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Impulsivity
Kinds of Impulsivity Selected AbstractsINTEGRATING CELERITY, IMPULSIVITY, AND EXTRALEGAL SANCTION THREATS INTO A MODEL OF GENERAL DETERRENCE: THEORY AND EVIDENCE,CRIMINOLOGY, Issue 4 2001DANIEL S. NAGIN We propose a model that integrates the extralegal consequences from conviction and impulsivity into the traditional deterrence framework. The model was tested with 252 college students, who completed a survey concerning drinking and driving. Key findings include the following: (1) Although variation in sanction certainty and severity predicted offending, variation in celerity did not; (2) the extralegal consequences from conviction appear to be at least as great a deterrent as the legal consequences; (3) the influence of sanction severity diminished with an individual's "present-orientation"; and (4) the certainty of punishment was far more robust a deterrent to offending than was the severity of punishment. [source] Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illnessACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010A. C. Swann Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG. Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness. Objective:, We investigated trait impulsivity in bipolar disorder and antisocial personality disorder (ASPD) with respect to severity and course of illness. Method:, Subjects included 78 controls, 34 ASPD, 61 bipolar disorder without Axis II disorder, and 24 bipolar disorder with ASPD, by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-I and -II). Data were analyzed using general linear model and probit analysis. Results:, Barratt Impulsiveness Scale (BIS-11) scores were higher in ASPD (effect sizes 0.5,0.8) or bipolar disorder (effect size 1.45) than in controls. Subjects with both had more suicide attempts and previous episodes than bipolar disorder alone, and more substance-use disorders and suicide attempts than ASPD alone. BIS-11 scores were not related to severity of crimes. Conclusion:, Impulsivity was higher in bipolar disorder with or without ASPD than in ASPD alone, and higher in ASPD than in controls. Adverse effects of bipolar disorder in ASPD, but not of ASPD in bipolar disorder, were accounted for by increased impulsivity. [source] A comparison of risk factors for habitual violence in pre-trial subjectsACTA PSYCHIATRICA SCANDINAVICA, Issue 2002S. Z. Kaliski Objective: Pre-trial referrals to the Valkenberg Hospital forensic unit over a 6-month period were studied. Habitually violent offenders were compared with those with no history of violence. Methods:, Risk factors known to be associated with violent behaviour were elicited, i.e. demographics, behaviour during index offence (such as impulsivity, identity of victim, use of weapon, accomplices, intoxication, psychotic symptoms), psychiatric and family histories, history of suicide attempts, past child abuse, head injury, criminal record, psychiatric diagnosis and presence of medical disorders. EEG's, Barratt's Impulsivity, Zuckerman's Sensation Seeking and Mini-Mental Scales were administered. Behaviour in the ward during the 30 days was also appraised. Logistic regression models were used to determine relative risks. Results:, There were 155 subjects; 89.7% were male, 71.6% were single and 58.7% were unemployed. For 44.5% the index offence was violent, and 9.7% had committed sexual offences; 61.9% had histories of habitual violence. A psychotic disorder was diagnosed in 32.3% and a personality disorder in 48.4%. Habitually violent subjects were distin- guished by a history of issuing threats (OR=3.68; CI=3.19,4.16; P= 0.000), delusions of persecution (OR=3.43; CI=2.67,4.17; P=0.001), history of conduct disorder (OR=1.95; CI=1.70,2.19; P=0.006), alcohol/substance abuse (OR=2.08; CI=1.53,2.61; P=0.008) and violent index offence (OR=1.66; CI=1.54,2.61; P=0.035). Conclusion: This seems to confirm the relationship between threats, feeling threatened, psychosis, a history of antisocial behaviour and alcohol abuse. [source] Impulsivity: The Behavioural and Neurological Science of DiscountingDRUG AND ALCOHOL REVIEW, Issue 5 2010Daniel J. Upton No abstract is available for this article. [source] REVIEW: Impulsivity as a determinant and consequence of drug use: a review of underlying processesADDICTION BIOLOGY, Issue 1 2009Harriet De Wit ABSTRACT Impulsive behaviors are closely linked to drug use and abuse, both as contributors to use and as consequences of use. Trait impulsivity is an important determinant of drug use during development, and in adults momentary ,state' increases in impulsive behavior may increase the likelihood of drug use, especially in individuals attempting to abstain. Conversely, acute and chronic effects of drug use may increase impulsive behaviors, which may in turn facilitate further drug use. However, these effects depend on the behavioral measure used to assess impulsivity. This article reviews data from controlled studies investigating different measures of impulsive behaviors, including delay discounting, behavioral inhibition and a newly proposed measure of inattention. Our findings support the hypothesis that drugs of abuse alter performance across independent behavioral measures of impulsivity. The findings lay the groundwork for studying the cognitive and neurobiological substrates of impulsivity, and for future studies on the role of impulsive behavior as both facilitator and a result of drug use. [source] Serotonin transporter deficiency in rats improves inhibitory control but not behavioural flexibilityEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2007Judith R. Homberg Abstract Impulsivity and