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PubMed2006

Impulsivity and compulsivity in patients with trichotillomania or skin picking compared with patients with obsessive-compulsive disorder.

To compare impulsivity and compulsivity, we performed a case control study comparing a group of 20 patients with obsessive-compulsive disorder with a group of 20 patients with skin picking and/or trichotillomania (SP/T). The instruments used were Structured Clinical Interview for DSM-IV Axis I Diagnosis, Yale-Brown Obsessive-Compulsive Scale, Schalling Impulsivity Scale, and Hamilton Anxiety and Depression Inventories. A Multidimensional Impulsive-Compulsive Spectrum Assessment Instrument was designed for this particular study. The Yale-Brown Obsessive-Compulsive Scale scores were significantly higher in patients with obsessive-compulsive disorder, compared with patients with SP/T (F = 90.29; P < .001). The Hamilton Inventories and Schalling Impulsivity Scale revealed no significant intergroup differences. The Multidimensional Impulsive-Compulsive Spectrum Assessment Instrument allowed us to find 6 statistically significant differences between groups: the ability or inability to delay an impulse, quick response or action planning, feelings of pleasure or guilt during or after an act, ritualization, and whether the patient believes he/she has losses or benefits if prevented from acting. In conclusion, SP/T should deserve further attention about their classification in future versions of diagnostic manuals because, as in International Classification of Diseases, Tenth Revision, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition includes these disorders in the same chapter as pathological gambling, kleptomania, pyromania and others. Despite their resemblance to compulsions, their classification under the Obsessive-Compulsive Spectrum needs particular phenomenological and neurobiologic investigation.

Adolescent↗

PubMed2005

Adversity among drug users: relationship to impulsivity.

Illicit substance users experience adverse life events, but few studies have examined the role of impulsivity in these events. The present investigation sought to establish a link between negative life experiences and a trait measure of impulsivity and demonstrate that this association remains even accounting for potential confounds. Participants were 330 heroin and cocaine users recruited from the community for a health service research study. Participants completed a structured interview that assessed topics including drug and alcohol use, impulsivity, and negative life events. This group of drug users reported high rates of adverse life events in the 6 months prior to the assessment. No specific substance abuse/dependence diagnosis or combination of diagnoses was associated with adversity. Number of substance-related diagnoses was associated with adverse life events, but not when adjusting for impulsivity. Experience of these events was significantly associated with impulsivity (p<.001), above and beyond the shared relation with demographic variables, substance abuse and dependence, and number of substance-related diagnoses. These findings document the high frequencies of recent adverse life events among illicit drug users and indicate that trait impulsivity is associated with increased risk of these life events.

Adult↗

PubMed2006

Impulsivity and bipolar disorder.

Impulsivity is frequently associated with bipolar disorder (BD) during manic episodes, but may also be present in euthymic bipolar patients. Aggression is an impulsivity-related behavior also found during manic episodes. The objective of this review is to further clarify the relationship between impulsivity and BD. A search in Medline and Psycinfo databases, combined with a manual search of selected references, was conducted to identify available literature on BD and impulsivity-related features. Although few studies have directly measured impulsivity in BD, available findings suggest that impulsivity is not only state-related, but also a trait component of BD, which could represent a core feature of the illness. Further research exploring the neurobiology of the impulsivity/BD relationship may contribute to elucidate the pathophysiology and to improve the diagnosis and treatment of this severe illness.

Aggression↗

PubMed2006

The neuroscience of impulsive and self-controlled decisions.

Impulsiveness and self-control are two antagonistic choice patterns. Whereas impulsive decisions can be exemplified by the preference for a small, immediate over a large, delayed reward, self-control can be characterised as the opposite preference order. This review focuses on current developments in investigating the neuroscience of impulsiveness and self-control, with particular emphasis on the neuroanatomy, psychopharmacology, and electrophysiology of this class of decision making. The role of the avian forebrain in representing and processing temporal reward discounting - a chief psychological mechanism responsible for producing impulsiveness - is especially highlighted. In addition to its role in impulsive decision making, the avian forebrain also appears to be involved in processing the key functions required for action- and self-control. In particular, recent electrophysiological studies indicate that single forebrain neurons reflect aspects of response omission strategy and the temporal scheduling of response withholding when execution of action needs to be controlled. In conclusion, the significant advances in this field of research may help to explain neuropathologies that are characterised by exaggerated impulsivity, or lack of self-control, as for instance attention deficit disorders, frontal lobe syndrome, drug addiction, or pathological gambling.

