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PubMed1997

Individual psychopathology relative to reports of unwanted sexual experiences as predictor of a bulimic eating pattern.

OBJECTIVE: The goal of this study was to determine whether family and individual psychopathology mediate the relationship between unwanted sexual experiences and bulimic eating behavior. METHOD: Sixty-one women diagnosed with bulimia nervosa and 92 women students and university staff who had never met critia for an eating disorder completed standardized questionnaires on eating behavior, sexual abuse, individual psychopathology, and family psychopathology. RESULTS: Linear regression showed bulimic eating behavior to be significantly related to sexual abuse (beta = .40; p < .0001; R2 = 8.9%). However, multiple regression analyses with family and individual psychopathology as independent variables in addition to sexual abuse showed only individual psychopathology to predict significantly abnormal eating behavior (beta = .53, p < .0001; overall R2 = 49.6%). Specifically, depressive symptoms, suicidality, and impulsive behavior, but not substance abuse, were the components of individual psychopathology most directly associated with bulimia. DISCUSSION: The findings suggest that the primary focus in treatment should not be the traumatic events themselves, but their long-term consequences for the individual.

Adolescent↗
PubMed1982

Pragmatic information on the eating disorders.

Anorexia nervosa and bulimia are the prevalent eating disorders in adolescence and can well be regarded as a public health problem. Information on weight history, menstrual history, eating behavior, purging behavior, preoccupation with and fear of weight gain, activity level, depressive symptomatology, and impulsive behaviors is necessary in order to make the diagnosis of anorexia nervosa or bulimia. It is important to remember that bulimia patients have a fluctuation of weight within a normal weight range and usually do not have amenorrhea. The treatment of anorexia nervosa must include medical management, psychotherapy, behavioral therapy, and family therapy. Beginning treatment with outpatient therapy may be successful in adolescents who have a good prognosis and whose parents are willing to cooperate in family therapy. If a patient remains underweight, then she is not being effectively treated for the anorexia nervosa. Most patients will need an initial hospitalization for nutritional rehabilitation and continued outpatient therapy. Recently, bulimia has been recognized as a discrete disorder. Treatment approaches are currently being developed for this disorder and include behavioral techniques, group therapy, antidepressant and anticonvulsant medication, and psychotherapy.

Adolescent↗
PubMed1994

Self-report study of impulsive and delinquent behavior in college students.

PURPOSE: This self-report study of college students sought to examine the relationship between risk-taking and delinquent behavior, to develop reliable measures of impulsiveness and attraction to thrill-seeking and risk-taking, and to measure the relationships among conventional correlates of delinquent behavior, personality factors, and delinquent behavior itself. METHODS: A sample of 296 undergraduate college students completed questionnaires pertaining to delinquent behavior and other activities, identification with educational goals and behavior, and attraction to thrill-seeking and risk-taking behavior, as well as items from the Self-Control and Socialization scales of the California Personality Inventory. RESULTS: Males who measured high in thrill-seeking behavior and low in self-control reported significantly more property delinquency. Interpersonal delinquency was most influenced by a lack of self-control. There was a negative correlation between substance abuse and socialization. The reasons most often given for property and substance delinquency were "fun/thrills" while those most often given for interpersonal delinquency involved "anger/revenge." CONCLUSION: Variables representing conventional sociological theories have often been treated as the immediate causal factors in juvenile delinquency, but their impact may be mediated through factors such as impulsiveness and an attraction to thrill-seeking and risk-taking.

Adolescent↗
PubMed1996

Purging behaviors, suicide attempts, and psychiatric symptoms in 398 eating disordered subjects.

OBJECTIVE: The present work investigates differences in psychiatric symptoms and self-injurious behaviors among different forms of purging behavior in eating disorders (ED). METHOD: The sample was composed of 398 subjects consecutively referred to an outpatient ED unit. RESULTS: Both in anorexia nervosa (AN) and bulimia nervosa (BN), psychiatric symptoms were significantly more serious in purging compared to nonpurging groups, while no significant difference emerged among divergent forms of purging behaviors. The presence of multiple methods to control weight appeared to be a predictor of impulsive behaviors, as subjects who used both vomiting and laxatives reported significantly higher frequency of self-injurious behaviors. In BN, the self-injury was often a suicide attempt. DISCUSSION: The impact of purging behavior on the prognosis of AN and BN should be further studied since our research has shown a trend towards more frequent self-damaging behaviors in subjects who resort to multiple forms of purging behavior.