aggression have been suggested to inversely correlate with central serotonin (5-HT) levels in a trait-like manner. However, this relationship is far from straightforward. In the present study we addressed the effect of lifelong reduced or absent serotonin transporter (SERT) function, which is associated with constitutively increased extracellular 5-HT levels, on impulsivity and aggression. We used unique SERT knockout rats in a resident,intruder test, five-choice serial reaction time task and serial reversal learning task to assay aggression, inhibitory control and behavioural flexibility, respectively. Homozygous SERT knockout rats (SERT,,/,) displayed reduced aggression and improved inhibitory control, but unchanged behavioural flexibility. The behavioural phenotype of heterozygous SERT knockout rats (SERT,+/,) was not different from that of wild-type controls in any of the behavioural paradigms. We determined monoamine (metabolite) tissue levels in the medial prefrontal cortex, orbitofrontal cortex, lateral hypothalamus, raphe nuclei and cerebrospinal fluid, and found that the 5-HT levels, but not other monoamine tissue levels, were reduced in SERT,,/, rats. In addition, the 5-hydroxyindoleacetic acid (5-HIAA)/5-HT ratio in cerebrospinal fluid was increased in these rats. In conclusion, our data show that the absence of the SERT affects aggression and inhibitory control, but not behavioural flexibility, characteristics that may reflect the trait-like consequences of constitutive changes in central 5-HT levels. [source] A voxel-based morphometry study of frontal gray matter correlates of impulsivity,HUMAN BRAIN MAPPING, Issue 4 2009Koji Matsuo Abstract Impulsivity is a personality trait exhibited by healthy individuals, but excessive impulsivity is associated with some mental disorders. Lesion and functional neuroimaging studies indicate that the ventromedial prefrontal region (VMPFC), including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC) and medial prefrontal cortex, and the amygdala may modulate impulsivity and aggression. However, no morphometric study has examined the association between VMPFC and impulsivity. We hypothesized that healthy subjects with high impulsivity would have smaller volumes in these brain regions compared with those with low impulsivity. Sixty-two healthy subjects were studied (age 35.4 ± 12.1 years) using a 1.5-T MRI system. The Barratt impulsiveness scale (BIS) was used to assess impulsivity. Images were processed using an optimized voxel-based morphometry (VBM) protocol. We calculated the correlations between BIS scale scores and the gray matter (GM) and white matter (WM) volumes of VMPFC and amygdala. GM volumes of the left and right OFC were inversely correlated with the BIS total score (P = 0.04 and 0.02, respectively). Left ACC GM volumes had a tendency to be inversely correlated with the BIS total score (P = 0.05). Right OFC GM volumes were inversely correlated with BIS nonplanning impulsivity, and left OFC GM volumes were inversely correlated with motor impulsivity. There were no significant WM volume correlations with impulsivity. The results of this morphometry study indicate that small OFC volume relate to high impulsivity and extend the prior finding that the VMPFC is involved in the circuit modulating impulsivity. Hum Brain Mapp 2009. © 2008 Wiley-Liss, Inc. [source] Twelve-year course and outcome predictors of anorexia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2006Dipl-Psych, Manfred M. Fichter MD Abstract Objective The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Method Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained. Results The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were deceased. At the 12-year follow-up 19.0% had AN, 9.5% had bulimia nervosa-purging type (BN-P), 19.0% were classified as eating disorder not otherwise specified (EDNOS). A total of 52.4% showed no major DSM-IV eating disorder and 0% had binge eating disorder (BED). Systematic,strictly empirically based,model building resulted in a parsimonious model including four predictors of unfavorable 12-year outcome explaining 45% of the variance, that is, sexual problems, impulsivity, long duration of inpatient treatment, and long duration of an eating disorder. Conclusion Mortality was high and symptomatic recovery protracted. Impulsivity, symptom severity, and chronicity were the important factors for predicting the 12-year outcome. © 2005 by Wiley Periodicals, Inc. [source] An investigation of the correlations between aggression, impulsiveness, social problem-solving, and alcohol useAGGRESSIVE BEHAVIOR, Issue 6 2002Mary McMurran Abstract Impulsivity has been shown to predict aggression and heavy drinking in males, and poor social problem-solving has been identified as a potential mediating variable in this relationship. We set out to investigate the inter-relationships among impulsiveness, social problem-solving, aggression, and alcohol use in a non-offender sample of British males (N=70). Of our proposed relationships, only two were significant: higher impulsivity was related to poorer social problem-solving, and poorer social problem-solving was related to greater aggression. Combining impulsivity and social problem-solving indicated that poor social problem-solving, not impulsivity, was what exerted the influence over aggression in this sample. Impulsivity perhaps presents an obstacle to learning in the early developmental years, and the legacy of poor problem-solving is what later contributes to aggression. Aggr. Behav. 