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PubMed1999

Impulsivity, dietary control and the urge to binge in bulimic syndromes.

OBJECTIVE: Naturalistic studies on sufferers of bulimic syndromes suggest that binge episodes are often precipitated by episodes of dietary restraint. However, evidence also implies that binge eating may, in certain psychopathological contexts, have less direct connection with dietary control factors. Applying an 8- to 22-day experience-sampling procedure in individuals with bulimic syndromes, we explored possible moderating effects of trait impulsivity upon the ongoing association between cognitive dietary control and binge eating. METHOD: Fifty-one women with bulimia spectrum eating disorders provided periodic daily observations on cognitive control over eating, urges to binge, and binge episodes. Impulsivity was assessed by self-report questionnaire. Hierarchical linear modeling techniques were used to assess relationships of interest. RESULTS: Urge to Binge was higher (on average) prior to eating binges than at comparable times on binge-free days, and thus seemed to signal the potential for binge eating. More importantly, scores on Urge to Binge and Dietary Control covaried systematically over time in most participants, but were desynchronous in highly impulsive individuals. CONCLUSIONS: Binge eating is closely linked to dietary control in most bulimic individuals, but this may be less typical of individuals showing marked impulsivity. We discuss factors that may explain the disconnection between Dietary Control and Urge to Binge in impulsive binge eaters as well as the implications of such factors for the management of bulimic patients with marked impulsivity.

Adult↗

PubMed1994

Impulsivity ratings in bulimia nervosa: relationship to binge eating behaviors.

Although impulsive behavioral patterns are often described by patients with bulimia nervosa, there has been little formal evaluation of the relationship between impulsivity and eating-related symptomatology in this disorder. In this controlled outpatient study, ratings on the Barratt Impulsivity Scale were significantly elevated in 20 women with bulimia nervosa in comparison to 20 healthy female volunteers. Frequency of binge eating episodes was not significantly correlated with impulsivity ratings. Although these results indicate increased prevalence of impulsive behavioral style in patients with bulimia nervosa, impulsivity per se does not appear to be a predictor of symptom severity as reflected in frequency of bulimic episodes.

Adult↗

PubMed2005

Impulsivity and compulsivity in bulimia nervosa.

OBJECTIVE: A primary objective of the current article is to investigate the relationship between impulsivity and compulsivity in patients with bulimia nervosa (BN). A second goal is to explore the relationship between impulsivity and compulsivity and related psychiatric problems. METHOD: Two-hundred four females with BN completed several measures of impulsivity and compulsivity as well as measures of personality, substance use, eating pathology, and depression. RESULTS: Participants reported considerable variability on measures of impulsivity and compulsivity and these scores were positively correlated with each other. Impulsive-compulsive groups differed in personality, substance use, eating, and depression. CONCLUSION: These findings suggest that impulsivity and compulsivity can coexist in BN patients and that both traits may provide useful information about comorbid problems in women with BN.

Adolescent↗

PubMed1999

Beyond discounting: possible experimental models of impulse control.

Animal studies of impulsivity have typically used one of three models: a delay of reward procedure, a differential reinforcement for low rate responding (DRL) procedure, or an autoshaping procedure. In each of these paradigms, we argue, measurement of impulsivity is implicitly or explicitly equated with the effect delay has on the value of reward. The steepness by which delay diminishes value (the temporal discount function) is treated as an index of impulsivity. In order to provide a better analog of human impulsivity, this model needs to be expanded to include the converse of impulsivity - self-control. Through mechanisms such as committing to long range interests before the onset of temptation, or through bundling individual choices into classes of choices that are made at once, human decision-making can often look far less myopic than single trial experiments predict. For people, impulsive behavior may be more often the result of the breakdown of self-control mechanisms than of steep discount functions. Existing animal models of self-control are discussed, and future directions are suggested for psychopharmacological research.

Animals↗

PubMed1999

The pharmacology of impulsive behaviour in rats VII: the effects of serotonergic agonists and antagonists on responding under a discrimination task using unreliable visual stimuli.

