Elevated Impulsivity Research Articles

Impulsivity in first-degree relatives at risk of psychosis and mania: a systematic review and meta-analysis.

Impulsivity is elevated in psychosis and during mania in bipolar disorder. Studies in unaffected relatives may help establish whether impulsivity is a heritable, state independent endophenotype. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in unaffected relatives of those with bipolar disorder, schizophrenia, and schizoaffective disorder, compared to controls. Databases were systematically searched up until March 2023 for articles reporting data on a behavioral or self-report measure of impulsivity in first-degree relatives and controls. Nineteen studies were included. Behavioral (10 studies, d = 0.35, p < 0.001) and self-reported impulsivity was significantly elevated in bipolar disorder relatives compared to controls (5 studies, d = 0.46, p < 0.001), with small effect sizes. Relatives of those with schizophrenia did not show significantly elevated impulsivity compared to controls on behavioral measures (6 studies, d = 0.42, p = 0.102). There were not enough studies to conduct a meta-analysis on self-report data in schizophrenia relatives or schizoaffective disorder relatives (self-report or behavioral). Study quality was good, however there was moderate to high heterogeneity in behavioral meta-analyses. Results suggest elevated impulsivity may be an endophenotype for bipolar disorder, present in an attenuated state before and after the illness and in at-risk individuals. This trait, amongst other behavioral and psychological indices, could be used to identify those who are at risk of developing bipolar disorder. Future research should refine measurement across studies and establish which components of impulsivity are affected in those at risk of psychotic and bipolar disorders.

Muscle recruitment during gait in individuals with unilateral transfemoral amputation due to trauma compared to able-bodied controls.

Individuals with transfemoral lower limb amputations walk with adapted gait. These kinetic and kinematic compensatory strategies will manifest as differences in muscle recruitment patterns. It is important to characterize these differences to understand the reduced endurance, reduced functionality, and progression of co-morbidities in this population. This study aims to characterize muscle recruitment during gait of highly functional individuals with traumatic transfemoral amputations donning state-of-the-art prosthetics compared to able-bodied controls. Inverse dynamic and static optimisation methods of musculoskeletal modelling were used to quantify muscle forces of the residual and intact limb over a gait cycle for 11 individuals with traumatic transfemoral amputation and for 11 able-bodied controls. Estimates of peak muscle activation and impulse were calculated to assess contraction intensity and energy expenditure. The generalized estimation equation method was used to compare the maximum values of force, peak activation, and impulse of the major muscles. The force exhibited by the residual limb's iliacus, psoas major, adductor longus, tensor fasciae latae and pectineus is significantly higher than the forces in these muscles of the intact contralateral limb group and the able-bodied control group (p < 0.001). These muscles appear to be recruited for their flexor moment arm, indicative of the increased demand due to the loss of the plantar flexors. The major hip extensors are recruited to a lesser degree in the residual limb group compared to the intact limb group (p < 0.001). The plantar flexors of the intact limb appear to compensate for the amputated limb with significantly higher forces compared to the able-bodied controls (p = 0.01). Significant differences found in impulse and peak activation consisted of higher values for the limbs (residual and/or intact) of individuals with transfemoral lower limb amputations compared to the able-bodied controls, demonstrating an elevated cost of gait. This study highlights asymmetry in hip muscle recruitment between the residual and the intact limb of individuals with transfemoral lower limb amputations. Overall elevated impulse and peak activation in the limbs of individuals with transfemoral amputation, compared to able-bodied controls, may manifest in the reduced walking endurance of this population. This demand should be minimised in rehabilitation protocols.