Adolescent↗
PubMed2003

Dopamine D3 receptor gene polymorphism and violent behavior: relation to impulsiveness and ADHD-related psychopathology.

Several lines of evidence indicate that dopaminergic neurotransmission is involved in the regulation of impulsive aggression and violence and that genetically determined variability in dopaminergic gene expression modifies complex traits including that of impulsivity and aggression. In this study we report an association of the dopamine D3 receptor (DRD3) polymorphism with impulsiveness according to Eysenck's EIQ and scores on the German short version of the Wender Utah Rating Scale (WURS-k), which we used for the assessment of a history of ADHD-related symptoms. This association was detected in a group of violent offenders, but not in non-violent individuals. Highest scores of EIQ impulsiveness and of the WURS-k were found in heterozygous violent individuals, while homozygotes showed significant lower rating scores, suggesting an heterosis effect. The results of our study suggest that variations of the DRD3 gene are likely involved in the regulation of impulsivity and some psychopathological aspects of ADHD related to violent behavior.

Adult↗
PubMed1998

Mood correlates with blood serotonin, but not with glucose measures in patients with recurrent suicidal behavior.

Depressive mood and impulsive-aggressive behavior are relevant to suicidal behavior and have been associated with decreased central serotonergic function. Impulsive behavior and aggression have also been related to abnormal glucose metabolism. To investigate these relationships further, blood serotonin (5-HT), blood glucose measures (glycated hemoglobin (HbA1C) and fructosamine) and self-reported depressive symptoms and anger were repeatedly measured, during a 1-year follow-up, in 106 patients who had recently attempted suicide for at least a second time. A major DSM-III-R Axis I diagnosis or use of antidepressants were reasons for exclusion. Intra-individual variations in blood 5-HT were inversely correlated with variations in depressive mood, self-depreciation, and anger, and positively with variations in fructosamine. Intra-individual variations of HbA1c or fructosamine were not correlated with mood. Mean blood 5-HT levels per patient were positively correlated with mean scores of depression and self-depreciation. The contrast between the intra-individual and the inter-individual correlations may reflect a difference between short- vs. long-term effects. The results do support an association between serotonergic function and mood, but not between glucose metabolism and mood, in recurrent suicide attempters.

Adolescent↗
PubMed2006

Case report: homicide by a 10-year-old girl with autistic disorder.

This case study presents a 10-year-old girl with a diagnosis of Autistic Disorder, who killed her 6-month-old sister by throwing her out of a window. Her aggressive-impulsive behavior had a persistent pattern. She had a history of epilepsy, and was frequently exposed to physical abuse. She never attended a structured treatment program. Here, we discuss the possible risk factors including history of epilepsy, unsupervised-disorganized home environment, existence of physical abuse-neglect and lack of appropriate treatment program leading to violent behavior.

Aggression↗
PubMed2006

Acute effects of 3,4-methylenedioxymethamphetamine (MDMA) on behavioral measures of impulsivity: alone and in combination with alcohol.

The use of 3,4-methylenedioxymethamphetamine (MDMA) has frequently been associated with increased levels of impulsivity during abstinence. The effects of MDMA on measures of impulsivity, however, have not yet been studied during intoxication. The present study was designed to assess the acute effects of MDMA and alcohol, alone and in combination, on behavioral measures of impulsivity and risk-taking behavior. A total of 18 recreational users of MDMA entered a double-blind placebo-controlled six-way crossover study. The treatments consisted of MDMA 0, 75, and 100 mg with and without alcohol. Alcohol dosing was designed to achieve a peak blood alcohol concentration (BAC) of about 0.06 g/dl during laboratory testing. Laboratory tests of impulsivity were conducted between 1.5 and 2 h post-MDMA and included a stop-signal task, a go/no-go task, and the Iowa gambling task. MDMA decreased stop reaction time in the stop-signal task indicating increased impulse control. Alcohol increased the proportion of commission errors in the stop-signal task and the go/no-go task. Signal detection analyses of alcohol-induced commission errors indicated that this effect may reflect impairment of perceptual or attentive processing rather than an increase of motor impulsivity per se. Performance in the Iowa gambling task was not affected by MDMA and alcohol, but there was a nonsignificant tendency towards improvement following alcohol intake. None of the behavioral measures of impulsivity showed a MDMA x alcohol interaction effect. The lack of interaction indicated that the CNS stimulant effects of MDMA were never sufficient to overcome alcohol-induced impairment of impulse control or risk-taking behavior.

