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Hyperactive symptoms, cognitive functioning, and drinking habits

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Hyperactive symptoms, cognitive functioning, and drinking habits

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HYPERACTIVE SYMPTOMS, COGNITIVE FUNCTIONING,
AND DRINKING HABITS
By
Sherry A. Span
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the Requirements for the Degree
MASTER OF ARTS
(Psychology)
December 1997
Copyright 1997 Sherry A. Span
Mitchell Earleywine, Ph.D. (Advisor)
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UMI Number: 1389982
Copyright 1998 by
Span., Sherry A.
All rights reserved.
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U N IV E R SIT Y O F S O U T H E R N C A U F O R N IA
T H E G R A D U A T E SC H O O L.
U N IV E R SIT Y PA R K
LOS A N G E L E S. C A L IF O R N IA 9 0 0 0 7
T h is thesis, w ritten by
A __________________
under the direction of h i / . Thesis C o m m ittee,
and approved by all its m em bers, has been p r e
sented to and accep ted b y the D ean of T h e
G raduate School, in p a rtia l fulfillm en t of the
requirements fo r the d e g ree of
THESIS COMMITTEE
- / S. .
Oftairman
I _____
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Acknowledgments
I thank my advisor, Mitch Earleywine, and commmittee
members, Adrian Raine and Laura Baker for their helpful
comments and assistance in preparing the manuscript.
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i i i
Table of Contents
Acknowledgments............................................ii
List of Tables.............................................iv
Abstract.................................................... v
Introduction................................................ 1
Cognitive Impairment and Alcohol Consumption....... 1
Cognitive Impairment and Hyperactivity..............4
Hyperactivity and Alcoholism.........................6
The Current Study.....................................8
Method.......................................................9
Participants...........................................9
Measures............................................... 9
Results.................................................... 12
Models................................................ 14
Analyses..............................................16
Discussion................................................. 19
References................................................. 27
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List of Tables
Page
Table 1. Measures of Fit for Each Model................ 16
Table 2. Comparisons Among Chi-squares for Alternative
Models..................................................... 17
Figure 1. Three-factor Model.............................18
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V
Abstract
Previous research has focused primarily on alcohol's
distinct relationship to either cognitive functioning or
hyperactivity. The current study examined the conjoint
relationship of all these variables. A three-factor
model of hyperactivity, drinking habits, and cognitive
functioning was focused upon. In this model, each of the
nine measures loaded on only one of the three factors.
Confirmatory factor analysis revealed that the proposed
three-factor model fit the data significantly better than
the two-factor, single-factor, or null models. A
significant relation between drinking habits and
hyperactivity was observed. Individuals who reported
elevated levels of hyperactivity also reportedly drink
more alcohol. Thus, hyperactivity may be a risk factor
for potential drinking problems. Cognitive functioning
moderated the relation between hyperactivity and drinking
habits. An estimated correlation between hyperactivity
and drinking habits of .408 (p < .05) was observed for
those with poorer cognitive performance; whereas, the
correlation between these constructs was .120 (n.s.) for
those with more efficient cognitive functioning.
Individuals, particularly those who show cognitive
impairment, may drink more alcohol to relieve the
symptoms of hyperactivity.
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Introduction
Alcohol has been linked to both hyperactivity (Sher,
1991; Workman-Daniels & Hesselbrock, 1987) and decrements
in cognitive performance (Ryback, 1971; Butters &
Granholm, 1987; Wilkinson, 1987). Previous research has
focused primarily on alcohol's distinct relationship to
either hyperactivity or cognitive performance. This
paper separately examines cognitive impairment as a
function of alcohol consumption and as a function of
hyperactivity. In addition, the relation between
hyperactivity and alcoholism is discussed. The current
study is one of the first to examine the conjoint
relationship of all three of these variables.
Cognitive Impairment and Alcohol Consumption
The continuity hypothesis proposes that a spectrum
of alcohol-related cognitive impairment exists with the
degree of impairment determined by the individual's
guantity, freguency, and duration of drinking (Ryback,
1971). The Korsakoff patient, the chronic alcoholic, and
the heavy social drinker each represent separate points
along this continuum. The Korsakoff patient represents
the most severely cognitively impaired drinker along the
continuum. Anterograde amnesia, retrograde amnesia,
visuoperceptive deficits, and problem-solving deficits
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are all we11-documented cognitive disorders associated
with Korsakoff's disorder (Butters & Granholm, 1987).
Chronic alcoholics also have shown deficits in
cognitive functioning. Alcoholics have consistently
performed poorly on tests of immediate adaptive ability
such as abstraction, visuospatial problem solving, and
formation of novel associations (Wilkinson, 1987). The
permanence of these cognitive deficits remains unclear.
