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Results for “Impulsive Behavior”

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PubMed2000

Needle sharing in opioid-dependent outpatients: psychological processes underlying risk.

Needle sharing contributes to the spread of the human immunodeficiency virus and other health concerns and remains a persistent problem among injection drug users. We determined whether needle sharing may be related to the discounting of the value of delayed outcomes. Outpatients in treatment for heroin dependence indicated preference for immediate versus delayed hypothetical monetary and heroin outcomes in a titration procedure that determined indifference points at various delays. The degree to which the delayed outcomes lost value was estimated with a nonlinear decay model. Participants who agreed to share a needle in a scenario (N=15) discounted delayed money more steeply than did the nonsharing group (N=17). Both groups discounted delayed heroin more steeply than delayed money. Persistent needle sharing may be related to the relative inability of delayed outcomes to impact current behavior. Training to mitigate the effect of delay on outcome value may offer reductions in needle sharing and drug abuse.

Adult↗

PubMed2006

Protective factors against suicidal behavior in depressed adults reporting childhood abuse.

Most previous studies compared suicidal behavior in subjects with and without a history of childhood abuse, whereas less attention was paid to the comparison of suicide attempters and nonattempters among subjects reporting childhood abuse. To identify risk and protective factors against suicidal behavior, we compared suicide attempters with nonattempters among the sample of 119 depressed inpatients who reported childhood abuse. Compared with nonattempters, suicide attempters were younger, had more self-rated depression severity and suicidal ideation, higher trait aggression and more cluster B personality disorder comorbidity, less coping potential, and fewer moral objections to suicide (MOS)/religious beliefs. Logistic regression showed that more severe suicidal ideation and fewer MOS/religious beliefs were associated with suicidal acts in subjects with reported childhood abuse. Furthermore, suicidal ideation and MOS/religious beliefs were significantly inversely correlated. The results of this clinical study add support to previous reports that religious/spiritual coping could serve as an additional resource in prevention of suicidal behavior for subjects with reported childhood abuse.

Adaptation, Psychological↗

PubMed2002

Characteristics of opiate dependent patients who attempt suicide.

OBJECTIVE: To describe the characteristics of opiate dependent patients who attempt suicide. METHOD: Opiate dependent patients (DSM-IV criteria) who had (N = 105) or had not (N = 141) attempted suicide were compared for family history of suicide, childhood trauma, personality traits, and experience of comorbidity with cocaine and/or alcohol dependence, major depressive disorder. and physical disorder. RESULTS: Significantly more opiate dependent patients who had attempted suicide were female (p < .0001) and unemployed (p < .0006). Patients who had attempted suicide reported significantly more family history of suicide and more childhood trauma; scored significantly higher for introversion, hostility, and neuroticism; and had experienced significantly more comorbidity with lifetime cocaine and alcohol dependence, major depressive disorder, and current physical disorder (p < .05 for all). CONCLUSION: Suicidal behavior in opiate dependent patients may involve risk factors from the family, childhood, personality, psychiatric, and physical domains.

Adult↗

PubMed1981

Maternal and personality determinants of adolescent smoking behavior.

This study examined the interconnection of maternal determinants and personality attributes of adolescent male tobacco users. The 39 mothers and their 39 sons were interviewed separately about their attitudes and the mother's child-rearing practices. The sons also responded to questions concerning their personality characteristics. In general, the findings indicated that adolescent tobacco use depends on the coexistence of certain personality predispositions and maternal conditions. Thus, with regard to personality factors, male smokers tended to be less in control of their impulses, less responsible and autonomous, more rebellious, and more likely to engage in interpersonal aggression. With respect to the coexisting maternal conditions, the mothers of smokers tended to be less traditional and affectionate, and less likely to serve as models for their sons.

Adolescent↗

PubMed2001

Free L-tryptophan plasma levels in antisocial violent offenders.

RATIONALE: Several studies have shown that impulsive violent behavior is associated with reduced serotonin metabolism in the brain, but no data exist on possible alterations of the serotonin precursor (free L-tryptophan) levels among violent offenders. OBJECTIVES: To study free L-tryptophan and kynurenine plasma levels among antisocial violent offenders. METHODS: Free L-tryptophan and competing amino acid (CAA) plasma levels were measured among 19 male impulsive antisocial violent offenders and 19 age-matched healthy male controls. RESULTS: Mean free L-tryptophan/(CAA) plasma levels were 160% (95% CI 116%-204%) higher among offenders than controls (P=0.000). Seventeen of the 19 offenders (89.5%) had values of more than 2 SD above the mean value of controls. The levels of kynurenine, the major metabolite of tryptophan, were slightly increased in offenders. CONCLUSION: Free plasma L-tryptophan/CAA levels were markedly increased among antisocial violent offenders indicating a disturbed tryptophan metabolism.

