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PubMed1989

Serotonergic studies in patients with affective and personality disorders. Correlates with suicidal and impulsive aggressive behavior.

Dysfunction of the central serotonergic system has been variously associated with depression and with suicidal and/or impulsive aggressive behavior. To evaluate central serotonergic function in relation to these variables, prolactin responses to a single-dose challenge with fenfluramine hydrochloride (60 mg orally), a serotonin releasing/uptake-inhibiting agent, were examined in 45 male patients with clearly defined major affective (n = 25) and/or personality disorder (n = 20) and in 18 normal male control patients. Prolactin responses to fenfluramine among all patients were reduced compared with responses of controls. Reduced prolactin responses to fenfluramine were correlated with history of suicide attempt in all patients but with clinician and self-reported ratings of impulsive aggression in patients with personality disorder only; there was no correlation with depression. These results suggest that reduced central serotonergic function is present in a subgroup of patients with major affective and/or personality disorder and is associated with history of suicide attempt in patients with either disorder, but with impulsive aggression in patients with personality disorder only.

Adult↗
PubMed2000

Multi-impulsivity among bulimic patients in Japan.

OBJECTIVE: Studies in Western world patients suggest the possible existence of a subgroup of patients with bulimia nervosa (BN) who display multiple problems with impulsivity, such as suicidal attempts. We assessed impulsive behaviors among BN patients in Japan to discuss them crossculturally. METHOD: Impulsive behaviors in 64 BN patients were assessed and multi-impulsivity (MI) was defined according to the definition proposed by Fichter, Quadflieg, and Rief (Psychological Medicine, 24, 591-604,1994). RESULTS: Nineteen patients (30%) met the definition of MI. BN patients with MI had more severe clinical features, such as concurrent depressive and anxious symptoms, global functioning, and higher prevalence of borderline personality disorder than BN patients without MI. DISCUSSION: These results showed the similarities between BN patients with MI in Japan and those patients in the Western world in clinical and psychopathological characteristics and a life-time incidence of each impulsive behavior. These findings may suggest culturally free bases for linkage between BN and MI.

Adult↗
PubMed1976

The effect of lithium on impulsive aggressive behavior in man.

The authors conducted a double-blind, placebo-controlled study of the effect of lithium on aggressive behavior. The 66 subjects, who were prisoners in a medium security institution, ranged in age from 16 to 24 years, were physically healthy and nonpsychotic, and had histories of chronic impulsive aggressive behavior. Subjects received lithium or placebo daily for up to 3 months. There was a significant reduction in aggressive behavior in the lithium group as measured by a decrease in infractions involving violence. The authors suggest that lithium can have a clinically useful effect upon impulsive aggressive behavior when this behavior is not associated with psychosis.

Adolescent↗
PubMed2003

Impulsive aggressive behavior: open-label treatment with citalopram.

BACKGROUND: Results from open-label and placebo-controlled trials suggest that the selective serotonin reuptake inhibitors reduce impulsive aggressive behavior. The objective of this open-label study was to investigate whether citalopram treatment has anti-aggressive effect on impulsive aggressive subjects meeting DSM-IV criteria for a cluster B personality disorder or intermittent explosive disorder. METHOD: In this 8-week trial, subjects were initiated on 20 mg/day of citalopram and titrated up to 60 mg/day by the fourth week, if tolerated. The primary outcome measure was the Overt Aggression Scale-Modified (OAS-M), a scale used to quantify verbal and physical aggression, subjective irritability, and overt irritability. Secondary outcome measures included the Barratt Impulsiveness Scale and Buss-Durkee Hostility Inventory. RESULTS: Of 25 subjects enrolled, 20 completed the study. The mean daily dose was 45.5 mg, and citalopram was generally well tolerated. Statistically significant decreases were found in the OAS-M aggression scores (32.82 +/- 19.76 to 4.73 +/- 7.57, p =.000), subjective irritability scores (3.50 +/- 0.60 to 1.45 +/- 1.18, p =.000), and overt irritability scores (3.23 +/- 0.81 to 0.91 +/- 1.02, p =.000). CONCLUSION: These results suggest that citalopram is an effective treatment for reducing impulsive aggressive behavior.

Adult↗
PubMed1995

Cognitive style of patients with anorexia nervosa and bulimia nervosa.

Nine female patients with anorexia nervosa and 7 female patients with bulimia nervosa were assessed on the Matching Familiar Figures Test (MFFT). This study found that subjects with bulimia nervosa responded more quickly than did the anorexic subjects. Results such as these suggest that not only are bulimic patients more behaviorally impulsive than anorexic patients, they are also more cognitively impulsive. Patients with anorexia nervosa in contrast seemed to display a reflective cognitive style. Extreme cognitive styles may contribute to resistance in treatment and/or relapse in anorexia or bulimia nervosa.

Adolescent↗
PubMed2006

Diazepam impairs behavioral inhibition but not delay discounting or risk taking in healthy adults.