28:439,445, 2002. © 2002 Wiley-Liss, Inc. [source] Control Yourself: Alcohol and ImpulsivityALCOHOLISM, Issue 8 2010Marc N. Potenza Impulsivity represents a complex, multifaceted construct with relevance to alcohol use, abuse, and dependence. Researchers are refining the definitions and assessment of different subtypes of impulsive behavior and relating these to the causes and consequences of alcohol-related behaviors and disorders. A satellite symposium on alcohol and impulsivity was held at the 2009 convention of the Research Society on Alcoholism. This article provides an overview of the rationale for the symposium, a synopsis of review and original research articles emanating from the symposium, and a description of the implications of the work and possible future research directions. [source] Insight Into the Relationship Between Impulsivity and Substance Abuse From Studies Using Animal ModelsALCOHOLISM, Issue 8 2010Catharine A. Winstanley Drug use disorders are often accompanied by deficits in the capacity to efficiently process reward-related information and to monitor, suppress, or override reward-controlled behavior when goals are in conflict with aversive or immediate outcomes. This emerging deficit in behavioral flexibility and impulse control may be a central component of the progression to addiction, as behavior becomes increasingly driven by drugs and drug-associated cues at the expense of more advantageous activities. Understanding how neural mechanisms implicated in impulse control are affected by addictive drugs may therefore prove a useful strategy in the search for new treatment options. Animal models of impulsivity and addiction could make a significant contribution to this endeavor. Here, some of the more common behavioral paradigms used to measure different aspects of impulsivity across species are outlined, and the importance of the response to reward-paired cues in such paradigms is discussed. Naturally occurring differences in forms of impulsivity have been found to be predictive of future drug self-administration, but drug exposure can also increase impulsive responding. Such data are in keeping with the suggestion that impulsivity may contribute to multiple stages within the spiral of addiction. From a neurobiological perspective, converging evidence from rat, monkey, and human studies suggest that compromised functioning within the orbitofrontal cortex may critically contribute to the cognitive sequelae of drug abuse. Changes in gene transcription and protein expression within this region may provide insight into the mechanism underlying drug-induced cortical hypofunction, reflecting new molecular targets for the treatment of uncontrolled drug-seeking and drug-taking behavior. [source] Recent Research on Impulsivity in Individuals With Drug Use and Mental Health Disorders: Implications for AlcoholismALCOHOLISM, Issue 8 2010Robert D. Rogers Alcohol misuse and dependence, and many of its accompanying psychological problems, are associated with heightened levels of impulsivity that both accelerate the development of clinically significant illness and complicate clinical outcome. This article reviews recent developments in our understanding of impulsivity as they relate to brain circuitry that might underlie these comorbid factors, focusing upon the clinical features of substance use (and dependence), bipolar disorder, and pathological gambling. Individuals who are affected by these disorders exhibit problems in several domains of impulsive behavior including deficient response or "motor" control, and the tolerance of prolonged delays prior to larger rewards at the expense of smaller rewards ("delay-discounting"). These populations, like alcoholic dependents, also exhibit impairments in risky decision-making that may reflect dysfunction of monoamine and catecholamine pathways. However, several areas of uncertainty exist including the specificity of impairments across disorders and the relationship between impulse control problems and altered evaluation of reward outcomes underlying observed impairments in action selection. [source] Behavioral and Biological Indicators of Impulsivity in the Development of Alcohol Use, Problems, and DisordersALCOHOLISM, Issue 8 2010C.W. Lejuez Alcohol use disorders (AUDs) are a devastating public health problem. The construct of impulsivity is biologically based and heritable, and its various dimensions are relevant for understanding alcohol use. The goal of the current manuscript is to review recent behavioral and biological research examining various dimensions of impulsivity and their relation to AUDs from risk for initial use through dependence and relapse. Moreover, we also highlight key psychological variables including affective processes as they relate to current use and early indications of alcohol problems, as well as psychopathology, violence, and aggression in relation to AUDs. Each section includes a critical summary and we conclude the review with future directions focused on issues relevant to measurement, causality, and intervention. Throughout the review, we attempt to be as specific as possible about the dimensions of impulsivity being referenced, while attempting to draw parallels and highlighting differences as the existing literature allows. [source] Pharmacologic Dissociation Between Impulsivity and Alcohol Drinking in High Alcohol Preferring MiceALCOHOLISM, Issue 8 2010Brandon G. Oberlin Background:, Impulsivity is genetically correlated with, and precedes, addictive behaviors and alcoholism. If impulsivity or attention is causally related to addiction, certain pharmacological manipulations of impulsivity and/or attention may affect alcohol drinking, and vice versa. The current studies were designed to explore the relationship among impulsivity, drinking, and