RATIONALE: The serotonergic systems have been implicated in the pathological impulsive behaviour on the basis of both clinical and preclinical data. However, impulsivity is probably made up of several independent factors, and the involvement of the diverse regulatory mechanisms of the serotonergic systems has not been widely studied. OBJECTIVE: The influence of a range of serotonergic agents on impulsivity was examined using a procedure designed to test the dimension of impulsivity termed "reflection-impulsivity" in rats. METHODS: An operant procedure was used in which the need to wait before responding was made explicit by using a signal which increased in predictive value the longer the subject waited before responding. First, the rats learned that a light signal indicated the availability of a food reinforcer if one of two levers was pressed. In the test procedure, on each trial, when the light was turned on it was only 50% likely to indicate the "correct" lever. After a brief interval it was turned off and on again, this time with a slightly higher probability (>50%) of indicating the correct lever. Over a period of a few seconds the probability that the light indicated the correct lever increased to almost 100%. Thus a quick response to the light would result in many errors, whereas a slow response could always result in food delivery. Once trained the rats were treated with a series of drugs: citalopram, (selective serotonin reuptake inhibitor), p-chloramphetamine (PCA, serotonin releaser), 8-OH-DPAT (5-HT(1A) agonist), RU24969 (primarily a 5-HT(1B) receptor agonist), DOI, (5-HT(2) agonist), WAY-100,635 (5-HT(1A) antagonist), ritanserin (5-HT(2) antagonist), and MDL-72222, (5-HT(3) antagonist). RESULTS: Of the test compounds, PCA, DOI and 8-OH-DPAT increased reaction times, whereas ritanserin reduced them. Citalopram and WAY-100,635 had no significant effects, RU-24969 appeared to disrupt responding, and MDL-72222 reduced premature responses and the number of short reaction times. CONCLUSIONS: Since agonists at the 5-HT(1A) and 5-HT(2) receptors both reduced impulsivity in this procedure, these data suggest that serotonin may promote "reflection" in this procedure via stimulation of these receptor subtypes.

Animals↗

PubMed2004

Effects of acute and chronic buspirone on impulsive choice and efflux of 5-HT and dopamine in hippocampus, nucleus accumbens and prefrontal cortex.

RATIONALE: Reduced central serotonin (5-HT) activity has been associated with impulsive choice behaviour, but there is no consensus about the precise nature of these effects. Behavioural and neurochemical effects of 5-HT(1A) agonists such as buspirone depend critically on the dose and the duration of treatment. We thus undertook a parametric study of the effects of acute and chronic buspirone on the performance on a test of delayed gratification, as well as on the efflux of serotonin and dopamine (DA) in cortical and subcortical regions in rats. OBJECTIVES: Three experiments examined (i) the effects of acute buspirone on impulsive choice and how such effects were modified by prior chronic exposure to buspirone; (ii) the effects of chronic buspirone on impulsive choice; (iii) the effects on impulsive choice of a selective 5-HT(1A) antagonist, WAY-100635 tested alone and in combination with buspirone; (iv) the effects of chronic and acute buspirone on 5-HT and DA efflux in anaesthetised rats. METHODS: In experiment 1, rats previously trained on the delayed gratification task were tested with acute buspirone (0.5, 1 and 2 mg/kg). The same rats were then treated with chronic buspirone (1 mg/kg/day) over the next 65 days, and the effects of acute buspirone (1 mg/kg) re-determined at 20, 45 and 65 days of chronic treatment. In experiment 2, two groups of rats trained on the delayed gratification task were treated either with saline or buspirone (1 mg/kg/day) continually for 65 days before being tested with acute buspirone (1 mg/kg), WAY-100635 (0.08 mg/kg), or a combination of the two drugs. In experiment 3, rats received the same regimen of buspirone dosing as in experiment 2, before receiving in-vivo microdialysis for 5-HT and DA in the ventral hippocampus, nucleus accumbens and medial prefrontal cortex. RESULTS: Acute buspirone dose dependently increased the choice for the small, immediate reinforcer (impulsive choice) but the effects of 1 mg/kg were reversed on chronic administration of buspirone. This increased choice of the large, delayed reinforcer, which was not accompanied by any changes in baseline (non-drugged) performance, was blocked by the 5-HT(1A) receptor antagonist WAY-100635. The chronic buspirone regimen did not alter buspirone-evoked reductions in 5-HT efflux in hippocampus but did lead to a differential effect of acute buspirone in medial prefrontal cortex, with the chronic buspirone and saline groups exhibiting decreases and increases in efflux, respectively. There were no systematic changes in DA efflux under any condition. CONCLUSIONS: These findings show that the effects of acute buspirone on impulsive choice are reversed following chronic treatment and are mediated by 5-HT(1A) receptors, and suggest, in addition, that the behavioural effects may involve changes in 5-HT functioning in medial prefrontal cortex.