Bergman (1987) suggests that these deficits remain stable
even after a long period of abstinence. Nevertheless,
Goldman (1987) states that cognitive impairment gradually
improves in abstinent alcoholics. Comparisons of
visuoperceptive and problem-solving deficits of Korsakoff
patients and long-term alcoholics lend support to the
continuity hypothesis. Alcoholics show deficits
comparable to Korsakoff patients' deficits. Both
alcoholics and Korsakoff patients seem unable to initiate
and maintain optimal strategies in problem solving tasks
(Butters & Granholm, 1987). For example, in a two-choice
visual task designed to determine which stimulus the
experimenter was reinforcing, both Korsakoff patients and
long-term alcoholics used inefficient problem-solving
strategies that did not incorporate the experimenter's
feedback (Oscar-Berman, 1973). Although the problem
solving approach of these two groups was qualitatively
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similar, the long-term alcoholics demonstrated fewer
errors than the Korsakoff patient. In addition, the
long-term alcoholics' performance fell between both the
Korsakoff patient and the non-alcoholic control group.
This study illustrates that a spectrum of cognitive
deficits may be created as a function of alcohol intake.
The pattern of cognitive deficits of heavy social
drinkers is less severe but similar to the deficits
observed in alcoholics (Waugh, Jackson, Fox, Hawke, &
Tuck, 1989). A group of men consuming 81-130 grams of
alcohol daily showed significant impairment in problem
solving, planning and organization, visuospatial
processing and learning ability when compared with more
moderate social drinkers (Waugh et al., 1989). The
previous research on the effects of light to moderate
social drinking on cognitive performance has yielded
mixed results (Parker, Parker, & Harford, 1991; Tracy &
Bates, 1994). Possible reasons for the lack of consensus
regarding moderate drinking's effects on cognitive
performance include: procedural differences in the
replication studies (Parker et al., 1991), the vagueness
of the term "social drinker" (Delin & Lee, 1992), and the
inability of current neuropsychological instruments to
detect subtle cognitive impairment(Tracy & Parker, 1994).
Determining whether subtle cognitive deficits result from
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moderate drinking is important. Tracy and Bates (1994)
emphasize that most moderate drinkers are young, and
cognitive deficits may result in a riskier path of
cognitive development. Furthermore, subtle cognitive
deficits may be an etiological factor in the development
of problem drinking.
Typically, previous researchers measured the
performance of alcoholics by the number of accurate
responses on neuropsychological tests(Glenn & Parsons,
1991). Glenn and Parsons (1990) have suggested that
assessing the speed of performance as well as accuracy on
neuropsychological tasks may improve detection of subtle
cognitive deficits. They created an "efficiency index"
(overall accuracy/time), and found that this index
detected cognitive impairment better than accuracy
measures or speed scores alone. Thus, time to correctly
answer an item on a neuropsychological test has been
shown to distinguish between alcoholics and controls.
The current study uses this efficiency index as a more
sensitive assessment of cognitive impairment due to
moderate drinking.
Cognitive Impairment and Hyperactivity
Although cognitive deficits may increase with
alcohol consumption, causality remains unclear. Numerous
other factors may also account for deficits in cognitive
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performance. For example, both anxiety and depression
have shown a negative effect on cognitive functioning
(Delin & Lee, 1992) . Hyperactivity may also lower
cognitive performance (Gorenstein, Mammato, & Sandy,
1989; Chelune, Ferguson, Koon, & Dickey, 1986), and
hyperactivity has been cited as one possible etiological
factor of alcoholism as well (Tarter, McBride, Buonpane,
& Schneider, 1977) .
The term hyperactive describes individuals who
display developmentally inappropriate inattention,
hyperactivity, and impulsivity (Schleser, Armstrong, &
Allen, 1990) . Hyperactivity may arise from a deficit in
the inhibitory mechanisms of the prefrontal cortex
(Gorenstein et al., 1989). Barkley (1997) has stated
that behavioral inhibition is the central symptom in
ADHD. He further proposed that behavior inhibition
affects executing goal-directed responses, inhibiting
task-irrelevant responses, and sensitivity to response
feedback. Individuals who are insensitive to response
feedback perseverate. Gorenstein et al. (1989) suggest
that perseverative responding on the Wisconsin Card Sort
is perhaps the single best index of prefrontal
dysfunction. Therefore, behavior inhibition may enable
an ADHD individual to complete a task quickly.
Nevertheless, the task may not be completed efficiently.
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The individual may commit many errors quickly before
choosing the correct answer. Assessing the number of
correct responses as a function of speed in this study
will evaluate the efficiency of cognitive functioning.
Previous research has focused on the cognitive
deficits of children with ADHD. Hyperactive children
commit a significantly greater number of perseverative
errors on the Wisconsin Card Sort than controls
(Gorenstein et al., 1989; Chelune et al., 1986). Lee,
Vaughan, & Kopp (1983) also found that measures of
behavior inhibition are positively associated with both
measures of visuospatial and working memory.
Nevertheless, little research has been done on adults
concerning the impact of hyperactive symptoms on
cognitive processing. The current study involves adults
reporting both current hyperactive symptoms and
retrospective child hyperactive symptoms.
