Impulsive Personality Research Articles

Impulsivity partially mediates the association between reduced working memory capacity and alcohol problems

Although alcohol use disorders (AUDs) have been associated with impulsive personality traits and reduced working memory capacity (WMC), less is known about the nature of their interrelationships. This study was designed to test the hypothesis that low WMC is associated with both impulsive personality and alcohol problems, and that impulsive personality mediates the association between low WMC and alcohol problems. Measures of impulsive personality, WMC, and alcohol problems were assessed in a sample of young adults (N = 474), that varied widely in severity of alcohol problems, 57% of whom had alcohol dependence. Simple correlations revealed that WMC, impulsive personality traits, and alcohol problems were all significantly related. Structural equation models (SEMs) showed that impulsivity partially mediated the association between WMC and alcohol problems. Although directionality cannot be determined from these cross-sectional data, the results suggest that reduced WMC may promote impulsivity, which in turn, predisposes to alcohol problems.

Pathways to Age of Onset of Heroin Use: A Structural Model Approach Exploring the Relationship of the COMT Gene, Impulsivity and Childhood Trauma

BackgroundThe interaction of the association of dopamine genes, impulsivity and childhood trauma with substance abuse remains unclear.ObjectivesTo clarify the impacts and the interactions of the Catechol -O-methyltransferase (COMT) gene, impulsivity and childhood trauma on the age of onset of heroin use among heroin dependent patients in China.Methods202 male and 248 female inpatients who meet DSM-IV criteria of heroin dependence were enrolled. Impulsivity and childhood trauma were measured using BIS-11 (Barratt Impulsiveness Scale-11) and ETISR-SF (Early Trauma Inventory Self Report-Short Form). The single nucleotide polymorphism (SNP) rs737866 on the COMT gene-which has previously been associated with heroin abuse, was genotyped using a DNA sequence detection system. Structural equations model was used to assess the interaction paths between these factors and the age of onset of heroin use.Principal FindingsChi-square test indicated the individuals with TT allele have earlier age of onset of heroin use than those with CT or CC allele. In the correlation analysis, the severity of childhood trauma was positively correlated to impulsive score, but both of them were negatively related to the age of onset of heroin use. In structure equation model, both the COMT gene and childhood trauma had impacts on the age of onset of heroin use directly or via impulsive personality.ConclusionsOur findings indicated that the COMT gene, impulsive personality traits and childhood trauma experience were interacted to impact the age of onset of heroin use, which play a critical role in the development of heroin dependence. The impact of environmental factor was greater than the COMT gene in the development of heroin dependence.

Usefulness of the International Personality Disorder Examination screening questionnaire for borderline and impulsive personality pathology in adolescents

The aim of this study was to analyze the usefulness of the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) for identifying DSM-IV and ICD-10 Borderline and Impulsive personality disorders (PD) in Spanish adolescents. MethodThe DSM-IV and ICD-10 IPDE-SQ screeners were used and compared with the diagnoses obtained with the IPDE semistructured interview in a sample of 125 adolescents treated in a psychiatric department. ResultsFor primary screening, the cutoff point with the best combination of sensitivity and specificity for ICD-10 impulsive and borderline PDs was obtained with three positive items, whereas for DSM-IV borderline the best PD cut-off was five positive items. For secondary screening, the best option would be one item above the cut-off points proposed for primary screening. ConclusionThe 3-item cut-off point in the IPDE-SQ produces a high proportion of false positives on impulsive and borderline PDs in clinical adolescents. We propose several cut-off points, depending on whether the study is designed to perform primary or secondary screening.