There are reports that diazepam can increase, decrease, or have no effect on measures of impulsive behavior, which may be related, in part, to differences among the tasks used to measure impulsivity. This study examined the effects of a relatively high dose of diazepam (20 mg) on 5 measures of impulsive behavior in healthy adult men and women. Volunteers (N = 18) participated in a 2-session double-blind randomized design in which they received 20 mg diazepam or placebo. One hour after ingesting the capsule, participants completed mood questionnaires and several impulsivity tasks to measure subtypes of impulsive behavior, including behavioral inhibition, delay and probability discounting, and risk taking. Diazepam impaired behavioral inhibition but had no effect on measures of discounting or risk taking. These results are discussed in the context of other recent findings suggesting that different behavioral indices of impulsivity are dissociable and governed by separate underlying mechanisms.

Adolescent↗
PubMed2003

Effects of THC on behavioral measures of impulsivity in humans.

This study investigated the acute effects of delta(9)-tetrahydrocannabinol (THC) on four behavioral measures of impulsivity in recreational marijuana users. Although impulsive behavior has been studied using several different measures of impulsivity, few studies have utilized more than one of these measures on a single cohort. In this study, 37 healthy men and women participated in three sessions, in which they received capsules containing placebo, 7.5, or 15 mg THC in randomized order under double-blind conditions. Subjects were tested on the following four tasks: the Stop task, which measures the ability to inhibit a prepotent motor response; a Go/no-go task; a Delay discounting task, which measures the value of delayed or uncertain reinforcers; and a time estimation task, which measures alterations in time perception through a time reproduction procedure. Subjects also completed mood questionnaires and general measures of performance. THC produced its expected effects on subjective measures including increases in ARCI euphoria and marijuana scales. THC increased impulsive responding on the Stop task but did not affect performance on either the Go/no-go or Delay or Probability discounting tasks. On the time reproduction task, THC increased estimates of the duration of short intervals while not affecting estimates of longer intervals. There were no significant correlations between the four tasks either before or after drug administration. These results suggest that THC may increase certain forms of impulsive behavior while not affecting other impulsive behaviors. The dissociations between the four measures of impulsivity suggest that impulsivity is an assemblage of distinct components rather than a unitary process.

Adolescent↗
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

Lowering of serotonin by rapid tryptophan depletion increases impulsiveness in normal individuals.

RATIONALE: Reduced serotonergic activity has been associated with impulsive behavior; however, intervention studies have been scarce. OBJECTIVES: To examine whether induced lowering of serotonin (5-HT) levels would increase behavioral measures of impulsivity. METHODS: Twenty-four healthy young males ingested a mixture of the essential amino acids except for tryptophan in a balanced, randomized, double-blind, placebo-controlled, cross-over study design. The continuous-performance test-identical pairs was administered when the plasma concentration of tryptophan was expected to be at the lowest point. The plasma concentrations of 23 amino acids were measured at baseline and 5 h after the ingestion of the amino acid mixture. RESULTS: The intervention led to a dramatic fall in free and total plasma tryptophan, and the tryptophan/large neutral amino acids ratio. This in turn has been shown to lower the level of 5-HT in the central nervous system. The tryptophan depletion resulted in a statistically significant more impulsive- or disinhibited response style on the continuous-performance test-identical pairs when the subjects were solving verbal tasks. Depleted subjects exposed to spatial stimuli had fewer correct responses and a decreased ability to discriminate between stimuli. CONCLUSIONS: These results indicate that a rapid lowering of tryptophan increases impulsiveness and decreases discriminating ability in normal individuals. The effect of 5-HT depletion on discriminating ability in this study was similar to that previously reported in depressed patients.

Adult↗
PubMed2001

Serum cholesterol, suicidal behavior and impulsivity in cocaine-dependent patients.

Relationships between serum cholesterol and suicidal behavior have been reported. As suicidal behavior is common in cocaine dependence, we looked for a relationship with serum cholesterol. To do this, we compared 57 cocaine-dependent patients who had attempted suicide with 111 cocaine-dependent patients who had never attempted suicide for their admission total serum cholesterol levels. We found that there were no significant differences between cocaine-dependent patients who had or had not attempted suicide in their total serum cholesterol levels. Also, there were no significant correlations between total serum cholesterol levels and scores on the Barratt Impulsivity Scale. Thus, admission total serum cholesterol does not appear to be clinically useful in the assessment of suicidal behavior in cocaine-dependent patients.

Adult↗
PubMed2004

Impulsive-like behavior in differential-reinforcement-of-low-rate 36 s responding in mice depends on training history.