vigilance in selectively bred High Alcohol Preferring (HAP) mice, a line that has previously demonstrated both high impulsivity and high alcohol consumption. Amphetamine, naltrexone, and memantine were tested in a delay discounting (DD) task for their effects on impulsivity and vigilance. The same drugs and doses were also assessed for effects on alcohol drinking in a 2-bottle choice test. Methods:, HAP mice were subjected to a modified version of adjusting amount DD using 0.5-second and 10-second delays to detect decreases and increases, respectively, in impulsive responding. In 2 experiments, mice were given amphetamine (0.4, 0.8, or 1.2 mg/kg), naltrexone (3 and 10 mg/kg), and memantine (1 and 5 mg/kg) before DD testing. Another pair of studies used scheduled access, 2-bottle choice drinking to assess effects of amphetamine (0.4, 1.2, or 3.0 mg/kg), naltrexone (3 and 10 mg/kg), and memantine (1 and 5 mg/kg) on alcohol consumption. Results:, Amphetamine dose-dependently reduced impulsivity and vigilance decrement in DD, but similar doses left alcohol drinking unaffected. Naltrexone and memantine decreased alcohol intake at doses that did not affect water drinking but had no effects on impulsivity or vigilance decrement in the DD task. Conclusions:, Contrary to our hypothesis, none of the drugs tested here, while effective on either alcohol drinking or impulsivity, decreased both behaviors. These findings suggest that the genetic association between drinking and impulsivity observed in this population is mediated by mechanisms other than those targeted by the drugs tested in these studies. [source] Interactive Effects of Cumulative Stress and Impulsivity on Alcohol ConsumptionALCOHOLISM, Issue 8 2010Fox Helen C. Background:, Alcohol addiction may reflect adaptations to stress, reward, and regulatory brain systems. While extensive research has identified both stress and impulsivity as independent risk factors for drinking, few studies have assessed the interactive relationship between stress and impulsivity in terms of hazardous drinking within a community sample of regular drinkers. Methods:, One hundred and thirty regular drinkers (56M/74F) from the local community were assessed for hazardous and harmful patterns of alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT). All participants were also administered the Barratt Impulsiveness Scale (BIS-11) as a measure of trait impulsivity and the Cumulative Stress/Adversity Checklist (CSC) as a comprehensive measure of cumulative adverse life events. Standard multiple regression models were used to ascertain the independent and interactive nature of both overall stress and impulsivity as well as specific types of stress and impulsivity on hazardous and harmful drinking. Results:, Recent life stress, cumulative traumatic stress, overall impulsivity, and nonplanning-related impulsivity as well as cognitive and motor-related impulsivity were all independently predictive of AUDIT scores. However, the interaction between cumulative stress and total impulsivity scores accounted for a significant amount of the variance, indicating that a high to moderate number of adverse events and a high trait impulsivity rating interacted to affect greater AUDIT scores. The subscale of cumulative life trauma accounted for the most variance in AUDIT scores among the stress and impulsivity subscales. Conclusions:, Findings highlight the interactive relationship between stress and impulsivity with regard to hazardous drinking. The specific importance of cumulative traumatic stress as a marker for problem drinking is also discussed. [source] Developmental Trajectories of Impulsivity and Their Association With Alcohol Use and Related Outcomes During Emerging and Young Adulthood IALCOHOLISM, Issue 8 2010Andrew K. Littlefield Background:, Research has documented normative patterns of personality change during emerging and young adulthood that reflect decreases in traits associated with substance use, such as impulsivity. However, evidence suggests variability in these developmental changes. Methods:, This study examined trajectories of impulsivity and their association with substance use and related problems from ages 18 to 35. Analyses were based on data collected from a cohort of college students (N = 489), at high and low risk for AUDs, first assessed as freshmen at a large, public university. Results:, Mixture modeling identified five trajectory groups that differed in baseline levels of impulsivity and developmental patterns of change. Notably, the trajectory group that exhibited the sharpest declines in impulsivity tended to display accelerated decreases in alcohol involvement from ages 18 to 25 compared to the other impulsivity groups. Conclusion:, Findings highlight the developmental nature of impulsivity across emerging and young adulthood and provide an empirical framework to identify key covariates of individual changes of impulsivity. [source] Concurrent and Discriminant Validity of DSM-IV Symptoms of Impaired Control Over Alcohol Consumption in AdolescentsALCOHOLISM, Issue 4 2002Tammy Chung Background: Little research has examined impaired control over alcohol consumption in adolescents. This study examined the concurrent and discriminant validity of two DSM-IV dependence criteria that reflect impaired control over drinking: "using more or longer than intended" (Larger/Longer) and "persistent desire or unsuccessful efforts to quit or cut down" (Quit/Cut Down). Methods: Adolescent drinkers, ages 13,19 (N= 173), were recruited from addictions treatment (76%) and community sources (24%). A modified SCID that included assessment of alcohol craving and questionnaires measuring