Distress Driven Impulsivity as a Risk Factor and Treatment Target for Substance Use Disorder




Malouf, Elizabeth Taymans

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This dissertation investigated distress-driven impulsivity as a potential treatment target for substance misuse among jail inmates. This dissertation included two studies that examined: 1) the relationship between distress-driven impulsivity and pre-incarceration substance misuse [Study 1] and 2) changes in distress-driven impulsivity before and after a mindfulness-based intervention [Study 2]. In Study 1, 108 jail inmates completed self-report and behavioral measures of distress-driven impulsivity and provided retrospective reports of pre-incarceration substance misuse. A self-report measure of distress-driven impulsivity was significantly related to alcohol and hard drug misuse and marginally significantly related to marijuana misuse. When controlling for the effects of general impulsivity, the relationship between self-reported distress-driven impulsivity and alcohol misuse remained significant, while the relationship with hard drug misuse dropped to non-significant. Regarding behavioral measures, a behavioral measure of distress-intolerance was related to hard drug misuse while a behavioral measure of distress-driven risk taking was related to marijuana misuse. Study 2 was a small scale Randomized Clinical Trial of a mindfulness-based re-entry intervention in a sample of 40 jail inmates. There was some evidence that the treatment group improved in general impulsivity compared to the control group. While no evidence of improvements in distress-driven impulsivity was observed, the small sample size of this study limited the ability to detect effects. Attendance and participant feedback suggested that this treatment was feasible and acceptable in a high-risk sample of jail inmates. Implications for future research and treatment are discussed.



Psychology, Distress Tolerance, Impulsivity, Negative Urgency, Substance Abuse, Substance Use Disorder