Impulsivity In Adolescents Research Articles

Heritability and Longitudinal Stability of Impulsivity in Adolescence

Impulsivity is a multifaceted personality construct that plays an important role throughout the lifespan in psychopathological disorders involving self-regulated behaviors. Its genetic and environmental etiology, however, is not clearly understood during the important developmental period of adolescence. This study investigated the relative influence of genes and environment on self-reported impulsive traits in adolescent twins measured on two separate occasions (waves) between the ages of 11 and 16. An adolescent version of the Barratt Impulsiveness Scale (BIS) developed for this study was factored into subscales reflecting inattention, motor impulsivity, and non-planning. Genetic analyses of these BIS subscales showed moderate heritability, ranging from 33-56% at the early wave (age 11-13 years) and 19-44% at the later wave (age 14-16 years). Moreover, genetic influences explained half or more of the variance of a single latent factor common to these subscales within each wave. Genetic effects specific to each subscale also emerged as significant, with the exception of motor impulsivity. Shared twin environment was not significant for either the latent or specific impulsivity factors at either wave. Phenotypic correlations between waves ranged from r = 0.25 to 0.42 for subscales. The stability correlation between the two latent impulsivity factors was r = 0.43, of which 76% was attributable to shared genetic effects, suggesting strong genetic continuity from mid to late adolescence. These results contribute to our understanding of the nature of impulsivity by demonstrating both multidimensionality and genetic specificity to different facets of this complex construct, as well as highlighting the importance of stable genetic influences across adolescence.

Are impulsive adolescents differentially influenced by the good and bad of neighborhood and family?

Using the differential susceptibility perspective (Belsky & Pluess, 2009) as a guiding frame-work, age 12 neighborhood disadvantage (ND) and family characteristics (parental knowledge) were examined as moderators of the relations between age 12 youth impulsivity and the development (ages 13, 14, and 15) of positive (community activities) and negative (antisocial behavior; ASB) adolescent behavior. An interaction between ND and youth impulsivity (age 12) operated with differential susceptibility, but only for female community activities at age 13: under low levels of ND, impulsive adolescent females engaged in the highest levels of community activities, whereas under high ND, they engaged in the lowest levels. Exploratory analysis showed the association between community activities and ND to be partially related to parents' or adults' engagement in informal social controls (e.g., alerting the police with misbehavior in the neighborhood). Differential susceptibility effects were not identified for: (i) parental knowledge and impulsivity; (ii) ASB (ages 13, 14 or 15); or (iii) community involvement at ages 14 and 15. Findings provide limited evidence for impulsivity as a differential susceptibility phenotype.

Impulsivity in Adolescents with Bipolar Disorder and/or Attention-Deficit/Hyperactivity Disorder and Healthy Controls as Measured by the Barratt Impulsiveness Scale

To compare the type and degree of impulsivity among adolescents with bipolar disorder (BD), adolescents with attention-deficit/hyperactivity disorder (ADHD), and healthy comparison subjects using the Barratt Impulsiveness Scale, Version 11 (BIS-11). Manic adolescents with BD (n=31), adolescents with ADHD (n=30), and healthy subjects (n=25) completed the BIS-11, a 30-item, self-report scale with three subscales (cognitive, motor, and nonplanning). The BIS-11 total and subscale scores were compared among groups. We also examined associations among the BIS-11, Young Mania Rating Scale and co-occurring disruptive behavioral disorders (DBDs) within the BD group. Total and each subscale scores were significantly higher for the BD group than for the healthy controls (p<0.05). The total scores and the cognitive and motor subscale scores were significantly higher for the ADHD group than for the healthy control group (p<0.05). However, there was no statistically significant difference between the nonplanning subscale scores of the ADHD group and the healthy control group (p>0.05). There were no significant differences between the BD and ADHD groups or between the BD groups with and without ADHD. The BD patients with DBDs (i.e., oppositional defiant disorder or conduct disorder) scored significantly higher on the motor subscale than did BD patients without DBDs. There were no statistically significant associations between the Young Mania Rating Scale and BIS-11 scores within the BD group. Our findings suggest that impulsivity is elevated in adolescents with BD as well as adolescents with ADHD, except for nonplanning impulsivity, which was not significantly different between adolescents with ADHD and the healthy comparison group. This may suggest that nonplanning impulsivity is relatively specific to adolescents with BD. Additionally, our data indicate that elevations in impulsivity, as measured by the BIS-11, may be independent of symptoms severity and, therefore, may be a stable, trait-related component of BD.