dependence severity, attempts to limit drinking, and impulsivity were administered. Results: Larger/Longer had higher prevalence and an earlier onset than Quit/Cut Down, suggesting that the symptoms respectively represent milder and more severe manifestations of impaired control over drinking. Both symptoms were associated with drinking frequency, dependence severity, episodes of passing out, and an independent measure of unsuccessful attempts to limit drinking. Alcohol craving was associated with both Larger/Longer and Quit/Cut Down. Impulsivity was correlated with Larger/Longer but not Quit/Cut Down. Conclusions: Larger/Longer and Quit/Cut Down demonstrated adequate concurrent validity. The two symptoms were distinguished by severity and differential relations with impulsivity, suggesting that Larger/Longer and Quit/Cut Down reflect different types of impaired control over alcohol consumption. Results suggest the need for improved description and scaling of the impaired control construct in adolescents. [source] Serotonin, Impulsivity, and Alcohol Use Disorders in the Older Adolescent: A Psychobiological StudyALCOHOLISM, Issue 11 2000Paul H. Soloff Background: Alcohol use disorders (AUDs) among adolescents are associated with a high prevalence of conduct disorder (CD), much as type II alcoholism in adults is associated with impulsive-aggressive behavior and antisocial personality traits. Adults with impulsive personality disorders and AUD demonstrate diminished central serotonergic responsiveness to serotonergic agonists. Dysregulation of central serotonergic function may contribute to a vulnerability to impulsive-aggressive behavior, CD, and AUD. We studied older adolescents, both male and female, to examine the relationships between sex, dispositional impulsivity, aggressivity, CD, and responsiveness to serotonergic challenge with d,l fenfluramine (FEN) early in the development of AUD. Methods: Thirty-six adolescents between the ages of 16 and 21 years were assessed for DSM-IV AUD and other Axis I disorders by using the Psychoactive Substance Use Disorders section of the Structured Clinical Interview for DSM III-R, the Schedule for Affective Disorders and Schizophrenia for School-Age Children,Present and Lifetime Version, and CD interviews. Impulsivity and aggressivity were assessed by the Barratt Impulsiveness Scale, Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Eysenck Impulsiveness Questionnaire, Youth Self Report, and Multidimensional Personality Questionnaires. FEN was administered as 0.8 mg/kg to a maximum of 60 mg, and blood was sampled at fixed intervals for prolactin, cortisol, fenfluramine, and norfenfluramine levels. Results: Eighteen adolescents (12 male, 6 female) with AUD scored significantly higher on all measures of impulsivity and aggressivity compared with 18 healthy controls (12 male, 6 female). There were no significant differences between groups in peak prolactin or cortisol responses (minus baseline), or area-under-the-curve determinations (AUC); however, 9 subjects with AUD and comorbid CD had significantly elevated cortisol AUC levels compared with subjects with AUD and no CD or with normal controls. In the total sample, cortisol AUC was associated positively with measures of aggression. Conclusions: Adolescents with early-onset AUD are characterized by impulsivity and aggressivity compared with healthy peers but do not demonstrate the diminished prolactin or cortisol responses to FEN characteristic of adult alcoholics with impulsive-aggression. [source] Cognitive impulsivity in Parkinson's disease patients: Assessment and pathophysiology,MOVEMENT DISORDERS, Issue 16 2009Gabriel Robert MSc Abstract Impulsivity may be induced by therapeutic interventions (dopamine replacement therapies and sub-thalamic nucleus (STN) stimulation) in patients with Parkinson's disease (PD). The present review has two goals. First, to describe the most frequently encountered facets of cognitive impulsivity and to stress the links between cognitive impulsivity and aspects such as reward-related decision making, risk-taking, and time-processing in healthy population. The most widely used related cognitive impulsivity paradigms are presented. Second, to review the results of studies on cognitive impulsivity in healthy volunteers and in patients with PD, the latter support the applicability and clinical relevance of this construct in PD population. Data show that PD treatments may favor impulsivity via different mechanisms. Suggestions on the roles of dopamine and STN in the pathophysiology of cognitive impulsivity are proposed. © 2009 Movement Disorder Society [source] Preparation of parents by teaching of distraction techniques does not reduce child anxiety at anaesthetic induction.PEDIATRIC ANESTHESIA, Issue 9 2002A. Watson Introduction For those children having surgery, induction of anaesthesia is one of the most stressful procedures the child experiences perioperatively. Current work has failed to show a benefit of parental presence at induction of anaesthesia for all children. The reasons for lack of effect may include the high anxiety levels of some parents and also that the role for parents at their child's induction is not delineated. The main aim of this study was to see if parental preparation by teaching of distraction techniques could reduce their child's anxiety during intravenous induction of anaesthesia. Methods After ethics committee approval 40 children aged 2,10 years old, ASA status I or II undergoing daycase surgery under general anaesthesia were enrolled into the study. To avoid possible confounding factors children with a history of previous, surgery, chronic illness or developmental