Animals↗

PubMed2005

Attentional blink in adolescents with varying levels of impulsivity.

We explore the temporal attention function in a non-clinical sample of adolescents varying in impulsivity, as assessed with the Barratt Impulsiveness Scale. In a Rapid Serial Visual Presentation task, in which two targets (T(1) and T(2)) were presented in close temporal proximity among distractors, participants tried to identify T(1) and detect T(2) in one (dual-task) experiment and only to detect T(2) in a second, control (single-task) experiment. The sensitivity of T(2) detection was analyzed using signal detection theory. The attentional blink -- the impairment in T(2) detection following the identification of T(1) -- was increased in magnitude and protracted in adolescents with high impulsivity, compared with those with low impulsivity. Moreover, a few more participants with high impulsivity appeared to have a blink temporally weighing toward a later time, an observation also made in children with attention deficit hyperactivity disorder (ADHD) in an earlier study. Taken together, these findings suggest impairment in temporal attention in adolescents with high impulsivity. As in ADHD children, a gating deficit may play a central role in this attention impairment.

Adolescent↗

PubMed2005

Impulsivity and methamphetamine use.

The purpose of this study was to explore the relationship between methamphetamine (meth) use and impulsivity in a sample of 385 HIV-negative heterosexually identified meth users. Participants who scored highest on a self-report measure of impulsivity were compared with those who scored lower in terms of background characteristics, meth use patterns, use of alcohol and other illicit drugs, sexual risk behavior, and psychiatric health variables. Methamphetamine users in the high impulsivity group were younger, less educated, used larger quantities of meth, were more likely to be binge users, had a larger number of sexual partners, engaged in more unprotected vaginal and oral sex, and scored higher on the Beck Depression Inventory as compared with those in the low impulsivity group. In a logistic regression analysis, Beck depression was the factor that best distinguished between meth users who scored high and those who scored low on impulsivity. Neurophysiological pathways that may underlie the relationship between impulsivity and meth use are discussed.

Adolescent↗

PubMed2006

Abnormal latent inhibition and impulsivity in coloboma mice, a model of ADHD.

Attention deficit hyperactivity disorder (ADHD) is characterized by hyperactivity, inattention, and impulsivity. The coloboma mouse model of ADHD exhibits profound hyperactivity. To determine whether coloboma mice exhibit other signs of ADHD, we assessed latent inhibition as a test of attention, and impulsivity in a delayed reinforcement paradigm. Latent inhibition was present in control mice but was disrupted in coloboma mice. Coloboma mice also exhibited impaired performance on the delayed reinforcement task and were not able to wait as long as control mice to obtain the greater reinforcer. Because norepinephrine mediates hyperactivity in coloboma mice, we examined the role of norepinephrine in disrupted latent inhibition and impulsivity. Reduction of norepinephrine with DSP-4 (N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine hydrochloride) restored latent inhibition but did not ameliorate impulsivity. In summary, coloboma mice exhibit hyperactivity, inattention as determined by latent inhibition, and impulsivity, and norepinephrine mediates hyperactivity and inattention but not impulsivity in these mice.

Animals↗

PubMed2005

Reduced punishment sensitivity in neural systems of behavior monitoring in impulsive individuals.

This study measured the response-locked event-related potential during a flanker task with performance-based monetarily rewarding and punishing trials in 37 undergraduate students separated into high- and low-impulsive groups based on a median split on self-reported Barrett Impulsiveness Scale. The high-impulsive group had a smaller medial frontal error-related negativity (ERN) on punishment trials than the low-impulsive group. The medial prefrontal neural system of behavior monitoring, indexed by the ERN, appears less sensitive to punishment signals in normal impulsivity. This reduced punishment sensitivity in impulsivity, a personality variation associated with several mental and personality disorders including ADHD and substance abuse may be related to the tendency to select short-term rewards despite potential long-term negative consequences in these individuals.

Adolescent↗

PubMed2005

A pilot genetic study of the continuum between compulsivity and impulsivity in females: the serotonin transporter promoter polymorphism.