Effects of a multicomponent behavioral intervention on impulsivity and cognitive deficits in adolescents with excess weight

The aim of this study was to explore the effects of a multidisciplinary behavioral intervention including cognitive behavioral therapy, structured physical activity, and dietary counseling on impulsive personality and cognitive skills and subsequent BMI loss in excess weight adolescents. Forty-two adolescents with excess weight (14 males and 28 females, range 12-17 years), as defined by the International Obesity Task Force Criteria, participated in our study. We used a longitudinal observational design with two assessments: before and after treatment. We collected baseline measures of impulsive personality (UPPS-P scale), cognitive performance (letter number sequencing, Stroop and Iowa gambling task), and biometric parameters. After 12 weeks of intervention, parallel measures were used to determine whether treatment-induced changes in impulsivity and cognition predicted changes in BMI. BMI showed a statistically significant reduction after treatment [from mean (SD) 29.36 (4.51) to 27.31 (4.41), Cohen's d=0.5]. Greater reductions in negative urgency (negative-emotion-driven impulsivity) and greater improvement in cognitive inhibitory control skills were associated with greater reductions in BMI. Because the design was correlational and lacked a control group, future studies should clarify whether these associations reflect a causal effect or just overlapping improvements associated with a third variable (e.g. increases in attention procurement or motivation).

Repetitive impulsassoziierte Verhaltensstörungen beim Morbus Parkinson

Parkinson's disease (PD) is associated with a number of behavioral disorders which may cause considerable social, professional or financial problems. Impulse control disorders (ICDs), such as pathological gambling, binge eating, compulsive shopping and hypersexuality occur in approximately 13-14% of PD patients. Further behavioral disorders are the dopamine dysregulation syndrome (DDS), a substance dependence characterized by craving for dopaminergic substances and punding (prolonged repetitive activities which are not goal-oriented).Treatment-related risk factors are dopamine agonists for ICDs and a high total dopaminergic dose for DDS and punding. Shared risk factors are young age at onset, impulsive personality traits, depression and possibly dyskinesia. At the neuronal level these behavioral disorders seem to be associated with changes in the reward system and dysfunction of the orbitofrontal cortex. The evidence level for management strategies is at present insufficient. For ICDs current clinical practice consists of discontinuation or reduction of dopamine agonists.

Extrastriatal dopaminergic abnormalities of DA homeostasis in Parkinson's patients with medication-induced pathological gambling: A [11C] FLB-457 and PET study

Impulse control disorders such as pathological gambling (PG) are a serious and common adverse effect of dopamine (DA) replacement medication in Parkinson's disease (PD). Patients with PG have increased impulsivity and abnormalities in striatal DA, in common with behavioural and substance addictions in the non-PD population. To date, no studies have investigated the role of extrastriatal dopaminergic abnormalities in PD patients with PG. We used the PET radiotracer, [11C] FLB-457, with high-affinity for extrastriatal DA D2/3 receptors. 14 PD patients on DA agonists were imaged while they performed a gambling task involving real monetary reward and a control task. Trait impulsivity was measured with the Barratt Impulsivity Scale (BIS). Seven of the patients had a history of PG that developed subsequent to DA agonist medication. Change in [11C] FLB-457 binding potential (BP) during gambling was reduced in PD with PG patients in the midbrain, where D2/D3 receptors are dominated by autoreceptors. The degree of change in [11C] FLB-457 binding in this region correlated with impulsivity. In the cortex, [11C] FLB-457 BP was significantly greater in the anterior cingulate cortex (ACC) in PD patients with PG during the control task, and binding in this region was also correlated with impulsivity. Our findings provide the first evidence that PD patients with PG have dysfunctional activation of DA autoreceptors in the midbrain and low DA tone in the ACC. Thus, altered striatal and cortical DA homeostasis may incur vulnerability for the development of PG in PD, linked with the impulsive personality trait.

Preventing risky driving: A novel and efficient brief intervention focusing on acknowledgement of personal risk factors

Impulsive personality is an important predictor of risky driving. Acknowledging their impulsive tendencies may help novice drivers to drive more safely. The aim of this study was to evaluate the efficacy of a novel brief intervention targeting novice drivers’ risky behavior in traffic, taking into account potential moderator effects. Driving school students (n=1866) were divided into an intervention group and a control group. The intervention consisted of a lecture and group work (1.5h). Subjects’ traffic offenses and crashes were monitored during the following year using police and traffic insurance fund databases. The groups were similar in their baseline characteristics. The intervention group had half as many speeding violations in the year following the intervention compared with the controls. The proportion of speeders was significantly lower in the intervention group compared with the control group in subgroups of subjects with medium cognitive abilities and low or medium BIS-11 impulsiveness levels. In alpha2A-adrenoceptor gene (ADRA2A) G allele carriers, general traffic risk and speeding decreased in response to the intervention, unlike in subjects with the CC genotype. It is concluded that brief interventions that are integrated into the driving education program and focus on personal psychological risk factors may be effective for improving traffic safety.