Parents’ Reactions to Youths’ Hyperactivity, Impulsivity, and Attention Problems

Hyperactivity, impulsivity, and attention problems (HIA) in children and adolescents are stressful for parents. In this study, we used theories of parents' perceived power and attributions for youths' behaviors to develop a model to understand parents' reactions to their youths' HIA. We followed 706 youths (376 boys and 330 girls, aged 10-12 years at T1) and their parents in a community-based project over 5 years. Measures of youths' HIA, youths' unresponsiveness to correction, parents' feelings of powerlessness, parental monitoring, and parents' negative behaviors toward their youths, were used. HIA in youths predicted increases in parents' perceptions that their youths were unresponsive to correction, which in turn prompted parents to feel more powerless over time. Further, parents' feelings of powerlessness were associated with increases in negative parenting behaviors over time. These results indicate a movement to more negative parenting practices over time as a result of youths' HIA.

O1-S04.04 Predictors of repeat Chlamydia trachomatis and/or Neisseria gonorrhoeae infections among African-American adolescent females

BackgroundYoung African-American females have the highest rates of Chlamydia (CT) and gonorrhoea (GC) in the US. Few studies have explored predictors of repeat STDs among this population. The objective was...

Compounded Effect of Early Adolescence Depressive Symptoms and Impulsivity on Late Adolescence Gambling: A Longitudinal Study

Depression and impulsivity have been positively correlated to problem gambling, but no study has focused on their combined effects on the onset of problem gambling. This study examined the possible synergistic effect of depressive symptoms and impulsivity in early adolescence on late adolescence gambling behaviors among a longitudinal cohort of 678 students from Baltimore, Maryland. The South Oaks Gambling Screen-Revised for Adolescents, Teacher Observation of Classroom Adaptation-Revised, and Baltimore How I Feel-Adolescent Version, were used to assess late adolescence gambling behaviors, early adolescence impulsivity, and depressive symptoms, respectively. Data analyses were conducted using analysis of variance and binary logistic regression models. Problem gamblers (PGs) were 12% of the sample (includes at-risk and PGs), 87.5% of whom were males and 12.5% were females (p < .001). Among males, there appeared to be a slight association between early adolescence depressive symptoms and late adolescence problem gambling. Compared with nongamblers and social gamblers, depressive symptoms increased the odds of problem gambling by four-fold (PGs vs. nongamblers: OR = 4.1, 95% CI = .73-22.47, p = .11; PGs vs. social gamblers: OR = 3.9, 95% CI = .78-19.31, p = .10). Among those with high depressive symptoms, increases in impulsivity decreased the odds of problem gambling while among those with high impulsivity, increases in depressive symptoms decreased the odds of problem gambling. Early adolescence depressive symptoms appear to be more positively associated with late adolescence problem gambling than early adolescence impulsivity, there seems to be a divisive interaction between depressive symptoms and impulsivity on problem gambling.

A distress tolerance skills group with impulsive adolescents

A distress tolerance skills group with impulsive adolescents

Guanfacine Extended-Release

Guanfacine, an alpha(2A)-adrenoceptor agonist, is available in the US as an extended-release (ER) tablet for the treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents (aged 6-17 years). In two large, randomized, double-blind, placebo-controlled trials of 8 and 9 weeks' duration, guanfacine ER (1-4 mg once daily) was effective in reducing the symptoms of ADHD (hyperactivity, impulsivity and inattention) in children and adolescents. There were significant reductions (denoting improvements) from baseline in ADHD rating scale IV (ADHD-RS-IV) total scores (the primary endpoint), compared with placebo. Oppositional symptoms were also significantly reduced from baseline in children with ADHD with oppositional symptoms who received guanfacine ER in a randomized, double-blind, placebo-controlled trial. Improvements in ADHD symptoms were sustained over 24 months in two noncomparative, open-label extension trials in children and adolescents who received guanfacine ER at an optimized dosage of 1-4 mg/day. Guanfacine ER was relatively well tolerated in clinical trials in children and adolescents. The most common treatment-emergent adverse events were somnolence-related, and tended to resolve over time.

