Impulsivity predicts poorer improvement in quality of life
during early treatment for people with
Adam J. Rubenis
, Rebecca E. Fitzpatrick
& Antonio Verdejo-Garcia
Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia,
Turning Point, Eastern Health, Fitzroy, VIC, Australia
Health Clinical School, Monash University, Fitzroy, VIC, Australia
Background and aims
Methamphetamine dependence is associated with heightened impulsivity and diminished qual-
ity of life, but the link between impulsivity and changes in quality of life during treatment has not been examined. We
aimed to investigate how different elements of impulsivity predict change in quality of life in the 6 weeks after engaging
Longitudinal, observational cohort study.
Public and private detoxiﬁcation and rehabil-
itation facilities in metropolitan Melbourne, Australia.
One hundred and eight individuals with metham-
phetamine dependence (81 male) tested within 3 weeks of commencing treatment; 80 (74%) were followed-up at 6
The Continuous Performance Test-2 measured impulsive action (cognitive and motor impulsiv-
ity); the Delay Discounting Task measured impulsive choice. Quality of life was measured with the World Health Organi-
zation Quality of Life Scale—Brief, which includes social, psychological, physical and environment domains. Control
variables included age, gender, estimated IQ, depression severity score, methamphetamine dependence severity score, can-
nabis dependence severity score and treatment modality.
We found that all three forms of impulsivity were sig-
niﬁcant predictors of change in the social domain: motor impulsivity (β = À0.54, P = 0.013), cognitive impulsivity
(β = À0.46, P = 0.029) and impulsive choice (β = À0.26, P = 0.019). Change in the psychological domain was predicted
signiﬁcantly by motor impulsivity (β = À0.45, P = 0.046). Control variables of age and depression were associated signif-
icantly with changes in the physical domain.
In Australian methamphetamine-dependent individuals, el-
evated impulsivity predicts lower improvement of social and psychological quality of life in the ﬁrst 6–9 weeks of treatment.
Keywords Cognitive tests, impulsive action, impulsive choice, impulsivity, methamphetamine dependence, quality of
Correspondence to: Antonio Verdejo-Garcia, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, 18 Innovation Walk, Clayton, VIC
3800, Australia. E-mail: firstname.lastname@example.org
Submitted 17 May 2017; initial review completed 13 August 2017; ﬁnal version accepted 4 October 2017
Methamphetamine dependence (MD) is associated consis-
tently with poor physical and mental health and high levels
of family and social conﬂict [1,2], impacting upon an
individual’s wellbeing and overall quality of life (QOL ).
QOL, the perception of one’s position in life, comprises
physical (energy, pain, and difﬁculties engaging with
activities of daily living and work), psychological (affect,
self-perception, perceived cognition), social (personal
relationships, social and sexual activity) and environmen-
tal (ﬁnancial/accommodation stability and access to
services/information) domains . Previous research has
identiﬁed that MD is associated with poorer QOL in at least
three of these domains: physical (physical and medical
impairment ), psychological (diminished emotional
control , high rates of anxiety, depression and psychosis
) and social (high interpersonal conﬂict and lower social
support ). Improvement in such domains is a key focus
for treatment, with QOL and wellbeing identiﬁed as key in-
dicators of addiction recovery and treatment success [8,9].
Heightened levels of impulsivity (acting without
sufﬁcient deliberation) have also been linked to poorer
QOL in people with stimulant dependence [10,11]. Indeed,
a latent class study based on impulsivity indices identiﬁed
that people with cocaine dependence and high impulsivity
© 2017 Society for the Study of Addiction Addiction, 113,668–676