According to some authors the obsessive-compulsive (OC) spectrum includes on one extreme, the Obsessive-Compulsive Disorder (OCD) and on the other extreme the most impulsive behaviors. This is a controversial idea and other authors define the OC spectrum in different ways. The serotonin transporter (5-HTT) gene is one of the main genes that control serotonergic function. A polymorphism in the promoter area of this gene classifies subjects with low expression as S individuals (s/s or s/l) and subjects with high expression as L individuals (l/l). This polymorphism was studied in female OCD patients (n = 24), non-impulsive controls (n = 112) and impulsive suicidal patients (n = 118) to support the OC spectrum hypothesis from a genetic perspective. A linear association exists among the serotonin transporter promoter functional genotypes (S versus L individuals) (chi2 linear by linear association = 8.9; df = 1; p = 0.003). The frequency of S individuals (s/l or s/s) was lowest in OCD (54%, 13/24); intermediate in non-impulsive controls (71%, 80/112) and highest in impulsive suicide attempters (82%, 96/117). More importantly, future studies need to consider that genetics may be related to behavioral dimensions (compulsivity to impulsivity) instead of to specific psychiatric disorders defined in clinical terms.

Adolescent↗

PubMed2001

Differential abnormalities in plasma 5-HIAA and platelet serotonin concentrations in violent suicide attempters: relationships with impulsivity and depression.

Brain serotonergic systems may participate in the regulation of mood, impulsivity and aggressive behavior. Because some monoaminergic mechanisms seem to be similar in the central nervous system and peripheral tissues, we tested whether serotonergic or dopaminergic biochemical parameters in peripheral venous blood are related or not to violent suicide behavior.We simultaneously studied plasma serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and platelet 5-HT content in patients within 3 days following a violent suicide attempt and in matched healthy controls. We examined their relationship with depression and impulsivity. Twenty seven drug-free suicide attempters and controls were included. Plasma 5-HIAA and platelet 5-HT concentrations were lower in suicide attempters than in controls. Fifteen patients were classified as impulsive (I), including all patients suffering from personality disorder and alcohol abuse, and 12 as non impulsive (NI), mostly melancholics. MADRS scores were similar in both I and NI suicide attempters. When controlling for age, plasma 5-HIAA was lower in I than in NI suicide attempters or controls; these findings are similar to those we observed recently with CSF 5-HIAA in I and NI violent suicide attempters. Contrarily, platelet 5-HT levels were lower in NI than in I patients or controls. Plasma HVA was not associated with suicide behavior. Plasma 5-HIAA concentration was inversely associated with the degree of impulsivity and platelet 5-HT with the intensity of depression. This study indicates that each peripheral serotonergic index is specifically related to a distinct clinical feature and shows differential alteration according to the impulsivity group. In I and NI drug-free violent suicide attempters an inverse figure between plasma 5-HIAA and platelet 5-HT data was observed indicating a non parallelism between these two peripheral variables. Further prospective studies are needed to investigate whether these peripheral serotonergic parameters may be used as helpful early predictors of violent suicide behavior.

Adolescent↗

PubMed2000

Relationship between impulsivity and platelet serotonin content in adolescents.

The relationship between impulsivity and serotonin function was explored in impulsive and non-depressed adolescents. Platelet serotonin content was chosen as a peripheral indicator of central serotonin function. Impulsivity was assessed with a questionnaire. All measures were performed once a week over a 6-week period for all subjects. Subjects comprised eight adolescent inpatients who were hospitalized as a result of their impulsive acts and eight healthy age- and sex-matched control subjects. Mean platelet serotonin concentration was significantly higher in the impulsive group than in the control group. Platelet serotonin concentration was positively correlated with the intensity of impulsivity in the patient group.

Adolescent↗

PubMed2001

Substance abuse, pathological gambling, and impulsiveness.