Acute Disease↗
PubMed2005

Interactions between serotonin and dopamine in the control of impulsive choice in rats: therapeutic implications for impulse control disorders.

Forebrain serotonergic lesions attenuate the ability of d-amphetamine to decrease impulsivity in a delay-discounting paradigm, potentially through interactions between the serotonin (5-HT) and dopamine (DA) systems. Nucleus accumbens (NAC) lesions increase impulsivity, but the extent to which accumbal DA is involved in regulating impulsive choice is unknown. In the current study, the effects of intra-accumbal infusions of 6-hydroxydopamine (6-OHDA) on impulsive choice were evaluated, in combination with d-amphetamine and serotonergic drugs, in order to investigate the importance of 5-HT : DA interactions in the control of impulsive behavior. Following training on a delay-discounting task, animals received intra-NAC 6-OHDA or sham surgery. Postoperatively, subjects received systemic injections of d-amphetamine (0, 0.3, 1.0, 1.5 mg/kg) and the 5-HT(1A) receptor agonist 8-OH-DPAT (0, 0.1, 0.3, 1.0 mg/kg). Intra-NAC 6-OHDA, which reduced local DA and NA levels by 70-75%, had no effect on delay-discounting, but transiently potentiated the d-amphetamine-induced decrease in impulsive choice. 8-OH-DPAT (1.0 mg/kg) increased impulsivity in sham-operated controls, an effect which was blocked by the 5-HT(1A) receptor antagonist WAY 100635. However, 8-OH-DPAT had no effect on impulsivity in 6-OHDA NAC lesioned rats. 8-OH-DPAT (0.3 mg/kg), which did not itself alter task performance, blocked the effect of d-amphetamine in sham-operated controls, while WAY 100635 augmented the effect of amphetamine in all subjects. In an additional experiment, intracerebroventricular administration of the selective serotonergic toxin 5,7-dihydroxytryptamine, which decreased forebrain 5-HT levels by 85-90%, did not block 8-OH-DPAT's ability to increase impulsive choice. These data suggest a significant role for 5-HT : DA interactions within the NAC in the control of impulsivity, and in the mechanism by which amphetamine decreases impulsive choice.

5,7-Dihydroxytryptamine↗
PubMed2006

Serotonin function is associated with behavioral response to a novel conspecific in marmosets.

The function of the central nervous system neurotransmitter serotonin (5-HT) contributes to individual differences in impulsive behavior in humans and nonhuman primates. We investigated the relationship between 5-HT function and behavioral responses to a novel social scenario in marmosets. In the first study, marmosets (n=10) were treated orally with fluoxetine HCl (FLX) or vehicle for two trial periods and exposed to a novel conspecific for a 20-min trial following each treatment. Levels of behavioral inhibition in response to a novel conspecific were quantified. The animals exhibited less inhibition toward the novel conspecific following the 14-day FLX treatment than they did following the vehicle treatment. In the second study we first characterized the parameters of the marmoset peripheral 5-HT system and further assessed the relationship between natural variation in peripheral 5-HT and 5-HIAA levels with behavioral inhibition in response to a novel conspecific (n=14). Individual peripheral 5-HT and 5-HIAA levels were higher in animals that exhibited more inhibition in response toward the stranger. We conclude that serotonergic influences play a role in behavioral response to a novel conspecific in marmosets.

Age Factors↗
PubMed1998

Linkage of antisocial alcoholism to the serotonin 5-HT1B receptor gene in 2 populations.