Hyperactivity and Alcoholism
Hyperactivity may also be a risk factor in the
etiology of certain types of alcoholism (Tarter et al.,
1977; Tarter & Edwards, 1988). Parsons (1987) stated
that alcoholics report more symptoms of childhood
hyperactivity than non-alcoholics. Zuckerman (1983)
suggests that people who seek new and arousing
experiences are more likely to experiment with alcohol
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and drugs. In addition, Cloninger (1987; as cited in
Sher, 1991) has reported that a subset of alcoholics
score high on the personality trait of novelty seeking.
Individuals high in novelty seeking display impulsivity,
exploratory behavior, distractibility, and excitability
(Cloninger, Sigvardsson, & Bohman, 1988). These
characteristics are very similar to hyperactivity.
Perhaps these individuals drink more to relieve the
symptoms of hyperactivity. These individuals could be
seeking either the stimulant or depressive properties of
alcohol to alleviate hyperactivity. Alcohol's effects
vary on both the ascending and descending limbs of the
blood alcohol curve (BAC). Stimulant effects are more
apparent than sedative effects on the ascending limb, and
sedative effects are more apparent than stimulant effects
on the descending limb (Martin, Earleywine, Perrine, &
Swift, 1993). Most often psychostimulants are prescribed
to treat hyperactive individuals (Rapport & Kelly, 1991).
Stimulant medication almost completely eliminates
hyperactive symptoms Wender, 1995) . Thus, the stimulant
effects of alcohol could lead the individual to
experience an alleviation of hyperactive symptoms.
Another possibility is that hyperactive individuals seek
the sedative properties of alcohol. Peterson and Pihl
(1990) suggest that hyperactive individuals might consume
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alcohol to dampen their increased physiological
responses. Those individuals may continue to drink to
maintain a lower state of physiological arousal. This
calmer state could lead to the individual experiencing an
alleviation of hyperactive symptoms.
The Current Study
The current study examines a continuum of alcohol
consumption. The labeling of drinkers as alcoholic,
heavy, or moderate that may have caused confusion in the
past has been eliminated (Delin & Lee, 1992). Cognitive
functioning will be examined as a function of the
quantity and frequency of alcohol consumed. In addition,
the efficiency index proposed by Glenn and Parsons (1990)
will be used as a more sensitive assessment of cognitive
functioning. If the continuity hypothesis is correct,
then a range of cognitive impairment should be found.
Cognitive impairment should increase with alcohol
consumption. Glenn, Errico, Parsons, King, and Nixon
(1993) suggest that some cognitive impairment found in
alcoholics may be premorbid or due to other factors. In
light of the previously discussed research above on
hyperactivity and alcoholism, it seems likely that
heavier drinkers will report more hyperactive symptoms.
This study will examine whether cognitive impairment is a
function of drinking, hyperactivity, or both.
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Method
Participants
One hundred students participated for extra credit
in their undergraduate psychology classes. The sample
consisted of 23 males, and 77 females. Ages ranged from
16 to 45 (mean = 22.0, SD = 4.54). Forty-eight
identified themselves as Caucasian, 19 as Asian, 11 as
Hispanic, and 10 as African American. Twelve students
chose not to identify race. They drank an average
freguency of 1.28 occasions/week (SD = 1.32). The
average amount consumed per occasion was 3.27 drinks (SD=
5.30). The average of the maximum amount consumed on a
single occasion was 4.73 drinks (SD = 4.83). Lighter
drinkers as opposed to heavier drinkers were more
prevalent with 58% of the subjects reporting that they
drank 3 drinks or fewer/week.
Measures
Assessment for drinking habits, hyperactivity, and
cognitive functioning was completed in a one-hour
session.
Drinking Habits. Subjects completed a
Quantity/Frequency/Maximum Index. Subjects reported the
average number of standard drinks (i.e., 12 oz. beer, 4
oz. glass of wine, 12 oz. wine cooler, mixed drink, or 1
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h oz. liquor) they consumed per drinking occasion in the
past three months, the average number of drinking
occasions per week in the past three months, and the
maximum number drinks consumed on one occasion in the
last three months. A similar measure has been used in
previous work and appears to be a valid index of alcohol
consumption (Earleywine & Martin, 1993) .
Hyperactivity. Participants filled out questionnaires to
assess retrospective childhood hyperactive symptoms and
current hyperactive symptoms. The items assessed the
symptoms listed by the Utah Criterion (Wender, Wood, &
Reimherr, 1985). The Utah Criterion for the diagnosis of
ADHD in adults was designed to better identify cases of
adulthood ADHD and to increase inter-rater reliability
than the DSM-IIIR (Wender, 1995). The questionnaire was
divided into a child form and an adult form. Subjects
were instructed to circle statements that applied to
them. Examples of statements from the child form
included: "As a child, I daydreamed a lot and was
distractible", and "As a child, I was always on the go."
Examples of statements from the adult form included: "I
have trouble with my mind wandering", and "I feel a
constant need to be doing things."