Analysis of Variance↗

PubMed2004

Impulsivity (delay discounting) as a predictor of acquisition of IV cocaine self-administration in female rats.

RATIONALE: Previous research in humans suggests a relationship between drug abuse and impulsivity as shown by selection of a smaller immediate reward over a larger delayed reward. However, it is not clear whether impulsivity precedes drug abuse or drug abuse influences impulsivity. OBJECTIVE: The hypothesis of the present experiment was that rats selected for choosing smaller, immediate over larger, delayed food would acquire IV cocaine self-administration faster than those choosing larger, delayed food rewards. METHODS: Female rats were screened for locomotor activity and trained on a delay discounting procedure that allowed them access to two response levers and a food pellet dispenser. Under a fixed-ratio (FR) 1 schedule, responding on one lever resulted in immediate delivery of one 45 mg pellet, while responding on the other lever resulted in delivery of three 45 mg pellets after a variable delay that increased after responses on the delay lever and decreased after responses on the immediate lever. For each rat, a mean adjusted delay (MAD) was calculated for each daily session, and stability was defined as MADs varying less than 5 s across 5 days. Based on their average MADs, rats were separated into low impulsive (LoI) and high impulsive (HiI) groups, implanted with an indwelling IV catheter, and trained to lever press for cocaine (0.2 mg/kg) under an FR1 schedule. RESULTS: There were no differences in locomotor activity between the LoI and HiI groups; however, a greater percentage of the HiI group acquired cocaine self-administration, and they did so at a significantly faster rate than the LoI rats. CONCLUSIONS: Performance on the delay discounting model of impulsivity predicted vulnerability to subsequent acquisition of cocaine self-administration.

Animals↗

PubMed2005

Alcohol-induced impulsivity in rats: an effect of cue salience?

RATIONALE: There is a common assumption that alcohol produces impulsive behaviors, thereby increasing the preference for immediate over delayed rewards. An alternative explanation, provided by alcohol myopia theory, is that alcohol alters attentional processes such that intoxicated individuals respond exclusively to the most salient cues in their environment. OBJECTIVES: We tested these two hypotheses in rats using standard (impulsivity) and modified (cue salience) versions of the delayed reinforcement task. METHODS: In the impulsivity paradigm, rats were trained to choose between a small immediate reward (2 sucrose pellets) and a large delayed reward (12 sucrose pellets after 10 s) in a T-maze. In the cue salience paradigm, a light in one arm predicted either the small or the large reward, but the arm paired with the light varied across trials. In separate experiments, we examined how changes in delay to the large reward, alcohol administration, or alcohol combined with either a serotonin agonist [para-chloroamphetamine (pCA) at doses of 0.1, 0.4, 0.7, and 1.0 mg/kg, s.c.)] or a dopamine antagonist [cis-(Z)-flupenthixol dihydrochloride (alpha-flupenthixol) at doses of 0.0125, 0.025, 0.05, and 0.1 mg/kg, i.p.] affected performance in each task. RESULTS: Increasing the delay to the large reward increased impulsivity in both paradigms, but it had no effect on responding to a salient cue. Alcohol (0.6, 0.9, 1.2, and 1.8 g/kg, i.p.) increased the choice of the immediate reward and increased the choice of the lit arm, regardless of whether it signaled the small or the large reward. pCA selectively reduced alcohol-induced impulsivity, whereas alpha-flupenthixol selectively reduced responding to a salient cue. CONCLUSIONS: Rats, like humans, are influenced by cue salience when intoxicated. Although this alcohol myopia effect could explain alcohol-induced impulsivity, the two processes are probably distinct because they are mediated by dissociable pharmacological mechanisms.

