Co-occurrence of alcohol use disorder and behavioral addictions: Relevance of impulsivity and craving

Purpose: The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving. Methods: 95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample. Results: 28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ2=6.27; p =014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p <01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p <003), were found. BIS-11 (t=-2.36; p =020), OCDS obsessive (Z=-4.13; p <001), OCDS compulsive (Z=-2.12; p =034) and VASc (Z=-4.94; p <001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p =012) and higher craving levels (VASc scores; OR=2.48; p <001). Conclusions: Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.