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Neuropsychological Battery. Subjects completed three
neuropsychological tasks on an IBM compatible PC. For
each of these tasks, subjects were instructed to work as
quickly and accurately as possible. Average efficiency
indices [number correct/reaction time for correct
responses] was recorded for each task. Subjects
performed practice trials when appropriate. The practice
trials were not included in the statistical analyses.
1. Little Men Test (Acker & Acker, 1982) . Subjects made
left/right discriminations regarding a manikin that was
rotated along two axes. The manikin was presented for 32
trials holding a briefcase in his hand. The task
required subjects to determine which hand was holding the
briefcase. The manikin was facing the subject or facing
away, standing on his feet or standing upside down. Each
position reflected one of the four levels of difficulty
of the task. This task assessed visuospatial
orientation.
2. Visual Perceptual Analysis (Acker & Acker, 1982).
Subjects were required to detect differences in geometric
patterns. Three five-by-four matrices were presented for
24 trials. Each matrix consisted of 20 blocks. Matrix
patterns differed by 2 or 4 blocks creating two levels of
difficulty. Subjects were required to identify the one
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matrix that differed from the other two. This task
assessed complex visual inspection.
3. Bexley-Maudsley Category Sorting Test (Acker & Acker,
1982). This task was a computerized version of the
Wisconsin Card Sort (Berg, 1948). Subjects developed
sorting criteria based on abstract concepts (orientation,
number, color, and type of elements). As the computer
altered the solutions, subjects were required to modify
their sorting techniques. For example, the computer may
have initially reinforced sorting by color, but then
reinforced sorting by number without alerting the subject
in advance. After each sort, subjects received feedback
regarding the accuracy of their response. Subjects
successfully completed a category after six consecutive
correct responses. Six categories were to be sorted.
There were two levels of difficulty. Level one consisted
of successful completion of categories 1-3. Level two
consisted of successful completion of categories. 4-6.
This task assessed flexibility in problem solving.
Results
Nine measures were analyzed. These measures
included: three measures for drinking habits (quantity,
frequency, and maximum), two measures for hyperactivity
(childhood and adulthood), and four measures for
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cognitive functioning (efficiency indices [number
correct/reaction time for correct responses] for: the
Little Men Test, both levels of the Visual Perceptual
Analysis, and the Bexley-Maudsley Category Sorting Test).
The data were analyzed using Joreskog and Sorbom's
(1986) LISREL VI program. Confirmatory factor analyses
were performed to determine which of four possible models
was most consistent with the data. The possible models
included a 3-factor model, a 2-factor model, a single
factor model, and a null model. Descriptions of each
model follow.
Several indices were used to evaluate the magnitude
of the overall fit for each of the models. These
included: chi-square, ratio of chi-square to degrees of
freedom (RATIO), the Parsimonious Fit Index (PFI) , and
Akaike's Information Criterion (AIC). Chi-square
illustrates the magnitude of the difference between the
model and the data. RATIO, PFI, and AIC illustrate the
magnitude of the difference between the model and the
data with respect to the number of degrees of freedom.
Smaller chi-square, RATIO, or AIC values indicate better
overall fit of the model. PFI values do not exceed 1.0,
and larger values indicate better overall fit. Specific
aspects of each model were also evaluated. T-values were
computed for each parameter to determine which
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associations between variables were contributing
significantly to the fit of the model.
Models
Three-factor model. The 3-factor model specified that
each of the nine measures would weigh on only one of
three underlying factors. The three factors included:
drinking habits, hyperactivity, and cognitive
functioning. Thus, quantity, frequency, and maximum
measures of alcohol consumption served as indicators of
drinking habits. Both forms of the Utah Criterion
(Wender, Wood, & Reimherr, 1985) served as indicators of
hyperactivity. Efficiency indices for the Little Men
Test, both levels of the Visual Perceptual Analysis, and
the Bexley-Maudsley Category Sorting Test (Acker & Acker,
1982) served as indicators of cognitive functioning. An
illustration of the model appears in figure 1. Measures
of fit appear in table 1. The T values for the factor
loadings were all significant. The estimated correlation
among the factors of hyperactivity and drinking habits
was significant. Thus, as reported alcohol consumption
increased, reported hyperactivity increased as well. All
other correlations among the factors were not
significant.
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2. Two-factor model. The 2-factor model tested whether
the variation in the data could be explained by the mode
of collection. One factor consisted of self-report data,
and the other factor consisted of data collected by the
computer. Thus, quantity, frequency, and maximum
measures of alcohol consumption and both forms of the
Utah Criterion (Wender, Wood, & Reimherr, 1985) served as
indicators of self-report data. Efficiency indices for
the Little Men Test, both levels of the Visual Perceptual
Analysis, and the Bexley-Maudsley Category Sorting Test
(Acker & Acker, 1982) served as indicators of
computerized data. Measures of fit appear in table 1.
