Impulsive alcoholics likely to die sooner

Alcohol misuse is known to increase the risk of premature death, and impulsivity -- excessive risk-taking, disregard of consequences and poor self-control -- has been shown to affect longevity regardless of drinking habits.

To see whether impulsivity posed a risk for alcohol abusers, the researchers tested 515 people when they first sought help for drinking problems and again one year later, and then the researchers followed them for another 15 years. During this period, 93 individuals died.

Those who had scored high on a measure of impulsivity a year after seeking help for their drinking problems were more likely to die in the years following, and this held true even after researchers took factors like drinking severity and existing physical health problems into account.

Why impulsivity compounds the risk of alcohol misuse was not clear from the study, said lead author Daniel Blonigen, Ph.D., a research health science specialist at the Center for Health Care Evaluation of the Palo Alto Veterans Affairs Medical Center. The study appears online and in the November issue of the journal Alcoholism: Clinical and Experimental Research. . "Based on past research, impulsivity is related to a wide range of health risk behaviors [besides heavy drinking], like smoking, drug use, dangerous driving and risky sexual activities," Blonigen said. Impulsive behavior could also increase exposure to stressful situations, with a negative physiological impact, he said.

On the positive side, the study found that individuals who reported strong supportive relationships with peers and friends to be somewhat protected from the consequences of impulsivity: They were less likely to die than those who lacked that resource.

"What seemed important was the strength of friendship, the degree of trust and the ability to confide," Blonigen said. "The numbers of friends didn't make much difference."

The findings "reaffirm the importance of measuring and emphasizing the social support network in alcohol treatment programs," Blonigen said.

Kenneth Sher, Ph.D., a professor of psychology at University of Missouri, found the moderating effect of peer support on mortality "not surprising… you would expect things like social environment to potentiate or attenuate risk." He added that such influences might cut both ways: "If you're around people who keep you in line it will help; if they themselves are heavily involved in problem behavior, it could have the opposite effect."

Findings such as Blonigen's, he said, support the health value of interventions to reduce impulsivity, both on a population-wide and individual level.