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PubMed1995

Subtypes of adult antisocial behavior among drug abusers.

Recent work has shown that a substantial proportion of injecting drug users would have met criteria for antisocial personality disorder (ASPD) if the childhood trajectory of conduct disorder (CD) were ignored. From among 545 St. Louis, Missouri, drug users interviewed in person, we evaluated the clinical homogeneity of the 405 men and women with adult antisocial behaviors who did and did not have conduct disorder. The fully diagnosed ASPD group (those with CD) was distinguishable from the adult antisocial behavior only group without CD on all childhood behaviors, adult impulsive and aggressive behaviors, and measures of severe drug abuse, including earlier age of onset of drug use and drug treatment utilization. Clinical homogeneity of the groups was reflected by the group's similarity on indices such as types of adult antisocial behaviors, consequences of drug use, injection drug use history, and comorbid psychiatric disorders. Implications for a modification in the concept of ASPD are addressed.

Adult↗
PubMed2002

Early developmental precursors of impulsive and inattentive behavior: from infancy to middle childhood.

BACKGROUND: We examined infancy and toddler-age precursors of impulsivity and inattention in school-age children. Children (50 boys, 39 girls) had been participants since infancy in the Bloomington Longitudinal Study. METHOD: Individual differences in children's self-regulatory competence were assessed at 8 years of age, using laboratory tests and observations of three central constructs: Inhibitory Control, Behavioral Control, and Attentional Disengagement. RESULTS: We found that measures of caregiver-child interaction, child temperament, and child cognitive competence during the toddler period significantly predicted variations in children's later impulsive functioning. However, the strength of these relationships, and the type and combination of significant risk factors, were differentially patterned in relation to specific subtypes of later child impulsivity. CONCLUSIONS: These data provide further evidence for the multidimensional nature of child impulsivity, and they highlight the importance of examining toddler-age precursors of children's later self-regulatory competence.

Adult↗
PubMed1999

Studies of the 48 bp repeat polymorphism of the DRD4 gene in impulsive, compulsive, addictive behaviors: Tourette syndrome, ADHD, pathological gambling, and substance abuse.

Prior studies have reported an association between the presence of the 7 repeat allele of the 48 bp repeat polymorphism of the third cytoplasmic loop of the dopamine D4 receptor gene (DRD4) and novelty seeking behaviors, attention deficit hyperactivity disorder (ADHD), Tourette syndrome (TS), pathological gambling, and substance abuse. However, other studies have failed to replicate some of these observations. To determine whether we could replicate these associations we genotyped 737 individuals from four different groups of control subjects, and 707 index subjects from four different groups of impulsive, compulsive addictive behaviors including substance abuse, pathological gambling, TS, and ADHD. Chi-square analysis of those carrying the 7 allele versus non-7 allele carriers was not significant for any of the groups using a Bonferroni corrected alpha of.0125. However, chi-square analysis of those carrying any 5 to 8 allele versus noncarriers was significant for pathological gambling (p <.0001), ADHD (p </=.01) and the total index group (p </=.0004). When the comparison included all 7 alleles the results were significant for gamblers (p <.0001), TS (p </=.003), ADHD (p </=.003), and the total group (p </=.0002). There was a significant increase in the frequency of heterozygosity versus homozygosity for all alleles for pathological gamblers (p </=.0031) and the total index group (p </=.0015), suggesting that heterosis played a role. In the substance abuse subjects a quantitative summary variable for the severity of drug dependence, based on the Addiction Severity Index, showed that the scores varied by increasing severity across the following genotypes: 44 </= heterozygotes </= 77 </= 22. Studies of other quantitative traits indicated an important role for the 2 allele and the 22, 24, and 27 genotypes. All studies indicated that the role of the DRD4 gene in impulsive, compulsive, addictive behaviors is more complex than a sole focus on the 7 versus non-7 alleles.

Alleles↗
PubMed2005

Stimulation of the posterior hypothalamus for medically intractable impulsive and violent behavior.