DAT1 and COMT Effects on Delay Discounting and Trait Impulsivity in Male Adolescents with Attention Deficit/Hyperactivity Disorder and Healthy Controls

Choice impulsivity has been linked to dopamine function and is consistently observed in attention deficit/hyperactivity disorder (ADHD) as a preference for smaller-immediate over larger-delayed rewards using choice-delay paradigms. More sophisticated delay discounting paradigms have yielded inconsistent results. Context and sample characteristics may have contributed to these variations. In this study we examine the effect of type (real vs hypothetical) and magnitude of reward as well as of variation in dopamine genes on choice impulsivity. We selected 36 male adolescents with ADHD-combined subtype (ADHD-CT) and 32 controls (mean age=15.42, SD=2.05) to form four roughly equally sized subgroups on the basis of DAT1(10/6) haplotype dosage (2 copies and <2 copies). Participants, who were also genotyped for the COMT(val158met) and DRD4(48bp-VNTR) polymorphisms, performed a hypothetical and a real-time discounting task and provided self-ratings of trait impulsivity. The ADHD-CT group discounted rewards more steeply than controls only in the hypothetical task, with delay, but not reward magnitude, influencing choices. They also rated themselves as more impulsive compared with controls. DAT1(10/6) dosage and the COMT(Val158Met) genotype predicted trait impulsivity and discounting rates in the hypothetical task, but not in the real-time task. Our results directly link variation in genes putatively influencing dopamine signaling in the prefrontal cortex (COMT(Val158Met)) and the striatum (DAT1(10/6)) with discounting rates in a hypothetical task (but not a real-time task) and self-ratings of trait impulsivity in ADHD-CT and healthy controls. The lack of magnitude effects in the hypothetical task suggests that discounting in this task may be influenced by different processes in ADHD-CT than in healthy controls.

The role of contextual risk, impulsivity, and parental knowledge in the development of adolescent antisocial behavior.

The present study (a) tests main and moderational effects of neighborhood and family risk, and adolescent impulsivity on the development of male and female antisocial behavior (ASB) and (b) examines the extent to which these effects work indirectly through parental knowledge. Adolescents (N = 4,597; 51% male) reported on informal social control in their neighborhoods, their family types, and impulsivity at age 12, and on parental monitoring and ASB at ages 13 and 15 years. Neighborhoods were further defined as risk and nonrisk in economic deprivation by census-level data. Main effects of neighborhood risk, single parenthood, and impulsivity on ASB were found for male and female adolescents. For female adolescents, impulsivity interacted with neighborhood economic deprivation and with family type in the prediction of parental knowledge. Impulsivity and contextual risk factors in part increased adolescent ASB through decreasing parental knowledge. Theoretical and policy implications are discussed.

Consumo de drogas en adolescentes: El papel del estrés, la impulsividad y los esquemas relacionados con la falta de límites

The aim of this study was to assess the association between stress, cognitive schemas, impulsivity, and substance use in adolescents. A sample of 657 adolescents (367 girls and 290 boys) completed measures of stressful life events, cognitive schemas of grandiosity and insufficient self-control, impulsive style of problem-solving and substance use. The results indicated that stressful life events and the cognitive schemas were significantly associated with substance use. In addition, the impulsive style of problem-solving moderated the relationship between stressors and substance use, this association being stronger among more impulsive adolescents. Finally, the results indicated that boys scored higher on Grandiosity and on the use of marijuana, cocaine, LSD and ecstasy, while girls scored higher on tobacco use (smoking). Despite these differences, gender did not moderate the association between schemas and substance use.