3. Single-factor model. The single-factor model tested
whether the eight measures were actually measuring a
single underlying construct. Perhaps the nine indicators
could be measuring a single underlying construct such as
disinhibitory disorder. Measures of fit appear in table
1.
4. Null model. Each measure was assumed to measure its
own, independent, underlying factor in the null model.
Measures of fit appear in table 1.
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Table 1
Measures of Fit for Each Model
Model Chi-square(d.f.) RATIO PFI AIC
3-Factor 34.27(24) 1.43 .84 76.27
2-Factor 97.86(25) 3.91 .77 137.86
1-Factor 170.34 (27) 6.31 .72 206.34
Null 611.57(27) 22. 65 + 647.57
Ratio = Chi-square/d.f.
PFI = [(null - model)/null]*(d.f. model)/(d.f. null)
AIC = Chi-square + 2*(no. of estimated parameters)
d.f. = degrees of freedom
+ PFI cannot be computed for the null model
Analyses
Comparisons among- Models. Simple comparisons of model
fits can be made by examining the chi-square, RATIO, PFI,
and AIC values in table 1. These measures indicate that
the three-factor model fits the data better than any of
the alternative models. Models can also be compared by
subtracting their chi-squares. A significant difference
in chi-squares indicates a better fit of the model to the
data. These measures appear in table 2. The three-
factor model indicates a significantly better fit to the
data than any of the alternative models. This model is
illustrated in figure 1.
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Table 2
Comparisons Among Chi-scruares for Alternative Models
Comparison DIFF (d.f.)
3 FACTOR vs. 2 FACTOR
3 FACTOR vs. 1 FACTOR
3 FACTOR vs. NULL
2 FACTOR vs. 1 FACTOR
2 FACTOR vs. NULL
1 FACTOR vs. NULL
63.59(1)*
136.07(3)*
577.3 (3)*
72.48 (2)*
513.71(2)*
CANNOT BE COMPUTED
DIFF = CHI SQUARE MODEL 2 - CHI SQUARE MODEL 1
*p < .01
Moderator Analysis. Because the 3-factor model best fit
the data and only the correlation between the factors of
hyperactivity and drinking habits was significant,
further analysis was conducted using Baron & Kenny's
(198 6) framework for determining moderating variables.
The four efficiency index scores of cognitive performance
were transformed into standard scores. These standard
scores were summed to form a composite cognitive
efficiency index. Stacked two-group analyses were
performed to determine whether the composite
neuropsychological efficiency measure moderated the
association between hyperactivity and drinking habits.
The stacked model without equality constraints fit the
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HYPERACTIVT
-.13
V NEUROPSYCH
.28* fPERFORMANCI
.20
DRINKING
HABITS
*p<.05
Figure 1. Three-factor Model
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1 9
data better than the stacked model with equality
constraints, (chi-square = 4.38(8) vs. 12.73 (9)). The
chi-square difference between the models was significant
(chi-square difference = (8.35(1), p < .01), suggesting
that the association between drinking habits and
hyperactivity symptoms differs for individuals high and
low on cognitive performance. The unconstrained model
revealed an estimated correlation between drinking habits
and hyperactivity of .408 (p < .05) for individuals low
on cognitive performance; whereas, the correlation
between these constructs was only .120 (n.s.) for
individuals high on cognitive performance.
Discussion
Confirmatory factor analysis indicated that the
three-factor model fit the data better than any of the
alternative models. Therefore, the nine measures weighed
on only one of the three underlying factors. These
factors were: hyperactivity, cognitive functioning, and
drinking habits. This model fit the data better than a
two-factor model that collapsed across mode of data
collection. Also, the three-factor model fit the data
better than a single-factor model or a null model.
Therefore, the data did not suggest that a single
construct such as disinhibition was assessed. In
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addition, the data did not indicate that nine unique,
orthogonal factors were assessed either.
Although all factor loadings in the three-factor
model were significant, only the correlation between
hyperactivity and drinking habits was significant. The
positive correlation indicates that individuals who
reportedly drink more also report more hyperactive
symptoms as well. Nevertheless, cognitive functioning
moderated the relation between hyperactivity and drinking
habits. Individuals who performed more poorly on
neuropsychological tasks indicated a significant positive
correlation between drinking habits and hyperactive
symptoms. Perhaps, individuals who show cognitive
impairment may drink more to alleviate the symptoms of
hyperactivity. In contrast, individuals who performed
better on neuropsychological tasks did not have a
significant relation between drinking habits and
hyperactive symptoms. Therefore, better cognitive
functioning may act as a buffer preventing individuals
from drinking more to relieve symptoms of hyperactivity.
The mechanism underlying the relation between
hyperactivity and drinking habits for those who show
cognitive impairment could involve either the stimulant
or depressive properties of alcohol. Alcohol's effects
vary on both the ascending and descending limbs of the
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21
blood alcohol curve (BAC). Stimulant effects are more
prominent than sedative effects on the ascending limb,
and sedative effects are more prominent than stimulant
effects on the descending limb (Martin, Earleywine,
Perrine, & Swift, 1993). Heavier drinkers experience
fewer sedative effects than lighter drinkers (Leigh,
1987). One possibility underlying the link between
hyperactivity and drinking habits is that these
individuals are seeking the stimulant effects of alcohol.