Prior behavioral history in operant conditioning paradigms may induce impulsive-like responding as shown in rats. Little is known to what extent behavioral history influences subsequent behavior in mice, therefore the present study investigated the effects of lever-pressing under a fixed-ratio 5 schedule of reinforcement on subsequent differential-reinforcement-of-low-rate (DRL) 36 s performance in wild type mice compared to the behavior of 5-HT1B receptor knockout mice. Acquisition of both autoshaping and fixed-ratio 5 training was faster in 5-HT1B receptor knockout compared to wild type mice. Nevertheless, in the DRL 36 s procedure no differences were observed between genotypes. Both wild type and 5-HT1B receptor knockout mice displayed premature or impulsive-like responding in the DRL 36 s procedure, for example a peak location of responses around 20 s and high rates of responding. Taken together, the present data suggest that impulsive-like responding in the DRL 36 s procedure in mice depends on prior behavioral history.

Animals↗
PubMed2007

The effect of catecholamine depletion by alpha-methyl-para-tyrosine on measures of cognitive performance and sleep in abstinent MDMA users.

(+/-) 3, 4-Methylenedioxymethamphetamine (MDMA) is a popular recreational drug of abuse and a brain serotonin (5-HT) neurotoxin in animals. Growing evidence suggests that humans who use MDMA recreationally can also develop 5-HT neurotoxic injury, although functional consequences have been difficult to identify. Twenty-five abstinent MDMA users and 23 non-MDMA using controls were studied to determine whether pharmacologic depletion of brain catecholamines by alpha-methyl-para-tyrosine (AMPT) would differentially effect MDMA users on measures of cognition and sleep, two processes dually modulated by brain serotonergic and catecholaminergic neurons. During a 5-day in-patient study, all subjects underwent formal neuropsychiatric testing, repeated computerized cognitive testing, and all-night sleep studies. At baseline, MDMA users had performance deficits on tasks of verbal and visuospatial working memory and displayed increased behavioral impulsivity on several computerized tasks, reflecting a tendency to perform quickly at the expense of accuracy. Baseline sleep architecture was also altered in abstinent MDMA users compared to controls. AMPT produced differential effects in MDMA users compared to controls on several cognitive and sleep measures. Differences in cognitive performance, impulsivity, and sleep were significantly correlated with MDMA use. These data extend findings from earlier studies demonstrating cognitive deficits, behavioral impulsivity, and sleep alterations in abstinent MDMA users, and suggest that lasting effects of MDMA lead to alterations in the ability to modulate behaviors reciprocally influenced by 5-HT and catecholamines. More research is needed to determine potential relationships between sleep abnormalities, cognitive deficits and impulsive behavior in abstinent MDMA users.

Adult↗
PubMed1999

Association between low activity serotonin transporter promoter genotype and early onset alcoholism with habitual impulsive violent behavior.

A common 44-base pair insertion/deletion polymorphism in the promoter region of the human serotonin transporter (5-HTT) gene has been observed to be associated with affective illness and anxiety-related traits. This biallelic functional polymorphism, designated long (L) and short (S), affects 5-HTT gene expression since the S promoter is less active than the L promoter. Since there is strong evidence of a disturbance in brain serotonergic transmission among antisocial, impulsive, and violent type 2 alcoholic subjects, we decided to test the hypothesis that the frequency of the S allele, which is associated with reduced 5-HTT gene expression, is higher among habitually violent type 2 alcoholics when compared with race and gender-matched healthy controls and non-violent late-onset (type 1) alcoholics. The 5-HTT promoter genotype was determined by a PCR-based method in 114 late onset (type 1) non-violent alcoholics, 51 impulsive violent recidivistic offenders with early onset alcoholism (type 2), and 54 healthy controls. All index subjects and controls were white Caucasian males of Finnish origin. The S allele frequency was higher among type 2 alcoholics compared with type 1 alcoholics (chi2 = 4.86, P = 0.028) and healthy controls (chi2 = 8.24, P = 0.004). The odds ratio for SS genotype vs LL genotype was 3.90, 95% Cl 1.37-11.11, P = 0.011 when type 2 alcoholics were compared with healthy controls. The results suggest that the 5-HTT 'S' promoter polymorphism is associated with an increased risk for early onset alcoholism associated with antisocial personality disorder and impulsive, habitually violent behavior.

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↗
PubMed2006

Is multi-impulsive bulimia a distinct type of bulimia nervosa: Psychopathology and EMA findings.

OBJECTIVE: To determine if clinically defined multi-impulsive bulimia (MIB) can be validated using an empirical classification approach. METHOD: One hundred and twenty-five women who met DSM-IV criteria for bulimia nervosa were interviewed and completed a two-week EMA protocol. Participants who reported at least three highly impulsive behaviors were compared to participants who did not report such impulsive behavior. Also, Latent Class Analysis (LCA) was conducted to determine if the MIB classification could be replicated empirically. RESULTS: LCA produced a two-class solution consistent with the traditional clinical approach to MIB classification. In both approaches, MIB was associated with higher levels of anxiety disorders, child abuse, and daily self-damaging behaviors than the non-MIB class. CONCLUSION: Clinical classification of MIB was empirically supported through LCA. Although the classes failed to differ in bulimic behavior, MIB appears to represent a group of bulimic individuals with significant trauma histories and associated psychopathology.

Adolescent↗