Assoziation von aggressivem und impulsivem Verhalten mit klinischen Verlaufsparametern der Alkoholabhängigkeit

Zusammenfassung

Ziele: Untersucht wurde die Assoziation von aggressivem und impulsivem Verhalten bei Alkoholabhängigen mit den klinischen Variablen Geschlecht, familiäre Belastung, Trinkmenge, Ersterkrankungsalter sowie psychiatrische Auffälligkeiten und Suizidversuche. Methoden: In die Arbeit eingeschlossen wurden 468 alkoholabhängige Patienten (364 Männer). Die Impulsivitäts- und Aggressionswerte wurden anhand der psychometrischen Selbstbeurteilungsskalen Barratt Impulsiveness Scale (BIS), Buss Durkee Hostility Inventory (BDHI), Temperament and Character Inventory (TCI) sowie NEO-Five-Factor-Inventory (NEO-FFI) ermittelt. Es wurde jeweils ein „median split“ der Summenwerte des BIS, Buss Durkee Physical Assault (tätlicher Angriff), Buss Durkee Irritability (Reizbarkeit), TCI und NEO-FFI durchgeführt. Ergebnisse: Es konnte kein Zusammenhang zwischen aggressivem Verhalten und dem Geschlecht sowie der familiären Belastung mit Alkoholstörungen festgestellt werden. Dagegen ergaben sich bei dem Ersterkrankungsalter, der täglichen Trinkmenge sowie den psychiatrischen Auffälligkeiten einschließlich der Suizidalität einige signifikante Zusammenhänge. Patienten mit höheren Werten bei den Unterpunkten Impulsivität, Reizbarkeit, tätlicher Angriff und Neugierverhalten wiesen ein statistisch jüngeres Ersterkrankungsalter auf. Auch tranken alkoholabhängige Personen mit höheren Werten bei Reizbarkeit, tätlichem Angriff und Neugierverhalten signifikant mehr als Personen mit niedrigeren Werten. Die Auftretenswahrscheinlichkeit von Suizidversuchen war assoziiert mit höheren Werten bei den Punkten Reizbarkeit, tätlicher Angriff und Neurotizismus sowie mit niedrigeren Werten bei der Extraversion. Unsere Ergebnisse entsprachen somit nur teilweise Cloningers Einteilung des Alkoholismus in zwei typische Verlaufsformen (Typ-I und II). Fazit: Die Ergebnisse zeigen eine Assoziation des aggressiven/impulsiven Verhaltens bei Alkoholabhängigen mit einigen klinischen Verlaufsparametern, jedoch nicht mit dem Geschlecht und der familiären Belastung. Es ist anzunehmen, dass Cloningers Prototypen lediglich zwei Extreme auf einer fortlaufenden Skala möglicher Ausprägungsformen des Alkoholabusus darstellen.

Summary

Aims: We analysed the association of aggressive and impulsive behaviour in Alcoholics with the clinical parameters sex, family history, amount of drink, age of onset as well as psychiatric disorders and suicides. Methods: The study included 468 alcoholic patients (364 men and 104 women). Behavioural and personality traits were evaluated using the self-report questionnaires Barratt Impulsiveness Scale (BIS), Buss Durkee Hostility Inventory (BDHI), Temperament and Character Inventory (TCI) and NEO-Five-Factor Inventory (NEO-FFI). A median split in in BIS, Buss Durkee Physical Assault, Buss Durkee Irritability, TCI and NEO-FFI was conducted. Results: No association could be detected between aggressive behaviour and sex or positive family history regarding alcoholism. However, we were able to make out significant results for age of onset, daily amount of drink and psychiatric disorders including suicides. Alcohol dependent patients with higher scores in the categories impulsivity, irritability, physical assault and novelty seeking presented a significant younger age of onset. Also, patients who scored higher in irritability, physical assault and novelty seeking consumed more pure alcohol per day than patients with lower scores in these categories. The occurrence of suicide attempts was associated with higher scores in irritability, physical assault as well as neuroticism and with lower scores in extraversion. Our results were only partly consistent with Cloningers’ classification of alcoholism in two patterns (Type I and II). Conclusion: Our results reveal an association of aggressive/impulsive behaviour in Alcoholics with some clinical parameters but not with sex and family history. It can be assumed that Cloningers’ prototypes are only two extremes on a continuous scale of possible manifestations of alcohol abuse.

Schlüsselwörter

Alkohol - Aggression - Geschlecht - familiäre Belastung - Ersterkrankungsalter - Trinkmenge - psychiatrische Störungen

Keywords

Alcohol - aggression - sex - family history - age of onset - amount of drink - psychiatric disorders

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