Animals↗

PubMed2006

Involvement of a polymorphism in the 5-HT2A receptor gene in impulsive behavior.

RATIONALE AND OBJECTIVE: Impulsive behavior has been suggested to occur due to a dysfunction of serotonergic 5-HT neurotransmission. After evaluation by a self-reporting measure, a polymorphism in the promoter of the 5-HT2A receptor gene has been proposed to underlie the impulsive behavior; however, this hypothesis is not convincing. In this study, we examined whether this 5-HT2A receptor gene polymorphism is involved in impulsive aggression by evaluating a behavioral task (go/no-go task) in normal volunteers. MATERIALS AND METHODS: The polymorphism of the 5-HT2A receptor gene promoter was analyzed by polymerase chain reaction using lymphocytes from 71 volunteers. Impulsivity was defined as the number of commission errors (responding when one should not) made during a go/no-go task (a larger number of commission errors indicates greater difficulty in inhibiting the behavior). RESULTS: The subjects in the group with the A-1438A allele of the 5-HT2A receptor gene (A-1438A group) made more commission errors under the punishment-reward condition in a go/no-go task than those in the G-1438G group. CONCLUSIONS: These results suggest the possible involvement of the A-1438A polymorphism of the 5-HT2A receptor gene in impulsive behavior; this was evaluated using a behavioral task measure that can directly reveal the traits of human impulsive behavior.

Adult↗

PubMed1998

The pharmacology of impulsive behaviour in rats II: the effects of amphetamine, haloperidol, imipramine, chlordiazepoxide and other drugs on fixed consecutive number schedules (FCN 8 and FCN 32).

The effects of drugs on one aspect of impulsive behaviour were evaluated using a schedule in which rats were trained to complete a fixed consecutive number of responses on one of two levers before pressing the second to obtain a reinforcer (FCN). Terminating the chain before completing the FCN resulted in the omission of the food, and can be considered an impulsive decision. Two groups of food-deprived rats were trained to press either 8 or 32 times on the left lever (FCN lever) of a two lever operant chamber before pressing the right lever (Reinforcement lever) to deliver a food pellet. Responding on the Reinforcement lever before completion of the sequence resulted in a short time-out and the rat had to begin the sequence again. After responding had stabilised, the rats were treated with a range of doses of a number of drugs. Impulsivity was assessed by several measures, including the mean chain length and the proportion of chains terminating in food delivery, and the distribution of chain lengths was analysed. The efficiency of the rats was similar under both FCN 8 and FCN 32, although it was more difficult to maintain a consistent baseline under FCN 32. Under the FCN 8 schedule, significant decreases in chain length were obtained with d-amphetamine (0.8-2.4 mg/kg), haloperidol (0.1 mg/kg), ethanol (1 and 3 g/kg) and chlordiazepoxide (10.0 mg/kg), and there were alterations in other measures consistent with an increase in impulsivity. Imipramine (1-10 mg/kg), citalopram (1-10 mg/kg) and metergoline (0.3-3.0 mg/kg) had no effect on mean chain length, although the first two drugs shifted the chain length distribution to the left. d-Amphetamine (0.4-1.2 mg/kg) and PCPA (100 mg/kg) reduced chain length and had other effects consistent with increased impulsivity under FCN 32 schedule, whereas imipramine had little, and citalopram no, effect. Taken generally, effect of the active drugs was relatively non-specific, including both a reduction in response rate and alterations in choice measures proposed to reflect an increase in impulsivity. Detailed analysis of the effect of amphetamine revealed that three processes were at work: chain shortening, an increased preference for the lever most closely associated with food delivery, and a gradual shift in the control over responding from the response sequence (pattern) to the individual lever press (act).

Amphetamine↗

PubMed2002

Impulsivity and aggression as predictors of suicide attempts in alcoholics.

