Impulsivity, Emotional Dysregulation and Executive Function Deficits Could Be Associated with Alcohol and Drug Abuse in Eating Disorders

• Main Authors: María Lozano-Madrid, Danielle Clark Bryan, Roser Granero, Isabel Sánchez, Nadine Riesco, Núria Mallorquí-Bagué, Susana Jiménez-Murcia, Janet Treasure, Fernando Fernández-Aranda
• Format: Article
• Language: English
• Published: MDPI AG 2020-06-01
• Series: Journal of Clinical Medicine
• Subjects: eating disorder; alcohol and/or drug abuse; substance use disorder; executive functions; impulsivity; emotional dysregulation
• Online Access: https://www.mdpi.com/2077-0383/9/6/1936

Background: Empirical data suggests a high comorbid occurrence of eating disorders (EDs) and substance use disorders (SUDs), as well as neurological and psychological shared characteristics. However, no prior study has identified the neuropsychological features of this subgroup. This study examines the prevalence of alcohol and/or drug abuse (A/DA) symptoms in ED patients. It also compares the clinical features and neuropsychological performance of ED patients with and without A/DA symptoms. Methods: 145 participants (74.5% females) with various forms of diagnosed EDs underwent a comprehensive clinical (TCI-R, SCL-90-R and EDI-2) and neuropsychological assessment (Stroop, WCST and IGT). Results: Approximately 19% of ED patients (across ED subtypes) had A/DA symptoms. Those with A/DA symptoms showed more impulsive behaviours and higher levels of interoceptive awareness (EDI-2), somatisation (SCL-90-R) and novelty seeking (TCI-R). This group also had a lower score in the Stroop-words measure, made more perseverative errors in the WCST and showed a weaker learning trajectory in the IGT. Conclusions: ED patients with A/DA symptoms display a specific phenotype characterised by greater impulsive personality, emotional dysregulation and problems with executive control. Patients with these temperamental traits may be at high risk of developing a SUD.