delay were excluded form participation. No children were given sedative premedication. After written informed consent by the parent, each child and parent was randomly assigned to an intervention or control group. Parents in the intervention group received preparation from a play specialist working on the children's surgical ward. It involved preparation for events in the anaesthetic room and instruction on methods of distraction for their child during induction using novel toys, books or blowing bubbles appropriate to the child's age. Preoperative information collected included demographic and baseline data. The temperament of the child was measured using the EASI (Emotionality, Activity, Sociability, Impulsivity) instrument of child temperament(l). In the anaesthetic room all children were planned to have intravenous induction of anaesthesia after prior application of EMLA cream. Anxiety of the child was measured by the modified Yale Preoperative Anxiety Scale (mYPAS)(2) by a blinded independent observer at three time points: entrance to the anaesthetic room, intravenous cannulation and at anaesthesia induction. Cooperation of the child was measured by the Induction Compliance Checklist (ICC) by the same observer (3). Postoperative data collected included parental satisfaction and anxiety scores measured by the Stait Trait Anxiety Inventory (STAI)(4) and at one week the behaviour of the child was measured Using the Posthospitalisation Behavioural Questionnaire (PHBQ)(5). Normally distributed data were analysed by a two-sample t-test, categorical data by Pearson's Chi-squared test and non-parametric data by the Wilcoxon rank-sum test. Results One parent withdrew after enrolment. This left 22 children in the control group and 17 in the intervention group. There were no significant differences in demographic and baseline data of the children between the two groups including ethnic origin, number of siblings, birth order of the child, recent stressful events in the child's life, previous hospital admissions and the temperament of the child. Parent demographics were also similar between groups including parent's age, sex, relationship to child and level of education. There were no significant differences in child anxiety or cooperation during induction measured by mYPAS and ICC between the control and intervention groups. More parents in the preparation group distracted their child than those without preparation but this did not reach significance. Parental anxiety immediately postinduction was similar between groups as was the level of parental satisfaction. The incidence of development of new negative postoperative behaviour of the child at one week was not significantly different between groups. Discussion This study shows that giving an active role for parents in the induction room, particularly by instructing them on distracting techniques for their child, does not reduce their child's anxiety compared to conventional parental presence. We conclude resources should not be directed at this type of parental preparation. Further work should examine the usefulness of distraction by nursing staff or play specialists during anaesthetic induction. [source] Visual P3 amplitude and self-reported psychopathic personality traits: Frontal reduction is associated with self-centered impulsivityPSYCHOPHYSIOLOGY, Issue 1 2009Scott R. Carlson Abstract Past studies have examined P3 amplitude as an index of cognitive function related to psychopathy with mixed results. Psychopathy is a heterogeneous set of dissociable traits, and no previous study has examined relationships between P3 and specific traits. A Two Process Theory (TPT) of psychopathy has recently been advanced predicting that P3 reductions are related to only one dimension. We evaluated the relationship between P3 and the two factors of the Psychopathic Personality Inventory (PPI) in 96 undergraduates who performed a visual task. One factor of the PPI, Self-Centered Impulsivity, is related to the dimension of the TPT predicted to underlie P3 reduction. Frontal amplitude reduction was uniquely and inversely related to this trait. The other PPI factor, Fearless Dominance, was associated with faster reaction times. Future work on psychopathic personality and P3 should evaluate whether relationships are unique to one personality dimension. [source] Behavioral measures of impulsivity and the law,BEHAVIORAL SCIENCES & THE LAW, Issue 6 2008Charles W. Mathias Ph.D. The General Theory of Crime proposes that crime is explained by the combination of situational opportunity and lack of self-control. Impulsivity is one of the important components of self-control. Because behavioral measures of impulsivity are becoming more commonly utilized to assess forensic populations, this manuscript provides an overview of three current behavioral measures. In doing so, an example of their application is provided using a group of individuals likely to come into contact with the legal system: adolescents with Conduct Disorder. Earlier age of onset of Conduct Disorder symptoms has been shown to be an important predictor of the persistence of poor outcomes into adulthood, including participation in criminal activities. This study found differential behavioral profiles across distinct measures of impulsivity by those with childhood- versus adolescent-onset Conduct Disorder. Legal implications for defining behavioral deficits using behavioral measures of impulsivity and their current limitations are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Facets of psychopathy, Axis II traits, and behavioral dysregulation among jail detaineesBEHAVIORAL SCIENCES & THE LAW, Issue 4 2007Richard