INTRODUCTION: The aim of this study was to assess the potential role of impulsive and aggressive behavior in the pathogenesis of suicide attempts in alcoholics. Impulsive and aggressive behavior as well as a psychiatric comorbidity with depressive conditions and personality disorders have been reported to be significant risk factors for suicide attempts in alcoholics. We hypothesized that alcoholics with a history of violent suicide attempts show an increased level of impulsive and aggressive behavior. Furthermore, the potential influence of concurrent personality disorders and depressive conditions were assessed. MATERIAL AND METHODS: 182 detoxified alcohol-dependent subjects were enrolled into the study. Impulsive and aggressive traits were assessed using the Buss-Durkee Hostility Inventory and the Brown-Goodwin Assessment for Lifetime History of Aggression, personality disorders using the SCID II. Characteristics of alcohol dependence and suicide attempts were evaluated using the Semi-Structured Assessment on Genetics in Alcoholism (SSAGA). RESULTS: Alcohol-dependent subjects with a history of suicidal behavior show a profile with higher impulsive and aggressive behavior. No significant association between these traits and concurrent borderline and antisocial personality disorder was found. Subjects with suicide attempts tended to have a significantly higher rate of depressive disorders. DISCUSSION: These results suggest that impulsive and aggressive traits might contribute significantly to the risk of suicide attempts in alcoholics.

Adult↗

PubMed2004

Negative correlation between right prefrontal activity during response inhibition and impulsiveness: a fMRI study.

Behavioral disinhibition in Go/No-Go task is thought to be associated with impulsiveness in humans. Recent imaging studies showed that neural circuits involving diverse areas of the frontal cortex and other association cortex sites such as the parietal cortex are implicated in the inhibition of response during No-Go trials. The aim of the present study was to investigate the association between regional cerebral activation during No-Go trials and impulsiveness. Seventeen right-handed healthy volunteers participated in the study. We used functional magnetic resonance imaging to measure the brain activation during a Go/No-Go task. The Barratt Impulsiveness Scale, 11(th) version (BIS-11) was used to measure impulsiveness. Activated regions included the right middle frontal gyrus and the inferior parietal lobe, which is consistent with previous neuroimaging studies. A negative correlation was observed between the motor impulsiveness of BIS-11 and No-Go-related activation in the right dorsolateral prefrontal cortex (RDLPFC). Our results suggest that the RDLPFC is the area most sensitive to differences in individual motor impulsiveness and its activity may be an indicator of the individual capacity for response inhibition.

Adult↗

PubMed1990

Impulse control in obsessive-compulsive disorder: a biopsychopathological approach.

1. The dichotomy between behaviors (some pathological, some falling into the realm of criminality) characterized by an excessive impulsivity and others, such as obsessive-compulsive disorder (OCD), in which a high resistance towards inner or outer impulses dominate, can not be sustained any more. 2. Classical descriptions of OCD include behavior patterns of low control of impulses, and individuals showing "low control of impulse disorders" are, more often than not, high controllers in the periods of time when the impulsivity is in the background. 3. Evidence from biological research and from treatment outcome studies also suggest common traits in the "hyponomic" (impulsive) and "hypernomic" (obsessive) individuals, related to serotonin (5-HT) metabolism disturbances.

Humans↗

PubMed1992

The conceptualization of impulsivity for psychiatric nursing practice.

This article conceptualizes impulsivity from the perspective of psychiatric nurses in the inpatient setting. A theoretical model of the nature and the process of impulsivity is developed phenomenologically from information obtained from psychiatric nurses and patient chart reviews. The impulsive event is characterized by three elements: (1) precipitants of the behavior, (2) characteristics of the impulsive event, and (3) staff response. The expression of these elements differentiates impulsivity according to patient domains of psychotic and nonpsychotic illnesses. The emerging differentiation provides the opportunity to develop distinct nursing interventions that target the impulsivity within each of these domains.

Attitude of Health Personnel↗

PubMed2006

Risk perception and impulsivity: association with risky behaviors and substance abuse disorders.

Low risk perception and high impulsivity, in conjunction with substance abuse disorders, are associated with the occurrence of injury in the general population. The study described in this article investigated the association of risk perception and impulsivity with risky behaviors (infrequent seat belt use, drinking and driving, riding with a drunk driver, binge drinking, and speeding for the thrill) among adults with unintentional blunt trauma. Patients (N = 756) were assessed for substance abuse disorders and participation in risky behaviors. Risk perception and impulsivity were measured by questionnaire. Pearson's chi-square statistic was used to investigate risk perception, impulsivity, substance abuse, and possible confounders relative to risky behaviors. Odds ratios were calculated using logistic regression methodology. Univariate results indicated that low risk perception and high impulsivity were significant risk factors for risky behaviors. After adjustment for confounding factors, low risk perception and high impulsivity remained significantly associated with risky behaviors in the trauma patient population.

