Attentional impulsivity accounts for the association of antisociality with craving and mental health problems in incarcerated individuals with substance dependence

• Date: 24 July 2023
• Pages: 653-667
• DOI: https://doi.org/10.1108/IJPH-03-2022-0023
• Published date: 24 July 2023
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Daniela Reichl,Bruno Heindl,Anette Lea Distler,Sabine Steins-Loeber

Attentional impulsivity accounts for the

association of antisociality with craving

and mental health problems in

incarcerated individuals with

substance dependence

Daniela Reichl, Bruno Heindl, Anette Lea Distler and Sabine Steins-Loeber

Abstract

Purpose –Prisoners with substanceuse disorder (SUD) are at risk of mental health problems. Given the

common co-occurringof psychopathic traits with SUDs, probablybecause of underlying impulsive traits

(Ellingson et al., 2018), this study aims to examine the relation between psychopathy (impulsive

antisociality and fearless dominance) and the functioning of incarcerated individuals with SUD. The

authors investigated whether impulsivity (motor, nonplanning and attentional) can account for the

relationship between one psychopathy facet (impulsive antisociality) and craving and mental health

problems.

Design/methodology/approach –The authors assessed self-reported impulsivity, psychopathy,

craving and mental health problems in 121 male incarcerated individuals with SUD and calculated

cross-sectionallinear regression analysesand mediation models.

Findings –Impulsive antisociality was positively related to all impulsivity facets, craving and mental

health problems. Attentional impulsivity mediated the relationship of impulsive antisociality withcraving

and mental health problems. Fearless dominance was related to lower attentional and nonplanning

impulsivity,craving and mental health problems.

Research limitations/implications –Future studies should investigate these relations in longitudinal

studiesand evaluate tailored approaches, for example,mindfulness interventions.

Practical implications –Interventionsto reduce craving and improve mental health might be important

for those who display self-centered, antisocial behavior but are less relevant for those with fearless,

dominant interpersonal behavior. Addressing attentional impulsivity may be of special interest in this

regard.

Originality/value –To the best of the authors’ knowledge, this study was the first to investigate the

mediating roleof different impulsivity facets for the associationof impulsive antisociality with cravingand

with mentalhealth problems in incarcerated individualswith SUD.

Keywords Psychopathy, Fearless dominance, Impulsiveness, Substance use, Addiction, Forensic

Paper type Research paper

Introduction

Substance use disorder (SUD) seems to be strongly associated with delinquency (Probst

et al., 2020), which might account for the high prevalence in incarcerated samples (Fazel

et al.,2017

) compared to the general population (Baranyi et al.,2019). In turn, drug users in

prison, especially those with the diagnosis of SUD, are at risk of psychiatric problems, for

example, suicide (Zhong et al.,2021) and mental health problems (e.g. depression, anxiety

Daniela Reichl is based at

the Department of Clinical

Psychology and

Psychotherapy,

Otto-Friedrich-University

Bamberg, Bamberg,

Germany. Bruno Heindl is

based at the

Justizvollzugsanstalt

Amberg (Amberg Prison),

Amberg, Germany.

Anette Lea Distler and

Sabine Steins-Loeber are

both based at the

Department of Clinical

Psychology and

Psychotherapy,

Otto-Friedrich-University

Bamberg, Bamberg,

Germany.

Received 18 March 2022

Revised 27 May 2023

Accepted 9 July 2023

DOI 10.1108/IJPH-03-2022-0023 VOL. 19 NO. 4 2023, pp. 653-667, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 653