OBJECTIVE: To describe the therapeutic effect of deep brain stimulation for the treatment of patients with below-average IQs who are affected by aggressive and disruptive behavior and who are resistant to any drug and/or conservative treatment (including occupational therapy). PATIENTS AND METHODS: Two consecutive patients suffering from mental retardation with aggressive and disruptive behavior and resistant to any pharmacological treatment underwent deep brain stimulation electrode placement in the posteromedial hypothalamus for continuous chronic high-frequency stimulation (HFS). The stereotactic coordinates of the target were chosen according to the study by Sano et al., which involved hypothalamic stereotactic lesions. RESULTS: HFS of the posteromedial hypothalamus demonstrated consistent improvement of disruptive behavior in both patients at the follow-up evaluation 1 year later. CONCLUSIONS: HFS of the posteromedial hypothalamus showed similar results to those obtained by Sano et al. in the 1960s with radiofrequency lesions of the same target volume. The reversibility of neurostimulation allows HFS to control disruptive behavior when conservative treatments are ineffective, and drug therapy is uneventful or causes severe side effects. In conclusion, this neuromodulation procedure improved the quality of life and the range of social relationships for both of the treated patients.

Adult↗
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↗
PubMed2003

Low platelet MAO activity associated with high dysfunctional impulsivity and antisocial behavior: evidence from drunk drivers.

RATIONALE: Low platelet monoamine oxidase (MAO) activity is associated with problem drinking and other deviant behaviors. Since the majority of alcohol abusers are smokers, and tobacco smoke has a direct inhibitory effect on the enzyme, these associations may not be meaningful. OBJECTIVE: The authors compared platelet MAO activity and impulsivity in police-referred subjects caught driving while intoxicated and in control subjects, controlling for smoking. METHODS: Platelet MAO activity was measured radioenzymatically and impulsivity scores obtained from questionnaires. Smoking status was self-reported. RESULTS: Subjects caught driving while intoxicated had significantly higher dysfunctional impulsivity and lower platelet MAO activity than control subjects. This difference in platelet MAO activity between the two groups was significant in non-smokers and ex-smokers. CONCLUSIONS: These findings demonstrate that platelet MAO activity is lower in subjects with socially deviant behavior, and the association of low platelet MAO and problem drinking is not an artifact of smoking.

Adult↗
PubMed1990

Cerebrospinal fluid monoamine metabolites, aggression, and impulsivity in disruptive behavior disorders of children and adolescents.

Cerebrospinal fluid levels of 5-hydroxyindoleacetic acid, a metabolite of serotonin, were measured in relation to aggression, impulsivity, and social functioning in 29 children and adolescents with disruptive behavior disorders. The cerebrospinal fluid 5-hydroxyindoleacetic acid level was low compared with that of age-, sex-, and race-matched patients with obsessive-compulsive disorder. Within the disruptive group, significant negative correlations with age-corrected 5-hydroxyindoleacetic acid level were seen for the child's report of aggression toward people and the expressed emotionality of the child toward his or her mother; other correlations of age-corrected 5-hydroxyindoleacetic acid level with measures of aggression were in the expected negative direction but did not reach statistical significance. Impulsivity per se and socioenvironmental factors were not significantly related to cerebrospinal fluid 5-hydroxyindoleacetic acid concentration.

Adolescent↗
PubMed2006

College drinking behaviors: mediational links between parenting styles, impulse control, and alcohol-related outcomes.

Mediational links between parenting styles (authoritative, authoritarian, permissive), impulsiveness (general control), drinking control (specific control), and alcohol use and abuse were tested. A pattern-mixture approach (for modeling non-ignorable missing data) with multiple-group structural equation models with 421 (206 female, 215 male) college students was used. Gender was examined as a potential moderator of parenting styles on control processes related to drinking. Specifically, the parent-child gender match was found to have implications for increased levels of impulsiveness (a significant mediator of parenting effects on drinking control). These findings suggest that a parent with a permissive parenting style who is the same gender as the respondent can directly influence control processes and indirectly influence alcohol use and abuse.

Alcohol Drinking↗
PubMed2002

Immediate and delayed memory tasks: a computerized behavioral measure of memory, attention, and impulsivity.