This study evaluated behavioral and self-report indices of impulsiveness in pathological gambling substance abusers (n=27), non-pathological gambling substance abusers (n=63), and non-pathological gambling/non-substance abusing controls (n=21). The Bechara card task measured preferences for decks of cards that ranged in magnitude and probability of delayed and immediate rewards and punishers. The Stanford Time Perception Inventory (STPI) assessed orientation to the future, the Zuckerman Sensation Seeking Scale evaluated sensation seeking, and the Eysenck and Barratt scales measured impulsivity. A Principal Components analysis revealed that these personality measures comprised three distinct measures of impulsivity: impulse control, novelty seeking and time orientation. Linear contrast analyses revealed that substance abuse and pathological gambling resulted in additive effects on the impulse control and time orientation factors, but not on the novelty-seeking scale. Performance on the card task did not correlate with any of the three factors derived from the personality scale scores, but the presence of both substance abuse and pathological gambling had an additive effect on preferences for decks containing greater immediate gains but resulting in large punishers and overall net losses. These results provide further evidence of an association among substance abuse, pathological gambling, and impulsivity.

Adult↗

PubMed2002

Acute administration of d-amphetamine decreases impulsivity in healthy volunteers.

This study investigated the acute behavioral effects of d-amphetamine on several behavioral indices of impulsivity. Impulsivity has been defined, variously, as difficulty in inhibiting inappropriate behaviors, inability to wait, insensitivity to delayed consequences or an alteration in the perception of time; standardized procedures have been developed to measure these behavioral dimensions. However, it is not known how drugs affect these measures, and few studies have examined more than one measure in a single study. In this study, 36 healthy men and women participated in three sessions, in which they received placebo, 10 mg, or 20 mg d-amphetamine in randomized order. On each session they performed the following five tasks: the Stop Task, which measures behavioral inhibition, a delay discounting task, which measures the relative value of immediate vs. delayed rewards, a delay of gratification task, a Go/No-Go task, and a time estimation task. Subjects also completed mood questionnaires. Amphetamine produced its expected subjective, mood-altering effects, including increases in POMS Friendliness and Elation scales, and ARCI Euphoria and Stimulant scales. On the measures of impulsivity, amphetamine decreased impulsive responding on three of the tasks: on the Stop Task it decreased Stop reaction times without affecting Go reaction time, on the Go/No-Go task, it decreased the number of false alarms, and on the delay discounting measure, amphetamine (20 mg) decreased k values indicating less discounting of delayed reward. Other measures of impulsive behavior were unaffected. These results suggest that acute doses of amphetamine decrease several forms of impulsive behavior. These findings extend and confirm previous findings in humans and laboratory animals.

Adolescent↗

PubMed2004

Relationship between motor proficiency, attention, impulse, and activity in children with ADHD.

The aim of this study was to investigate the relationship between motor performance, attention deficit, impulsiveness, and hyperactivity in children with attention-deficit--hyperactivity disorder (ADHD). Participants were 42 school-aged children with ADHD (36 males, 6 females; mean age 8 years 2 months, SD 1 year 2 months; range 6 years to 11 years), and 42 age- and sex-matched children without ADHD (mean age 8 years 3 months, SD 1 year 1 month; range 6 years to 11 years). Motor abilities were assessed with the Bruininks-Oseretsky Test of Motor Proficiency. Attention and impulse control were measured with the Gordon Diagnostic System, and assessment of activity level was based on two Activity Level Rating Scales that were completed by parents and teachers. Analysis by t-test revealed a significant difference between children with and without ADHD in fine and gross motor skills, impulse control, and attention. Stepwise regression indicated that attention, impulse control, and parent ratings of activity level were the three best predictors of gross motor skills for children with ADHD, accounting for 55.9% of the variance. Attention and impulse control were the two best predictors of fine motor skills, accounting for 45.7% of the variance. Attention and impulse control were consistently found to be important predictors of both fine and gross motor skills in children with ADHD. However, the fact that activity level was a predictor for gross motor proficiency but not for fine motor tasks suggests that different behavioral processes are involved in fine and gross motor performance to different extents.

Attention↗

PubMed2002

Serotonergic and cognitive impairment in impulsive aggressive personality disordered offenders: are there implications for treatment?