BACKGROUND: In mice, quantitative trait locus studies and behavioral evaluation of animals deleted for 5-HT1B have implicated this serotonin autoreceptor in alcohol consumption and aggressive behavior. We therefore investigated whether the 5-HT1B gene (HTR1B) is linked to alcoholism with aggressive and impulsive behavior in the human, as represented by 2 psychiatric diagnoses: antisocial personality disorder and intermittent explosive disorder comorbid with alcoholism. METHODS: Linkage was first tested in 640 Finnish subjects, including 166 alcoholic criminal offenders, 261 relatives, and 213 healthy controls. This was followed by a study in a large multigenerational family derived from a Southwestern American Indian tribe (n=418) with a high rate of alcoholism. All subjects were psychiatrically interviewed, blind-rated for psychiatric diagnoses, and typed for a HTR1B G861C polymorphism and for a closely linked short-tandem repeat locus, D6S284. Linkage was evaluated in sib pairs, and by using an association approach in which pedigree randomization corrects for nonindependence of observations on related subjects. RESULTS: In Finnish sib pairs, antisocial alcoholism showed significant evidence of linkage to HTR1B G861C (P=.04) and weak evidence with D6S284 (P=.06). By association analysis, the 183 Finnish antisocial alcoholics had a significantly higher HTR1B-861C allele frequency than the other 457 Finns we studied (P=.005). In the Southwestern American Indian tribe, significant sib pair linkage of antisocial alcoholism to HTR1B G861C (P=.01) was again observed, and there was also significant linkage to D6S284 (P=.01). CONCLUSION: These results suggest that a locus predisposing to antisocial alcoholism may be linked to HTR1B at 6q13-15.

Adolescent↗
PubMed2004

Psychopharmacology in fragile X syndrome--present and future.

In addition to cognitive disability, fragile X syndrome (FXS) is associated with behavioral problems that are often functionally limiting. There are few controlled trials to guide treatment; however, available information does suggest that medications can be quite helpful for a number of categories of behavioral disturbance in FXS. Specifically, stimulants appear to be quite useful for management of distractibility, hyperactivity, and impulsive behavior; antidepressants help with anxiety, obsessive-compulsive behaviors and mood dysregulation; and antipsychotics can reduce aggression. These medications are supportive and help minimize dysfunctional behaviors and maximize functioning. As more is learned about the neural functions of FMRP, medications in the future will be expected to target specific synaptic mechanisms dysregulated in FXS brain and thus ameliorate the cognitive deficit with resultant behavioral improvements. This article summarizes knowledge about effectiveness and approaches to management of currently available psychopharmacology for behavior in FXS and discusses early leads to future treatments for cognition.

Adrenergic alpha-Agonists↗
PubMed1993

Predictors of falls among right-hemisphere stroke patients in the rehabilitation setting.

The purpose of the study was to examine neuropsychological and general medical risk factors for falls among a high-risk patient group in an inpatient rehabilitation setting. The sample consisted of 32 nonambulatory males who had sustained a right-hemisphere stroke (R-CVA). The Fall Assessment Questionnaire (FAQ) was introduced as a measure of known risk factors for falls in an inpatient setting. Neuropsychological assessment included measures of attention, perceptual deficits, hemispatial neglect, and impulsivity. A predictive model generated using multiple regression found that the FAQ combined with a measure of behavioral impulsivity successfully predicted fall status in 78% to 81% of cases, depending upon the cutting score used (p < .003). R-CVA patients who fell were more impulsive (p < .001) and received higher FAQ scores (p < .001). Perceptual deficit as measured by the Rey-Osterreith Complex Figure and general inattention as measured by Digit Span (reverse) were associated with falls (p < .04); however, they did not add to the model predicting which of the R-CVA patients would fall. It was suggested that impulsivity may act as an important mediating factor in determining individual risk for fall.

Accidental Falls↗
PubMed1999

Treatment attrition among alcohol-dependent men: is it related to novelty seeking personality traits?

