Role Of Impulsivity Research Articles

The role of impulsivity, cognitive bias, and reasoned action in understanding college student gambling

Factors related to gambling behavior among college students in the USA are examined by applying the theory of reasoned action (TRA) and incorporating the concepts of impulsivity and cognitive bias. This study uses a broader approach to analyze gambling behavior by including financial behavior variables using ordinary least squares (OLS) and logistic regressions. The survey data were collected through a self-administered online questionnaire of college students from 19 colleges and universities in the fall of 2010. With a sample of 5024 college students, a majority of the respondents (84.45%) in this study report that they did not gamble in the last 30 days. The results of multivariate analysis indicate that gambling is related to attitudes toward gambling, cognitive bias toward gambling, subjective norms of family members regarding financial behavior, and impulsivity. Underestimation of financial behavior (cognitive bias toward financial behavior) was found to be associated with only gambling frequency but not gambling propensity.

Aggression in Schizophrenia and its Relationship to Neural Circuitry of Urgency

Aggression in Schizophrenia and its Relationship to Neural Circuitry of Urgency

The role of impulsivity in dropout from treatment for cigarette smoking

Impulsivity is a variable that has been associated with drug use. This study analyzes impulsivity from two different paradigms, one considering it as a trait and the other based on its behavioral correlates, such as disinhibition and impulsive decision-making in the treatment prognosis (maintain abstinence, relapse and dropout) of smokers after outpatient treatment. The participants in the study were 113 smokers who requested treatment for nicotine addiction. They were assigned to three groups according to whether or not they remained abstinent one month after beginning treatment; thus, group 1 was abstinent, group 2 had relapsed, and group 3 had dropped out of treatment. The participants filled out the Semi-structured Interview for Smokers, the Fargerström Test for Nicotine Dependence, the Temperament and Character Inventory-Revised (TCI-R) and the Delay Discounting Task (DDT). The Delay Discounting variable presents lower scores in the dropout group than in the relapse and abstinent groups, with the highest scores in the relapse group. Differences were also found on the Harm Avoidance (HA) variable, with lower scores in the dropout group compared to the relapse group. The importance of these results lies in the consideration of the smoker’s personality profile in order to prevent both dropout and relapse.

Introduction to special section: ADHD, impulsivity, and alcohol abuse.

The goal of this special section is to highlight progress made and primary research reports on the relation between Attention Deficit Hyperactivity Disorder (ADHD), impulsivity, and alcohol use disorders (AUDs) utilizing a diverse range of methods. The four papers examine various psychological processes underlying the broad construct of impulsivity that are related largely to impairments in inhibitory control. The section addresses the influences of reward sensitivity, working memory/attention control, and social functioning in the development and persistence of AUDs among individuals with ADHD. These papers are important because they approach the relation between ADHD and AUDs, and the role of impulsivity, from varied perspectives.

Impulsivity as a predictor of treatment outcome in substance use disorders: Review and synthesis

Impulsivity is a widely studied personality trait and research construct that has been implicated as a risk factor for substance use, including initiating and continuing use. However, relatively few studies have examined impulsivity as a predictor of treatment outcome. Because impulsivity has been operationalised in many different ways, cross-comparisons of empirical studies have been difficult. The PubMed database was searched in September 2013. Reference lists of papers retrieved from this search were also manually scanned for additional resources. Studies were included if they presented data that assessed impulsivity as a predictor of treatment outcomes. The body of literature reviewed in this paper suggests that higher pretreatment impulsivity, regardless of how it is measured, usually is associated with poorer treatment outcomes. Recent data indicate that some psychosocial and pharmacological treatments may directly impact impulsivity and thus represent an interesting avenue for further research. Impulsivity appears to be a key predictor of substance use treatment outcomes and warrants more attention in the improvement of treatment outcomes. Suggestions for future research on the role of impulsivity in substance use treatment are provided.

Brain γ‐aminobutyric acid: a neglected role in impulsivity

The investigation of impulsivity as a core marker of several major neuropsychiatric disorders has been greatly influenced by the therapeutic efficacy of drugs that block the reuptake of dopamine and noradrenaline in the brain. As a result, research into the neural mechanisms of impulsivity has focused on the catecholamine systems as the loci responsible for the expression of impulsive behaviour and the primary mechanism of action of clinically effective drugs for attention-deficit hyperactivity disorder (ADHD). However, abnormalities in the catecholamine systems alone are unlikely to account for the full diversity and complexity of impulsivity subtypes, nor can they fully explain co-morbid brain disorders such as drug addiction. Here we review the lesser-studied role of γ-aminobutyric acid (GABA) in impulsivity, a major target of the dopaminergic and noradrenergic systems in the prefrontal cortex and striatum, and consider how abnormalities in this inhibitory neurotransmitter might contribute to several forms of impulsive behaviour in humans and experimental animals. Our analysis reveals several promising leads for future research that may help inform the development of new therapies for disorders of impulse control.