Psychostimulants represent the traditional therapeutic
approach for hyperactive individuals (Rapport & Kelly,
1991). Wender (1995) reports that treatment with
stimulant medication has the effect of almost complete
remission of hyperactive symptoms. In addition,
hyperactive children medicated with Methylphenidate (a
stimulant) have been shown to perform significantly
better on cognitive tasks than controls on placebo
(Rapport & Kelly, 1991). Therefore, the stimulant
effects of alcohol may lead to the subjective experience
of an alleviation of hyperactive symptoms. Another
possibility underlying the link between hyperactivity and
drinking habits is that individuals are seeking the
sedative properties of alcohol. Peterson and Pihl (1990)
suggest that hyperactive individuals might consume
alcohol to lessen increased physiological reactivity by
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22
interfering with their responses to novel stimuli. Thus,
the sedative effects of alcohol may help to dampen the
increased physiological response. Those individuals who
enjoy the decrease in hyperactive symptoms may continue
to drink to maintain a calmer state. This calmer state
could lead to the subjective experience of an alleviation
of hyperactive symptoms.
The data suggest that individuals who function
better cognitively can control the link between
hyperactivity and drinking better than their counterparts
who function at a lower level cognitively. These
individuals may not expect alcohol to alleviate their
hyperactive symptoms. Perhaps individuals whose
cognitive functioning is more effective have found other
ways to cope with their hyperactivity. They may engage
in an increased amount of physical exercise prior to
attempting a task that requires sustained focused
attention. This exercise could allow better
concentration by functioning to arouse the individual as
a psychostimulant would. These individuals may also have
learned to resist distractibility by completing tasks in
environments that offer few sources of distraction.
Another possible coping strategy could involve breaking
large tasks down into their smaller components. By
creating a series of small goals, long periods of focused
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2 3
attention may not be necessary. Finally, these
individuals may also demonstrate more capability of
seeking professional help. They may be taking
psychostimulants to control hyperactive symptoms.
Screening for medications was not performed in the
current experiment, and this issue needs to be explored
in future studies. The results of this study suggest
that the best targets for intervention are hyperactive
individuals who function well cognitively, yet still
report drinking to excess. This subgroup could possibly
be taught some of the alternative strategies discussed
above for managing their hyperactive symptoms.
Several limitations of this study suggest further
research. This convenience sample consisted of young
college students. Studies of older adults and
individuals who do not attend college would help to
increase generalizability. In addition, this sample
consisted primarily of light drinkers with the majority
(58%) reporting that they drank three drinks or fewer per
week. A sample with a broader spectrum of drinking
habits would also increase generalizability.
Previous research has shown a significant relation
between the constructs of cognitive functioning with both
drinking habits (Ryback, 1971; Wilkinson, 1987) and
hyperactivity (Gorenstein et al., 1989). Methodological
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2 4
differences between the previous studies and the current
study may account for the different outcomes. Gorenstein
et al. (1989) used hyperactive children between the ages
of 8 and 12 as subjects. The current study used college
students with a mean age of 20 as subjects. Different
neuropsychological instruments were used in the
Gorenstein et al. (1989) study than the current study.
In addition, neuropsychological data was collected by
computerized tasks in the current study as opposed to
pencil and paper tasks in the former study. Ryback
(1971) incorporated data from other studies and
hypothesized that a continuum of cognitive impairment
existed with the Korsakoff's patient at one end and the
heavy social drinker at the other end of the spectrum.
The sample in the current study consisted mainly of
lighter drinkers. Perhaps, the amount of drinks consumed
on average by this sample was not enough to cause
cognitive impairment. Wilkinson (1987) discussed the
link between cognitive performance and the alcoholic as
well. He did not discuss the cognitive impairment of
light social drinkers. Also, a number of measurement
issues could account for the null results in this study.
Perhaps the neuropsychological measures used in this
study were not refined enough to detect the subtle
differences in performance exhibited by these
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2 5
individuals. This inability of current
neuropsychological instruments to detect subtle cognitive
impairment has been noted by previous researchers (Tracy
& Parker, 1994). In addition, improved assessments of
hyperactivity and drinking habits could detect subtleties
that may have not been detected by the measures employed
in this study. For example, hyperactivity could be
assessed further by gathering parent reports of the
subject's childhood hyperactive symptoms. Combining this
variety of instruments would help to assess this
construct more accurately. Alcohol consumption could
also be assessed more accurately using the Time Line
Followback (TLFB; Sobell, Maisto, Sobell, & Cooper,
1979). The TLFB asks subjects to recall the exact number
and type of drinks they consumed on each day for a period
of time such as the previous three months. This measure
has proven reliable and valid as an index of the number
of drinks consumed over the assessment period of interest
(Sobell et al., 1979). Further work employing other
measures for hyperactivity, drinking habits, and
cognitive performance seems warranted to determine
whether these null results may just be a measurement
issue.
