Abstract
Impulsive and compulsive symptoms often become apparent during young adulthood, which is a critical time for brain development and establishment of life goals. The aim of this study was to identify important associations with quality of life in young adults, across a range of clinical, questionnaire, and cognitive measures, focusing on impulsivity and compulsivity. Significant relationships between exploratory variables and quality of life were identified using Partial Least Squares (PLS). In the 479 participants (mean age 22.3 [SD 3.6] years), quality of life was best explained by a one-factor model (p < 0.001). Variables significantly associated with lower quality of life were: older age, greater alcohol consumption, and the presence of impulse control disorders (including gambling, compulsive buying, intermittent explosive disorder, compulsive sexual behavior, binge-eating, and skin picking), mood/anxiety disorders, post-traumatic stress disorder, and substance use disorder. Worse quality of life was also significantly explained by higher impulsiveness on the Barratt scale, and by relative impairments in extra-dimensional set-shifting and quality of decision-making. These findings suggest that impulse disorders merit more public health attention, especially problematic gambling. Performance on decision-making and set-shifting tasks also appears particularly important in understanding quality of life in young adults.
Highlights
Young adulthood involves major changes in an individual's environmental milieu – it constitutes a time of transition during which people may become more independent from family, begin substantive employment for the first time, and form life-long social relationships
Table Footer: Abbreviations: MINI = Mini International Neuropsychiatric Inventory; Minnesota Impulse Disorder Interview (MIDI) = Minnesota Impulse Disorders Inventory; SCI-GD = Structured Clinical Interview for Gambling Disorder; OC = Obsessive-compulsive; SST = Stop-Signal Task; CGT = Cambridge Gamble Task; IED = Intra-Dimensional/ExtraDimensional Shift Task; ED = Extra-dimensional set-shift. # Errors to criterion calculated from trials to criterion. ∼ Prevalence estimate for any mental disorder
Adulthood is a crucial period, when young people may be exposed for the first time to a degree of independence and outlets for impulsive and compulsive behaviors
Summary
Young adulthood involves major changes in an individual's environmental milieu – it constitutes a time of transition during which people may become more independent from family (e.g. moving to university), begin substantive employment for the first time, and form life-long social relationships (including partnerships). As well as external changes, young adulthood is a crucial time for brain development, both in terms of structure and function (Casey et al, 2017; Colver and Longwell, 2013; Sharda et al, 2015). Behavioral habits formed in youth often have longer-term implications and may persist over time, such as substance use disorders (Degenhardt et al, 2016), which in turn impact brain development and cognition (Cservenka and Brumback, 2017). Impulsivity refers to behaviors (or tendencies towards behaviors) that are unduly hasty, risky, and that lead to negative longer-term outcomes (Evenden, 1999). Compulsivity refers to behaviors (or tendencies towards behaviors) that are rigid, repetitive, and functionally impairing (Robbins et al, 2012). Compulsivity is less well studied from a longitudinal point of view, though translational research posits that certain behaviors (notably substance use) may shift from being impulsive to being compulsive with time, as behaviors are repeated (Belin et al, 2008; Koob and Le Moal, 2008)
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