Adult↗

PubMed2004

Methylphenidate treatment of attention-deficit/hyperactivity disorder secondary to traumatic brain injury: a critical appraisal of treatment studies.

OBJECTIVE: Are stimulants effective in treating attention-deficit/hyperactivity disorder secondary to traumatic brain injury (ADHD/TBI)? The authors reviewed and examined the current knowledge on efficacy of stimulant treatment ADHD/TBI. METHOD: A systematic review of the literature using a quality assessment scale to assess the quality of randomized clinical trials was undertaken. We identified all studies in which stimulants had been administered to individuals with ADHD/TBI. Information was extracted on study characteristics, interventions, and outcomes. A meta-analysis was not performed because of the limited number of studies with strict research design and the heterogeneity of outcome measures. Seven studies involving 118 subjects, 41 of whom were children and adolescents, were identified. RESULTS: Of the seven identified studies, one was a chart review, one used a single-blind, placebo-controlled crossover design, and five were double-blind, placebo-controlled crossovers. These studies used >50 subjective and objective tests to measure behavioral and cognitive outcomes. Methylphenidate (MPH) effects on behavior (hyperactivity, impulsivity) were evident but were not as robust as those typically observed with MPH in primary ADHD. The effect of MPH on cognition was less apparent. More favorable outcome was associated with initiation of treatment soon after head injury, although this factor was not systematically studied, and trials with relatively long durations. Studies with negative MPH response reported neither improvement in behavioral nor cognitive symptoms. CONCLUSION: There is only modest evidence to support the efficacy of MPH in the treatment of ADHD/TBI. While MPH might still be a promising treatment for ADHD/TBI, there is need for rigorous treatment outcome research among representative samples of ADHD/TBI individuals.

Adolescent↗

PubMed2004

[Structural dynamics and delinquent behavior].

Using key concepts of Janzarik's structural-dynamic model, this article describes some of the potential uses of this model in a forensic setting. We will especially take into account that aspect of Janzarik's work from the start of his research in the 1950s through to the late 1990s which particularly addressed forensic questions. Using the example of dynamic Unstetigkeit and structural derailment, the aspect of 'mental content becoming autonomous' will be considered regarding Schuldunfahigkeit. Taking the example of autopraxis, successful and disturbed balance between impulsivity and self-control in personality disorder will be clarified and concerning the concept of self-corruption the self-induced corroboration of dissocial attitudes will be explained. The author considers the user-friendly work of Janzarik to be a fundamental instrument for answering questions in forensic psychiatry.

Adolescent↗

PubMed1989

Cognitive person variables in the delay of gratification of older children at risk.

The components of self-regulation were analyzed, extending the self-imposed delay of gratification paradigm to older children with social adjustment problems. Delay behavior was related to a network of conceptually relevant cognitive person variables, consisting of attention deployment strategies during delay, knowledge of delay rules, and intelligence. A positive relationship was demonstrated between concurrent indexes of intelligence, attention deployment, and actual delay time. Moreover, attention deployment, measured as an individual differences variable during the delay process, had a direct, positive effect on delay behavior. Specifically, as the duration of delay and the frustration of the situation increased, children who spent a higher proportion of the time distracting themselves from the tempting elements of the delay situation were able to delay longer. The effect of attention deployment on delay behavior was significant even when age, intelligence, and delay rule knowledge were controlled. Likewise, delay rule knowledge significantly predicted delay time, even when age, attention deployment, and intelligence were controlled.

Age Factors↗

PubMed2003

Lessons learned in modeling virtual pediatric patients.

In two applications the authors are developing virtual pediatric characters for training and assessment. One application, a virtual pediatric standardized patient, is intended for medical school students rotating through pediatrics to train and assess their basic communications and procedural skills while interacting with kids. The other application presents at-risk teenagers with vignettes to assess risky behavior and impulsivity. Both applications rely on existing responsive virtual human technology. The authors are engaged in preliminary clinical trials for the work described in this paper.

Adolescent↗

PubMed1976

Rescue fantasies in homicide-suicide.