Accidents, Traffic↗

PubMedDate not supplied

Impulsivity in abstinent alcohol-dependent patients: relation to control subjects and type 1-/type 2-like traits.

Extensive literature has linked behavior control problems in childhood to risk for alcoholism, but impulsivity in alcohol-dependent adults has not been well characterized. Using a variety of laboratory measures of impulsivity, we assessed whether detoxified alcohol-dependent patients [(ADP); n = 130] were more impulsive than control subjects [(CS); n = 41]. In comparison with CS, ADP demonstrated (1) increased rates of commission errors, but not omission errors, in a continuous performance test, (2) a more severe devaluation of delayed reward, (3) increased rates of risky responses in a new risk-taking paradigm, and (4) higher psychometric scores of impulsivity and aggression. Across all subjects, aggressiveness correlated significantly with severity of delay discounting. A post hoc analysis of data obtained for male ADP indicated that, in comparison with patients with late onset of problem drinking and no problem-drinking parent, those ADP with earlier age of problem drinking and who reported a problem-drinking father (type 2-like alcohol dependence) demonstrated faster response latencies and more responses to non-target stimuli (commission errors) in the continuous performance test, as well as higher psychometric aggression. In contrast, these subtypes of male ADP did not differ in delay discounting and risk taking. These findings collectively indicate that, in comparison with CS, ADP are more impulsive in several dimensions, with elevated impulsivity in a working memory task as well as aggressivity characteristic of alcohol-dependent men with type 2-like features.

Adolescent↗

PubMed2004

Impulsivity and test meal intake in obese binge eating women.

Greater impulsivity has been observed in those with chemical (cocaine, marijuana, alcohol) and behavioral addictions (gambling, sex, shopping), as well as in individuals with personality and conduct disorders. Greater impulsivity has also been described in those with Bulimia Nervosa and attributed to aberrations in serotonin, as has eating in response to negative affect. However, less is known about the impact of impulsivity on eating behavior in obese humans in general, and in those who meet sub-clinical and full clinical criteria for Binge Eating Disorder (BED) in particular. Using a laboratory test meal paradigm, we demonstrated: (1) greater Motor Impulsivity (Barratt Impulsivity Scale (BIS) (p = 0.05) in those with BED (n = 11) as compared to those without BED (n = 11) (2) a positive correlation between BED criteria and BIS scores (p < 0.01) (3) a positive correlation between test meal duration and Zung Depression Score, and (4) a positive correlation between Motor Impulsivity and mood rated before consuming the test meal. These associations suggest potential aberrations in serotonin transmission in BED, and a possible target for pharmacotherapy of BED especially in those who are resistant to Cognitive Behavioral Therapy.

Adult↗

PubMed2005

Acute yohimbine increases laboratory-measured impulsivity in normal subjects.

BACKGROUND: State-dependent changes in impulsivity may be related to norepinephrine. To examine possible relationships between norepinephrine and acute changes in impulsivity, we measured effects of yohimbine, which increases norepinephrine release by blocking alpha-2 noradrenergic receptors, on laboratory-measured impulsivity in healthy subjects without psychiatric or substance-use disorders. METHODS: Impulsivity was assessed using the Immediate and Delayed Memory Tasks (IMT-DMT), derived from the Continuous Performance Test, before and after placebo or two doses of yohimbine, given 4 days apart. Blood pressure was monitored, and psychiatric symptoms were measured using self-rated visual analog scales. RESULTS: Yohimbine was associated with a dose-related increase in impulsive IMT commission errors, with an increase of > 50% relative to baseline at the higher dose. The activation factor of the Internal State Scale was increased at the same dose. CONCLUSIONS: These results are consistent with increased impulsivity in normal subjects given yohimbine, possibly related to increased norepinephrine.

Adrenergic alpha-Antagonists↗