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PubMed1994

[Serotonergic function and aggressive-impulsive behavior].

Considerable interest has been paid to the biological basis of the aggressive behavior, in the last two decades. The 5-HT function has been the most studied function in animal models, and studies carried out with either psychiatric patients, antisocial subjects, or normal people. An overwhelming evidence favors the importance of the 5-HT function in the modulation of aggressive behavior, particularly when 5-HT function is associated to loss of impulse control. Data from literature are reviewed. Results of a challenge serotonin test with fluoxetine in normal subjects are presented. The therapeutic implications of such studies are also discussed.

Adolescent↗
PubMed2003

Wolfram syndrome and suicide: Evidence for a role of WFS1 in suicidal and impulsive behavior.

There is evidence suggesting that subjects affected with the Wolfram syndrome (WFS) and normal carriers present an increased risk of psychiatric disorders, particularly depression and suicidal behavior. We investigated a possible role of the gene involved in WFS (WFS1) in the neurobiology of suicide and the potential modulatory effect on traits associated to suicidal behavior. Genetic variation at WFS1 (H611R, R456H, and I333V) was investigated in 111 suicide victims and 129 normal controls. Possible effects on psychopathology and behavioral traits were investigated in a subsample of suicide cases (N = 31) for whom phenotyping was carried out by means of structured psychiatric interviews and questionnaires adapted for psychological autopsies. We found a significantly higher frequency of the 611R/611R genotype in suicide completers as compared to controls (chi(2) = 19.21, df=2, P = 0.001). Suicide completers with this genotype had higher scores on measures of impulsivity (t = -3.15, df = 15.3, P = 0.006); novelty seeking (NS) (t = -3.35, df = 13.8, P = 0.005); and conversely, lower scores of persistence (t = 2.4, df = 16.6, P = 0.028). Scores of impulsivity and NS remained higher in subjects with the associated genotype after adjusting for age, gender, and psychopathology. These results suggest a role for WFS1 in the pathophysiology of impulsive suicide, and are consistent with previous clinical reports suggesting an increased risk of suicidal behavior in WFS homozygotes and heterozygotes. However, these findings are preliminary and should be confirmed in independent samples.

Adult↗
PubMed2000

[Treatment of paraphilia and sexually aggressive impulsive behavior with the LHRH-agonist leuprolide acetate].

Up to now there are no published results of therapy of paraphilia (Pedophilia, Sadism) and sexual aggressive impulsiveness with LHRH-(luteinizing hormone-releasing hormone) Agonists in the Germanspeaking countries. In this report we describe 11 patients which were treated with the LHRH-Agonist Leuprolide Acetate in a period of 12 months. The patients showed no tendency of sexual aggressive behaviour and reported an evident reduction of penile erection, ejaculation, masturbation, sexual deviant impulsiveness and fantasies. One patient died from suicide. In combination with other treatments LHRH-Agonists seem to be a very promising alternative to cyproterone acetate and its possible carcinogene effects.

Adult↗
PubMed1998

Aggressive and impulsive behavior in military psychiatric inpatients.

OBJECTIVE: To determine if a history of aggressive/impulsive behavior adversely affected the return to full duty of a military psychiatric inpatient population. METHOD: Charts were reviewed for aggressive/impulsive behavior as indicated by self-report on a standardized admission form and by history in 211 consecutive admissions pooled from two separate 2-month intervals during a 9-month period. RESULTS: Seventy-three percent of the population was between the ages of 17 and 24 years. Sixty-eight percent of the population reported a history of at least one school suspension/expulsion, arrest, or military nonjudicial punishment (males, 74%; females, 45%). Seven percent of patients reporting aggressive/impulsive behavior were returned to full duty unconditionally, compared with 28% of patients not reporting said behavior. Eighteen percent of patients met the criteria for adult antisocial behavior. Only one patient with adult antisocial behavior was returned to full duty. CONCLUSIONS: This study found that a history of aggressive/impulsive behavior was positively correlated with substance abuse and negatively correlated with return to full military duty.

Adolescent↗
PubMed2003

Effects of reinforcer magnitude on an animal model of impulsive behavior.

The effects of altering sucrose solution concentration on discounting of delayed rewards in rats were examined. Five different delays were used (0, 1, 2, 4, and 8s) and three different sucrose solution concentrations (3, 10, and 30%). It was hypothesized that high value sucrose solution concentrations would be discounted less than low value sucrose solution concentrations. The results indicated that the rats discounted the 30% sucrose solution concentration at a higher rate than the 3 or 10% sucrose solution concentration, a finding that apparently contradicted the hypothesis that higher value sucrose solution concentrations would be discounted less than lower value sucrose solution concentrations. However, a follow up experiment indicated that the 3 and 10% sucrose solution concentrations were preferred over the 30% concentration. Thus the results of Experiment 1 can be interpreted as supporting the hypothesis that high valued sucrose solution concentrations are discounted less than lower valued sucrose solution concentrations.