Impulsive personality and risk-taking behavior in motorcycle traffic offenders: A matched controlled study

This study examines a hypothesis that motorcyclists with a history of traffic offences will make riskier driving decisions and engage in more risk-taking behavior because of poor response inhibition, accentuated by the behavioral-impairment effect of impulsivity. Fifty-nine motorcyclists with previous traffic offences, and 54 matched controls, were compared on measures of impulsivity, response inhibition, risk-taking behavior, and risky decision making. Although self-reported impulsivity did not correlate with behavioral task measures and was independent of unlawful status, analyzing participants’ task performance confirmed that the traffic offenders were different to the control sample in terms of response inhibition, risk-taking behavior, and risky driving decisions. Offenders demonstrated poorer response inhibition and greater willingness to take risks. These findings have implications for further research into the development of more reliable and valid measures that can be used to study the impulsive behavior of at-risk motorcyclists and to design interventions that will modify their cognitive-behavioral characteristics.

Are DSM-IV-TR Borderline Personality Disorder, ICD-10 Emotionally Unstable Personality Disorder, and CCMD-III Impulsive Personality Disorder Analogous Diagnostic Categories Across Psychiatric Nomenclatures?

This study examined the validity of the borderline construct which encompasses diagnostic criteria from the DSM-IV-TR Borderline Personality Disorder (BPD), ICD-10 Emotionally Unstable Personality Disorder (EUPD), and CCMD-III Impulsive Personality Disorder (IPD) in a sample of 1,419 Chinese psychiatric patients. Participants completed the Chinese Personality Disorder Inventory and the Chinese Personality Assessment Inventory-2 assessing various disordered personality features. Adequate internal consistency was found for the borderline construct (α = .83). Exploratory factor analysis revealed two components: (1) affective and cognitive disturbances, and (2) impulse dysregulation, which were replicated by confirmatory factor analysis. Item analysis indicated that the various borderline criteria displayed similar levels of diagnostic efficiency, which does not support the elimination of fear of abandonment and transient psychotic features from the EUPD and IPD criteria set. Findings of this study suggest that BPD, EUPD, and IPD may represent analogous diagnostic categories across classification systems.

Trait impulsivity and prefrontal gray matter reductions in cocaine dependent individuals

BackgroundImpulsivity is thought to play a key role in cocaine addiction onset and progression; therefore, we hypothesized that different facets of impulsive personality may be significantly associated with brain structural abnormalities in cocaine-dependent individuals. MethodsThirty-eight cocaine-dependent individuals and 38 non-drug using controls completed the UPPS-P scale (measuring five different facets of impulsivity: sensation seeking, lack of premeditation, lack of perseverance, and positive and negative urgency) and were scanned on a 3T MRI scanner. We used whole-brain voxel-based morphometry analyses (VBM) to detect differences in gray matter (GM) and white matter (WM) volumes between cocaine users and controls, and to measure differences in the way that impulsivity relates to GM and WM volumes in cocaine users vs. controls. ResultsCocaine-dependent individuals had lower GM volumes in a number of sections of the orbitofrontal cortex, right inferior frontal gyrus, right insula, left amygdala and parahippocampal gyrus, temporal gyrus, and bilateral caudate. They also had lower WM volumes in the left inferior and medial frontal gyrus, superior temporal gyrus, right anterior cingulate cortex, insula and caudate. There was a positive correlation between trait impulsivity and GM volume in the left inferior/middle frontal gyrus of cocaine-dependent individuals, a pattern directly opposed to the association in controls. Conversely, in cocaine users lack of premeditation was negatively correlated with GM volume in the insula and the putamen. ConclusionsTrait impulsivity may influence cocaine dependence by impacting its neurobiological underpinnings in frontostriatal systems.