Graph analysis uncovers an opposing impact of methylphenidate on connectivity patterns within default mode network sub-divisions

BackgroundThe Default Mode Network (DMN) is a central neural network, with recent evidence indicating that it is composed of functionally distinct sub-networks. Methylphenidate (MPH) administration has been shown before to modulate impulsive behavior, though it is not yet clear whether these effects relate to MPH-induced changes in DMN connectivity. To address this gap, we assessed the impact of MPH administration on functional connectivity patterns within and between distinct DMN sub-networks and tested putative relations to variability in sub-scales of impulsivity.MethodsFifty-five right-handed healthy adults underwent two resting-state functional MRI (rs-fMRI) scans, following acute administration of either MPH (20 mg) or placebo, via a randomized double-blind placebo-controlled design. Graph modularity analysis was implemented to fractionate the DMN into distinct sub-networks based on the impact of MPH (vs. placebo) on DMN connectivity patterns with other neural networks.ResultsMPH administration led to an overall decreased DMN connectivity, particularly with the auditory, cinguloopercular, and somatomotor networks, and increased connectivity with the parietomedial network. Graph analysis revealed that the DMN could be fractionated into two distinct sub-networks, with one exhibiting MPH-induced increased connectivity and the other decreased connectivity. Decreased connectivity of the DMN sub-network with the cinguloopercular network following MPH administration was associated with elevated impulsivity and non-planning impulsiveness.ConclusionCurrent findings highlight the intricate effects of MPH administration on DMN rs-fMRI connectivity, uncovering its opposing impact on distinct DMN sub-divisions. MPH-induced dynamics in DMN connectivity patterns with other neural networks may account for some of the effects of MPH administration on impulsive behavior.

Breadth of substance use is associated with the selection of a larger food portion size via elevated impulsivity

Substance use is associated with altered or elevated food consumption and disordered eating. In the present study we examined whether breadth (variety) of drug use was associated with elevated portion size in a general population sample as it was in persons in recovery from substance use disorder. Furthermore, measures of emotional eating, impulsivity, food misuse, food craving were taken as possible mediators and reward responsiveness was examined as a potential moderator of this association. 444 adults (48.6 % women, mean age of 47.8 years) completed an online study in which they were asked to make judgements of ideal portion size for 6 different foods using a validated online tool that allowed participants to adjust the portion size of images of foods. Ideal portion size has been identified as a strong predictor of actual consumption. Participants were also asked to report the number of substances used in the past and provide anthropometric information. The results confirmed that breadth of drug use was associated with selection of higher portion size. Reward responsiveness was not a moderator of this relationship. Of the tested mediators, only impulsivity mediated the association between breadth of drug use and portion size. The results show that impulsivity may underlie the association between eating and substance use.

Comparative Analysis of Impulsivity Profiles in Children and Young Patients with Anorexia Nervosa Restrictive Type, Anorexia Nervosa Binge Eating/Purging Type, Bulimia Nervosa, and Binge Eating Disorder

IntroductionHigh levels of impulsivity are associated with individuals suffering from eating disorders. Impulsivity is a complex and multidimensional construct, with elevated impulsivity traits posing a specific risk in relation to binge-eating and purging disorders when compared to restrictive types eating disorders.ObjectivesOur aim was to identify the difference in impulsivity profile in children and young patients with eating disorders, including anorexia nervosa restrictive type (ANR), anorexia nervosa binge eating/purging type (ANP), bulimia nervosa (BN) and binge-eating disorder (BED).MethodsPatients aged 21 years or younger, meeting the DSM-V criteria for ANR (n=125), ANP (n=48), BN (n=38), and BED (n=37) were enrolled in the study. The participants had an average age of 16.3 ± 2.15 years. Data collection involved the administration of the UPPS Impulsiveness Scale (UPPS). Bilateral Student’s t-tests were conducted to evaluate potential statistically significant differences among the diagnostic groups.ResultsOur results indicated statistically significant differences in total impulsivity between patients diagnosed with ANR and each of the other eating disorders including ANP (T-Stud -2,19 p &lt; .02), BN (T-Stud -2.17p &lt; .03), and BED (T-Stud -2,68 p &lt; .008) (Figure 1). However, no significant differences were observed among the other eating disorder groups. Nevertheless, it is noteworthy that heightened impulsivity traits, particularly sensation-seeking tendencies, were a common feature among all subtypes of eating disorders, regardless of their specific diagnostic category. Impulsivity and age also exhibited a statistically significant negative correlation (r = -0.13, p = .03) (Figure 2).Image:Image 2:ConclusionsImpulsivity in individuals with restrictive and binge/purgative eating disorders differ significantly, with lower levels of impulsivity in ANR (Figure 1), except for sensation-seeking tendencies. This suggests that both groups may share a similar inclination for seeking intense emotions or engaging in emotionally arousing behaviors. As individuals age from adolescence to young adulthood, there is a tendency for impulsivity levels to decrease (Figure 2).Disclosure of InterestNone Declared