Functional and Dysfunctional Impulsivity in Childhood and Adolescence

There are few self-reports of impulsivity dealing with children, although this personality trait has been related to many behaviour problems in both children and adolescents. The appropriateness of the Dickman Impulsivity Inventory for Children (DII-c) and the Dickman Impulsivity Inventory (DII) to measure impulsivity in children and adolescents was assessed. The factorial structure of the DII-c and the internal consistencies for both inventories suggest the measured dimensions are not consistent until adulthood. These self-report measures are not appropriate for children and adolescents.

The effect of 5-HTT gene promoter polymorphism on impulsivity depends on family relations in girls

The short (S) allele of the 5-HTT gene promoter region polymorphism (5-HTTLPR), in combination with adverse environmental influence, leads to higher likelihood of depression. Impulsivity has been related to low serotonin turnover, poor regulation of affect, and problems in the family, including child maltreatment. The current study explored the effect of the 5-HTTLPR polymorphism in the serotonin transporter gene and adverse family environment on impulsivity in adolescents. Healthy adolescents participating in the Estonian Children Personality Behaviour and Health Study ( n = 483) filled the Adaptive and Maladaptive Impulsivity Scale (AMIS), Barratt Impulsiveness Scale (BIS-11), a scale measuring family relations, and were genotyped. While genotype alone was not associated with thoughtlessness, BIS-11 impulsiveness, fast decision-making or excitement seeking, 5-HTTLPR S allele carriers, however, had higher scores of disinhibition. In girls carrying the S allele, scores of thoughtlessness and disinhibition depended on family relations, being higher with less warmth in the family. Adverse family relations had no effect on impulsivity in girls with LL genotype. In boys, the effects of family relations on maladaptive impulsivity did not depend on genotype. However, the S allele and high maltreatment in the family both independently increased disinhibition and the BIS-11 score in boys. Family environment and the 5-HTTLPR genotype had no interactive effect on excitement seeking or fast decision-making. In summary, carrying the S allele may lead to high maladaptive impulsivity due to higher sensitivity to environmental adversity, which is more significantly expressed in girls.

BIS-11A -Hindi version: A preliminary study of impulsivity in rural and urban Indian adolescents

Context:Despite of there being a pressing need to gauge impulsivity scores, there is no behavioral instrument in India to assess the impulsivity in adolescents. No earlier studies have been done in India to access impulsivity in adolescents. Even in western countries, no study has been done in rural setting to access impulsivity, although segment of rural population is small in western nations with major population residing in urban areas.Aims:To translate BIS-11A into Hindi from English in a culturally sensitive manner and to do preliminary study in rural and urban areas.Settings and Design:First translation of BIS-11 (as it is meant for adults) and cultural substitution resulted in Hindi adult version. Adolescent version was derived from adult version by replacing adult activities with adolescent activities.Materials and Methods:BIS-11 English version was translated into Hindi and a back translation was made. As BIS-11 was developed for adults, answering some of the questions poses challenges for adolescents, so to be used with adolescents, questions that do not fit into adolescent age group were substituted keeping in view the activities of adolescents. Besides, questions that were not suitable as per the Indian culture were modified. Initially, these changes were made hypothetically by discussion among the authors and later a group of 48 school students were interviewed about the questions. Based on the interviews of students a final version was prepared. Translation, back translation, cultural substitution -hypothetically, and in school by discussion were carried out. The questionnaire was given to 120 urban high school students (in Jaipur, northern India) and 50 rural students (at Kanota, 25 km from Jaipur, northern India) and the scores were calculated as per the scoring method provided with original BIS-11.Statistical Analysis:T-test (two-tailed, two sample unequal variance, i.e., type 3) was used.Results:T-test (two-tailed, two sample unequal variance, i.e., type 3) found no significant difference between impulsivity scores of adolescents of urban and rural areas t 0.05(2)1 = 0.57, |t| < t 0.05(2)1, P > 0.05, P = 12.706. There were no gender related differences either.Conclusions:As impulsivity can lead to suicide and is implicated for substance abuse in disorders like Schizophrenia, it is important that culturally sensitive impulsivity studies are done in India on a large scale keeping in view the large size of population. Standardization of the BIS11-A Hindi version is being taken up. The work on Hindi version also generates necessity for other tasks if BIS-11(Hindi version) is to be used widely. Work on psychometric properties of Hindi version of BIS-11 A is being taken up. There is a need to devise a quick way to calculate impulsivity scores keeping in view the large population of India (1 billion out of which at least 33% is Hindi speaking, Census Survey of India, 2001). Besides, BIS-11A needs to be developed for other regional languages in India as there is a high-linguistic diversity in India.