Insight and suicidal behavior in first-episode schizophrenia

Suicidal behavior and suicide is prevalent in schizophrenia, with an estimated lifetime risk of approximately 5%. The risk is particularly high in the early phases of the disorder, and especially during the years around treatment initiation. Suicide attempts before first treatment contact are also prevalent, with the risk of suicide attempt associated with the length of untreated illness. Several risk factors are in common with the general population, and include previous suicide attempts, impulsive personality traits, substance abuse, depression and feelings of hopelessness. Recent research examines how patients’ subjective experiences, including their insight into having a severe mental illness and their beliefs about mental illnesses, may influence suicidal behavior. In this article, we will present a review of studies illustrating the complex background of suicide risk in schizophrenia, with a particular emphasis on the role of insight in the early phases of schizophrenia.

Toward a clinically useful and empirically based dimensional model of psychopathology

Toward a clinically useful and empirically based dimensional model of psychopathology

Predictors of Nonmedical Use of Prescription Stimulants

College students across the U.S. engage in nonmedical use of prescription stimulants (NMUPS) at increasing rates. While it has been found that use is frequently motivated by a belief that stimulants will act as a study aid, little is known about predictors of NMUPS. The present study addressed impulsivity, outcome expectancies, and evaluations of expected outcomes as predictors of NMUPS in a sample of 206 college students at a mid-Atlantic university. Approximately 26.1% of students endorsed past year NMUPS. Results indicated an increased likelihood of self-reported NMUPS was associated with increases in lack of premeditation, sensation seeking, positive expectancies and positive evaluations. Moreover, the extent to which participants believed that potential negative consequences were more severe was associated with a decreased likelihood of NMUPS. The current study suggests that impulsive personality, outcome expectancies, and evaluations of expected outcomes are important predictors of NMUPS among college students. Future research should consider other potential predictors of NMUPS in order to inform the development of prevention strategies.

P-75 - Relationship between impulsivity, mood disorders and personality traits in a sample of pathological gamblers

Introduction Pathological gambling refers to the uncontrollable impulse to gamble, irrespective of the interference the behaviour has on the individual's life. It often results in disrupted relationships, financial problems, criminal behaviour and yet the individual is unable to refrain. Aims Our aim is to evaluate the relationship among impulsivity traits, personality assessment and psychiatric comorbidity in a sample of pathological gamblers. Methods 78 pathological gamblers were evaluated with the following instruments: MINI to evaluate psychiatric comorbidity; TCI to evaluate personality traits, and BIS-11 to evaluate impulsivity. Pathological gambling was assessed with DSM-IV-TR criteria. Results In our sample we found an average score of BIS-11 (66,9) slightly higher than the score of the general population (63,8). The scores of TCI, compared with the mean scores of the general population, differ significantly with regard to NS, RD, C, ST. As to MINI, it reveals a significant prevalence of Major Depressive Episode, Dysthymia, GAD, and risk of suicide. We identified two groups at high and low impulsivity and we conducted an analysis in relation to personality traits measured by TCI and incidence of psychiatric comorbidity measured by the MINI. The group with high impulsivity was associated with significantly higher scores of NS and HA, and lower RD and SD. Also in this group there was a higher incidence of Major Depressive Episode and GAD. Conclusions The analysis allows to identify the impulsive trait as a discriminating factor of two different types of players in relation to personality characteristics and psychiatric comorbidity.

Mortality at 9 years in alcohol-dependence: The respective roles of alcohol, tobacco, and vulnerability genes