Associations between impulsivity and fecal microbiota in individuals abstaining from methamphetamine.

Methamphetamine (MA) abuse is a major public problem, and impulsivity is both a prominent risk factor and a consequence of addiction. Hence, clarifying the biological mechanism of impulsivity may facilitate the understanding of addiction to MA. The microbiota-gut-brain axis was suggested to underlie a biological mechanism of impulsivity induced by MA. We therefore recruited 62 MA addicts and 50 healthy controls (HCs) to investigate the alterations in impulsivity and fecal microbiota and the associations between them in the MA group. Thereafter, 25 MA abusers who abstained from MA for less than 3 months were followed up for 2 months to investigate the relationship between impulsivity and microbiota as abstinence became longer. 16S rRNA sequencing was conducted for microbiota identification. Elevated impulsivity and dysbiosis characterized by an increase in opportunistic pathogens and a decrease in probiotics were identified in MA abusers, and both the increased impulsivity and disrupted microbiota tended to recover after longer abstinence from MA. Impulsivity was related to microbiota, and the effect of MA abuse on impulsivity was mediated by microbiota. Our findings potentially highlighted the importance of abstention and implicated the significant role of the microbiota-gut-brain axis in the interrelationship between microbiota and behaviors, as well as the potential of microbiota as a target for intervention of impulsivity.

Impulsivity across psychiatric disorders in young adults

PurposeImpulsivity is a common cognitive issue across several psychiatric illnesses but is most frequently associated with the DSM-5 Disruptive, Impulse Control and Conduct Disorders, ADHD, and addictive disorders. We hypothesized that a wide range of psychiatric disorders would be associated with elevated impulsivity, not just those commonly linked to impulsiveness. This study aimed to explore the relationship between impulsivity and various psychiatric disorders in young adults. Procedures700 non-treatment seeking participants (aged 18–29 years) were enrolled from the general community, provided demographic information, and underwent a psychiatric evaluation to screen for various psychiatric disorders. Each participant then completed the Barratt Impulsiveness Scale (BIS), a self-report measure of impulsivity, followed by the Stop Signal Task (SST), a computerized stop-attention task that measures impulse control. Impulsivity levels across psychiatric disorders were examined by analyzing z-scores relative to controls. Main findingsPatients with bulimia nervosa, comorbid panic disorder with agoraphobia, and borderline personality disorder showed the highest levels of attentional, motor, and non-planning impulsivity, respectively. The effect size of the difference in total BIS impulsivity was large (d > 0.8) for several conditions including eating, personality, addictive, and mood disorders. The effect size of the difference in impulsivity was not large for any of the measures of ADHD. As compared to other psychiatric disorders analyzed, trichotillomania showed the greatest levels of impulsivity as measured by SST. Principal conclusionsThis data indicates that a wide range of psychiatric disorders exhibit heightened impulsivity with findings differing across various cognitive domains. Comorbidity resulted in unique findings of elevated impulsivity. This may suggest utility in viewing impulsivity as a transdiagnostic factor for a broad range of psychiatric disorders. Future studies should analyze comorbidities and whether patient psychiatric medication impacts these findings.