Dysfunctional decision-making in pathological gambling: Pattern specificity and the role of impulsivity

Dysfunctional decision-making in individuals with pathological gambling (PGs) may result from dominating reward-driven processes, indicated by higher impulsivity. In the current study we examined (1) if PGs show specific decision-making impairments related to dominating reward-driven processes rather than to strategic planning deficits and (2) whether these impairments are related to impulsivity. Nineteen PGs according to DSM-IV and 19 matched control subjects undertook the Cambridge Gambling Task (CGT) to assess decision-making. The delay discounting paradigm (DDP) as well as the UPPS Impulsive Behavior Scale (measuring urgency, premeditation, perseverance and sensation seeking) were administered as multidimensional measures of impulsivity. Results revealed that (1) PGs exhibited higher risk seeking and an immediate reward focus in the CGT and, in contrast, comparable strategic planning to the control group. (2) Decision-making impairments were related to more severe delay discounting and, specifically, to increased urgency and less premeditation. Our findings suggest (1) the necessity to disentangle decision-making components in order to improve etiological models of PGs, and (2) that urgency and premeditation are specifically related to disadvantageous decision-making and should be tackled in intervention strategies focusing on emotion tolerance and control strategies.

EPA-1558 - The impact of seasonality in suicide attempts: a review

Seasonality in consummated suicides has been well established in the literature. Consistently, suicides using violent methods have been described to have higher seasonal variations than non-violent suicides. The literature is scarcer regarding seasonality in suicide attempts, although, to a lesser extent, seasonal patterns have also been described. It has been argued that, due to the lower prevalence of violent methods in attempted suicides, it is not surprising to find a weaker seasonal effect. However, the most widely used classification to determine the lethality of an event – non-violent (poisoning) vs. violent (all the other methods) – is somewhat simplistic, and may lack sensitivity when applied to attempted suicides. Lethality scales, such as the Risk-Rescue Rating, and the Beck Lethality scales are more reliable tools to measure the severity of a suicide attempt. Also, violent suicide methods have been associated with a higher level of lifetime aggression and higher levels of impulsivity. Here, we aim to review the available literature on seasonality in suicide attempts, with particular attention to high lethality attempts, and the role of impulsivity. We hypothesize that both high lethality attempts and high baseline impulsivity are related to a stronger seasonal variation in suicide attempts.

Suicidality and Injury of the Prefrontal Cortex in Multiple Incidents of Mild Traumatic Brain Injury

To the Editor The article by Bryan and Clemans 1 about the relationships between episodes of combat mild traumatic brain injury (mTBI) and suicide augments information on the role of repeated traumatic brain injury episodes in the genesis of brain injury and altered behavior. 2,3 The finding of a relationship between number of mTBI episodes and the likelihood of suicidality is consistent with prior observations demonstrating that the likelihood of an individual developing posttraumatic stress disorder increased with the number of episodes of combat mTBI that were associated with loss of consciousness (LOC). 4 We found that the relationship between posttraumatic stress disorder and the number of mTBI episodes was stronger for mTBI associated with LOC compared with the number of mTBI events that were not accompanied by LOC. We wonder if Bryan and Clemans 1 can comment on whether suicidality was related more strongly to episodes of mTBI with LOC compared with episodes without LOC. We would appreciate the thoughts of Bryan and Clemans 1 on the role of impulsivity in suicidality following mTBI. Our experience has been that impaired impulse control is associated with suicide attempts following combat mTBI. Individuals may flip into a suicidal state following an unpredictable setback. For example, we treated a veteran who had sustained multiple episodes of mTBI who received a note from a former acquaintance. The veteran thought the acquaintance intended to resume a romantic relationship. The veteran attempted suicide after discovering that the acquaintance did not desire romance. The attempted suicide was done impulsively. The veteran did not contact anyone to express distress. Impulsivity can reflect altered frontal lobe function. A recent study reported increased activation of the anterior cingulate and prefrontal cortex in combat veterans with histories of suicidal ideation. 5 We found that impaired olfaction increased with the number of mTBI events associated with LOC. 4 Because the olfactory cortex is located in the ventromedial prefrontal cortex, impaired olfaction may indicate prefrontal injury. The observation that an increased number of traumatic brain injury events are associated with increased risk of suicidality suggests that such individuals, their families, and caregivers should be targeted for interventions to prevent suicide including education to encourage the veteran to alert others when thoughts of suicide emerge. Families need education about mTBI to understand that even though the veteran may

