Effects of smoking abstinence on impulsive behavior among smokers high and low in symptoms of ADHD
Ashare, Rebecca L.
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Theories of smoking behavior have attempted to explain high relapse rates via a self-medication model in which abstinence-related deficits may lead to impulsive behavior. However, impulsive behavior is a multifaceted construct consisting of inhibitory control and impulsive choice and requiring multiple assessment measures. In addition, disorders characterized by deficits in inhibitory control (e.g., Attention-Deficit/Hyperactivity Disorder (ADHD)) and personality traits (e.g., impulsivity), have been linked to smoking behavior and may moderate abstinence-induced changes in impulsive behavior. In the present study, the effects of smoking abstinence on impulsivity were examined among a sample of adult smokers selected for high and low levels of ADHD symptoms. In a within-subjects design, participants ( N = 56) completed one session following overnight abstinence and one session non-abstinent, separated by approximately one week (order counterbalanced). Measures of impulsive behavior included response inhibition (i.e., Stop-signal task), interference control (i.e., attentional modification of prepulse inhibition (PPI) of startle), and impulsive choice (i.e., hypothetical delay discounting). Consistent with our hypotheses, abstinence decreased response inhibition and PPI. ADHD symptoms moderated abstinence effects on impulsive choice and response inhibition. However, the pattern was opposite our predictions such that the Low-ADHD group responded more impulsively when abstinent, whereas the High-ADHD group was relatively unaffected. These findings highlight the importance of utilizing multiple laboratory measures to examine a multifactorial construct such as impulsive behavior, particularly with respect to a complex process, such as smoking abstinence. These data also call attention to gaps in current theoretical models regarding the relationship among individual differences (e.g., ADHD symptoms), impulsive behavior, and smoking abstinence. The validity of assessing symptomatology in non-abstinent smokers and the role of processes related to impulsive behavior (e.g., reinforcing value of smoking) are discussed as possible explanations and directions for future research. Keywords: Smoking, Abstinence, Impulsivity, Attention-Deficit/Hyperactivity Disorder, Individual differences