Metabolic and functional substrates of impulsive decision-making in individuals with heroin addiction after prolonged methadone maintenance treatment

Elevated impulsivity has been frequently reported in individuals with opioid addiction receiving methadone maintenance therapy (MMT), but the underlying neural mechanisms and cognitive subprocesses are not fully understood. We acquired functional magnetic resonance imaging (fMRI) data from 37 subjects with heroin addiction receiving long-term MMT and 33 healthy controls who performed a probabilistic reversal learning task, and measured their resting-state brain glucose using fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Subjects receiving MMT exhibited significantly elevated self-reported impulsivity, and computational modeling revealed a marked impulsive decision bias manifested as switching more frequently without available evidence. Moreover, this impulsive decision bias was associated with the dose and duration of methadone use, irrelevant to the duration of heroin use. During the task, the switch-related hypoactivation in the left rostral middle frontal gyrus was correlated with the impulsive decision bias while the function of reward sensitivity was intact in subjects receiving MMT. Using prior brain-wide receptor density data, we found that the highest variance of regional metabolic abnormalities was explained by the spatial distribution of μ-opioid receptors among 10 types of neurotransmitter receptors. Heightened impulsivity in individuals receiving prolonged MMT is manifested as atypical choice bias and noise in decision-making processes, which is further driven by deficits in top-down cognitive control, other than reward sensitivity. Our findings uncover multifaceted mechanisms underlying elevated impulsivity in subjects receiving MMT, which might provide insights for developing complementary therapies to improve retention during MMT.

SLCO5A1 and synaptic assembly genes contribute to impulsivity in juvenile myoclonic epilepsy

Elevated impulsivity is a key component of attention-deficit hyperactivity disorder (ADHD), bipolar disorder and juvenile myoclonic epilepsy (JME). We performed a genome-wide association, colocalization, polygenic risk score, and pathway analysis of impulsivity in JME (n = 381). Results were followed up with functional characterisation using a drosophila model. We identified genome-wide associated SNPs at 8q13.3 (P = 7.5 × 10−9) and 10p11.21 (P = 3.6 × 10−8). The 8q13.3 locus colocalizes with SLCO5A1 expression quantitative trait loci in cerebral cortex (P = 9.5 × 10−3). SLCO5A1 codes for an organic anion transporter and upregulates synapse assembly/organisation genes. Pathway analysis demonstrates 12.7-fold enrichment for presynaptic membrane assembly genes (P = 0.0005) and 14.3-fold enrichment for presynaptic organisation genes (P = 0.0005) including NLGN1 and PTPRD. RNAi knockdown of Oatp30B, the Drosophila polypeptide with the highest homology to SLCO5A1, causes over-reactive startling behaviour (P = 8.7 × 10−3) and increased seizure-like events (P = 6.8 × 10−7). Polygenic risk score for ADHD genetically correlates with impulsivity scores in JME (P = 1.60 × 10−3). SLCO5A1 loss-of-function represents an impulsivity and seizure mechanism. Synaptic assembly genes may inform the aetiology of impulsivity in health and disease.

Impulsivity across severe mental disorders: a cross-sectional study of immune markers and psychopharmacotherapy