"Dropouts" are a major concern when monitoring treatment efficacy in clinical trials. Alcohol-dependent patients are especially prone to discontinuing treatment, perhaps because of impulsive behavior. The Tridimensional Personality Questionnaire (TPQ) measures a trait-like quality, novelty seeking, which may reflect impulsiveness. We tested the hypotheses that higher TPQ Novelty Seeking subscale scores would be associated with increased rates of treatment dropout and increased risk for dropping out earlier. A total of 170 alcohol-dependent men who participated in a double-blind, placebo-controlled pharmacotherapeutic trial for decreasing relapse drinking completed the TPQ and were monitored until treatment dropout. Logistic regression and Cox proportional hazards models were used to (1) describe the relationship between the TPQ Novelty Seeking score and the dichotomous outcome variable, treatment dropout; and (2) assess the effects of a number of potential confounding covariates on the relationship between the risk factor, novelty seeking, and the time to the outcome event. The mean Novelty Seeking score was significantly higher among study dropouts compared with nondropouts (p = 0.003). Higher Novelty Seeking scores were associated with a higher adjusted odds ratio for dropping out (adjusted odds ratio = 1.07, 95% confidence interval [CI] = 1.00-1.15) and a higher adjusted hazard rate for dropping out earlier (adjusted hazard rate = 1.05, 95% CI = 1.00-1.09). The TPQ Novelty Seeking subscale score may identify a subgroup of alcohol-dependent men who are at risk for dropping out of treatment. This information may be useful for developing treatment plans to encourage these high-risk patients to remain in treatment.

Adult↗
PubMed2001

Social impulsivity inversely associated with CSF 5-HIAA and fluoxetine exposure in vervet monkeys.

Animal and human research suggests that the central serotonin system is involved in the inhibition of impulsive behavior. Two studies were designed to assess this relationship in male vervet monkeys (Cercopithecus aethiops sabaeus) using a standardized test of impulsivity in a social context: the Intruder Challenge. In the first study, an index of impulsivity in response to an unfamiliar adult male intruder (including latency to approach and aggressive and assertive interactions) was inversely correlated with levels of the serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA) in cisternal cerebrospinal fluid (r = -0.33, p <.01, n = 138). The approach, but not aggressive, component of the Impulsivity Index was the primary contributor to this relationship (partial r = -0.27, p <.01). The second experiment compared responses to the Intruder Challenge after 9 weeks of daily treatment with fluoxetine (2 mg/kg, i.m.) or vehicle. Fluoxetine-treated subjects (n = 6) had significantly lower Impulsivity Index scores than controls (n = 12). The results from these two investigations provide evidence for serotonergic influences on social impulsivity.

Age Factors↗
PubMed2005

Wolfgang Amadeus Mozart's psychopathology in light of the current conceptualization of psychiatric disorders.

The study of Mozart's letters and biography leads us to reconsider the psychiatric disorders from which he suffered. Indeed, it seems that Mozart demonstrated depressive episodes, some of which were severe and corresponded to the criteria of the DSM-IV classification. However, the arguments put forward by other authors supporting the occurrence of manic or hypomanic episodes (thus constituting a bipolar disorder diagnosis) are not supported by sufficient historic proof. Indeed, the length of time that the behaviors suggesting manic symptoms lasted is not compatible with such a diagnosis. Rather, Mozart's mood swings and impulsive behavior correspond to some traits of a personality disorder, that is, for the most part, symptoms of the dependent personality disorder. Evidence for this diagnosis appears most notably in Mozart's reactions to his wife's absences, but also in occasional behaviors as well as mood lability. The divergences in the classification of Mozart's symptoms, either into the field of bipolar disorders or into that of personality disorders, are closely linked to the nosological uncertainties that are still a source of debate in today's psychiatric research. We discuss a means of overcoming this limitation by considering the concept of "soft bipolar spectrum," a conceptualization that corresponds to Mozart's psychiatric history.

Bipolar Disorder↗
PubMed1998

Differences in concentration ability among low- and high-SES Israeli students: a follow-up study.

Eighty students participated in a follow-up study investigating the relationship between the ability to concentrate and academic achievement among low-socioeconomic-status (LSES) and high-socioeconomic-status (HSES) 4th grades. The results indicated that the differences between the ability to concentrate and academic achievement found when the students were in the 1st grade (Norman & Breznitz, 1992) persisted, in part, to the 4th grade. Compared with HSES children, LSES children obtained significantly lower scores on measures of academic achievement and concentration. Additional measures of school behavior included in the present study revealed that LSES children were more likely to be characterized by aggressive-impulsive behavior. This behavior accounted for most of the differences found between HSES and LSES pupils on the academic and concentration measures.

Achievement↗