Role of Impulsivity and Other Personality Dimensions in Attempted Suicide with Self-Poisoning among Children and Adolescents

The objective of this study was to clarify the role of impulsivity and personality dimensions in attempted suicide among youth. The study included 120 youths who attempted suicide and 100 matched controls. Attempters of suicide had higher total scores and subscales of impulsivity than controls. They had higher novelty seeking, harm avoidance, and reward dependence scores, lower scores on persistence, self-directedness, and cooperativeness. A total of 77.5% of suicide attempters had psychiatric disorders compared to 2% of controls. Main factors predicting the occurrence of suicidal attempts were the presence of psychiatric disorder, impulsivity, stressful life events, and high reward dependence of suicide attempters. The study supports that impulsivity and personality traits play an important role in youth suicide independently or as a part of other interacting factors.

Dopamine D(2/3) receptor availability and human cognitive impulsivity: a high-resolution positron emission tomography imaging study with [¹¹C]raclopride.

Human impulsivity is a complex multidimensional construct encompassing cognitive, emotional, and behavioural aspects. Previous animal studies have suggested that striatal dopamine receptors play a critical role in impulsivity. In this study, we investigated the relationship between self-reported impulsiveness and dopamine D(2/3) receptor availability in striatal subdivisions in healthy subjects using high-resolution positron emission tomography (PET) with [11C]raclopride. Twenty-one participants completed 3-T magnetic resonance imaging and high-resolution PET scans with [11C]raclopride. The trait of impulsiveness was measured using the Barratt Impulsiveness Scale (BIS-11). Partial correlation analysis was performed between BIS-11 scores and D(2/3) receptor availability in striatal subregions, controlling for the confounding effects of temperament characteristics that are conceptually or empirically related to dopamine, which were measured by the Temperament and Character Inventory. The analysis revealed that the non-planning (p = 0.004) and attentional (p = 0.007) impulsiveness subscale scores on the BIS-11 had significant positive correlations with D(2/3) receptor availability in the pre-commissural dorsal caudate. There was a tendency towards positive correlation between non-planning impulsiveness score and D(2/3) receptor availability in the post-commissural caudate. These results suggest that cognitive subtrait of impulsivity is associated with D(2/3) receptor availability in the associative striatum that plays a critical role in cognitive processes involving attention to detail, judgement of alternative outcomes, and inhibitory control.

The Role of Impulsivity, Inattention and Comorbid ADHD in Patients with Bulimia Nervosa

IntroductionLittle is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD) in the development and maintenance of bulimia nervosa (BN). In particular, their specific contribution to disordered eating symptoms and whether they have additive effects to the general psychopathological burden remains unclear.MethodsFifty-seven female patients seeking treatment for BN and 40 healthy controls completed diagnostic questionnaires and interviews that investigated: a) ADHD, b) impulsivity, c) eating disorders and d) general psychopathology. Attentional processes and impulsivity were assessed by a comprehensive computer-based neuropsychological battery.ResultsTwenty-one percent of patients with BN met the clinical cut-off for previous childhood ADHD compared to 2.5% of healthy controls. Adult ADHD according to DSM IV was also more prevalent in patients with BN, with an odds ratio of 4.2. Patients with BN and previous childhood ADHD were more impulsive and inattentive than patients with BN alone. These patients also displayed more severely disordered eating patterns and more general psychopathological symptoms compared with those without ADHD. Severity of eating disorder symptoms was better explained by inattentiveness than by either impulsivity or hyperactivity.DiscussionOur data suggest an elevated rate of former childhood and current ADHD-symptoms in treatment-seeking patients with BN. Stronger impulsivity and inattention associated with more severe neuropsychological deficits and eating disorder symptoms indicate an additive risk that is clinically relevant for these patients. Thus, clinicians should identify comorbid patients who might profit from additional ADHD-specific treatments.

Pesticides availability and medically serious suicide attempts in China.