Gambling Problems and Features of Attention Deficit Hyperactivity Disorder Among Children and Adolescents

Adolescence has been typically described as a developmental stage during which risky behaviors are common. Although considerable attention has been paid to high-profile risky behaviors, including alcohol and drug abuse, eating disorders, and smoking, little attention has focused on adolescent problem gambling. Given the DSM criteria of problem gambling being designated as an impulse control disorder, the relationship between adolescent problem gambling and impulsivity was assessed by using 2336 adolescents aged 12 to 19 years. Adolescents experiencing problem gambling- related behaviors were found to have a greater number of self-reported Attention Deficit Hyperactivity Disorder symptoms. The results are discussed with respect to the relationship between adolescent impulsivity and gambling problems.

Memory for Angry Faces, Impulsivity, and Problematic Behavior in Adolescence

Research has shown that cognitive processes like the attribution of hostile intention or angry emotion to others contribute to the development and maintenance of conduct problems. However, the role of memory has been understudied in comparison with attribution biases. The aim of this study was thus to test if a memory bias for angry faces was related to conduct problems in youth. Adolescents from a junior secondary school were presented with angry and happy faces and were later asked to recognize the same faces with a neutral expression. They also completed an impulsivity questionnaire. A teacher assessed their behavior. The results showed that a better recognition of angry faces than happy faces predicted conduct problems and hyperactivity/inattention as reported by the teacher. The memory bias effect was more pronounced for impulsive adolescents. It is suggested that a memory bias for angry faces favors disruptive behavior but that a good ability to control impulses may moderate the negative impact of this bias.

The Efficacy and Tolerability of Quetiapine versus Divalproex for the Treatment of Impulsivity and Reactive Aggression in Adolescents with Co-Occurring Bipolar Disorder and Disruptive Behavior Disorder(s)

The aim of this study was to compare the efficacy and tolerability of quetiapine and divalproex for the treatment of impulsivity and reactive aggression in adolescents with co-occurring bipolar disorder and disruptive behavior disorders. Patients were included in this post hoc analysis if they scored > or = 14 on the Positive and Negative Syndrome Scale (PANSS) Excited Component (EC) and > or = 4 on at least one of the PANSS EC items, had a current diagnosis of bipolar I disorder, manic or mixed episode, and had a lifetime and/or current diagnosis of a disruptive behavioral disorder (DBD) [conduct disorder (CD) or oppositional defiant disorder (ODD)]. Thirty-three (92%) of the 36 subjects with bipolar disorder and DBD met the PANSS EC inclusion criteria. These thirty-three adolescents were randomized to quetiapine (400-600 mg/day) or divalproex (serum level 80-120 microg/mL) for 28 days in this double-blinded study. The primary efficacy measure was change in PANSS Excited Component (EC) score over the study period and at each time point. Repeated measures analysis of variance (ANOVA) demonstrated statistically significant within-treatment-group effects for divalproex (baseline = 20.6, end point = 13.3, p < 0.0001) and quetiapine (baseline = 18.8, end point = 10.8, p < 0.0001) for the PANSS EC. There were no statistically significant treatment group differences in PANSS EC changes from baseline to end point scores (p = 0.7, d = 0.14). Mixed regression analyses (comparison of slopes, DAY*TREATMENT) revealed that there was no significant difference in the rate of improvement in the PANSS EC scores between the two treatment groups [F(1,31) = 0.78, p = 0.39, d = 0.28]. Quetiapine and divalproex showed similar efficacy for the treatment of impulsivity and reactive aggression related to co-occurring bipolar and disruptive behavior disorders in adolescents. Quetiapine and divalproex are both useful as monotherapy for the treatment of impulsivity and reactive aggression in adolescents with bipolar and disruptive behavior disorders. Placebo-controlled studies are necessary.