BackgroundImpulsivity is a transdiagnostic feature linked to severe clinical expression and a potential target for psychopharmacological strategies. Biological underpinnings are largely unknown, but involvement of immune dysregulation has been indicated, and the effects of psychopharmacological agents vary. We investigated if impulsivity was associated with circulating immune marker levels and with a range of psychopharmacological treatment regimens in severe mental disorders.MethodsImpulsivity was assessed in a sample (N = 657) of patients with schizophrenia or schizophreniform disorder (SCZ) (N = 116) or bipolar disorder (BD) (N = 159) and healthy participants (N = 382) using the Barratt Impulsiveness Scale (BIS-11) questionnaire. Plasma levels of systemic immune markers (RANTES, IL-1RA, IL-18, IL-18BP, sTNFR-1) were measured by enzyme immunoassays. Patients underwent thorough clinical assessment, including evaluation of psychotropic medication. Associations were assessed using linear regressions.ResultsImpulsivity was positively associated with SCZ (p < 0.001) and BD (p < 0.001) diagnosis and negatively associated with age (p < 0.05), but not significantly associated with any of the circulating immune markers independently of diagnostic status. Among patients, impulsivity was negatively associated with lithium treatment (p = 0.003) and positively associated with antidepressant treatment (p = 0.011) after controlling for diagnosis, psychotropic co-medications, manic symptoms, and depressive symptoms.ConclusionsWe report elevated impulsivity across SCZ and BD but no associations to systemic immune dysregulation based on the current immune marker selection. The present study reveals associations between impulsivity in severe mental disorders and treatment with lithium and antidepressants, with opposite directions. Future studies are warranted to determine the causal directionality of the observed associations with psychopharmacotherapy.

Impulsive choice in individuals with comorbid amphetamine use disorder and attention deficit-hyperactivity disorder.

Amphetamine use disorder (AMPH) and attention deficit-hyperactivity disorder (ADHD) often co-occur and are associated with poor treatment outcomes. Elevated impulsivity is a core feature in both disorders. Little is known however about the specific neurocognitive profile regarding different facets of impulsivity, and specifically impulsive choice, in comorbid populations. Three groups (ADHD + AMPH, ADHD only and healthy controls (HC)) were assessed with self-reported impulsivity and cognitive tasks of impulsive choice, operationalized as delay aversion (DA) and reflection impulsivity. Twenty-nine participants with comorbid ADHD + AMPH, 25 participants with ADHD only and 116 HC completed screening, including self-rating scales, and cognitive testing. 20, 16 and 114 participants completed computerized cognitive tasks in the ADHD + AMPH group, ADHD group and HC group, respectively. The ADHD + AMPH group reported significantly higher motor, attentional and non-planning impulsiveness, and showed a significantly higher degree of impulsive choice, compared to both groups. There were no differences in task-related impulsiveness between ADHD only and HC. The current findings suggest that individuals with ADHD + AMPH have overall elevated levels of impulsivity compared to individuals with ADHD only. In addition, that ADHD + AMPH is specifically associated with impairments in task-related impulsive choice, which was not found in ADHD only compared to HC. The neurocognitive profile in this specific patient group may represent a need for more systematic screening within healthcare settings in order to develop effective and targeted treatment for comorbid patients. EudraCT, 2012-004298-20.

Exploring the impact of childhood maltreatment and BPD on impulsivity in crimes of passion.

Crimes of passion, characterized as unpremeditated impulsive aggression, have garnered increasing attention in recent years. Impulsivity, a major factor in crimes of passion, is also a common feature of various health conditions, including Borderline Personality Disorder (BPD). Childhood maltreatment is considered a significant precursor to BPD and is closely related to impulsivity. Although prior research has affirmed the relationship between impulsivity, childhood maltreatment, BPD, and criminal behavior, few studies have examined these variables' interconnections within the context of crimes of passion. This study seeks to explore the relationship between childhood maltreatment, BPD, and impulsivity in crimes of passion, assessing the former's impact on the latter. Our research examined 133 crimes of passion offenders and 149 other offenders from the Shenzhen male prison in China. All 282 participants completed The Abbreviated Version of The Barratt Impulsiveness Scale (ABIS), The UPPS Impulsivity Scale (Urgency, Premeditation, Perseverance, Sensation Seeking), The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), and The Childhood Trauma Questionnaire (CTQ). Our findings indicated that (1) crimes of passion offenders scored significantly higher in emotional neglect, physical neglect, and overall childhood maltreatment than did other offenders, and childhood maltreatment scores were notably higher in the high BPD trait group. (2) Crimes of passion offenders demonstrated significantly elevated impulsivity in attention and nonplanning scales compared to other offenders. Impulsivity scores across all scales were also significantly higher in the high BPD trait group. (3) Emotional neglect was found to significantly influence the urgency scale in crimes of passion offenders. An interaction effect was noted between physical abuse and high BPD traits, leading to increased impulsivity in crimes of passion offenders. This study underscores the predictive roles of childhood maltreatment and BPD in determining impulsivity within the context of crimes of passion.