Pesticides availability and medically serious suicide attempts in China.

Impulsivity in Relation to Stress in Patients With Borderline Personality Disorder With and Without Co-occurring Attention-Deficit/Hyperactivity Disorder

Impulsivity is regarded as a key feature in borderline personality disorder (BPD). However, discrepancies in previous research indicate that the role of impulsivity in BPD is not yet fully understood. For example, state-dependent impulsivity in individuals with BPD may be related to co-occurring psychiatric conditions such as attention-deficit/hyperactivity disorder (ADHD) and to emotional states. We assessed self-reports of trait and state impulsivity and response inhibition before and after an experimental stress induction in 15 patients with BPD without ADHD, 15 patients with BPD and ADHD, 15 patients with ADHD, and 15 healthy participants. The patients in both BPD subgroups reported a stress-dependent increase of state impulsivity, which was not observed in the other groups. Response inhibition was impaired in the patients with BPD and ADHD but not in those without ADHD compared with the healthy participants. We suggest that stress levels and co-occurring ADHD should receive attention in future studies on impulsivity in BPD.

2821 – Dopamine D2/3 receptor availability and human cognitive impulsivity: a high-resolution PET imaging study with [11C]raclopride

: Human impulsivity is a complex multidimensional construct encompassing cognitive, emotional, and behavioral aspects. Previous animal studies have suggested that striatal dopamine receptors play a critical role in impulsivity. In this study, we investigated the relationship between self-reported cognitive impulsiveness and dopamine D2/3 receptor availability in striatal subdivisions in healthy subjects using high-resolution positron emission tomography (PET) with [11C]raclopride. Twenty-one participants completed 3-Tesla magnetic resonance imaging and high-resolution PET scans with [11C]raclopride. The trait of impulsiveness was measured using the Barratt Impulsiveness Scale (BIS-11). Partial correlation analysis was performed between BIS-11 scores and D2/3 receptor availability in striatal subregions, controlling for the confounding effects of temperament characteristics that are conceptually or empirically related to dopamine, which were measured by the Temperament and Character Inventory. The analysis revealed that the non-planning ( p = 0.004) and attentional ( p = 0.007) impulsiveness subscale scores on the BIS-11 had significant positive correlations with D2/3 receptor availability in the pre-commissural dorsal caudate. There was a tendency toward positive correlation between non-planning impulsiveness score and D2/3 receptor availability in the post-commissural caudate. These results suggest that cognitive subtrait of impulsivity is associated with D2/3 receptor availability in the associative striatum that plays a critical role in cognitive processes involving attention to detail, judgment of alternative outcomes, and inhibitory control.

Dissecting the Effects of Disease and Treatment on Impulsivity in Parkinson's Disease

Converging evidence, including observations in patients with Parkinson's disease (PD), suggests that dopamine plays a role in impulsivity. This multi-faceted construct includes considerations of both time and risk; determining how these more specific processes are affected by PD and dopaminergic treatment can inform neurobiological models. We examined the effects of PD and its treatment on temporal discounting and risky decision-making in a cohort of 23 mild-moderate PD patients and 20 healthy participants. Patients completed the Balloon Analogue Risk Task and a temporal discounting paradigm both on and off their usual dopamine replacement therapy. PD patients did not differ from controls in their initial risk-taking on the Balloon Analogue Risk Task, but took progressively more risks across trials when on medication. A subset of patients and controls was tested again, 1.5-3 years later, to explore the effects of disease progression. On follow-up, baseline risk-taking diminished in patients, but the tendency to take increasing risks across trials persisted. Neither disease progression nor its treatment affected the temporal discounting rate. These findings suggest a different neural basis for temporal discounting and risk-taking, and demonstrate that risk-taking can be further decomposed into initial and trial-by-trial effects, with dopamine affecting only the latter.