Sex differences in the relationship between white matter microstructure and impulsivity in adolescents

Rapid maturational brain changes occur during adolescence--a time associated with risk-taking behaviors and improvements in cognition. The present study examined the relationship between white matter (WM) microstructure, impulsive behavior and response inhibition in female and male adolescents. Twenty-one healthy adolescents underwent diffusion tensor imaging using a 3.0-T magnetic resonance imaging system. Impulse control was assessed using the Bar-On Emotional Quotient Inventory, Youth Version. Response inhibition was assessed using the Stroop Color-Word Interference Test. Fractional anisotropy (FA), a measure of WM coherence, and trace, a measure of overall diffusivity, were determined from voxels manually placed in the midline and in the left and right forward-projecting arms of the genu and the splenium of the corpus callosum. Sex-specific differences were observed for the relationship between FA and impulsive behavior in the right anterior callosum for males and in the splenium for females. Males, compared to females, displayed significantly higher FA in the left WM region. Although trace was not associated with impulse control, trace in the genu (for females) and splenium (males and females) was associated with Stroop performance. Regional differences in trace also were evident, with lower values in the splenium observed than in all other regions. Although the latter significantly improved with age, no sex differences in impulse control or in Stroop performance were detected. The present findings provide supporting evidence for sex-related differences in the development of WM microstructure during adolescence. These data further suggest a neurobiological mechanism underlying some of the emotional and cognitive changes commonly observed in males versus females during the adolescent period.

Measuring Impulsivity in Adolescents With Serious Substance and Conduct Problems

Adolescents with substance use and conduct disorders have high rates of aggression and attention deficit hyperactivity disorder (ADHD), all of which have been characterized in part by impulsivity. Developing measures that capture impulsivity behaviorally and correlate with self-reported impulsivity has been difficult. One promising behavioral measure, however, is a variant of the continuous performance test, the Immediate Memory Test/Delayed Memory Test (IMT/DMT). The authors showed significant group differences between adolescents in treatment for serious substance and conduct problems and community controls on impulsivity measures, both behavioral and self-report, as well as on aggression and problem behavior measures. Furthermore, the IMT/DMT correlated significantly with self-reported impulsivity. In summary, the IMT/DMT may be an effective behavioral measure of impulsivity in adolescents.

Impulsivity, suicidality and alcohol use disorders in adolescents and young adults with borderline personality disorder

Borderline Personality Disorder (BPD) is a severe and disabling psychiatric condition that typically emerges in late adolescence or early adulthood. Nearly 50% of individuals with BPD have a co-occurring Alcohol Use Disorder (AUD) at some point in the course of their illness. This study explores clinical characteristics of adolescents and young adults (age 30 years and younger) with BPD and AUD (N=21) compared to BPD without any history of substance use disorders (N=17). Based on theoretical considerations and previous findings, we hypothesized that adolescents and young adults with BPD and AUDs would be more impulsive and exhibit higher rates of suicidal behavior than individuals with BPD and no substance use disorders. Consistent with our first hypothesis, the BPD/AUD group was more impulsive than the BPD only group. However, the two groups did not differ on measures of suicidal behavior. Overall, impulsivity was correlated with total number of suicide attempts in the adolescent/young adult group. When older BPD participants were included in the comparison (up to age 55), the BPD/AUD group exhibited more lifetime suicide attempts that were higher in medical lethality than the BPD only group, suggesting an overall increased lifetime suicide risk in the BPD/AUD group. The relationship between impulsivity, AUD, and suicidal behavior and lifetime suicide risk in adolescent and young adults with BPD is discussed.