Corticostriatal connectivity mediates the reciprocal relationship between parent-reported sleep duration and impulsivity in early adolescents.

Adolescence, a developmental period characterized by significant changes in sleep, is associated with normative increases in impulsivity. While short sleep duration has been linked to elevated impulsivity, the neural mechanism underlying the relationship between short sleep duration and elevated impulsivity remains poorly understood. We analyzed a dataset of 7,884 drug-naive 9-10 year-olds from the Adolescent Brain Cognitive Development (ABCD) study. Among them, 5,166 have two-year follow-up neuroimaging data. Linear mixed-effects models, mediation analyses, and longitudinal mediation analyses were used to investigate the relationship between parent-reported sleep duration, impulsivity, and functional and structural connectivity between the cortex and the striatum. We found that less sleep duration is significantly associated with higher positive and negative urgency, which are two affect-related components of impulsivity. In addition, we observed a link between short sleep duration and reduced corticostriatal connectivity. Neural pathways associated with short sleep duration-functional connectivity between the cingulo-opercular network and the left caudate, and between the cingulo-parietal network and the right pallidum-mediated the association between sleep duration and positive urgency both at baseline and two-year follow-up. Longitudinal mediation analyses further revealed that short sleep duration and elevated positive urgency exacerbated each other through these two corticostriatal connectivities. These findings highlight the key role of corticostriatal connectivities in the reciprocal relationship between short sleep duration and elevated impulsivity. Given the increasing prevalence of short sleep duration in adolescents, the link between sleep duration, impulsivity, and corticostriatal connectivities has important implications for timely interventions to address impulsive problems in early adolescents.

Serotonergic and dopaminergic control of impulsivity in gambling disorder.

Gambling disorder (GD) is major public health issue. The disorder is often characterized by elevated impulsivity with evidence from analogous substance use disorders underlining prominent roles of brain monoamines in addiction susceptibility and outcome. Critically, GD allows the study of addiction mechanisms without the confounder of the effects of chronic substances. Here, we assessed the roles of striatal dopamine transporter binding and extrastriatal serotonin transporter binding in GD as a function of impulsivity using [123 I]FP-CIT SPECT imaging in 20 older adults with GD (DSM-5 criteria; mean age 64 years) and 40 non-GD age- and sex-matched controls. We focused on GD in older individuals because there are prominent age-related changes in neurotransmitter function and because there are no reported neuroimaging studies of GD in older adults. Volume-of-interest-based and voxelwise analyses were performed. GD patients scored clearly higher on impulsivity and had higher tracer binding in the ventromedial prefrontal cortex than controls (p < 0.001), likely reflecting serotonin transporter activity. The binding in the medial prefrontal cortex positively correlated with impulsivity over the whole sample (r = 0.62, p < 0.001) as well as separately in GD patients (r = 0.46, p = 0.04) and controls (r = 0.52, p < 0.001). Striatal tracer binding, reflecting dopamine transporter activity was also positively correlated with impulsivity but showed no group differences. These findings highlight the role of prefrontal serotonergic function in GD and impulsivity. They identify cerebral coordinates of a potential target for neuromodulation for both GD and high impulsivity, a core phenotypic dimensional cognitive marker in addictions.

Impulsivity in Bipolar Disorder: State or Trait?