Aims: Different vulnerability genes have been proposed in alcohol dependence, but replications are sparse, probably due to 1) phenotypical heterogeneity and 2) difficulties to rely on reliable definition of the correct phenotype. Indeed, specific subgroups of patients may be more directly concerned with some vulnerability genes, the actions of these genes being more directly related to their function. We postulated that three potential vulnerability genes, that were at least twice associated with alcohol dependence, influence the extreme of the severity of alcohol dependence, i.e. mortality, through traits with which they were previously associated, namely impulsivity and antisocial personality disorder and the 5-HT1B gene, suicide attempt and the short allele of 5-HTTLPR, and addictive disorder comorbidity and the DRD2 gene. Methods: We analysed the survival status of a male alcohol-dependent sample (n = 126) recruited 9 years before, and could compare 61 surviving patients to 41 patients who died during this period (representing 81.0% of the initial sample). Results: The main clinical characteristic that was associated with an increased mortality rate was a larger cumulative tobacco use (pack-years). We also found that the C allele of the 5-HT1b was the only one in excess in the non-surviving patients. Contrary to our hypothesis, impulsivity and antisocial personality disorder were not explaining the role of this gene. Conclusions: Even if there is a significant involvement of the 5- HT1B C allele, no intermediate phenotype was detected in our sample. The relatively short delay of 9 years and the somewhat old age at baseline of our patients could have limited the influence of psychiatric comorbidity or the specificities of alcohol dependence, explaining why the only detected co-factor was tobacco consumption. Tobacco dependence is therefore the main factor to explain mortality within the first decade, and the effect of this comorbid condition is not explained by three vulnerability genes previously associated to alcohol dependence.

P-80 - Transcranial magnetic stimulation as potential therapeutic tool on alcohol disorders: evidences and proposals

Transcranial magnetic stimulation (TMS) is a non invasive technique of brain stimulation which could be an interesting therapeutic tool in addictive disorders, being offline repetitive TMS (rTMS) the main strategy used due to it allows to disrupt underlying brain areas and examine behavioral consequences, (Knoch et al., 2006). There are some evidences that rTMS over the dorso-lateral prefrontal (DLPF) cortex is effective reducing craving in several drugs, such as cocaine, tobacco and alcohol (Camprodon et al., 2007; Amiaz et al., 2009; Mishra et al. 2010). In fact, a decrease on cocaine craving could be observed with a single session of rTMS. Complementary, the application of single and paired-pulse TMS in controlled paradigms is a novel and promising strategy in this area: recent results showed that reward modulated TMS-induced motor-evoked potentials, showing greater cortical inhibition during reward expectation (Gupta and Aron, 2010). Regarding alcohol abuse, there is a narrow relation between alcohol consumption and impulsiveness. On one hand, alcohol consumption produces impulsive behavior and desinhibition (Marinkovic et al. 2011); and on the other hand, impulsiveness personality trait predisposes to abusive alcohol consumption (Magid et al. 2007). Considering these evidences and the effectiveness of rTMS as therapeutic tool, use rTMS to reduce impulsivity could be a new approach to alcohol disorders treatment. Prefrontal cortex is a good candidate for this purpose since its pivotal role in impulsiveness behavior (Crews and Boettinger, 2009). Thus, we suggest that high frequency rTMS stimulation could improve the ability of alcohol abusers for control their drinking impulse.

Structural Network Topology Revealed by White Matter Tractography in Cannabis Users: A Graph Theoretical Analysis

Endocannabinoid receptors modulate synaptic plasticity in the brain and may therefore impact cortical connectivity not only during development but also in response to substance abuse in later life. Such alterations may not be evident in volumetric measures utilized in brain imaging, but could affect the local and global organization of brain networks. To test this hypothesis, we used a novel computational approach to estimate network measures of structural brain connectivity derived from diffusion tensor imaging (DTI) and white matter tractography. Twelve adult cannabis (CB) users and 13 healthy subjects were evaluated using a graph theoretic analysis of both global and local brain network properties. Structural brain networks in both CB subjects and controls exhibited robust small-world network attributes in both groups. However, CB subjects showed significantly decreased global network efficiency and significantly increased clustering coefficients (degree to which nodes tend to cluster around individual nodes). CB subjects also exhibited altered patterns of local network organization in the cingulate region. Among all subjects, schizotypal and impulsive personality characteristics correlated with global efficiency but not with the clustering coefficient. Our data indicate that structural brain networks in CB subjects are less efficiently integrated and exhibit altered regional connectivity. These differences in network properties may reflect physiological processes secondary to substance abuse-induced synaptic plasticity, or differences in brain organization that increase vulnerability to substance use.