Thirteen homicide-suicides, events in which an individual murders one or more persons and kills himself immediately afterward, were studied. Findings were presented in terms of the setting in which these events occurred, the relationship between perpetrator and victim, and the rationalizations produced by the perpetrators to explain their behavior. The results are interpreted to suggest that persons who commit homicide-suicide are acting out a three-party rescue fantasy in an attempt to resolve unbearable stress.

Acting Out↗

PubMed2000

Electrodermal hyporeactivity and antisocial behavior: does anxiety mediate the relationship?

Electrodermal hyporeactivity in the anticipation of aversive stimuli is a highly reliable correlate of diagnosed psychopathy and undersocialized aggressive conduct disorder (UACD), and it has been interpreted as reflecting a weak behavioral inhibition system (BIS) as conceptualized in Gray's work (e.g., in: Royce, J.R. (Ed.), Multivariate Analysis and Psychological Theory. Academic Press, New York, NY, p. 409, 1973). This interpretation predicts that electrodermal hyporeactivity should be associated with a single dimension of temperament involving both low anxiety and behavioral disinhibition. However, temperament scales identify separate dimensions of trait anxiety/neuroticism and inhibitory control, and most investigators have assumed that the BIS is associated with the trait anxiety/neuroticism dimension. The present review supports the view that electrodermal hyporeactivity is associated with both low anxiety and disinhibition, as expected, and, possibly, with poor control of emotional expression. Additionally, electrodermal hyporeactivity appears to relate to an impulsivity dimension among psychopaths rather than to the core personality features of psychopathy. Recent findings raise the possibility that psychopaths suffer from a broader deficit (sometimes described as an executive function deficit) than a weak BIS and that electrodermal hyporeactivity might relate to this broader deficit. It is proposed that problems with impulsivity are more strongly documented than the broader concept of executive function deficits and that a primary disinhibition can produce secondary executive function deficits. A disinhibitory deficit is consistent with the weak BIS hypothesis. Overall, the results appear to be consistent with the electrodermal hyporeactivity-weak BIS hypothesis, but many issues remain to be resolved.

Antisocial Personality Disorder↗

PubMed1995

Medroxyprogesterone treatment for paraphiliacs.

This study addresses the following questions: (1) what are the essential components of a medroxyprogesterone acetate (MPA) pretreatment evaluation?; (2) do paraphilic men treated with MPA (Depo-Provera) report a lowering of both deviant and nondeviant sexual drive and activities?; (3) is behavioral improvement associated with testosterone level reductions?; and (4) what significant side effects are associated with MPA treatment? A total of 29 paraphilic men who underwent a comprehensive psychiatric, medical, and legal evaluation and were eligible for treatment with MPA were followed naturalistically while receiving concurrent MPA and group therapy. The principal outcome measures were data obtained from a weekly self-reported psychosexual inventory that quantified five dimensions of deviant and nondeviant sexual activities and testosterone levels that were drawn pretreatment and after three and six months of MPA. Self-reported data were analyzed by nonparametric methods. Because MPA's effectiveness is evident early in treatment, we report on data from the first six months. Subjects reported a differential rate of suppression of sexual activities, a median of up to two weeks for deviant and 2 to 10 weeks for nondeviant behaviors (p < or = .01 for each of the five dimensions). Testosterone levels suppressed to less than 0.5 ng per milliliter for all but two subjects at three months and for all at six months. Recidivism was reported for one subject. Except for one subject who developed pulmonary emboli, no major medical problems were encountered. MPA safely and effectively reduced sex drive, controlled deviant sexual impulses and behavior, and lowered the testosterone levels of these paraphilic men during the first six months of treatment. However, the relative rapidity and completeness of the response raises questions regarding possible distortions in self-reported sexual activities. This should alert the practicing clinician to consider the use of collateral sources of information in interpreting treatment outcome for patients with paraphilic behaviors. Also, longer follow-up periods are required for monitoring treatment efficacy.

Adolescent↗

PubMed2005

Childhood temperament and family environment as predictors of internalizing and externalizing trajectories from ages 5 to 17.

Childhood temperament and family environment have been shown to predict internalizing and externalizing behavior; however, less is known about how temperament and family environment interact to predict changes in problem behavior. We conducted latent growth curve modeling on a sample assessed at ages 5, 7, 10, 14, and 17 (N = 337). Externalizing behavior decreased over time for both sexes, and internalizing behavior increased over time for girls only. Two childhood variables (fear/shyness and maternal depression) predicted boys' and girls' age-17 internalizing behavior, harsh discipline uniquely predicted boys' age-17 internalizing behavior, and maternal depression and lower family income uniquely predicted increases in girls' internalizing behavior. For externalizing behavior, an array of temperament, family environment, and Temperament x Family Environment variables predicted age-17 behavior for both sexes. Sex differences were present in the prediction of externalizing slopes, with maternal depression predicting increases in boys' externalizing behavior only when impulsivity was low, and harsh discipline predicting increases in girls' externalizing behavior only when impulsivity was high or when fear/shyness was low.

