After controlling for neuroticism, both negative and positive urgency were associated with use of hard drugs, and negative urgency was associated with AUDIT total score; however, contrary to previous findings, the urgency traits were not associated with any other indicators of problematic substance use we examined. Results suggest that the urgency traits relate differentially to indicators of problematic substance use in males and females, which should be taken into consideration by clinicians and in future studies. Also contrary to hypotheses, the urgency traits were not related to impulsive decision- making on the IGT, and mood condition did not moderate the relationship between urgency traits and IGT performance. It is likely that our visual mood manipulation procedure was not effective at eliciting a sufficient emotion state so as to induce impulsive behaviors in those with elevated urgency. Results suggest that, while both self-report measures of the urgency traits and the IGT are designed to assess impulsivity, they are likely measuring distinct processes. 5 Dedication In loving memory of Cody. “Brothers are like streetlights along the road, they don’t make distance any shorter but they light up the path and make the walk worthwhile.” -Author Unknown 6 Acknowledgments I would like to first thank my advisor, Julie Suhr, for her unwavering patience and encouragement on both this project and throughout my graduate training. I would also like to thank my dissertation committee: Drs. Ryan Shorey, Sarah Racine, Nicholas Allen, and Deborah McAvoy for their flexibility and thoughtful guidance. Additionally, I am appreciative of my research assistants who helped tremendously with data collection: Sydney Jones, Taylor Gardner, Marissa Kamlowsky, Katherine Russell, Maggie Shaver, Gabrielle Romeo, and Jasmine Simpkins. I would also like to thank my parents and Mike for their continuous support and love. 7 Table of Contents Page Abstract ............................................................................................................................... 3 Dedication ........................................................................................................................... 5 Acknowledgments............................................................................................................... 6 List of Tables ...................................................................................................................... 9 Chapter 1: Introduction ..................................................................................................... 11 Personality Traits and Alcohol Use ............................................................................ 11 Neuroticism and alcohol use. ................................................................................ 11 Impulsivity/urgency and alcohol use. ................................................................... 12 Urgency and Rash Action ........................................................................................... 16 Measurement of rash action: Self-report or behavior? ......................................... 18 Neural mechanisms of impulsivity, urgency, and rash action. ............................. 21 The Role of Mood State in Urgency and Impulsivity ................................................. 24 Limitations of the Current Literature .......................................................................... 25 The Present Study ....................................................................................................... 27 Chapter 2: Methods ........................................................................................................... 29 Participants .................................................................................................................. 29 Measures ..................................................................................................................... 30 Alcohol Use Disorders Identification Test-Self Report Version (AUDIT). ......... 30 National Institute on Drug Abuse-modified Alcohol, Smoking and Substance Involvement Screening Test, Version 2.0 (NIDA-modified ASSIST V2.0). ....... 31 Problematic alcohol use. ....................................................................................... 32 NEO Five-Factor Inventory-3 (NEO-FFI-3) neuroticism..................................... 32 UPPS-P Impulsive Behavior Scale (UPPS-P). ..................................................... 33 Positive and Negative Affect Scale (PANAS). ..................................................... 33 The Affect Grid. .................................................................................................... 34 Alcohol Craving Questionnaire-Short Form-Revised (ACQ-SF-R)..................... 34 Iowa Gambling Task (IGT). ................................................................................. 35 Procedure .................................................................................................................... 35 Analyses ...................................................................................................................... 37 Chapter 3: Results ............................................................................................................. 39 Group Differences ....................................................................................................... 39 8 Mood Manipulation Check ......................................................................................... 39 Hypothesis 1: Urgency and Self-Reported Substance Use ......................................... 41 Hypothesis 2: Urgency and Risky Decision-Making.................................................. 43 Hypothesis 3: Relationship of Urgency to Decision-Making in Heightened Emotion State............................................................................................................................. 43 Relationship of Urgency to Craving in Heightened Emotion State ............................ 47 Supplemental Analyses ............................................................................................... 50 Chapter 4: Discussion ....................................................................................................... 56 Limitations and Future Directions .............................................................................. 67 References ......................................................................................................................... 70 Appendix A: Measures ..................................................................................................... 99 Appendix B: Tests of Normality ..................................................................................... 135 Appendix C: The Affect Grid ......................................................................................... 137 Appendix D: Nonparametric Analyses ........................................................................... 138 Appendix E: Supplemental Analyses.............................................................................