Despite the limitations of this study, the observed
relation between hyperactivity and drinking habits has
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2 6
raised a number of interesting questions that warrant
further investigation. The current study suggests that
hyperactivity may contribute to problem drinking,
supporting previous research (Tarter et al., 1977; Tarter
& Edwards, 1988). The results of this study further
suggest that the group of hyperactive individuals at
greatest risk for problem drinking are those who have
poorer cognitive functioning. One issue that needs to be
investigated further is what this group at highest risk
expects to gain from consuming alcohol. Two possible
pathways for increased drinking were hypothesized above.
Hyperactive individuals with poorer cognitive functioning
may drink more either for the stimulant or sedative
properties of alcohol. Replicating this study and
assessing for expectancies using the Anticipated Biphasic
Alcohol Effects Scale (Earleywine & Martin, 1993) would
help clarify which effects were being sought. In
addition, self-report measures assessing how alcohol
consumption affects hyperactive symptoms are needed. The
knowledge gained from the proposed study would enable a
greater understanding of how the three variables of
cognitive functioning, drinking habits, and hyperactivity
relate to one another. This information could aid in the
design of effective interventions to prevent problem
drinking.
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2 7
References
Acker, W., & Acker, C. (1982). Bexley Maudslev
Automated Processing Screening and Bexley Maudslev
Category Sorting Test Manual. Windsor, Great Britain:
NFER-Nelson Publishing Co.
Barkley, R.A. (1997). Behavioral inhibition,
sustained attention, and executive functions:
Constructing a unifying theory of ADHD. Psychological
Bulletin. 121. 65-94.
Baron, R.M. & Kenney, D.A. (1986) . The moderator-
mediator variable distinction in social psychological
research: Conceptual, strategic, and statistical
considerations. Journal of Personality and Social
Psychology. 51. 1173-1182.
Berg, E. (1948). A simple technique for measuring
flexibility in thinking. Journal of General Psychology.
39. 15-22.
Bergman, H. (1987) . Brain dysfunction related to
alcoholism: some results from the KARTAD project. In 0.
Parsons, N. Butters, & P.P. Nathan (Eds.),
Neuropsychology of alcoholism: Implications for diagnosis
and treatment (pp. 21-44). New York: The Guilford Press.
Butters, N. & Granholm, E. (1987) . The continuity
hypothesis: Some conclusions and their implications for
the etiology and neuropathology of alcoholic Korsakoff's
syndrome. In 0. Parsons, N. Butters, & P.F. Nathan
(Eds.), Neuropsychology of alcoholism: Implications for
diagnosis and treatment (pp. 176-206). New York: The
Guilford Press.
Chelune, G.J., Ferguson, W., Koon, R., & Dickey,
T.O. (1986). Frontal lobe disinhibition in attention
deficit disorder. Child Psychiatry and Human
Development. 16. 221-234.
Cloninger, C.R., Sigvardsson, S., & Bohman, M.
(1988). Childhood personality predict alcohol abuse in
young adults. Alcoholism: Clinical and Experimental
Research. 12. 494-505.
Cohen, J. (1988). Statistical Power Analysis for
the Behavioral Sciences (2nd ed.). Hillsdale, NJ:
Lawrence Erlbaum.
R eproduced with perm ission of the copyright owner. Further reproduction prohibited without perm ission.
2 8
Delin, C.R., & Lee, T.H. (1992) . Drinking and the
brain: Current evidence. Alcohol and Alcoholism, 27,
117-126.
Earleywine, M., & Martin, C.S. (1993). Anticipated
stimulant and sedative effects of ethanol vary with limb
of the blood alcohol curve and dosage. Alcoholism:
Clinical and Experimental Research. 17, 135-139.
Glenn, S.W., Errico, A.L., Parsons, O.A., King,
A.C., & Nixon, S.J. (1993). The role of antisocial,
affective, and childhood behavioral characteristics in
alcoholics' neuropsychological performance. Alcoholism:
Clinical and Experimental Research, 17, 162-169.
Glenn, S.W., & Parsons, O.A. (1991). Impaired
efficiency in female alcoholics' neuropsychological
performance. Journal of Clinical and Experimental
Neuropsychology, 13. 895-908.
Glenn, S.W., & Parsons, O.A.. (1990). The role of
time in neuropsychological performance: Investigation and
application in an alcoholic population. The Clinical
Neuropsvcholoqist, 4, 344-354.
Goldman, M.A. (1987). The role of Time and practice
in recovery of function in alcoholics. In 0. Parsons, N.
Butters, & P.F. Nathan (Eds.), Neuropsychology of
alcoholism: Implications for diagnosis and treatment (pp.
291-321). New York: The Guilford Press.
Gorenstein, E.E., Mammato, C.A., & Sandy, J.M.