Adolescent↗

PubMed2001

The role of personality in the onset of eating disorders and treatment implications.

The relationship of personality and eating disorders is largely unclear. The development of well-specified conceptual models of this relationship, developments in family history, behavior genetic and prospective longitudinal research methodology, and careful consideration of how trait constructs may interact with state variables to produce or maintain eating disorders all will help to advance this area of research.

Feeding and Eating Disorders↗

PubMed2000

Early developmental precursors of externalizing behavior in middle childhood and adolescence.

This study examined the infancy- and toddler-age precursors of children's later externalizing problem behavior. Risk constructs included suboptimal patterns of observed caregiver-child interaction and the caregiver's perception of child difficultness and resistance to control. In addition, a novel dimension of caregiver-child relationship quality, the caregiver's perception of her toddler's unresponsiveness to her, was examined as a possible precursor of children's externalizing behavior. Externalizing problem outcomes were assessed throughout the school-age period and again at age 17, using multiple informants. As toddlers, children at risk for later externalizing behavior were perceived as difficult and resistant to control, and relationships with their caregivers were relatively low in warmth and affective enjoyment. Finally, the caregiver's perception of her toddler as emotionally unresponsive to her was a consistent predictor of later externalizing behavior, suggesting that negative maternal cognitions associated with child conduct problems may begin in toddlerhood. These predictive patterns were similar for boys and girls, and with minor exceptions, generalized across different subdimensions of externalizing problem behavior. Our findings underscore the importance of the infancy and toddler periods to children's long-term behavioral adjustment, and indicate the desirability of further research into the nature of caregivers' early perceptions of child unresponsiveness.

Adolescent↗

PubMed2001

Brain serotonin dysfunction accounts for aggression in male mice lacking neuronal nitric oxide synthase.

Genetically engineered mice with targeted disruption of the neuronal nitric oxide synthase (nNOS) gene established the inhibitory role of nitric oxide (NO) in male impulsive aggressive behavior. This was later confirmed by using selective nNOS inhibitors in male wild-type mice. The molecular mechanisms accounting for the aggressive behavior caused by the lack of neuronally derived NO is not known. Recent studies suggest that central serotonergic neuronal circuits and particularly 5-HT(1A) and 5-HT(1B) receptors play a prominent role in the regulation of aggression. Accordingly, we investigated whether the aggressiveness caused by the lack of nNOS might be because of alterations in serotonergic function. We now demonstrate that the excessive aggressiveness and impulsiveness of nNOS knockout mice is caused by selective decrements in serotonin (5-HT) turnover and deficient 5-HT(1A) and 5-HT(1B) receptor function in brain regions regulating emotion. These results indicate an important role for NO in normal brain 5-HT function and may have significant implications for the treatment of psychiatric disorders characterized by aggressiveness and impulsivity.

5-Hydroxytryptophan↗

PubMed1985

Affective and behavioral features of DSM-III borderline personality disorder. Are they valid?

This study was designed to determine if a set of seven clinical features, closely reflecting Diagnostic and Statistical Manual III criteria, were individually and collectively more common in borderlines compared to patients with schizophrenia, affective disorders, and anxiety disorders. A 7-item borderline subscale was generated from the expanded Brief Psychiatric Rating Scale and administered to 1,762 psychiatric inpatients. Results indicated that scores on the total borderline scale were significantly higher in borderline patients compared to the control groups. Borderline patients manifested significantly more hostility, uncooperativeness, manipulativeness, impulsiveness, emotional lability, and antisocial trends compared to controls.

Adult↗

PubMed1976

Relationships between symptomatology and SES-related factors in hyperkinetic/MBD boys.

Relationships among symptomatology, socioeconomic status, and parenting styles were examined for 113 hyperkinetic/minimal brain dysfunction boys from intact families. Primary symptoms (e.g. hyperactivity) did not vary as a function of SES, but SES-related differences emerged for secondary symptoms (e.g., aggressive behavior, self-esteem deficits) and for parenting variables. Parenting variables were found to be better predictors of secondary symptoms than was SES. Implications for further research are offered.

Affect↗