Rogers Ph.D. Forensic evaluations of offender populations often consider psychopathy as an integral component of these consultations. Vexing issues remain of whether psychopathic traits should be evaluated consistently irrespective of demographic characteristics (e.g. gender), comorbidity (e.g. other Axis II pathology), or setting (e.g. jail or community). The current study examined gender differences for psychopathy and Axis II traits in a nonreferred jail sample of predominantly nonviolent offenders. Participants with moderate to high levels of psychopathy evidenced substantial comorbidity, especially with Cluster B personality disorders. Facets of psychopathy and Axis II traits varied substantially across both genders. In addition, the research evaluated Lynam's Hyperactivity, Impulsivity, and Attention difficulties (HIA) model of psychopathy. These initial data found little support for the HIA model in this jail sample. In testing competing hypotheses, the HIA model was substantially better at predicting Cluster B traits than psychopathy per se. Copyright © 2007 John Wiley & Sons, Ltd. [source] Cigarette smoking is associated with suicidality in bipolar disorderBIPOLAR DISORDERS, Issue 7 2009Michael J Ostacher Objectives:, Cigarette smoking in individuals with bipolar disorder has been associated with suicidal behavior, although the precise relationship between the two remains unclear. Methods:, In this prospective observational study of 116 individuals with bipolar disorder, we examined the association between smoking and suicidality as measured by Linehan's Suicide Behaviors Questionnaire (SBQ) and prospective suicide attempts over a nine-month period. Impulsivity was measured by the Barratt Impulsiveness Scale. Results:, Smoking was associated with higher baseline SBQ scores in univariate and adjusted analyses, but was not significant after statistical adjustment for impulsivity in a regression model. A higher proportion of smokers at baseline made a suicide attempt during the follow-up period (5/31, 16.1%) compared to nonsmokers (3/85, 3.5%); p = 0.031, odds ratio = 5.25 (95% confidence interval: 1.2,23.5). Smoking at baseline also significantly predicted higher SBQ score at nine months. Conclusions:, In this study, current cigarette smoking was a predictor of current and nine-month suicidal ideation and behavior in bipolar disorder, and it is likely that impulsivity accounts for some of this relationship. [source] Impulsivity, risk taking, alcohol abuse, and bipolar disorder: response to Thomas RichardsonBIPOLAR DISORDERS, Issue 5 2009M. Kathleen Holmes No abstract is available for this article. [source] Manic symptoms and impulsivity during bipolar depressive episodesBIPOLAR DISORDERS, Issue 3 2007Alan C Swann Objectives:, In contrast to the extensive literature on the frequent occurrence of depressive symptoms in manic patients, there is little information about manic symptoms in bipolar depressions. Impulsivity is a prominent component of the manic syndrome, so manic features during depressive syndromes may be associated with impulsivity and its consequences, including increased risk of substance abuse and suicidal behavior. Therefore, we investigated the prevalence of manic symptoms and their relationships to impulsivity and clinical characteristics in patients with bipolar depressive episodes. Methods:, In 56 bipolar I or II depressed subjects, we investigated the presence of manic symptoms, using Mania Rating Scale (MRS) scores from the Schedule for Affective Disorders and Schizophrenia (SADS), and examined its association with other psychiatric symptoms (depression, anxiety, and psychosis), age of onset, history of alcohol and/or other substance abuse and of suicidal behavior, and measures of impulsivity. Results:, MRS ranged from 0 to 29 (25th,75th percentile, range 4,13), and correlated significantly with anxiety and psychosis, but not with depression, suggesting the superimposition of a separate psychopathological mechanism. Impulsivity and history of substance abuse, head trauma, or suicide attempt increased with increasing MRS. Receiver-operating curve analysis showed that MRS could divide patients into two groups based on history of alcohol abuse and suicide attempt, with an inflection point corresponding to an MRS score of 6. Discussion:, Even modest manic symptoms during bipolar depressive episodes were associated with greater impulsivity, and with histories of alcohol abuse and suicide attempts. Manic symptoms during depressive episodes suggest the presence of a potentially dangerous combination of depression and impulsivity. [source] Trait impulsivity in female patients with borderline personality disorder and matched controlsACTA NEUROPSYCHIATRICA, Issue 3 2010Jørgen Assar Mortensen Mortensen JA, Rasmussen IA, Håberg A. Trait impulsivity in female patients with borderline personality disorder and matched controls. Objective: Impulsivity has been shown to load on two separate factors, rash impulsivity and sensitivity to reward (SR) in several factor analytic studies. The aims of the current study were to explore the nature of impulsivity in women with borderline personality disorder (BPD) and matched controls, and the underlying neuronal correlates for rash impulsivity and SR. Methods: Fifteen females diagnosed with BPD and 15 matched controls were recruited. All completed the impulsiveness-venturesomeness scale (I7), the sensitivity to punishment (SP) - sensitivity to reward (SR) questionnaire, and performed a Go-NoGo block-design functional magnetic resonance imaging (fMRI) paradigm at 3T. Correlation analyses were done with I7, SP and SR scores with the level of activation in