A paired case-control study on psychosocial factors of suicide attempters

Objective To explore the roles on psychosocial factors of suicide behavior in the suicide attempters.Methods 132 suicide attempters and 132 matched controls treated in the emergency department were assessed using certain psychosocial questionnaires,such as Health Questionnaire of WHO,Questionnaire of Life Measure ( QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory ( BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale ( BAS),Social Surpport Rate Scale and Questionnaire of Coping Style (QCS).Results ( 1 ) The results of single-factor analysis showed that the scores of Health Questionnaire of WHO and QL were lower in the suicide attempter group than those in the control group( suicide attempter group:17.07±3.07 and 9.76 ±7.11; control group:13.42 ±3.31 and 17.08 ±3.81,all P＜0.05),otherwise the scores of BDI,BAI,BIS and BAS were higher( suicide attempter group:15.22 ± 11.22,27.87 ± 7.24,87.67 ±20.08 and 73.74 ± 19.61 ; control group:6.87 ± 6.36,26.22 ± 5.44,73.34 ± 14.54 and 63.78 ± 16.44,all P ＜ 0.05 ).Among QCS,the sub-score of self-blaming was higher( 3.42 ± 2.44 VS 2.35 ± 2.04,P ＜ 0.05 ),otherwise the sub-scores of question solvation,asking for help and rationalization were lower( all P ＜ 0.05 ).( 2 ) The result of multi-factors analysis showed that gender,mean education times,the scores of QL,HQ,BDI,and BIS,sub-score of rationalization,and so on,entried the Logistic aggressive equaltion.Conclusion The status of health,quality of life,depressive and anxious mood,impulsive and aggressive personality,and certain coping style play important role. Key words: Suicide attempter; Psychosocial factors; Case control study

Impulsive personality and the ability to resist immediate reward: An fMRI study examining interindividual differences in the neural mechanisms underlying self‐control

The ability to resist immediate rewards is crucial for lifetime success and individual well-being. Using functional magnetic resonance imaging, we assessed the association between trait impulsivity and the neural underpinnings of the ability to control immediate reward desiring. Low and high extreme impulsivity groups were compared with regard to their behavioral performance and brain activation in situations, in which they had to forego immediate rewards with varying value to achieve a superordinate long-term goal. We found that highly impulsive (HI) individuals, who successfully compensated for their lack in behavioral self-control, engaged two complementary brain mechanisms when choosing actions in favor of a long-term goal, but at the expense of an immediate reward. First, self-controlled decisions led to a general attenuation of reward-related activation in the nucleus accumbens, which was accompanied by an increased inverse connectivity with the anteroventral prefrontal cortex. Second, HI subjects controlled their desire for increasingly valuable, but suboptimal rewards through a linear reduction of activation in the ventromedial prefrontal cortex (VMPFC). This was achieved by an increased inverse coupling between the VMPFC and the ventral striatum. Importantly, the neural mechanisms observed in the HI group differed from those in extremely controlled individuals, despite similar behavioral performance. Collectively, these results suggest trait-specific neural mechanisms that allow HI individuals to control their desire for immediate reward.

Neuropsychological profiling of impulsivity and compulsivity in cocaine dependent individuals

Research on the relative impact of trait impulsivity vs. drug exposure on neuropsychological probes of response inhibition vs. response perseveration has been posited as a valid pathway to explore the transition between impulsivity and compulsivity on psychostimulant dependence. The objectives of this study are to examine performance differences between cocaine-dependent individuals (CDI) and healthy comparison individuals (HCI) on neuropsychological probes of inhibition and perseveration and to examine the predictive impact of trait impulsivity-a proxy of premorbid vulnerability, and severity of cocaine use-a proxy of drug exposure, on CDI's performance. Forty-two CDI and 65 HCI were assessed using the UPPS-P Scale (trait impulsivity), the Stroop and go/no-go (inhibition) and revised-strategy application and probabilistic reversal tests (perseveration). CDI, compared to HCI, have elevated scores on trait impulsivity and perform significantly poorer on inhibition and perseveration, with specific detrimental effects of duration of cocaine use on perseveration. CDI have both inhibition and perseveration deficits; both patterns were broadly indicative of orbitofrontal dysfunction in the context of reinforcement learning. Impulsive personality and cocaine exposure jointly contribute to deficits in response perseveration or compulsivity.