Journal Article↗
PubMed1994

Attention-deficit hyperactivity disorder. Getting control of impulsive behavior.

A sizable number of school-aged children, more often boys, may have attention-deficit hyperactivity disorder (ADHD). Its cause is unknown. Some investigators implicate food additives or lead poisoning. These theories are not supported by study results, however. Physicians are dependent on reports of parents and teachers to diagnose ADHD, since the children may not show signs at an office visit. The presence of criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, third revised edition, and descriptions by parents and teachers of significant and pervasive impairment at home or school are diagnostic. Treatment is essential to minimize the academic failure, rejection, and loss of self-esteem that can result from the behaviors that typify ADHD. Use of stimulant medication is the most effective intervention and should be continued as long as it provides benefits without adverse effects. Concomitant behavioral therapy may be useful, and the entire family may benefit from psychotherapy.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

Familial transmission of Continuous Performance Test behavior: attentional and impulsive response characteristics.

Continuous Performance Tests (CPTs) provide information on attentional processing and impulsive behavior. The results of previous research that used self-report measures have provided evidence for familial transmission (through genetic and/or environmental influences) of impulsive characteristics. The authors of the present study examined whether the impulsive behavioral parameters that are measured by the CPT also share familial relationships. The researchers asked 26 healthy parent-adolescent pairs to complete the Immediate and Delayed Memory Tasks (IMT/DMT; D. M. Dougherty, 1999; D. M. Dougherty, D. M. Marsh, & C. W. Mathias, 2002), a modified CPT (B. A. Cornblatt, N. J. Risch, G. Faris, D. Friedman, & L. Erlenmeyer-Kimling, 1988; H. E. Rosvold, A. Mirsky, I. Sarason, E. D. Breansome, Jr., & L. H. Beck, 1956), and the Barratt Impulsiveness Scale (BIS; J. H. Patton, M. S. Stanford, & E. S. Barratt, 1995), a self-report measure. The main findings can be summarized as follows: (a) commission errors (but not correct detections) on the IMT and DMT were correlated between parents and their adolescent children, (b) adolescents emitted a higher proportion of commission errors than did their parents, and (c) self-reported impulsivity (i.e., BIS) was correlated with commission errors for parents, but not for adolescents. The findings of this study support the use of an objective behavioral measure of impulsivity to assess familial relationships of impulsivity.

Adolescent↗
PubMed1998

The changing profile of anorexia nervosa at the Toronto Programme for Eating Disorders.

The present study is a retrospective comparison of anorexic patients of the restricting subtype (AN) with those of the bulimic subtype (AN+BN) over three consecutive 5-year time periods. Subjects consisted of 806 female out-patients diagnosed as either AN or AN+BN between 1978 and 1994 during an assessment of their eating problem at the University of Toronto Programme for Eating Disorders in Toronto, Canada. During each time period an increasing proportion of subjects was diagnosed with AN+BN than with AN. Subjects with AN+BN reported a longer duration of illness prior to being assessed. Over time, subjects in both groups appeared to weigh more, and were less likely to report amenorrhea. Subjects from both groups reported higher frequencies of purging behavior, impulsive behaviors, and associated affective symptoms in the later time periods. Over time, the differences between the two subgroups of patients became less distinct. The results indicate changes in the clinical profile of patients with anorexia nervosa seen at the Toronto Programme for Eating Disorders over the past 16 years. The implications of these changes are explored.

Adolescent↗
PubMed1999

Working memory, executive processes and the effects of alcohol on Go/No-Go learning: testing a model of behavioral regulation and impulsivity.

RATIONALE: Impulsivity is associated with increased risk for alcoholism. Alcohol also may increase impulsive behavior, although little is known about the processes underlying this effect. OBJECTIVES: This study tested a model proposing that the executive processes of working memory (WM) and conditional associative learning (CAL) modulate behavioral inhibition. Subjects had either a positive (FHP) or a negative (FHN) family history of alcoholism. Hypotheses were that alcohol would increase Go/No-Go impulsive responding but only in subjects with low working memory capacity (low-WM), low-CAL ability, or FHP for alcoholism. The model also predicted that WM and CAL modulate inhibitory responses to contingency reversal on a Go/No-Go task. METHODS: A Go/No-Go learning task with a midway contingency reversal was administered to 71 FHP and 78 FHN subjects when sober and after drinking one of two moderate doses of alcohol. WM (digits backward) and CAL (conditional spatial association task) were also assessed when sober. RESULTS: Alcohol resulted in more false alarms but only in low-WM subjects. Both WM and CAL modulated learning to inhibit behavior after contingency reversal, suggesting separate modulation mechanisms for WM and CAL. Subjects with low- capacity WM and subjects with low-capacity CAL ability had more difficulty learning response inhibition after contingency reversal. FHPs and FHNs did not differ in their response to alcohol. CONCLUSIONS: The results support our model of the modulatory role of WM and CAL in the ongoing regulation of behavioral inhibitory systems. The results also suggest that individuals with low capacity WM are more susceptible to alcohol's effect of increasing impulsive behavior, suggesting that alcohol reduces the capacity of working memory to modulate response inhibition.