BACKGROUND: Reduced serotonin (5-HT) function and deficits on neuropsychological tasks have been separately reported in antisocial populations. We investigated whether these impairments are independent or associated factors underlying impulsivity in aggressive personality disordered (PD) offenders and healthy controls and whether there are associated changes in quantitative brain measures. METHODS: This study reports on the findings from a sample of 51 PD offenders and 24 controls, recruited from maximum security psychiatric hospitals, who were characterized using the Special Hospital Assessment of Personality and Socialisation (SHAPS). Subjects underwent assessment of 5-HT function (prolactin response to D-fenfluramine challenge), neuropsychological testing and had a diagnostic MRI scan. Of this sample 19 controls and 24 patients also had quantitative measurement of frontal and temporal lobe volumes on magnetic resonance imaging (MRI). RESULTS: Non-psychopathic (low-impulsive) aggressive PDs had enhanced 5-HT function compared with controls and highly impulsive aggressive psychopaths. Primary and secondary psychopaths had poorer executive/frontal, but not memory/temporal neuropsychological function than controls and non-psychopaths. There were no significant group differences in frontal or temporal lobe brain volumes. Although impulsivity and aggression are correlated constructs impulsivity appeared to be related to both executive function and 5-HT function, while aggression only correlated inversely with executive/frontal and memory/temporal function. 5-HT did not directly correlate with frontal or temporal volume or function. CONCLUSION: Impulsivity appears to be contributed to by both impaired neuropsychological function and 5-HT function. Impaired neuropsychological function alone makes a contribution to aggression. Treatment needs to take account of the neuropsychological and biochemical deficits in this challenging population.

Adult↗

PubMed2003

Impulsivity and verbal deficits associated with domestic violence.

While neurobiological factors are known to play a role in human aggression, relatively few studies have examined neuropsychological contributions to propensity for violence. We previously demonstrated cognitive deficits among men who committed domestic violence (batterers) compared to non-violent controls. Batterers had deficits in verbal ability, learning and executive problem-solving ability. These findings led us to examine whether executive control problems involving impulsivity contribute to problems with behavioral control among batterers, and to further examine their deficits in verbal functioning. Batterers (n = 41) enrolled in a domestic violence program were compared to 20 non-violent men of similar age, education, and socioeconomic background on neuropsychological tests of executive functioning, including impulsivity. Questionnaires and structured clinical interviews were used to assess emotional distress, aggression and self-reported impulsivity. Batterers showed greater impulsivity compared to non-batterers on several neuropsychological measures. Yet, the severity of these deficits was relatively mild and not evident in all batterers. Consistent with our previous findings, significant verbal deficits were again observed among the batterers. These findings suggest that while impulsivity may be a factor associated with domestic violence, it probably is not the sole determinant of the strong relationship between cognitive functioning and batterer status that we previously observed. Both verbal expressive deficits and behavioral impulsivity appear to be relevant variables in predisposing men to domestic violence.

Adult↗

PubMed1990

Impulsive motor behavior: effects of personality and goal salience.

This experiment used a circle tracing paradigm to extend our recent theoretical development concerning the contributions of extraversion and neuroticism to impulsive performance on continuous motor tasks. Subjects (N = 137) completed the Eysenck Personality Questionnaire and were randomly assigned to 1 of 2 circle conditions: The goal condition provided subjects with a salient behavioral end point for their tracings, whereas the no-goal condition promoted behavioral uncertainty. In both conditions, Ss were asked to trace the circle under neutral and inhibition instructions. Using Gray's impulsivity and anxiety dimensions to group subjects, impulsive subjects under inhibition instructions displayed significantly faster tracing speed than nonimpulsive subjects in the presence of a salient goal, whereas anxious subjects appeared behaviorally impulsive in a situation promoting uncertainty and response conflict. Conceptualizing impulsivity and anxiety in terms of extraversion and neuroticism, with impulsive Ss as neurotic extraverts and anxious Ss as neurotic-introverts, it is proposed that Ss' level of extraversion determines the type of stimuli to which they are responsive, and that level of neuroticism influences the magnitude of this reaction.

Adult↗

PubMed2002

Impulse control differences between abstinent heroin users and matched controls.

OBJECTIVE: Heroin use has been associated with increased impulsive behaviour. This study examined the lasting effect of heroin use on impulse control in a group of ex-heroin addicts. RESEARCH DESIGN AND METHOD: Twenty-eight men, 14 ex-heroin addicts and 14 matched controls, participated in this study. The impulse control ability between the two groups was compared. Each participant was individually interviewed for demographic data and testing of their impulse control ability using the Porteus Maze Test. RESULTS: The findings indicated that the ex-heroin addicts performed significantly more poorly on the measure of impulse control than the matched controls. CONCLUSIONS: This observation suggests that the adverse effect of heroin on impulse control may be long lasting. Alternative explanations for the findings were also discussed.

Adult↗