different brain areas in the whole group. An independent group t -test was used to explore any differences between the BPD group and the matched controls. Results: I7 scores correlated negatively with activity in the left orbitofrontal cortex, amygdala and precuneus, and bilaterally in the cingulate cortices during response inhibition for the entire sample. SP yielded negative correlations in the right superior frontal gyrus and parahippocampal gyrus. No activity related to response inhibition correlated to SR. The Go-NoGo task gave similar brain activity in BPD and matched controls, but behaviourally the BPD group had significantly more commission errors in the NoGo blocks. The BPD group had increased I7 and SP scores indicating rash impulsiveness combined with heightened SP. Conclusion: These results imply that successful impulse inhibition involves interaction between the impulsive and the emotional systems. Furthermore, impulsivity in BPD is described as rash impulsivity, coexisting with increased SP. [source] The Relations of Effortful Control and Impulsivity to Children's Resiliency and AdjustmentCHILD DEVELOPMENT, Issue 1 2004Nancy Eisenberg The unique relations of effortful control and impulsivity to resiliency and adjustment were examined when children were 4.5 to 8 years old, and 2 years later. Parents and teachers reported on all constructs and children's attentional persistence was observed. In concurrent structural equation models, effortful control and impulsivity uniquely and directly predicted resiliency and externalizing problems and indirectly predicted internalizing problems (through resiliency). Teacher-reported anger moderated the relations of effortful control and impulsivity to externalizing problems. In the longitudinal model, all relations held at T2 except for the path from impulsivity to externalizing problems. Evidence of bidirectional effects also was obtained. The results indicate that effortful control and impulsivity are distinct constructs with some unique prediction of resiliency and adjustment. [source] Engagement in a medium secure personality disorder service: A comparative study of psychological functioning and offending outcomesCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2010Lucy McCarthy Background,Specialist treatment programmes for personality disordered offenders suffer from high rates of non-completion. This has important consequences for service providers and individual patients. Method,Data from hospital records and the Offenders Index were compared for groups of treatment completers (n = 22) and non-completers (n = 59) discharged from a specialist treatment programme. Results,Twenty-seven per cent of patients completed treatment, 37% were expelled for rule breaking and 35% disengaged early from treatment. Psychometric assessments of anger expression and anxiety showed no differences between the groups, however, treatment completers showed lower levels of impulsivity and psychopathy than either of the non-completer groups. Rates of post-discharge offending for grave and standard list offences were 56.8 and 10.8%, respectively. Conclusions,Despite careful selection methods, a large proportion of personality-disordered patients admitted to specialist units failed to complete treatment. Psychometric assessments of anger expression, anxiety and impulsivity showed limited utility in differentiating treatment completers and non-completers. Sample size limitations in this naturalistic follow-up impacted on the interpretation of differences observed between the groups on the primary outcome measure of re-offending after discharge. Copyright © 2010 John Wiley & Sons, Ltd. [source] Inhibition deficits of serious delinquent boys of low intelligenceCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007Roos Koolhof Introduction,Studies have shown that low intelligence (IQ) and delinquency are strongly associated. This study focuses on inhibitory deficits as the source for the association between low IQ and delinquency. Further, the authors explore whether serious delinquent boys with a low IQ are exposed to more risk factors than serious delinquent boys with an average to high IQ. They also examine the extent to which low IQ and higher IQ serious delinquents incurred contact with the juvenile court because of their delinquent behaviour. Methods,Cross-sectional and longitudinal data from the Pittsburgh Youth Study were used to constitute four groups of boys: low IQ serious delinquents (n = 39), higher IQ serious delinquents (n = 149), low IQ non-to-moderate delinquents (n = 21) and higher IQ non-to-moderate delinquents (n = 219). Results,Low IQ serious delinquents committed more delinquent acts than higher IQ serious offenders. Low IQ serious delinquent boys also exhibited the highest levels of cognitive and behavioural impulsivity. There were no differences between low IQ and higher IQ serious delinquents on measures of empathy and guilt feelings. Instead, elevations on these characteristics were associated with serious offenders as a whole. Compared with higher IQ serious delinquents, low IQ serious delinquents were exposed to more risk factors, such as low academic achievement, being old for grade, depressed mood and poor housing. Conclusions,Inhibition deficits appear important in the aetiology of delinquency, especially among low IQ boys. Serious delinquent boys are all impulsive, but the higher IQ serious delinquents seem to have a better cognitive control system. Interventions aimed at low IQ boys should focus on the remediation of behavioural impulsivity as well as cognitive impulsivity. Copyright © 2007 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||