The Immediate and Delayed Memory Task (IMT/DMT), a variant of the Continuous Performance Test (CPT), is a new software package designed to be a flexible research tool for the study of attention, memory, and impulsivity. This package allows researchers to determine the design to be used during a testing session and to manipulate many of the parameters. It features two components: the IMT and the DMT, both of which present sequential 2- to 7-digit stimuli with variable presentation rates and intertrial intervals. Subjects respond to identically matched stimuli presented consecutively, spanning a brief period of time (IMT), or to stimuli spanning a greater period of time (during which intervening stimuli to be ignored appear; DMT). Task complexity can be adjusted to suit applications for both children and adults. Preliminary studies have demonstrated that these laboratory tasks are sensitive to group differences, produce stable baselines of performance, and are sensitive to drug-induced performance decrements.

Attention↗
PubMed1998

Platelet serotonin, monoamine oxidase activity, and [3H]paroxetine binding related to impulsive suicide attempts and borderline personality disorder.

BACKGROUND: The aim of the present study was to examine the relationship between suicidal behavior and impulsiveness, and more generally borderline personality disorder on the one hand, and platelet indicators of central serotonergic function on the other. METHODS: After a suicide attempt platelet serotonergic measures were obtained from 144 patients with at least one previous attempt. A major DSM-III-R Axis I diagnosis and the use of antidepressants were reasons for exclusion. RESULTS: Platelet monoamine oxidase (MAO) activity was negatively correlated with the personality traits "multi-impulsive behavior" and "disinhibition." In accordance, platelet MAO activity was also lower in patients with less-planned suicide attempts. Platelet serotonin (5-HT) and recidivism were positively correlated with borderline personality disorder, in particular chronic feelings of emptiness. Platelet 5-HT was lower in patients with alcohol abuse. The maximum number of binding sites (Bmax) for paroxetine binding was positively correlated with "sensation seeking." CONCLUSIONS: These findings support the hypothesis that serotonergic involvement in impulsive suicidal behavior is mediated by the relationship between serotonergic function and impulsiveness as personality trait. Other borderline personality traits relevant to recurrent suicidal behavior, in particular chronic feelings of emptiness, appear also related to serotonergic measures.

Adolescent↗
PubMed2001

Case series: amantadine open-label treatment of impulsive and aggressive behavior in hospitalized children with developmental disabilities.

OBJECTIVE: A growing body of literature implicates interactions between glutamatergic and neostriatal dopaminergic neurotransmitter systems in the development and expression of impulsivity, hyperactivity, and stereotypy. Amantadine hydrochloride, a drug used in young children for influenza prophylaxis, acts both as an indirect dopamine agonist as well as an N-methyl-D-aspartate (NMDA) receptor antagonist. Thus an open clinical trial of this medication for the treatment of symptoms of impulse control disorders in children was performed. METHOD: A total of eight children (seven with neurodevelopmental disorders and all inpatients) with target behaviors refractory to other treatments were selected after parental informed consent. All patients were male and ranged in age from 4 to 12 years. Outcome was based on subjective consensus clinical ratings by the multidisciplinary treatment team. RESULTS: For four of the children, amantadine was associated with marked clinical improvement. In the remainder, improvement was also observed. Amantadine was well tolerated. CONCLUSIONS: On the basis of this experience, it appears that amantadine hydrochloride or related NMDA antagonists may warrant additional study in this and related populations.

Aggression↗
PubMed2002

A dimensional impulsive-aggressive phenotype is associated with the A218C polymorphism of the tryptophan hydroxylase gene: a pilot study in well-characterized impulsive inpatients.

Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in the biosynthesis of serotonin, and association and linkage studies of its variants in suicidal and impulsive-aggressive behavior have brought conflicting results. This pilot study was designed to investigate whether TPH A218C genotypes could be associated with impulsive behavioral tendencies (IBTs) in consecutively admitted nonpsychotic nonorganic inpatients. Patients (20 females and 34 males; age, 38.8 +/- 11.8) did not differ from healthy nonimpulsive controls (16 females and 11 males; age, 35.2 +/- 10.2) regarding TPH genotypes, but in the patients, the number of IBT was related to the presence of the 218C allele. It was concluded that impulsive-aggressive behavior may be associated with the TPH genotype in well-characterized impulsive patients and that the present results stress the importance of considering impulsiveness-aggressiveness in studies investigating the relationship between suicidal behavior and TPH genotypes.