Impulsive behaviour is a key characteristic of mania in bipolar disorder (BD). However, there is mixed evidence as to whether impulsivity is a trait feature of the disorder, present in the euthymic state in the absence of mania. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in euthymic BD in comparison to controls. Electronic databases were searched for papers published until April 2022 reporting data on a self-report or behavioural measure of impulsivity in a euthymic BD group and a healthy control group. In total, 46 studies were identified. Euthymic BD showed significantly higher levels of self-reported impulsivity compared to controls (large effect size). Euthymic BD also showed significantly higher levels of impulsivity on response inhibition and inattention tasks, with moderate and large effect sizes, respectively. Only two studies measured delay of gratification, finding no significant differences between groups. Our results suggest impulsivity may be a trait feature of BD, however longitudinal cohort studies are required to confirm whether elevated impulsivity is present before illness onset. Future research should establish whether cognitive interventions are beneficial in improving impulsivity in BD.

Between- and Within-Person Correlates of Alcohol-Impaired Driving in First-Year University Students: The Roles of Impulsivity, Binge Drinking, Depression, and Anxiety.

University students are a high-risk demographic for alcohol-impaired driving (AID), a leading contributor to death and injury on Canadian roads. Although between-person correlates of AID are well established, little research has identified within-person correlates that elucidate when AID occurs. Accordingly, this study investigated whether between- and within-person variability in impulsivity, binge drinking, depression, and anxiety are associated with AID in university students. Participants were 633 first-year students (75% female, mean age = 17.97 [SD = 0.76]) from a Canadian university who completed seven monthly surveys. Multilevel models disaggregated between- and within-person associations. Between-person elevations in negative and positive urgency, sensation seeking, lack of premeditation, binge drinking, and depression were associated with greater odds of AID. Within-person elevations in negative urgency, sensation seeking, and binge drinking were associated with greater odds of AID, whereas within-person elevations in depression were associated with lower odds of AID. These results support existing research regarding who is most likely to engage in AID (students with elevated impulsivity, binge drinking, and depression) and extend this research by identifying under what conditions AID is likeliest to occur (when impulsivity and binge drinking are higher than usual, and depression is lower than usual). The opposing between- and within-person associations of depression with AID highlight the need for careful specification of hypotheses, as findings at the between-person level may not generalize to the within-person level. Moving forward, research that elucidates not only for whom but also when AID occurs may be best positioned to inform intervention and prevention efforts among university students.

A-293 Impulsivity and Executive Function in Older Adults with Personality Disorders

Abstract Objective: This review examines the impact of age on impulsivity-related executive functions (IREF) in personality disorders (PDs) characterized by impulsivity, i.e., antisocial (ASPD)/borderline (BPD) PDs. ASPD/BPD prevalence decreases with age, and general consensus purports a positive age effect on impulsivity -- despite longitudinal studies showing generally reduced executive function (EF) with age. This review explores the apparent contradiction between diminished EF in older adulthood and declines in impulsivity believed to occur with age. Data Selection: Searches (e.g., “impulsivity”, “aging”, “ASPD”/”BPD”, “EF”) across Google Scholar and PsycINFO yielded studies incorporating self-reported impulsivity and neuropsychological IREF measures. 19 studies (1997-2021) spanning, a) self-reported/trait impulsivity in ASPD/BPD, b) IREF in ASPD/BPD,) c) impulsivity/EF in normal aging, and d) ASPD/BPD in older adulthood, were informally extracted. Included EF studies incorporated measures of inhibition, delay discounting, and/or planning; studies limited to other executive skills were excluded. Data Synthesis: Cross-sectional, longitudinal, and meta-analytic self-report and neuropsychological results reflect elevated impulsivity in ASPD/BPD groups. Despite prior research suggesting decreased impulsivity with age, this review demonstrates mixed/contradictory results for older ASPD/BPD groups and possible explanations. Conclusions: Mixed findings perpetuate questions surrounding IREF in older ASPD/BPD groups. However, executive dysfunction and PDs are individually associated with functional impairment in aging. Greater understanding of IREF and ASPD/BPD in aging populations could identify those in need of intervention to mitigate functional consequences. Future research using wider age ranges, consistent operationalization of constructs, and increased control for confounds, would allow for better understanding of PDs’ unique impact on EF in older adulthood and the associated consequences.