Genetic variants in the catechol‐o‐methyltransferase gene are associated with impulsivity and executive function: Relevance for major depression

The catechol-o-methyltransferase (COMT) gene has been extensively investigated in depression with somewhat contradictory results but the role of impulsivity, as a possible intermediate phenotype in this disorder, has not been considered yet. In our study, four tagging SNPs in the COMT gene (rs933271, rs740603, rs4680, rs4646316) were genotyped in two independent population cohorts: Manchester (n = 1267) and Budapest (n = 942). First, we investigated the association between COMT genotypes, impulsivity, neuroticism and depression using haplotype trend regression, and constructed a model using structural equation modeling to investigate the interaction between these factors. Secondly, we tested the effect of executive function on this model in a smaller interviewed sample (n = 207). Our results demonstrated that COMT haplotypes were significantly associated with impulsivity in the combined cohort, showing the same direction of effects in both populations. The COMT effect on depressive symptoms (in subjects without history of depression) and on executive function (interviewed sample) showed the opposite pattern to impulsivity. Structural equation models demonstrated that COMT and impulsivity acted, both together (through neuroticism) and independently, to increase the risk of depression. In addition, better executive function also operated as a risk factor for depression, possibly though reduced ability to flexibly disengage negative emotions. In conclusion, variations in the COMT gene exert complex effects on susceptibility to depression involving various intermediate phenotypes, such as impulsivity and executive function. These findings emphasise that modeling of disease pathways at phenotypic level are valuable for identifying genetic risk factors.

The role of impulsivity in the relationship between anxiety and suicidal ideation

The purpose of the present study was to examine the degree to which trait and cognitive (looming cognitive style) measures of anxiety are associated with suicidal ideation (SI), as well as whether trait and cognitive (time misperception) measures of impulsivity moderate the association between these variables. The sample included 100 undergraduate students (72% female) who completed the Spielberger State-Trait Anxiety Inventory, Looming Maladaptive Style Questionnaire, Barratt Impulsiveness Scale, Time Paradigm Version 1.0 Task, Beck Scale for Suicidal Ideation, and the Brief Symptom Inventory. Trait anxiety and looming cognitive style were found to be positively associated with SI. Further, both trait impulsivity and time misperception moderated the association between these variables and SI, but in a different manner. Consistent with study hypotheses, among those high in trait anxiety, greater overestimation of time was associated with a higher likelihood of SI. Contrary to study hypotheses, among those low in trait anxiety, high trait impulsivity was associated with a greater likelihood of SI. The same pattern of results was found when looming cognitive style served as the independent variable. The use of a cross-sectional design limits the ability to determine the temporal relationship of the study variables. Further, the sample included predominantly Caucasian undergraduates and thus study results may not generalize to other populations. Clinically, results suggest that high trait anxiety, looming cognitive style, time misperception, and trait impulsivity may be important risk factors for SI among college students and thus should be assessed when students present for treatment. Treatments that focus on problem solving, cognitive restructuring, and affect regulation strategies may help decrease anxiety and impulsivity, which in turn may help reduce the likelihood of suicidal thoughts.

Reward processing and intertemporal decision making in adults and adolescents: The role of impulsivity and decision consistency

Several studies report differences between adults and adolescents in reward processing and impulsivity. Consistently, adolescents are more impulsive in their decision making, as measured by intertemporal choice tasks. Since impulsivity affects an individual’s perception and neural processing of rewards, it is unclear whether previously reported differences in brain activation between adults and adolescents are primarily due to maturation of the brain reward system or differences in impulsivity (i.e. discounting behaviour). To disentangle this, we analysed data from 235 adolescents and 29 adults who performed an intertemporal choice task in which monetary rewards were adapted to individual impulsivity. Using functional magnetic resonance imaging (fMRI), we measured brain activity and assessed impulsivity and consistency of choices at the behavioural level. Although adolescents discounted delayed rewards more steeply than adults, when controlling for impulsivity, neural processing of reward value did not differ between groups. However, more impulsive subjects showed a lower brain response to delayed rewards, independent of age. Concerning decision making, adolescents exhibited a lower consistency of choices and less brain activity in the parietal network than adults.We conclude that processing of the value of prospective delayed rewards is more sensitive to discounting behaviour than to chronological age. Lower consistency of intertemporal choices might indicate ongoing maturation of parietal brain areas in adolescents.

Circadian Preference and the Big Five: The Role of Impulsivity and Sensation Seeking

In the present study, the relationship between personality dimensions and Circadian Preference was evaluated using a structural equation modeling approach. Participants (N = 390; 53.8% female, mean age: 26.8 ± 8.1 yrs) completed measures of Circadian Preference, Impulsivity, Sensation Seeking, and the Big Five factors. A mediation structural equation model assessed the direct and indirect effects of the Big Five factors on Circadian Preference. The results showed that Impulsivity and Sensation Seeking were significantly associated with Eveningness, whereas no significant direct effects of the Big Five traits were detected once the effects of Impulsivity and Sensation Seeking were taken into account. (Author correspondence: p.russo@unibo.it)