Adolescent↗
PubMed2005

Laboratory behavioral measures of impulsivity.

Previous research and theory have conceptualized impulsivity as a multifaceted construct that requires multiple modes of measurement for accurate assessment. This article describes a software package that includes four paradigms for measuring multiple and unique aspects of impulsivity. Specifically, four tasks are described: (1) the two choice impulsivity paradigm, (2) the single key impulsivity paradigm, (3) the GoStop impulsivity paradigm, and (4) the time paradigm. These tasks measure processes related to the capacity to tolerate delay for reward, to inhibit an already initiated response, and to estimate the passage of time. These processes have been found to be important to the understanding of impulsive behaviors. The programs are flexible and allow the experimenter to manipulate a number of parameters related to delay-reward contingencies, timing, performance feedback/payment, and data output variables. Manipulation of these parameters makes the paradigms scalable to a wide range of ability levels and appropriate for samples ranging from children to adults. The four paradigms in this software package are available at no cost and can be obtained by contacting the corresponding author.

Animals↗
PubMed2006

Behavioral models of impulsivity in relation to ADHD: translation between clinical and preclinical studies.

Impulsivity, broadly defined as action without foresight, is a component of numerous psychiatric illnesses including attention deficit/hyperactivity disorder (ADHD), mania and substance abuse. In order to investigate the mechanisms underpinning impulsive behavior, the nature of impulsivity itself needs to be defined in operational terms that can be used as the basis for empirical investigation. Due to the range of behaviors that the term impulsivity describes, it has been suggested that impulsivity is not a unitary construct, but encompasses a variety of related phenomena that may differ in their biological basis. Through fractionating impulsivity into these component parts, it has proved possible to devise different behavioral paradigms to measure various aspects of impulsivity in both humans and laboratory animals. This review describes and evaluates some of the current behavioral models of impulsivity developed for use with rodents based on human neuropsychological tests, focusing on the five-choice serial reaction time task, the stop-signal reaction time task and delay-discounting paradigms. Furthermore, the contributions made by preclinical studies using such methodology to improve our understanding of the neural and neurochemical basis of impulsivity and ADHD are discussed, with particular reference to the involvement of both the serotonergic and dopaminergic systems, and frontostriatal circuitry.

Attention Deficit Disorder with Hyperactivity↗
PubMed1980

Impulsive suicidal behavior.

Previous studies have noted that a considerable proportion of suicidal behavior is impulsive. The present study aimed to ascertain the degree to which this was so and to consider whether impulsive attempters differed from non-impulsive attempters on variables such as demographic and motivational factors and circumstances that surrounded the occurrence of the act. Based on a criterion of less than 5 minutes' premeditation, 40% of two large, consecutive series were judged to have acted impulsively. While few variables differentiated between the two groups, impulsive attempters were less depressed, motivated by the desire to reduce tension, more likely to consider that they would survive, and to report that someone saw them perform the act.

Adult↗
PubMed2006

Topiramate plus citalopram in the treatment of Compulsive-Impulsive Sexual Behaviors.

Compulsive-Impulsive Sexual Behaviors (C-ISBs) include repetitive sexual acts and compulsive sexual thoughts which occur so frequently and with such intensity that they interfere with sexual intimacy and interpersonal and occupational functioning and whose categorization and effective treatments are still unclear. We report the case of a patient affected by C-ISBs and bipolar disorder of type II who improved dramatically after three months' addition of topiramate to citalopram. Topiramate is a powerful anticonvulsant which has recently been proposed also for the treatment of migraine, bipolar disorder and binge eating disorder. This case-report suggests that topiramate might be beneficial in augmentation with citalopram in patients suffering from C-ISBs, although controlled studies to confirm our findings are needed.

Journal Article↗
PubMed2001

Pathways mediating sexual abuse and eating disturbance in children.

OBJECTIVE: To examine the relationship between childhood maltreatment and eating disorders in a sample of children. METHOD: Twenty 10-15-year-old female children who were receiving treatment following reported childhood sexual abuse and 20 age-matched controls were compared on a series of measures assessing eating disorder behaviors, body image concerns, substance use, mood, impulsive behavior, and self-concept. RESULTS: Sexually abused children reported higher levels of eating disorder behaviors, impulsive behaviors, and drug abuse than controls. Furthermore, behavioral impulsivity provided the strongest mediational effect between a history of childhood sexual abuse and purging and restrictive dieting behavior. Drug use proved to be a significant secondary mediator of the childhood sexual abuse eating disorder behavior association. DISCUSSION: These data support the hypothesis that childhood sexual abuse is related to disordered eating in children, and extend similar findings that have been previously reported with adults. Behavioral impulsivity and drug use appear to be significant mechanisms that influence eating disorder behavior following childhood sexual abuse.

Adolescent↗