(1989). Performance of inattentive-overactive children on
selected measures of prefrontal-type function. Journal
of Clinical Psychology, 45. 619-632.
Joreskog, K., & Sorbom, D. (1986). LISREL VI:
User's guide. Mooresville, IN: Scientific Software, Inc.
Lee, M., Vaughn, B.E., & Kopp, C.B. (1983). The
role of self-control in young children's performance on a
delayed response memory for locatio task. Developmental
Psychology. 19, 40-44.
Leigh, B.C. (1987). Beliefs about the effects of
alcohol on self and others. Journal of Studies on
Alcohol. 48. 467-475.
R eproduced with perm ission of the copyright owner. Further reproduction prohibited without perm ission.
2 9
Martin, E.S., Earleywine, M., Perrine, M., & Swift,
R. (1993). Development and validation of the biphasic
alcohol effects scale. Alcoholism: Clinical and
Experimental Research. 17. 140-146.
Oscar-Berman, M. (1973). Hypothesis testing and
focusing behavior during concept formation by amnesic
Korsakoff patients. Neuropsvcholoaia. 11. 191-198.
Parker, E.S., Parker, D.A., & Harford, T.C. (1991).
Specifying the relationship between alcohol use and
cognitive loss: The effects of frequency of consumption
and psychological distress. Journal of Studies on
Alcohol. 52. 366-373.
Parsons, O.A. (1987). Neuropsychological
consequences of alcohol abuse: Many questions-some
answers. In O. Parsons, N. Butters, & P.F. Nathan
(Eds.), Neuropsychology of alcoholism: Implications for
diagnosis and treatment (pp. 153-175). New York: The
Guilford Press.
Peterson, J.B., & Pihl, R.O. (1990). Information
processing, neuropsychological function, and the
inherited predisposition to alcoholism. Neuropsychology
Review. 1. 343-369.
Rapport, M.D., & Kelly, K.L. (1991).
Psychostimulant effects on learning and cognitive
function: Findings and implications for children with
attention deficit hyperactivity disorder. Clinical
Psychology Review. 11. 61-92.
Ryback, R.S. (1971). The continuum and specificity
of the effects of alcohol on memory. Quarterly Journal
of Studies on Alcohol. 32. 995-1016.
Sher, K.J. (1991) . Children of alcoholics: A
critical appraisal of theory and research. Chicago: The
University of Chicago Press.
Tarter, R.E., & Edwards, K.E. (1988).
Psychological factors associated with the risk for
alcoholism. Alcoholism: Clinical and Experimental
Research. 12. 471-480.
Tarter, R.E., McBride, H., Buonpane, N., &
Schneider, D.U. (1977). Differentiation of alcoholics.
Archives of General Psychiatry. 34. 761-768.
R eproduced with perm ission of the copyright owner. Further reproduction prohibited without perm ission.
3 0
Tracy, J.I., & Bates, M.E. (1994). Models of
functional organization as a method for detecting
cognitive deficits: Data from a sample of social
drinkers. Journal of Studies on Alcohol. 55. 726-738.
Waugh, M., Jackson, M., Fox, G.A., Hawke, S.H., &
Tuck, R.R. (1989). Effect of social drinking on
neuropsychological performance. British Journal of
Addiction. 84. 659-667.
Wender, P.H. (1995). Attention Deficit Disorder in
Adults. New York: Oxford University Press.
Wender, P.H., Wood, D.R., & Reimherr, F.W. (1985).
Pharmacological treatment of attention deficit disorder,
residual type (ADD, RT, "minimal brain dysfunction,"
"hyperactivity") in adults. Psychomantiacoloav Bulletin.
21. 222-231.
Wilkinson, D.A. (1987). CT scan and
neuropsychological assessments of alcoholism. In 0.
Parsons, N. Butters, & P.F. Nathan (Eds.),
Neuropsychology of alcoholism: Implications for diagnosis
and treatment (pp. 76-102) . New York: The Guilford
Press.
Workman-Daniels, K.L., & Hesselbrock, V.M. (1987).
Childhood problem behavior and neuropsychological
functioning in persons at risk for alcoholism. Journal
of Studies on Alcohol. 48. 187-193.
Zuckerman, M. (1983). A biological theory of
sensation seeking. In M. Zuckerman (Ed.), Biological
bases of sensation seeking, impulsivity. and anxiety.
Hillsdale, NJ: Lawrence Erlbaum Associates.
R eproduced with perm ission of the copyright owner. Further reproduction prohibited without perm ission.
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Asset Metadata

Creator Span, Sherry A. (author)

Core Title Hyperactive symptoms, cognitive functioning, and drinking habits

School Graduate School

Degree Master of Arts

Degree Program Psychology

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,Psychology, clinical,psychology, cognitive

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Earleywine, Mitchell (committee chair), Baker, Laura A. (committee member), Raine, Adrian (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-19461

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Rights Span, Sherry A.

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Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

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