Adult↗
PubMed1993

Personality disorder, tendency to impulsive violence, and suicidal behavior in adolescents.

Inpatient suicide attempters (n = 37) were compared with never-suicidal psychiatric controls (n = 29) with respect to prevalence and severity of personality disorder, history of aggression and assaultive behavior, and other measures of impulsive violence. Attempters, compared with controls, were more likely to show evidence of personality disorder or trait, particularly those of the borderline type. Attempters showed greater number of borderline symptoms than did controls, even after removing the item relating to suicidality. There were no differences between the groups with respect to lifetime history of aggression, history of assaultive behavior, or self-report measures of a tendency to impulsive aggression. Those attempters with personality disorder were much more likely to have made a previous attempt. The apparently high prevalence of personality disorder among adolescent inpatient suicide attempters indicates that the social impairment associated with personality disorder be viewed as an important aspect of treatment.

Adolescent↗
PubMed1987

Development of strategic skills in impulsive and reflective children: a longitudinal study of metacognition.

This study examined the relationships between metamemory and strategic behavior in impulsive and reflective children. One hundred thirty children from the fourth, fifth, and sixth grades participated. Seventy-seven of these children had been tested 3 years earlier on metamemory and cognitive tempo tasks. At pretraining, children were assessed on metamemory, cognitive tempo, summarization skills, and teacher ratings of impulsive behavior in the classroom. Next, children in three experimental groups received prose summarization instructions, summarization instructions in conjunction with metacognitive training about the importance of a reflective approach to learning, or no instructions. Following training, children were again measured on tempo, summarization skills, and teacher ratings of impulsivity. Analyses of strategy maintenance data indicated superior performance for children who had received both summarization and metacognitive training. Causal modeling analyses showed that early metamemory was an antecedent of later strategy acquisition. The dual role of metacognition as a precursor of later strategy acquisition and controller of lower level strategies was highlighted.

Child↗
PubMed2004

Reflective and impulsive determinants of social behavior.

This article describes a 2-systems model that explains social behavior as a joint function of reflective and impulsive processes. In particular, it is assumed that social behavior is controlled by 2 interacting systems that follow different operating principles. The reflective system generates behavioral decisions that are based on knowledge about facts and values, whereas the impulsive system elicits behavior through associative links and motivational orientations. The proposed model describes how the 2 systems interact at various stages of processing, and how their outputs may determine behavior in a synergistic or antagonistic fashion. It extends previous models by integrating motivational components that allow more precise predictions of behavior. The implications of this reflective-impulsive model are applied to various phenomena from social psychology and beyond. Extending previous dual-process accounts, this model is not limited to specific domains of mental functioning and attempts to integrate cognitive, motivational, and behavioral mechanisms.

Affect↗
PubMed2004

Suicidal behaviors and drug abuse: impulsivity and its assessment.

Impulsivity appears to play an important role in suicidal behaviors and drug abuse, which are two psychiatric problems that may interact with one another. Interpretation of the literature on impulsivity in these behaviors may be complicated by the variety of measurement techniques for the assessment of impulsivity. There are three general types of impulsivity assessment: self-report, biological, and laboratory behavioral. Because laboratory behavioral measures both meet an operational definition of impulsivity and are sensitive to state-dependent changes in impulsivity, this paper presents data that focuses on laboratory behavioral performance among samples emitting suicidal behaviors or substance abuse. To better account for influence of impulsivity in these psychiatric disturbances, no single source of measurement should be used without the consideration of other types of instruments.

Decision Making↗
PubMedDate not supplied

Impulsivity in the prediction of suicidal behavior in adolescent populations.

Impulsivity has been identified as a key factor in risk of suicidal behavior in adolescent and adult patients. However, a lack of consensus about the definition of impulsivity has led to difficulty in its measurement. Impulsivity self-report scales exhibit low intercorrelations, are subject to response bias, and incorporate multiple subfactors. Performance tests may be less sensitive to response biases, as well as be more precise measures of dimensions of impulsivity, but each test alone does not provide a comprehensive measure of the trait. Assessing impulsivity in child and adolescent groups presents additional methodological problems, such as an overlap between limited impulse control due to developmental factors and psychopathology. A multiple measures approach to assessing impulsivity is suggested.

Adolescent↗