Impulsivity and Reflective Thinking in Veterans Seeking Care for Substance Use Disorder

Objective: Substance use disorder (SUD) is a major public health crisis, with increased overdose deaths in the past decade. This has coincided with a tremendous amount of research on those who misuse substances. However, extensive research on SUD vulnerability characteristics such as impulsivity may be complemented by research on theoretically relevant aspects of cognition. The Cognitive Reflection Test (CRT) was designed to measure a person’s ability to subdue quick, intuitive decisions to reflect or deliberate. To some decision making theorists, this measure may help explain why some people are better able to inhibit “gut reactions” than others. Methods: We recruited 140 veterans from a Veterans Affairs medical center; 91 of whom were receiving SUD treatment. Participants completed the CRT and a measure of trait impulsivity (the UPPS-P). We ran planned ANCOVAs assessing differences in the number of correct answers on the CRT and the proportion of errors that were intuitive. Results: Participants who were receiving treatment gave significantly fewer correct, reflective answers on the CRT compared to controls. However, there were no significant differences in the proportion of errors that were due to intuitive responses. These findings did not change when controlling for age and/or trait impulsivity. Conclusion: Those suffering from SUD may exhibit cognitive deficits that do not stem from intuitive thinking. These deficits may, in turn, exacerbate issues arising from elevated impulsivity. Additional research which better incorporates decision making theory may be invaluable in providing clinically-relevant results and positive public health outcomes.

Behavioral characteristics of dopamine D5 receptor knockout mice

Major psychiatric disorders such as attention-deficit/hyperactivity disorder and schizophrenia are often accompanied by elevated impulsivity. However, anti-impulsive drug treatments are still limited. To explore a novel molecular target, we examined the role of dopamine D5 receptors in impulse control using mice that completely lack D5 receptors (D5KO mice). We also measured spontaneous activity and learning/memory ability because these deficits could confound the assessment of impulsivity. We found small but significant effects of D5 receptor knockout on home cage activity only at specific times of the day. In addition, an analysis using the q-learning model revealed that D5KO mice displayed lower behavioral adjustment after impulsive actions. However, our results also showed that baseline impulsive actions and the effects of an anti-impulsive drug in D5KO mice were comparable to those in wild-type littermates. Moreover, unlike previous studies that used other D5 receptor-deficient mouse lines, we did not observe reductions in locomotor activity, working memory deficits, or severe learning deficits in our line of D5KO mice. These findings demonstrate that D5 receptors are dispensable for impulse control. Our results also indicate that time series analysis and detailed analysis of the learning process are necessary to clarify the behavioral functions of D5 receptors.

Dopamine-induced changes to thalamic GABA concentration in impulsive Parkinson disease patients

Impulsivity is inherent to behavioral disorders such as substance abuse and binge eating. While the role of dopamine in impulse behavior is well established, γ-aminobutyric acid (GABA) therapies have promise for the treatment of maladaptive behaviors. In Parkinson disease (PD), dopaminergic therapies can result in the development of impulsive and compulsive behaviors, and this clinical syndrome shares similar pathophysiology to that seen in addiction, substance abuse, and binge-eating disorders. We hypothesized that impulsive PD patients have a reduced thalamic GABAergic response to dopamine therapy. To test this hypothesis, we employed GABA magnetic resonance spectroscopy, D2-like receptor PET imaging, and clinical and quantitative measures of impulsivity in PD patients (n = 33), before and after dopamine agonist administration. We find a blunted thalamic GABA response to dopamine agonists in patients with elevated impulsivity (p = 0.027). These results emphasize how dopamine treatment differentially augments thalamic GABA concentrations, which may modify behavioral impulsivity.